Thursday, February 25, 2010

Nutrition Corner: Vitamins

I was recently emailed by a patient of ours. She is pregnant with her third baby and wants to really make every effort to be healthy. She was wondering what minerals, vitamins, herbs, and spices were safe during pregnancy and in what amounts. I decided to break this down a bit and will talk about vitamins first. A couple posts will follow in the near future with more information about minerals and herbal use during pregnancy. Great questions Amy!

I've always felt that it's a struggle to get everything we need in our daily foods when it comes to minerals and vitamins. Or maybe I'm the one who struggles with that! Anyway, during pregnancy, healthy eating becomes even more critical due to eating 'for two'. Typically a prenatal vitamin (and it doesn't have to be a fancypants one at that!) is adequate for most women coupled with a healthy sensible diet. What follows are the most common minerals and vitamins we need (and why) and the amounts recommended for pregnancy. Keep in mind this is a general overview and that some women may have special needs. Also important to remember - it's better to get most minerals and vitamins from dietary sources as opposed to pill form.

First, a few definitions...
  • Protein - provides the structural base for all new cells and tissues in the mother and baby.

  • Carbs - Source of energy

  • Lipids - Fat....enuff said?

  • RDA - Recommended Daily Allowance

Vitamins

  • Thiamin, riboflavin, and niacin contribute to the production of energy. They are found in almost all foods but exceptionally good sources include whole grains, legumes (beans, etc), organ meats, pork, milk, cheese, lean meats, and leafy green veggies. RDAs respectively are 0.5, 0.6, and 6.6mg per 1000 calories eaten. So if you eat a 2000 calorie a day diet, then you should be getting 1mg a day of thiamin to maintain optimal health.
  • Folic acid is involved in DNA and RNA synthesis so very important for cell growth and division. It was found that having enough folic acid in the diet significantly reduced the liklihood of neural tube defects (NTD) such as spina bifida. It is recommended that women be taking folic acid prior to pregnancy or as soon as pregnancy is known to gain maximal effect. The recommended amount is 0.4mg per day. If a woman has previously had a child with a NTD, then she should be taking 4mg. Orange juice is the largest contributor of folate in America.It can also be found in many foods, however does not absorb as well as the synthetic (pill) form. Go figure!
  • Vitamin B12 is important for the nervous system. Deficiency in this vitamin is rare as it is present in all foods of animal origin (i.e. milk, eggs, meat, liver, cheese) as well as being manufactured by bacteria in the gut. The RDA is 2.2 mcg.
  • Vitamin B6 is another important vitamin involved in protein formation and can affect the nervous system as well. the RDA is 2.2mg per day. Some benefit may be gained in taking this vitamin in high doses (25mg three times a day) for women experiencing extreme nausea and vomiting during early pregnancy. Good sources for this vitamin include wheat, corn, liver, meat, and milk.
  • Vitamin A is involved with reproduction, the immune system, and vision among other things. This is one that you don't want to have too much of as it can be harmful to the growing baby. The RDA is 5000-8000 IU depending on what source you look at. Sources of Vitamin A include animal sources (butterfat, liver, egg yolk) and plant sources (drak green or deep yellow vegetables or fruits, fortified margarine).
  • Vitamin C assists in the formation of connective tissue, skin, tendons, and bones. The RDA is 60mg and this is easily met with dietary intake. Vitamin C rish foods include citrus fruits, papayas, strawberrries, melons, broccoli, potatoes, tomato, cabbage, green or chili peppers.
  • Vitamin D assist the body in maintaining calcium balance and absorption. Adequate intake is 5 mcg (adequate intake is used when insufficient evidence exists to develop an RDA). Most people are able to get adequate Vitamin D from sunlight exposure. Very few foods contain this vitamin. Cod liver oil and some fish (salmon, mackerel) contain high levels.
  • Vitamin E assists in absorption of Vitamin A, is an antioxidant, and is responsible for maintaining cellular membranes. It is extremely rare to be deficient in Vitamin E. The RDA is 15mg. Food sources include nuts, seeds, and vegetable oils. Green leafy veggies and fortified cereals contain significant amounts.
  • Vitamin K is essential for blood clotting. No supplementation is necessary unless a known defieciency (rare). Foods rich in vitamin K include green, leafy vegetables such as spinach, broccoli, asparagus, watercress, cabbage, cauliflower, green peas, beans, olives, canola, soybeans, meat, cereals, and dairy products.

Coming soon.....Minerals!

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