Brewer diet

[djsnjones]

I've come to understand that the Brewer Diet is an unpopular topic on this board. I'm not sure if I'm allowed to answer that question. Plus, I am sensitive to the fact that this is an old thread, after all. I did not intend to raise a ruckus when I posted. When I find out whether it's ok, I will answer your question.

Perhaps it would be better for those with questions to email me?

Peace,
Joy

[laura]

Hi Joy,
Of course you're allowed to answer questions! The only rule that applies here is that we don't permit direct linking to the sites referencing the diet or book; there are folks out there who are selling 'cures' for preeclampsia, and we don't ever permit linking to sites that advertise commercial 'cures' that purport to treat, cure, or otherwise mitigate the signs or symptoms of preeclampsia. If it costs money, we don't link to it! The survivors of this disease have endured enough without having their money taken, lol! [:)]

Earnest discussion is permitted-- but please be aware that this is a very emotional topic, particularly to those who feel betrayed that the 'cure' they tried didn't work for them. For this reason, we also ask that if you participate on our boards, that you have or have had preeclampsia; or are the 'support' person for someone with the disease, like a friend or family member.

[caryn]

Because I'm actually on a 24-hour vacation with my ILs at the moment the original portions of this post will be brief and then I will cut and paste from older posts, but:

Brewer claims that preeclamptic women aren't eating enough protein to grow a baby. Specifically, he claims that a shortage of dietary protein causes insufficient albumin in the bloodstream, leading to leaky vessels, leading to the downstream symptoms of preeclampsia. He is quite explicit about this as the causal mechanism.

But we have no peer-reviewed data which supports this as the mechanism, and a very, very large amount of data supporting a different mechanism.

The current Cochrane Review on this subject found no change in preeclampsia rates when women were advised to increase their protein and calorie intake, and no change in preeclampsia rates when women were advised to a high-protein diet. It did, however, find an increase in SGA births in the high-protein diet group. It concludes: "Dietary advice appears effective in increasing pregnant women's energy and protein intakes but is unlikely to confer major benefits on infant or maternal health."

Here's a link or two to the abstract: http://www.update-software.com/abstracts/AB000032.htm

http://tinyurl.com/3837ht

In addition, you may be aware of the results of two recent large studies: one examined supplementation with the antioxidants C and E, and found that they did not reduce risk, and the other examined supplementation with calcium, and found that it did not reduce risk of occurrence of preeclampsia, but did reduce the frequency of severe outcomes like eclampsia.

Here's a link to the PubMed abstract:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16641396&query_hl=5&itool=pubmed_docsum

Another recent large study published in the American Journal of Obstetrics and Gynecology analyzed almost 30 nutritional factors and found no relation between intake and the development of the hypertensive diseases of pregnancy.

Here's a link to the PubMed abstract:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=11262466&query_hl=7&itool=pubmed_DocSum

The current model for the development of these diseases implicates immune system involvement during initial placental implantation which results in a poorly implanted placenta with inadequately remodeled spiral arteries, and the release of two proteins (sFlt-1, a VEGF antagonist, and sEng, which improves the invasive capability of trophoblastic cells by compromising the maternal immune system) by the placenta.

The entire syndrome is thought to be driven by maternal-fetal conflict. Human babies have large heads and pack on a lot of subcutaneous fat to fuel brain growth; human mothers have small pelvises because they walk upright. The maternal immune system negotiates with the placenta throughout pregnancy to grow a baby the right size to a) thrive and b) fit out. The best evidence we have suggests that when the mother's body has to shut down the placenta before the placenta is interested in triggering labor, a process very similar to graft rejection happens.

Graft rejection is when a foreign organ (and the placenta is foreign; the father's genes shut off the mother's genes via epigenetic imprinting) is rejected by the immune system of the host.

No one would seriously suggest to a patient undergoing kidney transplant failure that the problem was that they were eating insufficient protein.

Here are links to the publicly available paper on this from the Journal of Clinical Investigation:
http://www.jci.org/cgi/content/full/111/5/649

and a PubMed abstract of a Nature Medicine article:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&dopt=Abstract&list_uids=16751767&query_hl=10&itool=pubmed_docsum

In addition, an article appeared in the New Yorker last year discussing this research further:
http://www.newyorker.com/fact/content/articles/060724fa_fact

The maternal-fetal conflict papers are also available in PubMed -- search on David Haig (at Harvard.) I don't have time to do that right now; I have to check out of the hotel. I can do it later if necessary.

I would be very interested to hear of any recent peer-reviewed research showing a causal link between nutrition and hypertensive outcomes, and would welcome any information supporting such a link. And actually, these discussions are quite popular -- in that they attract a lot of viewings and postings. It's just that there's no reason to think a high-protein diet can actually affect hypertensive pregnancies positively, so we don't tend to see much positive comment about this particular diet.

[djsnjones]

Thank you for the clarification of what's allowed here.

I do have an answer for the question of how chronic hypertension is different from the hypertension of pregnancy.

I also would like to clarify a bit of an inaccuracy in the definition of the Brewer philosophy as it's been presented here.

But I have never had pre-eclampsia, and I don't have any relatives with pre-eclampsia. I have had a couple of clients out of my 600-800 that I have helped get out of pre-eclampsia. So I'm not sure if I'm allowed to post here.

Joy

[djsnjones]

I'm also feeling very cautious about posting freely here because of the general feeling of having been "blamed", that I've heard from several mothers here.

If I am cleared for responding, in spite of the fact that I've never had PE, I would like to see if we can put aside the "blame" issue.

I have a lot of regrets in my life. In spite of the fact that I had been in the homebirth field for 6 years before my first son was born, I had a very traumatic hospital birth, contributed by choices that I made along the way. My sons are now 26 and 22, and I have many regrets about choices I made along the way, as we raised them. But I choose to not blame myself about that. I choose to understand that I did the best that I could with the information that I had at the time, and with the resources that I had at the time. And I choose to take that information about my past and learn from it what I can and use it to enlighten the rest of my life and that of others that I come in contact with (whenever it's appropriate).

And I believe that the focus of all teachers and healers ideally is to teach and to heal, not to blame. As nurses, and probably other healers as well, our first thought is to help the person coming to us get to a place of better health, not to blame them for any part of their dis-health.

However, I can hear the pain of those who felt blamed, regardless of what the intent was of the person they felt blamed by. And I want to try to be sensitive to that pain.

At the same time, I am concerned that I won't be able to respond freely and openly about how the Brewer Diet works, no matter how thoughtful and careful I try to be with my words, without someone here feeling blamed by what I say, no matter how often I say that I'm not doing that.

So if I hear that it's ok for me to post, can we find a way to set the "blame" issue aside for the time being?

Joy

[caryn]

Speaking for myself only: I'll accept that you're not blaming the women who developed preeclampsia for failing to eat enough protein as soon as you show me peer-reviewed studies showing a causal relationship between protein intake and hypertensive pregnancy.

I ate plenty of protein and calories (and my direct-entry midwife with more experience than you agreed with me!) My blood volume would have been plenty expanded if that had been the causal mechanism.

But it isn't. Or, at least, there is no reason whatsoever to think that it is. If you can come back with peer-reviewed data showing a relationship, then we can chat some more.

[djsnjones]

I am willing to answer questions.

I have not been in close enough contact with Gail Brewer lately to give you chapter and verse on peer-reviewed studies. I do know that many doctors have enthusiastically supported Dr. Brewer over the years.

I prefer to not compete with you, but I am willing to answer questions, which I am qualified to do.

I may need to leave home for a couple of hours now, so if I take awhile to respond it does not signify any rudeness on my part.

Joy

[caryn]

So, you have no evidence?

The thing is, this isn't a competition. This is a question of established facts. It's not impolite to ask for some.

[djsnjones]

Would you like me to answer the questions?

Joy

[caryn]

I would like you to provide peer-reviewed research supporting a causal link between diet, and hypertensive pregnancy outcomes. I've provided research showing that there is no evidence for such a link.

That makes the Brewer diet irrelevant, unless you can show that there is some established reason to suspect a link.