Natural Health News — Women who take fish oil supplements and probiotics in later pregnancy may reduce their child’s risk of food allergy and eczema, according to new research.

In one of the largest ever research reports of how a pregnant woman’s diet affects her baby’s allergy and eczema risk, scientists from London’s Imperial College assessed over 400 studies involving 1.5 million people.

As part of the study, they found that when pregnant women took a daily fish oil capsule from 20 weeks pregnant, and during the first three to four months of breastfeeding, risk of egg allergy in the child was reduced by 30%.

The team also found that taking a daily probiotic supplement from 36-38 weeks pregnant, and during the first three to six months of breastfeeding, reduced the risk of a child developing eczema by 22%.

The researchers, who published their meta-analysis in the journal PLOS Medicine, found no evidence that avoiding potentially allergenic foods such as nuts, dairy and eggs during pregnancy made a difference to a child’s allergy or eczema risk.

Dr Robert Boyle, lead author of the research from the Department of Medicine at Imperial College London, explained: “Food allergies and eczema in children are a growing problem across the world. Although there has been a suggestion that what a woman eats during pregnancy may affect her baby’s risk of developing allergies or eczema, until now there has never been such a comprehensive analysis of the data.”

He added: “Our research suggests probiotic and fish oil supplements may reduce a child’s risk of developing an allergic condition, and these findings need to be considered when guidelines for pregnant women are updated.”

The team also assessed a host of dietary factors during pregnancy including fruit, vegetable and vitamin intake, but found no clear evidence that any of these affected allergy or eczema risk.

Allergies, eczema still not well understood

Allergies to foods, such as nuts, egg, milk or wheat, affect around one in 20 children in the UK. They are caused by the immune system malfunctioning and over-reacting to these harmless foods. This triggers symptoms such as rashes, swelling, vomiting and wheezing.

Eczema affects around one in five children in the UK, and causes dry, cracked and itchy skin. The causes of eczema and allergies are not fully understood, but allergies are more common in people who suffer from eczema.

More research is now needed to understand how probiotics and fish oils may reduce allergy and eczema risk, said Dr Vanessa Garcia-Larsen, co-author of the study from the National Heart and Lung Institute at Imperial: “Despite allergies and eczema being on the rise, and affecting millions of children, we are still hunting for the root causes of these conditions, and how to prevent them.”

Dr Garcia-Larsen added: “This study has provided clues, which we now need to follow with further research.”

Significant benefits

In the current study, the team assessed 28 trials of probiotic supplements during pregnancy, involving around 6,000 women. Probiotics contain live bacteria that may influence the natural balance of bugs in the gut. Previous research has linked a disruption in naturally-occurring bacteria to allergy risk.

In the research, probiotics were taken during pregnancy and breastfeeding as a capsule, powder or drink (most yogurts do not contain enough probiotic). They were found to reduce the risk of a child developing eczema – between the ages of six months to three years – by 22%. This is the equivalent of 44 cases of eczema per 1000 children.

The scientists added that the probiotics, which mostly contained a bacterium called Lactobacillus rhamnosus, were not used in early pregnancy.

The team also assessed around 19 trials of fish oil supplements during pregnancy, involving around 15,000 people. These studies revealed a 30% reduction in risk of egg allergy by age one, which equates to a reduction of 31 cases of egg allergy per 1000 children. Egg allergy was tested with a skin test, where a tiny amount of egg is pricked onto the skin.

In the studies using fish oil supplements, the capsules contained a standard dose of omega-3 fatty acids (another type of fatty acid, called omega-6, was not found to have any effect on allergy risk).

Dr Boyle added that previous research suggests fish oils may help dampen down the immune system, and prevent it from over-reacting.

Most of the trials used supplements, although one involved eating oily fish, and a few others used non-fish oils such as nut oils. The Department of Health advises women to eat no more than two portions of oily fish a week, and to avoid shark, swordfish or marlin as these contain high levels of mercury.

The team also found that taking fish oil supplements during pregnancy reduced the child’s risk of peanut allergy by 38%. However they caution this finding was based only on two studies, and not as reliable as the egg allergy and eczema results.

Breastfeeding gives kids an immune boost too

The study also revealed some evidence for links between longer duration of breast feeding and a reduced risk of eczema, and breastfeeding was also linked with a lower risk of type one diabetes.

The findings of this study, funded by the Food Standards Agency, are being considered by the Government alongside the wider evidence base on infant feeding and the introduction of solids. As part of the cross-government review of complementary feeding, the risks and benefits associated with the timing of introduction of allergenic foods will also be considered.

The UK Food Standards Agency, which funded the study, advises that families should continue to follow the current Government advice to exclusively breastfeed for around the first six months of age, and continue breastfeeding thereafter. Solid foods should be introduced into the infant diet at around six months of age. Pregnant women should also continue to follow government dietary and supplement advice.

With regard to maternal and infant diets the review concludes that “current infant feeding guidance needs revision” and add that “guideline committees will need to carefully consider the key findings together with an evaluation of the safety, acceptability, and cost implications of advising probiotic or fish oil supplementation for pregnant and lactating women”.

According to a review published in Endocrine Connections rising levels of chemical production has led to “widespread environmental chemical contamination.” The researchers from the Centre National de la Recherche Scientifique, Université Paris-Sorbonne, further warn that current public health policy “does not fully address the risks to vulnerable populations.”

Widespread environmental contamination

Maternal thyroid hormones are essential for normal brain development of children and previous human studies have indicated that even moderate disruption to these hormones in pregnant women may affect cognitive development (e.g. IQ and mental abilities) and increase the risk of brain developmental disorders in their children.

In recent decades, an increase in chemical production has led to widespread environmental chemical contamination that can affect normal hormone function in those exposed, particularly in vulnerable populations, such as children and pregnant women.

Many of these identified endocrine-disrupting chemicals (EDCs), which include pesticides as well as chemicals used in the manufacture of drugs, cosmetics, furniture and plastics, have been reported to interfere with thyroid hormone function.

The authors further highlight that complex mixtures of these thyroid-disrupting chemicals are present in all humans, including children and pregnant women.

The risk is real

Lead researcher Prof Barbara Demeneix says that having reviewed data on pregnant women’s exposure to these chemicals, her team is convinced that the risk is real and that the data provide “a plausible link to the recent increased incidence of neurodevelopmental conditions, including autism spectrum disorders and attention deficit hyperactivity disorders.”

Prof Demeneix continues, “Many experts in the field, consider that the current testing guidelines for thyroid-disrupting chemicals are not sufficiently sensitive, do not take into account recent findings and do not adequately consider risks to vulnerable populations, such as pregnant women.”

Maternal depression during pregnancy can affect both the mother and her family. Although research has suggested that iron deficiency is associated with depression in the general population, this link has not been studied during the antenatal period.

To find out more Canadian researchers looked back at the records of women between the ages of 18 and 25 who were in middle to late pregnancy and who visited the Women’s Health Concerns Clinic in Hamilton, Ontario, in the period between 2009 and 2016. This particular hospital specialised in treating mood and anxiety disorders during the perinatal period, ​the researchers wrote in their report​​, which was published this month in the Journal of Obstetrics and Gynaecology Canada.

In addition to information on mood disorders the records also showed whether the women were iron deficient or not

This data showed that 31% of women were iron deficient. On average, those women who were iron deficient also scored higher on questionnaire, used to determine the presence of depression, than pregnant women with normal iron levels.

A potential risk factor

“The study of women in the second or third trimester of pregnancy suggests that a link exists between iron deficiency and antenatal depression”, ​the researchers wrote.

Even after adjusting for confounding variables, the findings persisted, the researchers argued, suggesting that “iron deficiency could be an important risk factor for the development of depression during pregnancy.”​

This was a small study and the researchers say that because the women studied were already at rick of mood disorders, the results may not be true for all pregnant women. They also added that the study design didn’t account for nutritional status of patients during pregnancy, and the iron deficiency may be a marker of poor nutrition in general.

Nevertheless they suggest that, but added that in spite of this “clinicians providing antenatal care may benefit from an awareness of the possible role of iron deficiency in the development and risk of maternal depression during pregnancy.” ​

• For more on this topic see our story Are supplements in pregnancy ‘unnecessary’?

In a small study published in the journal Phytomedicine, researchers at the Mashhad University of Medical Sciences in Iran, found that the 30 new mothers supplemented with 15 mg of saffron daily showed greater improvement in their symptoms compared to the same number of new mothers who took a placebo.

The intervention period lasted eight weeks, during which study participants were not allowed to receive any other behaviour therapy.

Symptom severity was judged, based on responses to what is known as the Beck Depression Inventory questionnaire, the most widely used psychometric test measuring severity of depression.

The researchers noted that in Iran, as elsewhere some degree post-partum depression is normal.

“Numerous adverse effects of antidepressants as well as the attitudes of breastfeeding mothers, who prefer to consume herbal medicine rather than chemical drugs, encouraged us to assess the effects of saffron (Crocus sativus L) on mothers suffering from mild-to-moderate postpartum depressive disorder,”​ they write.

Saffron’s mental health benefits​

Most saffron supplements available are aimed at assisting weight loss and satiety. Recently there has been research to suggest that antioxidants in saffron could help protect ageing eyes. But there is also emerging science to suggest mental health benefits.

A meta-analysis by researchers at the University of Florida, Gainesville included five studies in which saffron was compared to placebo (two studies) or to conventional anti-depressant treatment (three studies). ​

Results suggested that saffron (the dosage was 30 mg per day of powdered saffron) is significantly better than placebo in improving symptoms of depression and more or less equivalent to standard pharmaceutical antidepressants (i.e., imipramine or fluoxetine).”

This latest study adds on to the existing evidence for the benefits of saffron for people suffering from mild to moderate depression.”

One of the most expensive spices

Saffron is derived from derived from the stigma of the flower Crocus sativus, commonly known as the saffron crocus. It is one of the world’s most expensive spices because the stigmas of each flower need to be collected by hand and there are only a few per flower. A pound of saffron can cost $1,500 (£1,100). By comparison, a pound of organic turmeric root powder can sell for around £8).

This might seem to put the remedy outside the reach of many mothers. But commenting on the various studies of saffron benefits Stefan Gafner, chief scientific officer of the American Botanical Council noted that, “Not all studies were carried out with saffron stigma (which is the rather expensive saffron plant part used as a spice), but quite a few were done with the saffron petals, which are much less costly”.​

He adds that even if the stigma are used, the dosage of 30 mg per day (twice what was used in the current study) is so low that it is possible to manufacture an affordable saffron supplement.

It’s worth noting that there is no evidence yet on the safety or effectiveness of saffron for post-partum depression breastfeeding mothers, nevertheless the early results from these small trials are encouraging.

Natural Health News — As the rate of caesarean operations increases, so does the risk of urinary tract infections after birth. But a natural remedy, derived from rosehips could help keep infection in check.

Caesareans raise the risk of urinary tract infections because they require the mother to be catheterised post-surgery. As bacteria become more resistant to treatment with conventional medications a urinary tract infection can be hard to treat.

Some natural remedies like cranberries have produced good results in human tests. But while laboratory ​studies demonstrate that rose hips -or fruits of the Rosa canina ​plant -prevent the growth of UTI-causing bacteria Escherichia coli​, the researchers said that no clinical trials have been done yet looking specifically at the plant’s role in reducing post-partum UTIs, especially among women who have undergone caesareans.

A human trial

The triple-blind study, published in the journal Phytotherapy Research, involved 400 women recruited from two hospitals in Tabriz, in Iran who underwent a caesarean between August 2016 and March 2017. The women were divided into two groups of 200 women each taking either a rose hip supplement or placebo.

To be included, the women had to have had a caesarean in the 48 hours before they begin the intervention period, and to only have had a maximum of three doses of antibiotics post operation.

The doctors were looking for the incidence of any type of UTI during the 20-day follow-up.

Rich in vitamin C, flavonoids​

The capsules were made out of Rosa canina ​fruits procured from an herbalist in Tabriz and milled into a powder. For the placebo, starch powder was used.

A separate analysis of the capsules revealed that each contained 880 mg/100 mL of vitamin C, as well as flavonoids such as quercetin, which has been studied for its antibacterial effect.

The women took the rosehip or placebo capsules twice daily half an hour after meals with a glass of water. This period lasted from 48 hours after the caesarean and continued for 18 more days. The women were followed up with telephone calls to ascertain compliance with the regimen.

Significantly fewer UTIs​

After all women from both groups completed their intervention period, the researchers found that the total risk of UTI on the 7th​ to 10th​ days of the trial was significantly lower in the rose hip group compared to the placebo group.

For instance, only 4 women from the rose hip group had positive asymptomatic urine cultures, which means asymptomatic UTI, compared to 13 in the placebo group. After the 20^th ​day, just 3 women from the rose hip group had a UTI compared to 19 in the placebo group.

The results led the researchers to conclude that rose hip “can be used in post caesarean post-partum as an inexpensive and cost-effective substance for promoting maternal health.”​

It is also likely to be effective for the general treatment of UTIs as an alternative to conventional medications and as a natural therapy to stand alongside cranberries.

The positive effect of the herbal remedy, say the researchers from the University of Medical Sciences in Tabriz, could be due to the high vitamin C levels which can help prevent UTI through its antioxidant properties.

Analysis of two similar trials – one in the US and the other in the Australia – in which pregnant women took daily docosahexaenoic acid (DHA) supplements, found that both had found statistically significant reductions in early preterm birth.

Infants born very preterm often require lifesaving treatments and longer hospitalisations at birth and are at increased risk for additional hospitalisations in the first year of life – and that is in the developed world. Further, these infants are at risk for serious disability or death the earlier they are born.

“At present there is no effective method to prevent spontaneous early preterm birth,” said Susan Carlson, AJ Rice Professor of Nutrition at the University of Kansas Medical Center, and co-author of the analysis. “Our recent studies suggest that DHA could be a promising agent for reducing this critical public health problem.”

Significant reductions in preterm birth

The two studies looked at low-, moderate- and high-risk births in mothers supplemented with DHA during pregnancy as compared to mothers taking a placebo. The researchers estimated that more than 106,000 high-risk early preterm births could be avoided in the US and about 1,100 could be prevented in Australia each year if pregnant women took daily supplements of the omega-3 fatty acid.

To put the numbers in perspective the researchers suggest that the findings suggest that early preterm births could be reduced to only 1.3% in Australia or 1.5% of births in the US a figure they say may represent the lowest rate for pre-term birth that can be achieved in any population.

A daily dose

The US and Australian studies supplemented mothers with 600 mg and 800 mg DHA per day respectively and this was found to be particularly effective for women at higher risk for early preterm birth.

DHA is an omega-3 fatty acid that occurs naturally in cell membranes with the highest levels in brain cells. Humans and other mammals are able to make their own DHA from other fatty acids, but this is dependent on the quality of individual diets. Modern diets are low in DHA and most nutritionists advise topping up with supplements as the best way to ensure adequate levels.

Babies obtain DHA from their mother in utero and postnatally from human milk, but the amount received depends upon the mother’s own DHA status.

“US women typically consume less DHA than women in most of the developed world,” Carlson said noting that the intake of DHA in both the US and Australia is, for example, well below that reported by Japanese women.

The study was published in Prostaglandins, Leukotrienes and Essential Fatty Acids.

Women traditionally have been told to avoid eating or drinking during labour due ‘just in case’ they need emergency care with  a general anesthetic – which raises the risk they may aspirate, or inhale liquid or food into their lungs, which can cause pneumonia.

But when researchers reviewed the literature of hundreds of studies on the topic, published in 1990 or later, they determined that withholding food and liquids may be unnecessary for most women in labour.

Previous studies have identified a number of individual early life ‘risk factors’ but few have evaluated the size of their combined effects.

Scientists from the University of Southampton looked at five early life obesity risk factors: a short duration of breastfeeding (less than one month) and four maternal factors during pregnancy – obesity, excess pregnancy weight gain, smoking, and low vitamin D status.

Published in The American Journal of Clinical Nutrition, the research shows at age four, children with four or five of these factors were 3.99 times more likely to be overweight or obese than children who had experienced none, and fat mass was, on average, 19% higher.

By age six, the risk increased so that these children were 4.65 times more likely to be overweight or obese and fat mass was 47% higher. Importantly, these differences were not explained by other factors, such as the children’s quality of diet or physical activity levels.

The data analysed came from 991 children taking part in the Southampton Women’s Survey – one of the largest studies of mothers recruited before pregnancy, along with their infants and children.

A critical period

Professor Sian Robinson, who led the study, says: “Early life may be a ‘critical period’ when appetite and regulation of energy balance are programmed, which has lifelong consequences for the risk of gaining excess weight. Although the importance of early prevention is recognised, much of the focus is on school-aged children. Our findings suggest that interventions to prevent obesity need to start earlier, even before conception, and that having a healthy body weight and not smoking at this time could be key.”

Professor Cyrus Cooper, Director of the University’s MRC Lifecourse Epidemiology Unit comments: “This study is a very good example of the programme of multidisciplinary research being conducted at the Unit, in which we are seeking to understand the role of the mother’s diet and lifestyle as influences on the development and body composition of her child.

“The large differences in the risk of being overweight in childhood that were shown in this study highlight the importance of early life risk factors. These findings could have important implications for obesity prevention policy and will help us to design future interventions aimed at optimising body composition, with benefits for lifelong health.”

The study comes at the same time as a six part series in the medical journal the Lancet, shows that globally  progress toward tackling obesity has been “unacceptably slow”. In less than a generation, rates of child obesity have risen dramatically worldwide, yet few countries have taken regulatory steps to protect children or implemented recommended healthy food policies.

Gestational diabetes mellitus (GDM), which can occur in as many as 14% of all pregnancies, is characterized by carbohydrate intolerance and metabolic disorders.  It is more common in women who are overweight and can increase the risk of pre-eclampsia, pre-term delivery and delivery by caesarean section.

“We are aware of no study that has examined the effect of joint calcium-vitamin D supplementation on insulin function, lipid profiles, inflammatory factors and biomarkers of oxidative stress in GDM,” say the authors. “The current study was, therefore, done to investigate the effects of calcium plus vitamin D supplementation on metabolic status of pregnant women with GDM.”

This randomised placebo-controlled trial published in the journal  Diabetologia  researchers at the Isfahan University of Medical Sciences, Isfahan, Iran, studied 56 women with GDM. The women were randomly assigned to receive a daily placebo or a daily calcium (1000mg). In addition those women receiving 50000 IU (international units) vitamin D3 tablets two times during the study (at the beginning of the study and on day 21). Those in the placebo group also received two placebos at these same time points. Fasting blood samples were taken at the beginning of the study and at 6 weeks.

Metabolic improvements

The supplemented group showed significant reductions in fasting plasma glucose, insulin, and LDL or ‘bad’ cholesterol, as well as improvements in insulin sensitivity and increases in HDL or ‘good’ cholesterol, compared with those patients who took placebo.

The authors say: “Calcium plus vitamin D supplementation in GDM women had beneficial effects on metabolic profile”

This is important because elevated circulating levels of inflammatory markers and impaired insulin metabolism in GDM can predict the progression to type-2 diabetes  later in life and neonatal complications such as (babies large for gestational age, birth trauma, pre-eclampsia).

“In addition” the researchers note “increased inflammatory markers in GDM might predict the future development of both metabolic and cardiovascular disease.”