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  • Nutrition during pregnancy

Increased vitamin and mineral requirements

    • General Internal Medicine
    • Gynecology
    • Nutrition
    • Prevention and health care
    • RX
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  • 3 minute read

Pregnant women need little extra energy, but more vitamins and minerals than before pregnancy. Nutrients to which special attention should be paid during pregnancy are folic acid, iodine, iron and omega-3 fatty acids.

A balanced diet is particularly important during pregnancy and breastfeeding and has a positive effect both on the well-being of the mother and on the optimal development and health of the child. And this not only in the short term, but also long after pregnancy and breastfeeding. Food selection and thus the composition of nutrients should be particularly careful during pregnancy. On the one hand, the rapid growth and development of the unborn child place special demands on the mother’s body. On the other hand, food infections, such as toxoplasmosis or listeria, can pass to the unborn child and lead to serious illnesses and even death. Therefore, the right choice of food is of central importance. To meet the increased vitamin and mineral requirements, nutritional supplementation should be considered in parallel.

Take folic acid already before pregnancy

Since folate plays a central role in cell division and blood formation, an undersupply in the early stages of pregnancy can lead to significant complications: Premature births and miscarriages as well as severe malformations of the infant such as an open back (neural tube defect). Women who want to or could become pregnant should take 400 μg synthetic folic acid/day or equivalent doses of other folates in the form of a preparation in addition to a folate-rich diet so that the unborn child can develop optimally. The intake should be started at least 4 weeks before the beginning of pregnancy and maintained during the 1st trimester of pregnancy. If supplementation begins shortly before or even after conception, experts recommend taking a supplement containing 800 µg folic acid/day. Regardless of supplementation, pregnant women should increase their consumption of folate-rich foods such as green vegetables, especially leafy greens like spinach and lettuce, tomatoes, oranges, whole grains, potatoes, meat, eggs, and dairy products to meet their needs.

Sufficient iodine supply for physical and mental development

Iodine deficiency during pregnancy has particularly severe effects, such as an increased risk of premature birth and miscarriage. The infant is already born with a goiter and in the worst case permanent developmental disorders of the skeletal and nervous systems occur. Since the iodine requirement is increased during pregnancy, pregnant women should supplement iodine in the amount of 100 to 150 µg iodine/day. In addition to an iodine supplement, a good dietary intake of iodine is recommended via daily milk and dairy products, fish once or twice a week, especially sea fish, and the additional use of iodized salt. In the case of thyroid disorders, affected individuals should consult with their treating physician before supplementation.

SuSe II Still Study
There is a need for education and information regarding the supplementation of important nutrients for fetal development during pregnancy and also already in women of childbearing potential. This is the conclusion of the “Study to collect data on breastfeeding and infant feeding in Germany – SuSe II”, which the German Nutrition Society (DGE) has pre-published to accompany the 14th DGE Nutrition Report. Although 81.7% of the 966 women surveyed had supplemented folic acid during pregnancy, only 45.4%, or just under half of them, had started doing so – as recommended – before pregnancy. Because of the higher iodine requirement, pregnant women should also supplement iodine. Only half of the study participants followed this recommendation. “These results underline the importance of medical advice and education for women of childbearing age, but at the latest during pregnancy,” emphasized study leader Prof. Dr. Mathilde Kersting, Research Department of Pediatric Nutrition at the University Children’s Hospital Bochum (D).

Handle individually: Supplementation of iron and omega-3 fatty acids

Dietary supplementation of iron and omega-3 fatty acids should be managed on an individual basis depending on iron status and dietary history, respectively. Targeted iron supplementation in addition to a balanced diet should only be given after a medically diagnosed deficiency. To cover the demand for long-chain omega-3 fatty acids, at least one portion of fatty sea fish is recommended per week; if fish is not eaten, a preparation containing the omega-3 fatty acid docosahexaenoic acid should be taken.

Source: “Einnahme von Nahrungsergänzungsmitteln in Schwangerschaft,” Deutsche Gesellschaft für Ernährung e.V. Presseinformation 19/2020.

GP PRACTICE 2023; 18(8): 41

Autoren
  • Mirjam Peter, M.Sc.
Publikation
  • HAUSARZT PRAXIS
Related Topics
  • Folic acid
  • Iodine
  • Iron
  • Minerals
  • Nutrients
  • Nutrition
  • Pregnancy
  • Vitamins
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