More Articles on A Healthy Pregnancy

Thinking About Getting Pregnant?
Congratulations on Your Pregnancy! (for those who are newly pregnant)
What is a healthy pregnancy weight gain?
Can I continue to eat a vegetarian diet during pregnancy?
A Pregnancy Menu For You and Your Baby
Treating Nausea and Vomiting
What About Seafood?
Don't Eat That!
Pregnancy and Cholesterol
Wash Those Veggies!
Breastmilk, the Healthiest Diet for Babies
What DOES that Broccoli Do for My Baby?
Vitamin D Supplements in Pregnancy and Breastfeeding
New Research Affirms Individualized Vitamin D Supplementation for Pregnant Women
Breastfeeding: Developing a Future Gourmet
What to Do About The Flu
Gestational Diabetes
Decreasing the Risk of Gestation Diabetes
Keeping and Storing Breastmilk
Pregnancy Weight Gain Guidelines – Do We Need New Ones?
Breastfeeding: A Woman's Health Issue
Eating During Labor
Probiotics and a Decreased Risk of Gestational Diabetes
Pregnancy - a Time to be Active!
Clearing the Air : Quit Smoking for You and Your Child
What is a Healthy Pregnancy Diet for Obese Women?
Does Iron Intake Matter?
One Fish, Two Fish... Full Term Birth?
Folic acid in pregnancy and language development
A Mediterranean Diet, Pre-Pregnancy
There is No Substitute for a Healthy Diet
Honest Healthy Diets for Babies
Exercise for New Moms
A Healthy Pre-Pregnancy Diet and Gestational Diabetes
Vitamin D and Gestational Diabetes
Great News About Breastfeeding
Peanuts and Pregnancy
Fried Foods and Gestational Diabetes

Faith Bontrager, RN, BSN

Faith Bontrager, RN, BSNFaith's passion in nursing is to help people find the options they need to discover their personal path to optimum health. Ask her friends and they will tell you that their appreciation of nutritious food has grown through Faith. About Faith Bontrager, RN, BSN


           

 
 

A Healthy Pregnancy
Cholesterol and Pregnancy



A Question from a Reader:

I was so excited when I saw that Dr. Gourmet added a pregnancy section to the website! I have been using the site for healthy dinner meal ideas for more than a year, and my husband and I are big fans!

I am currently 36 years old and 7 months pregnant with my first child; I've gained 20 pounds so far. I started the pregnancy being overweight, but I do moderate exercise and I eat rather healthfully; unfortunately, a side effect of pregnancy is that I've been craving more refined carbohydrates than normal! I try to keep things under control, but I admittedly have been indulging in more sweets than what I had before becoming pregnant (my biggest downfall has been a bowl of ice cream or frozen yogurt once or twice a week).

I had high cholesterol before pregnancy (since my early 20s, my total cholesterol has been in the 240-250 range), but my HDL levels have always been quite good, over 60 mg/dL. My primary care doctor wanted me to get my cholesterol checked, so when I went for the glucose tolerance test, I asked for a fasting lipid panel, as well. This time, the total cholesterol came back at 355, with HDL being 90. I acknowledge that this is very high, but I thought that being pregnant is supposed to raise cholesterol levels--I'm writing because my primary care doctor wants to put me on a drug as soon as I deliver. I don't want to do that, though, and am wondering if you might have any insight into this topic?

Thanks in advance,
Denise

Faith Says...

Congratulations on your pregnancy! We at Dr. Gourmet are glad to be a part of your healthy diet plan.

I can not make a specific recommendation as to exactly what you should or shouldn't do regarding medications to reduce your cholesterol after delivery. Your decision needs to be based on many things, including your family history, your health history, a look at your complete health picture including all lab tests, your weight, your BMI, your blood pressure and other physical findings, your response (currently or in the past) to specific diet and exercise regimes, etc. not just one cholesterol test during pregnancy. Discuss all of these findings with your doctor. If your primary care doctor is not your obstetrician, you may want to discuss these findings with both doctors.

Here is some general information about cholesterol, pregnancy, and breastfeeding that can assist you in making an informed decision. I have included detailed citations for those who are interested in the supporting research.

Cholesterol and Pregnancy

Elevated cholesterol and triglyceride levels are common during pregnancy.1, 2 For this reason, most obstetricians do not recommend cholesterol testing during pregnancy.3 These changes in lipid profiles appear to be because of hormones. Women on birth control pills have changes in their lipid profiles, although not as much as women who are pregnant. There are even minor changes during the last part of the menstrual cycle.4

Cholesterol levels rise in the second trimester of pregnancy and peak during the third trimester. While cholesterol that is too high is a concern for many adults (and should be taken seriously!) cholesterol at its basic level is a necessary nutrient. It is important to your baby's brain development. Because of this fact, as well as the fact that cholesterol levels return to normal levels somewhere around 4 weeks after delivery,5 hyperlipidemia is not treated during pregnancy. Expected levels usually do not exceed 337, so your levels are higher than I would expect.6

Cholesterol levels usually drop somewhere around 4 weeks post partum. Most labs recommend waiting 6 weeks post partum to test cholesterol. As you discuss your risk factors with your physician, weigh the pros and cons of waiting 4-6 weeks after delivery to be retested before making a decision about medications.

Research indicates that cholesterol levels dropped most quickly in women who breastfeed their babies. Have you considered breastfeeding your baby? If your high cholesterol levels are related to your family history, your baby may also have high cholesterol later in life. We know that infants who were breastfed have lower cholesterol levels than infants who were not breastfed. Unless you and your doctor decide that your cholesterol levels are too high to wait to use medication, strongly consider breastfeeding; it could benefit both your and your baby's cholesterol levels. 7, 8

Since the Dr. Gourmet website is about great nutrition and gourmet cooking, I just had to mention – Breast milk has been shown to be the BEST nutrition for babies. As far as "meal preparation" - Did you know that babies prefer their own mother's milk to that of milk "prepared" by strangers? Ask any baby, its truly a gourmet meal!

About statins (cholesterol lowering medication) - Minimal amounts of most of these medications appear in mothers' milk. However, because we know so little about their effect on a growing baby, the current recommendation is that breastfeeding women not take these medications.

What can you do while you wait?

Don't worry! Yes, I know that is difficult. It is easy to worry about your own health and that of your baby. However, stress can contribute to higher cholesterol. Look at the evidence, talk to your doctor, make decisions and then go with it! Now is a good time to consider things that help you reduce stress. (music, nature sounds, water, touch…) Practice these now but also make a list of "stress reducers" and give it to your partner or doula so they can suggest these in early labor. A relaxed mom can labor more efficiently.

Eat well. Extremely low cholesterol diets are not recommended during pregnancy, but you will want to be moderate about your cholesterol and saturated fat intake. Make sure you include lots of fresh fruits and vegetables. Increase those whole grains. Oatmeal is good. If you like it, include it. Stay away from the high fat meats. Include sea food. Consider low fat frozen yogurt instead of the ice cream. Add nuts to your diet if you don't already eat them.

What about garlic? While the best research says that garlic has only moderate effect on cholesterol, it won't hurt you. If you like it, include it in your diet. If you include large amounts of garlic in your diet, you may want to decrease the amount as you get close to delivery. Several researchers recommend stopping garlic (at medicinal levels) one week before surgery because it might increase your clotting time (make it more likely that you would bleed).9 Don't worry about eating garlic while breastfeeding. Babies LIKE garlic in breast milk. 10

Exercise moderately. Staying active helps you stay healthy and can help with your cholesterol levels. Check with your doctor about the appropriate level of exercise for you. It can be as simple as a daily walk or as planned as a pregnancy exercise class.

One last thought. You mentioned craving "refined carbohydrates" during this pregnancy. Do you mean sweets? One "old midwives tale" that I have found in practice to have some merit is that pregnant women who crave sweets are often not eating enough protein for their specific needs. Eating more protein often diminishes the craving for sweets. Making sure you have adequate protein is especially important for you, as animal studies have indicated that both too low of a protein intake and too high a cholesterol level could possibly lead to IUGR (intra-uterine growth retardation), a condition where your baby does not grow like he or she should during late pregnancy. 11

Remember that food nourishes the "self" as well as the body. Here is my tip for foods that you really enjoy but that need to be limited, such as your ice cream. Go to the grocery store (or a specialty shop) and get the smallest amount of the best ice cream you can find. Bring it home. Put ONE SCOOP of this ice cream in a beautiful china dish and serve it to yourself with a cloth napkin. Sit at the table (not in front of the TV). Use a small spoon and savor every bite. Decide in advance how often you will have your "treat." Some women immediately give the rest of the container to a friend so they won't finish it. Others are fine waiting until the next "treat day." Giving yourself the highest quality treats available fills the "pampering" need we all have and rewards you for all you are doing for yourself and your child.

Nourish yourself and your child!


1. Qureshi IA, Xi XR, Limbu YR, Bin HY, Chen MI "Hyperlipidaemia during normal pregnancy, parturition and lactation." Ann Acad Med Singapore 1999 Mar 28(2): 217-21
2. Kalllio MJ, Silmes MA, Perheentup J, Salmenpera L, Miettinen TA "Serum cholesterol and lipoprotein concentrations in mothers during and after prolonged exclusive lactation." Metabolism 1992 Dec 42(12): 1327-30
3. "Cholesterol levels and the breastfeeding mom." JAMA 262 #15 2092 Oct 20 1989
4. Erkkola R, Vilkari J, Irjala K, Solakivi-Jaakkola T "One-year follow-up of lipoprotein metabolism after pregnancy." Biol Res Pregnancy Perinatol 1986 7(2):47-51
5. Qureshi IA, Xi XR, Limbu YR, Bin HY, Chen MI "Hyperlipidaemia during normal pregnancy, parturition and lactation." Ann Acad Med Signapore 1999 Mar 28(2): 217-21
6. Baranan A "Pregnancy-induced hyperlipoproteinemia: review of the literature." Reprod Sci. 2009 May;16(5):431-7
7. Christopher G Owen, Peter H Whincup, et. al American Journal of Clinical Nutrition, Vol. 88, No. 2, 305-314, August 2008
8. Christopher G. Owen, Peter H. Whincup, Katherine Odoki, Julie A. Gilg and Derek G. Cook. "Infant feeding and blood cholesterol: A study in adolescents and a systematic review." Pediatrics 2002-9;110(3):597-608
9. Brinker R Herb Contraindications and Drug Interactions 3ed. Sandy (OR): Eclectic Medical Publications: 2001. p 99-101
10. Mennella JA and Beauchamp GK. 1991. "Maternal diet alters the sensory qualities of human milk and the nursling's behavior."
11. Bhasin KK, van Nas A, Martin LJ, Davis RC, Devaskar SU, Lusis AJ. "Maternal low-protein diet or hypercholesterolemia reduces circulating essential amino acids and leads to intrauterine growth restriction." Diabetes. 2009 Mar;58(3):559-66