Pregnancy and Nutrient Depletion
In my last post I discussed some of the basics of nutrient depletion. Although anyone can suffer from inadequate levels of any of the essential nutrients the body relies on, there are specific times during the lifecycle that we are more vulnerable. Pregnant and postpartum mothers, infants, adolescents, and the elderly are all predisposed for different reasons to such nutrient depletion.
During pregnancy for example, the nutrient and energy requirement to grow another human is immense. Mamas need approximately 300-500 additional calories per day especially in the second and third trimesters. They require additional macronutrients, especially protein, and need to pay special attention to certain micronutrients including folate, DHA, and iron. Supplying the body with all of its nutritional needs from food alone can be challenging enough for the average person, and thus even more difficult for a woman that is responsible for another life in addition to her own. This is why prenatal vitamins are an essential part of any pregnancy nutritional strategy.
Factors that predispose pregnant women to nutrient deficiency:
Increased nutrient demand- growth of the fetus and maternal tissues requires nutrients at levels greater than those that support mom alone.
Increased blood volume-in order to supply oxygen to the growing baby, extra nutrients involved in red blood cell production and oxygen delivery are required.
Placental development- the placenta is designed for nutrient transport from mom to baby, yet it’s maturation relies on its own reservoir of nutrients to facilitate proper delivery.
Multiples- carrying more than one baby (twins/triplets) increases nutrient demand beyond that of a single baby pregnancy.
Hormonal fluctuations-hormonal shifts can initiate morning sickness contributing to nausea, vomiting and reduced food intake via food aversions; some hormones contribute to slowed motility and and gastric emptying also causing constipation potentially interfering with nutrient absorption (1)
Key nutrients crucial at different stages of pregnancy:
Folate is crucial, but especially during the first trimester (particularly days 17-30) for neural tube formation which matures into the brain and spinal chord. Adequate folate reduces the risk of the condition called spina bifida.
Iron, essential to the production of the oxygen carrying protein called hemoglobin, must be adequate to keep up with mom’s increased blood volume to support baby's growth; deficiency can result in iron-deficiency anemia for mom and/or baby
Calcium/Vitamin D-calcium is essential to bone, muscle, and nerve health; bone formation (bone ossification) begins as early as the 6th and 7th weeks of gestation; vitamin D is crucial to the absorption of calcium which is why these tow are often discussed in tandem. Vitamin D also regulates cell growth and function which is happening at such a rapid pace during this time
Iodine is important to nervous system and brain development (myelination and neuronal growth) by way of thyroid hormone production. After 20 weeks the demand for thyroid hormones to support baby’s growth significantly increases; iodine is a critical raw material for thyroid hormone synthesis.
Choline is not always included in prenatal vitamins but it is involved in many processes of fetal development especially cognitive and brain development, neural tube formation, gene expression and liver health. In fact, higher maternal choline intake during pregnancy is associated with superior cognitive outcomes in children (2)
Omega 3 fatty acids are necessary for proper development of the brain and the eyes; DHA more specifically acts as a major structural component of the brain and the retina and is important to memory, learning, and attention.
Strategies for preventing nutrient depletion during pregnancy:
Eat a whole foods, nutrient-dense diet comprised of all 3 macronutrients at each meal. Consider a ratio of approximately 40% carbohydrates, 30%protein, and 30%fat (easy to remember). The daily recommendations based on the Recommended Dietary Allowance (RDA) are general and based in grams rather than based on weight and activity level among other factors; adjust to meet your specific needs. Include a mix of colorful veggies, leafy greens, and cruciferous veggies through out the day.
Eat smaller more frequent meals-may be easier of digestion.
Try natural approaches- ginger, acupuncture/acupressure, and dehydration and electrolyte management are non-pharmaceutical approaches supported by research (1)
Fill in nutritional gaps with a high quality prenatal vitamin with the activated form of vitamins and minerals; Innate Response Baby and Me Multivitamin with folate in its methylated form and choline is a Rebel Roots favorite
Schedule routine prenatal check-ups with your healthcare provider-they can help monitor signs and symptoms associated with nutrient deficiencies and make appropriate recommendations for intervention
While undernourishment can result in overt disability, such as neural tube defect, other less detectable disturbances related to blood pressure, glucose regulation, and infection can also have long-lasting effects on the fetus well into adulthood. Often referred to as fetal programming, there exists a critical window of fetal development in which nutrition and other environmental factors have a significant impact on the fetus’ development. “Insufficient nutrition during this time results in permanent alterations to certain structural and physiological metabolic functions of the fetus.” This programs the fetus for greater disease susceptibility in adulthood. According to the research, infants born to mothers that were malnourished during pregnancy were at greater risk of chronic disease such as type 2 diabetes, cardiovascular disease, and obesity in later life. (3)
Between a nutrient-dense diet and a good prenatal vitamin, vibrant health can be achieved for both baby and mom. Take steps to work with a nutritional professional who can support your effort in meeting your prenatal nutritional needs. And while babies usually get what they need, this often comes at the expense of the mother. The postpartum period is an especially vulnerable time in which this becomes quite evident. Next we will explore the nutrients often undersupplied during the postpartum stage of motherhood, underlying causes, and prevention strategies.
To learn more about how a functional nutrition therapist can support you along your prenatal journey book a free 30 minute consult with Carla here.
References:
Liu C, Zhao G, Qiao D, Wang L, He Y, Zhao M, Fan Y, Jiang E. Emerging Progress in Nausea and Vomiting of Pregnancy and Hyperemesis Gravidarum: Challenges and Opportunities. Front Med (Lausanne). 2022 Jan 10;8:809270. doi: 10.3389/fmed.2021.809270. PMID: 35083256; PMCID: PMC8785858.
Bahnfleth CL, Strupp BJ, Caudill MA, Canfield RL. Prenatal choline supplementation improves child sustained attention: A 7-year follow-up of a randomized controlled feeding trial. FASEB J. 2022 Jan;36(1):e22054. doi: 10.1096/fj.202101217R. PMID: 34962672; PMCID: PMC9303951.
Kwon EJ, Kim YJ. What is fetal programming?: a lifetime health is under the control of in utero health. Obstet Gynecol Sci. 2017 Nov;60(6):506-519. doi: 10.5468/ogs.2017.60.6.506. Epub 2017 Oct 26. PMID: 29184858; PMCID: PMC5694724.