Common sense, some would say, yet so many doctors still recommend calorie and weight restriction during pregnancy, forgetting that a diet for pregnancy is not necessarily a diet for life. This tunnel vision may only worsen with a recent study which concluded that the "liberal" weight gain now recommended (25-35 pounds) during pregnancy is not necessary (Lancet, 1998; 351: 1054-5).
A century of observation proves nutritional therapists are on the right track. In 1893, Dr Pinnard in France noted: "Since using the milk diet in the treatment of pregnant women with oedema, proteinuria, headaches and visual disturbances, I have not come across one case of eclampsia in more than 5000 women." (Ann Ob Gyn, 1900: 12-13).
One famous study from nearly 60 years ago compared outcomes for two groups of 750 women, many of whom were malnourished before pregnancy. The group which received careful nutritional counselling and vitamin and mineral supplements had no cases of pre-eclampsia or eclampsia, compared with 64 cases in the control group. In addition, there was no prematurity (37 in the control group) and only three cases of infant death, compared with 41 in the control group (J Int Coll Surgeons, 1941, 4: 147-54).
In Australia, in 1952, Dr Reginald Hamlin achieved remarkable results in the Women's Hospital in Sydney with an energetic nutritional campaign. He made sure all new patients were lectured by the superintendent and dietician on the principles of good diet. They were told to adopt a high protein diet which included red meat, milk, eggs and fruit, and were given vitamins. He was also adamant that women attend their ante natal appointments. If they did not show up on the appointed day, he would sometimes send the police out to their homes to find out why. His methods were unconventional, but the results complete elimination of pre-eclampsia in the hospital could not be argued with (Lancet, 1952; i: 64).
Enter Dr Brewer
Dr Tom Brewer, an American obstetrician, is perhaps the most outspoken proponent of nutritional therapy for pre-eclampsia. Yet, Brewer's work has been all but ignored by the medical profession. Not because it doesn't work, but because Brewer himself is so outspoken about its benefits. Brewer wrote his first book about the benefits of dietary therapy in the treatment of pre-eclampsia back in 1966. His book, Metabolic Toxaemia of Late Pregnancy (Keats/Thorsons, 1982), remains a standard reference for anyone who rejects the "enigma" status of the disease and wishes to prevent or halt the progression of pre-eclampsia.
His work stems from noticing far higher rates of pre-eclampsia among his poorer, public clinic patients than among his better fed, private patients. Because of this, he started prescribing a liberal, high protein diet for his public patients in a deprived district of New Orleans,. As a result, he completely eradicated eclampsia and virtually eradicated pre-eclampsia from his practice.
This result has been confirmed in published papers, though, some would argue, not scientifically designed trials (J Green in Enkins, et al. Effective Care in Pregnancy and Childbirth, as above). It also has the backing of many women who, frustrated with the ineffectiveness of conventional treatment, choose to follow Brewer's diet.
Dietary red herrings
One of the reasons why the medical profession has concluded that dietary measures don't work is that its definition of "dietary measures" included only restrictive measures (weight gain, salt, fluids). There is plenty of evidence to show that restrictive regimens, far from preventing pre-eclampsia, may actually end up causing it (Baillieres Clin Ob Gyn, 1995; 9: 497-507).