Tagged with 'pregnancy'

Vitamin D is a must while pregnant and breastfeeding. All your questions answered here!

Why are probiotics important during pregnancy? Our dietitian covers that and more.

Don't purchase your prenatal vitamins before you read these tips for choosing the best one.

Ashwagandha is prized for its stimulating effects on fertility. Here are four ways ashwagandha contributes to male fertility.

We have a crisis going on right now – an environmental toxin crisis, and since the current federal law for toxic substances is too weak to protect you and your baby, I suggest you take matters into your own hands.

Your eyes and vision change throughout life. Use nutrition to support normal visual function.

What's up with my strong cravings for all things dairy right now?? Well, I did some investigating and check this out:

The amount of calcium your intestines absorb during pregnancy doubles!   

Another fun fact…about 80% of the calcium present in the baby’s skeleton at the end of pregnancy crossed the placenta during the third trimester and is mostly derived from the calcium in mom’s diet during pregnancy. The calcium mom eats seems to be the main way our bodies adapt to meet those high calcium demands during pregnancy (1). Amazing! That definitely explains the cravings and my baby needs the calcium with only 6 weeks left to grow.

How Much Calcium Does A Pregnant Woman Need? 

A pregnant woman needs 1,000 mg calcium per day and pregnant teenagers need 1,300 mg calcium per day (4).

A prenatal supplement isn’t going to provide a lot of calcium, and if needed, additional calcium can be supplemented alongside the prenatal supplement, especially in the third trimester of pregnancy when calcium's needed most. Calcium can be obtained from foods naturally rich in calcium, calcium-fortified foods and beverages, supplements, or a combination of all. 

A comparison of calcium-containing foods per serving relative to milk is shown here:

*References 2 and 3.

Choosing A Calcium Supplement 

First things first, please examine the nutrition label. You are looking for the amount of "elemental calcium,” not the milligrams or grams of calcium compound. For example, a 600 mg calcium tablet can actually contain only 150 mg of elemental calcium. Most high-quality manufacturers will specify on the label the milligram content of the compound and also the milligram content of "elemental calcium." If the label does not present this information, it would be best to avoid that product.

Maximize Absorption Of Your Calcium Supplement

1.  Look for the highly absorbable forms of calcium…calcium citrate and calcium citrate-malate.

2. The percentage of calcium absorbed in your intestines decreases as the quantity of calcium consumed increases (5).  This means, to maximize absorption, divide your calcium intake into more doses throughout the day.

3. The time you take your calcium is important because calcium taken with a meal is usually better absorbed than calcium taken without a meal (6). 

4. Take a dose of calcium at bedtime. Adding calcium at night seems to result in less removal of calcium from our bones during the night (7).

5. Calcium combined with Vitamin D increases calcium absorption, so vitamin D added to your calcium supplement is a good thing. Get all your vitamin D and pregnancy tips here.

One Last Perk About Calcium

Much research shows calcium supplementation during pregnancy decreases the severity of complications brought on by preeclampsia and also decreases your risk of delivering a premature baby (8, 9), especially in teenagers.

If you would like to read more pregnancy blogs, check out Prenatal Vitamins During Pregnancy, Probiotics During Pregnancy, and Vitamin D Tips During Pregnancy.

Bottom Line: Get your calcium from your diet whenever possible, and if you need additional calcium, look for a highly absorbable form and spread your dosage throughout the day.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1.  Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE. Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 1995;61:514–23.  

2.  Pennington JAT. Bowes and Church’s food values of portions commonly used. 15th ed. New York: Harper & Row, 1989.

3.  US Department of Agriculture. Composition of foods: vegetables and vegetable products. Washington, DC: US Government Printing Office, 1989. (Agriculture Handbook no. 8-11)

4.  Institute of Medicine. Dietary reference intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC:  National Academy Press, 1997.

5.  Wilkinson R. Absorption of calcium, phosphate and magnesium. In:  Nordin BEC, ed. Calcium, phosphate and magnesium metabolism.  New York: Churchill Livingstone, 1976:36-1 12.

6.  Heaney RP, Smith KT, Recker RR, Hinders SM. Meal effects on calcium absorption. Am I Clin Nutr 1989:49:372-6.

7.  Blumsohn A, Al-Dehaimi AW, Hemngton K, Shao P. Eyre DR.  Eastell R.  Effect of timing of calcium supplementation on the circadian rhythm of bone collagen degradation.  Bone Miner Res 1993;8(suppl):S 158(abstr).

8.  Imdad A, Bhutta ZA.  Effects of calcium supplementation during pregnancy on maternal, fetal and birth outcomes.  Paediatr Perinat Epidemiol.  2012 Jul;26 Suppl 1:138-52.

9.  Villar J et al.  World Health Organization randomized trial of calcium supplementation among low calcium intake pregnant women.  Am J Obstet Gynecol.  2006 Mar; 194(3):639-49.  

You’ve been through 40 weeks of pregnancy and your diet was an important piece of the journey. And now that you’re holding your beautiful baby you’re officially in the postpartum period, which lasts six months, and nutrition is still very important.

What Is Iron?

Iron is a critical mineral throughout postpartum. It’s needed to make hemoglobin, a part of red blood cells that transports oxygen and carbon dioxide. Iron picks up oxygen in the lungs, drives it through the bloodstream and drops it off in tissues like skin and muscles. Then, it picks up carbon dioxide and drives it back to the lungs where it’s exhaled. Not getting enough iron results in anemia. Fatigue, weakness, and dizziness are definitely not symptoms you want to experience when you’re already sleep deprived and have a new baby!

Do I Need Postpartum Iron?

Postpartum iron supplementation may be necessary when blood loss is higher than usual during vaginal delivery or the interval between pregnancies is less than two years. Some practitioners may recommend continuing to take your prenatal vitamins for a few months postpartum. The World Health Organization recommends taking an iron supplement for at least three months after delivery. 

During pregnancy, iron needs double, but return to pre-pregnancy levels in the postpartum period, which is 15 mg/day.

Sources of Iron

The body absorbs two to three times more iron from animal sources than from plants. Some of the best dietary sources of iron are: Oysters, lean beef, turkey, chicken, lean pork, and fish.

The body absorbs less of the iron from plants, but every bite counts. Some of the best plant sources of iron are: beans, tofu, dark leafy greens, fortified breakfast cereals, enriched rice, and whole-grain breads. To a lesser extent, potatoes with skin, watermelon, figs, spinach, chard, and dried fruits such as apricots, raisins, and prunes also contain iron.

Tips To Help Replenish Iron Stores:

• Combining vitamin C and iron enhances iron absorption, so eat them together. For example, broccoli and chicken, a peanut butter and jelly sandwich with an orange, a spinach salad with mandarin oranges, cereal with strawberries. Other good food sources of Vitamin C include: strawberries, cantaloupe, citrus fruits, broccoli, cauliflower, cabbage, tomatoes, potatoes, green and red peppers, and citrus juices.

• Cook with cast iron pots to add more iron to your diet.

• Black tea, coffee, whole-grain cereals, unleavened whole-grain breads, and legumes all contain tannic acid, which is shown to inhibit iron absorption. These foods should be consumed separately from iron-fortified foods and iron supplements.

Bottom Line: Eat a balanced diet that includes good sources of iron to prevent any deficiencies. Combine vegetarian sources of iron with vitamin C in the same meal. Ask your healthcare provider if starting an iron supplement or continuing your prenatal supplements is a good idea through the postpartum phase.

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

American Dietetic Association. Medical Nutrition Therapy. Chicago, Illinois. 2006. 

WHO. WHO recommendations on postnatal care of the mother and newborn. Geneva, World Health Organization; 2013 

Is it possible for a woman to grown a healthy baby if they eat vegan throughout their pregnancy? It is safe to say, yes, a vegan diet is able to support a healthy pregnancy. Vegans rely on fruits, vegetables, leafy greens, whole grains, nuts, seeds, beans and legumes as their staples.  

Overall, a well-balanced vegan diet tends to be lower in saturated fat and cholesterol and higher in fiber, magnesium, potassium, vitamin C, vitamin E, folate, and a wide range of phytochemicals compared to diets that include animal products. 

However, vegans may have lower intakes of protein, vitamin B₁₂, calcium, vitamin D, iron, zinc, and omega-3 fatty acids (DHA). Let’s take a closer look at these key nutrients pregnancy vegans want to pay closer attention to.  

Protein

Protein is crucial during pregnancy, both for yourself and your baby. In fact, pregnancy increases a woman’s protein needs because it’s a vital for building fetal tissue, including the brain. It also helps your breast and uterine tissue grow during pregnancy, and plays a role in your increasing blood supply.

In fact, when you’re pregnant, your daily requirement shoots up from about 50 grams per day to 75 grams per day (and even more if you’re carrying multiples). Vegans should consume 10% more than the typical recommendations because plant-based protein sources such as soy, legumes, nuts, seeds, grains, and vegetables, are more difficult to absorb than animal sources.    

Calories

A pregnant woman in her 2^nd and 3^rd trimester, or carrying multiples, needs more calories to ensure your baby is getting all the nutrients he needs. Many vegan diets are nutrient-dense but may not be calorie-dense, so pregnant women need to make sure they’re meeting their calorie needs. Pregnant vegans should plan ahead to have food with them as much as possible and snack on high-calorie options like nuts, nut butters, seeds, and dried fruit. Vegan sports bars also come in handy when you need a quick snack.

Vitamin B₁₂

This critical vitamin is only found in animal products. Vitamin B₁₂ is required for the production of red blood cells, and additional blood is needed during pregnancy to support the fetus growth. A prenatal vitamin contains vitamin B₁₂, and you also get it by consuming ample vitamin B₁₂-fortified foods such as whole grains, soy milk, meat alternatives, or nutrition bars, is essential to getting the recommended 2.4 mcg a day. 

Calcium

Did you know, the amount of calcium your intestines absorb during pregnancy doubles?!   

In addition, about 80% of the calcium present in the baby’s skeleton at the end of pregnancy crossed the placenta during the 3^rd trimester and is mostly derived from the calcium in mom’s diet during pregnancy. The calcium mom eats seems to be the main way our bodies adapt to meet those high calcium demands during pregnancy (1). Amazing! 

Since a vegan diet doesn’t include dairy products, which is a main calcium source, vegans tend to fall below the daily recommendations of 1,000 mg/day and 1,300 mg/day for teenagers. Here are Tips to Maximize Calcium Absorption.

Structured vegan diets should contain ample sources of highly bioavailable calcium from items such as broccoli, collards, calcium-set tofu, fortified fruit juices, and some fortified almond/soy milks. Still, a calcium supplement is often recommended to meet the body’s needs.

Iron

During pregnancy, the amount of blood in your body increases until you have almost 50% more than usual! Iron is crucial for this process because it’s needed to make more hemoglobin, which is the oxygen-carrying molecule found in red blood cells. Iron also helps maintain a healthy immune system.

When your iron is low, you are likely to feel fatigued, and vegans are at a high risk of suffering from iron-deficiency anemia because they don’t eat red meat (the most bioavailable dietary source of iron). If you're anemic, you have a harder time fighting infections, and you may have an increased risk of bleeding after you give birth.

One pitfall about iron…iron from plant-based foods is not absorbed as well as iron from animal foods, so the recommended intake for vegans is 1.8 times greater than meat-eaters.

Iron Tip: The iron in sprouted grains, legumes, and fermented foods, such as miso and tempeh is absorbed more readily.

Vitamin D

Vegan or not, this is one vitamin many people are low in, especially if your pregnancy takes place throughout the winter months. Vitamin D supports normal fetal growth during pregnancy, including bone, neurologic, and immune system development. Other interesting information suggests if a woman has low vitamin D levels during pregnancy, her baby may have an increased risk of getting eczema through the first year of life (2).

Also, low maternal vitamin D levels (<40 ng/mL) during pregnancy may be associated with an increased risk of preeclampsia, gestational diabetes mellitus, infection, preterm birth and a baby born small-for-gestational age (3).

How Much Vitamin D?

To meet your needs, consider a combination of vitamin D fortified foods, exposure to sunlight, and vitamin D supplementation. The recommendation for Vitamin D supplementation during pregnancy is controversial and varies depending on what source you’re reading. This makes it very difficult to know how much vitamin D is necessary to support a healthy body. Best bet is to talk to your doctor.

Here are vitamin D recommendations from a few health agencies willing to even commit to providing a number and, as you can see, the recommendations are extremely different!

• Institute of Medicine, Food and Nutrition Board: 600 IU for everyone up to age 70 (4)
• Vitamin D council: 6,000 IU for pregnant and lactating women (5)
• GrassrootsHealth: 4,000 IU for pregnant women after 12 weeks gestation (6)

Omega-3 Fatty Acids

One omega-3 fatty acid in particular, DHA, is especially important during pregnancy because it's absolutely vital for your unborn baby’s brain and eye development, nervous system, and immune system (7, 8, 9). Along with benefits to baby, a pregnant mom consuming omega-3’s reduces her risk of pre-term labor, pre-eclampsia, and possibly post-partum depression (8, 9). 

Following a vegan diet makes it difficult to eat the recommended 1.1 to 1.6 grams of omega-3 fatty acids per day, because they’re found in fatty fish and fish oils.

However, omega-3 fatty acid deficiency may become less of a concern by combining nuts, seeds (especially flax), vegetable oils, algae, and some leafy greens with fortified foods such as soy milk, rice milk, and vegan bars.

For pregnant and breastfeeding women, a minimum of 300 mg DHA daily (10). You're not going to overdose on this natural fat, so I always error on the side of a little higher.

Bottom Line: Take careful consideration when choosing your food in order to get the nutrients your body needs to grow a healthy baby. Talk to your health care provider about essential nutrients you may need more of during pregnancy.  

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

References:

1. Cross NA, Hillman LS, Allen SH, Krause GF, Vieira NE. Calcium homeostasis and bone metabolism during pregnancy, lactation, and postweaning: a longitudinal study. Am J Clin Nutr 1995;61:514–23.

2. Jones AP, Palmer D, Zhang G, Prescott SL. Cord blood 25-hydroxyvitamin D3 and allergic disease during infancy. Pediatrics.  2012 Nov;130(5):e1128-35.

3.  Wei SQ, Qi HP, Luo ZC, Fraser WD. Maternal Vitamin D Status and Adverse Pregnancy Outcomes: A Systematic Review and Meta-Analysis. J Matern Fetal Neonatal Med. 2013 Jan 13.  

4.  Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: National Academy Press, 2010.

5.  Vitamin D Supplementation. Vitamin D Council. 

6.  Hollis BW, Johnson D, Hulsey T, et al. Vitamin D Supplementation During Pregnancy:  Double-Blind, Randomized Clinical Trial of Safety and Effectiveness. J of Bone and Mineral Research. Vol 26, No.10, Oct. 2011:2341-2357. www.grassrootshealth.net

7.  Dunstan J.A., Mitoulas L.R., Dixon G., Doherty D.A., Hartmann P.E., Simmer K., Prescott S.L. The effects of fish oil supplementation in pregnancy on breast milk fatty acid composition over the course of lactation: A randomised controlled trial. Pediatr. Res. 2007;62:689–694.   

8.  Morse NL. Benefits of Docosahexaenoic Acid, Folic Acid, Vitamin D and Iodine on Fetal and Infant Brain Development and Function Following Maternal Supplementation during Pregnancy and Lactation. Nutrients. 2012 July; 4(7):799-840. 

9.  Jensen CL. Effects of n-3 fatty acids during pregnancy and lactation. Am J Clin Nutr. 2006 June; 83:S1452-1457S. 

10.  Simopoulos AP, Leaf A, Salem N. Conference report: workshop on the essentiality of and recommended dietary intakes for omega-6 and omega-3 fatty acids. J Am Coll Nutr 1999;18:487–9.

When it comes to conceiving a baby, diet and lifestyle are just as important for men as for women. About one-third of fertility problems are related to the male partner, so use the following information to guide you in making healthy choices.

Zinc is called an “essential trace element” because it's necessary for numerous chemical processes that take place within a cell. It is required for the activity of approximately 100 enzymes and it plays a role in immune function, protein synthesis, wound healing, DNA synthesis, and cell division. Zinc also supports normal growth and development during pregnancy, childhood, and adolescence and is required for proper sense of taste and smell. To maintain a steady state of zinc, daily intake is required because our bodies don’t have a specialized system for storing zinc.

There are six instances when people are at risk of zinc deficiency or inadequacy. Supplemental zinc may be appropriate in certain situations.

People with Gastrointestinal and Other Diseases

Digestive disorders such as ulcerative colitis, Crohn’s disease, and short bowel syndrome, can decrease zinc absorption. Other diseases associated with zinc deficiency include malabsorption syndrome, chronic liver disease, chronic renal disease, sickle cell disease, diabetes, malignancy, and other chronic illnesses. Chronic diarrhea also leads to excessive loss of zinc.

Vegetarians

The bioavailability of zinc from vegetarian diets is lower than from non-vegetarian diets because vegetarians do not eat meat, which is high in bioavailable zinc and may enhance zinc absorption. In addition, vegetarians typically eat high levels of legumes and whole grains, which contain phytates that bind zinc and inhibit absorption.

Vegetarians sometimes require as much as 50% more of the RDA for zinc than non-vegetarians.

Pregnant and Lactating Women

Pregnant women, particularly those starting their pregnancy with borderline zinc status, are at increased risk of becoming zinc insufficient due, in part, to high fetal requirements for zinc. Lactation can also deplete maternal zinc stores. For those reasons, the RDA for zinc is higher for pregnant and lactating women than for other women.

Older Infants Who Are Exclusively Breastfed

Breastmilk provides sufficient zinc (2 mg/day) for the first 4-6 months of life but does not provide recommended amounts of zinc for infants aged 7-12 months, who need 3 mg/day. In addition to breastmilk, infants aged 7-12 months should consume age-appropriate foods or formula containing zinc. Zinc supplementation has improved the growth rate in some children who demonstrate mild-to-moderate growth failure and who have a zinc deficiency.

People with Sickle Cell Disease

Results from a large cross-sectional survey suggest 44% of children with sickle cell disease have a low plasma zinc concentration, possibly due to increased nutrient requirements and/or poor nutritional status. Zinc deficiency also affects approximately 60%-70% of adults with sickle cell disease. Zinc supplementation has been shown to improve growth in children with sickle cell disease.

Alcoholics

Approximately 30%-50% of alcoholics have low zinc status because ethanol consumption decreases intestinal absorption of zinc and increases urinary zinc excretion. In addition, the variety and amount of food consumed by many alcoholics is limited, leading to inadequate zinc intake.

Foods Containing Zinc

A wide variety of foods in the American diet contain zinc. Oysters contain more zinc per serving than any other food, but red meat and poultry provide the majority of zinc. Other good food sources include chickpeas, kidney beans, almonds, cashews, certain types of seafood, such as crab and lobster, whole grains, fortified breakfast cereals, cheese, milk, and yogurt.

Aside from eating well-balanced, nutritious foods everyday, if you feel you are at risk of zinc deficiency, talk to your health care provider. 

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

Reference:

1. National Institutes of Health; Office of Dietary Supplements. Zinc: Fact Sheet for Health Professionals 

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