There is a magic formula for a healthy pregnancy: diet! You have to eat well and supplement. As in previous posts, the nine months in utero can be the most consequential in a person’s life, determining genetic predisposition, illness, and even the hard wiring of the brain. So, it makes sense to have laid the groundwork before even trying. The basic principals of healthy eating remain the same as when you were eating well and supplementing prior to trying for a baby, although nutrient needs to change a little each trimester. A few nutrients in pregnancy do deserve a special mention. Here’s what’s at the top of the list:
IRON
The recommended daily intake of iron (RDI) during pregnancy is 22-36mg (10-20mg more than in non-pregnant state). The amount needed depends on the amount of iron the mother has ‘stored’ in her body prior to pregnancy. If a woman’s iron stores are very low, she may need to get more from a supplement. I have a client at the moment carrying twins; her iron levels at first trimester are very low. Iron supplements are regularly provided for pregnant women, as its often difficult to get enough iron from food, especially in the absence of red meat. Unfortunately, iron supplements in the inorganic ‘sulphate’ format (often given by doctors) can cause constipation, so seek professional help here, and don’t routinely add iron as it builds up in the body, and too much of a good thing is no longer any good! Never self-prescribe iron as some people have a predisposition for iron build up in the body – you want to be tested regularly for your levels, preventing this from happening. More on this topic can be found here: http://healthybabycode.com/5-myths-about-pregnancy-nutrition-2-all-women-should-take-iron-during-pregnancy
CALCIUM
The RDI of calcium during pregnancy is 1200mg per day; 300mg more than for non-pregnant women. During the third trimester of pregnancy, there is a large shift of calcium to the baby, as it starts to develop and strengthen its bones. If the mother isn’t getting enough calcium in her diet, the calcium needed by the baby is drawn from the mother’s own bones. This can have a negative impact on the mother’s bone health years later, leading to osteopenia and potentially osteoperosis, which women can already be predisposed to develop. Low calcium intake during pregnancy may also cause the baby to have weak bones, and impaired bone development. Dietary sources of calcium include: pine nuts, sesame seeds and tahini, sardines (with bones), seaweed (e.g. kombu and nori), salmon, almonds, figs, spinach and watercress. These all yield higher calcium uptake levels than milk!
ZINC
Zinc is an extremely important mineral to take across all trimesters, and should be in a good prenatal diet too. Prior to preconception, zinc is involved in over 100 enzymatic reactions in the body and vital for immunity, hormonal function, and bone development.
Zinc is also vital for male fertility, as it helps improve motility, sperm count and the morphology (structure) of the sperm. If you are low in this mineral, it can affect your mood; mothers with post-natal depression have been tested, and generally show low levels of zinc.
Zinc is also needed to help heal and repair tissues after birth, and a massive dose is taken from the mother’s own stores by the baby immediately prior to birth, leaving the mother very low.
Zinc is needed specifically by the newborns. If you have low levels when breastfeeding, this can lead to an unsettled, unhappy baby.
OMEGA-3s
A decent intake of Omega-3 fatty acids is essential in maintaining the balanced production of hormone-like substances called prostaglandins. Prostaglandins help regulate many important physiological functions including blood pressure, blood clotting, nerve transmission, the inflammatory and allergic responses, as well as the function of the kidneys, gastrointestinal tract, and production of other hormones.
Large amounts of omega-3s are needed during pregnancy to help ensure the growing foetus has enough fats to develop. omega-3s have been found to be essential for both neurological and early visual development of the baby. However, the standard western diet is severely deficient in these critical nutrients. This omega-3 dietary deficiency is compounded by the fact that pregnant women become depleted when the foetus uses fatty acids to grow its nervous system. Omega-3s are also used after birth to make breast milk.
Research has confirmed that if pregnant women supplement their diet with EPA and DHA, it has a positive effect on visual and cognitive development of the baby. Studies have also shown that higher consumption of omega-3 fatty acids may reduce the risk of allergies in infants. Omega-3 fatty acids have positive effects on the pregnancy itself. Increased intake of EPA and DHA have been shown to prevent pre-term labour and delivery, lower the risk of pre-eclampsia, and may increase birth weight.
FOLATE
Folate is a B-group vitamin. Insufficient folate intake during pregnancy has been linked to neural tube defects, such as spina bifida in the unborn baby, and other issues such as facial clefts. To counteract the higher levels of spina bifida pre 1990s, some governments apply a mandatory enforcement of fortification of flour with folic acid. In the UK, some food industry giants have adopted this on their own, but in countries such as the US, Canada and Costa Rica, this has been in place for some time. Australia introduced mandatory folic acid fortification in 2009. In the UK there are some concerns that folic acid on its own increases colorectal cancer, and cause B12 deficiency, so the debate continues in spite of a recent push for mandating folic acid – it has get to come into force.
Folate should be taken prior to conception, and throughout the entire pregnancy (contrary to advice!). If this is implemented it can prevent 7/10 cases of neural tube defects. Low folate intake also increases the risk of multiple births (twins). Women who are in the early stages of pregnancy (or likely to become pregnant) should take folate supplements daily, and a good prenatal should provide this.
My professional advice would be against taking folic acid or methyl-folate on its own, as this imbalances other B vitamins, but as part of a good prenatal. Important whole-food sources of folate include: leafy green vegetables (like spinach, kale and collard greens), broccoli, asparagus, legumes, nuts and avocados.
ISSUES WITH FOLIC ACID
Some people may not be able to absorb folic acid, and in many cases without knowing this, giving them the synthetic form of folate (ie folic acid) as a supplement may be detrimental to their health. About 40-60% of the population has a genetic polymorphism that impairs the conversion of supplemental folic acid to its active form, l-methylfolate. In vivo, the body converts dietary folic acid to l-methylfolate through a series of enzymatic processes. The final stage is done with enzym methyletrahydrofolate reductase (MTHFR). Those with certain polymorphisms have inadequate MTHFR activity and should opt for a methyl-folate supplement instead.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3250974/
OTHER VITAMINS & MINERALS THAT ARE IMPORTANT
As well as iron and calcium, the other nutrients that should be boosted in the first and second trimesters include: vitamin C, B vitamins, vitamin D and magnesium. Vitamin D deficiency is at quite and alarming rate, particularly in the UK, so get your levels tested for this, and if low supplement with a therapeutic amount of vitamin D3 as suggested by your nutritionist or naturopath.
