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Using B Vitamins in Clinical Practice: Optimizing Patient Outcomes

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Antioxidant-Rich Diet in Pregnancy

coockingHuman pregnancy can be influenced by a wide range of health issues that vary from mild and reversible to severe and life-threatening, and many of the major ones like pre-eclampsia and gestational diabetes can be linked to oxidative stress. This may be because when the foeto-placental unit is poorly perfused, it produces more free radicals, damaging placental cells. Or it could be because the maternal immune system undergoes changes to support the developing fetus, resulting in a controlled increase in inflammation to protect against potential infections. Hormonal changes, such as increased production of progesterone and estrogen, can also contribute to systemic inflammation and oxidative stress.

Antioxidant supplements have been proposed by many scientists in this field, and the most recent findings on this topic are very interesting.

Vitamins C, E and Beta Carotene & Time to Pregnancy

With regards to the time it takes to get pregnant, time to pregnancy (TTP), it was found in 2022 that supplemental β-carotene was associated with a shorter TTP among women with a body mass index (BMI) of 25 kg/m² or higher and women under the age of 35.

Similarly, the intake of vitamin C from dietary supplements was linked to a shorter TTP among women with a BMI below 25 kg/m² and women under the age of 35. Among women aged 35 and above, the intake of supplemental vitamin E was also associated with a shorter TTP.

Antioxidants & Miscarriage Incidence

A case-control study using statistical models to analyze data and calculate the likelihood of risk-related outcomes after antioxidant supplementation in women with a history of miscarriage was performed in 2022. Higher vitamin D and B12 intake was found to have a significant effect, helping reduce certain risks, after taking other factors into account. A higher overall dietary antioxidant value was associated with a lower chance of miscarriage.

The scientists behind the study concluded that recommending a diet rich in antioxidants such as vitamin E, C, zinc, and selenium, as well as a nutritious diet containing vitamins B12 and D, may be an effective strategy to decrease the likelihood of miscarriage in women with a history of recurrent miscarriage.

Melatonin & Pre-Eclampsia

Melatonin, an antioxidant that regulates the body's internal clock, crosses the placental barrier and may impact fetal growth and brain development. In preeclampsia, melatonin levels are lower than in healthy pregnancies.

A 2022 randomized controlled trial on melatonin supplementation with 30 mg/daily versus the placebo showed a significantly longer interval from preeclampsia diagnosis to delivery in the intervention group. Although no significant change in maternal blood pressure or uterine artery pulsatility index was observed, those taking melatonin required less antihypertensive drugs compared to controls. Moreover, babies in the treated group had a higher rate of being small for gestational age.

Lycopene & Pre-Eclampsia

Lycopene has been widely studied for its antioxidant properties. Two trials conducted in India studied the effect of 4 mg lycopene supplementation on preeclampsia and fetal growth restriction (FGR) during the second trimester until delivery in women without any medical complications. One trial recruited 250 women who were pregnant for the first time and analyzed the effect of lycopene in preeclampsia and FGR. The other researchers randomized 54 pregnant women with a high risk for preeclampsia. Both studies showed a lower incidence of growth-restricted babies in the lycopene group. The first trial demonstrated a significantly lower incidence of preeclampsia in women given lycopene.

= A large study demonstrated that lycopene intake during pregnancy is inversely associated with gestational diabetes risk, even after adjusting for confounding factors, potentially due to its antioxidant capacity.

Selenium & Pre-Eclampsia

Selenium is a cofactor of the glutathione peroxidase and thioredoxin reductase. It is thought that its supplementation might benefit women at risk for pre-eclampsia-related intrauterine growth restriction through its capacity as an antioxidant and anti-inflammatory.

In a study of 60 high-risk women pregnant for the first time who were randomly divided into two groups to take either 100 μg selenium supplements or a placebo from 17 to 27 weeks of gestation, there were beneficial effects for women with a uterine artery pulsatility index of over 1.45 taking selenium. Markers of insulin metabolism and HDL-C levels also improved.

Antioxidants & Vitamin D Intake During Pregnancy & Allergic Disease Development in Children

A 2020 trial assessed the associations among cord blood concentrations of zinc (Zn); copper (Cu); selenium (Se); β-carotene; and vitamin A, E, and D, and the occurrence of atopic dermatitis, food allergy, allergic rhinitis, and asthma in 211 children between 7 and 9.

Statistically significant relationships were found between Zn; Cu; Se; and vitamin A, E, and D concentrations in cord blood and the prevalence of food allergy, allergic rhinitis, atopic dermatitis, and asthma in the children studied. The scientists stated that they believe that maternal diet may have substantial potential to modify immune tolerance and therefore the development of allergic disease in their children.

Zinc & Childhood Respiratory and Atopic Outcomes

The Avon Longitudinal Study of Parents and Children looked at the relationship between what mothers ate during pregnancy (including fruits, vegetables, vitamins C and E, carotene, zinc, and selenium) and the occurrence of asthma, atopy (allergic sensitization), and lung function in their children between 7 and 9 years old.

It was found that there were positive connections between maternal zinc intake and measures of lung function in the children, specifically forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC). For each increase in zinc intake during pregnancy, there was a corresponding, statistically-significant improvement in FEV1 and FVC.

In summary, multiple studies have explored the effects of various antioxidants and dietary factors on pregnancy outcomes and the health of both mothers and newborns. These studies have found associations between certain antioxidants, such as lycopene, selenium, and vitamins C, E, and D, and improved outcomes, like reduced risk of conditions like preeclampsia and fetal growth restriction. Additionally, maternal dietary patterns, such as consuming a pro-inflammatory diet, have been linked to adverse outcomes, including a higher likelihood of having large-for-gestational-age infants. Furthermore, zinc intake during pregnancy has shown positive associations with lung function in children. These findings suggest that incorporating antioxidants into the diet and adopting a healthy dietary pattern may contribute to better pregnancy outcomes and the long-term health of both mothers and their children.

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