Milk During Pregnancy May Lower a Baby’s Risk of Developing MS Later in Life

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Recent media reports have covered research announced ahead of the American Academy of Neurology’s (AAN) Annual Meeting in April which suggested that milk during pregnancy may lower a baby’s risk of developing multiple sclerosis (MS) later in life.

The theory from the researchers in Boston, announced in an AAN press release, was based on a survey of American mothers.

It was claimed that MS risk was lower among women born to mothers with high milk or dietary vitamin D intake in pregnancy.

Unfortunately UK media reports focused on the milk link ; however it is in fact the case that there are only trace elements of vitamin D in milk consumed in this country.

Unlike America, most of Britain’s milk is not fortified with vitamin D and so whatever quantity of milk is ingested, vitamin D levels in the body are likely to remain unaffected.

While it may be true that vitamin D has previously been shown to potentially play a role in MS, maintaining a healthy, balanced diet including oily fish and exposing skin to safe levels of sunshine are the best ways to increase levels of vitamin D.

No Need for Pregnant Women to Fast During Labor

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No Need for Pregnant Women to Fast During Labor

DETROIT –  There is no reason why pregnant women at low risk for complications during delivery should be denied fluids and food during labor, a new Cochrane research review concludes.

“Women should be free to eat and drink in labour, or not, as they wish,” the authors of the review wrote in the Cochrane Library, a publication of the Cochrane Collaboration, an international organization that evaluates medical research.

Dr. Jennifer Milosavljevic, a specialist in obstetrics and gynecology at Henry Ford Health System, Detroit, who was not involved in the Cochrane Review, agrees that pregnant women should be allowed to eat and/or drink during labor.

“In my experience,” she told Reuters Health in an email, “most pregnant patients at Henry Ford are placed on a clear liquid diet during labor which includes water, apple juice, cranberry juice, broth, and jello. If a patient is brought in for a prolonged induction of labor, she will typically be permitted to eat a regular diet and order anything off the menu in between different induction modalities.”

Milosavlievic has “not seen any adverse outcomes by allowing women the option of liquids and/or a regular diet in labor.”

Standard hospital policy for many decades has been to allow only tiny sips of water or ice chips for pregnant women in labor if they were thirsty. Why? It was feared, and some studies in the 1940s showed, that if a woman needed to undergo general anesthesia for a cesarean delivery, she might inhale regurgitated liquids or food particles that could lead to pneumonia and other lung damage.

But anesthesia practices have changed and improved since the 1940s, with more use of regional anesthesia and safer general anesthesia.

And recently, attitudes on food and drink during labor have begun to relax. Last September, the American College of Obstetricians and Gynecologists (ACOG) released a “Committee Opinion” advising doctors that women with a normal, uncomplicated labor may drink modest amounts of clear liquids such as water, fruit juice without pulp, carbonated beverages, clear tea, black coffee, and sports drinks. They fell short of saying food was okay, however, advising that women should avoid fluids with solid particles, such as soup.

“As for the continued restriction on food, the reality is that eating is the last thing most women are going to want to do since nausea and vomiting during labor is quite common,” Dr. William H. Barth, Jr., chair of ACOGs Committee on Obstetric Practice, noted in a written statement at the time.

But based on the evidence, Mandisa Singata of the East London Hospital Complex in East London, South Africa, an author on the new Cochrane Review, says “women should be able to make their own decisions about whether they want to eat or drink during labour, or not.”

Singata and colleagues systematically reviewed five studies involving more than 3100 pregnant that looked at the evidence for restricting food and drink in women who were considered unlikely to need anesthesia. One study looked at complete restriction versus giving women the freedom to eat and drink at will; two studies looked at water only versus giving women specific fluids and foods and two studies looked at water only versus giving women carbohydrate drinks.

The evidence showed no benefits or harms of restricting foods and fluids during labor in women at low risk of needing anesthesia.

Singata and colleagues acknowledge that many women may not feel like eating or drinking during labor. However, research has shown that some women find the food and drink restriction unpleasant. Poor nutritional balance may be also associated with longer and more painful labors. Drinking clear liquids in limited quantities has been found to bring comfort to women in labor and does not increase labor complications.

The researchers emphasize that they did not find any studies that assessed the risks of eating and drinking for women with a higher risk of needing anesthesia and so further research is need before specific recommendations can be made for this group.

SOURCE: Cochrane Library, 2010.

 

Cola Drinking Linked to Diabetes in Pregnancy

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NEW ORLEANS – Drinking lots of sugar-sweetened cola may increase women’s likelihood of developing diabetes during pregnancy, a condition known as gestational diabetes, new research shows.

Compared to women who had less than one such beverage a month, women who drank at least five servings of non-diet cola a week were at greater risk of gestational diabetes, even after accounting for their body mass index (BMI), level of physical activity, and other diabetes risk factors, researchers found.

Sugar-sweetened beverages are the top source of added sugar in US diets, and several studies have linked high sugary drink intake with an increased risk of type 2 diabetes in women, Dr. Liwei Chen of the Louisiana State University Health Science Center in New Orleans and colleagues note in the latest edition of the journal Diabetes Care.

But there is little information on whether consumption of sugar-sweetened beverages before pregnancy might increase gestational diabetes risk, they add.

To investigate, the researchers analyzed data from the Nurses Health Study II, looking at 13, 475 women who had at least one pregnancy between 1992 and 2001. During that time, 860 women reported having been diagnosed with gestational diabetes for the first time.

Women who drank five or more sugar-sweetened beverages of any type per week were 23 percent more likely to develop gestational diabetes than those who drank less than one serving a month, and the relationship remained even after the researchers accounted for other gestational diabetes risk factors such as BMI and family history of diabetes.

But accounting for a Western-style diet — heavy in red meats, processed meats, sweets, snacks and other less-healthy foods — did explain some of the association between diabetes and sugary drinks.

The researchers looked separately at cola beverages, because the caramel coloring used in them has been linked in animal studies to insulin resistance and inflammation. They found a 22 percent increased risk of developing diabetes during pregnancy for women who drank five or more non-diet colas a week, compared to women who had less than one serving of cola a month.

There was no relationship between diet beverage consumption and gestational diabetes risk.

The demands pregnancy puts on a woman’s metabolism may “unmask” a tendency toward developing diabetes and similar conditions, Chen and colleagues note. Drinking cola could contribute to this tendency by making for a sugar-filled diet, they add, which in and of itself may be harmful to the insulin-producing beta cells of the pancreas.

Because diet cola didn’t increase gestational diabetes risk, they add, caramel coloring isn’t likely to be a major factor in the relationship observed with non-diet cola.

The findings “are particularly relevant” given that so many people drink sugar-sweetened cola, the researchers write. They call for more research on sugar-sweetened beverage consumption and gestational diabetes, as well as other pregnancy outcomes.

SOURCE: Diabetes Care, December 2009.