This week Dr. Sears answers questions he gets pertaining to diet and pregnancy. Learn about the role diet plays in fertility, conception and the health of mom and baby.
Q: Dr. Sears we know that diet is important prior to conceiving and during gestation. What nutrients do you recommend women get enough of if they are thinking about conceiving or once they find out their pregnant?
A: Infertility is a growing problem and I believe that inflammation is a major contributor to that situation. That’s why I recommend both females and males contemplating conception consume an anti-inflammatory diet. Such a diet is not to lose excess body fat, but to reduce inflammation and establish the hormonal balance that makes it more likely for successful procreation. Such an anti-inflammatory diet is adequate in low-fat protein, moderate in carbohydrates (but rich in fruits and vegetables), and low in fat (especially saturated fat). The most important supplement for both males and females to improve the success of conception would be omega-3 fatty acids because of their hormonal benefits in reducing inflammation in females and improving sperm quality in males. Once the mother is pregnant, her nutrition becomes paramount for the baby. This means following the same anti-inflammatory diet during pregnancy and especially focusing on fiber rich foods (especially fermentable fiber) for her gut health.
Q: Most physicians recommend taking an omega-3 supplement when pregnant. Generally this is about 250-500mg or so of EPA and DHA. Do you think this is enough?
A: I think that 250-500mg is too low a dose to reap all the benefits that come from omega-3 supplementation. For general wellness I recommend individuals consume about 3000 mg of EPA and DHA per day and this is the same amount I’d recommend for pregnant women too.
Q: Do you need more omega-3s as pregnancy goes on or can you continue with the same dose?
A: Throughout pregnancy I recommend women stay with the same dose of 3000 mg of EPA and DHA per day. This is because in the last trimester of pregnancy the fetus is making about 250,000 new brain cells per minute and that requires a lot of omega-3 fatty acids.
Q: Once you deliver the baby can you stop taking omega-3s?
A: I wouldn’t recommend it. Omega3 fatty acids only last about 24-48 hours in the blood so it requires you take a consistent dosage regularly. During the pregnancy, the fetus has been depleting the omega-3s from the mother’s reserve to develop its brain. What this means is that after the birth of the child, the mother can develop a sense of depression without continued omega-3 supplementation to replace her internal stores. I recommend staying either with the same dose or and you may even need to bump up the dosage after delivery especially if the mother is breast feeding to ensure adequate levels of EPA and DHA in her breast milk. I always recommend testing the levels of omega-3s in your blood to determine what dose is right for you by keeping your AA/EPA ratio between 1.5 and 3.
Q: What are the benefits of omega-3s for both mom and child?
A: EPA and DHA the omega-3s found in fish oil are known for their role in supporting heart health, a healthy immune system and inflammatory response as well as supporting eye and brain development. They’ve also been shown to help minimize the risk of allergies in children. They work by increasing the production of the hormones known as resolvins that are key to maintaining low levels of inflammation in both the mother and the child.
Q: What do you look for in an omega-3 supplement?
A: The vast majority of fish oil products use the same raw material (sardines and anchovies), but what separates one from the other is their purification to remove toxins that are found in all fish oil products. Polychlorinated biphenyls (PCBs), are the most difficult toxins to remove from fish oil. That is why my standards for PCBs (less than 2 parts per billion) are 25 times more stringent than pharmaceutical standards and 45 times more rigid than those established for the dietary supplement industry. You also want to look at the total amount of EPA and DHA since that is where the health benefits of omega-3s come from. OmegaRx 2 supplies 750mg of EPA and DHA per gram (1 capsule). This is the highest purity fish oil with the highest amounts of EPA and DHA currently offered in the marketplace without a prescription. Each serving of OmegaRx 2 (4 capsules or 1 tsp) supplies 3000mg of EPA and DHA. Purity and potency are most important when looking to take an omega-3 supplement. But you also have to look at the price. Based on the cost per gram of EPA and DHA, OmegaRx 2 is probably the least expensive source of EPA and DHA (based on cost per gram) with the highest purity and the greatest potency.
Q: When you have morning sickness the last thing you can stomach is fruits, vegetables or even protein. It seems like crackers and ginger ale becoming the diet of choice. What do you recommend for women with morning sickness?
A: Pregnancy isn’t easy and morning sickness can be unbearable for some women. Morning sickness tends to decline as the pregnancy continues. My recommendation is try and keep up with your omega-3s and prenatal vitamin to cover your bases and the meals where you are feeling good try and get in as many vegetables and fruits you can even if it’s by adding it to a shake, with some protein powder, and some monounsaturated fat.
Q: Can fish oil help with some of the aches and pains of pregnancy?
A: Yes. Carrying around extra weight can take its toll especially in pregnancy with the pressure on the joints and stretching. The anti-inflammatory properties of omega-3 fatty acids have been shown to help with joint support and to help minimize some of the inflammation that results in pain.
Q: Women who might not struggle with high blood sugar or high blood pressure prior to becoming pregnant might start to have these numbers creep up during pregnancy or even lead to gestational diabetes and pre-eclampsia. Can diet and supplementation help?
A: The Zone diet is really ideal for individuals who are looking to support healthy blood pressure and healthy blood sugar. The Zone diet is not a weight loss diet, but an anti-inflammatory diet. I like to think of it as an anti-inflammatory lifestyle.Inflammation underlies many of these conditions associated with pregnancy. Omega-3s have been clinically shown to help support healthy blood pressure. Polyphenols which give fruits and vegetables their color, especially polyphenols found in berries known as delphinidins, may further help with blood sugar control. That’s why I consider all three dietary components (diet, omega-3 fatty acids, and polyphenols) to be important during pregnancy as well as afterwards whether the mother is nursing or not.
Q: If you can’t swallow fish oil capsules, what would you recommend?
A: Liquid fish oil is a great alternative for individuals who can’t swallow capsules or who require higher amounts of omega-3s. You can add the liquid omega-3 fatty acids to some high-quality olive oil (rich in polyphenols) and take it orally. Better yet, you can make an emulsion by adding some dry lecithin to about 3-4 ounces of water and the liquid omega-3 and then blend them with a high-speed hand blender. If you can swallow smaller capsules, but not the standard size microcapsules might be an option too. 
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