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Scientists at the UNC Chapel Hill Nutrition Research Institute are developing a “whole health” message for pregnant mothers emphasizing evidence-based, nutritional research that empowers them to make their own decisions on everything from drinking to dietary choices. 
Don’t eat this. Don’t drink that. In the face of recent Centers for Disease Control and Prevention (CDC) recommendations to abstain from drinking alcohol when pregnant and even when considering having a child, researchers at the UNC Nutrition Research Institute (NRI) at the North Carolina Research Campus urge women to educate themselves about the overall effects of alcohol and specific essential nutrients in their diet.
To Drink or Not to Drink When Pregnant
One of the first recommendations an expectant mother receives is to abstain from alcohol. The CDC stated that between 2011 and 2013, ten percent of pregnant women in the United States reported drinking during their pregnancy. Fetal alcohol spectrum disorder (FASD) researcher Philip May, Ph.D., who leads FASD research at the UNC NRI, believes that estimate to be low based on a  number of studies in Europe and Canada that have used biomarkers to measure actual alcohol use and two studies published in 2014 and 2015 that he led. Those studies of first-grade children in two cities in the Midwest and Rocky Mountain regions of the United States indicated that the prevalence of FASD is significantly higher in the general population than most people previously believed.

Research ProfessorFetal Alcohol Spectrum Disorders

Philip A. May, Ph.D. Research Professor
Fetal Alcohol Spectrum Disorders

In another recent study, May’s team of researchers connected maternal body mass index (BMI) and alcohol consumption to FASD in South African communities, a place where FASD rates are reported to be the highest in the world. May’s research team in South Africa studied a group of 57 South African mothers of children with FASD and a control group of 148 mothers with children who did not have FASD. The differences between mothers who drank during pregnancy, those who did not, and the development of their babies demonstrated a clear link between alcohol use during pregnancy and the brain defects associated with FASD.

“In the South African population, we are able to link alcohol very specifically to the actual physical, cognitive, and behavioral anomalies that we see in cases of FASD,” May explained. “The study illustrates, more clearly than ever, how vitally important a woman’s overall health is to the development of her babies.”

Women may not realize, May continued, that “alcohol disturbs the gastrointestinal absorption of proteins and vitamins. Whether a mother is not consuming the right nutrients, like choline and omega-3 fatty acids, or she is consuming alcohol that negates the impact of beneficial nutrients, the negative influence on a baby’s brain and other development can be substantial.”

This is why experts such as May encourage mothers to understand the effects of alcohol consumption on a developing fetus and make an educated decision about drinking while pregnant.

“Most experts recommend that women should not drink while they are pregnant,” he commented, “but I recognize that women need to make their own decisions about what is right for them and their children. To do that, they need the facts about how the alcohol they consume when pregnant could affect their children’s development in the womb and potentially throughout their lives.”

Carol Cheatham, Ph.D.Associate Professor, PsychologyNutrition for memory and attention abilities

Carol Cheatham, Ph.D.
Associate Professor, Psychology
Nutrition for memory and attention abilities

Fatty Acids and Brain Development
Alcohol is not the only dietary choice that may impact a child’s development. UNC NRI researcher Carol Cheatham, Ph.D., a developmental cognitive neuroscientist, studies the connection between omega-3 fatty acids and healthy brain function in babies and young children. Since fatty acids aid in healthy brain development and prevention of neurodegenerative disorders like Alzheimer’s, consuming these vital nutrients is critical for brain health both early and late in life.
B vitamins for the Brain
Along with fatty acids, B vitamins like choline and folate play a role in brain development in utero and throughout a person’s life. NRI Director Steven Zeisel, M.D., Ph.D., was one of the first to realize the importance of choline in a mothers’ diet. Choline is necessary for fetal brain development and nerve cell division, a key process in the development of the hippocampus, the memory center of the brain. Zeisel found that nearly 50 percent of women do not produce enough choline, and eating foods high in choline is vital during pregnancy. Zeisel has shown that low maternal choline led to decreased cortical development, which negatively impacts performance on cognitive tests.
Institute DirectorCholine as an essential nutrient

Steven H. Zeisel, M.D., Ph.D.
Institute Director
Choline as an essential nutrient

Just like the choice to abstain from alcohol and eat foods with omega-3 fatty acids, maintaining high  choline levels during pregnancy and throughout a child’s life is another factor in assuring healthy development. In collaboration with a research team in Sweden, Zeisel and his lab observed improved academic performances in 324 Swedish teens who had higher blood choline levels than lower-performing students demonstrating that choline is linked to improved cognition for teenagers.
UNC NRI researcher Natalia Krupenko, Ph.D., studies the role of folate in human health, specifically in connection to neural tube defects that are caused by folate deficiency. The body cannot produce folate on its own, so the vitamin must be included in the diet. Dark green leafy vegetables, fruit, and legumes are rich sources of folate. According to Krupenko, getting the recommended daily allowance of folate can help prevent these birth defects.
Assistant Professor, NutritionRole of folate in promoting health and preventing disease in humans

Natalia Krupenko, Ph.D.
Assistant Professor, Nutrition
Role of folate in promoting health and preventing disease in humans

The bottom line
The health and dietary choices of an expectant mother and her child are interconnected beginning at conception, during pregnancy and throughout life. Scientists at the UNC NRI are developing evidence-based, nutritional research that gives women a “whole health” perspective that empowers them to understand the effects of alcohol and essential nutrients and make the best decisions for the lifelong health and development of their children.