Pregnancy…

It poses a very interesting situation for women’s health.  As a women you are providing another human-being all of its essential nutrients for survival! According to the American College of Obstetricians and Gynecologists (ACOG), pregnant women should increase their usual servings of a variety of foods from five basic food groups to include the following:

• Three to four servings of fruits and vegetables
• Nine servings of whole-grain or enriched bread, cereal, rice, or pasta for energy
• Three servings of milk, yogurt, and cheese for calcium
• Three servings of meat, poultry, fish, eggs, nuts, dried beans, and peas for protein

During pregnancy, a woman’s daily intake requirements for certain nutrients, such as folic acid (folate), calcium, and iron will increase. So how do we know if we are meeting the needs? Here are some facts that you may not know.

Iron:

Iron needs nearly double in pregnancy and are not likely to be met by diet. Total pregnancy iron requirement is ~1000mg requiring 4 to 6 mg/d to be absorbed in the last two trimesters.

Iron deficiencies may result in anemia.  The symptoms of which are tiredness, lack of stamina, headaches, insomnia, breathlessness, and loss of appetite.

Iron supplementation in non-anemic women has been shown to improve birth weight and to lower the incidence of LBW and preterm LBW, without changing anemia rates, possibly because iron was preferentially going to the fetus and placenta
Because the iron needs are not likely to be met by diet, the CDC recommends low-dose iron supplementation from the first prenatal visit, and encouraging iron-rich foods and foods that enhance iron absorption.
To enhance absorption, iron should be taken on an empty stomach, separately from each other, and separately from prenatal vitamins (calcium and magnesium inhibit absorption) but absorption is also reduced 40% to 66%. Problems with tolerance of iron have been know to affect compliance and lower or intermittent doses may be effective in treating anemia in pregnancy.

Rather than just relying on iron supplements to treat iron deficiency anemia, a much better response may be found by using high-iron food sources. Vegetables like broccoli and bok choy are rich in iron. These vegetables are high iron and also high in vitamin C, which increases absorption of their iron content. The presence of vitamin C in these vegetables help absorb iron. Other options include: Cereals and grains, cow peas, black-eye beans, lentils, soyabeans, beetroot greens, mint, parsley, turnip greens, spinach, dried dates, watermelon, raisins, fish, beef liver, chicken liver, clams, mussels, oysters, pork liver, sardines, shrimp and turkey.

Vitamin D:

Pregnant American women do not get enough vitamin D and generic prenatal multivitamins are not filling the gap, according to a University of Pittsburgh Schools of the Health Sciences study.

“Our study shows that current vitamin D dietary intake recommendations are not enough to meet the demands of pregnancy,” said Lisa Bodnar, assistant professor of epidemiology at the University of Pittsburgh Graduate School of Public Health and lead author of the study. “Improving vitamin D status has tremendous capacity to benefit public health.

A newborn relies completely on its mother for its vitamin D stores. When newborns are born with insufficient vitamin D levels it leaves them at high risk for rickets and other health problems. Rickets is a disorder caused by a lack of vitamin D, calcium, or phosphate. It leads to softening and weakening of the bones.
This makes sense since vitamin D helps the body control calcium and phosphate levels. If the blood levels of these minerals become too low, the body may produce hormones that cause calcium and phosphate to be released from the bones; leading to weak and soft bones.

Research shows that infant rickets is becoming a major health issue. If rickets is not corrected while the child is still growing, skeletal deformities and short stature may be permanent. If it is corrected while the child is young, skeletal deformities often improve or disappear with time.

Very few foods in nature contain vitamin D. The flesh of fish (such as salmon, tuna, and mackerel) and fish liver oils are among the best sources for vitamin D. The best way to get sufficient vitamin D is good old sunlight. It has been suggested by some vitamin D researchers, that approximately 5-30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis. Interestingly complete cloud cover reduces UV energy by 50%; shade (including that produced by severe pollution) reduces it by 60%. UVB radiation does not penetrate glass, so exposure to sunshine indoors through a window does not produce vitamin D.  Individuals with limited sun exposure need to include good supplements in their diets.

Vitamin Safety…

Remember, more doesn’t always mean better. There is such a thing as “too much”. Avoid taking several different supplements, but rather take one prenatal multivitamin that includes a variety of needed nutrients in one dose. Combining supplements (such as taking a folic acid supplement along with your multivitamin, etc) can raise concerns because you run the risk of overdosing on a particular nutrient. Taking more than twice the RDA of any nutrient should be avoided during pregnancy. As with anything, supplementation should not replace a healthy diet, but should work to fill in the gaps.  Make sure to consult with your physician before making any decisions concerning your pregnancy health.