Pomegranates and Pregnancy
Subject: Pregnant women who drink pomegranate juice may prevent brain injury in their newborn infants in the event of oxygen deprivation. Pomegranate juice may also lessen the effects of high altitude exposure during pregnancy
Few things which we call preventive medicine are truly preventive. Rather, the majority of preventive strategies simply strive to identify disease earlier and help initiate treatment sooner. Rarely do we come upon a new strategy that truly prevents disease. This newsletter is about one way to prevent brain damage to newborn infants caused by oxygen deprivation.
A recent paper on hypoxic ischemic brain injury suggests expectant mothers can prevent brain injury in their infants by drinking pomegranate juice while pregnant.
Decreased blood flow and oxygen to the infant brain is bad news; it's linked to premature birth and other irregularities during pregnancy, birth and early development. The phenomenon is called hypoxia ischemia and causes brain injury in about 2 of every 1,000 full-term births and in a very high percentage of babies born early. When the infant brain doesn't get enough oxygen, brain cells die in huge numbers. Hypoxic ischemic brain injury can lead to seizures, a degenerative condition known as hypoxic ischemic encephalopathy, and mobility impairments including cerebral palsy. In simpler words, not getting enough oxygen to a newborn's brain is really bad news for a kid.
A study published this past June in Pediatric Research suggests that drinking pomegranate juice can prevent brain injury in newborns that are temporarily deprived of oxygen. The research was performed on mice rather than human babies but the information gained should translate over. Typically brain tissue dies rapidly when deprived of oxygen. When scientists lowered brain oxygen levels in newborn mice whose mothers drank water mixed with pomegranate concentrate, their brain loss was reduced by 60%. [i] In other words the brain damage was reduced by more than half. The study was conducted in collaboration with POM Wonderful, using the same pomegranate juice we see for sale locally.
The full text of this Pediatric Research article is available at:
Living in Colorado we grow accustomed to the altitude and rarely think of it. Yet past research, done decades ago, suggests that altitude has a significant effect on the health of our newborns and children. Average birth weight is lower in Colorado than elsewhere and decreases the higher the altitude the child is born. [ii] The amount of oxygen carried in a child's blood is lower in Colorado than elsewhere. [iii]
Recent research suggest that the fetus compensates physically for the lower oxygen available during gestation caused by the mom living at high altitudes in ways which may predispose the child to heart disease later in life when an adult. [iv] Could pomegranate juice prevent this as well? Don't know, but won't hurt.
Although this current study was on mice rather than humans, there is every reason to assume that the results will apply to human infants as well. From now on pomegranate juice will be part of our daily prescription for pregnant women in the last trimester of their pregnancies.
[i] Pediatr Res. 2005 Jun;57(6):858-64. Epub 2005 Mar 17.
Maternal dietary supplementation with pomegranate juice is neuroprotective in an animal model of neonatal hypoxic-ischemic brain injury.
Loren DJ, Seeram NP, Schulman RN, Holtzman DM.
Division of Neonatology, University of Washington , Seattle , WA 98195 , USA .
Neonatal hypoxic-ischemic brain injury remains a significant cause of morbidity and mortality and lacks effective therapies for prevention and treatment. Recently, interest in the biology of polyphenol compounds has led to the discovery that dietary supplementation with foods rich in polyphenols (e.g. blueberries, green tea extract) provides neuroprotection in adult animal models of ischemia and Alzheimer's disease. We sought to determine whether protection of the neonatal brain against a hypoxic-ischemic insult could be attained through supplementation of the maternal diet with pomegranate juice, notable for its high polyphenol content. Mouse dams were provided ad libitum access to drinking water with pomegranate juice, at one of three doses, as well as plain water, sugar water, and vitamin C water controls during the last third of pregnancy and throughout the duration of litter suckling. At postnatal day 7, pups underwent unilateral carotid ligation followed by exposure to 8% oxygen for 45 min. Brain injury was assessed histologically after 1 wk (percentage of tissue area loss) and biochemically after 24 h (caspase-3 activity). Dietary supplementation with pomegranate juice resulted in markedly decreased brain tissue loss (>60%) in all three brain regions assessed, with the highest pomegranate juice dose having greatest significance (p < or = 0.0001). Pomegranate juice also diminished caspase-3 activation by 84% in the hippocampus and 64% in the cortex. Ellagic acid, a polyphenolic component in pomegranate juice, was detected in plasma from treated but not control pups. These results demonstrate that maternal dietary supplementation with pomegranate juice is neuroprotective for the neonatal brain.
PMID: 15774834 [PubMed - in process]
[ii] JAMA. 1988 Jun 17;259(23):3427-32.
Altitude, low birth weight, and infant mortality in Colorado .
Unger C, Weiser JK, McCullough RE, Keefer S, Moore LG.
Department of Anthropology, University of Colorado , Denver .
A decrease in birth weight occurs at high altitude, but its relationship to infant mortality is unclear. We examined Colorado vital statistics recorded from 1979 through 1982 to determine whether high altitude increased infant mortality and whether decreased birth weight contributed to the mortality observed. Retardation of intrauterine growth reduced birth weight and doubled the frequency of low-birth-weight infants from the lowest (915 to 1523 m [3000 to 4999 ft]) to the highest (greater than or equal to 2744 m [greater than or equal to 9000 ft]) altitude in the state. Low birth weight increased mortality risk, but the mortality risk of low birth weight was decreased at high compared with low altitudes, resulting in similar infant mortality rates throughout the state. This finding differed from that of 1969 through 1973 when infant mortality doubled at high altitude. A 46% infant mortality reduction had occurred statewide over the ten years due chiefly to decreased mortality risk for preterm low-birth-weight infants. This reduction, particularly pronounced at high altitude, might have been due to better identification and transport of high-risk pregnancies to hospitals with tertiary neonatal treatment centers.
[iii] J Am Board Fam Pract. 1993 Sep-Oct;6(5):452-6.
Oxygen saturation in children living at moderate altitude.
Nicholas R, Yaron M, Reeves J.
Colorado Altitude Research Institute, Keystone.
BACKGROUND: Physicians caring for newborns and infants residing at or traveling to moderate altitude have little information available about the normal range for arterial oxygen saturation (SaO2) measured by pulse oximetry. To aid clinicians in making rational decisions about the oxygen status of children at moderate altitude, we measured SaO2 in newborns and infants who came to two family practice offices located at an altitude of 2800 meters (9000 feet) to obtain normal values for both well-child and illness visits. METHODS: SaO2 measured by pulse oximetry was recorded for children younger than 2 years seen consecutively in a family practice clinic for care for any reason. The children all resided at an altitude of 2800 m (9000 ft). RESULTS: The mean SaO2 for healthy awake infants was 91.7 percent, significantly lower than the reported normal ranges for either sea level or Denver . Saturation levels in infants with minor acute illnesses did not differ from saturation levels in healthy infants, while infants with lower respiratory tract infections had significantly lower SaO2 measurements. CONCLUSIONS: SaO2 levels are significantly lower in newborns and infants living at moderate altitude. Measurement of SaO2 at moderate altitude can be helpful in the care of both healthy and ill newborns or infants.
PMID: 8213235 [PubMed - indexed for MEDLINE]
[iv] Am J Physiol Regul Integr Comp Physiol. 2005 Jan;288(1):R16-24.
Fetal cerebrovascular acclimatization responses to high-altitude, long-term hypoxia: a model for prenatal programming of adult disease?
Longo LD, Pearce WJ.
Center for Perinatal Biology, Department of Physiology, Loma Linda University, School of Medicine, Loma Linda, CA 92350, USA. firstname.lastname@example.org
During the past several decades, many risk factors for cerebrovascular and cardiovascular disease have been identified. More recently, it has been appreciated that inadequate nutrition and/or other intrauterine factors during fetal development may play an important role in the genesis of these conditions. An additional stress factor that may "program" the fetus for disease later in life is chronic hypoxia. In studies originally designed to examine the function of developing cerebral arterial function in response to long-term hypoxia (LTH), it has become clear that many cellular and subcellular changes may have important implications for later life. Here we review some of the significant alterations in fetal cerebral artery structure and function induced by high-altitude (3,820 m, 12,470 ft) LTH ( approximately 110 days). LTH is associated with augmentation or upregulation of presynaptic functions, including responses to perivascular (i.e., sympathetic) nerve stimulation, and structural maturational changes. In contrast, many postsynaptic functions related to the Ca(2+)-dependent contractile pathway tend to be downregulated, whereas elements of the Ca(2+)-independent contraction pathway are upregulated. The results emphasize the role of high-altitude LTH in modulating many aspects of electromechanical and pharmacomechanical coupling in the developing cerebral vasculature. A complicating factor is that the regulation of cerebrovascular tone by Ca(2+)-dependent and Ca(2+)-independent pathways changes significantly as a function of maturational age. In addition to highlighting independent regulation of various elements of the signal transduction cascade, the studies demonstrate the potential for LTH to program the fetus for cerebrovascular and other disease as an adult.