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Healthnotes Newswire (July 31, 2008)—Premature babies are at risk for complications in their mental development, but new evidence shows that their brains may get a boost from fatty acids: A study in Pediatrics reports that breast milk supplemented with omega-3 DHA (docosahexaenoic acid) and omega-6 AA (arachidonic acid) may improve brain development in premature infants.DHA and AA are two types of fatty acids essential for many bodily functions including brain, eye, and nervous system development. The optimal amounts of these fatty acids for premature infants has not been determined, but researchers suggest that increasing the amounts in early infancy may reduce the risk of developmental problems later in life.

Learning disabilities and school-related problems are more common among premature infants than full-term infants. Prior studies, however, have shown that premature infants who are breast-fed have higher IQs than babies receiving formula milk. This finding was attributed to higher concentrations of DHA found in human milk compared with formula milk. The authors of the new study considered the possibility that increasing the DHA content of human milk and adding AA could further improve preemies’ brain development.

Study results encouraging

In the study, 141 premature infants weighing less than 1,500 grams (about 3 pounds) were randomly assigned to receive human breast milk supplemented with either 32 mg of DHA and 31 mg of AA per 100 ml of milk, or breast milk supplemented with soy oil and medium-chain triglyceride oil. Infants received more than 100 ml of human milk per kilogram of body weight per day beginning on the first or second day of birth and continuing until discharge from the hospital (an average of nine weeks).

At six months of age, infants who received the human milk supplemented with DHA and AA were better at problem-solving and were better able to discriminate between familiar and unfamiliar objects compared with infants in the control group.

“There is growing evidence that DHA and AA have specific functions related to memory and problem-solving,” said Christine Henriksen, PhD, lead author of the study from the Department of Nutrition at the University of Oslo, Norway. Dr. Henriksen and her colleagues point out that these functions are critical for being able to focus, be attentive, learn, and process information. Further research is needed to understand the long-term impact of supplementing with fatty acids on school performance and attention capacity later in life.

Ensure you eat your EFAs

Babies are dependent on breast milk and/or fortified formula milk for DHA and AA, but there are other important sources of essential fatty acids (EFAs) to consider as the child grows older. In addition, recent research has shown that it is important for pregnant women to eat plenty of fatty acids in order to help optimize their baby’s brain function. You can find them in these sources:

• Fatty fish such as salmon, halibut, and tuna are good sources of DHA, which is also found in smaller amounts in eggs. Pregnant women should balance the need for fatty acids from fish with reducing exposure to mercury by limiting the amount of fish they eat and avoiding fish high in mercury content.

• AA is found in meat, chicken, and eggs.

• Some people may benefit from supplements that contain fatty acids. Check with your doctor about the appropriateness of using supplements to further enrich your diet.

(Pediatrics 2008;121:1137–45)

Healthnotes Newswire (June 26, 2008)—It is well known that folic acid may help prevent birth defects if taken during pregnancy, and more evidence emerges all the time about the role of other nutrients, such as essential fatty acids from fish and other sources. Prior studies have shown that children who don’t get enough fatty acids in early childhood may have impaired vision and brain functioning and recent studies suggest that essential fatty acids taken by a mother in pregnancy support a developing child’s brain and central nervous system. Most recently, the American Journal of Clinical Nutrition reports that pregnant women who supplement with an omega-3 fatty acid have babies with sharper vision.

The current study sought to determine if supplementing with the omega-3 fatty acid DHA (docosahexaenoic acid) among pregnant women could improve their infants’ development. Among 135 women, 14 to 16 weeks into their pregnancy, half were randomly assigned to take 400 mg per day of supplemental DHA—the equivalent of eating about one pound of fatty fish such as salmon per week—or placebo.

All women continued their usual diet, which provided 10 to 760 mg of DHA per day. Compared to baby girls from the placebo group, babies whose mothers supplemented with DHA had significantly higher visual acuity scores 60 days after birth.

The International Society for the Study of Lipids and Fatty Acids recommends that all women consume 300 mg per day of DHA. The study’s authors determined that a DHA supplement of 400 mg per day should result in a low risk for DHA deficiency, although the optimal daily dosage is still not known.

Good sources of omega-3 fatty acids

To get more omega-3s in your diet, try these foods:

• Fatty fish such as salmon and sardines, and catfish, shrimp, and canned light tuna. Pregnant women are advised to limit their fish intake to two servings per week and to avoid fish that are more likely to be contaminated, such as shark, swordfish, king mackerel, and tilefish.

• Beans, seeds, and nuts such as soybeans, walnuts, and flaxseed.

• Dark green vegetables.

Mothers-to-be should check with their doctor about appropriate dietary and supplemental recommendations.

(Am J Clin Nutr 2008:87:548–57)

Healthnotes Newswire (June 12, 2008)—A cup of ginger tea is often just the thing to settle an upset stomach—but little is known about how it actually works. A new study, published in the European Journal of Gastroenterology and Hepatology, found that ginger stimulates digestion by speeding up the movement of food from the stomach into the upper small intestine.

Soothing to the stomach

After having nothing to eat or drink for eight hours, the 24 healthy men in the study were given either 1,200 mg of ginger or placebo, and then ate a bowl of soup. They answered questions about their digestive comfort, and digestive activity was measured by ultrasound. One week later, they repeated the test, but the ginger and placebo groups were reversed.

Muscle contractions in the stomach, which help to move food into the upper small intestine, were more frequent and the stomach emptied more quickly after ginger than placebo. After eating the soup, mild digestive discomfort was reported in those who had placebo but not ginger.

From the kitchen to your medicine cabinet

Ginger (Zingiber officinale) is popular as a culinary spice and as a medicinal herb. It is used all over the world to treat indigestion, gas and bloating, nausea, diarrhea, and irritable bowel syndrome. A well-known remedy for nausea during pregnancy and motion sickness, ginger has also has anti-inflammatory effects that make it a good choice for treating arthritis.

“Since low gastric motility has been associated with the digestive symptoms for which ginger is frequently used, if ginger improves the movement of food through the upper digestive tract in people with digestive problems, this could help to explain how it exerts its benefits,” said Dr. Rebecca Chollet, a naturopathic doctor who practices in New Hampshire and Vermont.

Ginger is often taken as tea, prepared by simmering the cut root in a covered pot. It can also be used as tincture (an alcohol-based extract), in capsules (as in this study), or added to common gas-producing foods like beans and lentils to prevent gas. At times when nausea makes eating or drinking difficult, crystallized ginger can be used like a lozenge.

A multifaceted approach may help your digestion

Other methods for preventing indigestion include eating slowly and being careful not to overeat. Like ginger, caraway, cumin, and fennel can be added to foods to reduce the chance of developing gas after eating. Digestive enzyme supplements are sometimes helpful when these measures are not enough.

(Eur J Gastroenterol Hepatol 2008;20:436–40)

Healthnotes Newswire (May 29, 2008)—Sometimes one of the many emotional and physical changes women experience as they prepare to give birth, depression during and after pregnancy has very few treatment options that are considered safe for pregnant and nursing mothers. Fortunately, a new study found that supplementing with omega-3 fatty acids from fish can safely relieve pregnancy-related depression.

The study, published in the Journal of Clinical Psychiatry, followed the progress of 36 pregnant women who began experiencing major depression during their second and third trimesters. They were given either 2.2 grams of EPA (eicosapentaenoic acid) plus 1.2 grams of DHA (docosahexaenoic acid) per day or a placebo for eight weeks.

Depression symptoms began to diminish within the first two weeks after starting treatment. The women using the omega-3 supplements saw greater improvement than the women in the placebo group, and this difference was more dramatic at weeks six and eight.

Hoping for a happy, healthy pregnancy

Mothers-to-be and their doctors are often anxious about using medications during pregnancy out of concern for the developing fetus. There is evidence that antidepressant medications might be associated with a higher rate of complications around childbirth, including premature delivery and low birth weight in newborns. On the other hand, untreated depression in pregnancy can also pose problems for the mother and baby.

Low levels of EPA and DHA have been linked to increased risk of depression, and several studies have foundthat omega-3 fatty acids from fish can be helpful. Pregnant women have lower levels of these fatty acids, as well as a number of other nutrients, because the growing fetus draws nutrients from the mother. Some studies have suggested that omega-3 fatty acid supplementation during pregnancy might benefit the fetus because these fatty acids are essential for normal neurological development.

“Mothers and their healthcare providers want treatments for pregnancy-related depression that are harmless for both the infant and mother, during pregnancy and nursing,” said lead study author Dr. Kuan-Pin Su at the Mind–Body Interface Center of the China Medical University Hospital, Taiwan. “In light of our findings, omega-3 fatty acids are a promising treatment option for depression during pregnancy. Further research will help to determine optimal dosage and ratio of EPA and DHA in treating depression during pregnancy and breast-feeding.”

Getting omega-3s in the diet

EPA and DHA are produced by cold-water fish such as salmon, tuna, and herring. Expecting mothers should steer clear of fish with high levels of mercury, a heavy metal contaminant that can cause neurological problems. Best bets include canned chunk light tuna, pink salmon, and herring, which are low in mercury and rich in EPA and DHA. The Natural Resource Defense Council, using data from the US Food and Drug Administration and Environmental Protection Agency, has determined that as much as 12 ounces of canned chunk light tuna per week can safely be eaten during pregnancy.

Another way to get EPA and DHA is by eating omega-3 eggs, which come from chickens that have been fed a diet high in flax meal. Flaxseeds are rich in an omega-3 fatty acid that is converted to EPA and DHA by the chicken.

Mothers-to-be can increase their chance of being healthy throughout pregnancy by staying well-nourished; eating plenty of fruits and vegetables, whole grains, legumes, and nuts and seeds; avoiding alcohol, refined sugar, and excessive caffeine; and staying physically active. Including some cold-water fish and omega-3 eggs, and possibly taking an EPA/DHA supplement, might also help them avoid pregnancy-related depression.

(J Clin Psychiatry 2008:e1–e8)

Healthnotes Newswire (May 8, 2008)—Omega-3 fatty acids from fish offer many benefits to developing babies during pregnancy. But do contaminants such as mercury make eating fish unsafe? According to a new study in the American Journal of Epidemiology, pregnant women who eat two or more servings of fish each week may be providing their children with important nutrients that aid in cognitive development. Choosing fish with low mercury content appears to be even more beneficial.

Fish contains important nutrients such as omega-3 fatty acids and is generally high in protein and low in saturated fat. Many studies have suggested that eating fish several times per week is good for heart health and for preventing diseases such as a cancer. But fish may also contain contaminants such as unhealthy mercury. As a result, the Environmental Protection Agency (EPA) recommends that pregnant women not eat more than two 6-ounce servings of fish per week.

The authors of this new study were concerned that if pregnant women limit fish intake, their babies may not receive enough omega-3 fatty acids, which could impair the brain’s cognitive development. To determine the risks and benefits of eating fish during pregnancy on child development, the authors looked at dietary habits of 341 pregnant women, their mercury levels during pregnancy, and the cognitive development of their children at age three.

Women who ate the most fish (more than two servings per week) had higher mercury levels. However, higher fish intake was associated with better cognitive test performance, regardless of mercury levels. Compared with the children of women who never ate fish, the children of women who ate more than two servings of fish per week but had the lowest mercury levels had better cognitive test performance.

“Recommendations for fish consumption during pregnancy should take into account the nutritional benefits of fish as well as the potential harms from mercury exposure,” said Emily Oken, MD, and her colleagues from Harvard Medical School and Harvard School of Public Health. The authors believe that if mercury contamination were not present, the cognitive benefits of eating fish would be greater. They point out that other contaminants such as polychlorinated biphenyls may also be present in fish and were not measured in this study but may have an adverse effect on child development.

Best bets for eating fish during pregnancy

For women who are or may become pregnant, choose fish that are likely to have lower mercury levels such as:

• Canned light tuna

• Shrimp

• Salmon

• Pollock

• Catfish

The EPA points out that fish that is used for fish sticks or fast food sandwiches tend to be fish that are lower in mercury content. Fish best avoided by pregnant women include shark, swordfish, king mackerel, and tilefish.

(Am J Epidemiol 2008 Mar 28)

(What You Need to Know About Mercury in Fish and Shellfish. Environmental Protection Agency. www.epa.gov/waterscience/fish/advice/)

Healthnotes Newswire (January 31, 2008)—For pregnant women, energy boosters such as nutritious beverages, protein snacks, and exercise may be a safer option than caffeine. A study in the American Journal of Obstetrics and Gynecology reports that drinking caffeinated beverages might increase miscarriage risk. “The main message for pregnant women is that they probably should consider stopping caffeine consumption during pregnancy,” says De-Kun Li, MD, the study’s lead investigator. “This research provides clearer and stronger evidence that high doses of caffeine intake during pregnancy can increase the risk of miscarriage.”The new study included 1,063 pregnant women who were members of the Kaiser Permanente Medical Care Program. The women were interviewed early in their pregnancies regarding their intake of caffeine-containing beverages (including coffee, tea, soft drinks, and hot chocolate) and about pregnancy-related symptoms like nausea and vomiting.

Women who drank 200 mg of caffeine per day—the amount found in 10 ounces of coffee or 25 ounces of tea—or more were over two times as likely to have a miscarriage than were those women who didn’t drink any caffeinated beverages. Drinking less than 200 mg per day also raised the risk, but to a lesser extent.

Caffeine crosses the placenta and may interfere with normal growth of the unborn baby. Most healthcare practitioners advise pregnant women to limit their caffeine intake, but until now specific recommendations about caffeine consumption during pregnancy couldn’t be made.

Women with morning sickness are known to be less likely to miscarry, and many of these women might also avoid caffeine because of their nausea. This has led to confusion about whether women with morning sickness are less likely to miscarry because they avoid caffeine or because they have healthier pregnancies overall. The new study helped to sort this out, finding that caffeine increased miscarriage risk—regardless of the presence of morning sickness.

Many pregnant women struggle with decreased energy during their pregnancies, especially during the first trimester. Thankfully, there are safer options than using caffeine that can help boost energy during these months.

Energy lifters for the mother-to-be

• “Perk up with natural energy boosts like a brisk walk, yoga stretches, and snacking on dried fruits and nuts,” suggests Tracy Flanagan, MD, director of Women’s Health, Kaiser Permanente Northern California.

• Keep blood sugar levels up with small, frequent meals and snacks that include a protein source like a hard boiled egg, slices of lean deli meats, a protein bar, or a fruit and yogurt smoothie.

• Make sure to get plenty of rest—this is key to avoiding the need for an artificial energy spike.

• “Stay hydrated by replacing caffeinated drinks with more nutritious fluids,” offers Michelle Palmer, certified nurse-midwife. “Lemon water is a refreshing pick-me-up.”

(Am J Obstet Gynecol doi 10.1016/j.ajog.2007.10.803)