November 15, 2012

Nutrition and Pregnancy: Pay it forward

If you're a mom- or dad-to-be, you naturally want your future child to be as healthy as possible. At first, you might be thinking in terms of a healthy infant (you know, 10 fingers, 10 toes and all the other good signs), and imagining them as a healthy young child.

You probably aren't thinking ahead to their health as an adult, and I really bet you aren't thinking about the health of any future grandchildren yet. The good news is that by taking steps to have a healthy pregnancy and a healthy baby, you are making a significant contribution to the health of your grandchildren. Crazy, I know.

Some of this has to do with the effects that what a woman does before and during pregnancy affects the anatomy and physiology of the growing fetus and child-to-be. Organ development, fat cell development, hormone levels and birth weight can affect whether the child will be prone to health problems like diabetes, cardiovascular disease, kidney disease and obesity as a child or an adult. The maternal factors that can tip the scales one way or the other include:
  • Nutrition before and during pregnancy
  • Use of tobacco or alcohol or exposure to other toxins during pregnancy
  • Stress during pregnancy
  • Weight at conception
  • Weight gain during pregnancy
However, these factors also have subtle influences on the growing child's genetic material (genes, DNA). Yes, children inherit half of their genes from their mothers, and half from their fathers, but those genes can be turned on (expressed) or turned off (not expressed). This is significant, because our DNA is essentially a massive string of code, with specific sections of that code (genes) providing instructions for making specific proteins. Enzymes are proteins, and enzymes drive the bajillion tiny little processes that go on in our cells to make our bodies operate.

Our DNA is also referred to as our genome. The system of "switches" on key areas of our DNA is referred to as our epigenome. If our genome is our hardware, our epigenome is our software. It takes many, many generations for the human DNA to shift, but the epigenome is more flexible, and can change in response to things that happen to us, including nutrition, psychological stress and exposure to environmental toxins. When exposure to a substance can lead to cancer, it's because that substance has turned on "pro-cancer" genes and/or turned off "anti-cancer" genes.

So what does this have to do with your grandchildren? Epigenetics is an exploding area of research, and one of the focus areas is how changes to the epigenome, especially during critical periods of development, can lead to disease. Pregnancy is one of those critical periods (for the fetus), and so is early childhood.

It would be totally unethical to conduct randomized control trials where one group of pregnant women was exposed to stress and given a terrible diet, while the other group was kept nourished and stress-free. But a lot of research has come out of some naturally occurring famines, looking at the outcomes for children who were in utero during those times, comparing them with siblings born during more normal times, and such. The Dutch Famine of 1994-45 is the best known of these.

Nutrition during pregnancy can influence the epigenome in numerous ways. One of the most notable nutrients is folic acid. While folic acid is extremely important in the first 21 days of pregnancy to help form the neural tube (early spinal cord), it remains important during the rest of pregnancy because of it's particular ability to flip the right genetic switches (in scientific parlance, it's a methyl donor). Diets that have an extreme micronutrient imbalance (very low in protein or in carbs, for example) have been linked to diabetes or obesity due to the silencing or activating of critical genes.

While much of the research looks at how these effects carryover from mother to daughter to granddaughter, men are not out of the picture by any means. Sons can pass on epigenetic changes to their sons and then to their grandsons. Because a woman's eggs (her genetic material) are all produced before birth, but a man's sperm (his genetic material) develops during his childhood/adolescence, poor nutrition (famine, most notably) during childhood can affect his children and grandchildren.

The takeaway? Know that when you do all you can to have a healthy, well-nourished pregnancy, you are building a healthy foundation not just for your child, but for future branches of your family tree.

If you're curious about epigentics (it's a fascinating topic!), here are links to two resources I really like that are pretty friendly for those who don't have a science background:
I won't be doing a pregnancy post next Thursday because of the Thanksgiving holiday, but I will resume the following Thursday with some surprising things I learned about breastfeeding yesterday!

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