Supplements During Pregnancy - Are They Really Needed?
by Allison Gamble, Nutritionist

Part One

Eating for two (or more!) is not about consuming as many calories as possible, it's about the vitamins and minerals found in those calories!

Many moms-to-be wonder if multi-vitamin and mineral supplements are really necessary during pregnancy, so for this article, I set out to answer that question. For years I have lectured my family and friends about the reasons why supplements should not be a replacement for nutrients from food. I also felt the same way about pregnancy, if not stronger. I have always believed pregnancy is the time to be on your best behavior. I knew that if women were eating a variety of foods, not skipping meals and were exercising, they probably wouldn't need supplements. But then I started to think about the women who haven't planned for their pregnancies, and the women who are nauseated all the time, and the women who only tolerate turkey sandwiches and potato chips. Their nutritional status might rightfully need a boost. So I did a little investigating and am ready to share what I found out. Since it's easy to lose track of all the specific roles of vitamins and minerals, I thought I would briefly review some of their many functions. I will start with vitamins.

Thiamin, riboflavin and niacin are essential to help your body produce energy from the food you eat. Foods high in these vitamins are whole grains, legumes, organ meats and pork. Folic acid is involved in almost all aspects of DNA and RNA synthesis. If folic acid is lacking, cell division cannot proceed normally. Folic acid's role in preventing neural tube defects is a well known benefit. Vitamin B12 also plays a role in cell division and interacts with folic acid. Leafy green vegetables, liver, yeast, legumes, nuts, and whole grains are good sources of folic acid. B12 is available in all forms of animal origin. Vitamin B6 is important in amino acid metabolism and protein synthesis. There is also a possibility that B6 helps reduce severe nausea and vomiting. Studies have shown a reduction in those symptoms when women were given B6 supplements. Sources are liver, meats, cabbage, bananas, eggs, corn, whole wheat, fish and rolled oats. Vitamin D helps maintain calcium balance. Vitamins A, C, E and K help preserve structural and functional properties of cells. Vitamin E is found in vegetable oils, nuts, seeds, and whole grains. Vitamin C is found in citrus fruits, berries, and green vegetables. On a side note about vitamin A, many women are concerned with the possibility of birth defects from consuming high levels of vitamin A. The form of vitamin A found in foods - beta-carotene - will not cause toxicity. The form of vitamin A you want to watch levels of is retinol. The drug containing retinol taken orally to fight acne was found to produce birth defects. Those women were taking 25,000 IU per day. FYI: 100 percent of the daily value is 5,000 IU. Researchers recommend women trying to get pregnant should not take more than 8,000 IU per day of retinol. Supplements with preformed vitamin A should also be avoided during the first trimester, unless you are found to be deficient.

Now on to the minerals! Iron is needed for the manufacture of hemoglobin. The fetus accumulates the most iron in the last trimester, and draws on the mother's stores as its source for iron. Women whose iron stores are exhausted before pregnancy can reduce their baby's risk of anemia by taking iron supplements during 20-24 weeks gestation. If not, it can take up to two years after pregnancy to return to your pre-pregnancy levels. Iron deficiency may cause spontaneous abortion, premature delivery, low birth weight, still birth, and perinatal death due to the lack of oxygen in the mother's cells. The Journal of the American Medical Association's March 1997 issue reported that 7.8 million women in the U.S. are iron deficient and 3.3 million women have iron deficiency anemia. Minorities, women with low incomes, and women with multiple births are more likely to be iron deficient. Good sources are meats, egg yolk, whole wheat, seafood, green leafy vegetables, nuts and legumes.

Don't miss Part Two!