This article is part of our Healthy Body Healthy Mind series and is part 3 in our series on Achieving Optimal Nutrition and Health in Pre-Conception and Pregnancy
by Amy Pearman BHSc (Nut Med) ANTA and owner of High on Natural Health
Folate in pregnancy
Folate is vital and well known as an important nutrient in pre-conception care and pregnancy and is a common and an important edition to multivitamin preparations for these stages.
It is vital for proper DNA synthesis and regulation and research has time and again proved its importance in preventing birth defects such as neural tube defects and spina bifida and in doing this improves pregnancy outcomes. Folate is also vital for the maturation and quality of the developing ovum.
| The recommended daily intake of folate during pre-conception care and pregnancy is 800mcg and should be consumed in this amount daily for at least three months pre-conceptually and during, at least, the first trimester of pregnancy. |
Due to its protective effects against spontaneous abortion, diseases of the placenta and the health and development of red blood cells of both the mother and baby throughout the pregnancy, the continuation of a wholefood diet, rich in folate, and a quality pregnancy multivitamin is encouraged after the first trimester also.
Foods that are high in folate and are recommended throughout preconception and pregnancy include: Dark green leafy vegetables; spinach, kale, silverbeet, cabbage, broccoli, asparagus, watercress and lentils, beans, eggs, barley.
Iodine in pregnancy
Iodine is required for normal foetal brain and nervous system development in early pregnancy and throughout foetal development.
| It is required at 150mcg/day during preconception and should be increased to 250mcg/day when pregnancy is achieved to promote healthy physical and mental development. |
It can be hard to achieve adequate iodine through your diet alone, with foods that are known to be high in iodine few and far between, seaweeds (wakame, nori, dulse, kelp, spirulina) being the best sources. Iodine is therefore hard to acquire in adequate levels from the diet and is an important and common edition to preconception and pregnancy multivitamins in adequate levels.
Iron in pregnancy
Iron is required for healthy red blood cell production, transport of oxygen to the body’s cells and as the foetus grows and the mother’s blood volume increases to compensate and the foetus own cardiovascular system develops, the requirement for iron is then even greater. Excessive tiredness often occurs as a result of decreased iron levels and stores during pregnancy.
| During pre-conception 18mg/day of iron is needed, increasing to 27mg/day during pregnancy. |
If you have a history of anaemia or are vegetarian or vegan and at a higher risk of deficiency, you may wish to consult a healthcare practitioner prior to conceiving to assess your iron status.
Omega-3 in pregnancy
As mentioned earlier omega-3 fats are vital in preconception, throughout pregnancy and lactation and throughout childhood development also. It is particularly the DHA, and to a lesser degree the EPA component of omega-3 which is most beneficial in these stages. DHA is needed for foetal nervous system development and maintenance, eye and brain development, cognitive development, to decrease the risk of pre-term births and birth complications. Improved eye-hand coordination and improved IQ are also noticed in children up until 4 years of age who received adequate DHA and omega-3 throughout foetal development. DHA also has beneficial effects for the mother’s nervous system and nerve transmission and can help to reduce the risk of post-natal depression after the birth.
The highest dietary source of omega-3 DHA and EPA are fish oils, particularly from deep -sea oily fish although due to possible contaminants, such as Mercury and pollutants, these dietary sources should be consumed in moderation as a source of omega-3 and some fish should be avoided altogether due to high Mercury content. For this reason high quality and mercury tested fish oil supplementation is often recommended for women planning to conceive and throughout their pregnancy and post-natal period to achieve the required omega-3 fat intake.
Not all fish oil supplements are the same; many contain low quality fish oils with little of the vital component for pre-conception and pregnancy, DHA, many are insufficiently and irregularly tested for mercury and other pollutants found in ocean fish and/or are processed in a way which deteriorates the fish oils and reduces their efficacy. Do not be fooled by cheap, often non-therapeutic and potentially harmful fish oil supplements, which can be purchased over the counter. I recommend always speaking to a health professional for advice regarding fish oil supplements and choosing a practitioner-grade supplement.
| Required intake of omega-3 during preconception and pregnancy:minimum of 3 grams of omega-3 essential fats daily, including 600mg-800mg DHA. |
It is recommended that no more than a total of 335grams (approx.2 serves) of low-mercury containing fish and no more than two 85gm tins of tuna per week be consumed during pre-conception and pregnancy.
| Fish that are high in Mercury- AVOID | Fish lower in Mercury |
| Shark (flake) Swordfish Fresh tuna Mackerel | Salmon Trout Whiting Sardines/anchovies Snapper |
Other good sources of omega-3 include: walnuts, chia seeds, chia seed oil, flaxseeds/linseeds.
These sources of omega-3 contain a different type of omega-3 fat, which rely on adequate levels of some nutrients for conversion to EPA/DHA in the body and therefore are not as bioavailable as fish and fish oils themselves.
Probiotics in pregnancy
Probiotics are beneficial bacteria that populate certain areas of the body and convey many health-promoting benefits. Probiotics are most commonly known for and have long been recommended and prescribed to regulate and maintain gastrointestinal health and function and improve gastrointestinal disorders. There are many, many different probiotic or bacterial strains and they contribute different and varying functions and effects to the digestive, urogenital and immune systems.
Recent research has now found that particular strains of bacteria also have a positive effect on infant health and help to decrease the incidence of allergy presentation and symptoms in the first year of life when supplemented during pregnancy. This is particularly important when the incidence of allergies is, is general, on the increase and is especially important and relevant for mother’s who suffer from allergies themselves (or the baby’s father does) and therefore their offspring are already at an increased risk of developing allergies in infancy and early years. I find this to be a commonly reported fear for expecting mother’s- preventing and decreasing allergies and intolerances in their babies.
Not just any or all probiotic supplements available over the counter provide the combination or required strengths of probiotics for the desired action. I would recommend consulting with a healthcare professional for advice about probiotic supplements before purchasing a product that may not suit your requirements.
Calcium in pregnancy
Calcium is an important mineral needed in relatively large amounts and should be an important inclusion in preconception care and right throughout pregnancy to maximise and maintain the mother’s stores, which are drawn on and can become depleted as the baby’s bones are formed, during the second half of the pregnancy, as well as being used directly by the growing baby. If dietary calcium is inadequate, supplementation may be recommended.
| Calcium requirement in pre-conception care and pregnancy: 1300mg daily |
Magnesium in pregnancy
Magnesium is essential to preconception and pregnancy care and nutrition. It is needed in many processes and functions throughout all body systems and is especially important for energy production in the expecting mum and energy for the growth of the baby. Magnesium is also important (along with calcium) in bone formation, in stress reduction and nervous system health.
| Magnesium requirement in preconception and pregnancy: Minimum of 500mg daily, up to 1000mg.Adequate intake and levels of calcium and magnesium have also been shown to reduce the incidence and severity of muscle cramping and restless legs syndrome, two common symptoms reported by women during pregnancy, especially in the last trimester. |
The requirement for nearly all nutrients increases during pre-conception and then pregnancy and consuming a wholesome and nutritious wholefood diet is vital to obtain the required vitamins and minerals for you and your unborn baby’s health over this time. Due to the consequences of not meeting these recommendations on a daily basis, I would definitely recommend taking a practitioner grade pregnancy multivitamin daily, that is high quality, providing needed nutrients in sufficient quantities and in forms which enhance their absorption. Additionally I would recommend a practitioner grade fish oil supplement and probiotic.
It is important to note that supplements should never replace a balanced diet but are to be used in conjunction with this to boost your nutrition and optimise your energy, health and wellbeing and that of your baby.
Additionally, some women may have increased needs for particular nutrients, depending on their overall health or any underlying conditions and may require a higher intake of foods containing these nutrients or further supplementation.
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Amy Pearman BHSc (Nut Med) ANTA is a registered nutritionist practising out of her newly opened natural health clinic on the Mornington Peninsula – High On Natural Health, where she provides private consultations in clinical nutrition for people of all ages with a holistic focus. To see all her articles, click here.
The information in this article is intended as a guide only for women who are planning to conceive or are pregnant and are in general good health. Women with poor nutrition and/or underlying health conditions, especially those directly linked to subfertility, such as Polycystic Ovarian syndrome (PCOS) and obesity, may require additional nutrition, dietary recommendations and advice from a health professional when planning to conceive.
