Tag Archive for: pregnancy

Your Oral Microbiome and Infertility

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Is there a relationship between the health of your teeth and your ability to conceive? Yes, and in today’s message, I’ll give you the latest research to come to that conclusion. This week’s messages provide insight into some of the health issues surrounding infertility. It’s also a kick-off of the second edition of my Healthy Babies CD and download.

In a review article, researchers examined the literature that was related to periodontal disease and women’s health. The examined systematic reviews, meta-analyses, and narrative reviews to evaluate all possible associations between periodontitis, systemic diseases, and women. The strongest association they found in the published literature was between infertility and periodontal disease, a growth in pathogenic bacteria in the gums surrounding the teeth. With open access to the bloodstream, these bacteria can affect many disease conditions such as heart disease. They can also contribute to infertility. And let’s be realistic: carrying a baby is a health challenge. You don’t need any rogue bacteria attacking your mouth or the rest of your body.

In this case, the solution for periodontal disease is simple: treat the periodontal disease and begin good oral hygiene including flossing, regular brushing, and regular dental check-ups. That will contribute to a healthy oral microbiome. There may still be other factors related to infertility that should be addressed, but you’ll have ruled out one possible obstacle as well as doing something great for your overall health.

What are you prepared to do today?

Dr. Chet

 

Reference: Curr Med Res Opin. 2017. Mar 24:1-11.

 

How Your Microbiome Affects Infertility

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Many couples struggle with infertility; they want to start a family but time passes with no results. This week, I’ll cover three recent studies that examine some factors that may affect fertility.

Researchers tested the fluids from the cervical-vaginal area in 96 subjects to examine the microbiome: were there any differences in the microbes in these women when compared to an established database of microbes typically found in that area? They found differences in the quantities of several bacteria. The researchers commented that the pattern of the microbiome was similar to women with bacterial vaginosis; it didn’t mean they had the condition, simply that there was a similar pattern in the microbiome. The researchers concluded that testing techniques could be developed along with treatment specific to the microbiome that could help infertility.

In this case, the researchers provided more questions and areas for further research. Where’s the solution? What can we do now? Ask yourself this: what makes the microbiome healthy in general? Without question, one of the primary ways is through diet. Eating vegetables, yogurt, and fermented foods contributes to a healthy microbiome.

What are you prepared to do today?

Dr. Chet

 

Reference: J Cell Physiol. 2017 Jul;232(7):1681-1688. doi: 10.1002/jcp.25806.

 

The Bottom Line on Folic Acid

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Based on the studies covered in the Tuesday and Thursday posts, you may be confused about what you should do when it comes to folic acid, especially if you’re pregnant or thinking about getting pregnant. I read a lot of research to come up with this analysis and here’s what I found.

There are three areas of concern:

  • Too much folic acid could mask a B12 deficiency during pregnancy; there’s no research to support that. It can happen in the elderly who have problems absorbing B12, but doesn’t seem to happen in women of child-bearing age.
  • Excess blood folic acid may be related to tumor acceleration; there’s some rodent research to suggest some relationship but nothing in humans. They have also cited research on folic acid supplementation and prostate cancer. I examined numerous studies and there’s no clear relationship; some show some type of relationship, others show a reduction in risk.
  • There may be some effect on the children of mothers who get too much folic acid; there’s one study that suggest an increase in asthma in offspring but most studies seem to demonstrate a protective effect.

Where does that leave us? Most of the studies are not done very well when it comes to folate and folic acid intake. The folic acid intake is dependent on Food Frequency Questionnaires, which have severe limitations. The methodology for determining blood folic acid levels vary from study to study. The associations between intake and problems are weak at best.

But when it comes to pregnancy, there may be a solution. In a recent study, researchers examined the relationship between neural tube defects and the red blood cell folate level. As the estimated levels increased, the risk of neural tube defects decreased. The level which seemed to provide the lowest risk of neural tube defects was greater than 1,000 nmol/L. This was a single study and used interesting statistical techniques, but it seemed to provide for more precise folic acid supplementation.

 

The Bottom Line

The benefits of folic acid on neural tube defects have been impressive, and the concern over excess supplementation may be legitimate or not. It could be that women process folic acid too well or not well enough and that could impact dietary and supplementation intake. Research on the MTHFR polymorphisms continue with no recommendation for its diagnostic use at this time.

If you’re concerned, talk with your physician about getting a blood folate test. Levels of RBC folate levels can be estimated from that result. One key point: the test would be most beneficial before conception because neural tube defects happen in the first month of pregnancy. Still it’s one way to be more cautious in spite of the limited risk.

Let me close by saying that in all the research I did, what I could not find is any association between reasonable folic acid intake and miscarriages or other issues during pregnancy. Folic acid appears to be safe and protective and should be a part of prenatal nutrition.

If you want to know more about having the healthiest baby you can, check out Healthy Babies: From Conception to Breastfeeding. It’s available as a CD or MP3 download.

What are you prepared to do today?

Dr. Chet

 

Reference: BMJ 2014;349:g4554 doi: 10.1136/bmj.g4554

 

Prenatal Nutrition: More on Folic Acid

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The second study on folic acid supplementation before pregnancy examined similar blood and red blood cell folic acid levels at different times during pregnancy and in cord blood (1). The difference was that half of the subjects were randomly provided with 400 mcg folic acid to take during their second and third trimesters. As you would expect, the women who supplemented their diets had higher levels of all variables than controls.

The difference between the two studies I’ve examined was that even with supplementation, the unmetabolized folic acid levels were virtually undetectable in cord blood in this study. Moreover, the red blood cell levels of folic acid were considered to be in the normal range in spite of the supplementation.

Two studies. One suggests that prenatal supplements should consider reducing the amounts, while the other suggests that there’s no effect in the most common amount found in supplements. I’ll make sense of this in Saturday’s post.

What are you prepared to do today?

Dr. Chet

 

Reference: J Nutr 2016;146:494–500.

 

Prenatal Nutrition: Should You Worry About Folic Acid?

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I’ve been working on updating the research for the second edition of the Healthy Babies CD, and that includes nutrients such as probiotics, vitamin D, and one of the most important nutrients, folic acid. Since folic acid was added to cereal grains in 1998, there have been significant reductions in neural tube defects, but folic acid is not without controversy: the concern is getting too much folic acid from foods and supplements. There have been some studies suggesting a relationship between excess folic acid and an increased risk of some diseases. This week, I’m going to cover three studies that examine folic acid before and during pregnancy to help clarify things.

In a study published in 2015, researchers examined the levels of folic acid and unmetabolized folic acid (UFA) in the mother’s blood early in the pregnancy, at delivery, and in the umbilical cord blood. They found that folic acid and red blood cell (RBC) folic acid did not significantly change. There were differences between those who did and did not supplement with folic acid. They did find UFA in the blood and cord blood. The researchers felt that the RBC folic acid blood levels and the UFA were too high and that folic acid supplements should be changed to reflect the high readings.

Are their conclusions warranted? Let’s take a look at another study that examined the same variables the following year. I’ll let you know what a difference a year makes on Thursday.

What are you prepared to do today?

Dr. Chet

 

Reference: Am J Clin Nutr 2015;102:848–57.

 

Should You Exercise During Pregnancy?

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While everyone wants a healthy baby, many women would like to control their weight gain and avoid gestational diabetes during pregnancy. That’s why I noticed one more article in the Medicine and Science in Sports and Exercise issue I read; in addition, I’ve recording the updated Healthy Babies: From Conception to Breastfeeding audio and want to include the latest research.

Researchers examined data from three studies on the effects of exercise on pregnant women. The first study included land-based exercises, the second was water-based exercises, and the third was a combination. They were compared with a control group of pregnant women who didn’t exercise. Here’s what researchers discovered:

  • Women who exercise in any way gained less weight; while it’s necessary to gain some weight while you grow a little person inside you, exercise helped women keep their weight from exceeding desirable levels.
  • Women who performed water exercises or a combination of water and land exercise had fewer cases of gestational diabetes. The authors theorized that because of the buoyancy factor of the water, women perceived water exercise as being less strenuous on the back and other joints and were able to exercise more.

The message is clear, ladies: it’s important to keep moving while you’re pregnant, under the guidance of your physician, of course. And it seems you can get even more benefits if you can work out in a pool. It’s a great investment in yourself and your life with your little one. And men, it wouldn’t hurt you to get in the pool, too—now that I have a two-year-old grandson, I have a new respect for the physical demands of fatherhood and you need to be ready.

What are you prepared to do today?

Dr. Chet

 

Reference: MSSE. DOI: 10.1249/MSS.0000000000001234

 

Symptoms of Vitamin E Deficiency

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If 90% of us are deficient in vitamin E as recent research estimated, what are some of the issues we could face? That’s one of the problems the author was examining because there are no documented overt symptoms of vitamin E deficiency other than children who cannot absorb it or in times of extreme malnutrition (1). That’s one reason it’s so difficult to pinpoint vitamin E deficiencies in people.

The symptoms are mostly neurological disorders that continue to get worse. It can cause nerve death in the peripheral sensory nerves—the arms and legs—and ataxia, which . . .

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