Wednesday, August 3, 2011

Diet during pregnancy and breast cancer risk reduction in female offspring

During pregnancy, women are counseled to refrain from consuming certain types of foods, beverages and medications in order to avoid jeopardizing the health and development of the fetus. In fact, the American Pregnancy Association has a list of a dozen items they recommend expectant mothers omit from their diets. However, there are some additions, such as folic acid, that, when taken before and/or during pregnancy, can actually reduce the risk of birth defects and other disorders.

Research presented today at the Era of Hope conference, a scientific meeting hosted by the Department of Defense Breast Cancer Research Program (BCRP), reveals findings suggesting that if an expectant mother increases her consumption of foods high in certain fatty acids or nutrients during her pregnancy, she can potentially reduce the risk of breast cancer in her female offspring.

The research delves into breast cancer risk reductions attributed to the fetus when the mother, while pregnant, increases omega 3 fatty acids within her diet or consumes dietary methyl nutrients (methionine, choline, folate and vitamin B12). Some findings hypothesize that these diet augmentations may even prevent breast cancer from ever developing in the offspring.

"This is exciting and intriguing research," said Captain Melissa Kaime, M.D., Director of the Congressionally Directed Medical Research Programs (CDMRP), under which the BCRP is managed. "To be able to reduce the risk and possibly prevent this devastating disease before birth is an incredible notion; the BCRP is proud to support research with such potential."

Maternal Consumption of Omega 3 Fatty Acids to Reduce Breast Cancer Risk in Offspring
Principal Investigator: Philippe T. Georgel, PhD, Marshall University

Maternal dietary alterations, including increasing the consumption of omega 3 fatty acids, may reduce the risk of breast cancer to the fetus by causing epigenetic changes in utero and later through nursing. These changes may alter gene expression permanently, a change referred to as imprinting. Researchers at Marshall University conducted a study to investigate whether having a diet rich in omega 3s while pregnant would result in changes to fetal mammary gland gene expression, thereby reducing the chance that female offspring would later develop breast cancer.

In this study, there was a reduced incidence of mammary gland cancer observed for the offspring of mice that, while pregnant and nursing, consumed a diet containing canola oil, rich in omega 3, compared with the offspring of mice that, while pregnant and nursing, consumed a diet containing corn oil rich in omega 6 fatty acids. Reviewing the gene expression profiles of both groups showed that many genes related to cancer development differed between the two groups. Significant differences in the patterns of two important epigenetic markers were also observed.

"Pregnant women should be mindful of what they consume since their diet may incite epigenetic changes that could impact the development of their offspring, not just in utero but also for time to come," said Dr. Philippe Georgel, Marshall University. "Additional research continues, as we seek to elucidate the effect of diet on breast cancer-specific gene expression."

In Utero Exposure to Dietary Methyl Nutrients and Breast Cancer Risk in Offspring
Principal Investigator: Chung S. Park PhD, North Dakota State University

Links are being drawn to complete mammary gland development of the mother during pregnancy and reduction in breast cancer risk in her daughters. Supplementing the mother's diet with lipotropic nutrients (methionine, choline, folate and vitamin B12) is thought to increase methyl metabolism which stimulates the full development of the mammary gland, thereby inducing an epigenetic imprint in the mammary gland of the fetus and decreasing its breast cancer risk. Investigators at North Dakota State University are researching this link with the overall objective of determining the extent to which supplementing diets with methyl nutrients during pregnancy reduces the offspring's overall breast cancer susceptibility.

The study looked at 45 pregnant rats and randomized them into two groups: one to receive a control and the other to be fed a methyl-supplemented diet. Once the pups were born, they were separated into three additional groups depending on the feeding regime of their mother. When the female pups reached a specific age, they were exposed to a chemical that induced breast cancer and researchers charted when the first tumor appeared and measured all tumor sizes and volumes. Results demonstrated that the offspring from the methyl-supplemented diet group showed a decrease in tumor incidence and growth when compared to the control group. Also, they had fewer tumors and fewer tumors that multiplied.

"The conclusions of this study suggest that we may be able to prevent the development of breast cancer in daughters of women at risk for breast cancer by supplementing the mother's diet during pregnancy," said Dr. Chung Park, North Dakota State University. "We look forward to exploring this study further to strengthen the implications of these initial findings."

Gum Disease Can Increase the Time It Takes to Become Pregnant

Professor Roger Hart told the annual meeting of the European Society of Human Reproduction and Embryology that the negative effect of gum disease on conception was of the same order of magnitude as the effect of obesity.

Periodontal (gum) disease is a chronic, infectious and inflammatory disease of the gums and supporting tissues. It is caused by the normal bacteria that exist in everyone's mouths, which, if unchecked, can create inflammation around the tooth; the gum starts to pull away from the tooth, creating spaces (periodontal pockets) that become infected. The inflammation sets off a cascade of tissue-destructive events that can pass into the circulation. As a result, periodontal disease has been associated with heart disease, type 2 diabetes, respiratory and kidney disease, and problems in pregnancy such as miscarriage and premature birth. Around 10% of the population is believed to have severe periodontal disease. Regular brushing and flossing of teeth is the best way of preventing it.

Prof Hart, who is Professor of Reproductive Medicine at the University of Western Australia (Perth, Australia) and Medical Director of Fertility Specialists of Western Australia, said: "Until now, there have been no published studies that investigate whether gum disease can affect a woman's chance of conceiving, so this is the first report to suggest that gum disease might be one of several factors that could be modified to improve the chances of a pregnancy."

The researchers followed a group 3737 pregnant women, who were taking part in a Western Australian study called the SMILE study, and they analysed information on pregnancy planning and pregnancy outcomes for 3416 of them.

They found that women with gum disease took an average of just over seven months to become pregnant -- two months longer than the average of five months that it took women without gum disease to conceive.

In addition, non-Caucasian women with gum disease were more likely to take over a year to become pregnant compared to those without gum disease: their increased risk of later conception was 13.9% compared to 6.2% for women without gum disease. Caucasian women with gum disease also tended to take longer to conceive than those who were disease-free but the difference was not statistically significant (8.6% of Caucasian women with gum disease took over one year to conceive and 6.2% of women with gum disease).

Information on time to conception was available for 1,956 women, and of, these, 146 women took longer than 12 months to conceive -- an indicator of impaired fertility. They were more likely to be older, non-Caucasian, to smoke and to have a body mass index over 25 kg/m2. Out of the 3416 women, 1014 (26%) had periodontal disease.

Prof Hart said: "Our data suggest that the presence of periodontal disease is a modifiable risk factor, which can increase a woman's time to conception, particularly for non-Caucasians. It exerts a negative influence on fertility that is of the same order of magnitude as obesity. This study also confirms other, known negative influences upon time to conception for a woman; these include being over 35 years of age, being overweight or obese, and being a smoker. There was no correlation between the time it took to become pregnant and the socio-economic status of the woman.

"All women about to plan for a family should be encouraged to see their general practitioner to ensure that they are as healthy as possible before trying to conceive and so that they can be given appropriate lifestyle advice with respect to weight loss, diet and assistance with stopping smoking and drinking, plus the commencement of folic acid supplements. Additionally, it now appears that all women should also be encouraged to see their dentist to have any gum disease treated before trying to conceive. It is easily treated, usually involving no more than four dental visits.

"The SMILE study was one of the three largest randomised controlled trials performed in Western Australia. It showed conclusively that although treatment of periodontal disease does not prevent pre-term birth in any ethnic group, the treatment itself does not have any harmful effect on the mother or fetus during pregnancy."

Prof Hart said that the reason why pregnancies in non-Caucasian women were more affected by gum disease could be because these women appeared to have a higher level of inflammatory response to the condition.

Monday, August 1, 2011

Study shows protective benefits of DHA taken during pregnancy

An Emory University study published online today in Pediatrics suggests consuming Omega 3 fatty acids during pregnancy helps protects babies against illness during early infancy.

The randomized, placebo-controlled trial followed approximately 1,100 pregnant women and 900 infants in Mexico. The women were supplemented daily with 400 mg of Docosahexaenoic Acid (DHA) supplements in the algal form or placebo from 18 to 22 weeks gestation through childbirth.

Researchers found those whose mothers took DHA supplements had fewer colds and shorter illnesses at one, three and six months of age.

"This is a large scale, robust study that underscores the importance of good nutrition during pregnancy," says Usha Ramakrishnan, PhD, associate professor, Hubert Department of Global Health at Emory's Rollins School of Public Health. "Our findings indicate that pregnant women taking 400 mg of DHA are more likely to deliver healthier infants."

At one month of age, the infants in the DHA group experienced a reduced occurrence of cold symptoms by 25 percent, including a shorter duration of cough, phlegm and wheezing.

At age three months, the infants in the DHA group spent 14 percent less time ill.

At six months of age, infants in the DHA group experienced shorter duration of fever, nasal secretion, difficulty breathing and rash, though longer duration of vomiting. Ramakrishnan and her colleagues have previously reported findings that show offspring of women pregnant with their first child who received 400 mg DHA during pregnancy delivered babies who were 100 grams heavier at birth and 3/4 cm longer at 18 months of age.

The study, funded by the NIH and the March of Dimes Foundation, also found increased DHA levels in breast milk. All of the infants participating in the study were breastfed.