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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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062524---Keto-Blog

Ketogenic Diets and Aging

Chances are, you or someone you know has tried the keto diet at some point in time. This high-fat, very low-carbohydrate eating plan appeals to many due to its promise of rapid weight loss. In this blog, Dr. Sears explores some of the latest scientific findings on ketogenic diets and provides caution before hopping on this trend. What is a Ketogenic Diet? The ketogenic diet is a high-fat, very low-carbohydrate eating plan. This significant reduction in carbohydrates to induce a metabolic state is called ketosis. This only occurs when there is not enough carbohydrates in your liver to completely convert fatty acids to carbon dioxide and water. The normal conversion generates the chemical energy (ATP) that keeps us alive. In the absence of ketosis, each fatty acid generates 108 molecules of ATP when oxidized in the mitochondria. Ketone bodies make less ATP when they are metabolized by mitochondria. How much less? About five times less. This is like switching the gasoline in your car from high-octane fuel to low octane fuel as ketone bodies increase in the blood. Furthermore, contrary to popular belief, ketones are not an ideal energy source for the brain, as glucose remains the preferred fuel for ATP production in brain cells. Lack of blood glucose is a highly stressful situation for the brain. This is why the body secretes the stress hormone cortisol from the adrenal glands during ketosis to breakdown protein and convert the amino acids into glucose for the brain. This explains why even under complete starvation for 38 days, the blood glucose levels never dropped below 68 mg/dL. This is still considered as a normal blood sugar level. Where did this blood glucose come from if there was none in the diet for 38 days? The answer is neo-glucogenesis primarily using lean body mass. Ketogenic Diets Pros and Cons Interest in ketogenic diets rises and falls about every 20 years. They’re very low-carbohydrate diets that claim that carbohydrates make you fat and keep you fat. This is simply not true. It is not carbohydrates per se but a disrupted metabolism that makes you fat. To be more specific, it is the inhibition of AMPK, the master regulator of your metabolism that makes you fat. Why? As AMPK activity increases, you burn stored fat faster. Frankly, I’ve always been amazed by the re-emergence of ketogenic diets. Eighteen years ago, I published the premier clinical study demonstrating that, under equal calorie intake in which all the food was provided to the subjects for six weeks, the Zone Diet was better than a ketogenic diet in reducing total weight, excess body fat, and inflammation. Now, a recent study revealed some more very concerning findings about the long-term effects of ketogenic diets. This new study indicated that following a keto diet causes a rise in senescent cells, popularly known as “zombie cells.” Zombie Cells are damaged cells that no longer divide but don't die. That’s bad enough, but zombie cells continue spreading inflammation throughout the body. As the number of zombie cells increases in your body, they become a living nightmare. Why? Zombie cells accelerate aging because they cause the earlier development of many chronic diseases. In this study they found that zombie cells in the animals began to appear while they were on a ketogenic diet. The zombie cells then disappeared when researchers changed the diet to a “non-ketogenic diet” (i.e., the Zone diet). And when the animals were given a Keto diet again, the zombie cells reappeared. Notice a trend? If you want to hear more about this study you can listen to our recent podcast at Dr.Sears.com. Based on earlier blogs, this adds to the list of downsides for following a ketogenic diet versus the Zone Diet. PROS Rapid initial weight loss: This is primarily due to the loss of retained water from the glycogen stores in the liver, which is rapidly used up to maintain blood sugar levels. Since these glycogen stores in the liver contain significant levels of retained water, much of the initial weight loss is water rather than stored body fat. If your main goal is loss retained water, this can be seen as a benefit. Of course, going to a sauna would also work. Reduced hunger: Ketogenic diets are rich in protein. Any increase in protein intake can help reduce hunger. CONS Production of acetone: One of the ketone bodies produced during ketosis is acetone, which is also the main chemical in nail polish. Increased calcium loss: A ketogenic diet can lead to higher calcium loss from bones. Limited fat utilization: High levels of dietary fat reduce the likelihood of using stored body fat for energy unless you also significantly restrict calories. Reduced energy levels: The lack of ATP production on a ketogenic diet can lead to easier fatigue during mild exercise. Damage from cheat meals: After seven days on a keto diet, a single high-carb cheat meal can damage blood vessels. Lack of polyphenols: This makes it difficult to activate genes that optimize metabolism by improving mitochondrial efficiency in converting fat into ATP. No long-term weight loss advantage: Long-term studies show no difference in weight loss between a ketogenic diet and a low-fat, high-carb diet. No short-term metabolic advantage: Careful studies demonstrate that fat loss on a ketogenic diet is the same as on a low-fat, high-carb diet with the same caloric intake. Compromised gut health: A lack of fermentable fiber from carbohydrates can lead to poor gut health and an increased risk of developing a leaky gut, which can cause significant inflammation. Furthermore, short-chain fatty acids (SCFA) are the metabolic product of fermentable fiber. These SCFA are powerful epigenetic signaling agents that enhance gene transcription. Ketosis generates a different type of hydroxylated short fatty acid (3-hydroxyl butyrate, that has no effect on gene transcription. In addition, the lack of SCFA has significant negative consequences on the gut-brain axis. Cortisol build-up: To produce glucose for the brain, cortisol levels increase to breakdown protein to make sufficient glucose via neoglucogenesis. Excess cortisol can lead to insulin resistance that cause regain of some of initially loss body fat. In addition, increased cortisol levels cause a depressed immune system as well as destruction of memory cells in the hippocampus. The initial benefits of following the ketogenic diet result in some initial weight loss (primarily water weight rather than fat loss), long-term studies show no significant differences in overall weight loss. Now new findings show a ketogenic diet may lead to significant adverse health consequences by accelerating the formation of zombie cells. Call me crazy, but I feel the key to longevity and wellness comes down to better metabolic control instead of living in a constant state of ketosis. Following Metabolic Engineering® for a lifetime provides that pathway of losing body fat without ketosis. References 1. Johnston CS, Tjonn SL, Swan PD, White A, Hutchins H, and Sears B. “Ketogenic low-carbohydrate diets have no metabolic advantage over nonketogenic low-carbohydrate diets.” Am J Clin Nutr 2006 83:1055-61. 2. White AM, Johnston CS, Swan PD, Tjonn SL, and Sears B. “Blood ketones are directly related to fatigue and perceived effort during exercise in overweight adults adhering to low-carbohydrate diets for weight loss: a pilot study.” J Am Diet Assoc. 2007 107:1792-1796. 3. Sung-Jen Wei, Joseph R Schell, E Sandra Chocron, Mahboubeh Varmazyad, Guogang Xu, Wan Hsi Chen, Gloria M Martinez, Felix F Dong, Prethish Sreenivas, Rolando Trevino Jr , Haiyan Jiang, Yan Du, Afaf Saliba, Wei Qian, Brandon Lorenzana, Alia Nazarullah, Jenny Chang, Kumar Sharma, Erin Munkácsy, Nobuo Horikoshi, David Gius. Ketogenic diet induces p53-dependent cellular senescence in multiple organs. Sci Adv. 2024 May 17;10(20):eado1463. doi: 10.1126/sciadv.ado1463. 4. Owen OE, Felig P, Morgan AP, Wahren J, Cahill GF Jr. Liver and kidney metabolism during prolonged starvation. J Clin Invest. 1969 Mar;48(3):574-83. doi: 10.1172/JCI106016. 5. Chriett, S., Dąbek, A., Wojtala, M. et al. Prominent action of butyrate over β-hydroxybutyrate as histone deacetylase inhibitor, transcriptional modulator and anti-inflammatory molecule. Sci Rep 9, 742 (2019). https://doi.org/10.1038/s41598-018-36941-9. 6. Silva YP, Bernardi A, Frozza RL. The Role of Short-Chain Fatty Acids From Gut Microbiota in Gut-Brain Communication. Front Endocrinol (Lausanne). 2020 Jan 31;11:25. doi: 10.3389/fendo.2020.00025. 

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050824---Tofu-Blog

Tofu: Tips and Recipes Ideas

I have been eating tofu for a very long time, much longer than the 30 or so years I have been following the Zone Diet. Back then many of my favorite recipes came from the Tassajara cookbooks by Edward Espe Brown, the celebrated chef from the kitchen at California’s famous Zen Mountain Center, and cookbooks by Louise Hagler, a.k.a. Wendy Louise, a well-known authority on vegetarian cooking who is associated with a community in Tennessee known as The Farm. Those books are still among the best resources for tofu recipes. My mantra has always been if you don’t like something, don’t eat it. Keep this in mind if you’re new to tofu, start slowly by combining it with flavors and foods you like.    Tips and Suggestions    Firm-sprouted tofu is my preference for the Zone Diet. Unlike traditional tofu, which contains significant amounts of both protein and carbohydrate, sprouted has almost no carbohydrates. It’s lighter tasting, refreshing, and very filling.   Freezing tofu results in a chewy, sponge-like texture. I don’t recommend freezing, but some people prefer it when using tofu to substitute for meat in a recipe.    Baked tofu comes in a variety of flavors and makes an excellent quick meal with some vegetables and fruit added. It’s also great in salads.     Tofu made it into the book “The Top 100 Zone Foods” by Barry Sears.    Some recipes call for draining the tofu first. I find that usually isn’t necessary.   Tofu takes on the flavor of whatever is added to it.    Add nutritional yeast flakes to give a cheesy flavor to vegan tofu scrambles and dips. It’s also rich in protein and vitamin B12.   Cherry Vanilla Tofu “Ice Cream”   Tip: This doesn’t freeze or store well, so prepare only the amount you plan to serve immediately.   Using an immersion blender or a food processor blend equal parts of frozen dark cherries and firm tofu, plus some vanilla extract (preferably alcohol-free for best flavor). Serve immediately.  Tofu Scramble  This is great for breakfast, lunch, or dinner, and we’ve even brought it on long day hikes for a snack.   Crumble some firm tofu and stir in a generous amount of seasonings, taking care not to overdo it with the salt. Heat in a well-seasoned or nonstick skillet with a little Zone-friendly oil to the desired doneness.    Optional: If time allows, sauté some chopped onion in the skillet before adding the tofu and seasonings.    My favorite seasoning combination for this dish at my house is onion powder, garlic powder, turmeric, paprika, some oregano or thyme, nutritional yeast flakes, salt, and ground black pepper. The yellow color of the turmeric makes it somewhat like scrambled eggs.   Tofu Veggie Almond Pasta Salad   Dressing: Thin some smooth almond butter by stirring in some water, a little vinegar, and either soy sauce or Bragg’s Liquid Aminos (an unfermented soy sauce found in the health food section of most grocery stores).    Toss together cooked Dr. Sears’ Zone PastaRx Fusilli, tofu cut into cubes, matchstick cut red bell pepper, chopped green parts of scallions (a.k.a. green onions), and the almond butter dressing. Serve immediately or chill to serve later. It will keep well in the fridge for two or three days.   Use your imagination and see what you can come up with.  Experiment and have fun with it. Try using tofu to make cheesecakes, whipped desserts, tofu chocolate pudding, tofu “cream” based soups, tofu pot pie (think chicken pot pie), tofu burgers, tofu burritos, Buffalo tofu (like Buffalo wings), layered Mediterranean dips, tofu “meatballs”, grilled tofu, and more.    Enjoy! 

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