Choline: Journal reveals importance of, most prenatals don’t contain

I was excited to see that the August 2010 issue of the Journal of the American Dietetic Association covered choline as a feature story. While we hear about the importance of supplementing with a prenatal vitamin containing folic acid and iron, choline seems to the be nutrient most forgotten. We may see this change soon.eggs are high in vitamin b

What it is While choline is a B vitamin that can be assimilated, or made, from other compounds in the body, the demand for this nutrient increases dramatically during pregnancy, possibly bringing the mother’s stores dangerously low and putting her liver at risk and baby’s brain and spinal cord development at a disadvantage. Since the body can make some choline and it’s used in so many of the body’s processes, it has been difficult for researchers to pinpoint how much the body actually needs. This is why choline is set at the Adequate Intake (AI) level only, 450 milligrams, instead of a Recommended Dietary Allowance (RDA). What may shock you is that the average pregnant American woman is only getting 75% of the AI, according to the National Health and Nutrition Examination Survey (2003-04). Surprisingly, even the leading prenatal vitamins don’t contain choline. Nada. Zip. Zero.

Where to get it (or not) Here is a look at some prenatal vitamins and the amount of choline they contain*:

Nature Made Prenatal Multi: 0 mg

Nature Made Prenatal Multi + DHA: 0 mg

S7 Prenatal drink mix (liquid prenatal vitamin): 450 mg

One-A-Day Prenatal: 0 mg

Promise Prenatal: 0 mg

Of course, it’s important to know that prenatal vitamins aren’t the only source of choline. As a registered dietitian I will almost always recommend first first. Foods that are good sources of choline include eggs (115 mg/1 large), beef steak (110mg/3 oz), salmon (100mg/3 oz), and navy beans (1 cup). In this case,the animal, poultry, and fish proteins are the winner, containing the highest amount of choline, and vegetables come in at a respectable second.

Simply put, if you’re eating a balanced diet containing protein foods and vegetables, you’re probably consuming enough choline. If not, you may want to take a closer look at your diet to see if you are getting at least 450 mg daily.

*Daily dosage for each brand is one capsule, with the exception of S7 Prenatal which is 2 packets daily, the recommended daily dose. Values taken from the manufacturers website.

Talk with your doctor or registered dietitian before taking any vitamin supplement. This blog is for awareness purposes only and is not meant to provide or replace the advice of your medical care provider.

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DHA & The New USDA Dietary Guidelines: What you need to know

It’s almost official, according to recently released Report of the Dietary Guidelines Committee on the Dietary Guidelines for Americans, 2010. Say whuh? If you read your cereal box in the morning, you’ve probably seen the MyPyramid, formerly known as the Food Guide Pyramid. Every five years it goes to committee and gets a face lift. In this report, one of the major conclusions highlights DHA.Cooked Salmon Filter

DHA, short for docosahexaenoic acid, is a type of omega-3 fatty acid that is naturally ocurring in fatty fish and some fortified foods. Studies in recent years have linked adequate intakes with higher IQs in infants and toddlers and healthy eye development. The USDA report is taking a stand, stating

Moderate evidence indicates that increased maternal dietary intake of long chain n-3 PUFA, in particular docosahexaenoic acid (DHA) from at least 2 servings of seafood per week, during pregnancy and lactation is associated with increased DHA levels in breast milk and improved infant health outcomes, such as visual acuity and cognitive development.”

This statement is modeled after fish and seafood that provide 250 milligrams of DHA + EPA (another omega-3) per day. To help you take these recommendations into action, here are are quick tips to get you started.

What constitutes a serving?:

4 ounces of cooked fish

What are some commonly found fish I can find that are rich in DHA and also lower in mercury and environmental contaminants?

Wild Alaskan Salmon, light canned tuna, Pacific halibut, US barramundi, anchovies, Alaskan or Canadian black cod, Pacific sardines, farmed rainbow trout, mahi mahi, herring

What are some commonly found fish that I should completely avoid during pregnancy and breastfeeding?

Wild striped bass, American and European eel, king mackerel, bluefin tuna, shark, swordfish

What’s an easy way to remember all this?

If you have web access on your cell phone, there is a mobile version that is easy to use and navigate.

How can I get enough DHA if I don’t eat the recommended servings of fish each week?

While eating foods containing natural sources of DHA are usually the best way to get it, studies have shown how fortified foods and nutritional supplements may be an effective way to get similar benefits. While many prenatal vitamins do not contain DHA, S7 Prenatal drink mix contains a good source of it and is an easy, tasty way to get your liquid vitamins.

Consult with your physician or registered dietitian before taking any diet supplement.

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About Pregnancy: Getting ready to breastfeed

While I always knew I wanted to breastfeed, I didn’t really think about the logistics of doing so until the middle of my pregnancy. The first time I saw a Boppy pillow, I wondered what kind of strange apparatus it was, and the flanges on a breast pump looked like some sort of headphone or walkie talkie. Quite frankly, the first few weeks of breastfeeding for me were no walk in the park. While it was one of the biggest challenges in my life, both mentally and physically, it was one of the most rewarding. Here are some important things to that helped get me through it that may help you, too.

Cropped shot of a bikini

Money can’t buy you happiness, but it sure can buy you comfort and convenience. Think of it this way, one year of regular formula costs about $1,200 per year, which is a lot more than you’ll pay for good quality breastfeeding gear, not to mention the money you’ll save from not having to take a sick baby to the doctor.

The items I found to be indispensable included these:

  • My Breast Friend breastfeeding pillow
  • Medela Pump-in-Style breast pump (double pump is a necessity unless you want to sit in a chair for double the time).
  • Good nursing bras that are at least somewhat attractive. I liked the Bravado brand for daytime, Medela for bedtime, and Spanks, which isn’t technically a nursing bra but offers minimal coverage for lower cut tops.
  • Hooter Hiders nursing cover comes in fun prints and has a rigid piece of plastic at the top so you can see what you’re doing down there.
  • Medela breastmilk bags attach to your pump with adhesive strips. These can go from your pump to fridge to freezer and back again, quickly.

Ladies who lounge. When away from home, scout out places that have decent, comfortable women’s lounges where you can feed your baby or pump. My faves included Nordstroms when at the mall, Babies R Us when buying baby gear, and much obliging nursing boutiques.

Feed the beast. Besides during pregnancy and breastfeeding, I can’t think of a time in my life where I could have been so insanely hungry or thirsty. Keep snacks in your car at all times, like granola bars, trail mix, pistachios, and bottled water so you don’t get stuck going through the drive-through. Also, remember to keep taking your pregnancy vitamins. I really enjoyed taking my S7 Prenatal drink mix to quench my thirst, plus, provide me with a host of essential nutrients like the omega 3 DHA, folic acid and vitamin D3.

Ricky don’t lose that number. Ask a friend for the number of a good lactation consultant she used and enter it into the speed dial on your phone. If you’re sent home from the hospital with battered boobs like I was, you’ll want to run, not walk, to the nearest expert, to get you and your baby off to a solid start. Ask if they will take your phone calls, too, to answer your follow up questions over the phone.

Finally, try not to feel scared, embarassed, or shy about nursing. Women have been doing it for a very long time and it is one of the best gifts you can give to your baby!

Consult with your physician before taking any nutritional supplement.

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About Pregnancy: Surviving the first two weeks with your newborn

Nothing can fully prepare you for the first two weeks with your first newborn baby.

Yes, my husband and I took all of the newborn classes and read all of the books about babies. Still, one week after delivery while sitting in on a breastfeeding group, was I capable of bursting into tears if the wind blew the wrong way. This initial time provides conditions for the perfect storm: total and utter sleep deprivation, sore engorged boobs, too fat to fit into your regular clothes, swelling “down there”, and raging hormones. Add to this a newborn’s shrill cries and you could send the strongest person to a meltdown.

Tired woman relaxing in a chair

I’m here to tell you, ladies, that what you’re experiencing, or about to, is completely normal. To help you through this, I’m offering you my unabridged tips.

Rest up before labor. Screw getting the nursury ready late at night in those last few weeks before the baby comes, since your visitors can help you with this later. Do, though, tie up any loose ends at work so you won’t be stressing later. Make sure to get enough sleep before your due date so that you start out strong at the beginning of this marathon.

Read the book, The Happiest Baby on the Block, by Dr. Harvey Karp. Though, four weeks post partum a lactation consultant told me to read this, I can only wish I knew about it sooner. It explains the five S’s which become your holy grail for a peaceful baby: swaddling, shushing, sucking, swinging, and side or stomach position. If you read the book that rhymes with Schmaby Mise, erase that from your memory for now and for another eight weeks, and even then, heed it with caution if you heed it at all.

Remember to eat and take your prenatal vitamins. You nourished your baby for the past nine months and now the demands are even higher if you’re breastfeeding. If you can believe it, it actually takes more calories now to sustain adequate milk supply than it did to build a single baby, assuming you weren’t underweight going into pregnancy. Studies support how getting adequate DHA, a type of omega-3 fatty acid, is important for supporting baby’s brain development in the third trimester and first two years of life. For more info about pregnancy vitamins, read this.

Sleep when the baby sleeps. I know, this is the hundredth time you’ve been advised this. This is really important! Eat your food, drop the dishes, and get to bed. Use earplugs if needed, but sleep, even it’s just for 30 minutes. Four hours of sleep is better than three, afterall.

Be nice to your baby daddy. Hopefully your partner is being pretty supportive, getting meals ready, and taking the baby off your hands. If he is, say “thank you” once in awhile since you’ll get more bees with honey than vinegar. Try not to interfere too much when he’s taking care of the baby, unless he asks for help. A diaper put on backwards isn’t the end of the world, plus, he’ll learn on his own when the mustardy poop leaks out the side of the diaper.

Finally, take time to just sit and stare at this amazing masterpiece you helped create. They do grow as quickly as people say.

Consult with your physician before taking any nutritional supplement.

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About Pregnancy: Traveling for two

As I plan a summer trip to France with my one year old and husband, I’ve been searching all over the internet for tips and advice. While my father-in-law’s first response was “Gosh, can’t you get a nanny?” fortunately one of my best friends, Natalie (who happens to be co-creator of S7 Prenatal), was ecstatic. The times they are a changing.


As I digress, in this day and age pregnant women are traveling for successful careers, to attend distant baby showers, and take babymoons with their loving hubbies. Before you travel, consider some of my tips before you leave.

Travel Light

The further along you are, the less you ought to be lifting a heavy piece of carry-on luggage above your head. You may be lucky to have a handsome man offer to lift it for you, or you may be as unfortunate as I was to have a man say under his breath, “If you can’t lift it you should have checked it.” (Gasp!) Or, being scolded by the flight attendant for bringing it. Pack as light as you can and check luggage when you are further along.

Stay hydrated

The friendly skies are a very dry environment, making it crucial for you to sip or chug fluids throughout your flight. Even better, help save the planet and some money by bringing your own aluminum water bottle instead of having to spend $4 at the airport. Keep it near during take-off and landing when the attendants have to take away your beverage due to their policy.

Bring Snacks

Low blood sugar levels + empty tummy + pregnant woman with morning sickness = not fun. To avoid this unpleasantry, bring a variety of snacks with you like an apple, raisins, whole grain crackers, and cashews so you can nibble away like a field mouse. Heck, I’d even bring a wrapped stick of cheese. I prefer at least one salty and one sweet snack because I never knew which would satisfy me until that second. If you seeking morning sickness cures bring gingersnaps and saltines or whatever else helps you. If your prenatal vitamin contains ginger for nausea, like S7 Prenatal vitamin drink mix, you could wait to take a dose until right before the flight. For more information, read my blog on snacks to help with morning sickness.

Stay Mobile

Doctors recommend walking around while in flight once the pilot has deemed it safe to do so, to prevent blood clots in the legs and ankle swelling. Also, stretch your legs out, flex and straighten your feet with your ankles, and whatever else you can manage to do from your seat.

Get an Aisle Seat

When you book your flight be sure to request an aisle seat so you retain the control over how often you can politely get in and out of your seat to stretch and go to the bathroom for the seventh time.

Traveling while pregnant can be a fun experience and opportunity to fit in some more baby-free fun before delivery. Just be safe, have fun, and don’t do anything stupid. Blue skies!

Consult with your medical care provider before taking any nutritional supplements. This article is for awareness purposes only and is not meant to replace the advice or your doctor.

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