Brewer diet

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Re : Brewer diet

Postby frumiousb » Thu Nov 22, 2007 05:00 am

I've been watching this thread with interest, but refraining from commenting. At the risk of repeating some of the good comments made by others, I've decided that I want to say this.


If you talked to me about the Brewer Diet, I would probably react in much of the same way as women in this forum have already done. But you misunderstand, I think, the reasons. I would love to believe in the Brewer diet. If you gave me some real proof, then I would grab any chance with both hands and pull. I am very far from believing that the medical/scientific world has everything done and dusted in the area of pregnancy and medicine. You only have to go through a severe preeclamptic pregnancy to realize how far into voodoo you actually get, even at the leading hospitals. Nobody wants to test theories on pregnant women. The ethics of placebo tests are *extremely* murky. Most of the medication is used off-list because no drug company wants the risk of releasing drugs aimed at pregnancy-related conditions. How do you test them adequately? What about the lawsuits? It's obvious that in my situation the remedies that they have are similar to the line from House about preeclampsia-- "get out your beads and pray".

This said, I need something more than anecdotal evidence from your practice to be willing to believe in a theory like Brewer. Most of the discussion that I have seen around it has been downright offensive. If a woman is pre-e free, then hey! it was a success. If a woman got pre-e anyhow, then she must have needed some tweaking in her diet or been overstressed during the pregnancy. Let's see the studies in a high-risk population. Where is the survey of results from a variety of practices? Anything? Because of the vacuum in the medical information, pregnancy is rife with quackery. Take cough medicine to help you conceive. Don't take clomid, that's not natural-- take "herbs" instead. Vitex, anyone? Eat pineapple. Don't eat pineapple. Protein is the key. No, wheat is the key. Eat rice instead of bread. Avoid mango and bananas unless you happen to be another kind of person, in which case one banana per day is okay. Drink Red Raspberry leaf tea. Ad infinitum, ad nauseum.

When pushed, many of the proponents of these theories do a lot what you have done. It is a *big* red flag for me when someone defends the lack of evidence with some general mumble about distrusting scientists who are all in the pay of the drug companies. Now, I do realize that you are not doing that. You are obviously coming with good intentions, and have made clear that you are speaking from an anecdotal practitioner perspective. That's okay. We would probably be a lot more receptive to that if it didn't require us to accept, prima facie, the Brewer Diet. I also think that you need to be a little bit more aware of who you are talking to with your posts. Are you trying to talk to us, or are you trying to correct the record for search engines?

Your comment about believing home birth to be more natural really annoyed me, to be honest. Again, don't you think that many of us would like that experience? *If* I manage to get pregnant again without miscarrying early and *if* I manage to carry a child without either it dying or me dying then I will still never achieve that naturally. From my last m/c I realized that pregnancy for me means getting used to life with a plastic wand shoved up my you-know-where every week. It means blood pressures twice a day. It means a team of doctors. It means fear. It is the farthest thing from natural.

There are times when I *completely* agree that a "natural" and healthy-living based approach to pregnancy is the right thing for the vast majority of women. We are not in that majority. I live in the Netherlands, where most pregnancies happen under the care of a midwife and never even see an ob/gyn. Homebirths are extremely common. The philosophy here is that pregnancy is not a disease and should not be treated like one. I have seen for myself with my friends how wonderful that is for most of the women. They go to birthing centers and midwife practices and play with brightly colored balls. Super!

But I have also seen that when it goes wrong, how badly this approach can go wrong. I started having symptoms *very* early in the pregnancy. I was part of a combined midwife/medical practice, and the first line for problems is seeing a midwife. I got told that everything that I was experiencing was first-time mother jitters. The midwife fought against tests being done on the problems-- I suppose that she thought that they were humoring me. When I started having contractions, and felt as though I couldn't breathe, I got sent to an acupuncturist. (She was cool, actually. And encouraged me to fight for the testing I needed.) I got balanced diet tips-- including a menu for a high-protein diet. I got told that what was going on was normal. It wasn't until I ended up in the emergency room with my kidneys practically failing and the baby dying that they ran the bloody tests. (When I called that morning to report that my hands and face were severely swollen, she suggested that I had just slept on them wrong.) And then it wasn't until after Sophie was dead and I started researching that I realized that every single symptom that I had was normal for severe early onset pree/HELLP. I don't blame the midwife for this. She had probably never seen a case as severe as I in her practice. It's rare. But her refusal to accept that there was something seriously going wrong kept me from getting the medical attention that I needed. It most likely would not have made a difference in the outcomes. But you can understand, I hope, how that "most likely" keeps me awake at night.

And now? I trust my MFM. I trust medical studies. I trust this group of women. I don't trust a single other person or theory unless it's based in something real that I can read.

You are welcome here, and welcome to post your corrections. But please remember to whom you are speaking and what you are trying to achieve. We are all interested.


*which will be my first, last, and only cranky Internet post this fine Thanksgiving morning! Happy Thanksgiving everyone!*

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Re : Brewer diet

Postby celticepona » Wed Nov 21, 2007 10:36 am

Joy, may I add just one thing. Ive taken quite a few classes for my education degree and learned the value of teamwork and collaboration. I know you mentioned that you do not have the time or energy to expend on doing scientific research to back the brewer diet. That's ok, we all cant do everything. But what you may be able to do is collaborate with someone who can do the research on your behalf. I looked at your website and your articles and links. I feel that your site could benefit with links to credible articles from medical journals. You say your husband is a professor? Perhaps you could team up with a college student who is looking for a research topic for a thesis or project and have that student or team of students research the topic? Just an idea.

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Re : Brewer diet

Postby celticepona » Wed Nov 21, 2007 09:30 am

quote:Originally posted by celticepona

[quote]Originally posted by onesock

Joy, I am not sure why you would feel muzzled...we have asked you questions, yet we have gotten no answers. You keep saying that you don't want to expend the energy looking for reasons that it might not work,or proof that it does work, but we are talking about the lives of mothers and babies here. In my opinion, it is worth the energy to make sure it is safe and everything is claims to be, which if it really were, it should not be that hard to prove. We just want proof...that is all. I was reading one of the PE stories on your website where the lady developed high blood pressure in her pregnancy and it was blamed on stressful relationships that she was involved in...once again blaming the mother for the problem. Around here, we never blame the mother for PE, particularly when it comes to the mother inducing her own high blood pressure, or not eating the right foods.

Hello Joy and welcome. (I've been offline and out of the loop so I am a late poster here) I also welcome your discussion and hope that you can shed some light on your theory. I echo onesock, PE is very serious to us and we have all been touched by it here. I am now in my second pregnancy and pretty sure that PE will rear it's ugly head again down the road unfortunately. Therefore, I understand you may be very busy, but please do take the time to look up medical journals for articles that support your theory. With all due respect, I went to an ob for my first pregnancy who beleived in no medication, all-natural minimal invasive methods, and my PE spun out of control and was a terrifying horrible experience that I am thankful that my daughter and I are ok. My doctor seemed to know little about the disease and his background knowledge of it was old fasihioned. Although he did not mention the brewer diet, I wished that he had been up to date on his research on how to treat me. Now I am NOT linking the brewer diet or any of your theories to anything that drastic, but all I am saying is that after my doctor failed me I came here to this foundation, which has helped me more than my old doctor ever could. Now I am more educated about PE, am going to a high risk peri and feel safer going into this pregnancy. I know you said that doing the research is not your role in this life...I know how time consuming research can be...I have a master's degree and did plenty of research over the years and it is very time consuming and energy draining, however, due to the severity of the disease we have/have had, I feel that research into possible treatments or cures for PE are very important. That's all. I am sure that if you dug up current, up to date research that the Brewer Diet was successful in preventing PE I know I would be very intrigued by it. Anyway, have a Happy Thanksgiving and hope to talk to you in the future.

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Re : Brewer diet

Postby caryn » Wed Nov 21, 2007 07:16 am

quote:Originally posted by deerhart

In the long run, they are going to most likely find out that there are many causes to PE. PE is a symptom of something else going on in the body and a good analogy to it is a fever. A fever is the same response to a variety of different things.

Exactly. I want to hammer home this point, because it's critical to recognize that any theoretical explanation for PE is going to have to handle a multifactorial heterogeneous cause.

I would argue (obviously) that the best candidate to date is the idea that soluble factors are upregulated by the placenta in response to hypoxia and that those factors cause the downstream damage in order to benefit the fetus. Raising the mother's blood pressure means that more blood will be pumped across the placental interface, which grows a larger baby. These are likely adaptive responses to shallow implantation/hypoxia.

We know preeclampsia is related to:
chronic hypertension
chronic liver and kidney disease
diabetes, gestational or otherwise
autoimmune conditions
living at a high altitude
living in a polluted valley
sleep apnea
using barrier contraceptive methods
first pregnancies
a history of preeclamptic pregnancies
trisomy 16

and doubtless some others that I'm forgetting.

About a year ago I was looking at a slide of a 10 cm placenta from a delivery at 26 weeks. Multipara with 5 previous normal pregnancies, spontaneous labors, healthy babies. This was a emergency delivery at 26 weeks, following severe PE and HELLP syndrome.

The placenta had taken upon itself the task of going trisomy 16 in some of the lobes but not in others. The embryonic cell line was uncompromised, so the baby wasn't trisomy 16 and was one of those 480g babies who make it, after a rocky start. Trisomy 16 is highly compromised -- essentially none of the embryos make it out of the embryonic stage -- but only part of the placenta was compromised, so the pregnancy was able to be maintained for a significant length of time.

Definitely not related to dietary protein and calorie intake and a compromised blood volume thereby, you know?

The particularly compelling thing about the current understanding of the mechanism thought to underpin PE is that it can handle all of these risk factors. Either they're related to a hyperactive immune system, they cause you to become hypoxic, or they directly upregulate sFlt-1. And the best way I can explain the current understanding of the mechanism is this:

Current research suggests that the spiral arteries of the placenta do not appropriately establish an interface with the uterus in most cases of preeclampsia, failing to develop as broadly or as deeply as they would in normal placental invasion. This results in a shallowly implanted placenta, predisposing the pregnancy to early miscarriage or later preeclampsia. This shallow implantation compromises blood flow to the placenta, which eventually becomes hypoxic when the fetus begins to demand more exchanged nutrients and oxygen than the placenta can ferry. In response to this insufficiently oxygenated state, two known proteins are released by the placenta, soluble vascular factors which bind to proteins produced by the mother's body.

Occasionally preeclampsia is not associated with shallowly implanted placentae; in those women, it appears to be the case that either adequate oxygenation or perfusion cannot be maintained for some other reason (the eventual development of hypoxia results in the same downstream effects) or the placenta directly manufactures the proteins which are generally produced only by hypoxia regardless(trisomy 16).

And it's not just, well, *me* saying this. Here's just one review (note: typing "preeclampsia hypoxia" into the PubMed search engine returns 21 pages of results.)

It is now believed that preeclampsia is a two stage disease. In the first stage, a defective implantation and placentation, causes a reduction in uteroplacental perfusion and placental ischemia/hypoxia. Placental ischemia may promote the release of a variety of factors to the maternal circulation. In the second stage, these factors initiate a cascade of cellular and molecular events leading to endothelial and vascular dysfunction. The endothelial dysfunction leads to the clinically recognized symptoms of the syndrome, which include hypertension, proteinuria, thrombocytopenia and impaired liver function. Hypertension is mediated by various endothelial and non-endothelial regulatory factors that are altered in preeclampsia.

and here's another:

The pathophysiology of the disease involves impaired trophoblast invasion, abnormal genetic polymorphism, vascular endothelial cell activation, immune intolerance by the maternal immune system, but also an exaggeration of a systemic inflammatory process. Preeclampsia is one of the major causes of maternal and perinatal morbidities including preterm births and therefore merits ongoing intensive research. The inflammatory process is determined by immunogenetic and non-immunogenetic factors. While inflammation mostly appears to be related to immunogenic determinants such as HLA antigens, paternity, monocytes, proinflammatory cytokines and NK cells, also responses not directly related to the immune system have been observed such as related to hypoxia or agonistic autoantibodies directed against vasoconstrictive angiotensin II receptors.

Any explanation for preeclampsia is going to have to be able to handle the known data, including the studies showing that the population with the lowest quintile of urinary placental growth factor has a 29-fold increase in their risk of preeclampsia. (Soluble flt is an antagonist of placental growth factor.)

One of our researchers says our state of knowledge about preeclampsia is like our knowledge about blindness at the turn of the 20th century. Nowadays, no one would say that macular degeneration and retinopathy of prematurity were caused by the same condition even though they both caused blindness. Preeclampsia, too, is caused by multiple things *that lead to the same downstream symptoms.*

I can riff on this for hours so I'll stop now. [:D]

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Re : Brewer diet

Postby deerhart » Wed Nov 21, 2007 01:51 am

I'm not sure that any inaccuracies on our site matter to a great extent towards the breadth of this discussion.

The two sides are basically arguing different portions of the scientific theory. He who I shall not name (got to get an HP quote in there LOL!) had an hypothesis, which did not turn into a theory because to date no other research has been able to duplicate the hypothesis. Just as the researchers working today have hypothesis that they are trying to turn into theories by having others replicate their results.

PE is a rare enough condition that many people in the field can go their entire career and never see a case. That does not correlate to whatever they are doing in their practice "prevents" PE.

In the long run, they are going to most likely find out that there are many causes to PE. PE is a symptom of something else going on in the body and a good analogy to it is a fever. A fever is the same response to a variety of different things. For some women, like me, our bouts of PE are caused due to blood clotting disorders and having clots in our circulatory system (and I have NEVER seen anyone anywhere claim that eating a specific diet will lower the fibrinogen in someones body or regulate the Ig family antibodies). For others its other autoimmune issues and yes even for some there could be a dietary component.

The problem anyone supporting a 1 size fits all approach to the prevent of PE is that if it really was that simple, PE would have been eradicated 30-40 years ago, the Noble Prize for Medicine would have been awarded, and the person's name would be etched in stone with the other great discoveries of the modern age. Contrary to some beliefs, the medical community doesn't ignore valid treatments of life threatening condition for 30-40 years just because they don't want a doctor to get the credit. I use the 30-50 year time frame because the last time I looked at that particular site (albet several several years ago) there were only 1 or 2 articles in the reference section (showing the research) that had been written in my life time.

No one here is trying to blast you or say that you can't have your beliefs or theories etc.. But you must remember that your talking to the women that for the most part have had severe PE if not been on the brink of death. Many of us have had PE more then once. Some of us have the typical expected bout and some of us have a more atypical presentation (I am an atypical gal). Many of us have undergone tons of tests to figure out WHY this happened to us. Some (like me) have found pretty solid conclusive answers, some have found conditions that could be the culprit, and others are left with more questions then answers.

The one thing that is a common thread that runs through ALL of us, is that we all did what we felt was best for ourself and the children we were carrying. We all went through an extremely traumatic experience. Many lost their children, some are here because they lost a daughter, mother, wife to this. This is a place for some answers and also a place for healing. I don't think that there are very many here who haven't 2nd guessed themselves and asked what if I had just done this or I had just done that?

This is why it is EXTREMELY important that all the information that is presented here meets scientific standards. None of us want to get our hopes up that the answer has been found, only to find out that the hypothesis doesn't pass muster. Part of the scientific standards are that the research data be reliable and that the data can be reproduced. I am extremely proficient at searching the web (for my job I have to be) especially with medical data. In the 7 years I have been searching for things on PE, I have not yet seen any cases where this diet has been tested and the data replicated. Why? I cannot answer that. I can't say its because they tried and failed or because they never tried. It could also be because the data and protocols of the research was never released so that it COULD be tested. If that occurred, again, I can't answer why that didn't happen. I can hypothesize on why but that would be it.

If the group of us that have done extensive research have missed this information, I guarantee that we would LOVE to have it. But the likelihood of that happening is slim.

We are a protective group because we know the raw emotion that occurs after you've been through PE. There is already present a tremendous amount of guilt, shame, fear, anxiety and terror. Our bodies have failed us at the one thing that is supposed to happen completely naturally and saying that well if you had only eaten this you would have never gotten sick increases those feelings 1 million times over. The answer is rarely that simple. The entire process of creating and giving birth to a child is an absolutely amazing and complex thing. There are so many instances where it could have gone wrong, heck our own bodies work like that and it is rarely a single thing we did or didn't do that leads to something happening (people with heart disease don't get it just by what they eat, or just because they didn't exercise enough, its a combination of factors).

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Re : Brewer diet

Postby jenn » Tue Nov 20, 2007 05:49 pm

Call me late to the party on this topic.
And a whopper it is was catching up on.
But I've been very busy moving into a new home.

Joy, I wanted to say your passion and dedication to the Brewer's Diet is like none I've ever seen. I wish you the best in your continuation.

I myself am completely neutral on the topic.

What I do know is that I suffered a near death experiance with HELLP and am lucky to be here today.
I, like you, want to bring PE to it's knees and even it's end.

With both my pregnancies, I didn't know about the Brewer's diet.
With my first I couldn't eat anything... I threw up everything from begining to end.
With my second, I ate chocalte chip cookies and milk non-stop from start to finish.
The second baby was PE free!!
Perhaps I should start a new theory with the "Cookie and Milk Diet" eh?
Just kidding.
I enjoy bringing light to sticky situations.

But Joy, I do hope the boards haven't let a bad taste with you.
In the end, we all share the same passion, "Anti-PE".
We have taken different roads with this, yours is the Brewer's Diet, and who'd I be to say your wrong.

I wish you warm holidays wishes, and wish your son well in college.


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Re : Brewer diet

Postby djsnjones » Tue Nov 20, 2007 04:35 pm

Thanks. The same to you all. [:)]

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Re : Brewer diet

Postby caryn » Tue Nov 20, 2007 04:27 pm

No worries. Have a good holiday.

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Re : Brewer diet

Postby djsnjones » Tue Nov 20, 2007 04:14 pm

I have decided to let this rest over the holidays, and give myself time to think about whether to come back to post regarding those inaccuracies, and I will come back with that decision next Monday (depending on whether I have to drive my son back to college that day).


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Re : Brewer diet

Postby mom29 » Tue Nov 20, 2007 04:10 pm

Even though Joy doesn't have any peer-reviewed stuff, I would be curious to see what she considers "inaccuracies" about the BD on this site.

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