A Simple Guide to Vitamins in Pregnancy
Maintaining a healthy, balanced diet throughout your lifespan is vital for ensuring optimal nutrient requirements are met to support health, while simultaneously preventing illness. At no time is this more imperative than during pregnancy, whereby nutrition is required to not only support the health of the mother during a period of rapid change, but to ensure proper growth and development of baby, too. The benefits of adequate nutrition during this time go way beyond the third trimester, with research indicating that mother’s diet in pregnancy may influence baby’s health right up until their second birthday! As such, the upmost emphasis must be given to food choices and vitamins in pregnancy to positively influence the health of the next generation.
Vitamins and minerals in pregnancy
When it comes to pregnancy, it is well understood that the energy needs of the mother rise due to increasing demands on the body as the foetus develops into a little human – although this is only during the final trimester, when women are recommended to consume an additional 200kcals per day[1]. Micronutrient requirements during this time are perhaps less well understood by the general population. There are no special requirements as such, as all essential vitamins and minerals for adults are still required during pregnancy, although requirements of some in particular increase during this period to support baby’s development.
As always, a Food First approach is recommended and expectant mums should be advised to eat a balanced diet including a variety of foods from all food groups. However, due to increased demands on the body, alongside nausea experienced by many women in pregnancy, this is not always possible and therefore supplementation is often recommended to bridge the gap. Our Pregnancy Support Formula contains a range of carefully selected vitamins and minerals specifically tailored to the needs of pregnancy.
What vitamins and minerals are required in pregnancy?
There are several nutrients that warrant special attention during gestation, including folic acid, vitamin D, iron and calcium. Let’s take a look at these nutrients in more detail…
Folic acid
Folic acid (or folate, in its naturally occurring form) is a B vitamin present in foods such as dark leafy green vegetables, beans, wholegrains and seeds. It has many roles in the body, a vital one being supporting the production of DNA and RNA; folic acid is also required to allow baby’s spinal cord and nervous system to develop healthily, and supplementation has been shown to significantly reduce the risk of neural tube defects, such as spina bifida, in newborns[2]. Folate is also needed to produce healthy red blood cells and is critical during periods of rapid growth, such as during pregnancy. Despite folate being found in a wide variety of foods, it is difficult to get the amount recommended for a healthy pregnancy from food alone. Furthermore, folic acid (the synthetic form of folate) is more readily absorbed by the body, with reported bioavailability rates of 85% and 50%, retrospectively[3]. As such, UK guidelines recommend supplementation of 400mcg folic acid daily from pre-conception up until 12 weeks of pregnancy.
Vitamin D
Vitamin D is widespread throughout the human body and plays important roles in brain health, immune response, muscle function, mood, bone health and more. The NHS recommends everyone in the UK takes 10mcg vitamin D daily in the winter months – including those who are pregnant[4]. Vitamin D helps the body maintain calcium homeostasis, and inadequate intake of vitamin D during gestation may increase the risk of rickets developing in the offspring[5]. While vitamin D requirements do not increase during pregnancy, it is vital that mother meets her requirements of this nutrient to support baby’s growing bones and teeth. Alongside supplementation, vitamin D can be found in some foods including eggs, oily fish, red meat and some specially fortified foods.
Iron
Iron is a mineral required for the production of hemoglobin, a component of red blood cells, which carries oxygen around the body. During pregnancy, blood volume increases substantially to contribute to optimal growth and development of the foetus; in fact, it is thought that approximately 45% more blood, equal to around 1250ml, is produced compared to pre-pregnancy levels[6]. As such, ensuring iron stores are adequate is imperative. Due to this increase in blood volume, iron-deficiency anaemia is very common in pregnancy, and can increase the risk of premature birth and postpartum depression, not to mention cause extreme fatigue for the mother[7]. Fortunately, this can be easily prevented by eating iron-rich foods (red meat, dark leafy greens, dried fruit and nuts) and taking iron supplementation, if necessary.
Calcium
Calcium is vital to support bone, teeth, heart and nervous system development in the growing baby. Furthermore, optimal calcium intake may reduce the risk of hypertension and preeclampsia for mum[8]. As such, calcium requirements increase from 700mg in non-pregnant women, to 1000mg in expectant mothers, resulting in a difference of 300mg a day. This can be met by eating calcium-rich foods including cheese, milk, tahini, tofu or fish with bones; alternatively, supplementation can be a useful way to ensure adequate intake during this time, especially if mother is unable to tolerate these foods due to nausea.
Should other nutrients be considered in pregnancy?
While the aforementioned nutrients are required in higher amounts during pregnancy, there are still a range of essential nutrients that are equally as important to promote healthy development of baby, and both pregnancy and postpartum health of mum. Choline, magnesium and chromium, for example, are required for healthy blood sugar balance; compromised blood sugar control is common during pregnancy, especially during the later stages, increasing the risk of gestational diabetes and pre-eclampsia[9], so supporting healthy blood sugar balance is vital.
Zinc, a mineral found primarily in seafood, is required for healthy fertility, and low concentrations during pregnancy have been linked to pre-term births and prolonged labour[10]. Finally, B vitamins help to metabolise energy from the food we eat; energy levels of the mother are often low during pregnancy (after all, the body is going through huge change and growing a human!) so ensuring sufficient B vitamin intake throughout pregnancy is paramount.
In conclusion, a range of nutrients are required for a healthy pregnancy. Special consideration should be given to ensuring adequate intake of folic acid, vitamin D, iron and calcium, though it is vital that all nutrient needs are met to promote positive outcomes for both mother and baby. While intake from food should be encouraged, meeting increased requirements may prove challenging for many expectant mothers and therefore exploring supplementation would be advised.
References
[1] Recommendations: Weight management before, during and after pregnancy: Guidance (no date) NICE. Available at: https://www.nice.org.uk/guidance/ph27/chapter/Recommendations#recommendation-2-pregnant-women (Accessed: March 12, 2023).
[2] van Gool, J.D. et al. (2018) “Folic acid and primary prevention of neural tube defects: A review,” Reproductive Toxicology, 80, pp. 73–84. Available at: https://doi.org/10.1016/j.reprotox.2018.05.004.
[3] Winkels, R.M. et al. (2007) “Bioavailability of food folates is 80% of that of folic acid,” The American Journal of Clinical Nutrition, 85(2), pp. 465–473. Available at: https://doi.org/10.1093/ajcn/85.2.465.
[4] Vitamins, supplements and nutrition in pregnancy (2020) NHS. Available at: https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/#:~:text=Vitamin%20D%20in%20pregnancy,bones%2C%20teeth%20and%20muscles%20healthy. (Accessed: March 10, 2023).
[5] von Websky, K. et al. (2018) “Impact of vitamin D on pregnancy-related disorders and on offspring outcome,” The Journal of Steroid Biochemistry and Molecular Biology, 180, pp. 51–64. Available at: https://doi.org/10.1016/j.jsbmb.2017.11.008.
[6] Sanghavi, M. and Rutherford, J.D. (2014) “Cardiovascular physiology of pregnancy,” Circulation, 130(12), pp. 1003–1008. Available at: https://doi.org/10.1161/circulationaha.114.009029.
[7] Abu-Ouf, N.M. and Jan, M.M. (2015) “The impact of maternal iron deficiency and iron deficiency anemia on child’s health,” Saudi Medical Journal, 36(2), pp. 146–149. Available at: https://doi.org/10.15537/smj.2015.2.10289.
[8] Hofmeyr, G.J. et al. (2019) “Calcium supplementation commencing before or early in pregnancy, for preventing hypertensive disorders of pregnancy,” Cochrane Database of Systematic Reviews, 2019(9). Available at: https://doi.org/10.1002/14651858.cd011192.pub3.
[9] Gestational diabetes (2022) Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. Available at: https://www.cdc.gov/diabetes/basics/gestational.html (Accessed: March 10, 2023).
[10] Ota, E. et al. (2015) “Zinc supplementation for improving pregnancy and infant outcome,” Cochrane Database of Systematic Reviews [Preprint]. Available at: https://doi.org/10.1002/14651858.cd000230.pub5.
