Healthy Pregnancy Series - Part 5: Vitamins, Supplements and Nutrition During Pregnancy
14.12.22 0 Comments
Eating a healthy, varied diet in pregnancy will help you get most of the vitamins and minerals you need. But when you're pregnant, or there's a chance you might get pregnant, it’s important to also take a folic acid supplement. It's recommended that you take 400 micrograms of folic acid every day – from before you're pregnant until you're 12 weeks pregnant. This is to reduce the risk of problems in the baby's development in the early weeks of pregnancy. It is also recommended that you take a daily vitamin D supplement. Another very important nutrient is vitamin A. But let's get this straight.
Vitamin A in Pregnancy
Vitamin A (retinol) is essential for the growth and differentiation of a number of cells and tissues. Notably during pregnancy and throughout the breastfeeding period, vitamin A has an important role in the healthy development of the fetus and the newborn, with lung development and maturation being particularly important. However, pregnant women or those considering becoming pregnant are generally advised to avoid the intake of vitamin A rich liver and liver foods due to its overuse toxicity. Too much vitamin A can harm your baby, but on the other hand, it's not good not to take this vitamin at all, as your body and baby need it in a safe amount.
How to Solve It?
Beta-carotene is an ideal form of vitamin A. Beta-carotene is a precursursor form of vitamin A. It is converted to vitamin A in the body on an ‘as-required’ basis which reduces the risk of vitamin A toxicity. In its unconverted form, beta-carotene acts as an antioxidant in the body, neutralising potentially damaging free radicals. If it is converted in the body then its actions are those of vitamin A. This makes it safe during pregnancy when high levels of vitamin A itself (retinol) should be avoided. Carotenoids are generally non-toxic.
Always check the label of your nutritional supplement and avoid vitamin A supplement in the form of retinol. Do not take cod liver oil or any supplements containing vitamin A (retinol) when you are pregnant. Avoid liver or liver products such as paté, as these are are very high in vitamin A.
If you want to get your folic acid from a multivitamin tablet, make sure the tablet does not contain vitamin A in the form of retinol but beta-carotene.
Folic Acid in Pregnancy
As already mentioned, the recommended dose of folic acid (vitamin B9) is 400 micrograms per day - from the period before pregnancy until the 12th week of pregnancy. Folic acid can help prevent birth defects known as neural tube defects, including spina bifida. If you were not taking folic acid before conception, you should start as soon as you find out you are pregnant.
If you have a higher chance of the pregnancy being affected by neural tube defects, you will be advised to take a higher dose of folic acid (5 milligrams). You will also be advised to take it every day until the 12th week of pregnancy. You may have a higher chance of neural tube defects if you:
- you or the child's biological father have a neural tube disorder
- you or the child's biological father have a family history of neural tube defects
- you have had a previous pregnancy affected by a neural tube defect
- you have diabetes
- you are taking anti-epileptic drugs
- you are taking antiretroviral medicine for HIV
If any of these apply to you, talk to your doctor. He may prescribe a higher dose of folic acid. Your doctor may also recommend additional screening tests during pregnancy.
Synthetic folic acid is harmful
Both deficiency and excess of folic acid can have negative effects. Synthetic folic acid is not the same as natural folate. Synthetic folic acid must be converted into folate by the body. However, it has a limited capacity to do so. Unconverted folic acid remains circulating in the blood and tissues. What happens next with this acid has not yet been sufficiently investigated. Current evidence suggests that such unmodified folic acid has the potential to disrupt normal folate metabolism and even promote cancer growth. The body can absorb up to twice as much synthetic folic acid as natural folate.
Folate is a B vitamin that helps the body make healthy new cells. Folate is naturally present in many foods, including vegetables (especially asparagus, Brussels sprouts, and dark green leafy vegetables such as spinach), fruits and fruit juices (especially oranges and orange juice), nuts (such as walnuts), beans, and peas. For Folate is 400 micrograms (mcg) per day. For dietary folate equivalents (DFE), it is 600 mcg per day. Taking folic acid is also recommended while breastfeeding. Breastfeeding mothers should consume 500 mcg of DFE per day. It is difficult to get the amount of folate recommended for healthy pregnancy and breastfeeding from the food itself, which is why it is important to take a nutritional supplement.
Folinic acid (5-formyl tetrahydrofolate) is one of the active forms in the group of B9 vitamins, known as folates. Unlike folic acid (which is a synthetic form of folate), folinic acid is one of the forms of folate that occurs naturally in food. Folic acid can be converted in the body to any of the other active forms of folate.
Mary Ruth's Prenatal and Postnatal Liquid Multivitamin contains folinic acid as a more bioavailable and better usable form of folic acid for the body.
Make sure that the folic acid is in the form of folinic acid or folate!
Vitamin D in Pregnancy
You need minimum 10 micrograms of vitamin D every day, especially between the months of September and March.
Vitamin D regulates the amount of calcium and phosphate in the body, which are needed to maintain healthy bones, teeth and muscles. The body makes vitamin D when our skin is exposed to summer sunlight (late March/early April to late September).
It is not known exactly how much time it takes to be in the sun to make enough vitamin D to meet the body's needs, but if you are in the sun, make sure to cover up or protect your skin with sunscreen before your skin starts to redden or burn.
Vitamin D is mainly found in foods of animal origin or is artificially added to some foods. The amount added to these products may vary and may only be small. Because vitamin D is only found in small amounts in foods, either naturally or added, it is difficult to get enough from the diet alone. If you are a vegan or vegetarian, it may be even more important for you to supplement the missing amount of vitamin D in the form of a nutritional supplement.
Do not take more than 100 micrograms (4,000 IU) of vitamin D per day, as this could be harmful to you.
If you have dark skin, cover up a lot, or spend a lot of time indoors, you may be at particular risk of vitamin D deficiency. You may need to consider taking a daily vitamin D supplement year-round. Consult your doctor.
Vitamin D is most often obtained from fish or sheep lanolin. There is a high risk of toxicity from these forms of vitamin D. Fish carry the risk of contaminating the oceans with heavy metals, especially mercury. Lanolin, in turn, is obtained by a chemical process from wool treated with anti-tick preparations. Therefore, the safest form of vitamin D is obtained from plant sources, for example, wild algae. This form of vitamin D is also suitable for vegans.
Iron in Pregnancy
If you don't have enough iron, you are likely to be very tired and may suffer from anemia.
Iron is naturally found in cane molasses, nettles, green leafy vegetables, dried fruits and nuts.
If the level of iron in your blood decreases, your doctor will recommend that you take iron supplements. Iron is well absorbed together with vitamin C.
Vitamin C in Pregnancy
Vitamin C protects cells and helps keep them healthy.
It is found in a wide variety of fruits and vegetables, and a balanced diet can provide all the vitamin C you need.
Good sources include:
- oranges and orange juice
- red and green pepper
- black currants
- Brussels sprouts
Vitamin C helps the body absorb iron.
Calcium in Pregnancy
Calcium is vital for the formation of a child's bones and teeth.
Sources of calcium include:
- milk, cheese and yogurt
- green leafy vegetables such as arugula, watercress or kale
- fish where you eat bones, such as sardines.
It can be difficult for vegans to get enough calcium from their diet. Calcium is well absorbed together with vitamins D3 and K2.
Magnesium in Pregnancy
Magnesium is an essential mineral important for more than 600 enzymatic processes in the human body. It is involved in protein synthesis, mitochondrial function, neuromuscular activity, bone formation and immune system competence. The state of magnesium in the body is important for the development of the fetus during pregnancy and for the growth of the newborn during the postnatal period. In addition, magnesium is able to influence fetal programming and the manifestation of disease in childhood or adulthood.
Omega-3 in Pregnancy
Adequate consumption of omega-3 fatty acids is vital during pregnancy because they are critical building blocks of the fetal brain and retina. Omega-3 fatty acids may also play a role in determining the length of pregnancy and preventing perinatal depression. The most biologically active forms of omega-3 fatty acids are docosahexaenoic acid and eicosapentaenoic acid. However, recent surveys suggest that pregnant women eat little fish and therefore do not consume enough omega-3 fatty acids, primarily because of concerns about the adverse effects of mercury and other contaminants on the developing fetus. Therefore, it is necessary to include in the daily routine an omega-3 nutritional supplement, which is obtained from seaweed.
Nausea, Vomiting and Constipation during Pregnancy
Nausea and vomiting affects about 85% of pregnancies and can significantly affect quality of life, especially during early pregnancy. In a recent study, researchers found that symptoms of pregnancy-related nausea, vomiting, and constipation were significantly improved by probiotics. During pregnancy, hormones such as estrogen and progesterone increase, causing many physical changes. These increases can also alter the gut microbiome, likely affecting digestive system functions and causing adverse symptoms such as nausea, vomiting, and constipation. Probiotic intake also significantly improved quality-of-life symptoms such as fatigue, aversion to food, and difficulty maintaining normal social activities, as reported in questionnaires.
One finding was that low amounts of bacteria that carry an enzyme called bile salt hydrolase, which makes bile acid to absorb nutrients, were associated with more pregnancy-related vomiting. Probiotics increase bile salt hydrolase-producing bacteria, which may explain why the supplements reduced levels of nausea and vomiting.
Another finding was that high levels of the gut microbes Akkermansia and A. muciniphila at the start of the study were associated with more vomiting. The probiotic significantly reduced the amount of these particular microbes and also reduced vomiting. This suggests that Akkermansia and A. muciniphila may be reliable biomarkers that can predict vomiting in pregnancy.
Another finding was that vitamin E levels increased after taking probiotics. Higher vitamin E levels were associated with lower vomiting scores.
Probiotics have also been found to significantly help with constipation.
Iodine in Pregnancy
Iodine helps the growth and development of the child, especially the brain. The child receives iodine from the mother, so pregnant and lactating women need it to a greater extent. During pregnancy and breastfeeding, eat iodine-rich foods and supplement with Eidon Ionic Minerals Liquid Ionic Iodine. During pregnancy and breastfeeding, it is recommended to take 150 mcg and from the 2nd trimester 250 mcg of iodine per day.
Vegetarian, vegan and Special Diet Restrictions during Pregnancy
A varied and balanced vegetarian diet should provide enough nutrients for you and your baby even during pregnancy.
But it may be harder for you to get enough iron, vitamin D3 and vitamin B12.
Talk to your midwife or doctor about how to ensure you are getting enough of these important nutrients.
If you are vegan or follow a restricted diet due to a food intolerance (for example, a gluten-free diet for celiac disease), consult your midwife or general practitioner.
Ask a nutritionist for advice on how to make sure you're getting all the nutrients you and your baby need.
In general, when choosing nutritional supplements, the rule applies: natural rather than synthetic, plant rather than animal. This way you eliminate the risk of contamination with toxic substances.
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