Preventing eclampsia : an interview with Tom Brewer, MD

Townsend Letter for Doctors and Patients, Nov, 2004 by CJ Puotinen

The most serious risk for an overweight patient is the doctor who assumes that if you're pregnant and have even slightly elevated blood pressure, you have toxemia and should stay in bed, stay away from salt, take diuretics and hypertension medications, try to lose weight, and get ready for a C-section or induced labor.

The symptoms of toxemia or eclampsia can seem to develop rapidly, but they actually progress gradually, with enough warning for the patient to reverse the trend. Midwives who follow my diet call this treatment "Turn It Around." That's exactly what they do, they turn the condition around. Most doctors believe that once eclampsia begins, it can't be corrected. That's an aphorism or a received wisdom, a shared belief, but it isn't true at all. One of my mentors, Maurice Strauss, (5) discovered in the 1930s that women who had severe morning sickness throughout their pregnancies often went into convulsions, but when he put them on high-protein diets as therapy, they stopped vomiting and experienced a normal pregnancy.

I've found that the only time hypertension doesn't respond to nutritional therapy is when it's a preexisting condition that isn't caused by diet, and that's unusual. Almost all pregnant women who have hypertension and edema have it because they aren't getting enough protein, other nutrients, salt, and fluids.

Another problem pregnant women face is gestational diabetes testing. Medical doctors assume all pregnant women are at risk for diabetes, so they test their blood sugar, but they don't use normal values to diagnose the results, they use a reference range based on test results from undernourished pregnant women. As a result, the glucose tolerance test (GTT) values for pregnancy are too low for women who follow the Brewer Pregnancy Diet. Women who are well-nourished are able to meet their babies' glucose needs without lowering their own, but most pregnant women in America exhibit lower plasma glucose levels than the rest of the adult population because they are not eating well. Doctors who insist on giving a GTT to women on the Brewer Pregnancy Diet should use the new diagnostic criteria established for non-pregnant individuals to avoid making an incorrect diagnosis of diabetes.

If a patient insists on taking the GTT, she should load up on starchy foods such as bread, potatoes, rice, pasta, and sugars for three days prior to the test. These carbohydrates help the liver store glycogen in preparation for the all-night fast imposed by the GTT protocol. This glycogen reserve can then stabilize the blood sugar during fasting. Without carbohydrate loading, you exhaust your liver's storage of glycogen overnight and may test out with a diabetic curve when, in fact, you are not diabetic at all, you're just temporarily glycogen-depleted.

Q: What about other risk factors, like smoking or exposure to environmental pollution?

Dr. Brewer: I always told pregnant women to try to refrain from smoking, drinking alcohol, and using street drugs, and I still think that's sensible advice. But when one of my patients told me her sister smoked two packs of cigarettes a day through five pregnancies, and all of her babies were full-term and weighed eight pounds, that convinced me more than ever that nutrition is the most important factor.