Drs. Magryta and Grey: Maternal and child health, part 3

Third in a series of four on maternal and child health

In the Journal Pediatrics from April 2017, a team of doctors wrote a lengthy supplement called the "research gaps at the intersection of pediatric neurodevelopment, nutrition, and inflammation in low resource settings." We are going to attempt to distill this comprehensive review into palatable bites.

"Accumulating data from animal and human studies indicate that the prenatal environment plays a significant role in shaping children's neurocognitive development. Clinical, epidemiologic, and basic science research suggests that two experiences relatively common in pregnancy - an unhealthy maternal diet and psychosocial distress - significantly affect children's future neurodevelopment."

Our experience over the years of private obstetric and pediatric medicine is that the above statement is correct and that vaccines are not involved in the outcome neurologically. We make this statement because we care about every child and the disinformation in society is rampant regarding vaccinations.

What do we know?

First, myriad studies prove that maternal malnutrition is associated with poorer infant outcomes in general. In the British Medical Journal, Dr. Martin Neovius looked at 1.2 million live births and found that "Risks of any major congenital malformation increased with maternal overweight and increasing severity of obesity." By definition, these mothers are calorically overloaded but nutritionally deprived. Maternal depression and undernutrition are associated with poorer neurological outcomes in offspring.

The mechanisms underpinning these poor outcomes in children are likely related to the thousands of biochemical and epigenetic pathways that are negatively affected by inappropriate micronutrient and macronutrient volumes coupled with stress induced elevated hormone levels bathing the fetus throughout pregnancy.

The research is clear that maternal insufficiencies of iron, zinc, choline, folic acid, B12 and many other micronutrients are each independently associated with disease risk, especially where it relates to neuro-cognition.

For example, Dr. Steven Zeisel and his group out of the local research campus in Kannapolis have published many papers on the effects of maternal choline on newborns.

A diet of poor-quality American fast food and heavily processed food is missing the basic nutrients for an optimal outcome. The fetal brain is growing rapidly with over 100,000 new cells per minute at its peak. If a mother consumes a calorie-rich and nutrient-poor diet during critical periods of brain development, the outcome is suboptimal or worse.

Animal and human studies have also proven that malnutrition, which can be defined as under- and over-nutrition, has long-term negative effects on gene regulation. Dr. Moshe Szyf's work specifically noted that conserved epigenetic effects from maternal stress can carry on for generations.

In other words, if a mother is chronically negatively stressed during pregnancy, the infant will have worse stress responses over his or her lifetime as well as the next few generations' responses.

Dr. Randy Jirtle's Agouti mouse studies proved that food-based natural compounds can beneficially change a gene's on/off status to stop disease in an offspring. His colleague, Dr. Dana Dolinoy, followed up on his work by looking at the effects of a synthetic plastic chemical called bisphenol A on the same pregnant mouse model. The plasticizer had an opposite effect on the same cassette of genes leading to a disease state.

The take-home point from these studies is that food-based nutrition has a positive effect on offspring gene function, while synthetic chemicals have an opposite and deleterious effect.

Let us put all of this together in a nice box. We have a major problem in modern society. The science is very clear that mothers are wonderful vessels of child development when treated well. When a mother is stressed, exposed to chemicals and/or poorly fed, her offspring will not have the best chance of neurological success.

In a society of significant riches, we need to support mothers in every way possible for their sake and equally so for the next generation's optimal outcome.

The answer to this issue has been around for millennia. As with the Blue Zones data, we need to physically move, eat a healthy, predominantly vegetable-based whole-foods diet, avoid chemicals and support each other as a village and family.

Dr. Chris Magryta is a physician at Salisbury Pediatric Associates. Contact him at newsletter@salisburypediatrics.com

Dr. Erin Grey is a physician at Novant Health Carolina Women's Health Associates.