Whole-Food Supplements: The Prenatal Vitamin Option by Gerri L. Ryan, CPM, LMMuch has been written concerning the nutritional needs of pregnant women and whether the average diet supplies the necessary vitamins, minerals and nutrients to grow a healthy baby. This subject is quite polarized—some studies stating that adequate nutritional intake does not require supplementation and some indicating that specific supplementation may be needed for various risk factors. While this article does not attempt to resolve this question, it does propose an alternative to traditional prenatal vitamins—whole-food supplementation.
Adequate NutritionIdeally, nutrients should be obtained from whole, organic foods eaten fresh from the garden with little or no cooking. Whole foods contain micronutrients that allow for optimal absorption of proteins, vitamins, minerals and calories needed for maintaining healthy bodies and growing healthy babies. The ideal diet would contain whole grains, legumes, fruits and vegetables along with adequate high quality proteins and essential fatty acids. The reality is that few families can or do eat in the manner noted above. Our diets are full of foods that sit on the shelf (ours or the store’s) for weeks prior to consumption. Even if the processed foods we consume contain added vitamins and minerals, are they in such a form that the body can absorb and utilize them beneficially? Specific risk factors increase the need of supplementation for many expectant women. Women in these categories often include:· Working women· City dwellers· Teenage women (under 18)· Women having babies less than one year apart· Women bearing more than one baby (multiples)· Underweight women· Overweight women· Breastfeeding women· Women with previous or current eating disorders· Women using over-the-counter medications and herbs· Women with certain socio-economic risk factorso Low incomeo Cigarette useo Substance abuseo Alcohol consumptionOther factors that may affect sufficiency of nutritional intake include stress and a busy lifestyle. The importance of high quality food cannot be emphasized enough. Supplementation cannot make up for a diet high in refined and processed foods. However, supplementation can be used to augment specific nutritional deficiencies. Supplementation OptionsFor those women who can benefit from supplementation, what is the best form of supplementation? Standard, off-the-shelf prenatal vitamins contain sufficient folic acid and usually the Recommended Dietary Allowance (RDA) of other vitamins and minerals. But keep in mind that RDA is the minimum amount necessary to prevent malnutrition, not the optimal amount to ensure good nutrition for mom and baby. Most prenatal vitamins do not contain sufficient amounts of vitamins, essential fatty acids, bioflavonoids, minerals and antioxidants for optimal health. Many formulas contain vitamin A acetate instead of beta-carotene, raising the concern of birth defects from oversupplementation. Vitamin A acetate is a fat-soluble substance that can build up in the tissue to toxic levels. Conversely, beta-carotene converts into vitamin A in our bodies at safe levels. When we have enough vitamin A, the body simply turns off the conversion and therefore will not accumulate to dangerous levels.If whole food is the best way to obtain adequate nutrition, it stands to reason that whole-food supplements would be the best choice. A pharmaceutical grade supplement that contains nutrients and antioxidants actually provides food at the cellular level. Whole-food supplements are “grown” or “cultured” in food nutrients, thereby picking up the bio-active (live) nature of whole food. These bio-active nutrients are vitamins and minerals cultured in fermented organic soy, fruits and vegetables. This allows the body to recognize the supplements as food and makes them easily digested and palatable to pregnant women. The active nutrients enhance the bioavailability and potency of the supplements consumed. The digestive process actually begins in the mouth. As we chew food, it mixes with saliva, which begins to break down starches. Proteins need the stomach acids to begin breaking them down, and as the food begins its journey into the small intestines, minerals are freed up and can begin to pass through the gut and into the blood. Other minerals attach themselves to amino acids, which are absorbed by the cells lining the gut and then carried into the blood stream to the liver, where they will be sent on their way for use by cells throughout the body. Simple inorganic mineral salts used in many vitamins, such as oxides, carbonates, sulfates and phosphates are just not available for use by the cells. Make sure the vitamins use chelated minerals or are part of a whole-food supplement that the body will recognize as food. For a more complete discussion of how the body absorbs minerals see Comparative Guide to Nutritional Supplements noted in the references.Some prenatal supplements provide “extras” such as organic Class I herbs that are completely safe during pregnancy and enhance the uptake of various vitamins and minerals. A good balance of vitamins and chelated minerals that are easily digested can be found in whole-food supplements. Most of my clients report no stomach upset and less constipation and indigestion after switching to whole food supplements. I appreciate that these contain fruits, herbs and grains as well as 10 strains of beneficial probiotics that promote digestion. Probiotics are beneficial strains of bacteria that live in the gut and aid the digestive process. They are also known to reduce diarrhea and overcolinization of negative bacteria such as candida (yeast). For women with yeast issues, I usually recommend a separate, stronger probiotic that can be used seven to 10 days. Gerri L. Ryan, CPM, LM, is the mother of four grown children. She practices as a midwife in San Diego and is a DONA approved doula trainer. Sources:Barker, D.J.P. 1998. Mothers, Babies and Health in Later Life. Churchill Livingstone, New York.Coad, J., and M. Dunstall. 2001. Anatomy and Physiology for Midwives. London: Mosby.Frye, A. 1998. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice. Portland, OR: Labrys Press.MacWilliam, Lyle. 2003. Comparative Guide to Nutritional Supplements. Vernon, BC, Canada: Northern Dimensions Publishing.Nichols, F., and E. Swelling. 1997. Maternal-Newborn Nursing: Theory and Practice. Philadelphia, PA: W.B. Saunders Co. Varney, H. 1997. Varney’s Midwifery, 3rd Ed., Sudbury, MA: Jones & Bartlett Publishers.Lewis, Gerald R.J. 2002. Dietary Supplements—Fad, Fable or Fact? Mt. Roskill, Auckland, New Zealand: Lewis Publications.
