Monday, May 9, 2011

Prenatal Vitamins Update: Food-based better?

I have previously written about getting vitamins and phytochemicals from food versus supplements.  There have been a few recent studies regarding this issue that specifically relate to pregnant women.  Here is an update on Food V. Supplements, some recommendations for food-based prenatal supplements, and a general pregnancy news update:

Be wary of extra iron in your prenatal vitamin: It may not improve your hemoglobin levels and the strain on your body to excrete extra iron might be an added source of stress (original source).  Consider getting your iron from food unless you are actually anemic.  In another article, results found that iron intake from food and supplements was positively correlated with birth weight but the opposite was not true - insufficient iron did not lead to lower birth weights.  The co-author states "... that doesn't necessarily mean women should take iron supplements during pregnancy."  For now, have your doctor or midwife test your iron stores and decide if you need to eat more iron or take a supplement.

In this study (subscription required) supplemental iodine was negatively associated with infant  neurodevelopment.   Maternal intake of ≥150 μg/day, compared with <100 μg/day, of iodine from supplements was associated with a 5.2-point decrease in Psychomotor Development Index.  The authors state: "Further evidence on the safety and effectiveness of iodine supplementation during pregnancy is needed before it is systematically recommended in iodine-sufficient or mildly deficient areas."  Since many new prenatal vitamins are adding 150 μg to their daily dose, this is something to look out for and discuss with your doctor. 

Here is a recent review of folic acid (versus the natural folate found in food), including the possibility of a related link between folic acid from supplements and breast cancer.  Also see this article about asthma in children of mothers who took supplemental folic acid in late pregnancy.

Here is the conclusion from the review article:
"Since the original link of low folate status to neural tube defects was detected, we have fortified and glamorized intakes of folic acid beyond the Dietary Reference Intakes (DRI). However, when supplementing with folic acid, more isn’t necessarily better. The data at times are conflicting and even show duality—some folate is good but perhaps too much is harmful. Overall, the evidence supports the notion that a well-rounded intake of folate from vegetables appears safe, but overconsumption of folic acid from supplements and fortification of bread and cereal products may have a ricochet effect. The supplement industry is a multimillion dollar conglomerate, and more Americans take dietary supplements than ever before. A recent Nielsen poll revealed that half of Americans take dietary supplements every day, whereas another survey showed that 60% of Americans take a multivitamin every day. Multivitamins tend to have folic acid at levels at or above the DRI in order to prevent neural tube defects. In a fortified world, are we promoting disease while trying to prevent it at the same time? Only time and more studies will reveal the answer.

If you are interested in lower iron levels, folate (as opposed to folic acid), and natural sources of iodine, you can find it in these food-based prenatal supplements.  Note: Although there are only a few on the market and not much research, some clinicians are started to recommend food-based supplements.  Always discuss your supplement routine with your doctor or nutritionist.

Omega-3 Add-on:

More Pregnancy Research and News:

Postpartum news: Stress May Help Spur Weight Gain in New Moms
Chicken or egg? Stress spurs weight gain and weight gain feeds depression


  1. You have a very well researched blog here! I am bookmarking it! I agree that getting all the necessary prenatal vitamins from natural food sources is best, but think for many women with low quality diets, this is very unrealistic. How do you think New Chapter's perfect prenatal vitamins stack up in this debat? They are after all whole foods in themselves (if I recall - 50 calories per pill or something crazy like that!)

  2. My wife is pregnant and I have heard conflicting information. Thank you for this view point. I value most view points by RDs.

  3. Very insightful on the folic acid and iron topics. It never made sense to me that women needed to supplement so much while pregnant.

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  5. I would recommend whole foods for the main diet of expecting mothers. Pre-natal vitamins are only food supplements after all. Fruits and vegetables will ensure a healthy mommy and baby.

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