Beyond Folic Acid: The Supplements That Support a Healthy Pregnancy

Why Supplements Matter for Pregnancy

Conceiving, maintaining a pregnancy, and growing a baby from a two-celled embryo to a fully formed human with intricate biological functions and innate intelligence is one of the most complex and awe-inspiring processes the human body can undertake. It takes incredible strain on the mother's body, as the demands of the baby are favoured over the mother's. It takes an astonishing 80,000 kcal to maintain a pregnancy from start to finish and a lot of additional nutrients.

The baby is created out of what the mother eats. The additional calories and nutrition needed are taken directly from the mother's body. Pregnant mothers are advised to eat healthy and take folic acid, but sadly, this advice does not go nearly as far as it should. A healthy pregnancy and baby are so much more than just about folic acid and ‘eating healthy’. As the saying goes… It's much easier to grow healthy children than to fix broken adults. This statement has an incredible amount of truth behind it, and research has found that the nutritional environment of the baby before birth has a profound effect lasting well into adulthood. Research published in the Journal of American Clinical Nutrition concluded that major diseases of later life, including coronary heart disease, hypertension, and type 2 diabetes, originate in impaired intrauterine growth and development. It also concluded that there are strong pointers to the importance of the foetal maternoplacental nutrient supply, and if it fails to match the demands of the baby, long-term health consequences can result (1).

A healthy pregnancy isn't just about the baby. It's also about the health of the mother. The baby will take what it needs first, leaving the mother with less, or even worse still, none of the nutrition they need. A lack of nutrients can make pregnant women extra tired, with low moods, and there is plenty of evidence out there that shows a direct link between nutrition status and preeclampsia (2).

A healthy, balanced diet and a healthy lifestyle make a massive difference to the health of the pregnancy and baby. Unfortunately, due to the loss of nutrients in the soil and therefore food over the last 100 years, it can be challenging to meet the optimal level of nutrition of all nutrients through diet alone. As well as the decrease in nutrition, there are a few genetic variations that can make it hard for people with them to process specific nutrients if they are not in their active form. In high-quality food supplements, these nutrients are already in their active form, helping men with these genetic mutations to achieve the optimal level of nutrients.

Which nutrients are particularly important during pregnancy?

Vitamin D: Vitamin D synthesis through sunlight alone is, in most cases, not enough. Unless you spend vast amounts of time in the sun with minimal clothing, you are likely to need a vitamin D supplement. There are also genetic mutations that mean that some men can't store vitamin D, meaning that daily supplementation, especially in the winter, is essential for health. Vitamin D is needed for the absorption of calcium and phosphorus, which are used for the growth of the foetal bones and teeth. Vitamin D is also essential for muscles and immunity. Research concludes that higher maternal vitamin D levels are linked to a reduced risk of complications, including premature birth, preeclampsia, and infections, and that mothers who had sufficient vitamin D  had better birth outcomes, such as a healthy birthweight and stronger immune markers (3).

Vitamin E: Vitamin E is a fat-soluble antioxidant that protects cells from oxidative stress. During pregnancy, oxidative stress increases due to the high metabolic demands of foetal growth and placental development. Vitamin E helps to protect both the mother and baby from oxidative damage. Research has linked excessive oxidative stress to preeclampsia (4).

Vitamin K: Vitamin K is needed for normal blood clotting. Adequate maternal stores may help to prevent complications caused by not enough clotting factors during delivery and the post-partum period.

Vitamin C: Vitamin C is needed for the formation of collagen, a major structural protein in the developing baby's bones, teeth, cartilage, connective tissue, and skin. There are several genetic mutations that dramatically increase the amount of vitamin C needed each day. Vitamin C also increases the rate of iron absorption in the gut by preventing it from turning into an insoluble form. Iron, of course, is needed for the prevention of anaemia, which is common during pregnancy as blood volume increases.

B vitamins and Folate: B vitamins are needed for a vast number of functions within the body and during pregnancy. The most well-known B vitamin needed for pregnancy is folate. 400 mcg of folate is recommended for all women of reproductive age as it helps to protect against birth defects such as spina bifida, cleft lip, and cleft palate. Unfortunately, the official channels recommend folic acid, the synthetic form of folate. Some women can't metabolise folic acid. The active form of folate - methylfolate can be used by all women, even if they have the genetic factors, meaning they can't metabolise folic acid.

The other B vitamins are also essential for pregnancy. They contribute towards energy production, needed in higher quantities due to the energy demands of pregnancy. Vitamin B1 is needed for the nervous system, vitamin B2 is needed for the production of red blood cells, vitamin B3 is needed for foetal brain development, vitamin B5 is needed for vitamin D synthesis, vitamin B6 is needed for immunity, and vitamin B12 is needed for the nervous system. B vitamins are water-soluble and need to be taken every day.

Calcium and Magnesium: Calcium and magnesium work together and in balance with each other. Calcium is needed as a structural component of foetal bones and teeth. Research concludes that adequate calcium reduces the risk of preeclampsia (5). Magnesium is also a major component of bones and teeth in the foetus. Magnesium plays a large role in over 300 enzymatic reactions in the body, including those related to hormone synthesis and balance, making it essential for pregnancy.

Iron: Iron is a metal needed for the formation of hemoglobin and oxygen transport. Many women become deficient in iron during pregnancy. This is because blood volume increases, and therefore, the need for iron increases. Researchers have found that only 20 to 35% of women have enough iron stores to get through an entire pregnancy without supplementation. Iron levels drop during pregnancy, especially in the last few months, and many women become deficient if they don't take iron supplements (6).

Zinc: Zinc is essential for the synthesis of DNA. During pregnancy, there is a rapid rate of DNA synthesis, and adequate zinc is needed for the rapidly growing and developing foetus.

Iodine: Iodine is needed for normal growth in children, and this starts when the child is a foetus. Iodine is essential for thyroid function, controls metabolism in the mother and foetus. The World Health Organisation concludes that iodine is essential for the regulation of foetal brain and nervous system development. A woman's iodine requirement substantially increases during pregnancy, and an insufficient intake increases the risk of negative pregnancy and infant outcomes and intellectual impairment (7).

Choline: Choline is a vitamin-like substance that is recommended for supplementation during pregnancy. Choline is a precursor for acetylcholine, which is a neurotransmitter essential for brain development.

Myo-inositol: Myo-inositol is often taken by those who want to regulate blood sugar balance. Research concludes that myo-inositol has a similar effect in pregnant women and may be useful to those at risk of developing gestational diabetes (8).

Omega 3: Omega 3 supplementation is essential. The active component DHA is directly incorporated into the foetal brain. Research has found that a daily DHA supplement taking during pregnancy lead to a greater gestation, greater infant size and a reduction in premature births (9).

Conclusion

A balanced diet and healthy lifestyle are the foundation for a healthy pregnancy. However, some nutrients require additional supplementation to maintain optimal health of the mother and baby. A well-formulated supplement will provide those nutrients in the most bioavailable forms to ensure that everyone, even those with genetic mutations, receives optimal nutrition.

References

1.  Fetal nutrition and adult disease - ScienceDirect
2. Nutritional Status and Nutrients Related to Preeclampsia Risk - PMC
3. Vitamin D status during pregnancy: maternal, fetal, and postnatal outcomes - PubMed
4. Oxidative stress: Normal pregnancy versus preeclampsia - ScienceDirect
5. Calcium supplementation for the prevention of hypertensive disorders of pregnancy: current evidence and programmatic considerations - PMC
6. Iron status in pregnant women and women of reproductive age in Europe - ScienceDirect
7. Iodine in pregnancy and lactation
8. Myo-inositol supplementation for prevention of gestational diabetes mellitus in overweight and obese pregnant women: a systematic review and meta-analysis | Diabetology & Metabolic Syndrome | Full Text
9. DHA supplementation and pregnancy outcomes - ScienceDirect