Preterm Birth? It Was the Cookies
It seems there may be some wisdom in the traditional cultural practice of sanctioning nutrient-dense foods for preconception couples, and engaging in several months of preparatory care. The first of its kind, a study by Greiger et al entitled Preconception Dietary Patterns in Human Pregnancies Are Associated with Preterm Delivery has attempted to quantify the potential negative impact of poor dietary choices before pregnancy on pregnancy outcomes. As is the current standard in evaluation of adverse exposures in pregnancy, this study looks only at gross birth outcomes and not at longitudinal neurodevelopmental, metabolic, or carcinogenic risks that may have been seeded by toxic preconception and antenatal influences.
Since my involvement in the perinatal world, it has long irked me that cohort studies purporting to assess the impact of exposures such as medications, do not control for underlying risk factors such as nutrient-poor processed diet and associated inflammation – the current explanation for births gone awry.
Despite being a retrospective (think – women had to recall what they ate the previous year) cross-sectional study, researchers were able to observe distinct dietary patterns with statistically significant associations to preterm birth – women who ate processed food were 50% more likely to deliver prematurely (<37 weeks). They conclude:
“In conclusion, nutrition before pregnancy is associated with perinatal outcomes. A dietary pattern containing fish, meat, chicken, and fruit and some whole grains is associated with reduced likelihood for preterm delivery, whereas a dietary pattern mainly consisting of discretionary items, such as takeaway foods, potato chips, refined grains, and added sugar, is associated with preterm delivery and shorter birth length. Dietary intake is an important modifiable risk factor, and our work highlights the importance of promoting a healthy diet before pregnancy and acknowledges that behavior change strategies might be necessary during pregnancy to improve perinatal outcomes and the longer-term health of the child”
With a focus on macronutrients – protein, fats, and carbohydrates – the discussion is limited with regard to the nuances of food as information. Firstly, a high fat diet has become synonymous with one rich in distorted, heated, and processed vegetable oils rather than the naturally occurring fats in an ancestral model of eating. Secondly, we are learning more every day about the information that is contained in real food, that so far surpasses what can be quantified on a package label. This information is was links our genes and their optimal expression to our own ecology in the microbial community we all live in, as well as to our greater environment of living entities. Stay tuned for a more detailed post on my preconception dietary recommendations!
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