Annotated Bibliography of Scientific Studies



(adapted and reprinted with permission from Metabolic ToxemiaAs-defined-by-the-1997-Merriam-Webster-M... of Late Pregnancy by Tom Brewer, M.D.. Originally published by the Society for the Protection of the Unborn through Nutrition (SPUN), 1982) publishes this annotated bibliography to help those interested and concerned people who want to explore the unequivocal role of foods, salt, water and drugs in determining the outcome of human pregnancy. Presented is a representative sample of decades of international research and practical clinical observations which have documented that prenatal nutrition is the predominant cause of maternal complications and a continuum of neurological, physical, motor, and behavioral abnormalities in the offspring. In fact, recognizes that maternal nutrition is as vital to maternal/fetal and neonatal health as the regular intake of oxygen.

This concept remains an unpopular point of view in U.S. obstetrics and nutrition science. The entire field is considered “controversial” by practicing physicians and research academics alike, but pregnant women and their families need correct, scientific, practical knowledge now, such as that which we have compiled.

The protective effects of enough good foods, salt and water and the dangers of harmful drugs have been demonstrated by researchers and practitioners all over the world, and yet since no “ethical” research worker can starve a pregnant woman under experimental conditions (as animal nutrition scientists are able to do), nutritional nonchalance and neglect continue to characterize the traditional prenatal care which pregnant women still receive in the U.S. in 2000. Contemporary textbooks of obstetrics, perinatology, internal medicine, pediatrics and even nutrition science still regard some of the works and point of view in this bibliography as “unscientific” simply because the studies establish a causal relationship, not just a statistical association, between malnutrition during pregnancy and major maternal/fetal and neonatal complications. Disregarding this direct cause-and-effect relationship is institutionalized among academicians in obstetrics, nursing, public health, nutrition and other professions who preoccupy themselves with unlimited, meaningless abstractions while neglecting the basic principles of ensuring maternal and newborn health.

The irrational, unscientific use of restrictive diets in prenatal care, i.e., low-protein, low-calorie and low-salt diets, has been thoroughly documented as being harmful to both the mother and her unborn child. Moreover, the blind use of “weight limitation” in pregnancy management has been exposed by clinical observations on many thousands of pregnancies and has been shown to be dangerous since it leads to malnutrition, especially in the last half of gestation.

This bibliography offers a foundation for sane obstetrical practices now which can make primary prevention of metabolic toxemia of late pregnancy, abruptio placentae, severe infections, low birth weight and brain damage a reality for all pregnant women and their unborn babies regardless of age, parity, race or socioeconomic status. It is essential that both mother and fetus be protected from all harmful drugs, other dangerous chemicals, and radiation as well as from the obvious ravages of prenatal malnutrition.


  1. Ross, Robert A.. “Relation of vitamin deficiency to the toxemia of pregnancy.” So. Med. J. 28:120, 1935.
    In North Carolina, he identified role of malnutrition and poverty in eclampsiaA-convulsive-state:-an-attack-of-convuls... and other human reproductive casualty.
  2. Strauss, M.B. “Observations on the etiology of the toxemias of pregnancy.” Am. J. Med. Sci. 190:811, 1935.
    Internist at Harvard recognized the role of proteins and related deficiencies in the etiology of eclampsia. Toxemia subsided in women placed on a 260-gram protein, well-balanced diet, with injections of vitamin B.
  3. Dodge, E., and Frost, T. “Relation between blood plasma proteins and toxemias of pregnancy.” JAMA 111:1398, 1938.
    The authors observed that low-protein diets, often prescribed by physicians for the treatment of toxemia of pregnancy, increased the severity of the disease. They successfully improved the condition with diets consisting of six or more eggs daily, one to two quarts of milk, lean meat, legumes and other nutritious foods; and they directly linked toxemia with low serum albumin and inadequate protein intake.
  4. Tompkins, Winslow T. “The significance of nutritional deficiency in pregnancy: A preliminary report.” J. Intl. Col. Surg. 4:147, 1941.
    Eradicated pre-eclampsia/eclampsia, low birth weight, and still birth at Philadelphia Lying-in Hospital. Infant mortality was reduced to 4 per 1000 births.
  5. Burke, Bertha S., et al. “Nutrition studies during pregnancy.” Am. J. Obstet. Gynecol. 46:83, 1943.
    Confirmed nutritional thesis of the etiology of eclampsia and demonstrated the protective effect of adequate nutrition on the mother, fetus/neonate and infant.
  6. Cameron, C. S., and Graham, S. “Antenatal diet and its influence on stillbirths and prematurity.” Glasgow Med. J. 24:1, 1944.
    In both prospective and retrospective studies, maternal malnutrition was found to cause low birth weights, stillbirth and infant mortality.
  7. Antonov, A. N. “Children born during the siege of Leningrad in 1942.” J. Pediatrics 30:250, 1947.
    War-caused famine led to widespread incidence of infertility, amenorrhea, a low birth weight incidence of 49%, and infant mortality of 500 per 1,000 live births.
  8. Mitchell, J., et al. “Dietary habits of a group of severe preeclamptics in Alabama.” J. Natl. Med. Assn. 41:122, 1949.
    Toxemia was found to be closely associated with inadequate nutrition. When placed on a sound diet providing, on the average, 124 grams of protein per day, all of the toxemic women improved.
  9. Ferguson, James H. “Maternal death in the rural South: A study of forty-seven consecutive cases.” JAMA 146:1388, 1951.
    The author described the severe poverty and malnutrition of toxemic women in rural Mississippi.
  10. Hamlin, Reginald. “The prevention of eclampsia and preeclampsiaA-toxic-condition-developing-in-late-pre....” Lancet 1:64, 1952.
    Eradicated eclampsia by an aggressive nutrition education program in a prenatal clinic, Women’s Hospital, Sydney, Australia.
  11. Tompkins, W. and Wiehl, D. “Nutrition and nutritional deficiencies as related to the premature.”Pediatric Clin. No. Am. 1:687, 1954.
    Weight at birth was highly associated with prenatal nutrition, weight gain during pregnancy, and pre-pregnancy weight. The low-birth-weight incidence among women who received protein and vitamin supplementation, gained substantial weight during pregnancy, and were not underweight at conception was less than 2%. In contrast, 24% of the babies born to women most likely to be malnourished were underweight at birth.
  12. Knobloch, H., et al. “Neuropsychiatric sequelae of prematurity: A longitudinal study.” JAMA 161:581, 1956.
    A well-controlled and meticulously designed longitudinal scientific study linking low birth weight to neurological dysfunction and impaired cognitive potential.
  13. Robinson, Margaret. “Salt in pregnancy.”Lancet 1:178, 1958. Classic study at St. Thomas Hospital, London.
    Among 2000 pregnant women, those put on a “low-sodium diet” experimentally had over twice the incidence of toxemia and significantly higher perinatal mortality than those told to “eat more salt.” This study should not have been done because it was unphysiological and needlessly harmed many mothers and babies.
  14. Brewer, T. H. “Limitations of diuretics therapy in the management of severe toxemia: The significance of hypoalbuminemia.”Am. J. Obstet. Gynecol. 83:1352, 1962.
    First published account of the threat diuretics pose to the health of mothers and their unborn by attacking maternal and fetal plasma volumes. This warning went unheeded, as the use of sodium diuretics became a routine practice in prenatal care among most obstetricians in the U.S.
  15. Green, G. H. “Maternal mortality in the toxaemias of pregnancy.” Aus. N.Z. J. Obstet. Gynaecol. 2:145, 1962.
    Ten toxemic women died in hypovolemic shock, without excess blood loss or infection.
  16. Brewer, T. H. “Administration of human serum albumin in seveacuteute toxaemia of pregnancy.” J. Obstet. Gynecol. Br. Cwlth. 70:1001, 1963.
    Rejected by editors of U.S. medical journals, this paper demonstrated the nutritional pathogenesis of metabolic toxemia of late pregnancy, stressing the problem of maternal hypovolemia.
  17. Brewer T. H. “Human pregnancy nutrition: A clinical view.” Obstet. Gynecol. 30:605, 1967.
    Advocates application of scientific nutrition and physiology in human prenatal care.
  18. Iyengar, Leela. “Urinary estrogen excretion in undernourished pregnant Indian women: Effect of dietary supplements on urinary estrogen and birth weights of infants.” Am. J. Obstet. Gynecol. 102:834, 1968.
    Demonstrated beneficial effects on fetal growth by improving maternal diets as late as the 36th week of gestation.
  19. Brewer, T. H. “A case of recurrent abruption placentae.” Del. Med. J. 41:325, 1969.
    Dietary history recorded of a woman who had two abruptions and two neonatal deaths of low-birth-weight babies in one year. After her malnutrition was corrected, she had a normal baby with no complications.
  20. Bletka, M., et al. “Volume of whole blood and absolute amount of serum proteins in the early stage of late toxemia of pregnancy.” Am. J. Obstet. Gynecol. 106:10, 1970.
    Valuable observation documenting that hypovolemia and hypoalbuminemia precede hypertension and other signs of metabolic toxemia of late pregnancy.
  21. Brewer, T. H. “Human pregnancy nutrition: An examination of traditional assumptions.” Aus. N.Z. J. Obstet. Gynaecol. 10:87, 1970.
    Exposes the incorrect ideology and dangers of the routine obstetrical practices of weight control, salt restriction and the use of sodium diuretics.
  22. Duffus, G. M., et al. “The relationship between baby weight and changes in maternal weight, total body water, plasma volumes, electrolyte and proteins and urinary oestriol excretion.” J. Obstet. Gynaecol. Br. Cwlth. 78:97, 1971.
    Total circulating protein mass correlated most significantly with infant birth weight.
  23. Platt, B. S. and Stewart, R. J. C. “Reversible and irreversible effects of protein-calorie deficiency on the central nervous system of animals and man.” World Rev. Nutr. Diet. 13:43, 1971.
    Neurological dysfunction is extensively linked to malnutrition in both animal and human studies in this review of 177 works.
  24. Brewer, T. H. “Human maternal-fetal nutrition.” Obstet. Gynecol. 40:868, 1972.
    Another call for the application of physiology and basic nutrition science in human prenatal care this paper criticizes the positions of the American College of Obstetricians and Gynecologists in this field; i.e., “nothing is known.”.
  25. Hibbard, Lester. “Maternal mortality due to acute toxemia.” Obstet. Gynecol. 42:263, 1973.
    Reports alarming increase in maternal deaths from metabolic toxemia of late pregnancy. Most of the toxemic women had been placed on low-salt and/or low-calorie diets. Some were also given sodium diuretics.
  26. Brewer, T. H. “Metabolic toxemia of late pregnancy in a county prenatal nutrition education project: A preliminary report.” J. Reprod. Med. 13:175, 1974.
    Data from National Institutes of Health retrospective study of 5,615 pregnancies delivered in Contra Costa County, CA, 1965-70, a 5� year period. No cases of eclampsia were found, or whether any maternal deaths in the nutrition project pregnancies. Not one woman had a cesarean for “severe pre-eclampsia” or “hypertension.”
  27. Grieve, J. F. K. “Prevention of gestational failure by high protein diet.” J. Reprod. Med. 13:170, 1974.
    Through nutrition education in his prenatal clinics and by hospitalized malnourished pregnant women for nutritional therapy, viz., “a pound of red meat every day,” an OB/GYN physician in Motherwell, Scotland, eradicated eclampsia and abruptio placentae. The incidence of perinatal death was reduced more than twentyfold.
  28. Habicht, J. P., et al. “Relation of maternal supplementary eating during pregnancy to birth weight and other sociobiological factors,” in Nutrition and Fetal Development. M. Winick, ed. New York: John Wiley & Sons, 1974.
    Caloric supplementation among low-income women resulted in eradication of stillbirth and a reduction of the incidence of low birth weight from 13.4 % to 3.5 %. Demonstrates the protein-sparing effects of calories from carbohydrates and fat among women on low-protein diet.
  29. Howard, Peggy. “Albumin concentrate can be used for preeclampsia.” OB/GYN News, October 1, 1974.
    All of the toxemic women given 50 grams of serum albumin daily gave birth to babies in good health. Infusion of serum albumin improved renal function, increased estriol excretion, prevented eclamptic convulsions, and resulted in a reduction in perinatal mortality to 1/4 the rate of the “controls” and eradication of abruptio placentae.
  30. Brewer, T. H. “Consequences of malnutrition in human pregnancy.” CIBA Review: Perinatal Medicine, pp. 5-6. Basel, Switzerland: CIBA-Geigy, Ltd. 1975.
    Discusses the role of malnutrition, including iatrogenicCaused-by,-or-originating-with,-the-doct... malnutrition, via physician-prescribed low-calorie, low-sodium diets and sodium diuretics in the etiology of metabolic toxemia of late pregnancy, abruptio placentae, low birth weight, prematurity, severe infections and brain damage in children. Another call for applied science in this field on the clinical level in human prenatal care.
  31. Lechtig, A., et al. “Effect of moderate maternal malnutrition on the placenta.” Am. J. Obstet. Gynecol. 123:191, 1975.
    Placental weight, associated with birth weight, increased with caloric supplementation, providing more evidence of the protein-sparing effect of calories.
  32. Higgings, Agnes C. “Nutritional status and the outcome of pregnancy.” J. Can. Diet. Assn. 37:17, 1976.
    Documents the value of nutrition education and food supplementation in the increasing birth weight, lowering infant mortality, and eradicating eclampsia.
  33. Matthews, D.D., et al. “Modern trends in the management of non-albuminuric hypertension in late pregnancy.” Br. Med. J. 2:623, 1978.
    Challenges the traditional therapies of hypertension in pregnancy: bedrest, sedation, low-sodium diets and sodium diuretics and pre-term induction. These are shown to be of no value or harmful. The authors still exhibit no conception of the role of malnutrition in causing hypovolemia.
  34. Laurence, K.M., et al. “Increased risk of recurrent of pregnancies complicated by fetal neural tube defects in mothers receiving poor diets, and possible benefit of dietary counseling.” Br. Med. J. 281:1592, 1980.
    Prospective and retrospective studies indicated that the second most common birth defect in the U.S. is preventable by sound nutrition. The incidence of neural tube defects was 18% in a control group of poorly nourished mothers.


  • Acosta-Sison, Honora. “Relation between state of nutrition of the mother and the birth weight of the fetus: A preliminary study.”. Philippine Islands Med. Assn. 9:174, 1929.
    The incidence of low birth weight was found to be nearly 10 times higher among poorly nourished women than in those determined to have good nutritional status.
  • Mellanby, Edward. “Nutrition and child-bearing.” Lancet 2:1131, 1933.
    Discussed the need for protective nutrients in human pregnancy and their eyes that eclampsia is a metabolic common nutrition-deficiency disease. He noted: “nutrition is the most important of all environmental factors in childbearing whether the problem be considered from the point of view of the mother or that of the offspring.”
  • Theobald, G.W. “Discussion on diet in pregnancy.” Proc. R. Soc. Med. 28:1388, 1935.
    Refuting various speculations about the causes of toxemia, the author concluded that its etiology is malnutrition.
  • Ebbs, John, et al. “The influence of prenatal diet on the mother and child.” J. Nutr. 22:515, 1941.
    The low-birth-weight incidence was 2.2 percent in the best nourished group.
  • Balfour, M. I. “Nutrition of expectant and nursing mothers. Interim report of the People’s League for Health.” Lancet 2:10, 1942.
    Food supplementation and nutrition education contributed to significant reductions in toxemia, perinatal death and maternal mortality.
  • Ross, Robert A., “Late toxemias of pregnancy: The number one obstetrical problem of the South.” Am. J. Obstet. Gynecol. 54:723, 1947.
    This grim report showed that the toxemia incidence and infant mortality were high among the malnourished poor.
  • Toverud, Guttorm. “The influence of nutrition on the course of pregnancy.” Milkbank Mem. Fund Qtr. 28:7, 1950.
    Proper nutrition reduced the incidence of low birth weight to 2.2% and halved that of stillbirths.
  • Jeans, P. C., et al. “Incidence of prematurity in relation to maternal nutrition.” J. Am. Diet. Assn. 31:576, 1955.
    Low birth weight was found to be highly correlated to prenatal nutrition.
  • Knobloch, H., and Pasamanick, B. “Prospective studies on the epidemiology of reproductive casualty: Methods, findings, and some implications.” Merrill-Palmer Qtr. Behav. Dev. 12:27, 1966.
    Maternal health is linked directly to child development.
  • Merrill-Palmer Qtr. Behav. Dev. 12:7, 1966.
    A continuum of neuropsychiatric disorders in this review of 49 scientific studies is associated with low birth weight and the presence of complications during pregnancy.

  • Schenider, Jan. “Low birth weight infants.” Obstet. Gynecol. 31:283, 1968.
    Documents the alarming rise in low birth weight in the U.S. after 1950.
  • Singer, J. E., et al. “Relationship of weight gain during pregnancy to birth weight and infant growth and development in the first year of life.” Obstet. Gynecol. 31:417, 1968.
    Weight gain during pregnancy is statistically related to birth weight and infant mental, neurological, and motor function. Unfortunately, the paper ignores the question of the quality of diet causing the weight gain.
  • Drillien, C. M. “School disposal and performance for children of different birth weight born 1953-1960.” Arch. Dis. Child. 44:562, 1969.
    Low birth weight is associated with an increase proneness to handicap and a lowered IQ. Birth weight was found to influence child development more than socioeconomic background.
  • Winick, M., and Rosso, P. “The effect of severe early malnutrition on cellular growth of human brain.” Pediatric Res. 3:181, 1969.
    Malnutrition during pregnancy is shown to lead to a significant reduction of brain cells in the newborn. Impaired hyperplasia of brain cells was reflected in their finding that brain weight, protein, RNA and DNA were substantially reduced in newborns of malnourished women.
  • Pike, R. L., and Gurskey, D. S. “Further evidence of Della tear he is defects produced by sodium restriction during pregnancy.” Am. J. Clin. Nutr. 23:883, 1970.
    The consequences of sodium deficiency, such as hypovolemia and stress on the renin-angiotensin-aldosterone homeostasis, are well documented.
  • Brewer, T. H., “Disease and Social Class,” in The Social Responsibility of the Scientist. Martin Brown, ed. New York: Free Pres, 1971.
    Examines mechanisms by which poverty and malnutrition cause human diseases including maternal and infant morbidity and mortality. Stresses the need for primary prevention.
  • Fort, A. T. “Adequate prenatal nutrition.” Obstet. Gynecol. 37:286, 1971.
    Proper fetal development and birth weight, the author states, are directly dependent upon the pregnant woman’s nutritional intake.
  • Schewitz, L. “Hypertension and renal disease in pregnancy.” Med. Clin. No. Am. 55:47, 1971.
    This erudite review of 100 studies demonstrated the absence of scientific validity increase driving a low-salt diet and/or sodium diuretics to edematous or hypertensive expectant mothers. Severely hypertensive pregnant women received 14 grams of salt daily without demonstrable harmful effects or increased blood pressures.
  • Chesley, Leon C. “Plasma volume and red cell volume in pregnancy.” Am. J. Obstet. Gynecol. 112:440, 1972.
    Leading expert in the field of “pre-eclampsia/eclampsia” condemned the use of sodium diuretics in toxemic patients because of their hypovolemic state. Subsequently, his highly regarded chapter entitled “The Hypertensive Diseases of Pregnancy” was dropped from Dr. Jack Pritchard’s edition of Williams Obstetrics.
  • Kelman, L., et al. “Effects of dietary protein restriction on albumin synthesis, albumin catabolism, and the plasma aminogram.” Am. J. Clin. Nutr. 25:1174, 1972.
    A valuable study done on men in South Africa which demonstrates the critical role of dietary protein intake in maintaining hepatic synthesis of serum albumin. Such studies in which daily protein intakes were reduced to 10 grams cannot be done ethically on human pregnancies, yet they demonstrate the pernicious effects of both low-protein and low-calorie diets.
  • Lowe, C. U. “Research in infant nutrition: The untapped well.” Am. J. Clin. Nutr. 25:245, 1972.
    Emphasizes that the abandonment of weight control, low-salt diets, and diuretics is necessary to significantly reduce the rates of prematurity and low birth weight.
  • Pike, Ruth L., and Smiciklas, H. “A reappraisal of sodium restriction during pregnancy.” Intl. J. Gynaecol. Obstet. 10:1, 1972.
    Demonstrates that salt is an essential, protective nutrient for human pregnancy and not a “poison,” as is still the by many OB/GYN physicians in the U.S.
  • Foote, R. G., et al. “The use of liberal salt diet in pre-eclamptic toxemia and essential hypertension with pregnancy.” New Zealand Med. J. 77:242, 1973.
    More clinical observations which destroyed the “salt is a killer” myth in human pregnancy.
  • Brewer, T.H. “Iatrogenic starvation in human pregnancy.” Medikon 4:14, 1974.
    A call for major changes in current U.S. OB/GYN nutrition and drug practices and antenatal care. Advocates that constructive actions be taken immediately to improve human maternal/fetal and neonatal health in the U.S. and to protect all pregnant women and their unborn from the ravages of prenatal malnutrition and harmful drugs.
  • Brewer, T. H. “Pancreatitis in pregnancy. ” J. Reprod. Med. 12:204, 1974.
    Another painful, often fatal complication of pregnancy linked to the use of sodium diuretics and low-sodium, low-calorie diets.
  • Brewer, T. H. “Toxemia - a disease of prejudice?” World Med. J. 21:70, 1974. Includes a review of Pathology of Toxemia of Pregnancy by H. L. Sheehan and J. B. Lynch (Edinburgh and London: Churchill Livingston, 1973).
    A great deal of emphasis is placed on the specific liver pathology associated with eclampsia.
  • Shneour, E. The Malnourished Mind. New York: Doubleday, 1974.
    Discusses, in a conversational manner, the unequivocal causal relationship between impaired development and malnutrition during pregnancy, infancy and childhood. Refutes the myth that mental deficiency is largely caused by genetic factors.
  • Williams, Phyllis S. Nourishing Your Unborn Child. New York: Avon, 1974.
    A useful guide for pregnant women, containing valuable information on pregnancy physiology, the role and sources of various nutrients, and 163 pages of menus and recipes.
  • Brewer, T. H. “Etiology of eclampsia.” Am. J. Obstet. Gynecol. 127:448, 1977.
    Refutes the age-old myth that eclampsia is a disease limited to the first pregnancy and another myth that it is caused by an occult “utero-placental ischemia.” The well nourished primigravida, protected from hypovolemia (the real cause of “utero-placental ischemia”) all through gestation, never develops eclampsia.
  • Brewer T. H., and Hodin, Jay. “Why Women Must Meet the Nutritional Stress of Pregnancy,” in 21st Century Obstetrics Now! Stewart and Stewart, ed. Marble Hill, Mo.: NAPSAC Press, 1977.
    Cites 143 references linking maternal malnutrition to a continuum of perinatal complications.
  • Williams, Sue Rodwell. “Nutrition during Pregnancy and Lactation,” in Nutrition and Diet Therapy, 3d ed. St. Louis: C. V. Mosby Co., 1977.
    An excellent textboproviding anga wealth informationion about basnutritionton science and iapplicationton on the clinical level. The first nutrition textbook to break with the traditional “nothing is known” position regarding the role of prenatal malnutrition in causing human reproductive casualtincludinging metabolic toxemia of late pregnancy.
  • Brewer, T. H. “The ‘No-Risk’ Pregnancy Diet,” in The Pregnancy after 30 Workbook. Gail Sforza Brewer, ed. Emmaus, Pa.: Rodale Press, 1978.
    Provides the expectant mother with the guidance she needs to maintain good health and give birth to a healthy, fully developed child. Valuable for women of any age.
  • Preventing Nutritional Complications of Pregnancy: A Manual for SPUN Counselors. Chicago: SPUN, 1978.
    A practical reference for those who wish to teach applied scientific nutrition and physiology to pregnant women. Concludes with a practical quiz of 25 questions.
  • Brewer, Gail Sforza. What Every Pregnant Woman Should Know: the Truth about Diets and Drugs in Pregnancy. New York: Penguin, 1979.
    An extremely valuable guide for the expectant mother. The author discusses physiological adjustment of pregnancy and how to meet its nutritional stresses to help the expectant mother maintain proper nutritional status, 92 pages of menus and recipes are included. Of equal importance to the reader is the books discussion of the history of all aspects of the salute of my to regimen (low-calorie and/or low-salt diets, blind weight limitations, use of sodium diuretics and amphetamines, etc.) to provide her with the confidence she needs to reject any regimen of nutritional mismanagement imposed by her health professionals.
  • Shanklin, Douglas, and Hodin, Jay. Maternal Nutrition and Child Health Springfield, IL: C. C. Thomas, 1979.
    This book, highly recommended for the health care professionals and others desiring scientific documentation of the role of malnutrition in human reproductive casualty, is a near-exhaustive review of prospective and retrospective scientific studies, physiological and neurological evidence, and epidemiological reviews linking prenatal malnutrition to a wide spectrum of perinatal complications. Containing 77 tables and graphs, the work cites 239 references. This book is an excellent antidote for the contemporary institutionalized nonchalance field of applied preventive nutrition prevalent among health care professionals.
  • Brewer, Gail Sforza. Lo Que Toda Mujer Embarazada Debe Saber: La Verdad Acerca de las Dietas y las Medicinas Durante el Embarazo. Mexico, D. F.: Editorial Diana, S.A., 1980.
    Spanish translation of number 34.
  • Gormican, Annette, et al. “Relationships of maternal weight gain, prepregnancy weight and infant birth weight.” J. Amer. Diet. Assn. 77:662, 1980.
    A retrospective controlled study documented that weight control and salt restrictions significantly reduced birth weight and resulted in other deleterious consequences.
  • Noble, Elizabeth. Having Twins. Boston: Houghton Mifflin, 1980.
    An absolutely unique book in that it recognizes and deals with the increased nutritional stresses of multiple fetuses and presents SPUN’s ideology and practical diet adapted for multiple births. (Note: the latest version of this book has not gotten rave reviews. People say it scared them! Check out the reviews on, and see what you think.)
  • “Prenatal nutritional counseling substantially reduces low birth weight deliveries.” Group Health News, March 1980.
    A voluntary prenatal nutrition education program at a Health Maintenance Organization resulted in a 61 percent reduction in the incidence of underweight births in addition to a significant decline morbidity and mortality.
  • Brewer, Gail, and Greene, Janice. Right from the Start Emmaus, Pa.,:Rodale Press, 1981.
    Incorporates the nutritional perspective on all aspects of fetal development, labor and delivery, breastfeeding, and first month after birth for mother and baby.
  • Kenefick, Madeline. Positively Pregnant. Los Angeles. Pinnacle Books, 1981.
    Containing a forward by SPUN’s president, Tom Brewer, M.D., the book appropriately proceeds to recommend SPUN’s diet, outline the specific role of nutrition in contributing to maternal health and fetal development, maintain an emphatic position against the use of physician-imposed restrictive diets and drugs, and discuss effective, common sense approaches in treating pregnancy-related complications. In contrast to other books which imply that pregnancy is a pathological process or, at best, fail to convey its pleasant aspects, the author successfully incorporated a balance of factual, practical information with humor while interspersing her personal experiences during pregnancy. Pregnant women, who will also benefit from the book’s 148 reference citations, useful glossary, and several illustrations, will find it delightful reading.
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