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Brewer diet

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Re : Brewer diet

Postby blythe » Sun Nov 18, 2007 10:35 pm

Thank you for your good intentions, I do believe you are trying to be helpful. Also, this topic does show up in searches, so selfishly, I appreciate the chance to add more research-based information for people looking up the diet.

I also appreciate your willingness to answer any questions regarding the diet. However, even though I have had no contact with the Brewers, I have read everything I can get my hands on about this issue. So have many, many other women here. You mentioned your own pregnancy-related struggles/issues, and I am sorry to hear that you, too, did not find birth an easy experience. However, unless you have had this disease, one that has killed babies and mothers, I don't know if you can understand the passion / obsession many of us have experienced in trying to keep ourselves and our babies safe from this disease.

We know this diet. We know every research article related to it. We know every research article about every other attempt at treatment and prevention. We know the old wives' tales. We know about Ina May Gaskin and The Farm's exceptionally low PE rate. We hear about Brewer's successes so many decades ago but search in vain for the actual data. We know our friends in Bradley childbirth classes who use the diet seem to have low rates of PE, but still never see hard numbers.

Because of the anecdotal "evidence" (individual stories) many of us (me included) still fell in the "may not help but can't hurt" camp. Then this study came out this summer (sorry, no pubmed abstract yet):

http://foodconsumer.org/7777/8888/C_hildren_amp_W_omen_33/100702262007_You_Are_What_Your_Mother_Ate.shtml
"That original study population was a group of mothers attending a maternity hospital in Motherwell, Scotland, between 1952 and 1976. These mothers had been advised to eat a high-meat, low-carbohydrate diet in an experimental attempt to prevent preeclampsia (hypertension during pregnancy). The advice was to eat 1 pound of red meat daily during pregnancy and to abstain from carbohydrate-rich foods such as bread and potatoes. Subsequent studies showed that the adult offspring of mothers with the highest recorded meat intakes went on to experience high cortisol and develop hypertension."

And, I know that the Motherwell diet is not exactly the same as Brewer. However, this study drove home the point for me that experimenting with my body could hurt my children, even if it takes decades to see the damage.

I love Caryn's literature review, Thank You, Caryn! I wanted to add just a few more thoughts:

60-85% of women *will not get PE again*. No matter what we do. So anyone can say "I did x and x prevented PE". But unless a lot of women, randomly selected, try the same prevention and *more than 60-85%* stay healthy (one of our research professors will be along to correct my poor explanation of statistics, but I think I'm close), then that "prevention" is just luck. It's just that PE is so scary that the natural human response is to latch on to something that promises to keep horrible things from happening to us. The Brewer diet is not the only thing people have latched onto. People have also tried low protein diets, salt restriction, massive *extra* salt, fish oil, eggs, calcium, vegan diets, no trans-fat diets, extra vitamin C, E, water immersion, progesterone, the list is fairly extensive... My personal theory is that it's a credit to Brewer's skills at self-promotion and partnership with the Bradley childbirth classes that has given the Brewer diet hypothesis extra longevity and staying power, despite the evidence against it.

Finally, even though you say Dr. Brewer did not blame women, in at least one letter to our founder, Anne Garrett, he did. And even if *he* normally didn't, many other people use this diet as a way to blame women for getting sick. Since there is no research-based evidence to support Brewer's protein diet, I personally would like it eradicated from serious discussion about the disease.
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Re : Brewer diet

Postby mada » Sun Nov 18, 2007 10:37 pm

Frankly,
I think Mr. Brewer is getting far too much attention..please...RIP!!!!!
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Re : Brewer diet

Postby onesock » Sun Nov 18, 2007 10:39 pm

Thank You Caryn for posting those URL's, I wasn't quite sure how to explain that it is triggered by an immune process/autoimmune/rejection.:) We can always count on you!!
BTW...I emailed you.[:p]
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Re : Brewer diet

Postby blythe » Sun Nov 18, 2007 11:22 pm

*laugh*
Thanks, Mada! [:)]
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Re : Brewer diet

Postby laura » Sun Nov 18, 2007 11:38 pm

Joy, I'm sorry you've found some of our posts condescending! I think I am familiar with everyone here very well, if they came off that way, it certainly isn't anyone's intention, especially mine.

I agree heartily with Heather- I very much appreciate your intent in coming her to assist us, you seem like a very kind and helpful person. I know the questions asked of you have been pointed, but I was looking forward to an opportunity for our members to see an earnest and knowledgeable discussion of the topic. As Caryn mentions, all too often we've heard the 'intiution' argument, which is difficult to refute, yet intuitively (ha,ha, I pun!) not satisfactory.

We are fortunate at the Foundation to have an expert (ie, PE researcher at a university faculty level) Medical Board, the movers and shakers who are pushing the science of this disease forward. I can understand the limitations of peer review, but the rigorous examination our MB offers prevents us from adopting any theory that isn't supported in peer-reviewed literature, because, as your husband points out, it is a great Quack filter!

I would also be very appreciative if someone could offer recent peer reviewed literature supporting diet based treatment of preeclampsia.

ETA: has anyone else noticed that our much vaunted and quoted WGR is now tagged with an "outdated" watermark on the CDC site? Outdated since 2001? Argh! When will we get a new one?
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Re : Brewer diet

Postby hhbeachgurl » Mon Nov 19, 2007 00:03 am

Joy, I too am sorry that you have found some of the psot condescending and I seconf Laura that I am quite sure no one meant to come across that way (Oh and please excues any typos in this as I am typing in the dark with a fussy 8 month old sleeping next to me.)
I just wanted to say that for me I do find the Brewers diet to blame the mother so to speak. I have had many many peope tell me that if I had only eaten healthier, eaten more protein, followed the Brewer Diet that I would not have developed PE, had weeks of bedrest, or had a preemie. That is extreamly hurtful and hard to hear while going through something and suffereing from a disease that could kill you and your unborn child. And afterwards while dealing with the after effects of PE to hear the same thing...well it is just devistating, especially when I was following the diet to a T when I developed PE at 29 weeks. I was planning on doing an all natural hypno birth, and those plans were ripped away from me as I needed Mag and an emergency C section due to fetal distress and the fact that my BP's were very high, I had cerebral edema, and central nervous system involvement. It is extreamly hard to listen to people tell me that I brought this on myself. It has been almost a year since my PE diagnosis and the fear I felt, the complete and utter fear that I experienced while fighting for my life and that of my daughter is as fresh as it was that day. So please understnad that if some people have come across condenscending in your eyes...this is what we have gone through, and continue to go through evertime someone tells us that "if you had just eaten better you wouldn't have had PE"

My question to you is this.....

We now know that many underlying disorders such as certain clotting disorders etc, can contribute to PE (it is suspected that I have one of these by my doctors due to my multiple miscarriages, though I have not been tested yet but will be before TTC again). How does the Brewers diet propose that by following it it can stop a person who has an underlying disorder that predisposes them from developing PE? It seems like if the Brewer's diet could cure PE in even before mention women, then why is it not being used to treat those underlying disorders by themselves sans pregnancy?
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Re : Brewer diet

Postby onesock » Mon Nov 19, 2007 01:25 am

Here is a link to what our experts on call had to say about it...(albeit, it is over 2 years old, I don't believe the standpoint has changed).
http://www.preeclampsia.org/forum/viewtopic.php?t=3919

No disrespect intended, but we are women that are very versed and have strong feelings about this disease. We just want facts...good, solid, researched, up to date proven facts. You can lead these horses to water, but you can't make them drink :)
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Re : Brewer diet

Postby sarab » Mon Nov 19, 2007 01:46 am

Joy, I too want to say that most of our posters would never intentionally be condescending, and I'm sorry if things have seemed that way.

I, like many other women here, researched everything - and I mean everything - I could find on this disease after my first train wreck pregnancy. Please believe me when I say that if I had found an ounce of concrete evidence to support this diet I would have been elbowing my way to the front of the line to try it. I can attest that if this diet were truly the cure-all that it claims to be the women of these forums would be it's greatest champions. Unfortunately we have yet to see any concrete evidence, so please forgive us for not jumping for joy - no pun intended. [:)]
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Re : Brewer diet

Postby taras mom » Mon Nov 19, 2007 03:29 am

quote:
Originally posted by djsnjones

1) I do not know if there are any peer-reviewed articles or research regarding the Brewer Diet. That does not mean that they do not exist--only that I am not privy to all of their files.


You wouldn't need to be "privy to all of their files" to post a link to any such articles; they would be publicly available, and Caryn[8D] would have posted a link long ago. And the Brewer folks would have tattooed them on Paris Hilton's midriff.

quote:
2) I talked with my husband on the subject of peer-review. My husband has been a college professor for about 27 years, and the chair of the Audio Arts and Acoustics Department for maybe 10 years. He said that the peer-review system has two sides to it. On the one hand it does succeed at eliminating quacks. On the other hand, it also succeeds at suppressing any point of view that happens to be unpopular, because any unpopular view will not get a fair chance for review.

The old story of Dr. Semmelweis would seem to be a classic example of this unfair suppression of an unpopular medical view, a suppression which was unrelated to how valid his view was.


The classic example of Dr. Semmelweis has little to do with modern publishing and peer review. Publishers and reviewers generally jump at the opportunity to take on unpopular or untested views, if only to reveal their flaws. There will always be examples of closed minds and narrow views, but can you seriously claim that Brewer has been unfairly shut out of hundreds of peer-reviewed publications consistently for 40 years? That none of them are interested in being the first to publish groundbreaking results?

quote:
Can any non-Brewer-oriented physician know enough about the Brewer Diet to be able to use it or prescribe it well enough to judge whether it "works" on any of their pre-eclamptic patients?


Brewer's site promotes the diet as straightforward and foolproof. Are you now saying it's too complex to be used except by doctors with special training? Keep in mind that many of the women here have been followed very closely by OBs and perinatologists--often experts in hypertensive disorders of pregnancy--with extra blood work, urine tests, ultrasounds, NSTs, Doppler, you name it. What further training and monitoring would you suggest to detect our critical dietary deficiencies? (Anyone who knows the story of Stone Soup will see where I'm going with this.) And isn't the diet supposed to PREVENT preeclampsia? If so, why wouldn't a doctor prescribe it to ALL pregnant patients--no judgment calls required?

With all due respect, the claims you've presented hinge on guesswork and nihilism. In the absence of controlled trials or at least a compellingly plausible mechanism of action, the Brewer diet doesn't even measure up to the many well-balanced pregnancy diets available from any OB or dietician. To claim otherwise IS victim blaming: It implies that blind faith in one particular, untested approach would have succeeded where all our best efforts failed.
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Re : Brewer diet

Postby annegarrett » Mon Nov 19, 2007 03:31 am

I also want to reinforce that we are vigorous debaters on this forum--even amongst ourselves (by ourselves, I mean moderators, not those who "share" our thinking. It is not personal. If someone feels I am wrong, trust me, people can and should say so. I personally appreciate the opportunity to enlarge my knowledge pool.

That being said--I was definitely a woman who went to the work of Brewer in hopes to prevent a subsequent preeclamptic pregnancy (having had one with number one). I followed the diet, with the support of my midwife, with great care and so was very surprised when everything went south. I ended up in the Intensive Care Unit. Trust me--I'm very open to "alternative" theories and diet. Folks that know me well know that when my mother was given a diagnosis of terminal cancer, I was the one who bought her the juicer and 7 different books on curing cancer with diet. And I believe that her diet did make a huge a difference. I believe it gave her five really productive and healthy years when she had been told to settle things up, she had five months. But the thing is--I have no evidence to support that. I have only my personal belief. So I can only say to folks--this is what I believe.

This organization was firmly founded on the belief that NO theory of a cure, treatment or otherwise was going to be promoted until we could get every single one of our medical board members to support it. That means even the theories that Caryn has referenced have not been officially "endorsed". When I wrote the PF brochure--it took a FULL YEAR to get the medical board to agree that it was correct. This is a high bar for a reason--because when we get something past it--we can go out there and support it. Right now, no "cure" has passed that bar. We have to consider also that we are not doctors, or nurses or midwives. And frankly, none of us know. The enemy here is not one another--the enemy is the disease.

I know a number of researchers who find "pieces" of Dr. B's work valuable (there are some high level doctors with the WHO who are strong proponents of calcium supplementation). A member of our medical board believes more good could come from calcium supplementation ("specifically in low-calcium intake countries") would save more lives than Magnesium sulfate. But this opinion is one of six and not shared by the others on the medical board. The thing is--and I've been to a LOT of conferences about preeclampsia--one year there is a flurry of research touting C&E supplementation and then the next we learn it's actually dangerous. The research is growing rapidly and as Caryn points out--the most exciting developments is the work out of Harvard that points to a real clue in what is causing this.

What I DO know is that this disease incidence actually went down in Europe during WWII and people presumed this was due to meat rationing. Or possibly because the men were gone so maybe there were less "primagravidas" or first borns...the thing is...we don't know.

I want to also say the Preeclampsia Foundation has a strong relationship with professional midwives associations and that our medical director works with midwives daily and is a strong supporter of the practice.

We encourage and participate in vigorous debate but at the end of the day--we are an organization that absolutely defers to solid peer-reviewed medical research, research that is recent, ongoing, and rigorous (and even THEN it has to be approved by six folks who rarely agree on anything) before we present it. Just imagine the challenge to get the website up!! So the thing is--our official stance is "we don't know" and so we are going to challenge anyone aggressively who says they do, but cannot put that theory through the same sort of rigor that we require of our own information before we offer it to the public. There are theories about the disease (treatment) which I firmly believe in, but I try to keep those to myself because they have not gone through this sort of rigourous review (clinical trials yes, but affirmation by the medical board, no), so they are (for the moment...:>)) MY beliefs and not fact.

I hope that helps a little. We're rough--no question--but we just as rough on ourselves as we are on anyone else here because at the end of the day, we take our obligation to our public very seriously.

Take care and thank you for caring for the women you've cared for--I'm sure you've done immense good in the world.
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