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Nutrition and Pregnancy

Your nutritional choices before, during, and after pregnancy have a major impact on the long-term health of both you and your baby. Prepare for a healthy pregnancy by eating a balanced diet, taking a high-quality prenatal supplement, and maintaining an overall healthy lifestyle including regular physical activity.

Before You Get Pregnant

It is never too soon to begin preparing for your baby. As soon as you are actively trying to get pregnant, start taking a preconception prenatal that provides a complete range of nutrients including extra folate, choline, and vitamin D. Folate and choline are important for the early development of a baby’s nervous system, which occurs in the first few weeks of pregnancy, often before a woman knows that she is pregnant. Taking enough vitamin D to maintain a normal vitamin D level is also important for a healthy pregnancy.

For women over 35, taking a supplement containing coenzyme Q10 (CoQ10) may be beneficial. Research indicates that CoQ10 supports mitochondrial energy production in the ovary for improved egg quality.1

Eating Right During Pregnancy

Good nutrition is essential for a healthy pregnancy. In addition to taking a high-quality prenatal supplement, mothers-to-be need to eat a variety of healthful foods every day.

A balanced diet to support a healthy pregnancy consists of colorful fruits and vegetables, whole grains (whole grain bread and pasta, brown rice, quinoa, couscous), lean protein (meats, poultry, fish, milk, beans, and tofu), and healthful fats (olive oil, walnuts, almonds, avocados). Drink plenty of water every day, and reduce extra calories from added sugars and fats that can lead to unhealthy weight gain during pregnancy. Cut down on foods like soda, sweets, fried foods and salty snacks.

An Overall Healthy Lifestyle During Pregnancy And Beyond

A lifestyle that includes healthy eating habits, regular physical activity, and refraining from smoking, excessive alcohol consumption, and substance abuse will support the lifelong health of your entire family. Making good choices now can influence your child to lead a healthy lifestyle into adulthood.

It is safe and recommended for most women to continue their exercise routine throughout pregnancy. Moderate exercise improves or maintains physical fitness, helps with weight management, and enhances well-being during pregnancy.2

Talk to your doctor to see if you need to make any modifications to your exercise program.

Key Nutrients for Pregnancy

There are many different prenatal supplements on the market. It is important to find one that is easy to swallow and that you tolerate well. A high-quality prenatal should generally contain the following nutrients.

Vitamin D

Optimal vitamin D levels are important for a healthy pregnancy. Low vitamin D blood levels are common among pregnant women and have been associated with increased risk of complications (gestational diabetes, pre-eclampsia, bacterial vaginosis, and preterm birth).3-6 Low intake of vitamin D during pregnancy has also been associated with low infant birth weights and increased risk of childhood asthma.7,8

Many prenatals contain only 400 IU of vitamin D, which recent research suggests is inadequate. For example, one study showed that even with 800 IU of vitamin D a day, most pregnant women and their infants did not achieve a normal vitamin D level.9 Recent studies tested 2,000 and 4,000 IU of vitamin D a day in pregnant women. The researchers found these doses were safe and effective in achieving normal vitamin D levels.

Pregnancy complications such as preterm labor and infection were lower in women with higher vitamin D levels at delivery.10,11

Look for a prenatal with 2,000 to 4,000 IU vitamin D3, the preferred form of vitamin D, per daily dose.

Folate (Folic Acid)

Folate is critical during your first trimester to reduce the risk of neural tube birth defects.12 It is important to start supplementing with folate while you are trying to conceive to assure you have adequate levels during the all-important first few weeks of pregnancy. Look for a prenatal with 1 mg (1,000 mcg).

Choline

Choline is important to promote your baby’s brain development. Choline needs are increased during pregnancy and lactation because of its critical role in fetal and infant brain development.13 The metabolism of choline and folic acid are interrelated, so choline may also contribute to healthy neural tube development.14

Despite choline’s importance, few women get enough in their diet, and most prenatals do not contain choline because it is difficult to put into a tablet. National survey results show that only 6% of women in the U.S. meet the recommended amount of choline each day.15 Eat choline-rich foods (egg yolks, fish, chicken, broccoli, and brussels sprouts), and choose a prenatal with at least 100 mg.

Vitamin B6

Vitamin B6 (pyridoxine) may help reduce nausea during pregnancy. Vitamin B6 has been shown to be effective in reducing the severity of nausea and vomiting. Studies indicate that 30 to 75 mg a day can be effective in decreasing morning sickness.16,17 Taking up to 100 mg a day of vitamin B6 during pregnancy is safe.18 If you are experiencing nausea, choose a prenatal with 30-75 mg.

Iodine

Iodine promotes normal thyroid function and nerve and brain development. Your iodine requirements are increased during pregnancy and lactation. The World Health Organization reports that inadequate iodine is still a concern for pregnant women in the United States. Iodine is required for normal thyroid function,19 and iodine deficiency during pregnancy can result in an increased risk of birth defects, miscarriage, and stillbirth.20,21 Look for a prenatal with 220 mcg, the amount recommended during pregnancy.22

Iron

Increased iron is recommended to meet your increased needs during pregnancy. Your iron needs increase during the second and third trimester due to greater iron use by your developing baby. Iron supplementation is recommended to prevent low iron stores and anemia, which have been associated with pregnancy complications.23 Once you confirm you are pregnant, look for a prenatal that contains 27 mg, the Recommended Daily Allowance for pregnant women.22

Biotin

Biotin is broken down more rapidly during pregnancy. Studies indicate that biotin deficiency may be common among pregnant women and potentially increase the risk of birth defects.24 Look for a prenatal that contains 30 mcg of biotin, the amount recommended during pregnancy.18

Docosahexaenoic acid (DHA)

DHA is beneficial for your baby’s brain and visual development. DHA is an omega-3 fat found in high amounts in certain fish and algae. Fish intake, as well as DHA supplementation during pregnancy, has been associated with improved birth weights and a reduced risk for preterm delivery.25-27 DHA is important for your baby’s mental and visual development during pregnancy and throughout infancy.28-30 Developing infants cannot efficiently produce their own DHA, so maternal stores of DHA continuously decrease during pregnancy as DHA is transferred to the baby. Many pregnant women do not get enough DHA from food. Choose a prenatal that meets the recommended daily intake of 250-300 mg a day.

 

References

1. Bentov et al. J Assist Reprod Genet. 2011; 28(773-783).
2. ACOG Committee. 2015:126(6):e135-42.
3. Zhang et al. 2008; 3(11):e3753.
4. Haugen et al. Epidemiology. 2009; 20(5):720-26.
5. Bodnar et al. J Nutr. 2009; 139:1157-61.
6. Miliku et al. Am J Clin Nutr. 2016 Jun;103(6):1514-22.
7. Scholl and Chen. Early Hum Dev. 2009; 85(4):231-4.
8. Erkkola. Clin Exp Allergy. 2009; 39(6):875-82.
9. Yu et al. Clin Endocrinol. 2009; 70:685-90.
10. Wagner et al. Am J Obstet Gynecol. 2013; 208(2):137.e1-13.
11. Wagner et al. J Steroid Biochem Mol Biol. 2013 136:313-20.
12. MRC Vitamin Study Research Group. Lancet. 1991; 338(8760):131-7.
13. Shaw et al. Epidemiology. 2009; 20(5):714-9.
14. Shaw et al. Am J Epidemiol. 2004; 160(2):102-9.
15. Wallace and Fulgoni. J Am Coll Nutr. 2016; 35(2):108-12.
16. Vutyavanich et al. Am J Obstet Gynecol. 1995; 173:881-4.
17. Sahakian et al. Obstet Gynecol. 1991; 78:33.
18. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes. National Academy Press. Washington, DC, 1998.
19. Delange. Public Health Nutr. 2007; 10(12A):1571-80.
20. De Escobar et al. Public Health Nutr. 2007; 10(12A):1554-70.
21. Hollowell and Haddow. Public Health Nutr. 2007;10(12A):1532-9.
22. Institute of Medicine. Food and Nutrition Board. Dietary Reference Intakes. National Academy Press. Washington, DC, 2001.
23. Gautam et al. Medscape J Med. 2008; 10(12):283.
24. Mock et al. Amer J Clin Nutr. 2002; 75:295-9.
25. Olsen and Secher. BMJ. 2002; 324(7335):447.
26. Carlson et al. Am J Clin Nutr. 2013; 97:808-15.
27. Smuts et al. Obstetrics and Gynecol. 2003; 101(3):469-79.
28. Judge et al. Lipids. 2007; 42:117–22.
29. Escolano-Margarit et al. J Nutr. 2011;141(6):1216-23.
30. Dunstan et al. Arch Dis Child Fetal Neonatal Ed. 2008;93(1):F45-50.

     

     

     

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