The New York Times reported yesterday that according to some doctors, kidney stones are showing up in kids more often. While reporter Laurie Tarkan does a decent job explaining that some pediatric kidney stone cases might be caused by diet, I think she is missing something crucial. And ironically the answer lies in the main photograph of the article, which depicts a girl sitting at a table with a tall glass of cola. Ms. Tarkan lists two nutrition-related causes of renal stones: too much salt and not enough water. The reason is that both of these create too much calcium and oxalate in the urine. She also mentions obesity, sucrose in colas, and high protein diets as possible causative factors. In fact, many theories are proposed in the medical literature, but there is still no consensus or there could be various causes and various types of stones.
I would like to propose another idea: As Ms. Tarker mentions, toxic chemicals such as Melamine can cause kidney stones. But what about a less infamous ingredient: phosphoric acid. Phosphoric acid is added to colas to provide a tangy or sour taste. Phosphoric acid has been correlated to osteoporosis due to the fact that it can pull calcium from the bones. There is even some solid evidence to back this up. When compared to citric acid colas (i.e. Sprite), the phosphoric acid colas (even diet colas!) were more like to cause kidney disease. Colas have also been shown to cause changes in calcium-oxalte formation in the urine, which would further bolster this theory. Other theories are abound, including causes such as flouridated water and too much vitamin C supplementation- another reason why over-supplementing is a bad idea.
So what should you feed your children (and yourself) to prevent kidney stones:
1. Water makes the urine less concentrated so it is less likely to form kidney stones. Children should not be introduced to colas. Their primary source of fluids should be milk and water. Even 100% juice should be limited because it replaces water. Remember, if they see you drinking tons of cola, they will want some too. Be a good role model.
2. Choose foods with less salt. Excess salt primarily comes from processed foods. So whenever possible, make food from scratch and use a combination of herbs and sea salt (in moderation) to flavor food.
3. Never put kids on a high protein diet if you think they are overweight. Some people believe that high protein diets cause kidney stones due to the breakdown of animal protein into uric acid. Although, this theory has not yet been proven, children should receive protein from multiple sources including vegetables and whole grains. And of course, exercise will help kids lose weight too.
4. Instead of supplementing your kids with vitamin C when you think they are getting sick, try giving them vitamin C-rich foods such as citrus fruits, cantelope, tomatoes, broccoli, cabbage, and red peppers.
Wednesday, October 29, 2008
Sunday, October 12, 2008
What does the state of the economy have to do with your unborn baby?
Last week, Tara Parker-Pope wrote an article in the New York Times about the unlikely connection between a failing economy and better health status. While this correlation is not always present, Parker-Pope points to certain situations in which mental well-being and health status actually improve during an economic downturn. In developing countries, laborers might have more time to spend with their families and to breastfeed their children. In industrialized countries, particularly in well-to-do families, if one earner loses their job or has a lighter work load, he or she could have more time to spend at home with their children, improving their mental well-being. Aside from spending quality time with family members, families usually eat healthier when money is tight and time is plentiful since they prepare food at home instead of dining out.
Because I believe in the fetal origins hypothesis, I believe that if there is a situation in which people might be healthier, and some of those people will be women of childbearing age, the result will be healthier children in the future. When I read Parker-Pope's article, I was reminded a conference I attended in June, hosted by the New York City Regional Perinatal Forum. One of the presenters, Dr. Michael Lu of UCLA, urged providers and perinatal health centers to consider a life course perspective when treating their patients: consider pre-conception and inter-conception health status, as well as health status during pregnancy, as important factors that affect the pregnancy as well as the future health status of the fetus.
Dr. Lu presented various research that indicates that chronic stress, which never "turns off" (as opposed to acute or major stress), creates "wear and tear" on bodily organs and systems. This "wear and tear" is in the form of stress hormones, which cross the placenta. Chronic maternal stress, including life events and pregnancy-related stress, elevate corticotrophin-releasing hormone (CRH), and adrenocorticotropin hormone (ACTH), cortisol, epinephrine, and norepinephrine. These hormonal changes make the hypocampus section of the brain (responsible for learning and memory) less sensitive and the amygdala section of the brain (responsible for anxiety) more sensitive, in addition to down-regulating certain receptors and impairing hormonal feedback mechanisms.
Research studies hypothesize and prove to varying extents, that these excess hormones can lead to decreased birth weight, preterm delivery, depressed immune systems, increased glucose intolerance (i.e. gestational diabetes), and reduce the effectiveness of fertility treatments. Some even speculate that excess amounts of CRH and cortisol in the fetal brain can alter the infant's termperement, increase ADHD, and increase depressive sypmtoms.
I am getting just as stressed writing this, as I am sure you are reading this. But don't fret. These research contributions are important to decifer because maternal stress can be modified. First of all, if you are pregnant or trying to become pregnant and the economic downturn means you have more time on your hands, harness this time to reduce stress and hormone levels. Relax, bond with family members, cook healthy food, and exercise.
In fact, one research study indicates that eating healthier food during pregnancy actually reduces pregnancy- related stress levels. This could be due to the fact that women feel empowered and in control of their health or because healthy food can decrease inflmmation. Low-mercury fish or fish oil supplements (i.e. cod liver oil, DHA/EPA supplements) and LOTS of fruits, vegetables, and whole grains provide the necessary omega-3 fatty acids and antioxidants to combat the effects of stress hormones.
If the economic downturn is making you more stressed, learn how to deal with the stress. Mindfullness-based stress reduction, yoga, and breathing techniques can all be incorporated into a busy day to help reduce stress hormones- and still make sure to eat a salad with dinner. In fact, I attented a mindfullness-based stress reduction class yesterday at the 92nd Street Y and learned some great techniques. I am figuring out unique ways to apply them to pre-pregnant, pregnant, and postpartum women and I will hopefully post about this again soon.
You can find some of the references for this post here, here, here, here, and here (full text subscriptions required).
Because I believe in the fetal origins hypothesis, I believe that if there is a situation in which people might be healthier, and some of those people will be women of childbearing age, the result will be healthier children in the future. When I read Parker-Pope's article, I was reminded a conference I attended in June, hosted by the New York City Regional Perinatal Forum. One of the presenters, Dr. Michael Lu of UCLA, urged providers and perinatal health centers to consider a life course perspective when treating their patients: consider pre-conception and inter-conception health status, as well as health status during pregnancy, as important factors that affect the pregnancy as well as the future health status of the fetus.
Dr. Lu presented various research that indicates that chronic stress, which never "turns off" (as opposed to acute or major stress), creates "wear and tear" on bodily organs and systems. This "wear and tear" is in the form of stress hormones, which cross the placenta. Chronic maternal stress, including life events and pregnancy-related stress, elevate corticotrophin-releasing hormone (CRH), and adrenocorticotropin hormone (ACTH), cortisol, epinephrine, and norepinephrine. These hormonal changes make the hypocampus section of the brain (responsible for learning and memory) less sensitive and the amygdala section of the brain (responsible for anxiety) more sensitive, in addition to down-regulating certain receptors and impairing hormonal feedback mechanisms.
Research studies hypothesize and prove to varying extents, that these excess hormones can lead to decreased birth weight, preterm delivery, depressed immune systems, increased glucose intolerance (i.e. gestational diabetes), and reduce the effectiveness of fertility treatments. Some even speculate that excess amounts of CRH and cortisol in the fetal brain can alter the infant's termperement, increase ADHD, and increase depressive sypmtoms.
I am getting just as stressed writing this, as I am sure you are reading this. But don't fret. These research contributions are important to decifer because maternal stress can be modified. First of all, if you are pregnant or trying to become pregnant and the economic downturn means you have more time on your hands, harness this time to reduce stress and hormone levels. Relax, bond with family members, cook healthy food, and exercise.
In fact, one research study indicates that eating healthier food during pregnancy actually reduces pregnancy- related stress levels. This could be due to the fact that women feel empowered and in control of their health or because healthy food can decrease inflmmation. Low-mercury fish or fish oil supplements (i.e. cod liver oil, DHA/EPA supplements) and LOTS of fruits, vegetables, and whole grains provide the necessary omega-3 fatty acids and antioxidants to combat the effects of stress hormones.
If the economic downturn is making you more stressed, learn how to deal with the stress. Mindfullness-based stress reduction, yoga, and breathing techniques can all be incorporated into a busy day to help reduce stress hormones- and still make sure to eat a salad with dinner. In fact, I attented a mindfullness-based stress reduction class yesterday at the 92nd Street Y and learned some great techniques. I am figuring out unique ways to apply them to pre-pregnant, pregnant, and postpartum women and I will hopefully post about this again soon.
You can find some of the references for this post here, here, here, here, and here (full text subscriptions required).
Sunday, October 5, 2008
Making Your Baby Healthy: Months Before Birth
In today’s New York Times Magazine, I was disturbed to see a major misrepresentation. The article described a social movement of fat-acceptance activists. Robin Marantz Henig made points with which I agreed: some people can be fat and healthy; we should emphasize intuitive eating; and the emotional and physical benefits of exercise are often under-emphasized. However, Henig quotes Dr. Leibel of Columbia University Medical Center who states that severely obese people have underlying genetic differences from the rest of the population, implying that they should not be blamed for their weight.
First of all, the Dr. Leibel is referring to the severely obese, while Henig's article focuses on all overweight people. The general breakdown is that people with a body mass index (BMI) over 25 are overweight; BMIs over 30 are obese; and BMIs over 35 are severely obese. For Henig to treat someone with a BMI of 27 the same as someone with a BMI of 37 is unfair, and likely goes beyond what Dr. Leibel was trying to say.
Second of all, Henig makes no mention of the fact that some genes can be determined by the fetal environment. Maybe we cannot blame overweight people for being overweight, but what if their weight was affected by what their mother ate while pregnant. A growing body of evidence points to the fetal environment as a crucial player in the fight against chronic diseases of adulthood.
Most parents-to-be are focused on having a healthy baby, but few think about making sure that that baby grows up to be a healthy adult. Thoughts about their baby’s long-term health tend to surface only after the birth, with many conversations focused on breastfeeding, first foods, healthy snacks, and raising healthy eaters. However, as the “developmental-origins of human disease" hypothesis [1] continues to gain momentum, and earn research money, pregnancy goals may have to change.
The basis for the developmental-origins hypothesis is that the fetus has “developmental plasticity,” the ability to develop in various ways depending on the fetal environment. Some of you might be thinking like Dr. Leibel: Don’t genes determine the future health of the fetus? Well, yes. But where do the genes come from? Nutritional genomics studies indicate that the genes fetuses receive from their parents can be regulated by nutrients the fetus receives during pregnancy.
Sometimes these changes can be a good way for the body to adapt to its environment. For example, the gene variant that regulates hemochromatosis (excessive iron absorption) may have been originally enabled in a low-iron environment, when the gene allowed the body to adapt to poor nutrition. But that same gene causes iron-overload in an adequate-iron environment if the gene is passed to future generations. Sometimes the gene is passed to the next generation, sometimes it is not. A more well known example involves folic acid. There are 2 genes that increase the risk for neural tube defects in an environment that is deficient in folic acid. This is why women are urged to take folic acid supplements; so that if they have those genes, the rich-folic acid environment will down-regulate the gene expression. Since the neural groove is formed during the 3rd gestational week, it is important to start taking folic acid prior to the pregnancy.
The fact that genes can be up and down regulated - that is, expressed or not - is proof that organisms evolve over time to adapt to their environments. But what if they adapt in ways which are not helpful? A fetus may respond to a limited nutritional environment by changing their metabolism, hormone production, and the way their tissues respond to hormones. These changes in tissue and organ development can result in disturbed responses later in life.
There are many example of how this plays out in real life. If we were to graph these variations based on birth weight, we see a “U” shape: infants who are born with low or high birth weight are more susceptible to these changes than infants born at average birth weights. In addition, fetal under-nutrition and over-nutrition is more likely to facilitate disease. This is no coincidence. Under and over nutrition are more likely to produce low and high birth weights.
What does all of this mean for children? Here are some examples from human and animal studies.
Human studies:
* Smaller size at birth, followed by rapid childhood growth, is associated with heart disease, stroke, diabetes, obesity, metabolic syndrome and osteoporosis.
* Over-nutrition during fetal growth or infancy (i.e. formula feeding) is associated with obesity, diabetes, and osteoporosis.
* Imbalances in B12 and folic acid may lead to insulin resistance.
* Chronic fetal anemia may lead to heart disease.
* Early prenatal famine is associated with schizophrenia.
Animal studies:
* A low protein diet in the pre-implantation period (0-4 days) is associated with altered organ development, low birth weight, increased postnatal growth, and adult hypertension.
* Excess glucocorticoids (steroid medication) during pregnancy leads to increased sensitivity to postnatal stress, and increased hypertension. The same result can also be caused by postnatal stress, defined as reduced grooming/licking by animal mothers.
What you can do to ensure a positive fetal environment:
Have a healthy weight gain during pregnancy. Women who have a normal weight before getting pregnant should gain 25 to 35 pounds. Women who are underweight before pregnancy should gain 28 to 40 pounds. And women who are overweight should gain 15 to 25 pounds. Obese women should gain at least 15 pounds. Eat fish high in omega-3 fatty acids and low in mercury or take a supplement. And, of course, eat a healthy diet before and during pregnancy to ensure a healthy balance of nutrients. Don’t know what a healthy pregnancy diet is? Sign us for my RSS feed to continue readings my posts.
Feed your children fish too. There is some evidence that omega-3 fatty acids can reverse some of the negative effects of poor nutrition during pregnancy.
I would love to know your thoughts, feel free to comment!
A few journal references for further research can be found here, here, here, and here (full-text subscriptions required).
[1] The Developmental Origins of Human Disease Hypothesis is also known as the Fetal Origins of Adult Disease Hypothesis and the Barker Hypothesis
First of all, the Dr. Leibel is referring to the severely obese, while Henig's article focuses on all overweight people. The general breakdown is that people with a body mass index (BMI) over 25 are overweight; BMIs over 30 are obese; and BMIs over 35 are severely obese. For Henig to treat someone with a BMI of 27 the same as someone with a BMI of 37 is unfair, and likely goes beyond what Dr. Leibel was trying to say.
Second of all, Henig makes no mention of the fact that some genes can be determined by the fetal environment. Maybe we cannot blame overweight people for being overweight, but what if their weight was affected by what their mother ate while pregnant. A growing body of evidence points to the fetal environment as a crucial player in the fight against chronic diseases of adulthood.
Most parents-to-be are focused on having a healthy baby, but few think about making sure that that baby grows up to be a healthy adult. Thoughts about their baby’s long-term health tend to surface only after the birth, with many conversations focused on breastfeeding, first foods, healthy snacks, and raising healthy eaters. However, as the “developmental-origins of human disease" hypothesis [1] continues to gain momentum, and earn research money, pregnancy goals may have to change.
The basis for the developmental-origins hypothesis is that the fetus has “developmental plasticity,” the ability to develop in various ways depending on the fetal environment. Some of you might be thinking like Dr. Leibel: Don’t genes determine the future health of the fetus? Well, yes. But where do the genes come from? Nutritional genomics studies indicate that the genes fetuses receive from their parents can be regulated by nutrients the fetus receives during pregnancy.
Sometimes these changes can be a good way for the body to adapt to its environment. For example, the gene variant that regulates hemochromatosis (excessive iron absorption) may have been originally enabled in a low-iron environment, when the gene allowed the body to adapt to poor nutrition. But that same gene causes iron-overload in an adequate-iron environment if the gene is passed to future generations. Sometimes the gene is passed to the next generation, sometimes it is not. A more well known example involves folic acid. There are 2 genes that increase the risk for neural tube defects in an environment that is deficient in folic acid. This is why women are urged to take folic acid supplements; so that if they have those genes, the rich-folic acid environment will down-regulate the gene expression. Since the neural groove is formed during the 3rd gestational week, it is important to start taking folic acid prior to the pregnancy.
The fact that genes can be up and down regulated - that is, expressed or not - is proof that organisms evolve over time to adapt to their environments. But what if they adapt in ways which are not helpful? A fetus may respond to a limited nutritional environment by changing their metabolism, hormone production, and the way their tissues respond to hormones. These changes in tissue and organ development can result in disturbed responses later in life.
There are many example of how this plays out in real life. If we were to graph these variations based on birth weight, we see a “U” shape: infants who are born with low or high birth weight are more susceptible to these changes than infants born at average birth weights. In addition, fetal under-nutrition and over-nutrition is more likely to facilitate disease. This is no coincidence. Under and over nutrition are more likely to produce low and high birth weights.
What does all of this mean for children? Here are some examples from human and animal studies.
Human studies:
* Smaller size at birth, followed by rapid childhood growth, is associated with heart disease, stroke, diabetes, obesity, metabolic syndrome and osteoporosis.
* Over-nutrition during fetal growth or infancy (i.e. formula feeding) is associated with obesity, diabetes, and osteoporosis.
* Imbalances in B12 and folic acid may lead to insulin resistance.
* Chronic fetal anemia may lead to heart disease.
* Early prenatal famine is associated with schizophrenia.
Animal studies:
* A low protein diet in the pre-implantation period (0-4 days) is associated with altered organ development, low birth weight, increased postnatal growth, and adult hypertension.
* Excess glucocorticoids (steroid medication) during pregnancy leads to increased sensitivity to postnatal stress, and increased hypertension. The same result can also be caused by postnatal stress, defined as reduced grooming/licking by animal mothers.
What you can do to ensure a positive fetal environment:
Have a healthy weight gain during pregnancy. Women who have a normal weight before getting pregnant should gain 25 to 35 pounds. Women who are underweight before pregnancy should gain 28 to 40 pounds. And women who are overweight should gain 15 to 25 pounds. Obese women should gain at least 15 pounds. Eat fish high in omega-3 fatty acids and low in mercury or take a supplement. And, of course, eat a healthy diet before and during pregnancy to ensure a healthy balance of nutrients. Don’t know what a healthy pregnancy diet is? Sign us for my RSS feed to continue readings my posts.
Feed your children fish too. There is some evidence that omega-3 fatty acids can reverse some of the negative effects of poor nutrition during pregnancy.
I would love to know your thoughts, feel free to comment!
A few journal references for further research can be found here, here, here, and here (full-text subscriptions required).
[1] The Developmental Origins of Human Disease Hypothesis is also known as the Fetal Origins of Adult Disease Hypothesis and the Barker Hypothesis
Menu Plan Monday- Dinners
This week we received many yummy vegetables from our CSA so it made menu planning easier:
Sunday: Beef and seitan stew with white sweet potato, black eyed peas, barley, and carrots (crock-pot)
Monday: Chicken baked with slices of yams and mushrooms, on a bed of green onion; Steamed cauliflower
Tuesday: Korean BBQ (Marinade: soy sauce, honey, mustard powder, garlic and onion powder); Rice with kale
Wednesday: Mushroom barley soup; Broccoli, Mashed lentils and potatoes; Chicken cutlet
Thursday: Bagels and lox; Salmon muffins; Cucumber & chickpea salad
Friday: Bulgur pilaf, Green salad, Ratatouille
Saturday: Leftovers!
Monday: Chicken baked with slices of yams and mushrooms, on a bed of green onion; Steamed cauliflower
Tuesday: Korean BBQ (Marinade: soy sauce, honey, mustard powder, garlic and onion powder); Rice with kale
Wednesday: Mushroom barley soup; Broccoli, Mashed lentils and potatoes; Chicken cutlet
Thursday: Bagels and lox; Salmon muffins; Cucumber & chickpea salad
Friday: Bulgur pilaf, Green salad, Ratatouille
Saturday: Leftovers!
Make sure to check out my other post from today about
making healthy babies months before they are born!
making healthy babies months before they are born!
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