THS reader Roselle sent in this question:
Is vitamin/mineral supplementation truly beneficial before & during pregnancy for women with a healthy diet?
The first thing I’d like to emphasize is the importance of this question. Adequate maternal nutrition prior to conception and during pregnancy can protect the baby from diabetes, stroke, heart disease, kidney disease and memory loss later in life.
Intuitively, most mothers know that what they eat will have a significant impact on the developing fetus. And traditional cultures have been aware of this for millennia. Special preconception and pregnancy diets have always emphasized foods that are particularly rich in certain nutrients known to promote healthy growth and development. In some cases, these groups provided special nutrients for fathers preparing to conceive as well.
Traditional cultures with access to the sea used fish eggs. Those that consumed dairy products used high-quality milk from the spring and fall when grass was green and rapidly growing. African groups whose water was low in iodine used the ashes of certain plant foods to supply this important element. These foods were always added to a foundational diet rich in liver and other organ meats, bones and skin, fats, seafood and whatever local plant foods were available.
In the Winter of 2007, Chris Masterjohn published a fantastic article called “Vitamins for Fetal Development: Conception to Birth” in the Wise Traditions in Food, Farming and the Healing Arts Journal. Masterjohn remarks:
“Although modern science still has much research to accomplish in order to fully elucidate the value of traditional wisdom, it has already confirmed the fact that many of the nutritional factors that we now recognize as the most important to embryonic and fetal development are the same ones emphasized in traditional pregnancy and preconception diets.” (p.26)
What are these nutrients that both modern science and traditional wisdom recognize as essential? Briefly, they include:
- Vitamin E: originally named “Fertility Factor X” in 1922 because rats could not reproduce without it. Recent research indicates it is almost certainly required for human reproduction.
- Vitamin A: vitamin A is necessary for the differentiation and patterning of all the cells, tissues, and organs within the developing body. It is especially important for the development of the communication systems between the sense organs and the brain. Vitamin A deficiency during pregnancy has been shown to produce spontaneous abortion in several different species of animals.
- Vitamin D: Vitamin D plays a role in lung development, and protects the newborn from tetany, convulsions and heart failure. Vitamin D probably plays a much larger role in fetal development than currently understood due to its interaction with vitamin A.
- Vitamin K: relatively little is known about vitamin K’s role in embryonic and fetal development compared to vitamins A & D. However, cases of birth defects that occurred with mothers taking Wafarin (which depletes the body of vitamin K) suggest that vitamin K plays an essential role in the development of proper facial proportions and the fundamental development of the nervous system.
- DHA: DHA may be necessary for the formation of neurons and for the synthesis of the important brain lipid phosphatidylserine. It is also the precursor to an important compound that protects the neurons from oxidative stress. The fetus hoards DHA from the mother and incorporates it into its brain at ten times the rate at which it can synthesize it.
- Biotin: biotin is a B vitamin that has also been called “vitamin H”. Researchers have recently discovered that marginal biotin deficiency during pregnancy is extremely common. Biotin deficiency has been shown to cause birth defects in rats. Whether this extends to humans is currently unknown, but there is little reason not to increase biotin intake during pregnancy as a precaution.
- Folate: the importance of folate during pregnancy is widely known. It is necessary for the production of new DNA, and new DNA is needed for new cells. Adequate folate intake prevents spinal cord and brain defects and increases birth weight. It may also prevent spontaneous abortion, mental retardation and deformities of the mouth, face and heart.
- Choline: a low intake of choline during pregnancy is associated with a four-fold increased risk of spinal cord and brain defects. Choline plays a direct role in the development of the brain; in particular, for the formation of neurons and synapses.
- Glycine: the amino acid glycine is “conditionally essential” during pregnancy. This means that while we can normally make enough of it ourselves to meet our needs, during pregnancy women must obtain it from the diet. It is required for protein synthesis in the fetus, and is almost certainly a limiting factor for fetal growth.
Based on the established role of the nutrients listed above, Masterjohn makes the following recommendations:
Nutritional recommendations for preconception and pregnancy
- Take a daily dose of high-vitamin cod liver oil (available online from Radiant Life and Green Pasture) to obtain 20,000 IU of vitamin A and 2,000 IU of vitamin D, and 2 grams of omega-3 fatty acids (roughly 1 3/4 teaspoons per day).
- Grass-fed animal fats supply vitamins E and K2; palm oil, fresh fruits and vegetables, nuts and freshly ground grains are also sources of vitamin E; fermented foods (cheese, yogurt, kefir, sauerkraut, etc.) are also good sources of vitamin K.
- Biotin can be obtained from liver and egg yolks. Cooked egg whites can be obtained in moderation, and raw egg yolks (from organic, pastured chickens of course) can be added to smoothies and cream to boost biotin status.
- Folate can be obtained from liver, legumes, beets and greens. Choline can be obtained from grass-fed dairy, egg yolks, liver, meat, cruciferous vegetables, nuts and legumes.
- Muscle meats and eggs should be used along with skin, bones and gelatin-rich broths to obtain glycine.
The answer to Roselle’s original question largely depends upon what is meant by “a healthy diet”. The low-fat, nutrient-depleted diet that is currently considered to be “healthy” by the medical establishment is likely to be deficient in several key nutrients, particularly the fat-soluble vitamins A, D & K and the omega-3 fatty acid DHA. However, even a nutrient-dense, whole foods diet may need to be supplemented with additional foods or additional servings of foods already in the diet.
Most of these can and should be obtained from local and organic foods. The exception is cod liver oil, which one of nature’s highest sources of vitamins A & D and a rich source of DHA as well. Not all cod liver oil is created alike, however. Most commercial brands contain synthetic vitamin A & D, which are known to be toxic at high doses. Unfortunately, this means you will have to order high-vitamin cod liver oil from a reputable company online. The brands I recommend are Green Pasture High-Vitamin Fermented Cod Liver Oil or High-Vitamin Cod Liver Oil, and Radiant Life Cod Liver Oil.
Finally, I highly recommend obtaining the Winter 2007 “Wise Traditions” journal and reading the full article by Chris Masterjohn. It will eventually be available on the Weston A. Price Foundation website, but it can take up to one year from the original publication time for an article to be posted to the website.
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