Are Low-Calorie Sweeteners Making Your Baby Fat?

Obesity is a major risk factor for problems conceiving and pregnancy complications. Obesity is a potentially modifiable risk factor, meaning this is something that you can change to improve your chances of getting pregnant, having a healthy pregnancy, and having a healthy kiddo. This subject is so important that I thought I would blog about it again.

 

In December, our blog brought you new data that revealed that people that used low-calorie sweeteners in their lifetime were more likely to be obese than those who didn’t use these sweeteners.

 

Today, we want to caution you even more about using these sweeteners. Researchers have found that women who drank at least one artificially sweetened beverage per day during pregnancy had children who were more likely to be obese by the time they turned 7 years old. These findings suggest that artificially sweetened beverages during pregnancy are not likely to be any better at reducing the risk for later childhood obesity than sugar sweetened beverages! So these patients may have been drinking the diet version without any measurable benefit for their children; diet versions may have actually lead to harm! Interestingly, substituting a glass of water for a sweetened beverage reduced their children’s obesity risk by nearly 20%!

 

I am always cautious in interpreting data, particularly when it comes to weight because we know that so many other factors could influence children’s weight gain (Ex: physical activity, etc). Although the data doesn’t prove that maternal artificially sweetened beverage consumption caused children to gain weight, the data is strong enough for me to counsel my patients to avoid drinking any drinks with artificial sweeteners when pregnant.

 

Take home points:

  • Limit using artificial sweeteners during pregnancy
  • Consider trying some of these more natural sweeteners; note that there are limited long-term studies of these alternatives in pregnancy.
  • If all the natural sweetener options are overwhelming, stick to the basics: a cold glass of water!

Another reason to eat whole grains

I spend a significant amount of time with each of my patients reviewing their lifestyle and dietary habits. Ultimately, we all have the same goal: happy healthy families. I strongly believe that part of my job as a reproductive endocrinologist and infertility physician is helping build healthier families. As I reviewed in previous posts, we believe that our habits before and during pregnancy can program many diseases in childhood and later in life.

 

I previously discussed the importance of whole grain diet as it relates to fertility. New research suggests yet another reason why you should consider whole grains, and stick with it throughout a pregnancy. Researchers found that children born to women with gestational diabetes who consumed the most refined grain (more than 156 grams per day) were twice as likely to be obese at age 7, compared to children born to women with gestational diabetes who ate the least amount of refined grain (less than 37 grams per day).

 

Take home point: eating refined carbs in pregnancy could increase the risk of your child being obese at a young age.  “You are what you eat” … and based on this study, your future child will be too.

 

What you can do:

  • Substitute one meal a day for something with more whole grains.

Why you should opt for the whole-grain option

Whole-Grains

I know- whole grains take some getting used to. New IVF data, however, suggests that you should hear me out and give that whole grain bagel and pasta a try.

 

In a recent study, investigators took a very close look at the dietary habits of people undergoing fertility treatments. Women who ate more whole grains (>52.4 g/day) had higher pregnancy rates than women who ate less whole grains. We have mentioned this whole grain study in our blog before: at least one serving of whole grains per day boosts the odds of success by 33%! It may even benefit women who have problems developing the lining in their uterus (endometrial lining): increasing whole grain intake by 1 serving a day was associated with an increase in endometrial thickness!

 

What you can do:

  • Make the healthier choice: substitute one meal a day for something with more whole grains

Dads- pay attention too!

In my fertility clinic, much of the discussion about pre-conception counseling, or what should be done to prepare for a healthy pregnancy, focuses on the female. We discuss a woman’s diet, vitamins, immunization status, supplements, exercise habits and more. New research is suggesting that dad needs to be involved in this health optimization before starting a family.

Epigenetics is a new hot term in science. We all have DNA, which is a roadmap of genes that encode the proteins that are expressed that make our bodies work. To describe it simply, epigenetics is the field that ensures that these genes are expressed at the right time, the right place, and the right amount. My research over the past three years has focused on epigenetics.

I am passionate about learning how our environment impacts our fertility. Epigenetics is an emerging link  to learning about your environment and how it may impact your genetic health: most toxins in our environment are not strong enough to cause DNA damage and mutations, but are able to impact gene expression, and ultimately the health of an individual, by altering epigenetic profiles. Exposure to endocrine disrupting chemicals in our environment, like those commonly found in plastics, induce epigenetic changes in sperm. Worse yet, these changes can be transmitted to future generations.

Recent studies suggest that epigenetic changes may be the key mechanism by which paternal factors such as age and weight contribute to health outcomes in their kids. For example, dads who smoke have children that are more likely to be overweight. Similarly, dads that are obese are more likely to have obese children as a result of epigenetic changes.

Dads- don’t lose hope. There are early indications that some paternal lifestyle-associated effects on sperm can be reverse through exercise, diet, and/or surgical weight loss. In my practice, I like to focus on the couple becoming the healthiest they can be before conceiving. Because ultimately, our goal is similar: we don’t just want to help you get pregnant, we want to help you be a healthy and happy family for generations to come.

If you’d like to take some steps to reduce the impact of your environment on your fertility, consider the following:

 

Your standard prenatal vitamin might not be enough

 I still remember feeling completely overwhelmed the first time I shopped for prenatal vitamins when I was ready to try to conceive. I’m sure I was putting too much thought into it, but like many others, I was going to take my fertility seriously and I wanted the BEST option. So why did my drugstore have over 5 different types of prenatal vitamins, all with a different concoction of what they claimed was “best?” Some of my friends reported using “prescription prenatal vitamins” and swore they were worth the cost.

I ultimately ended up buying prenatal vitamins that contained docosahexaenoic acid (DHA) since they were advertised as “supporting neurodevelopment” and who wouldn’t want a smarter baby? DHA is an omega-3- fatty acid that is important for brain development.  It has been recommended to eat foods which are high in omega-3 fatty acids for women who want to become pregnant or when nursing.  Although vegetarian sources are now available, fish and fish oil are often utilized for DHA supplementation. For months, I endured gross fishy tastes in my mouth and a fishy odor to my breath; all in the sake of helping my baby’s brain develop. Was it worth it?

The sale of prenatal supplements with DHA continues to increase, despite limited evidence that it actually helps brain development. A recent study suggests that DHA may not be all that it was chalked up to be. This group evaluated pregnant women who took DHA supplements and compared them to women who didn’t. There was no difference in cognitive, language, or motor development in the children from moms who took DHA compared to those that didn’t at 18 months, and 7 years- DHA doesn’t seem to result in smarter kids.  This data is strong enough for me to recommend that you can skip the DHA supplement in your prenatal vitamin, especially if you are having undesirable side effects like gross fish burps.

So what does a good prenatal vitamin need, anyway?

  • Folic acid- at least 400 micrograms; some patients require higher doses of folic acid
  • Iodine

Although a prenatal vitamin will help supplement your diet with extra amounts of vitamins and minerals, your diet should be the primary source. Iron, calcium, and vitamin D are particularly important in pregnancy.

My advice to anxious patients (like myself a few years ago) is simple: eat a well-balanced diet, stay healthy, and find an inexpensive prenatal vitamin that you like so that you remember to take every day.

Getting Healthy While Getting Pregnant! Flax Seeds for Hypertension

One of the most important aspects of boosting your chances of becoming pregnant is to optimize blood flow to your pelvis–this is true for both men and women! For women, this is even more important since pregnancy can exacerbate blood pressure problems dramatically. Rather than resort to medications, here’s a great nutritional tip. Introduce 30 grams of ground flax seed into your daily diet–that’s about a 1/4 cup. You can add this to salads, soups, cereals, smoothies or just about anything. Studies now show that this simple intervention can reduce your blood pressure more effectively than many of the popular–and much more expensive–medications. For those of us that love the science and want to see the proof, watch this brief video with links to the supporting studies:  http://nutritionfacts.org/video/flax-seeds-for-hypertension/

 

Resveratrol (supplement from red wine) could reduce the hormonal effects of Polycystic Ovary Syndrome

Here’s another fascinating study for women with PCOS; 1500 mg of the potent antioxidant from red wine can reduce testosterone levels by nearly 25%. This can not only improve egg quality and pregnancy rates but also reduce other symptoms of PCOS as well!

http://press.endocrine.org/doi/10.1210/jc.2016-1858