Everyone knows how important it is to take a prenatal vitamin when you’re pregnant – but how do you choose one? Which nutrients are the most important, and in what quantities? Are there additional nutrients not offered in a prenatal that are vital in pregnancy? In this blog article, we’ll look at which nutrients are most important in pregnancy, and how to choose a good quality prenatal to ensure your body and your baby are getting all the nutrition you need.
In terms of diet, refer to “Prenatal Spotlight 1: Fertility & Pregnancy Diet” for the ideal diet to consume during all phases of your pregnancy including preconception.
Folate (or “folic acid”) is the most well-known nutrient that is absolutely required to supplement in pregnancy. We know that folate is needed for the baby’s rapidly dividing cells, and protection against neural tube defects (1) (choline and B12 are also important for preventing neural tube defects). Folate may also protect against preterm birth (2). “Folic acid” is a low quality, less-absorbable form of this vitamin, so opt for folate in the form of L-methylfolate to ensure you are getting the active form of folate. A minimum of 400 mcg daily is needed, but optimal amounts would be closer to 800-1000 mcg daily. In addition to supplementation, certain foods contain good amounts of folate, such as:
- Green vegetables like spinach, asparagus, brussels sprouts, broccoli, kale, etc
- Organic free-range eggs, grass-fed beef liver
- Walnuts, flax seeds, and sunflower seeds (raw, unseasoned)
- Beans, peas and lentils
- Avocados, bananas, and citrus fruits
Iron-deficiency is becoming a larger problem amongst the female population, probably due to blood loss with monthly menstruation, inability to absorb iron, and inadequate amounts of iron in the diet. The prevalence of iron-deficiency anemia in pregnancy is 17-31% in North America (3). While this isn’t the case for every pregnant woman, testing iron levels in blood work would be a helpful way to determine your iron status before and during pregnancy. Your doctor will more than likely order this during your first round of bloodwork so you will know for sure.
During Trimester 3, your pregnant body’s need for iron goes up with additional need for your growing fetus and increasing red cell mass (4). Iron supplementation is helpful for preventing blood loss during delivery and increases oxygen-carrying capacity (4). After getting iron tested, consider taking a prenatal multivitamin that contains iron, take an additional iron supplement, and/or increase your intake of iron-rich foods, especially in trimester 3. Iron is best absorbed with vitamin C, so combining a vitamin C source with your iron will help you best absorb it. A classic example is a steak with a side of broccoli!
Foods rich in iron include:
- Grass-fed, free-range red meat, poultry, and pork
- Wild fish and shellfish
- Leafy greens, especially spinach (although these contain non-heme iron, so are not as absorbable)
- Legumes, nuts and seeds (especially pumpkin seeds and lentils)
- Whole grains, especially quinoa
- Dark chocolate! Ensure you are eating something with over 70% cocoa from a sustainable source
Antioxidants (vitamins A, C, E, zinc, selenium)
Antioxidants are important molecules for our overall health as they protect us against dangerous free radical chemicals. They do this by neutralizing free radical molecules, which otherwise would cause extensive oxidative stress in the body. Vitamins A, C, E, as well as zinc, selenium, and others, all act as antioxidants. Deficiencies of antioxidant minerals are linked to preeclampsia, fetal growth restriction, and long-term increased risk for diseases like cardiovascular disease. (5).
Additionally, vitamin A is important for maternal night vision, fetal eye development, as well as organ and skeletal development and fetal immune system development (6). Selenium supports healthy thyroid levels for both mom and baby in addition to its many antioxidant roles (5). Lastly, zinc has vital functions for cell division and differentiation in early pregnancy, and is shown to improve fetal growth (5).
Most vegetables and plant foods are very rich in antioxidants, so refer to the Fertility Diet in Prenatal Spotlight #1 to cover your bases here.
Magnesium has so many vital functions in the body, working with enzymes to regulate body temperature, support the nervous system, and muscles. It may reduce fetal growth restriction, preeclampsia, and low birthweight (7). Magnesium can also help with leg cramps and restless legs.
Calcium is known for its role in bone formation, but it has many other functions like muscle contractions and hormone functions (8). Especially during trimester 3, the body will pull calcium from the mother for the fetus, so if you are not consuming enough calcium, this means that calcium will be pulled from your own bones! Ensure you are eating sufficient calcium in your diet as well as supplementing it (leafy green veggies, sardines, and grass-fed dairy).
Of course, you will want a prenatal vitamin with other B vitamins like B6, B12, and key minerals like manganese, iodine, choline, etc.
In trimester 3, omega 3s and 6s play an important role in the neurodevelopment of the baby (9). DHA is a specific fatty acid derived from omega 3, and is an important nutrient for fetal development of the brain and eyes, and up to 18 months of life. Although seafood is a good source of DHA and other omega 3s fatty acids, mercury toxicity is a concern for pregnant women and infants, so we should still be limiting our intake of high mercury fish like tuna, shark, swordfish, and other predatory fish. An omega 3 supplement with both EPA and DHA is a safer choice for pregnancy to supply the required amount (9).
A high quality probiotic is highly recommended by nutritionists during pregnancy for setting up gut health for the baby. Probiotics have been shown to reduce cases of infant eczema, allergies, as well as a reduction in vaginal infections, gestational diabetes and even depression and anxiety postpartum (10). Along with these benefits, probiotics are generally helpful for the digestive system, regulating bowel movements and improving absorbability of nutrients. In pregnancy, digestion is slowed and not as efficient; therefore, adding in a quality probiotic can be an effective way of mitigating unpleasant pregnancy digestive symptoms!
There are many, many supplements on the market for prenatal nutrition. Ensure you are choosing a supplement with bioavailable folate (discussed above – as opposed to folic acid). This will be a higher quality supplement derived from whole foods as opposed to synthetic sources. Higher quality supplements will be more beneficial as they are more absorbable, are formulated to be more gentle on the stomach, and have been studied for appropriate dosages and combinations. Here are a few options from Nutrition Dispensary:
- NFH Prenatal SAP: therapeutic formulation that supplies 1000mcg of folate + 30mg of iron
- Thorne Basic Prenatal: supplies 680mcg of folate and 30mg of iron daily
- Pure Encapsulations PreNatal Nutrients: supplies 1000mcg of folate and 27mg of iron daily
Get in touch with Nutrition Dispensary for a nutritional consultation to discuss which supplement might best suit your needs.
Blog Written by: Jennifer Costello
Jan 2023 Nutrition Dispensary Inc.
Advice and/or information provided is not intended to diagnose, cure, treat or prevent disease.
Other Articles in the Prenatal Spotlight
Prenatal Spotlight 1: Fertility & Pregnancy Diet
Prenatal Spotlight 3: Common Pregnancy Woes
Prenatal Spotlight 4: Postpartum Nutrition
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