Why Therapeutic Benefits of Coffee Do NOT Apply to Pregnant Women

February 03, 2014
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Coffee in Pregnancy Tied to Smaller, Later Newborns

In a recent Norwegian study,¹ which included data on nearly 60,000 women, coffee and other caffeinated beverages increased the odds of delivering a low birth weight baby and/or extended the gestation period.

Lead researcher Dr. Verena Sengpiel, an obstetrician/gynecologist at the Sahlgrenska Academy of Sahlgrenska University in Goteborg, Sweden, believes the current recommendations from the American College of Obstetricians and Gynecologists should be re-evaluated. American women are currently advised to limit their caffeine intake during pregnancy to two cups of coffee per day.²

According to Dr. Sengpiel, this may be too much, even though her observational study cannot prove a cause-and-effect between caffeine and low birth weight. She told MedicineNet.com:

"We cannot say from our data whether caffeine is the specific substance responsible for the fetus being at greater risk of [becoming a] low birth weight infant, nor did we study if these babies actually had special health problems during the neonatal period."

Still, higher caffeine consumption was found to be associated with an increased risk for reduced birth weight. Every 100 mg of caffeine consumed by the mother per day equated to a nearly one ounce reduction in the baby's weight at birth.

Every 100 mg of caffeine also increased the length of the pregnancy by five hours. Interestingly, when the source of the caffeine was coffee, the length of the pregnancy was extended by eight hours. The reason for this difference is unknown. Seeing how your average cup of coffee contains anywhere between 95-200 mg of caffeine, it may be best to err on the side of caution. According to the featured article:³

"Dr. Jennifer Wu, an obstetrician/gynecologist at Lenox Hill Hospital in New York City, said, 'Other studies have indicated that caffeine can affect fetal weight, so this is in accord with findings of other studies.' Why caffeine might cause this effect is unclear, she said.

'We do know that caffeine crosses the placenta and the baby is not able to metabolize it very well, [so] it may affect some of the factors associated with growth,' Wu theorized. She advised that women limit the amount of caffeine they consume during pregnancy. The World Health Organization says 300 mg a day, but in the United States the recommended amount is 200 mg a day, she added."

Caffeine During Pregnancy May Damage Your Baby's Heart

Previous animal research from 2009⁴ found that drinking the equivalent of just two cups of coffee while pregnant could be enough to affect long-term heart function of the offspring. They also found that this minimal exposure could lead to increased levels of body fat in males, when compared to offspring not exposed to caffeine in the womb. Scott Rivkees, Yale's Associate Chair of Pediatric Research and a senior researcher on the study, told Medical News Today:⁵

"Our studies raise potential concerns about caffeine exposure during very early pregnancy, but further studies are necessary to evaluate caffeine's safety during pregnancy."

In the study, mice given caffeine during pregnancy produced embryos with "a thinner layer of tissue separating some of the heart's chambers than the group that was not given caffeine." Long term, this resulted in a 20 percent increase in body fat in males, and a 35 percent decrease in cardiac function. According to Gerald Weissman, M.D. and editor-in-chief of the FASEB Journal:⁶

"Caffeine is everywhere: in what we drink, in what we eat, in pills that we use to relieve pain, and even in candy... This report shows that despite popular notions of safety, there's one place it probably shouldn't be: in the diet of an expectant mother."

When You're Eating for Two...

There is rarely a more nutritionally demanding time during a woman's life than pregnancy (and later breastfeeding), when your intake of nutrients from foods and supplements are needed not only to keep your body running but also to nourish and support your rapidly growing baby. Proper nutrition is crucial at all stages of fetal development, and if mom doesn't eat right, her growing baby won't either.

If you're a woman in your childbearing years and you're planning to have children any time soon, it's imperative that you start eating healthy now. Research⁷ published just last year showed that women who ate a vegetable-rich diet during the year before pregnancy had a significantly lower risk of having a baby with certain birth defects as women who ate an unhealthy high-sugar diet. Specifically, compared to those who ate unhealthy, women on a healthy diet experienced:

One-half lower risk of anencephaly, a neural-tube defect that interferes with brain development and often results in miscarriage
Up to a one-third lower risk of cleft lip
One-quarter lower risk of cleft palate
One-fifth lower risk of spina bifida, another neural-tube defect

Unfortunately, the researchers lumped saturated fats in with "unhealthy fat," when they are actually crucial for pregnant women (and everyone, for that matter), and incorrectly labeled whole grains as healthy, when the majority of Americans need to limit them. So I believe their results may have been skewed and may have shown an even greater benefit if a true healthy diet had been defined.

Crucial Nutrients for Pregnant Women (and Women of Childbearing Age)

Healthy nutrition cannot be limited to a handful of nutrients; it can only be achieved by eating a variety of whole, high-quality foods daily. I cannot stress this enough, as if you seek to make up for a diet of processed foods by taking a multi-vitamin or eating a salad here and there, you are deceiving yourself and missing the point -- and the benefits.

For a succinct and easy-to-follow overview of the types of foods and nutrients that will support a healthy pregnancy, read my optimized nutrition plan. Ideally, by the time you enter pregnancy you will already be in the Intermediate or Advanced stage, but even the Beginner stage is far better that the typical American diet. As you'll see, it is focused on minimizing processed foods while increasing your intake of vegetables, healthy fats and high-quality sources of protein, all of which are ideal for nurturing a growing fetus.

For more detailed healthy pregnancy guidelines, please review my special report: "No-Nonsense Guide to a Naturally Healthy Pregnancy and Baby," which covers far more than the basic nutrition tips offered here. Some of the highlights you'll want to be sure to include though are:

Fermented Foods and/or Probiotics: Nearly everyone can benefit from optimizing the balance of good vs. bad bacteria in their gut using probiotics, but if you are pregnant or planning to be, this is of utmost importance to you and your new baby. One of the best ways to do this is to avoid sugar and processed foods and to include fermented foods in your diet.

Research shows giving pregnant women and newborns doses of good bacteria can:

Radically reduce the risk of developing autism or autism like disorders
Protect babies from developing eczema in childhood
Help prevent childhood allergies;⁸
Help optimize your baby's weight later in life;⁹
Improve the symptoms of colic, decreasing average crying times by about 75 percent;¹⁰
reduce your risk of premature labor

The best way to ensure optimal gut flora is to regularly consume traditionally fermented foods, which are naturally rich in probiotics. This includes Lassi, kefir, sauerkraut and other fermented veggies, natto, kim chee, and tempeh. A high-quality probiotic supplement is also an option, especially if you don't eat many fermented foods.

Vitamin D: I've included vitamin D here even though your main source of it should be from the sun, not from food. Along with reducing your risk of premature birth, studies have found that vitamin D may protect against a number of birth defects and autism, as well as pregnancy complications like high blood pressure. It is absolutely imperative that pregnant women maintain a blood level of between 50 and 70 ng/ml of 25 hydroxy D, and I am hopeful that in the not too distant future it will be mandatory for pregnant women to receive regular vitamin D blood test levels.
Vitamin B12: Vitamin B12 is one of the eight B complex vitamins and is naturally present in foods that come from animals, including meat, fish, eggs, milk and milk products. B12 is critical for normal neurological development and maintenance, and shortages can result in permanent birth defects. Note: If you eat a vegan diet, you are likely to be dangerously deficient in vitamin B12.
Folate in the form of Metafolate: Another B complex vitamin (vitamin B9), folic acid deficiency at the time of conception is known to increase the risk for birth defects such as spina bifida. Many women are aware of this and take folic acid supplements in their prenatal vitamins, but many are not aware that in order for folic acid to perform its crucial duties in your body, and for your fetus, it must first be activated into the biologically active form – L-5-MTHF. This is the form that's most usable by your body and the form that's able to cross the blood-brain barrier to carry out important brain functions. Nearly half of the population has difficulty converting folic acid to the bioactive 5-MTHF form because of a genetic reduction in enzyme activity, so it's important to look for metafolate or metafolin in your multi-vitamin instead of folic acid.

Be sure to read the label closely, as many companies don't use the bioactive form because it is too expensive and about 10 times more costly. Of course even better than a supplement would be a wide variety of healthy, fresh, organically grown vegetables, which will supply not only folic acid in the correct form but all the other important accessory micronutrients.

Animal-Based Omega-3 Fats: Most women have major deficiencies of animal-based omega-3 fat like EPA and DHA, which is unfortunate because fetal cells cannot form omega-3 fats, meaning a fetus must obtain all of its omega-3 fatty acids from mother's diet. A mother's dietary intake and plasma concentrations of DHA directly influence the DHA status of the developing fetus.

DHA (docosahexaenoic acid) is so essential to a child's development that if a mother and infant are deficient in it, the child's nervous system and immune system may never fully develop, and it can cause a lifetime of unexplained emotional, learning, and immune system disorders. DHA makes up 15 percent to 20 percent of the cerebral cortex and 30 percent to 60 percent of the retina so it is absolutely necessary for normal development of the fetus in utero, and as a baby post birth.

Studies have shown that sufficient levels of omega-3 fats optimize brain growth in children, especially during the third trimester. But because the fetus depends on the mother's DHA sources, the constant drain on a mother's DHA reserves can easily lead to a deficiency and some researchers believe that preeclampsia (pregnancy-related high blood pressure) and postpartum depression could be linked to a DHA deficiency. The DHA in animal-based omega-3 fats will also help to prevent the vast majority of premature deliveries.

If You're NOT Pregnant, Keep These Coffee Drinking Tips in Mind

Getting back to coffee, I believe there are ways to include coffee in a healthy lifestyle, provided you're not using it as a crutch to mask symptoms of a poor diet, resulting in flagging energy levels—and provided you're not pregnant. To learn more, see this previous article on the health benefits of coffee. That said, another major caveat to coffee drinking is quality. You can find a great deal of information at Coffee & Conservation.¹¹ Here are five primary considerations to follow if you want to use coffee for its therapeutic benefits:

Choose Organic: Coffee beans are one of the most heavily sprayed crops. So, you should select only coffee beans that are certified organic and hence grown without pesticides. This is important, as you will obliterate ANY positive effects if you consume coffee that's been doused in pesticides or other chemicals. Whenever possible, purchase sustainable "shade-grown" coffee to help prevent the continued destruction of our tropical rain forests and the birds that inhabit them. There are many who say shade grown coffee tastes better as well.
Whole Bean: You'll want to purchase whole bean coffee that smells and tastes fresh, not stale; if your coffee does not have a pleasant aroma, it is likely rancid. Grind it yourself to prevent rancidity as pre-ground coffee may be rancid by the time you get it home.
Drink It Black: If you're interested in the health benefits, drink your coffee black, without sugar or cream or flavorings. Add sugar and you'll certainly ruin any of the benefits by spiking your insulin levels, which contributes to insulin resistance. Make sure the water you're using is pure.
Coffee Filters: If you use a "drip" coffee maker, be sure to use non-bleached filters. The bright white ones are chlorine-bleached, and some of this chlorine will leach from the filter during the brewing process. Bleached filters are also notoriously full of dangerous disinfection byproducts, such as dioxin.
Coffee Mugs: Be careful about the container you use. Avoid plastic cups as the BPA will leach into your drink. Styrofoam cups can also leach chemicals. Your best bets include glass and ceramic travel mugs.

Again, remember that while coffee has the potential to be used therapeutically, you need to view it as both a drug and a whole food. As other drugs, caffeine can have a potent impact and should be respected and used with caution. As a whole food, it needs to fulfill certain criteria. Much of the commercial coffee available can be likened to "junk food" in that it's loaded with pesticide residues and otherwise of poor quality...

The most important caveat is to avoid coffee and other sources of caffeine during pregnancy. There are far too many contraindications during this time, and plenty of evidence that it can cause long-term harm. If you feel like you cannot drag yourself into work without one or more cups of coffee, you may want to address your diet and exercise, which is at the root of your fatigue. If you're supplying your body with the nutrients it needs, you simply won't need the extra energy boost.