metabolic syndromes

What is Fetal Programming?

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What is fetal pro­gram­ming? Every per­son liv­ing on earth was first exposed to a uter­ine envi­ron­ment that helped deter­mine their life­time health and devel­op­ment. The term for this phe­nom­e­non is fetal pro­gram­ming. It is a hot top­ic and deserves atten­tion.

Accept­ing the impor­tance of fetal pro­gram­ming places respon­si­bil­i­ty on the moth­er-to-be to do all she can to insure her body pro­vides nutri­ents and oxy­gen to her grow­ing infant while avoid­ing pos­si­ble risks and tox­ins. At the same time, genet­ic and envi­ron­men­tal fac­tors con­tribute great­ly to the poten­tial for some dis­or­ders and prob­lems that arise. Thus, we must be care­ful in assign­ing guide­lines for accept­able behav­ior or blame for poor out­comes to preg­nant women.

On the one hand, we can all see the neg­a­tive con­se­quences of some­thing like fetal alco­hol syndrome…clearly the result of mater­nal behav­ior. Is a preg­nant woman whose baby has been dam­aged in this way guilty of abuse?

But, what if a moth­er is obese, eats poor­ly and ends up with an infant with a dis­turbed metab­o­lism. Is this abuse? What if the moth­er has an infec­tion that results in cere­bral pal­sy? Or what if she lives near a high­way and invol­un­tar­i­ly inhales fumes that neg­a­tive­ly affect the pla­cen­ta?

How do you get a healthy baby? Of course, there are no guar­an­tees. There remain many unknown fac­tors that can affect the course and out­come of a preg­nan­cy. Some fac­tors we are aware of, such as avoid­ing cer­tain fumes or chem­i­cals.  There are some behav­iors we know can max­i­mize the poten­tial for a good out­come, such as eat­ing ade­quate pro­tein, aer­o­bic con­di­tion­ing and strength train­ing. [Note for new readers…lots of these fac­tors have been cov­ered in our pre­vi­ous posts.]

But, what about all the things we don’t know about?

If these goats eat the wrong grass, will they go into labor?

Here is a cau­tion­ary tale:  There is a species of goat that, if they eat a cer­tain type of skunk grass on day 14 (and only day 14) of preg­nan­cy, will not go into labor. Why? Plant tox­ins in this grass inter­fere with the devel­op­ment of a small por­tion of fetal brain, the par­aven­tric­u­lar nucle­us. This nucle­us is involved in the sig­nal­ing cycle of labor. With­out it, the moth­er will not go into labor!

What are the take-home mes­sages here?

  • Prob­a­bly no one is ever a per­fect fetus…too many pos­si­ble threats.
  • There are some threats we can avoid…being lazy, over-eat­ing, smok­ing.
  • There are some threats we can­not avoid, so we do the best we can.

Do the best you can by your baby…aerobic fit­ness, good nour­ish­ment, sleep, good hygiene and de-stress­ing your life.

Fitness Starts Early!

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Preg­nan­cy fit­ness is not only impor­tant for moms, but for the fetus as well. Evi­dence is clear that aer­o­bic fit­ness improves brain, heart, immune and meta­bol­ic function…at all ages, includ­ing in utero. If con­tin­ued ear­ly in life, healthy phys­i­cal adap­ta­tions that occur in the uterus become rein­forced behav­ior, prepar­ing a good foun­da­tion for a healthy lifestyle. Babies are acute observers of move­ment and activ­i­ty, and learn from each oth­er. A key com­po­nent of a good mom-baby pro­gram is the inter­ac­tion of the babies them­selves. A good teacher will facil­i­tate healthy activ­i­ty among our small­est class mem­bers!

There is grow­ing evi­dence that at all ages, aer­o­bic fit­ness pro­duces the great­est num­ber of ben­e­fits. Recent­ly, researchers deter­mined that aer­o­bic fit­ness in 9 and 10 year olds pro­duced ben­e­fits in the devel­op­ment of two impor­tant brain regions — the basal gan­glia and the hip­pocam­pus — that are sig­nif­i­cant fac­tors in prob­lem-solv­ing intel­li­gence. This is just one of the lat­est reports that tells us the capac­i­ty to absorb and use oxy­gen (which improves with aer­o­bic fit­ness) is a key to health, qual­i­ty and length of life…beginning in the womb!

Beyond Yoga

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Beyond Yoga

I love Yoga. But…Power Yoga, Hot Yoga, Fast Yoga, Pilates-Yoga, Fresh Yoga, Baby Yoga and even Pre­na­tal Yoga…not so much. I find these phe­nom­e­na strange.

Why? Well, 40 years ago – when I first learned Yoga – it was a priv­i­lege. A per­son came to Yoga in the search for a mean­ing­ful life path. It was a blend of the spir­i­tu­al and the phys­i­cal, and it required a com­mit­ment to what was revealed with­in the prac­tice. Before being allowed to take my first class, I had to demon­strate that I already prac­ticed med­i­ta­tion. It was not exer­cise per se.

It was not adapt­able like it is today. Depend­ing on the teacher, you learned an ancient sys­tem – Hatha, Vinyasa, Ash­tan­ga, Iyen­gar, or Kun­dali­ni. Those were the major meth­ods that have Hin­du roots, and those who prac­ticed these art forms knew what they were doing. The teach­ers them­selves had worked on their craft for decades. Today, I know only a few teach­ers who have a pro­found grasp of each of these meth­ods.

Why is Yoga so popular?

Is there some­thing with­in the work itself – even in the dilut­ed forms, hybrid ver­sions and the celebrity/competitive stu­dios – that allows it to thrive in the self-cen­tered, free-wheel­ing, brand­ing-crazy mar­ket­place of the ear­ly 21st cen­tu­ry devel­oped world?

I find the answer to this in a strange place:  Zen prac­tice, Bhud­dism. One of my favorite notions is from Suzuki’s text Zen Mind, Beginner’s Mind. “When you feel dis­agree­able, it is best to sit.” This is an ele­ment of nin – con­stan­cy – or being present in the moment. Not patience, which requires a rejec­tion of impa­tience and there­fore can­not accept the present as it is. When you sit – just sit peri­od, that’s it – all that is real is the moment. This is at the heart of all spir­i­tu­al expe­ri­ence.

I’m not an expert in Yoga. I don’t teach Yoga, although I have inte­grat­ed Yoga-based skills into my work. I have prac­ticed Hatha and Vinyasa over the years enough to learn how cer­tain skills are treated…belly breath­ing, slow deep breath­ing, main­tain­ing posi­tion and lis­ten­ing to the wis­dom of the body, and iso­met­ric strength­en­ing in prepa­ra­tion for more expan­sive shapes or motions. Long ago, I inte­grat­ed these skills from my Yoga expe­ri­ence into my teach­ing style because these skills are effec­tive for the pop­u­la­tions with which I work. But, I do not teach Yoga.

Can Research Help Us?

Researchers find Yoga a night­mare. There is so much vari­ance now in the prac­tice that find­ings from any one study can­not be trans­ferred to the gen­er­al pop­u­la­tion. One of the most reveal­ing exper­i­men­tal-design stud­ies found that none of the claims of Yoga improv­ing metab­o­lism could be demon­strat­ed. When asked why they thought this out­come had occurred, the teach­ers who were used in the study said they thought the par­tic­i­pants in the study were not fit enough to do Yoga!

One of the most suc­cess­ful Yoga teach­ers in my area, and one of my favorites, has for decades used a bicy­cle for her pri­ma­ry mode of trans­porta­tion. She cred­its her longevi­ty and suc­cess to Yoga. I attribute it to bicy­cling. Dr. Coop­er is right…fitness (which means aer­o­bic fit­ness) is the biggest bang for the buck. Unless you are fit, it is hard to exe­cute some of the more sub­tle demands of many exer­cise reg­i­mens.

Some Yoga teach­ers will say that you can make Yoga aer­o­bic or that some forms are aer­o­bic. OK, then it’s aer­o­bics, not Yoga. When­ev­er I see “aer­o­bic Yoga” it reminds me of aer­o­bic danc­ing. It’s help­ful to remem­ber that Yoga devel­oped in a time and place where sur­vival was depen­dent upon fit­ness. Peo­ple didn’t need to do more aer­o­bics to find enlight­en­ment. They need­ed reflec­tion and to be present in the moment.

So, I insist on aer­o­bic fit­ness as the first goal of a fit­ness reg­i­men. In the pre/postnatal field, this is the only con­sis­tent­ly demon­strat­ed fac­tor in improved out­comes. As a birth prepa­ra­tion there are Yoga-based fac­tors that will help in labor and birth IF THE WOMAN IS FIT ENOUGH. It is the fact that some Yoga-based skills help fit peo­ple find nin that is my jus­ti­fi­ca­tion for con­tin­u­ing to use them in con­junc­tion with aer­o­bics and spe­cial pre/postnatal prepa­ra­tion and recov­ery exer­cis­es.

But, there are cau­tions. Not all Yoga assanas (posi­tions) are safe for preg­nan­cy. Down-dog, in par­tic­u­lar, scares me because of inci­dents report­ed in obstet­ri­cal lit­er­a­ture in the 1980s and 1990s that indi­cate such a posi­tion is impli­cat­ed in fatal embolisms. Some shapes are just not doable and oth­ers become less com­fort­able over time. The ones that work have been iden­ti­fied since the 1940s and 1950s and inte­grat­ed into birth prepa­ra­tion cours­es.

What’s Next?

All exer­cise com­po­nents -

  • Mind/Body
  • Strength
  • Flex­i­bil­i­ty
  • Aer­o­bic or Car­dio­vas­cu­lar Fit­ness

- are nec­es­sary for a bal­anced fit­ness rou­tine. Too much empha­sis on any one fac­tor often results in injury. Aer­o­bics is where the great­est health ben­e­fits reside. Recent research has demon­strat­ed that it is phys­i­cal “fit­ness” (which we can mea­sure) as opposed to just spend­ing time in phys­i­cal activ­i­ty (which can be a wide range of inten­si­ties) that is respon­si­ble for improved health out­comes. Strength and flex­i­bil­i­ty train­ing need to be pur­po­sive. There are things we don’t need to do unless we are going to play pro foot­ball or dance Swan Lake! Mind/Body skills help us recov­er and pre­pare.

I for one will be glad when we get beyond yoga and back to cross train­ing!

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Pregnancy Pathway, Pregnancy — Nutrition

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Fresh fruit = vitamins & minerals!!

Fresh fruit = vit­a­mins & min­er­als!!

Ques­tion:

How many extra calo­ries do you need in each trimester to off­set the meta­bol­ic cost of preg­nan­cy?

Answer:

First trimester — 0; Sec­ond trimester — 300; Third trimester — 500 (source: Insti­tute of Med­i­cine).

Keep in mind that you may also need calo­ries for any fit­ness pro­gram you are doing. If you are con­tin­u­ing a pro­gram, the only change is due to the preg­nan­cy.

If you begin or increase your activ­i­ty, you need to take that into account. One yoga class = 100 — 150 calo­ries. One aer­o­bics class = 200–400 calo­ries. Walk one mile = 100 calo­ries.

1 slice whole grain bread = 50-100 calories

1 slice whole grain bread = 50–100 calo­ries

Be sure you read food labels so that you can bal­ance your food intake and your calo­rie out­put. A small woman (under 5′3″ & 130 lbs.) prob­a­bly needs about 1200 calo­ries per day as a base. A medi­um sized woman needs about 1400, and a large woman (over 5′9″ & 160 lbs.) prob­a­bly needs 1600 to 1800 calo­ries. Add your activ­i­ty and preg­nan­cy needs to your base amount.

Ques­tion:

What foods are nec­es­sary for a healthy preg­nan­cy?

Answer, part A:

PROTEIN. Lean pro­teins like turkey and those with omega 3 fats like ocean fish and eggs.…yes! EGGS!

Turkey is a good protein

Turkey is a good pro­tein

Ocean fish 1 or 2 times/wk = good protein & omega 3 fat

Ocean fish 1 or 2 times/wk = good pro­tein & omega 3 fat

Eggs are a perfect pregnancy food!

Eggs are a per­fect preg­nan­cy food!

70–90 grams of pro­tein are nec­es­sary each day, along with  ade­quate water.  These are need­ed to make an extra 40% blood vol­ume required to sup­port the pla­cen­ta.

Answer, part B:

WATER. Two (2) quarts of water…more if you are very active…are need­ed to make extra blood and to pre­vent dehy­dra­tion.

Ques­tion: What else?

Fresh vegetables also provide fiber

Fresh veg­eta­bles also pro­vide fiber

Answer: CARBS. Fresh, col­or­ful fruits & veg­gies pro­vide nec­es­sary vit­a­mins and min­er­als, as well as fiber. Eat 5 serv­ings a day from all the col­ors:  yel­low, orange, red, pur­ple and green, and you will get live vit­a­mins all day long that help your baby devel­op prop­er­ly! Fruits, veg­eta­bles and whole grains are low glycemic index car­bo­hy­drates — the good ones!

Dairy provides calcium

Dairy pro­vides cal­ci­um

Ques­tion:

Do I need dairy prod­ucts and red meat? Can I get the need­ed min­er­als in oth­er ways?

Answer:

Cal­ci­um is need­ed in ade­quate amounts for bones and teeth. It is most eas­i­ly obtained by drink­ing milk or eat­ing cheese, yogurt or cot­tage cheese. Soy, dark green leafy veg­eta­bles and cal­ci­um for­ti­fied juice are alter­na­tives.

Iron is nec­es­sary for red blood cells to take up oxy­gen. It is found in high amounts in beef,  and less­er amounts in raisins, spinach, and prune juice. Pre­na­tal vit­a­mins are your insur­ance against defi­cien­cies of these essen­tial min­er­als.

Ques­tion:

Any­thing else that’s essen­tial?

Answer:

Yes! Healthy FAT!!

Avocado is an excellent source of omega 6 fat

Avo­ca­do is an excel­lent source of omega 6 fat

In addi­tion to omega 3 fats found in fish, wal­nuts and flax seeds, you need also need omega 6 fats, which are found in avo­ca­dos, olive oil and oth­er veg­etable oils. Healthy fats help bal­ance car­dio­vas­cu­lar con­stric­tion and dila­tion, reduc­ing the risk for hyper­ten­sion.

Last Ques­tion:

What is a healthy weight gain?

Answer:

In 2009, the Nation­al Acad­e­my of Sci­ences revised its rec­om­men­da­tions. It now bases desir­able weight gain on pre-preg­nan­cy BMI (Body Mass Index…google this!).

BMI less than 18.5 (low) — 28 to 40 lbs.; BMI between 18.5–24.9 (nor­mal) — 25 to 35 lbs.; BMI 25.0 to 29.9 (high) — 15 to 25 lbs.; obese women (BMI over 30.0) — 11 to 20 lbs.

Com­ing Next: Avoid­ing Risks.

Pregnancy Pathway — Exercise

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How lucky is this? Just a few days ago, yet anoth­er study was released and has been cir­cu­lat­ing on Med­scape and oth­er med­ical sites that indi­cates exer­cise is ben­e­fi­cial in preg­nan­cy, whether the moth­er is a pre­vi­ous exer­cis­er or not. Just in time for this entry!

Behavior Affects Pregnancy Outcome

Behav­ior Affects Preg­nan­cy Out­come

Phys­i­cal exer­tion (we call it “exer­cise” nowa­days) is a nor­mal state for healthy humans. Only in the last cen­tu­ry has the desire to rest or the need to store extra calo­ries as fat become more pos­si­ble to achieve than our need to move about to sur­vive.

Preg­nan­cy is a state in which both of these fac­tors (rest­ing and stor­ing calo­ries) are enhanced through organ­ic changes in body chem­istry, adap­ta­tions that favor fetal sur­vival. The cur­rent seden­tary lifestyle exag­ger­ates these meta­bol­ic changes and results in syn­dromes that increase the risk for a num­ber of meta­bol­ic, car­dio­vas­cu­lar and immuno­log­i­cal dis­or­ders of preg­nan­cy.

When con­front­ed by the idea that it is coun­ter­in­tu­itive to think exer­cise in preg­nan­cy might be safe (let alone ben­e­fi­cial) I am dumb­found­ed. To me, it is coun­ter­in­tu­itive to think that a seden­tary lifestyle in preg­nan­cy might be safe!

Burning Calories in Pregnancy Improves Outcomes!

Burn­ing Calo­ries in Preg­nan­cy Improves Out­comes!

What is the evi­dence that exer­cise in preg­nan­cy is ben­e­fi­cial? Keep in mind that some stud­ies have been exe­cut­ed more expert­ly than oth­ers. But, what is com­pelling is that numer­ous well-respect­ed researchers have sought to test the hypoth­e­sis that exer­cise is not safe, but come away with results that indi­cate the oppo­site!

Here are some of the major find­ings:

• The pla­cen­ta is larg­er and has more trans­port sur­face in exer­cis­ers than seden­tary women

• The fetus­es of (aer­o­bic) exer­cis­ing moth­ers make ben­e­fi­cial car­dio­vas­cu­lar adap­ta­tions

• Women who do aer­o­bic exer­cise are less like­ly to devel­op severe preeclamp­sia or ges­ta­tion­al dia­betes, and the long term health prob­lems that accom­pa­ny these dis­or­ders

• Women who are aer­o­bi­cal­ly fit recov­er from birth 10 times faster than seden­tary women (as mea­sured by time need­ed to metab­o­lize free rad­i­cals pro­duced in labor)

• Women who exer­cise in preg­nan­cy are more like­ly to be phys­i­cal­ly fit in midlife

• Babies of aer­o­bi­cal­ly fit women are at reduced risk for pre­ma­tu­ri­ty and low birth weight
DTP_mover2
So, we have arrived at the take-home mes­sage: MOVE!! Preg­nan­cy works best when you move and burn calo­ries in a mod­er­ate to vig­or­ous fash­ion. But, alter­nate this activ­i­ty with rest and good nutri­tion, and be sure to stay well hydrat­ed.
If you want more specifics and resources on this top­ic, try these:
“Women and Exer­cise” in Varney’s Mid­wifery.

Pregnancy Pathway, Conception — Health Status

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Today: How the mother’s health sta­tus at the time of con­cep­tion affects the preg­nan­cy.

For com­plete graph­ic, see Feb. 5 or 23 post.

The Impact of Health Status at the time of conception.

The Impact of Health Sta­tus at the time of con­cep­tion.

When a woman becomes preg­nant, her health can be a major fac­tor how her preg­nan­cy will pro­ceed. If she has been exposed to a vir­u­lent infec­tion, it may have an impact on how well the implan­ta­tion goes. If she has meta­bol­ic syn­drome, she is at risk for com­pli­ca­tions such as ges­ta­tion­al dia­betes.

On the oth­er hand, if she has tak­en care of her­self, is phys­i­cal­ly fit and well nour­ished, is well rest­ed and has not been exposed to ill­ness­es that induce dra­mat­ic changes in her immune sys­tem, she has done her best to cre­ate a sit­u­a­tion in which her body is best pre­pared for the rig­ors of preg­nan­cy.

There are still genet­ic and envi­ron­men­tal fac­tors that can affect the course of the preg­nan­cy, but behav­ior is the one fac­tor that women have con­trol over. At Danc­ing Thru Preg­nan­cy we are fond of the notion that if you know a cer­tain behav­ior is the best for a sit­u­a­tion, it is smart to chose that behav­ior; if you do not, you are sab­o­tag­ing your­self.

So, if preg­nan­cy is in your head­lights, eat right, exer­cise, and be cau­tious about expo­sure to ill­ness and infec­tion. Wash your hands, use one of the hand cleansers, prac­tice safe sex (okay, so if you are try­ing to get pg, this may change, but in the mean­time!).

We wel­come com­ments on what you are doing to be healthy for preg­nan­cy!

Curl-up! Strong abs are part of physical fitness!

Curl-up! Strong abs are part of phys­i­cal fit­ness!

Pregnancy Pathway, Preconditions

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Please refer to Feb­ru­ary 5 entry for com­plete graph­ic. Today we turn to the ques­tion of pre­con­di­tions to preg­nan­cy and how they might affect mater­nal and off­spring health.

Preconditions

Pre­con­di­tions

Pre-exist­ing fac­tors that can influ­ence health out­comes include genet­ic fac­tors (fam­i­ly risk for heart dis­ease, for exam­ple), envi­ron­men­tal fac­tors (liv­ing in a build­ing with mold, for exam­ple), and behav­ior (eat­ing well and exer­cis­ing, for exam­ple). In each cat­e­go­ry, fac­tors will con­tribute to the health of the moth­er and even­tu­al­ly to off­spring health.

It is impor­tant to under­stand what major genet­ic fac­tors may affect your off­spring and whether the envi­ron­ment or behav­ior can help off­set neg­a­tive fac­tors. For exam­ple, there may be a his­to­ry of preeclamp­sia dur­ing preg­nan­cy in your fam­i­ly, but vig­or­ous aer­o­bic exer­cise in the six months pri­or to preg­nan­cy pro­vides a high degree of pro­tec­tion from this risk. Preeclamp­sia puts both moth­er and off­spring at risk for com­pli­ca­tions.

Oth­er genet­ic fac­tors that may be of con­se­quence include autoim­mune dis­or­ders, aller­gies, and meta­bol­ic syn­dromes. For exam­ple, so-called “thrifty genes” may pre­dis­pose you to a high weight gain in preg­nan­cy. But, you may be able to off­set health prob­lems asso­ci­at­ed with this by stay­ing active and eat­ing well.