Vitamin D Deficiency: Causes, Symptoms, and Prevention

Prenatal vitamins: What you need to know

Prenatal vitamins are special supplements designed to support expectant mothers. They provide essential vitamins and minerals that your body needs for a healthy pregnancy. Doctors often recommend starting them even before you conceive and continuing throughout your pregnancy.

A Balanced Diet is Great, But Prenatals Can Help Fill the Gaps

Prenatal Vitamins

While maintaining a nutritious diet is crucial during pregnancy, prenatal vitamins can be a valuable addition. They help ensure you and your developing baby receive all the necessary nutrients, even if your diet doesn't cover everything. Remember to discuss any vitamins, supplements, or herbal remedies

with your doctor before taking them during pregnancy.

Why take vitamins during pregnancy?

Pregnant women are advised to take a daily prenatal vitamin and mineral supplement. This is because sometimes, a woman's diet may not provide enough of certain nutrients that are crucial during pregnancy. A multivitamin can help fill in any gaps that may occur during the 9 months of pregnancy.

A multivitamin should contain 0.4 to 1 mg of folic acid, as well as iron (16 mg to 20 mg). The amounts may vary depending on your doctor's recommendations.

The Society of Obstetricians and Gynaecologists notes that a pregnant woman may need to take additional supplements, such as calcium, vitamin D, or iron, in addition to her prenatal multivitamin, depending on her diet and health. Discuss this with your doctor.

When to start taking prenatal vitamins?

As soon as you are planning to become pregnant, it is recommended to start taking prenatal vitamins, at least two to three months before conception. This is because it can sometimes take several months to rebalance your nutritional intake. It is therefore important to make an appointment with your doctor for a preconception consultation to discuss prenatal vitamins.

What a pregnant woman should know:

• It is important to start taking prenatal vitamins as soon as you are planning to become pregnant. This is because the neural tube, which develops into the brain and spinal cord, closes in the first month of pregnancy, often before you even know you are pregnant.
• Prenatal vitamins can help to prevent neural tube defects, such as spina bifida.
• In addition to folic acid, prenatal vitamins also contain other important nutrients for pregnancy, such as iron, calcium, and vitamin D.
• It is important to talk to your doctor about which prenatal vitamin is right for you.

How long should prenatal vitamins be taken?

It is recommended to take these dietary supplements throughout pregnancy and afterward, if the baby is breastfed by its mother. “Pregnancy and breastfeeding are periods when nutritional needs are greater. The child will draw on its mother's vitamins in utero and after birth. If the mother does not have enough vitamins and minerals, she will be even more tired,” warns the gynecologist. Once breastfeeding is over and her strength is restored, the mother can stop supplementing her diet.

Note:

• It is generally recommended that women start taking prenatal vitamins at least one month before conception.
• Some prenatal vitamins contain higher doses of folic acid, which is important for preventing neural tube defects.
• Women with certain medical conditions may need to take a different type of prenatal vitamin.
• It is important to talk to your doctor before starting any new supplement, including prenatal vitamins.

What are the recommended minerals and vitamins to take before and during pregnancy?

A prenatal vitamin is a supplement that combines essential vitamins and minerals for pregnant women. While you can find these over-the-counter at pharmacies without a prescription, consulting your doctor or gynecologist about the most suitable prenatal vitamin for you is recommended.

Prenatal Vitamins

Folic acid (vitamin B9):

This vitamin is important, especially early in pregnancy. It is involved in the formation of the embryo's spine and brain from the first few days after conception.

By the time a woman knows she is pregnant, this crucial stage has already passed. This is why doctors recommend that women who are planning a pregnancy take a multivitamin containing folic acid 2 to 3 months before conceiving. This is also why it is recommended that even all women who may become pregnant without planning it "by accident" take a folic acid supplement every day.

Throughout pregnancy, folic acid is involved in the formation of new tissues, blood cells, the brain, and the nervous system. A deficiency in folic acid can cause growth retardation, birth defects, or neural tube abnormalities (such as spina bifida). Severe physical disabilities or mental deficiencies can result.

The daily folic acid requirements of pregnant women vary from 0.4 mg to 1 mg per day. Those of women with a family or personal history of neural tube defects are even higher.

Note:

• Folic acid is also important for men, as it helps to prevent sperm defects.
• The best way to get folic acid is from food sources, such as leafy green vegetables, beans, lentils, and nuts.
• However, many people do not get enough folic acid from their diet alone, so taking a supplement can be helpful.
• Folic acid supplements are safe for most people to take. However, it is always best to talk to your doctor before starting any new supplement, especially if you are pregnant or breastfeeding.

Folic acid is important to prevent neural tube defects.

Folic acid sources:

In terms of diet, vitamin B9 is provided by legumes, green leafy vegetables, wheat germ, brewer's yeast, egg yolks, and liver. However, despite normal intakes of vitamin B9, its concentration in red blood cells and serum is low. Given the importance of this vitamin, it is therefore recommended to supplement with folic acid from the preconception period.

Vitamin A:

• Multivitamins should contain no more than 10,000 IU of vitamin A. A high dose of this vitamin can be toxic to fetal health and may cause birth defects.
• Pregnant women's multivitamins, however, are far from this maximum. They are therefore perfectly safe.

Iron:

Iron is found in red blood cells. It allows red blood cells to capture oxygen in the lungs and transport it throughout the body, including to the fetus through the placenta. Pregnant women need more iron because their blood volume increases. Additionally, they need to provide iron to their unborn baby. A baby's iron stores at birth last for at most the first 6 months of life.

An adequate intake of iron reduces the risk of premature birth, low birth weight, or early newborn death.

Iron deficiency can cause anemia. This can lead to fatigue and shortness of breath with exertion. The deficiency can be detected by a blood test. Women who are vegetarians and those who have pregnancies close together or multiples are at greater risk of iron deficiency.

Iron-Rich Foods:

• Meat and poultry: Beef, lamb, pork, chicken, and turkey are all excellent sources of heme iron, which is the type of iron most readily absorbed by the body.
• Fish and seafood: Salmon, sardines, tuna, and other fish and seafood are also good sources of heme iron.
• Eggs: Eggs are a rich source of both heme and non-heme iron, making them a good option for vegetarians and vegans.
• Legumes: Beans, lentils, and peas are all plant-based sources of non-heme iron.
• Fortified foods: Some breakfast cereals, pieces of bread, and pasta are fortified with iron, which can help to increase your iron intake.
• Dark leafy green vegetables: Spinach, kale, and collard greens are all good sources of non-heme iron.
• Dried fruits: Dried apricots, raisins, and prunes are all good sources of iron.
• Nuts and seeds: Pumpkin seeds, cashews, and almonds are all good sources of iron.

It's important to note that the body's ability to absorb non-heme iron can be enhanced by consuming foods rich in vitamin C, such as citrus fruits, tomatoes, and bell peppers. Vitamin C helps to convert non-heme iron into a form that can be more easily absorbed by the intestines.

If you're concerned about your iron intake, talk to your doctor. They can check your iron levels and recommend a diet or supplements if necessary.

Calcium for Baby and Mother

Calcium needs increase by 30% during pregnancy. The fetus needs it to build its skeleton. Calcium is used to build bones and teeth. If the pregnant woman's diet is not rich enough in calcium, the unborn baby will draw it directly from the mother's reserves. Calcium is also said to help maintain good blood pressure during pregnancy.

If the pregnant woman eats few calcium-rich foods, supplements are recommended. A supplement of 1 g of calcium per day is said to help reduce the risk of preeclampsia (high blood pressure during pregnancy) in women with low calcium intake. In Canada, this is the case for about 41% of women aged 19 to 50. It is therefore appropriate to seek advice from a nutritionist.

List of calcium-rich foods that are beneficial for pregnant women:

• Dairy products: Milk, yogurt, and cheese are excellent sources of calcium. Choose low-fat or fat-free options whenever possible.
• Leafy green vegetables: Kale, spinach, and collard greens are all packed with calcium. They are also good sources of iron and folate, which are important for pregnant women.
• Canned fish: Sardines and salmon are canned fish that are good sources of calcium. They are also a good source of omega-3 fatty acids, which are important for brain development.
• Tofu: Tofu is a good source of plant-based calcium. It is also a good source of protein and iron.
• Fortified foods: Some cereals, orange juice, and plant-based milks are fortified with calcium. These can be good options for women who do not consume dairy products.

In addition to eating calcium-rich foods, pregnant women should also get enough vitamin D. Vitamin D helps the body absorb calcium. Good sources of vitamin D include sunlight, fatty fish, and fortified foods.

Pregnant women should aim to get 1,000 milligrams of calcium per day. Most women can get this amount by eating a healthy diet. However, some women may need to take a calcium supplement.

It is important to talk to a doctor about whether or not a calcium supplement is right for you.

Tips for getting enough calcium during pregnancy:

• Eat calcium-rich foods throughout the day.
• Pair calcium-rich foods with foods that are high in vitamin C. Vitamin C helps the body absorb calcium.
• Limit your intake of caffeine and alcohol. These substances can interfere with calcium absorption.
• Get regular exercise. Weight-bearing exercise can help to build strong bones.

By following these tips, pregnant women can ensure that they are getting enough calcium to support their own health and the health of their babies.

Vitamin D for Baby's Skeleton

This vitamin plays a crucial role in the assimilation of calcium and its fixation to bones. It therefore helps the baby to build its skeleton and teeth. Vitamin D also participates in cell growth and the normal functioning of the mother's and baby's immune system.

The sun is the best source of vitamin D. If you are pregnant in the summer, take advantage of its rays, while thinking about protecting your skin. In winter and during periods of low sun exposure, you can find it in egg yolks (which must be cooked well), fatty fish, and foods containing whole milk such as Emmental cheese.

Remark:

• The recommended daily intake of vitamin D for pregnant women is 600 IU.
• Vitamin D deficiency can lead to rickets in babies, a condition that causes soft and weak bones.
• Breastfed babies need to be supplemented with vitamin D, as breast milk does not contain enough of it.
• Formula-fed babies usually get enough vitamin D from their formula.

Vitamin B12 for fetal DNA synthesis

Vitamin B12 plays a crucial role in cell division and the production of red blood cells. It also contributes to the proper functioning of the immune system and reduces fatigue. Therefore, it is recommended to increase your intake by about 10% during pregnancy.

This vitamin is mainly found in animal products, so we recommend that vegetarian and vegan women take supplements that contain it. The best sources of vitamin B12 are: milk, meat, fish (herring, tuna, salmon), and seafood (shrimp).

Omega-3: Benefits of Omega-3 for Pregnant Women

The benefits of omega-3 fatty acids for pregnant women are becoming increasingly well documented. These good fats contribute to both the health of the pregnant woman and that of the fetus. Indeed, omega-3s are involved in the development of the baby's brain and eyes. In addition, they have been shown to help the mother maintain good morale throughout pregnancy and after birth.

In general, it is said that the population does not eat enough omega-3 fats. This is why it is recommended that pregnant women eat at least two meals of fatty fish per week (200 to 350 g of cooked fish in total).

An analysis of 70 studies concluded that taking omega-3 supplements during pregnancy reduced the risk of premature (before 37 weeks) and very premature (before 34 weeks) births. However, for women with a low-risk pregnancy, there would be no advantage to taking an omega-3 supplement. There would be no drawbacks either, but it is better to prioritize fish consumption, as the combination of omega-3 with other nutrients is more beneficial.

Remark:

• The best sources of omega-3 fatty acids are fatty fish, such as salmon, mackerel, and sardines.
• Other good sources of omega-3s include nuts, seeds, and eggs.
• It is important to choose omega-3 supplements that are low in mercury and other contaminants.
• Pregnant women should talk to their doctor before taking any omega-3 supplements.

Foods rich in omega-3 for pregnant women:

Pregnant women need to take extra care of their diet to ensure the health of both themselves and their babies. One important nutrient that is essential during pregnancy is omega-3 fatty acids. Omega-3s play a crucial role in brain development, eye health, and reducing inflammation. While the body can produce some omega-3s, it is essential to get enough from food or supplements. 

The best omega-3 rich foods for pregnant women:

Fatty fish: Fatty fish like salmon, mackerel, sardines, and herring are excellent sources of DHA and EPA, the two most important types of omega-3s. Aim to eat at least two servings of fatty fish per week.

• Eggs: Eggs are another good source of omega-3s, especially DHA. Choose eggs that are pasture-raised or enriched with omega-3s.
• Nuts and seeds: Nuts and seeds like chia seeds, flaxseeds, and walnuts are rich in ALA, another type of omega-3. ALA can be converted to DHA and EPA in the body, but in small amounts.
• Fortified foods: Some foods, such as milk, yogurt, and orange juice, are fortified with omega-3s. Check food labels for omega-3 content when making choices.
• Algae oil: Algae oil is a vegan source of DHA and EPA. It is a good option for pregnant women who do not eat fish or other animal products.

It is important to note that some fish, such as shark, swordfish, and king mackerel, may contain high levels of mercury, which can be harmful to the developing baby. Limit your intake of these fish.

In addition to eating omega-3 rich foods, pregnant women may also want to consider taking an omega-3 supplement. However, it is important to talk to your doctor before starting any new supplements during pregnancy.

Remark:

• Cook your fish using healthy methods, such as baking, grilling, or broiling.
• Add chia seeds or flaxseeds to your smoothies, oatmeal, or yogurt.
• Snack on nuts and seeds throughout the day.
• Choose fortified foods whenever possible.

By following these tips, pregnant women can ensure they are getting enough omega-3s to support the health of both themselves and their babies.

Vitamin B12 for fetal DNA synthesis

Vitamin B12 plays a crucial role in cell division and the production of red blood cells. It also contributes to the proper functioning of the immune system and reduces fatigue. Therefore, it is recommended that pregnant women increase their intake of vitamin B12 by about 10%.

This vitamin is primarily found in animal products. Therefore, we recommend that vegetarian and vegan women take supplements to ensure adequate intake. The best sources of vitamin B12 include:

• Milk.
• Meat.
• Fish (herring, tuna, salmon).
• Shellfish (shrimp).

Remark:

• Vitamin B12 is essential for fetal DNA synthesis and development.
• Pregnant women should increase their vitamin B12 intake by 10%.
• Vegetarian and vegan women may need to take supplements to meet their vitamin B12 needs.
• Good sources of vitamin B12 include animal products such as milk, meat, fish, and shellfish.

Iodine

Iodine is a trace mineral found in the body in very small amounts. It helps the body produce thyroid hormones, which are essential for bone growth, muscle contraction, heart rate, and nutrient absorption. Iodine also contributes to fetal brain growth, and deficiency can lead to developmental problems.

Table salt sold in Canada has been enriched for over 100 years. However, it is recommended to reduce salt intake, which decreases iodine intake in the population. Processed commercial foods – which are very salty – are not enriched with iodine. The solution is therefore to cook as much as possible and to allow yourself to add small pinches of salt here and there.

Vitamins to avoid during pregnancy

While some vitamins are beneficial during pregnancy, others should be consumed in moderation or even avoided altogether.

Vitamin A, also known as retinol, is essential for maintaining the immune system and iron metabolism. It is therefore not to be banned during pregnancy, but its consumption must be controlled. Indeed, too high a dose of vitamin A could disrupt the development of the fetus, causing malformations. Good to know: liver is the food that contains the most vitamin A in the form of retinol. So avoid consuming it, at least during the first trimester.

Vitamin needs during pregnancy vary from woman to woman. In general, we recommend that you consult your doctor to find out your specific needs. Choose the nutrients you need and limit different sources of vitamins to avoid overdose. Overall, it is advisable to vary your diet as much as possible to ensure the best possible pregnancy.

To be consumed as part of a varied, balanced diet and a healthy lifestyle.

Remark:

• The paragraph emphasizes that while some vitamins are essential during pregnancy, others should be consumed with caution.
• Vitamin A is particularly important, but excessive intake can be harmful to the fetus. Liver is the richest source of vitamin A, so it should be avoided, especially during the first trimester.
• Individual vitamin needs vary during pregnancy, so consulting a doctor is recommended.
• A balanced and varied diet is crucial for a healthy pregnancy.