Month 3 Fine-tine your intake

You know that what you eat influences the development of your unborn baby, but you may not know what impact these nutrients have.

There is growing scientific evidence that specific micronutrients are required during different periods of pregnancy for optimal growth and development of Baby. So often we hear that vitamins are important, and there is a general assumption that since they are natural, they are all safe.

This blanket safety assumption is dangerous – and especially so during pregnancy. What of the lesser-known micronutrients in pregnancy? What is important to know about these vitamins?

VITAMIN A

This fat-soluble vitamin is stored in the liver, and is important for the development of the heart, lungs, eyes, kidneys, bones, and the circulatory, respiratory and central nervous systems in the developing foetus. It is also important for fat metabolism in the foetus and fighting off infections. Vitamin A is naturally found in two forms: preformed vitamin A (retinol) and beta-carotene, which is a specific carotenoid. Preformed vitamin A is used directly by the body and is found mostly in animal products. The carotenoids, however, are found in fruits and vegetables (typically those that are orange), and the body converts this ingredient into vitamin A. The average Western diet provides plenty of vitamin A in the retinol form since it is available in meat, dairy, fish, eggs and fortified cereals. In addition, the fruits and vegetables we eat have carotenoids in them, which means that the body can manufacture vitamin A, should it need to.

During pregnancy, it is important that your preformed vitamin A consumption (like liver) is not excessive, as it can cause birth defects and liver toxicity in the developing foetus. This is not true for the carotenoids (fruits and vegetables), however, since they are converted to vitamin A as needed by the body.

For this reason, you also shouldn’t double up on antenatal supplements that contain preformed vitamin A.

If you’re pregnant or planning a pregnancy, avoid using high-dose vitamin A medications that are used to manage acne.

Folic acid or folate is regarded as somewhat of a pregnancy superhero vitamin. Folate is important in the production of red blood cells and the development of the neural tube into the brain as well as the spinal cord of the foetus. The birth defects associated with lack of folate occur within three to four weeks of pregnancy. Therefore it is important to take folic acid when you’re trying to fall pregnant. You don’t want it to be too late for folic acid once you realise you’re pregnant, but this can happen.

It is recommended that all women of childbearing age take a supplement with folic acid in it. If you are taking an antenatal supplement with approximately 400ug to 600ug (mcg) of folic acid, it is not recommended that you take any additional folic acid.

This is because high doses of folic acid have been associated with the development of some cancers. In addition to the neural tube issues associated with folate deficiency, supplementation with folate can ensure your baby is protected against cleft lip, premature birth, low birth weight, miscarriage and poor growth in the womb. Foods naturally high in folate include dark-green leafy vegetables, lentils, and fortified cereals.

VITAMIN D

This vitamin is called the sunshine vitamin, since the body makes it when it is exposed to the sun. However, this conversion is affected by the use of sunscreen. Vitamin D conversion cannot happen through glass either. Many pregnant women avoid the sun since they are prone to pigmentation changes made worse by pregnancy.

Certain medications and gastrointestinal malabsorption illnesses such as Crohn’s and coeliac disease can also reduce absorption. Deficiency of this vitamin during pregnancy has been associated with growth retardation and skeletal abnormalities in the growing foetus and can also extend to poor bone development and compromised immune function in the infant, which could extend well into adulthood. Deficiency in vitamin D has also been linked to pregnancy complications such as preeclampsia. In addition, long-term vitamin D deficiency has been linked to autoimmune illnesses such as diabetes, high blood pressure, multiple sclerosis and cardiovascular disease. But sunshine is not the only source of vitamin D. A safer option is food. Foods that are rich in vitamin D include fatty fish, eggs, fortified milk and cereals. Taking an antenatal supplement will ensure that you obtain some vitamin D. It is, however, very important to note that vitamin D can reach toxicity levels in the blood and should not be taken in large doses without the supervision of your medical practitioner.

CHOLINE

This important nutrient is necessary to assist in proper development of brain cells. A number of scientific studies have shown adequate choline intake during pregnancy may have an impact not only on Baby’s ability to learn and remember, but may also protect against certain mental illness. Choline, like folate, is also important in the development of the foetal neural tube. Foods that are rich in choline include eggs, meat, fish, raw spinach and some nuts. Most antenatal vitamin supplements do not contain choline, hence dietary sources remain the best option. ●