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.
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.
Nutritional Recommendations for Preconception and Pregnancy
Based on the established role of the nutrients listed above, Masterjohn makes the following recommendations:
- Take a daily dose of high-vitamin cod liver oil (I recommend Extra Virgin Cod Liver Oil from Rosita as my preferred cod liver oil product) 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.
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The answer to Roselle’s original question largely depends upon what is meant by “a healthy 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. I recommend Extra Virgin Cod Liver Oil from Rosita as my preferred cod liver oil product. It is real Norwegian cod liver oil that is fresh, raw & handcrafted from wild livers using a very rare ancient extraction technique which uses nature to separate the oil from its liver. No chemicals, solvents and mechanical devices are ever used during the extraction process, and it is free of heavy metals, dioxins, PCBs, and other contaminants (verified by independent testing on Rosita’s website).
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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Hi, I would like more information on protein intake for pregnant mommies. I am a Nutritionist and work primarily with preconception clients, but since the goal is that my preconception clients become prenatal clients, I work with both populations. I recommend about 15-20% protein for moms-to-be. And also tell them, not to worry about hitting this mark… FOCUS ON FAT! I realized I don’t have a great research study to pull the protein amount from, and most of my clients are being told by their OBs to have a way higher intake of protein. Therefore I would like to have help finding research to back my claims, or rebuttal them… thats okay too.
i’m having a hard time finding information about giving cod liver oil to babies. My son is 4 months old and I would like to start giving him 1/4 tsp Green Pastures fermented CLO because, as of three months old, he has only Holle formula as I’m unable to continue breastfeeding. Is giving CLO recommended?
You say that – and it is free of heavy metals, dioxins, PCBs, and other contaminants (verified by independent testing on Rosita’s website). – It is not what I read on their website. I’m pregnant and I wanted to order this oil but I choose not to because there is actually some traces of Dioxines and BPC in their Cod liver oil. Can you comment about that please ?
Did you ever find an answer? I’m fairly certain all fish/cod liver oils will have trace amounts of dioxins.
Dana, I’m sorry to to hear about your daughter’s difficulties and thank you for the information.
Chris, I continue to be confused about Vitamin A and pregnancy. Paul Jaminet, for instance, suggests that even if a pregnant woman is consuming adequate Vitamin D, she should rely on diet and not take any supplemental A (even Green Pastures’ FCLO) because of the risk of toxicity over 10,000I IUs. He also says to avoid supplemental folic acid. Chris Masterjohn suggests that 5,000 IUs can be adequate for pregnancy. Of course the doctors and midwives are very concerned about anyone taking too much Vitamin A, but could this be mainly based on the study in which the women were taking synthetic A and were probably D-deficient?
For me in terms of nourishing a growing baby, the question remains: is it safer to rely on diet (in which you may inadvertently become deficient in an important nutrient) or supplements (which may result in toxicity or other imbalances)?
I know this is an old article but for the edification of anyone out there trying to conceive, I wanted to add what I’ve learned the hard way about vitamin A and pregnancy.
Vitamin A is vital for:
-bilateral symmetry on the outside of the body, meaning the right side of your body is a close mirror to the left side
-bilateral *A*symmetry on the inside of the body, meaning an uneven distribution of organs, but in such a way that they fit together in the body cavity properly
-proper eye development
-proper ureteral bud development. The ureteral bud develops in one direction to become the nephrons or filtering structures of the kidney, and develops in the other direction to become the ureter, or tube leading from the kidney to the bladder.
If you do some digging on Google and Science Daily you will find studies supporting everything I’ve said here. I mean to put together an article for Associated Content or similar, Real Soon Now, because this stuff is all tremendously important, and now they’re telling pregnant women not to eat liver.
I suffered from just enough vitamin A shortage in my second (and so far last) pregnancy that while my daughter’s eyes appear to have developed correctly, she was born with vesicoureteral reflux into both kidneys, meaning the valves where the ureters meet the bladder were not closing correctly and the urine sometimes ran backwards. Additionally, the right kidney was significantly smaller than the left–some asymmetry is expected, but not that much–and the ureter on that side was noticeably enlarged. The left side eventually corrected itself as her bladder grew. The right side needed surgical reinsertion.
I have done some digging around after hearing rumors, and it turns out that urinary tract defects are the most common class of defects in the developed world. I have also been advised by a friend who at that time worked in an organ transplant clinic that VUR is a major risk factor for end-stage renal disease later in life. There is not exactly a surplus of kidneys on the organ market, as it were, so that’s going to mean dialysis at some point if we’re not very careful (and, who knows, maybe even if we are).
The pediatric urologist said he didn’t know why kids get VUR but that it was probably hereditary since a child with the disorder has a 30 percent chance of having a sibling with the disorder as well. I think he’s only halfway right–a mother who is malnourished for one pregnancy is likely to be malnourished for another, especially subsequent pregnancies from the first one where something went wrong developmentally.
Again, they are telling pregnant women not to eat liver. They are actually telling them to depend on beta carotene even though it is known that infants and very small children can’t convert beta carotene, so it stands to reason an embryo or a fetus can’t either. And I’ve also heard of a couple of studies, one in the US and one in the UK, where they found that between 40 and 50 percent of the study respondents were not able to convert beta carotene adequately to get their vitamin A needs met. The studies were small and it’s unknown to me whether the researchers controlled for diabetes, hypothyroidism and other conditions that interfere with beta carotene conversion. But we know that not all expectant mothers are in perfect health, either, especially if it’s not their first pregnancy.
We wouldn’t need the March of Dimes half so much if we’d just give mothers better dietary advice, and make the foods they actually need more available to them.