Pregnancy: Your Guide to Eating Right (cont.)
Erica Oberg, ND, MPH
Erica Oberg, ND, MPH
Dr. Erica Oberg, ND, MPH, received a BA in anthropology from the University of Colorado, her doctorate of naturopathic medicine (ND) from Bastyr University, and a masters of public health (MPH) in health services research from the University of Washington. She completed her residency at the Bastyr Center for Natural Health in ambulatory primary care and fellowship training at the Health Promotion Research Center at the University of Washington.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
Getting enough folate
Folate occurs naturally in vegetables and whole grains but it is lost in the processing of refined grains. Folate deficiency increases the risk of congenital anomalies, most notably neural tube defects such as spina bifida. For this reason, it's one of the most serious nutritional deficiencies in pregnancy. Unfortunately, the critical time for neural tube development occurs in the first few weeks of pregnancy, often before a woman knows she's pregnant and thus when she is less likely to be taking a prenatal vitamin with folic acid or getting enough in the diet. Because of this, fortification of grain products (adding back in what was lost in processing) was mandated in 1998, and the prevalence of neural tube defects has dropped dramatically. Unfortunately, these foods are fortified with synthetic folic acid, not folate, and a very common genetic variant of the MTHFR gene (that codes for an enzyme important in processing of amino acids), makes it difficult for people to convert folic acid to useable folate and pregnant women with this variant are at particular risk. Researchers have suggested it would be much better to supplement pregnant women, and enrich food, with the active form methyl tetrahydrofolate, rather than folic acid11. Fortunately, pregnant women can get the necessary 600mcg of active, natural form folate from these dietary sources:
Getting enough Iodine
Iodine needs increase by almost 50% during pregnancy. Iodine is used for thyroid hormone function and for the developing nervous system of the fetus. Women who have iodine deficiency, or are hypothyroid for other reasons, are at risk of slowing the brain development of their baby. Pregnant women need 220mcg of iodine and the American Thyroid Association suggests pregnant women supplement with 150mcg of iodine daily12. Seaweed and seafood are the major source of iodine, but because of the need to limit mercury exposure in pregnancy, relying on seafood may not be wise.
Getting enough zinc
Research suggests that 82% of pregnant women are deficient in zinc, which makes it one of the most important nutrients to pay attention to during pregnancy12. In addition to the negative outcomes of low birth weight, early delivery, and preeclampsia that result from deficiency, zinc is important for the immune system of the mother and baby. Iron competes with zinc for absorption, so women who are supplementing with extra iron also need to make sure they are getting extra zinc. Some food sources are:
Getting enough vitamin D
Pregnant women need 600 IU of vitamin D according to the USDA RDA guidelines; however, many experts believe this estimate is far too low. Humans synthesize vitamin D from sun exposure and there are very few food sources. Additionally, factors such as skin pigmentation, obesity, and sunscreen usage impact the ability to make vitamin D from sunlight. In clinical practice, I measure patients' blood levels of vitamin D and find that many are deficient even if they are taking a 2000mcg vitamin D3 supplement every day. Pregnant women who are concerned about vitamin D can consult a midwife, naturopathic midwife, or obstetrician who is willing to test their vitamin D levels so they know how much they need. Here are a few food sources:
Medically Reviewed by a Doctor on 1/28/2015
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