Fetal alcohol syndrome

fasExposure of fetus to alcohol

Although most nutrients are affected by alcohol intake, specific nutrients noted from numerous studies are thiamin, riboflavin, vitamin B-12, vitamin E, selenium, vitamin A, vitamin C, folic acid, vitamin D, zinc, and a few trace minerals. Alcohol is metabolized within hepatocytes by 1 of the 3 following pathways:

  • Alcohol dehydrogenase pathway (ADH): The first pathway, known as ADH, occurs in the cytosol of the hepatocyte (Fig. 2). ADH metabolizes ethanol to acetaldehyde, which is subsequently converted into acetic acid in mitochondria (20). In the ADH pathway, ethanol competes with vitamin A, or retinol, for metabolism because both substrates are metabolized by the same pathway (this is discussed later). Ultimately, ethanol is oxidized, which leads to the production of acetaldehyde and large amounts of NADH.

Alcohol effects on vitamin A

Alcohol consumption during pregnancy depletes maternal vitamin A stores, which can interrupt normal cell growth of the fetus. The proposed mechanism for this is that when both retinol and alcohol are present, ADH involved in the rate-limiting step of retinol oxidation has a higher affinity to alcohol, therefore preferentially metabolizing alcohol instead of retinol. This results in a deficiency in retinoic acid synthesis (39, 40), which is required to signal and control the cells involved in fetal development, organogenesis, organ homeostasis, cell and neuronal growth and differentiation, development of the CNS, and limb morphogenesis (16, 40).

DHA

DHA is highly important during fetal development because it plays an essential role in cognitive and visual development, as well as the development of the CNS (53, 54). DHA is also a precursor of a potent neurotrophic factor (neuroprotectin D1), which protects the brain and retina against injury-induced oxidative stress and enhances cell survivals in these tissues. Thus, it is recognized as a conditionally essential nutrient for infants. There is no RDA for DHA, but the Adequate Intake (AI) for n–3 FAs for pregnancy is 1.4 g/d (55). DHA is esterified to membrane phospholipids to maintain optimal fluidity and cellular integrity. Among phospholipids, phosphatidylserine has been the most studied in association with CNS development (54, 56, 57). Optimal neuronal development of the fetus is dependent on maternal intake and dietary status of DHA. In humans, the accumulation and integration of DHA into phosphatidylserine and cell membranes occurs from 16 wk to term and continues into the early postnatal development period (53). It is specifically during the last trimester in which DHA is rapidly incorporated into phosphatidylserine synthesis and storage in the hippocampus, because it is during this period in which human brain growth rapidly occurs (57, 58).

Folate (folic acid)

Folic acid, a water-soluble vitamin, has been identified as an essential nutrient that may provide a protective effect against gestational ethanol exposure. For folic acid to become metabolically active, it must be reduced to tetrahydrofolic acid (FH4) as a carrier for single-carbon moieties. FH4 is involved in the biosynthesis of the DNA and RNA precursors thymidylate and purine bases (64). Therefore, adequate maternal folic acid status is integral for optimal fetal growth and development. During pregnancy, the demand for folic acid is increased because it is not only required to support the mother for increased RBC formation but also to support the rapid growth of the fetus, including neural tube formation (65). The RDA for folic acid during pregnancy is 600 μg/d (66), and dietary sources are found in green leafy vegetables, beef, liver, pulses, and foods produced from whole wheat.

Alcohol effects on zinc

Alcohol consumption on a chronic basis itself reduces the availability of zinc because there is decreased intake and absorption and increased urinary excretion. When acute zinc deficiency occurs as a result of ethanol exposure, metallothionein, a low-molecular-weight protein body, sequesters plasma zinc to the liver, resulting in a reduction in plasma zinc. This leads to decreased amounts available for placental transport, resulting in fetal zinc deficiency (81, 82).

Choline

Choline and its metabolites are invaluable in neurotransmission (acetylcholine), structural integrity of cell plasma membranes (phosphatidylcholine and sphingomyelin), and cell signaling and in folate-independent pathways as a methyl donor via its metabolite, betaine (42, 90). This nutrient is the most-studied nutrient related to brain development and memory function and has been classified as an essential nutrient by the Institute of Medicine and National Academy of Sciences in the United States (66).

Choline supplementation in animal models

A recent study looked at the effect of choline supplementation on specific neurons that are altered in FASD (94). Pregnant rat dams were fed an alcohol-containing liquid diet or a control diet during GDs 7 and 21 with or without choline (642 mg/L choline chloride). The results showed that gestational choline supplementation prevented the adverse effects of alcohol on the neurons (Table 1) (94). Previous research from Thomas and colleagues (9599) showed that perinatal choline supplementation can reduce the severity of FASD—specifically, hyperactivity and learning deficits in the rat model. The authors found that choline chloride supplementation (250 mg · kg−1 · d−1 choline chloride) prevented ethanol-induced alterations in tasks that require behavioral flexibility such as spontaneous alternation behavior and memory (Table 1) (98).

Antioxidants

Antioxidants are compounds that are produced to scavenge free radicals and other compounds that threaten cellular oxidation. Cells can neutralize and scavenge reactive oxygen species through the enzymatic activity of SOD, glutathione peroxidase (GPx), and catalase. Nutrients such as folate, vitamin C (ascorbic acid), vitamin E (α-tocopherol), selenium, and zinc are important contributors to antioxidant activity.

Selenium

Selenium is a micronutrient that serves as an important component for the generation of the enzyme GPx. GPx inhibits oxidation because it is involved in scavenging free radicals, specifically hydrogen peroxide, and converting them to harmless products such as water. Selenium-based GPx primarily is active within the cytosol or the mitochondria. The amount of selenium obtained from the diet is based on the amount in the soil or water where the food source was grown. Once consumed, it is predominantly stored in the liver, because alcohol metabolism in the liver produces various reactive oxygen species and free radicals. The RDA for selenium during pregnancy is 60 μg/d (105).

Alcohol effects on selenium.

Typically, selenium deposits and plasma concentratons are low in chronic alcoholics because of decreased dietary intake and increased production of free radicals resulting from alcohol metabolism (107). However, selenium concentrations in the plasma were reported to be increased and were significantly greater in women who drank heavily, defined as >140 g/wk, during their pregnancy in comparison to abstinent women and those who consumed alcohol moderately (108).

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Pregnancy changes the brain for as long as two years

For the first time, scientists have found evidence of specific and long-lasting changes in the brains of pregnant women. The changes were measured in brain areas that are responsible for social cognition and the ability to understand the thoughts and intentions of others, suggesting that they may intensify maternal bonding with a newborn.

The neuroimaging study, conducted in Spain, was prospective, looking at the brains of 25 first-time mothers before and after pregnancy, and again two years after the women gave birth. The researchers compared the brain images of these new mothers to those of 19 first-time fathers, as well as 17 men and 20 women without children. The pattern of structural changes the researchers observed in the new mothers were so distinct that it was possible to identify the mothers just from their brain scans. Those changes endured for at least two years, except for a partial return to its previous state in the hippocampus, a brain structure heavily involved with memory.

The MRI study showed changes in gray matter, the outer layer of the brain that contains the cell bodies of neurons. The gray matter in certain areas shrunk in size after pregnancy, a phenomenon known as “gray matter pruning.” A similar shrinkage is seen in early childhood and during adolescence. The gray matter contains many interconnections among neurons, and during pruning, the most important connections are strengthened and the others are left to wither. Rather than indicating a loss of ability, pruning is generally taken to mean that a brain region has become more specialized.

The researchers also found that some women had more gray matter pruning than others, and those with the most pruning seemed to bond best with their babies. “The gray matter volume changes of pregnancy significantly predicted the quality of mother-to-infant attachment and the absence of hostility toward their newborns in the postpartum period,” the authors wrote in a study published Monday in Nature Neuroscience.

In a further experiment, the researchers showed women pictures of several babies and found, unsurprisingly, that the women’s brains responded more strongly to photos of their own babies. The brain images, they said, revealed “the strongest neural activity in response to the women’s babies corresponded to regions that lost gray matter volume across pregnancy.”

Pregnancy is associated with a surge of sex hormones akin to the heightened production of sex hormones during puberty. The researchers noted that gray matter also is pruned during adolescence, when a spectrum of emotional, cognitive and behavioral neural changes begin to fine tune the teenage brain.

Cordelia Fine, a psychologist at the University of Melbourne who had no part in this research, said that “this is a solid study,” despite the small sample size. Fine has written several books about gender and how male-female differences are often overstated in science. “The authors are appropriately careful not to conclude that the brain changes they observe are caused by hormones (or by hormones alone), since they don’t show this directly. However, this is certainly a plausible hypothesis.”

Fine cautions that the brain areas identified by the scientists are also responsible for other functions, not simply attachment. A more significant caveat, she said, is that while the authors of the study “speculate that the structural brain changes they see underlie maturation” of neural networks that “could facilitate attachment . . . it’s worth noting that the authors measured empathy before and after pregnancy, and found no change.”

According to the authors of the study, these brain changes may “serve an adaptive purpose for pending motherhood,” that is, the stronger the mother-child attachment, the greater chance the child survives.

Before, during and after pregnancy diet

Many tumors in young children might be influenced by the environment in utero and months before conception.

Some drugs or medications linger in a woman’s body months before conception. During the first trimester, a miscarriage is possible when the embryo or fetus is not completely formed (nervous system and major organs).

A study related the older age of a man who is alcoholic and young age (of mother with borderline diabetes) to the chance of having a baby with bipolar disorder.

Older women tend to have higher IQ babies. But I believe that nurture during and after the birth of the baby helps in ensuring healthy and growing cells.  I massaged my babies during the first year of their lives before each bath.

In cases of SID, blue babies or newborn who have difficulty breathing during labor and after birth or did not breath at all, they are greatly influenced by the environment (healthy mother with no environmental toxins) during pregnancy.

One mile walk a day (mother) can prevent a long labor and provide oxygenation to the growing baby. During labor, be in seated (sideways) or upright, incorporate deep belly breaths in between contractions and have a helper pressed your ankle to facilitate labor.

Any drugs, legal, OTC, prescribed, alcohol, toxic foods, pools with fungus,molds, parasites or bacteria, cat poops and other toxins can affect the growing fetus.

Pregnant mother’s diet

  • Fresh whole foods, avoiding crustaceans since they are bottom feeders and tend to soak up more toxins
  • Avoid too much consumption of sugar, alcohol and salt in the absence of fiber-rich veggies
  • Avoid medications, drugs, alcohol and smoking
  • Get some nature walks, sunshine
  • Cooked green veggies every day if possible
  • During the first trimester, eat more greens and proteins and more healthy carbs during the last trimester
  • Eat iron rich food during the last trimester such as greens, mollases, dark chocolates, raisins, liver and meat (Liquid Fluradix supplement from whole foods or chelated iron can be used if needed based on blood tests)
  • Lemon and vinegar helps in the absorption of nutrients from whole foods
  • Take probiotics or prepare a homemade pickled veggies
  • Make your own fresh squeezed veggies juice if possible
  • Wash fresh produce with salt water and/or diluted vinegar