Brewer Diet?

Are you pregnant again after having preeclampsia once already in a previous pregnancy? Post your thoughts/concerns here - there are others who share your feelings. This is also the home of our Bedrest Buddies Support group.

Brewer Diet?

Postby fiber » Fri Jul 25, 2003 03:01 pm

hi, I'm new here and just starting to TTC for #2.
I want to do everything I can to avoid pre-E the second time around.
I recently ran across information about a high-protein for pre-E by Dr. Brewer. It's not new but no one bothered to mention it my first time around even though I expressed concern since both my DM and DGrandmother had HELLP and Pre-E respectively.
Anyone using the Brewer diet, or know anything about it?

Mama to Seth Anders 3-30-02 (35 weeks, pre-E, IUGR, 3 lbs.15oz)
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Re : Brewer Diet?

Postby laura » Fri Jul 25, 2003 08:05 pm

hey there fiber! Welcome- you are not alone! many of us ended up here out of concern over preeclampsia in a subsequent pregnancy, and we have talked about the Brewers diet a couple of times.

The Preeclampsia Foundation doesn't advocate any particular treatment as good or bad but a couple of us personally are of opinion that the diet doesn't take into account some of the underlying disorders that are associated with PE, that you see women who eat fritos and chug coke and have horrible diets who have healthy pregnancies, and that some of the studies cited by Brewer are VERY old- here's a link to one of the threads talking about it.

http://www.preeclampsia.org/forum/viewtopic.php?t=287

You might be better served by a preconception consult with a perinatologist, and get screened for underlying disorders-- sometimes women who have had pe- especially severe pe or pe remote from their due date- have problems with underlying hypertension, clotting disorders, or autoimmune disorders. Sometimes, just identifying what the real problems might be goes a long way into making a second pregnancy healthier. Best of luck to you!!



Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
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Re : Brewer Diet?

Postby fiber » Sat Jul 26, 2003 12:34 am

thanks for pointing me in the right direction.
I agree about PE not being solely diet related. Lots of people with poor diets don't get it.
In my case it seems to be genetic (mother and grandmother had it). My hope about the diet is that if my genetics make me prone to it, the diet might help.
I'll check out the earlier discussion.

Mama to Seth Anders 3-30-02 (35 weeks, pre-E, IUGR, 3 lbs.15oz)
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Re : Brewer Diet?

Postby sarahedgcomb » Sun Jul 27, 2003 08:07 am

Hi there

I am also curious about the Brewer Diet and have even purchased the book online. I'm pregnant again and my son is now 2 years old. 2 years ago, I had early preeclampsia and gave birth at 32 weeks. However, my blood pressure had started to rise a few weeks before then. I ended up having a c-section and my son was born at 2 1/2 pounds and was IUGR. He was in the NICU for 3 months. In my pathology reports, my placenta was very small for it's gestation and had blood clots in it.

Before I got pregnant this time, I went to an obgyn who specializes in preeclampsia. He orded many, many blood tests (everything from liver function tests, coagulation tests, kidney function tests, blood vitamin levels, enzyme levels, etc.) I think in total they drew about 15 vials of blood. I also did a 24 hour urine catch. All of my tests came back normal and my blood pressure was 110/70 - also normal.

Like I said, I have the brewer diet, and I'm going to follow it a "T". I saw a message that said a lot of the studies that are associated with it are old and outdated. I have to say that I disagree with this. The book was updated and republished in 2000- I don't think that's too outdated. The diet is seems to be sound and very straightfoward. It even stresses and encourages women to find out if they have an unerlying disorder before becoming pregnant again. If you read about pregnancy nutrition, the Brewer Diet doesn't differ much from what you read about in any current pregnancy book.

I know in my last pregnancy I did not eat the quality or the quantity of what's in this "diet" (I don't think it's really a diet, per se, but a sound way of eating). I didn't get enough protein nor did I get enough calcium or calories to sustain a normal pregnancy. I relied on supplements to get my nutrion, and clearly this did not work for me.

I also have friends and sister who gulped down soda, bags of chips, pints of ice cream, etc and didn't have any problems. I think it's just what your body can handle and what is too much stress for your body -- and also how the placenta attaches itself and sustains the pregnancy. I agree that there are a lot of people (and maybe myself when pregnant) with underlying problems like kidney disease, preexisting high blood pressure, blood clotting disorders, enzyme disorders and I truley believe that before embarking on another pregnancy, one should be screened for all of these potential risks. But even if you have a potential risk, you should follow a sound diet that's rich in lean meat, milk, eggs, fruits, vegtables and whole grains and sufficient in calories, it's just common sense.

Before I became pregnant again, and after the birth of my son,I had started to take vitamin supplements - 1000 mg of vitamin C, 400 IU of vitamin E and 400 mg of Folic Acid. With my doctor's approval, I'm contuing these supplements, along with a prenatal vitamin. He also suggested I take 80mg of asprin before bedtime. So, a week ago, at 6 weeks pregnant, I started that.

I think I'll check in to this board to let everyone know how the diet is going and how the pregnancy is coming along. I think it would be interesting to follow.

Fiber... good luck with your pregnancy. Maybe we can compare notes and see how the diet works for us.

Sarah [:)]



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Re : Brewer Diet?

Postby laura » Sun Jul 27, 2003 11:04 am

Sarah, I respect your choice to do what ever you think you need to do to prevent preeclampsia again, but check out this bibliography for Dr. Brewer- all the studies noted range from 1933-1970's. Perhaps I'm biased, but I perceive that research to be old.

His own research cited is 30 years old. And it looks like a majority of it is not peer reviewed- a huge distinction. They may have re-printed the material recently, but all of the case studies cited are old. He mentions two studies from the 90's- just two studies that are studying something else, not even related to his diet, or any diet!

Also, he mentions things on the website about using diuretics and amphetamines for pe- who here has ever been treated with diuretics or speed? Who has had docs that told them to lose weight? That may have happened twenty years ago, but not now. I was tremendously salt sensitive during both of my hypertensive pregnancies... had I followed his "normal" diet, I would have become ill.


Good for you for choosing to focus on a healthy diet- But I am suspect of any claim that something like this is a panacea for all ills, and even more suspect of any doc who tells women who experience edema that it is "always normal"-- IF you have been following his diet.



Laura-28
DH Jack-30
Allie 5-13-98 (35 weeks-pre-e)
Baby Camille 4-17-03 (36 weeks- htn and oligo)
http://www.babiesonline.com/babies/c/camilleandallie/
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Re : Brewer Diet?

Postby annegarrett » Sun Jul 27, 2003 10:25 pm

Sarah,

I think it is great that you have decided to try to prevent preeclampsia with a healthy diet--we absolutely recommend that pregnant women do eat a healthy diet high in fresh fruits, vegetables, etc...

There are several diets that claim to cure preeclampsia and frankly--it is just hard to study a diet because there are so many variables and because the researchers have to rely on women being accurate in their reporting--one woman's healthy diet is not always the same or even as healthy as another's.

I know women who swear by this diet but we haven't studied it--so the Preeclampsia Foundation doesn't endorse it nor discourage its use. The tricky thing in studying such a diet is usually the women who are using it are doing so AFTER experiencing preeclampsia. Studying anything (aspirin, heparin, antihypertensives, etc...) after experiencing preeclampsia is tricky because MOST women don't get it again--even high risk women usually have less than a 50% chance of getting preeclampsia again so if you don't get it--women tend to decide whatever they did differently is "the thing" that cured them. Our perspective here at the Foundation is that you not do anything that might increase your risk--so some of the concerns with the Brewer diet would include excess protein if you develop this disease due to kidney problems. A woman who has compromised kidneys will have trouble handling regular animal protein loads--excessive loads even moreso. It sounds like though you have checked all that out.

A few experts I know think that there may be merit to the Brewer diet--others (most) are quite strongly opposed to it because various aspects of it have been studied and not proven to be significant. The fact is though--what is not significant to a large pool of women--may--individually be extremely significant. One woman may benefit immensely from low dose aspirin--while the large study pool may show it to be unimpressive. SO--I for one would be very interested in hearing how your pregnancy goes. I do know of a group on The Farm who strongly believe preeclampsia is due to malnutrition--however they recommend a vegetarian diet (vegan, I believe) and report a low incidence to nil incidence of preeclampsia among their members. While they note they are midwives--my understanding is they are not nurse midwives. Still--I know them to be very kindhearted and passionate women who believe strongly in their cure for this disease.

I know enough women who are exceptionally good eaters--organic, whole grain, tons of fresh fruits, vegetarians, salmon eaters, etc...to agree with Laura--if one diet were the answer--I would have thought we would have known by now--but--who knows--maybe not.

I do know my mother has had "terminal" breast cancer for five years and believe in my heart of hearts that a healthy vegetarian diet full of fresh organic juice and free of processed sugars and wheat has given us the four and half years past the point where we were told she would "be gone." So--I am the last person to say a diet won't work--rather--the non-profit I run doesn't "endorse" any cure or treatment until it is really truly studied. Laura is right--the Brewer diet references are as old and older than I am--he isn't accepted as an authority by his peers and frankly--he has been pretty unpleasant with us and members of our organization--casting aspersions on our work and our intent. Clearly--he feels very strongly about his diet and feels we haven't given him the proper support--however I find it very inappropriate to suggest that a woman who dies from this disease is responsible for that death because of her poor eating habits--which, unfortunately, is something he has done. Perhaps this is because his own work has been marginalized unfairly. It is hard to know...but I will say that our work here has been reviewed by well over 8 specialists in the field of hypertension in pregnancy and none of them recommend this diet. I would love to hear how it goes--but like Laura--I would caution anyone who thinks there is a cure-all without ensuring that their doctor knows what they are doing--that goes for taking baby aspirin, etc...every week we are called because someone has "found a cure" and we have to weigh it all and have our specialists review it. There is no question that excess weight is a risk factor--so clearly--whatever you can do to safely reduce that is important. I say this because I followed such a diet quite carefully the one time I nearly died as a result of preeclampsia...so frankly, I am a bit reluctant to encourage anyone to put all their eggs in this particular basket. As long as you are seeing a really good doctor who knows you are on this diet--then I am sure everything will turn out well--but I would just encourage you to continue to be vigilant and do let us know how things turn out--I would very much like to hear that for some women that this diet is a cure. That would be wonderful news indeed.

Do take care and keep us updated on your pregnancy--

Anne
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Re : Brewer Diet?

Postby sarahedgcomb » Sun Jul 27, 2003 10:49 pm

Alutiiq 98,

I just checked out the bibliography for the reseach background in the book I have and yes, you're right, there are many studies that are quoted and were performed from the 1930's - throughout the '70's... but there are also many from the 1990's. I wouldn't consider those to be too old and outdated.

As for women being told to watch their weight gain throughout pregnancy or women worrying themselves about gaining too much weight, I think this still goes on. I think this results in women not getting enough good nutrion for the duration of their pregnancy. I have lots of friends now who are pregnant and healthy and they're worried about gaining too much weight. I don't think that's particulary healthy. Especially if you're eating the right foods to begin with. As for women beging treated with diuretics for high blood pressure, I don't know if this happens anymore, probably not. I don't think in my last posting I said I was following a "high sodium" diet. All of the foods I mentioned were whole foods: eggs, milk, lean meat, fruits, veggies and whole grains. I didn't say I was adding lots of sodium to my diet. Nor does the Brewer Diet advocate that. The only thing he says is you can salt your food to taste. And, in normal and most "high-risk" pregnancies, sodium restricion isn't practiced either. Maybe you have a speical case. Everybody's different.

I'm not saying that a diet is a "panacea for all ills" in fact, that's not what I said in my last posting either. Before I embarked on this pregnancy, I had all of the tests done to determine if I had an underlying medical condition. I had all of the liver function tests done, blood clotting, kindney function, I also had an echocardiogram, urinalysis, vitamin levels, enzyme levels, etc. I had the total workup. After I found out that everything was funtioning normally (while in a non-pregnant state), I checked with my doctor about the Brewer Diet. He said it was a very sound diet and gave me the go-ahead to follow it. I'm also taking supplements and asprin. I haven't diagnosed myself, I've found myself a specialist, I'm seeing the doctor every 3 weeks for the duration of the pregancy and I feel following this diet is just extra insurance for a healthy pregnancy.

As for edema being normal in pregnancy, it is in fact normal, IF you don't have proteinura, high blood pressure and have normal results in your blood work. All edema is not the same. All Dr. Brewer says is that if you're properly nourished and you don't have an unerlying disorder, your edema is a normal part of pregnancy.

As for the posting from Fiber, I would also suggest that she sees a high-risk specialist before embarking on another pregnancy. It seems like preeclampsia runs in her family since her grandmother and DM had HELLP and Pre-E. That will give her at least some piece of mind for the next time around.

I personally don't know why people on this site seem so opposed to trying to change the way they eat. The Brewer "Diet" isn't any different from any nutrition advice you'd get from any preganancy book. In fact, I have The Pregnancy Book by Dr. Sears, The New Pregnancy and Childbirth book by Sheila Kitzinger, What to Expect when You're Expecting and others... and they all cover nutrition during pregnancy. And you know what, none of them contradict what the Brewer diet stesses. They all cite that proper nutition is very important and they all recommend that you eat the same kinds of foods that the Brewer diet suggests you eat: eggs, milk, lean meat, fruits & veggies and whole grains.

Sarah [:)]






Sarah
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Re : Brewer Diet?

Postby sarahedgcomb » Sun Jul 27, 2003 11:01 pm

Hi Anne,

Thanks for your posting. I must have posted my response to at the same time you posted your response to me, because when I went to post, I saw your posting.

I liked what you had to say and I agree that a diet isn't a cure-all for anything. I'm just giving it a shot - under the supervision of a high-risk specialist. I'm hoping that for me, it will be the "smoking-gun" as to why this happened to me in the firt time around. I know I did not follow a balanced, healthy, calorie rich diet the first time around and I'm hoping that it doesn't happen again, or if it does, my baby will have gotten the best nutrition and had the best opportunity to grow as big as possible before we have to give birth.

Thanks for your response,

Sarah

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Re : Brewer Diet?

Postby fiber » Tue Jul 29, 2003 12:34 am

thanks for all the responses. I'm taking them all to heart. My main goal is to be as healthy as possible going into this and to avoid PE again if possible. The Brewer Diet, from what I can see is similar to other pregnancy diets. The two eggs per day seems a bit much but otherwise it seems reasonable. I was shocked when I saw the number of servings listed for different food types, but when I check the book out from the library it listed the number of ounces that equal a serving and it really isn't as much food as I'd thought.
I agree that there is no cure all diet and that there are probably many factors involved in PE. I certainly wouldn't follow the diet if it was contradictory to what my doctor or midwife suggested. For example, the issue about protein and kidney problems that was mentioned. Fortunately, my PE came late and was only high bp (extremely high, though I can't remember the numbers now) and some protein in the urine. None of my organs were affected.
I do think that Sarah is doing the right thing by improving her diet if her diet during pregnancy #1 was poor. I don't think it can hurt.

Mama to Seth Anders 3-30-02 (35 weeks, pre-E, IUGR, 3 lbs.15oz)
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Re : Brewer Diet?

Postby deerhart » Tue Jul 29, 2003 03:09 pm

I don't think anyone was saying that people shouldn't eat healthy while pregnant.

But, one diet is not healthy for all, period. We are all different people with different needs and I would have very little problems saying that a nutrionist would not typically put a normal person on the brewer diet.

I personally could not eat or follow that diet as its way way way to much for me and I eat alot of calories as it is.

The issue is that idea that ONE SINGLE diet is the answer. its really not. My typical diet is really not that far off of the brewer diet (I have less milk and less eggs, and never ever liver) and its been that way for years and years. I ate extremely well almsot all of my life. I always had to I was an athelete. Tons of fresh food, little red meat etc..

The question to ask is is this diet right for me or healthy for me. For me the answer would be no, the brewer diet is too many calaries for me and would cause me to gain an excessive amount of weight that after birth I would not be able to lose becuase of the higher calorie intake.
If someone is worried that they aren't eating healthy enough for themselves and their baby, they need to seek out a nutrionist who can design a diet for them, that takes into account thier likes/dislikes, current body weight, build, needed calorie intake etc.. to reach that goal.

That is not saying that diet isn't important at all, its instead saying that diet is an individual thing and needs to be suited and created for that individual, not a one size covers all thing.

Erin
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