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Pregnancy Q&A With Dr. Sears

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.  060920-Pregnancy-Q&A-With-Dr.-Sears-CTA

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Dr. Sears Q&A: Weight Loss

With so much interest in weight loss and so much buzz around weight loss drugs, we put together some of the top questions we get in this latest Q&A blog. Here Dr. Sears answers your questions on weight loss, weight loss drugs and what he thinks is the most scientifically backed way to lose weight. See what he has to say.Question: What medical conditions could impede weight loss, and how can they be identified?  Answer:  Any condition associated with insulin resistance will make it difficult to lose weight.  This would include diabetes, heart disease, neurological disease, etc.  Also, any drug that induces insulin resistance will also make it difficult to lose weight.  These include corticosteroids and many neurological drugs. Question: How do hormones affect weight loss, and which imbalances are most detrimental? Answer: High levels of insulin (caused by insulin resistance), high levels of cortisol (caused by stress), and low levels of satiety hormones such as GLP-1 will make weight loss difficult. Question: Is there a connection between sleep quality and weight loss? Answer: Poor quality sleep increases cortisol levels that lead to insulin resistance. The higher your level of insulin resistance, the more difficult it is for any organ to remove glucose from the blood for transport into the cell, where it can be converted to energy. This i Question: Do any weight loss supplements work?  Answer: Not really. You have to restrict calories to activate AMPK which causes your body to effectively burn excess stored body fat.   Question: What medications are FDA approved for weight loss? Answer: There are number of approved older drugs, but the most widely used is still an old drug (Phentermine) that was only recently approved for long-term use. However, the new injectable GLP-1 receptor agonists are more powerful and more popular. The scientific name for the most well-known injectable weight-loss drug is semaglutide, which is marketed under the tradenames Ozempic and Wegovy. In simple terms, these injectable drugs activate the release of the hormone GLP-1 from the gut that goes directly to the brain to tell you to stop eating. These drugs were initially developed to treat type 2 diabetes, but the clinical studies in overweight and obese individuals demonstrated significant weight loss at higher levels. Question: What are the unintended side effects of weight loss medications (i.e. GLP-1s, dual GIP/GLP-1). Answer: One major problem is that the lack of hunger caused by the drug makes you less likely to consume sufficient protein to maintain lean body mass.  Lean body mass is defined as functional tissue such as organs (including the brain) and bone.  Nearly 40 percent of the weight loss in obese patients comes from loss of lean body mass.  Without adequate protein (especially on a diet that is calorie-restricted because of lack of hunger), the replacement of damaged cells is compromised.  The skin and hair are the first site to suffer.  This lack of protein also makes it difficult to maintain mitochondrial function that provides energy for each of your 30 trillion cells. As a result, fatigue (both mental and physical) is often experienced. Question: Would you recommend an injectable weight loss drug? Answer: The answer is no. There is a big difference between weight loss and fat loss. Weight loss is the combined loss of stored body fat and lean body mass (i.e., muscle). You want to lose fat but not muscle. Although the weight loss using weekly semaglutide injections is impressive according to the literature, a deeper look shows that about 40 percent of that weight loss is due to loss of lean body mass. That is not a good sign. It suggests that the injections reduce hunger to the extent that the person has little desire to eat enough protein to maintain muscle mass. In essence, the drug increases the patients' sarcopenia (muscle loss). One of the consequences of sarcopenia is increased frailty. Also once you stop using these weight loss drugs, the weight quickly returns. Question: Does a high protein diet help with weight loss? Answer: Most high protein diets are ketogenic diets that disrupt metabolism in addition to being high fat.  The appropriate diet is protein-adequate (about 30 grams of protein at each meal), carbohydrate-moderate (primarily non-starchy vegetables, low-fat (to reduce calories) and rich in fermentable fiber.  The common name for such a diet is the Zone diet. The ideal amount of protein at each meal for weight loss is about 30 grams. Less than 30 grams of protein at meal will not generate the hormonal signals from the gut to stop hunger. Too much protein at meal, greater than 30 grams, will inhibit AMPK activity which helps cells burn excess stored fat.  

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020524-Winter-E-Newsletter-Blog-4

Aging: Can You Slow It Down?

The first few weeks of the New Year are often focused on the resolve to lose weight, when in actuality people should focus their goals on slowing down aging, no matter the time of year. The only regimen that clinically achieves results in slowing the aging process is calorie restriction without malnutrition. Why? It’s not simply losing weight but orchestrating the complex interplay of reducing senescent cells, reprograming your metabolism, and changing gene expression, leading to a longer and better life.   A Timeline of Calorie Restriction   The first recorded human experiments with calorie restriction began with the written books of Luigi Cornaro in the 16th century, as I outlined in my book The Anti-Aging Zone, published in 1999. However, the molecular mechanisms of why calorie restriction is so effective required more recent breakthroughs in metabolism and epigenetics that were confirmed with the CALERIE study that carefully controlled the diets of 225 participants over two years and then ongoing testing of their retained blood samples.     The results of the CALERIE study have been impressive. However, the one clear take-home lesson was that reduction of insulin resistance was the most predictive blood marker correlated with the genetic changes and the decrease in senescent cells that ultimately accelerate aging.   The Zone on Calorie Restriction   The Zone diet is a calorie-restricted diet that was patented to reduce insulin resistance. It requires balancing macronutrients at each meal to generate the rapid hormonal changes that give rise to satiety. Only then can you follow calorie restriction for a lifetime without hunger and fatigue. It starts with having enough protein at each meal to create satiety in the brain's appetite control center. You need about 30 grams of protein (no more, but no less) at each meal to generate the same hormonal responses induced by the recent injectable weight loss drugs. However, you also must balance that protein with an adequate level of low-glycemic carbohydrates (about 40 grams) to stabilize blood glucose levels, and then add a dash of monounsaturated fat (about 15 grams). Over the years, it has been demonstrated by more than 40 research publications that the Zone diet is superior to ketogenic diets and the Mediterranean diet under controlled clinical research.    A New Technology to Slow Down Aging  Unfortunately, many people think the Zone diet requires too much thinking.  That’s why I developed Zone Foods to overcome that problem. The first generation of Zone Foods demonstrated dramatic reductions in insulin resistance compared to a control group, getting an equal number of calories (1). The second generation of Zone Foods offers greater variety and even more appetite suppression without thinking. This second generation will include new and improved versions of the Zone Pasta and Zone Bars, with new additions of Zone Muffins, Zone Oatmeal, Zone Granola, Zone Soups, and Zone Cookies (coming soon!). Each Zone Food contains 15 grams of protein, balanced with the appropriate level of low-glycemic carbohydrates, so any combination of two Zone Foods will provide the critical 30 grams of protein at a meal to stop hunger and maintain peak mental awareness for the next five hours. The growing variety of Zone Foods makes following the Zone diet incredibly easy. If you are never hungry, that indicates that you are reducing insulin resistance. The long-term benefit to you is slowing aging, which is only possible with lifelong use of Metabolic Engineering that starts with the Zone diet as its foundation. You May Also Like: Reaching the Zone Using Metabolic Engineering

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