Pregnancy Nutrition: Supplements

Although nutrition is important in every stage of life, it is especially crucial right before conception and during pregnancy. Many women obsess over what they should and should not eat, while others view pregnancy as a time to eat whatever they want. What many women neglect, however, is the importance of choosing the right supplements. There are many supplements available that market to pregnant women, but the scary thing is that supplements are not regulated by the FDA.

So what should you look for in a prenatal vitamin?

First of all, if you are on a plant-based diet, the nutrients of primary concern are vitamin B12, iron, and vitamin D. Be sure to let your OB know that you would like those levels checked. Another good one to check is folate, but because it is found in many green vegetables, beans, and citrus fruits, it is unlikely that you will be deficient.

If you are not on a plant-based diet, definitely have your levels checked for folate, iron, calcium, and vitamin D. If your folate levels are low, increase your intake of green vegetables and legumes rather than taking the folic acid supplement that your OB will likely give you.

Folate v. Folic Acid

Folate is a vitamin (B9) found naturally in beans, greens, grains, and citrus fruits. It helps the body build and maintain DNA, and is important in helping the body make new cells (for example, red blood cells). The RDA for pregnant women is 600 micrograms/day, and 500 micrograms when breastfeeding.

In the 1960s, Richard Smithells and Elizabeth Hubbard noticed a correlation between women who had given birth to babies with neural tube defects and the women’s folate levels. They then organized a multi-center intervention study on women who had previously had a baby with a neural tube defect and found that the risk of recurrence with women who were supplemented with folate was 1/7 that of the unsupplemented women. Further studies showed similar results, so doctors began recommending that pregnant women supplement with the synthetic form, folic acid.

Starting in 1998, the FDA required that foods made with enriched flour, cereals, and dietary supplements be enriched with folic acid. If you look at the nutrition facts on your box of cereal, there’s a good chance it contains folic acid.

The problem is that while folic acid does help prevent neural tube defects, it is processed differently by the body than naturally occurring folate. Folic acid can build up in your body and play a role in cancer initiation and progression. There is even a theory that folate can “turn on” good genes, while folic acid does the opposite. Several studies show a strong increase in breast cancer in women who supplemented with folic acid during their pregnancies (read more here).

For these reasons, do NOT take a prenatal vitamin that contains folic acid. Instead, increase your vegetable intake and eat a good variety. If you are concerned about your folate levels, simply ask your OB to test them.

These are the supplements I took during my pregnancy and continue to take because I am still breastfeeding. This is not a sponsored post, so I’m not getting paid to recommend them. Dr. Joel Fuhrman keeps up with the latest nutrition research and designs his vitamins based on this research. You can order his vitamins from his website, www.drfuhrman.com.

I also recommend taking a DHA supplement in addition to eating natural sources of DHA, such as walnuts, flax, and chia seeds. DHA is needed for development of the baby’s central nervous system and vision, among other things.

Note: I took a version of this brand of DHA that is specifically for pregnancy. The bottle pictured above contains trace amounts of rosemary extract, which has been known to cause early contractions. I doubt these DHA pills contain enough rosemary extract to be harmful, but be sure you buy supplements specifically for pregnancy to be safe.

If you need to supplement vitamin D and calcium, opt for vitamin D3 (which is absorbed better than D2) and calcium carbonate (which is absorbed better than calcium citrate). Dr. Fuhrman also makes a D3 and calcium supplement, if you’re interested.

This is just part 1 of my pregnancy nutrition series. Next I will talk more about diet, but I know there is a lot of confusion with supplements and wanted to clear that up first. Stay tuned for more information on prenatal nutrition!

Contact me or comment below if you have any questions!