Pregnancy and prenatal vitamins and minerals

The Key Nutrients To Support Healthy Pregnancy

Whether you are currently trying to conceive, pregnant or are now breast-feeding, there is never a better time to start optimising your health through nutrition. Here at Equi, we advocate a varied and nutritious diet alongside our comprehensive formulas to support optimal health and wellbeing. Our award winning Pregnancy Formula provides 26 of the finest ingredients to support your fertility journey from your pre-conception plan right through to breastfeeding. We spoke to fertility nutritionist Jen Walpole (mBANT rCNHC) about some of the key nutrients that are needed in pregnancy to support Mum and baby. 

“Ideally, start supplementing your diet around three months ahead of conception. This timeframe factors in the maturation of oocytes (eggs), as well as a consideration for any nutrient deficiencies that might need supporting (1). Often, women have been on the oral contraceptive pill (OCP) for a long period of time and without realising, this may have depleted some of the key nutrients essential for pregnancy”.

 
Pregnancy and Folate Vs Folic Acid

Many women understand the importance of supplementing folic acid during pregnancy due to its involvement in prevention of neural birth defects. However, few are aware that about 40-60% of the population (2) are not able to make the conversion of the synthetic form (folic acid) to the active form, known as folate. This is why it’s important to point out the use of the active form ‘5-methyltetrahydrofolate’ in the Pregnancy Formula. As well as protecting baby during development, this form of folate alongside B12 supplementation has been shown (3) to protect against anaemia in pregnancy. Alongside supplementation additional folate can be obtained from the diet through dark green leafy veg such as broccoli, kale, pak choy, Brussel sprouts, spring greens as well as lentils, chickpeas and beans.

 
Best B Vitamins for Pregnancy 

I’ve already touched on two of the key B vitamins for pregnancy (folate, B9 and B12), but the rest of the B vitamins are also important when it comes to fertility. Why? Several studies have highlighted that taking the OCP may result in depletion of the B vitamins including B1, B2, B3 (4) and B6 (5). Optimising the B’s during your pre-conception period are pretty important for a healthy pregnancy. Whilst during pregnancy, maintaining optimal levels through supplementation will also support energy levels as they are involved in energy production in every single body cell. If you do start to feel nauseous and therefore, unable to eat a varied diet in the early pregnancy stages, supplementation can keep your levels on track in the meantime!

 
Pregnancy and Choline

Studies support the supplementation of choline (6) (sometimes categorised as a B vitamin) in pregnancy as it plays a vital role in brain and tissue development. In particular, it’s an important nutrient to supplement early on in pregnancy (ideally ahead of conception) since the foundation of brain development is established in the first 2 years of life from conception (7). Whilst we can obtain choline from food sources such as eggs, fish and red meat, but we likely won’t get enough of this without supplementing. This is why we add VitaCholine™️, an optimal form of this essential nutrient to our Pregnancy Formula and you can read more about the importance of choline during pregnancy here. 

 
Pregnancy and Vitamin D

We know that Vitamin D is super important for supporting a healthy immune system and for fertility (8), yet many of us are not hitting the optimal levels. This is because we rely on UVB sun rays making contact with the skin to produce vitamin D. Not only that but darker skin requires stronger rays too, which is sadly not something we experience often in the UK! Whilst the guidelines in the UK are to supplement 400IU per day during the winter months, a recent study (r9) concluded that actually more like 1000IU per day during preconception or pregnancy is needed to achieve optimal concentrations. Since this level is included in the Pregnancy Formula, there is no need to add in additional supplementation of vitamin D, which is super helpful.

 
Nutrients to Support Thyroid Function

The thyroid is a hormone producing gland that has a butterfly shaped appearance, located in front of the windpipe. The thyroid hormones regulate metabolism, growth and development and numerous studies suggest that optimal thyroid function (10) is crucial when it comes to a healthy pregnancy. Key nutrients that support the production of the thyroid hormones during pregnancy include Selenium (11) Iodine (12) and Zinc (13). For many reasons (including soil depletion of minerals), it can prove a challenge to get in these key nutrients through food so it’s a good idea to ensure they are part of your supplement formula. However, food sources to include in your diet are brazil nuts (around x3 per day max is enough to deliver enough selenium), fish, seafood, pumpkin seeds, wholegrains and meat.

 
Antioxidants and Pregnancy

Vitamins A, C and E have a protective role to play in the body as antioxidants, defending against tissue damage from ‘free radicals’. You can ensure to optimise your intake of these key nutrients by ‘eating the rainbow’. Vitamin A, in one of its food-forms is known as beta-carotene and is rich in lots of orange foods such as carrots, squash, sweet potato and mangoes as well as some greens such as spinach and broccoli. You can also find some of the active form of vitamin A in egg yolk, beef and bone broth. Vitamin C is not only found in citrus fruits but also kiwi, tomatoes, peppers and greens again including kale and watercress. What’s great about this vitamin is that it not only important for maintaining a healthy pregnancy but enhances iron absorption (with iron being essential for pregnancy too), and it also plays an important role in rejuvenating ‘used’ Vitamin E. Nuts, seeds and avocado are good sources of vitamin E. So, by making sure you are focusing on a varied and whole foods diet, you will ensure you are ticking these antioxidants off of your pregnancy nutrition list.

 
The Mediterranean Diet

Taking into consideration some of the key nutrients that are important for pregnancy, the Mediterranean diet is a favourable option to consider. Studies support its use in fertility (14) as well as during pregnancy (15) itself due to its association with favourable outcomes for the health of both mother and baby. In fact, a recent study (16) highlighted the use of this dietary pattern in reducing the risk of gestational diabetes and weight gain during pregnancy. So, what does the Mediterranean diet consist of? The foundation of the diet is very much plant-based with an array of vegetables, beans, lentils, nuts, seeds, some fruit and wholegrains (think about that rainbow again!). Within its plant-based core, healthy fats are important, which can be obtained from olive oil, olives, avocado, nuts and seeds. Fish 2-3 times per week, with at least one portion being of the oily variety such as salmon, anchovies or mackerel. Dairy intake in modest portions such as full fat Greek yoghurt, 2-3 servings of eggs per week and modest cheese or milk. It’s important to note that the best option is full fat and organic ideally. Meat and poultry are included in this diet in moderation. For example, some organic poultry 1-3 times per week would be satisfactory and some occasional ideally grass-fed, red meat 1-2 per week, which is also supportive of iron levels in pregnancy. Processed foods do not feature, however, a little of what you fancy is important too, especially as we know that it can be difficult to eat well all the time when tired and nauseas. If you want more advice on what to eat during pregnancy, including government advice on what needs to be cut out altogether, check out this article.
 

Pregnancy and Omega 3

Whilst these can be obtained in the diet as mentioned, the richest source of omega 3 is oily fish yet it is advised in pregnancy to consume no more than 1 portion per week (due to heavy metal toxicity). Therefore, it’s a good idea to supplement a good quality omega 3 in the form of a fish oil during pregnancy. A recent update of a Cochrane review (17) supported the supplementation of omega 3 (particularly DHA and EPA) during pregnancy. We created our Pregnancy Oil Edition as the perfect partner to Pregnancy Formula, which is high in super pure, triglyceride form DHA omega 3 to support healthy foetal brain development. This is also supportive during breastfeeding.

"I had no pregnancy symptoms at all, and felt so fit and well the whole way through, having started to take my Equi supplements a few weeks before I conceived. They've also continued to keep me strong since the birth of my son three months' ago, and have provided me with vital nutrients whilst I've had a (lovely) parasite stealing all my precious reserves! An amazing product and I’d highly recommend Equi to anyone. I’ll definitely take them again if I’m lucky enough to have more children." Camilla ⭐️⭐️⭐️⭐️⭐️ 

References

  1. Schaefer, E. and Nock, D., 2019. The Impact of Preconceptional Multiple-Micronutrient Supplementation on Female Fertility. Clinical Medicine Insights: Women's Health, 12, pp.1179562X1984386
  2. JA, G. and SJ, B., 2021. Multivitamin Supplementation During Pregnancy: Emphasis on Folic Acid and l-Methylfolate. [online] PubMed. Available at: <https://pubmed.ncbi.nlm.nih.gov/22229066/> [Accessed 6 April 2021].
  3. Bentley, S., Hermes, A., Phillips, D., Daoud, Y. and Hanna, S., 2011. Comparative Effectiveness of a Prenatal Medical Food to Prenatal Vitamins on Hemoglobin Levels and Adverse Outcomes: A Retrospective Analysis. Clinical Therapeutics, 33(2), pp.204-210.
  4. Park, B. and Kim, J., 2016. Oral Contraceptive Use, Micronutrient Deficiency, and Obesity among Premenopausal Females in Korea: The Necessity of Dietary Supplements and Food Intake Improvement. PLOS ONE, 11(6), p.e0158177.
  5. Wilson, S., Bivins, B., Russell, K. and Bailey, L., 2011. Oral contraceptive use: impact on folate, vitamin B6, and vitamin B12 status. Nutrition Reviews, 69(10), pp.572-583.
  6. Korsmo, H., Jiang, X. and Caudill, M., 2019. Choline: Exploring the Growing Science on Its Benefits for Moms and Babies. Nutrients, 11(8), p.1823.
  7. Derbyshire, E. and Obeid, R., 2020. Choline, Neurological Development and Brain Function: A Systematic Review Focusing on the First 1000 Days. Nutrients, 12(6), p.1731.
  8. Fung, J., Hartman, T., Schleicher, R. and Goldman, M., 2017. Association of vitamin D intake and serum levels with fertility: results from the Lifestyle and Fertility Study. Fertility and Sterility, 108(2), pp.302-311.
  9. Pilz, S., Zittermann, A., Obeid, R., Hahn, A., Pludowski, P., Trummer, C., Lerchbaum, E., Pérez-López, F., Karras, S. and März, W., 2018. The Role of Vitamin D in Fertility and during Pregnancy and Lactation: A Review of Clinical Data. International Journal of Environmental Research and Public Health, 15(10), p.2241.
  10. Li, J., Liu, A., Liu, H., Li, C., Wang, W., Han, C., Wang, X., Zhang, Y., Teng, W. and Shan, Z., 2019. Maternal TSH levels at first trimester and subsequent spontaneous miscarriage: a nested case–control study. Endocrine Connections, 8(9), pp.1288-1293.
  11. Duntas, L., 2020. Selenium and at-risk pregnancy: challenges and controversies. Thyroid Research, 13(1).
  12. Lee, S. and Pearce, E., 2015. Iodine intake in pregnancy—even a little excess is too much. Nature Reviews Endocrinology, 11(5), pp.260-261.
  13. Ota, E., Mori, R., Middleton, P., Tobe-Gai, R., Mahomed, K., Miyazaki, C. and Bhutta, Z., 2015. Zinc supplementation for improving pregnancy and infant outcome. Cochrane Database of Systematic Reviews,.
  14. Karayiannis, D., Kontogianni, M., Mendorou, C., Mastrominas, M. and Yiannakouris, N., 2018. Adherence to the Mediterranean diet and IVF success rate among non-obese women attempting fertility. Human Reproduction, 33(3), pp.494-502.
  15. Amati, F., Hassounah, S. and Swaka, A., 2019. The Impact of Mediterranean Dietary Patterns During Pregnancy on Maternal and Offspring Health. Nutrients, 11(5), p.1098.
  16. Al Wattar, B., Dodds, J., Placzek, A., Beresford, L., Spyreli, E., Moore, A., Gonzalez Carreras, F., Austin, F., Murugesu, N., Roseboom, T., Bes-Rastrollo, M., Hitman, G., Hooper, R., Khan, K. and Thangaratinam, S., 2019. Mediterranean-style diet in pregnant women with metabolic risk factors (ESTEEM): A pragmatic multicentre randomised trial. PLOS Medicine, 16(7), p.e1002857.
  17. Middleton, P., Gomersall, J., Gould, J., Shepherd, E., Olsen, S. and Makrides, M., 2019. Omega-3 Fatty Acid Addition During Pregnancy. Obstetrical & Gynecological Survey, 74(4), pp.189-191.
 

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Disclaimer: Certain supplements are used for different reasons and a one-size-fits-all approach shouldn’t be adopted. In addition, pregnant women and anyone on medication should always consult a doctor before embarking on a supplements programme. As with all articles on www.equilondon.com, this is no substitution for individual medical or nutritional advice.