2013-12-15

Pregnancy- the time to start Obesity Prevention for your Child

Pregnancy- the time to start Obesity Prevention for your Child

In December, 2013, the New England Journal of Medicine published an important essay on the timing of preventing obesity in one's life.   http://www.nejm.org/doi/full/10.1056/NEJMp1310577

The compelling point of the essay is that the situation during pregnancy and early infancy can, to a large degree, determine if the child will become obese.    The article establishes that a critical opportunity to prevent obesity in your child is during your pregnancy and the months after birth.   

Of course, eating habits remain central to the effort to prevent obesity, but the actual structure of fat cells in a person can be determined during that person's pre-natal period and during their early infancy.

The article notes three major influences on whether a baby will grow up to be obese:
  1. The weight status of the baby's mother during pregnancy.
  2. Rapid weight gain during 3-6 months of age.
  3. Whether solid foods are introduced before 4 months of age or not.
  4. Exposure to endocrine-active compounds during pregnancy, after birth, in the food.
The weight status of the baby's mother during pregnancy.
The evidence strongly suggests that if the mother is obese during pregnancy, the developing child is more likely to have more and larger fat cells.  If those structures move in that direction, that person may be more likely to be obese, even eating the same foods as someone who has fewer and smaller fat cells.
Obesity during pregnancy also greatly increases the chance of the mother developing the diabetes of pregnancy, or gestational diabetes.  Gestational diabetes can directly impact the development of fat cells in the baby leading to greater risk for obesity for that baby when an adult.

Rapid weight gain during 3-6 months of age
Surprisingly, if an infant gains weight very rapidly during the period 3-6 months of age, that baby will grow up to have a significantly greater chance of being obese and of having heart problems.   This is an issue whether the infant is nursed or formula-fed.

Whether solid foods are introduced before 4 months of age or not.
In formula-fed infants only, starting solid foods before 4 months of age increases the child's risk of being obese by age 3 years old sixfold!

Exposure to endocrine-active compounds during pregnancy, after birth, in the food.
This category of risk was not described in any detail, but there are substances, mainly in plastics, which have estrogen-like impact on people.  The include specific substances such as BPA, and categories of substances such as phthalates.  Exposure to such substances during pregnancy can increase the risk of obesity later in life for the developing child.

Bottom Line
What happens during pregnancy can have a powerful impact on whether your child will be at risk for developing obesity, no matter how much they eat.  
We recommend that:
  • Women exert any effort possible to keep their BMI in the, or at least towards, the normal range during pregnancy.   
  • We should resist the excitement of explosive weight gain during 3-6 months of age.  Steady weight gain is quite fine.
  • Solid foods should not be started until 4 months of age
  • Efforts to minimize exposure to phthalate or BPA containing plastics should begin at conception and throughout the pregnancy, infancy, and childhood.
Dr. Arthur Lavin



*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.

2013-12-05

Is Soy Safe for Pregnancy, Safe for Baby?

CDC edamame

Is Soy Safe for Pregnancy, Safe for Baby?

The soybean is a wonderful food.  It is rich in a wide range of nutrients, and an excellent source of protein.
From a food use perspective, the soybean is nearly infinitely adaptable in its ability to take on any taste and texture.

As a result, soy finds its way into a surprising number of foods we eat.   Of course these include foods where the soybean is visible in the food or name, such as edamame, soy sauce, tofu, soy-based infant formulas, and soy milk.   But if you consider the number of foods that have an ingredient with the word vegetable in it, with phrases such as vegetable flavoring, vegetable emulsifier, vegetable gum, vegetable starch, the exposure to soy in our food is extensive.

If soy is so wonderful, what controversy surrounds it?  The controversy is limited to one chemical in soybeans, phytoestrogens.   Phytoestrogens are molecules in plants that look like the molecule found in humans called estrogen.  As you know, estrogen is the paradigm hormone of being female.  It is estrogen that makes breasts develop, that helps control the menstrual cycle, and that helps maintain pregnancy and nursing.

The concern is whether the estrogen-like compounds in soybeans actually have estrogen effects in the human body.  It turns out very tiny differences in hormone molecules lead to dramatic differences in function.  Estrogen, for example, when altered by a very tiny amount becomes testosterone, the male hormone.  So we know tiny differences change function quite a bit!

So the question is, if you eat phytoestrogen from soy, does it do anything?  So far, the evidence leans heavily towards this answer: No.  If it did act as an estrogen in humans, we should see breast development in children, puberty pushed early in girls, and later in boys.   There is no evidence that any of these events occur in people who eat soy products.  Some research actually raises the possibility that phytoestrogens may decrease the incidence, in adults, of developing breast and prostate cancer.  But again, there are essentially no data on any group of people having a measurable difference in their lives in any way from eating or not eating soy.

Therefore, at this time, pending finding any actual impact on people, we are recommending to people that eating soy is safe for pregnant women, for infants, and all people.


*Disclaimer* The comments contained in this electronic source of information do not constitute and are not designed to imply that they constitute any form of individual medical advice. The information provided is purely for informational purposes only and not relevant to any person's particular medical condition or situation. If you have any medical concerns about yourself or your family please contact your physician immediately. In order to provide our patients the best uninfluenced information that science has to offer,we do not accept samples of drugs, advertising tchotchkes, money, food, or any item from outside vendors.
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