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Prenatal vitamins, also known as prenatal supplements, are vitamin and mineral supplements intended to be taken before and during pregnancy and during postnatal lactation. Although not intended to replace a healthy diet, prenatal vitamins provide women of childbearing age with nutrients recognized by the various health organizations including the American Dietetic Association [1] as helpful for a healthy pregnancy outcome. It may be appropriate to start taking prenatal vitamins once the woman enters childbearing age, [2] however if a person is not pregnant or planning to become pregnant the Mayo Clinic [3] does not recommend taking these supplements. Prenatal vitamins are similar to other multivitamins but do contain different amounts of specific nutrients to better suit the needs of an expecting mother. [3]
Vitamins and minerals such as folic acid, calcium, [3] and iron [4] are in higher concentrations, while nutrients such as vitamin A are reduced to reflect the current understanding of the role that these compounds play in fetal development.
The increased dosage of folic acid [5] or folates reflects the American Dietetic Associations position that women should consume "400 μg per day of synthetic folic acid from fortified foods (cereals and other grains), supplements or both, in addition to consuming folate from foods in a varied diet." [6] Taking the appropriate amount of folic acid before conception can reduce or prevent the incidence of neural tube defects by as much as 70%. The recommendation to start folic acid before conception is supported by a meta-analysis of 41 studies, but is beneficial after conception as well. [2] Often prenatal vitamins also have a reduced dosage of vitamins that may be detrimental to the fetus when taken in high doses (such as vitamin A). [7]
Many prenatal manufacturers have chosen to include the omega-3 fatty acid, docosahexaenoic acid (DHA) in their product, either as an ingredient in the formula or as a complementary softgel. Although explicitly in many formulas to support neural development, the omega-3 fatty acids are used by both mother and fetus to create the phospholipid bilayer that makes up cell membranes. [7]
L-arginine has tentative evidence of benefit in reducing intrauterine growth restriction. [8]
Many women have difficulty tolerating prenatal vitamins or experience constipation as a result of the high iron content. [9] Due to tolerance challenges, the prenatal vitamin industry has developed a multitude of dosage forms to meet the needs and tolerances of expecting mothers. The most common form of prenatal vitamin is the compressed tablet which is available through all channels and at various quality levels. Category leaders utilize this as the dosage form of choice.[ citation needed ] Other organizations within the category offer products in a variety of dosage forms such as liquids, prenatal vitamin soft chews, vitamin chewables, and even jellied prenatal vitamins.
Prenatal vitamins are available both over the counter in retail stores as well as by prescription from medical professionals. Although prescription vitamins are often covered by insurance, the relative potency of prescription-grade products are typically not significantly different from those available through retail. Differences in prescription versus retail vitamins do however exist in consistency and quality level, as well as the relative bioavailability of some specific ingredients. For example, many[ citation needed ] prescription prenatal vitamins will contain a more bioavailable form of folate, 5-methyltetrahydrofolate (5-MTHF). Doses of folic acid over 1 mg are prescription only. The amount of non-prescription prenatal vitamins needed to achieve this dose may have too much vitamin A and lead to fetal toxicity. [2]
Vitamins are organic molecules that are essential to an organism in small quantities for proper metabolic function. Essential nutrients cannot be synthesized in the organism in sufficient quantities for survival, and therefore must be obtained through the diet. For example, Vitamin C can be synthesized by some species but not by others; it is not considered a vitamin in the first instance but is in the second. Most vitamins are not single molecules, but groups of related molecules called vitamers. For example, there are eight vitamers of vitamin E: four tocopherols and four tocotrienols.
Folate, also known as vitamin B9 and folacin, is one of the B vitamins. Manufactured folic acid, which is converted into folate by the body, is used as a dietary supplement and in food fortification as it is more stable during processing and storage. Folate is required for the body to make DNA and RNA and metabolise amino acids necessary for cell division. As the human body cannot make folate, it is required in the diet, making it an essential nutrient. It occurs naturally in many foods. The recommended adult daily intake of folate in the U.S. is 400 micrograms from foods or dietary supplements.
A dietary supplement is a manufactured product intended to supplement a person's diet by taking a pill, capsule, tablet, powder, or liquid. A supplement can provide nutrients either extracted from food sources, or that are synthetic. The classes of nutrient compounds in supplements include vitamins, minerals, fiber, fatty acids, and amino acids. Dietary supplements can also contain substances that have not been confirmed as being essential to life, and so are not nutrients per se, but are marketed as having a beneficial biological effect, such as plant pigments or polyphenols. Animals can also be a source of supplement ingredients, such as collagen from chickens or fish for example. These are also sold individually and in combination, and may be combined with nutrient ingredients. The European Commission has also established harmonized rules to help insure that food supplements are safe and appropriately labeled.
Spina bifida /ˌspaɪnə ˈbɪfɪdə/ is a birth defect in which there is incomplete closing of the spine and the membranes around the spinal cord during early development in pregnancy. There are three main types: spina bifida occulta, meningocele and myelomeningocele. Meningocele and myelomeningocele may be grouped as spina bifida cystica. The most common location is the lower back, but in rare cases it may be in the middle back or neck.
Vegetarian nutrition is the set of health-related challenges and advantages of vegetarian diets.
Pregnancy is the time during which one or more offspring develops (gestates) inside a woman's uterus (womb). A multiple pregnancy involves more than one offspring, such as with twins.
Nutrition and pregnancy refers to the nutrient intake, and dietary planning that is undertaken before, during and after pregnancy. Nutrition of the fetus begins at conception. For this reason, the nutrition of the mother is important from before conception as well as throughout pregnancy and breastfeeding. An ever-increasing number of studies have shown that the nutrition of the mother will have an effect on the child, up to and including the risk for cancer, cardiovascular disease, hypertension and diabetes throughout life.
Neural tube defects (NTDs) are a group of birth defects in which an opening in the spine or cranium remains from early in human development. In the third week of pregnancy called gastrulation, specialized cells on the dorsal side of the embryo begin to change shape and form the neural tube. When the neural tube does not close completely, an NTD develops.
Fetal warfarin syndrome is a disorder of the embryo which occurs in a child whose mother took the medication warfarin during pregnancy. Resulting abnormalities include low birth weight, slower growth, intellectual disability, deafness, small head size, and malformed bones, cartilage, and joints.
Food fortification or enrichment is the process of adding micronutrients to food. It can be carried out by food manufacturers, or by governments as a public health policy which aims to reduce the number of people with dietary deficiencies within a population. The predominant diet within a region can lack particular nutrients due to the local soil or from inherent deficiencies within the staple foods; the addition of micronutrients to staples and condiments can prevent large-scale deficiency diseases in these cases.
Folate deficiency, also known as vitamin B9 deficiency, is a low level of folate and derivatives in the body. This may result in a type of anemia in which red blood cells become abnormally large and is a late finding in folate deficiency and folate deficiency anemia is the term given for this medical condition. Signs of folate deficiency are often subtle. Symptoms may include feeling tired, heart palpitations, shortness of breath, feeling faint, open sores on the tongue, loss of appetite, changes in the color of the skin or hair, irritability, and behavioral changes. Temporary reversible infertility may occur. Folate deficiency anemia during pregnancy may give rise to the birth of low weight birth premature infants and infants with neural tube defects.
Pre-conception counseling is a meeting with a health-care professional by a woman before attempting to become pregnant. It generally includes a pre-conception risk assessment for any potential complications of pregnancy as well as modifications of risk factors, such as increasing folic acid intake to reduce the risk of neural tube defects and counseling on smoking cessation, alcohol reduction, and medications that may compromise fetal development. Physicians, midwives and baby experts recommend that a woman visit them as soon as the woman is contemplating having a child, and optimally around 3 to 6 months before actual attempts are made to conceive. This time frame allows a woman to better prepare her body for successful conception (fertilization) and pregnancy, and allows her to reduce any health risks which are within her control. Agencies such as the March of Dimes have developed screening tools that healthcare providers can use with their patients. In addition, obstetricians or midwives have developed comprehensive check-lists and assessments for the woman who is planning to become pregnant.
Antifolates are a class of antimetabolite medications that antagonise (that is, block) the actions of folic acid (vitamin B9). Folic acid's primary function in the body is as a cofactor to various methyltransferases involved in serine, methionine, thymidine and purine biosynthesis. Consequently, antifolates inhibit cell division, DNA/RNA synthesis and repair and protein synthesis. Some such as proguanil, pyrimethamine and trimethoprim selectively inhibit folate's actions in microbial organisms such as bacteria, protozoa and fungi. The majority of antifolates work by inhibiting dihydrofolate reductase (DHFR).
Women should speak to their doctor or healthcare professional before starting or stopping any medications while pregnant. Non-essential drugs and medications should be avoided while pregnant. Tobacco, alcohol, marijuana, and illicit drug use while pregnant may be dangerous for the unborn baby and may lead to severe health problems and/or birth defects. Even small amounts of alcohol, tobacco, and marijuana have not been proven to be safe when taken while pregnant. In some cases, for example, if the mother has epilepsy or diabetes, the risk of stopping a medication may be worse than risks associated with taking the medication while pregnant. The mother's healthcare professional will help make these decisions about the safest way to protect the health of both the mother and unborn child. In addition to medications and substances, some dietary supplements are important for a healthy pregnancy, however, others may cause harm to the unborn child.
Nutritional neuroscience is the scientific discipline that studies the effects various components of the diet such as minerals, vitamins, protein, carbohydrates, fats, dietary supplements, synthetic hormones, and food additives have on neurochemistry, neurobiology, behavior, and cognition.
Prenatal nutrition addresses nutrient recommendations before and during pregnancy. Nutrition and weight management before and during pregnancy has a profound effect on the development of infants. This is a rather critical time for healthy development since infants rely heavily on maternal stores and nutrient for optimal growth and health outcome later in life.
Nutriepigenomics is the study of food nutrients and their effects on human health through epigenetic modifications. There is now considerable evidence that nutritional imbalances during gestation and lactation are linked to non-communicable diseases, such as obesity, cardiovascular disease, diabetes, hypertension, and cancer. If metabolic disturbances occur during critical time windows of development, the resulting epigenetic alterations can lead to permanent changes in tissue and organ structure or function and predispose individuals to disease.
Vegan nutrition refers to the nutritional and human health aspects of vegan diets. A well-planned, balanced vegan diet is suitable to meet all recommendations for nutrients in every stage of human life. Vegan diets tend to be higher in dietary fiber, magnesium, folic acid, vitamin C, vitamin E, iron, and phytochemicals; and lower in calories, saturated fat, cholesterol, long-chain omega-3 fatty acids, vitamin D, calcium, zinc, and vitamin B12.
Relatively speaking, the brain consumes an immense amount of energy in comparison to the rest of the body. The mechanisms involved in the transfer of energy from foods to neurons are likely to be fundamental to the control of brain function. Human bodily processes, including the brain, all require both macronutrients, as well as micronutrients.
Anemia is a condition in which blood has a lower-than-normal amount of red blood cells or hemoglobin. Anemia in pregnancy is a decrease in the total red blood cells (RBCs) or hemoglobin in the blood during pregnancy. Anemia is an extremely common condition in pregnancy world-wide, conferring a number of health risks to mother and child. While anemia in pregnancy may be pathologic, in normal pregnancies, the increase in RBC mass is smaller than the increase in plasma volume, leading to a mild decrease in hemoglobin concentration referred to as physiologic anemia. Maternal signs and symptoms are usually non-specific, but can include: fatigue, pallor, dyspnea, palpitations, and dizziness. There are numerous well-known maternal consequences of anemia including: maternal cardiovascular strain, reduced physical and mental performance, reduced peripartum blood reserves, increased risk for peripartum blood product transfusion, and increased risk for maternal mortality.