vitamins

High-dose vitamin D safe during pregnancy

Taking high doses of vitamin D during pregnancy is safe and appears to reduce the risk of preterm birth and infections, say the authors of a study that compared different amounts of supplementation in expectant mothers.

But their recommendation that pregnant women should take 4,000 international units of vitamin D daily -- at least 10 times the standard recommended amount -- is sure to generate controversy.

"When we first proposed the study in 2002, it was heresy to even think about giving more than 400 international units a day of vitamin D," co-principal investigator Dr. Carol Wagner said from Vancouver, where the two-part study is being presented at an international pediatrics meeting.

"Diet doesn't provide enough vitamin D, and we don't go in the sun as much as we need (to)," said Wagner, adding that her research team set out to determine the optimal dose of vitamin D supplements for pregnant women that would promote health without doing harm.

The researchers enrolled 494 pregnant women at 12 to 16 weeks' gestation in the study and assigned them to three groups: one group received 400 IUs of vitamin D a day until delivery; the second got 2,000 IUs; and the third 4,000 IUs. The women were tested monthly to ensure they were not suffering any negative effects.

Neither the women nor the researchers knew what dose of vitamin D they were receiving in the study, a "blinded," randomized controlled trial whose methodology is considered the gold standard of medical science.

"What we found was that 2,000 was better than 400, and 4,000 was the best, without any adverse events that were associated with vitamin D," said Wagner. "And then ... we found fewer infections in the 4,000 group and fewer preterm labors and-or preterm birth deliveries in the 4,000 group compared to the 400 group."

Analysis of the data also showed that the women taking 4,000 units of vitamin D had half the rate of pregnancy-related disorders, such as gestational diabetes and preeclampsia, compared to expectant mothers taking 400 units.

However, Wagner conceded that the notion of pregnant women taking a daily dose of 4,000 IUs of vitamin D will likely stir some debate, especially within the medical community. The current recommended daily dose is 200 to 400 IUs daily.

Dr. Gideon Koren, head of the Motherisk Program at Toronto's Hospital for Sick Children, said the study is too small to provide such a definitive recommendation and to "declare therapeutic superiority" of 4,000 units of vitamin D.

"I think for now women should be sure that they get the recommended dose. I don't know that this study by itself should send women to buy 4,000. No, no way. I don't think this is sufficient."

"The study's important to show that it doesn't cause side-effects, but I think to tell women that they need 4,000 - to go from 400 to 4,000 - is huge."

However, Dr. Reinhold Vieth, head of the Bone and Mineral Laboratory at Mount Sinai Hospital in Toronto, has long argued that recommended daily amounts (RDAs) for vitamin D are outdated and woefully inadequate.

Vieth, who has conducted numerous studies on vitamin D in different patient populations, said the Canadian Pediatric Society has been advocating 2,000 units during pregnancy since 2007.

"The next step, 4,000, well, I bet you they'll come up with that in a couple of years, because this (the Wagner-group study) has to get published first," he said, adding that he agrees that pregnant women should be taking that level of vitamin D daily.

Dr. Robert Gagnon, a spokesman for the Society of Obstetricians and Gynecologists of Canada (SOGC), said the study was well-designed and its findings are important.

The Montreal specialist said SOGC is in the process of reviewing the medical literature before deciding on its official recommendation for expectant mothers.

"We need to see all the details of the study before we come to the recommendation," he said. "To say (pregnant women) should take 4,000, I think it's a little premature for that."

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Migraine drugs don’t up birth defect risk: study

A study in nearly 70,000 pregnant women has found no link between migraine drugs called triptans and the risk of birth defects.

However, the researchers did find a "slight increase" in the risk of excessive bleeding during labor, and the failure of the uterus to contract normally after delivery, for women who used the drugs while pregnant.

Triptans are among the most powerful drugs used for migraine; others include aspirin, Excedrin, and ibuprofen.

While as many as three in 10 women may develop migraines during their childbearing years, women often shy away from using such drugs during pregnancy because of safety concerns, according to study co-author Katerina Nezvalova-Henriksen of the University of Oslo in Norway and her colleagues.

However, the authors of the study in Headache note, untreated migraine may itself carry risks for mother and child; some studies have linked it to pre-eclampsia, a potentially deadly pregnancy complication.

"While it is important to exert caution when using any medications during pregnancy, this study indicates" that pregnant women can either start or continue taking triptans without "any major risk" of miscarriage, premature delivery, or other bad outcomes, the authors conclude.

Nezvalova-Henriksen and her team studied nearly 70,000 women. Two percent, or 1,535, had used sumatriptan (Imitrex), rizatriptan (Maxalt), zolmitriptan (Zomig), or eletriptan (Relpax) in pregnancy.

Less than one percent -- 373 women -- had used the drugs before getting pregnant but not during pregnancy.

The overall birth defect rate, which encompasses everything from large birthmarks to serious heart problems, was the same among women who had taken triptans during pregnancy and those who didn't have migraines: 5 percent. Among those who had used triptans in the past but not during pregnancy, it was slightly higher: 6 percent.

The women who used triptans were also more likely than non-triptan users to take other drugs during pregnancy, including acetaminophen (Tylenol) with codeine and non-steroidal anti-inflammatory drugs such as ibuprofen.

However, the rate of major birth defects - such as serious problems of the limbs or internal organs -- was 3 percent for all three groups. That rate - about one in 33 births - is about what would be expected for all birth defects in the general population.

The researchers did find that women who used triptans in their second or third trimester were more likely to develop a condition called atonic uterus, in which the uterus fails to contract back to its normal size after delivery. This is the leading cause of excessive bleeding after delivery. They were also more likely to lose significant amounts of blood during labor and delivery.

And during pregnancy, they were more likely to suffer from vomiting than women who had never used the drug; they were also more likely to develop pre-eclampsia or eclampsia, and more likely to have deficiencies in the B-vitamin folate.

While many women who suffer migraines will experience improvements in their symptoms after their first trimester, Nezvalova-Henriksen and her team note, those whose symptoms don't improve by then aren't likely to get better.

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Mom’s anemia may raise schizophrenia risk in offspring

Children of mothers who had been diagnosed with anemia during pregnancy, most likely due to iron deficiency, had a significantly elevated risk of developing the mental disorder, the study's lead researcher Dr. Holger Srensen of the University Hospital of Copenhagen in Demark, told Reuters Health by email.

Iron is necessary for the production of hemoglobin, a protein that distributes oxygen throughout the body. Because a pregnant woman carries an additional set of organs and tissues -- and almost 50 percent more blood -- she needs extra iron to ensure that enough oxygen gets around.

"We speculate that maternal iron deficiency may disrupt essential pathways that affect the delivery of oxygen and nutrients to the fetus," Srensen said. Earlier research has suggested that a failure to meet the iron demands of a developing brain might heighten a child's vulnerability to disorders such as schizophrenia.

To further investigate this potential link, Srensen and colleagues analyzed the psychiatric outcomes of a large group of Danish children born between 1978 and 1998 -- the biggest cohort in which the relationship has been examined. Each child was followed from age 10 until the onset of schizophrenia, death or the study's closure on December 31, 2008.

Among 1,115,752 newborns, 17,940 (1.6 percent) were exposed to anemia in the womb. A total of 3,422 -- including 41 from the exposed group -- went on to develop schizophrenia, according to the report published in the journal Schizophrenia Bulletin.

After accounting for differences between the two groups and other relevant factors, including the parents' ages and history of mental illness, exposure to anemia in the womb was associated with a 60 percent increased risk of schizophrenia in offspring during the 20 years of the study.

The researchers further concluded that 0.58 percent of schizophrenia cases (a total of about 20 diagnoses) could have been prevented had there been no cases of anemia among the mothers.

These figures may be underestimates of anemia's true impact, according to Srensen and colleagues. It is possible that some pregnant women received anemia diagnoses and treatment from general practitioners outside the hospital, and therefore outside of the Danish registry used for the study.

Schizophrenia diagnoses may have been under reported as well. Even the oldest cohort members were only followed until age 30. Rates of schizophrenia peak around age 22 or 23, noted Srensen, so the study "may have missed around 50 percent of cases with a later onset."

The researchers also lacked access to the women's precise hemoglobin levels, which prevented assessment of the relative severity of anemia.

Despite its unresolved relationship with schizophrenia, prevention and treatment of maternal anemia remains straightforward. "Checking for iron-deficiency anemia (or anemia from other causes), and correcting a deficit," Srensen said, "is relatively simple in a clinical setting."

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Milk in pregnancy may lower MS risk

Mothers-to-be can reduce their babies' risk of developing multiple sclerosis in later life by drinking milk, research suggests.

The link emerged from a study of 35,794 female nurses whose mothers provided information about their diet during pregnancy. Of the nurses taking part, 199 developed multiple sclerosis (MS) over a 16-year period.

The researchers found that the risk of MS was lower among women born to mothers who drank a lot of milk while pregnant. A similar trend was seen for vitamin D. Mothers who had a relatively high vitamin D intake during pregnancy also gave birth to daughters with a reduced risk of MS.

Dr Fariba Mirzaei, from the Harvard School of Public Health in Boston, US, who led the study, said: "The risk of MS among daughters whose mothers consumed four glasses of milk per day was 56% lower than daughters whose mothers consumed less than three glasses of milk per month.

"We also found the risk of MS among daughters whose mothers were in the top 20% of vitamin D intake during pregnancy was 45% lower than daughters whose mothers were in the bottom 20% for vitamin D intake during pregnancy."

She added: "There is growing evidence that vitamin D has an effect on MS. The results of this study suggest that this effect may begin in the womb."

Exposure to sunlight, oily fish such as salmon and mackerel and fortified milk are key sources of vitamin D.

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50 Foods Every Pregnant Woman Should Eat

The following foods ought to find their way into a pregnancy diet, even if some of them must be ingested in moderation or within certain parameters.

Kidney Beans

Mayo Clinic states that 1 cup of boiled kidney beans a day provides pregnant women with 5.2 out of the suggested 27 milligrams of iron. Dry, as opposed to canned or fresh, legumes typically nurture more efficient absorption – a tip which comes straight from the National Medical Library at the National Institute of Health.

Beef

Pregnant women should veer towards leaner cuts of beef, which provides valuable proteins and iron necessary for fetal development and healthy blood – among other benefits, of course. Mayo Clinic recommends 3 ounces of beef tenderloin (or equivalent a day, as it provides 3 milligrams of iron per serving.

Cereal

Cereals, most especially those with added iron and calcium, provide pregnant women with a plethora of important nutrients. Based on statistics compiled by the USDA and expressed by the Mayo Clinic, ¾ of a cup of fortified cereal provides a whopping 18 milligrams of iron a day out of the recommended 27. One cup of cereal with extra calcium offers between 100 to 1,000 milligrams of the suggested 1,000 a day (1,300 for teenage pregnancies. In addition, ¾ of a cup also contains 400 micrograms of folic acid, and Mayo Clinic experts believe that 800 micrograms a day prior to conception, and 1,000 a day following it is the healthiest habit.

Dark Meat Turkey

Consuming 3.5 ounces of dark meat turkey provides 2.3 out of the recommended 27 milligrams of iron a day, according to the Mayo Clinic. It is also an excellent source of protein as well.

Chicken

Pregnant women need around 71 grams of protein a day in order to facilitate fetal growth, and Mayo Clinic states that 3 ounces of chicken breast offers 27.6 grams of this necessary substance. Chicken also introduces valuable iron into a pregnant woman’s diet.

Salmon

3 ounces of canned pink salmon (bones included provides mother and child alike with 181 milligrams of calcium out of Mayo Clinic’s suggested 1,000 a day (1,300 for teenagers. Purchasing boneless fish reduces the amount of calcium substantially. In addition, 3 ounces of salmon served any style offers 21.6 of the recommended 71 grams of protein a day. However, pregnant women are advised to stay away from uncooked or smoked salmon due to the associated potential health hazards.

Eggs

While pregnant women must avoid raw or undercooked eggs due to the increased risk of salmonella, the cooked variety makes for an essential addition to their diets. 1 large hard-boiled egg a day involves 6.3 grams of protein out of the suggested 71 and, according to the National Medical Library at the National Institute of Health, also serves as an excellent source of iron. They particularly recommend the yolks.

Oranges

As a citrus fruit, oranges serve as an amazing source of Vitamin C, which the National Medical Library at the National Institute of Health declares as one possible means of increasing iron absorption. Mayo Clinic also states that 1 small fruit involves 30 micrograms of folic acid. 6 ounces of fortified orange juice tacks on an additional 200 to 260 milligrams of calcium as well.

Spinach

Like citrus fruits, the National Medical Library at the National Institute of Health claims that spinach and other leafy greens can help strengthen the body’s absorption of iron by up to 3 times the normal rate. ½ a cup of spinach plays host to 100 micrograms’ worth of folic acid, 3.2 milligrams of iron, and 120 milligrams of calcium.

Yogurt

Another excellent and indispensable source of calcium, 8 ounces of low-fat yogurt provide 415 milligrams of the nutrient essential to fortify bones, teeth, and the circulatory, nervous, and muscular systems. Should a fetus receive an insufficient amount of calcium from its mother, it will begin leeching off its mother’s skeleton instead – rendering her far more susceptible to potentially devastating cracks and breaks.

Asparagus

Mayo Clinic states that 4 boiled asparagus spears offer pregnant women 85 micrograms out of the recommended 1,000 (800 prior to conception of folic acid needed in a day.

Great Northern Beans

Dried beans stand as an excellent source of both folic acid and protein, with ½ a cup of the Great Northern variety containing 90 micrograms of the former.

Tofu

For pregnant women on staunch vegetarian or vegan diets, tofu makes for a viable enough replacement when it comes to adding protein and magnesium. The various brands of Mori-Nu, for example, contain between 4 and 6 grams per 3 ounce serving. Tofu, fortunately, is a versatile enough ingredient to be enjoyed in a wide variety of ways.

Bananas

Considered a heart-healthy hallmark of sensible eating, 1 400 milligram Chiquita Banana offers pregnant women 15% of the Food Guide Pyramid’s recommended daily amount of Vitamin C, 12% of fiber, and 20% of Vitamin B6. All of these nutrients help keep a mother and her unborn child healthy and strong throughout all three trimesters.

Brown Rice

National Medical Library at the National Institute of Health touts that pregnant women ought to ingest 350-400 milligrams of magnesium a day, and brown rice and other whole grains prove an excellent source. The USDA particularly praises them as a valuable conduit for folic acid as well.

Almonds

According to the Almond Board of California, one ounce of almonds– or approximately 23 nuts – contains 6 grams of protein, 76 of magnesium, 3.5 of fiber, and 75 of calcium.

Avocados

Not only do avocados contain 2% of the Food Pyramid’s recommended daily value of iron, 4% of the potassium, 8% of the folate, 4% of the fiber, and 4% of the Vitamin C, but the California Avocado Commission also praises its status as a “nutrient-booster.” Consuming an avocado helps the body facilitate the absorption of alpha and beta carotene and other fat-soluble nutrients

Pomegranates

This popular super food has experienced something of a trendy resurgence lately, mostly due to its fantastic antioxidant properties. Men’s Fitness ran an article about the celebrated pomegranate, discussing how it contains 16% of the Vitamin C and 10% of the potassium needed in a day as well as 10 grams of fiber for every 1 cup.

Tomatoes

According to Gary Ibsen’s Tomato Fest farm, these internationally enjoyed, antioxidant-laden fruits also come packed with Vitamins A and C, calcium, and potassium – all nutrients necessary for a healthy pregnancy.

Walnuts

The California Walnut Commission celebrates these beloved tree nuts for their numerous healthful benefits. Pregnant women and their unborn children receive 4.6 grams of protein, 2 grams of dietary fiber, 0.9 milligrams of iron, 47 milligrams of magnesium, 0.9 milligrams of zinc, and 132 milligrams of potassium for every 30 grams of the actual edible part of the nut.

Swiss Chard

In addition to aiding the body in absorbing iron and other minerals, Swiss chard and its fellow leafy greens are also excellent sources of many nutrients necessary for healthy pregnancies. According to the University of Illinois, 1 cup of the chopped leaves hosts 3 grams of protein, 102 milligrams of calcium, 4 milligrams of iron, 960 grams of potassium, 32 milligrams of Vitamin C, and 15 micrograms of folate. It also contains 151 of the 320 milligrams of magnesium suggested by the University of Maryland Medical Center as the ideal daily intake for pregnant women. This dietary essential helps ensure normal organ formation and function.

Apples

University of Illinois handily provides information on all the health benefits related to apples. An amazing fruit for the pregnant and non-pregnant alike, a fresh, medium-sized, uncooked, and unpeeled apple provides 4 grams of dietary fiber, soluble and insoluble fiber alike, 10 milligrams of calcium, .25 milligrams of iron, 8 milligrams of Vitamin C, and 4 micrograms of folate. Peeling the skin off robs the food of most of its Vitamin C, however, so pregnant women are advised to wash the apple as is before eating it to the core.

Carrots

Carrots surge with beta carotene, with only a half-cup serving providing a body with 4 times more than the recommended daily intake. Beta carotene converts itself into Vitamin A upon digestion, and the National Institute of Health statistics posit that pregnant adult women need around 2,565 International Units a day, while pregnant teenagers should take in around 2,500. University of Illinois states that one ½ cup of cooked carrots provides a staggering 19, 152 IU of Vitamin A acquired through the metabolizing of beta carotene. This valuable nutrient helps stimulate cellular and brain growth in everyone – not only fetuses and infants.

Pears

Pregnant women need plenty of fiber and Vitamin C to keep themselves and their , and pears provide them with one juicy route of acquisition. According to Pear Bureau Northwest, 1 medium-sized pear provides consumers with 24% of the dietary fiber and 10% of the Vitamin C recommended for a non-pregnant individual’s daily intake.

Strawberries

Many people do not realize that strawberries actually contain more Vitamin C than citrus fruits. University of Illinois outlines their benefits to everyone – not only pregnant women. 1 cup of sliced fresh strawberries contains 44.84 IU of Vitamin A, 29.38 micrograms of folate, 44.82 milligrams of potassium, 16.60 milligrams of magnesium, 0.63 milligrams of iron, 23.24 milligrams of calcium, 3.81 grams of dietary fiber, 1 gram of protein, and a startling 94.12 milligrams of Vitamin C.

Kale

Another dark, leafy green, Kale is considered an excellent source of fiber, Vitamin A, calcium, and beta carotene – among others. All of these, however, are entirely necessary nutrients for pregnant women.

Grapefruit

According to the USDA, ½ a cup of raw grapefruit – no matter the pulp color – contains 1066 IU of Vitamin A, 39.6 milligrams of Vitamin C, 9 milligrams of magnesium, 160 milligrams of potassium, and 14 milligrams of calcium. The Wheat Foods Council also praises grapefruit juice as a recommended source of folic acid, with 23 DFE per cup.

Broccoli

Broccoli contains 2.4 grams of dietary fiber, 2.3 grams of protein, 49 milligrams of Vitamin C, 53.3 nanograms of folic acid, and 89 milligrams of calcium – all nutrients necessary to stimulate fetal growth and keep a mother-to-be healthy throughout her pregnancy. All nutritional statistics courtesy of University of Illinois.

Oatmeal

½ a cup of original, unflavored Quaker Oats without add-ins provide the pregnant and non-pregnant both with 15% of the dietary fiber, 5 grams of the protein, and 10% of the iron needed in a day. While allowances shift when a woman is with child, that still does not change the fact that oatmeal remains one of the better menu items for her to consider.

Chickpeas

Also known as garbanzo beans and serving as one of the main ingredients of the popular hummus dip (which pregnant women may enjoy as a healthy snack, Purdue University considers chickpeas a great source of protein and dietary fiber, and Wheat Foods Council ranks it as one of the best sources of folic acid. Cooked chickpeas and pinto beans both provide between 140 and 145 DFE of folic acid per ½ cup.

Okra

According to the Wheat Foods Council, cooked okra provides 37 DFE of folic acid for pregnant women hoping to prevent birth defects. University of Illinois offers even more nutritional information on these valuable plants. In addition to the folic acid, okra also contains 2 grams of dietary fiber, 1.52 grams of protein, 460 IU of Vitamin A, 13.04 milligrams of Vitamin C, 50.4 milligrams of calcium, 256.6 milligrams of potassium, and 46 milligrams of magnesium as well.

Sunflower Seeds

½ a cup of dry-roasted sunflower seeds offer pregnant women 152 DFE of the folic acid (information courtesy of Wheat Foods Council necessary for a healthy, stable pregnancy. 1 ounce of Planter’s brand sunflower seed kernels contains 12% of the recommended daily value for dietary fiber, 4% of the calcium, and 10% of the iron. They also come laden with 23% of the total fat, and ought to be consumed in moderation as a result.

Lentils

Wheat Foods Council places cooked lentils as offering 180 DFE per cup, making it the best source of folic acid for pregnant women. Beyond that, however, the USA Dry Peas, Lentils and Chickpeas (a resource validated by the USDA praises it as a viable meat replacement for women with both voluntary and involuntary dietary restrictions. ¼ of a cup of lentils also provides the pregnant with 8 grams of protein, 14% of the recommended daily allowance of iron as dictated by the Food Pyramid, and 2% of both the calcium and Vitamin C.

Pineapple

Pregnant women needing Vitamin C, manganese, and folic acid to help nurture their unborn child should consider pineapple as one possible route towards supplying these nutrients. Wheat Foods Council lists it as one of recommended sources of folic acid, with 23 DFE per cup of juice. And Maui Pineapple Company states that two slices of their fruit offers 100% of the Vitamin C needed in a day as well as significant amounts of manganese.

Portobello Mushrooms

Along with lentils, portobello mushrooms serve as a meat replacement for those with strict dietary restrictions or vegetarian or vegan diets. Prevention Magazine lists these hearty fungi as containing 4 grams of protein, 2 grams of fiber, 778.03 milligrams of potassium, and 0.23 milligrams of manganese.

Read the rest of the list here.

Pregnancy in Winter Months Increases Risk of Newborn Neurological Problems

Sunlight is important for our health. In these days when people are afraid of skin cancer and smother on sunscreen, Vitamin D absorption has been reduced. Vitamin D is also vital to infant development, and new research suggests that mothers who are pregnant during winter months have an increased risk of delivering babies with neurological issues. Of particular concern is the increase in babies with multiple sclerosis (MS) born in April.

According to research published in the European Journal of Neurology, lack of vitamin D in pregnancy "predisposes" individuals to MS. The Telegraph reports:

Vitamin D, which is largely gained through sunlight and food, is known to regulate a gene that can predispose individuals to MS. If the gene is passed on to the unborn child, without being regulated by a sufficient amount of vitamin D, it could “hard wire” them to develop the disease in later life…

Professor George Ebers, from Oxford University’s department of clinical neurology at the John Radcliffe Hospital, said: “The difference [in developing MS in Scotland] between being born in April versus November is an astounding 50per cent. This is real, there’s no doubt of a seasonal link. There are different theories, but I think the April excess of births could be linked to a sunlight deficiency.

Should parents living in climates that lack winter sun try to conceive at times to avoid winter pregnancies? Researchers believe this may be prudent if there is a family history of neurological disorders, such as MS, but most women can simply take a vitamin D supplement.

Vitamin D has also been shown to be important in preventing the flu.

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ADHD linked to obesity during pregnancy

Children are at double the risk of displaying symptoms of attention deficit hyperactivity disorder if their mother was overweight or obese when she became pregnant, according to European research.

It confirms for the first time in a large-scale study a suspected link between mothers' weight and children's mental health.

The study of nearly 2000 Swedish children identified a reduced ability to pay attention at school or preschool among those whose mothers had been overweight. This was even after taking into account the possible effects of mothers' mental health - which could influence the children's upbringing - and the children's own weight.

Children of obese mothers were also twice as likely to express negative emotions such as sadness and fear, and to have difficulty dealing with these appropriately, according to the research by Alina Rodriguez, a psychologist from the University of Uppsala. Her study followed the health of children from the first weeks of their mother's pregnancy through to age five.

Dr Rodriguez said a possible explanation was that excess weight might disrupt mothers' metabolism, making it harder for nutrients essential to brain development to reach the foetus.

Pregnancy puts huge stress on the metabolism, she said, and excessive weight gain might throw it out of balance - perhaps by raising mothers' levels of blood glucose, or of the hormone leptin.

Alternatively, the findings might result from inadequate vitamin D - which is linked to mental development and is known to be present in lower levels in overweight women - or from greater exposure to damaging chemicals, which accumulate in body fat.

Dr Rodriguez said her results, published in the Journal of Child Psychology and Psychiatry, could not prove whether maternal obesity caused the problems.

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Finally, an Excuse for Pregnant Women to Eat Bacon and Eggs

If you're pregnant and looking for an excuse to eat bacon and eggs, now you've got one: a new research study published in the January 2010 print issue of the FASEB Journal by a team of University of North Carolina researchers shows that choline plays a critical role in helping fetal brains develop regions associated with memory. Choline is found in meats, including pork, as well as chicken eggs.

"Our study in mice indicates that the diet of a pregnant mother, especially choline in that diet, can change the epigenetic switches that control brain development in the fetus," said Steven Zeisel, the senior scientist involved in the work and a senior member of the FASEB Journal's editorial board. "Understanding more about how diet modifies our genes could be very important for assuring optimal development."

Zeisel and colleagues made this discovery by feeding two groups of pregnant mice different diets during the window of time when a fetus develops its hippocampus, that part of the brain responsible for memory. The first group received no choline while the other received choline (1.1g/Kg). The group that received no choline had changes in epigenetic marks on the proteins (histones) that wrap genes in cells responsible for the creation of new brain cells (neural progenitor cells). Then, by isolating these cells from the developing brains and growing them in cell culture, the scientists determined the expression of genes for two proteins that regulate neuronal cell creation and maturation. These two proteins (G9a and Calb1) were changed in the brains of fetuses whose mothers were fed low choline diets.

The Agricultural Research Service says that "experts suggest that an adequate choline intake is 425 milligrams a day for women and 550 milligrams a day for men. Top sources of choline include meat, nuts, and eggs."

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Folic Acid May Help Prevent Fetal Heart Defects

Here's another reason for pregnant women to take folic acid supplements: they help prevent fetal heart malformations, new research from the Netherlands suggests.

"Given the relatively high prevalence of congenital heart defects worldwide, our findings are important for public health," Dr. Ingrid M. van Beynum of Radboud University in Nijmegen and her colleagues write.

Folic acid supplements are now recommended for all pregnant women, and women planning on becoming pregnant, in order to prevent birth defects involving the neural tube such as spina bifida. Many countries, including the US, now require bread and other wheat products to be fortified with folic acid for this reason, but this practice hasn't been adopted in The Netherlands.

To investigate further, the researchers used a national register of birth defects to identify 611 mothers who had given birth to a child with a heart defect, matching them to 2,401 women who delivered babies with genetic defects or other birth defects unrelated to folate.

Women who took a supplement containing at least 400 micrograms of folic acid were nearly 20 percent less likely to have a child with a heart defect, compared to other non-folate-related malformations, while their risk compared to the general population was 26 percent lower.

Their risk of having a child with a heart defect involving the septum -- which separates one side of the heart from the other -- was nearly 40 percent lower than that of the general population.

The current study couldn't show whether taking more or less than 400 micrograms of folic acid would be more effective in preventing heart defects, the researchers note, although there's increasing evidence that heavier women may need to take more folic acid to get the same protective effects.

The researchers conclude that women who want to become pregnant should take folic acid supplements around the time of conception, not only to prevent neural tube defects but also to reduce the risk of congenital heart defects.

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