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One of the most important reasons to take a multivitamin early in pregnancy is to ensure adequate intake of folic acid. In 1996, the FDA felt it was so important, that they stepped in and required most grains to be fortified with the vitamin (among others). Now, most breakfast cereals contain the full amount of folate needed in a single serving. (1) Not to undermine the importance of the prenatal vitamin (as it is still essential to take during pregnancy and lactation), but due to the number of items that are fortified, it's impact isn't as grand as it once was.
Move over folate, DHA is the new nutrient in the spotlight. Americans have the lowest omega-3 intake of any developed country. This fact has enormous health consequences, especially for a developing baby. This article will simply explain what DHA is, how much you need, how to get it in your diet, why a supplement is vitally important and (in my opinion) what prenatal DHA is safest to take - Nordic Naturals.
Docosahexaenoic acid (DHA) is an essential fatty acid that is obtained only through diet. It is 1 member of 3 of the famous omega-3 family. The other family members are eicosapentaenoic acid (EPA) and alpha linolenic acid (ALA). In general, omega-3s have been found to reduce the risk for many diseases. Omega-3 deficiency is actually ranked as the 8th leading cause of preventable death. (2)
The biggest take-home point is this: it's not only the amount of omega-3s that are important, it's the ratio of omega-6s to omega-3s that matters most.
Omega-6s are another family of fatty acids. High amounts of omega-6 are found in a vast number of foods, even "healthy" ones. Too much omega-6 promotes many diseases, therefore, keeping the ratio of omega-6/omega-3 low is of vital importance. (3)
High amounts of Omega 3s are found in fish, algae, walnuts, flax and flaxseed oil, canoa oil, some eggs and leafy vegetables. Grass-fed beef also has omega-3. Specifically, DHA and EPA are most concentrated in fatty fish such as salmon, sardines, herring, mackerel and albacore tuna. (4)
High amounts of Omega 6s are found in grain-fed beef and corn, soybean, sunflower and safflower oil. They are also found in healthy foods such as coconut oil, olive oil, pecans and avocados. The American diet is full of processed foods which are typically made with oils high in omega-6 and beef resulting in a very unhealthy America. (5)
Even healthy foods can contain omega-6s, therefore it's best to work on increasing your omega-3 intake to reduce your omega-6 / omega-3 ratio.
Read more from The American College of Obstetricians and Gynecologists : How to meet recommended levels during pregnancy.
It has been a difficult message to deliver: eat fish during pregnancy for enormous health benefits, but be sure to limit the amount and avoid certain types. Confusing? Seems like it, but it's quite simple. Here's the breakdown:
You can safely eat two servings (12 ounces) per week of fish or other seafood. Just keep your albacore tuna intake to once weekly (6 oz). That's it! It's important to know that the kinds of fish and seafood you can eat is much larger than the small list of fish to avoid.
Really, there are only 4 kinds of fish that should be avoided during pregnancy: shark, swordfish, king mackerel, and tilefish.
For more on this subject read: Fish: Friend or Foe?
And if you're interested in some heavier reading on the topic, read: Seafood Risks and Benefits, a White Paper.
Image by alpha one Via Flickr Image altered
No matter how healthy your diet is, you can't get everything you and your baby need from diet alone. Coming directly from a review in Obstetrics and Gynecology, "Unfortunately, it is impossible for pregnant women to meet their omega-3 fatty acid requirements from omega-3-rich vegetable oils and 2 servings of seafood a week. Two servings of fish per week only provide about 100 to 250 mg per day of omega-3 fatty acids, of which 50 to 100 mg is from DHA; plant-based oils supply insignificant amounts of EPA and no DHA. During pregnancy, the dietary goal for omega-3 fatty acids is 650 mg, of which 300 is DHA.
Thus, in order make up the omega-3 fatty acid deficit in the diet, pregnant women are left with essentially 2 choices: fish oil supplements supplying EPA and DHA, or algae-derived DHA.
Specifically, depending upon the omega-3 content of the seafood consumed during the week, each day pregnant women would need an additional 400 to 550 mg of omega-3 PUFAs (EPA and DHA), of which about 225 mg should be DHA." (6) The FDA recommends that the intake for consumers not exceed 3 g/day of EPA plus DHA with no more than 2 g/day from dietary supplementation. (7)
Image by magpie 372 via Flickr Image altered
Not a surprise that your baby exclusively depends on you...for everything! Your developing baby and newborn infant depend on your supply of DHA via the placenta and breastmilk. Interesting fact: a baby's brain is made up of 60% lipids. Of those lipids, 20% of them are DHA. (8) The scary truth is, if you aren't consuming enough DHA, your health and your baby's health are put at risk.
Babies need DHA for growth and function of nerve tissue and for brain and eye function. If mom doesn't have much to provide, a small amount can be made in their liver from ALA, but it may be insufficient to support optimal brain and retina development. This may leave mom depleted, putting you at higher risk for heart disease, stroke, cancer, inflammation and other conditions. (9)
When holding your newborn baby, the last thing you want to feel is sadness. If your intake of DHA, wasn't adequate during pregnancy, your risk of experiencing major depression after birth may be elevated. Breastfeeding may further compound the risk if your intake of DHA continues to be inadequate. (10)
Your baby's birth weight is strongly associated with mortality risk during their first year. (11) Researchers found that taking fish oil supplements beginning in early pregnancy (15 months) was associated with higher weight babies. (12) In an Icelandic fishing community, women with the lowest fish intake during pregnancy had children who weighed less, were shorter in length and had a smaller head circumference compared with those who ate more fish. However this study found a limit; that going overboard is detrimental. The group of women who took the highest amount of fish oil (11ml/day), had the smallest babies. (This may be due to their intake of high levels of vitamin A and D.) (13)
Too much of a good thing can be bad. Don't overload on any nutrient, vitamin, mineral or food.
Premature babies are at risk for apnea, respiratory distress, bleeding in the brain, significant heart, vision and intestinal problems, jaundice, anemia, lung damage, infections and long-term health consequences. (14) The longer your baby stays in the womb the better! Multiple studies have shown that women who have delivered premature babies have low levels of omega-3s and high levels of omega-6s. When women supplement with omega-3s during pregnancy, it significantly reduces the risk of delivering early. (15) If you ensure your intake of 600mg of DHA during pregnancy, you will cut your risk of delivering before 34 weeks and your baby will likely weigh more at birth, compared to moms who choose not to supplement. (16)
Benefits of supplementing with omega-3s during pregnancy can reach years beyond delivery. One review found that moms who took an omega-3 may had a lessened risk of having children with asthma and food allergies. Important to note, supplementation during lactation did not provide the same effects. (17) Omega-3s directly influence immunity via the membranes of baby's immune cells, in short, by reducing inflammation. (18)
Who doesn't want a smarter child? Give them every opportunity to do their best by supporting their brain growth starting with the quality of your diet during pregnancy and lactation. One study found that children who were born to mothers who had taken cod liver oil (high in omega-3 and DHA), during pregnancy and lactation, scored higher on mental processing tests, compared to mom's who took a corn oil supplement. They noted, "maternal intake of DHA during pregnancy was the only variable of statistical significance for the children’s mental processing scores at 4 years of age." (19)
Image by meagan jean via Flickr
Type 1 Diabetes is much different than type 2, that is so common in America. Type 1 is a lifelong disease, usually discovered in childhood, that results in awful complications if not well controlled. One study found that moms who had taken cod liver oil during pregnancy had a reduced risk of having children with type 1 diabetes. However, they were unsure if the protective effect was due to vitamin D, the omega-3 fatty acids or both. (20)
There is not a family out there that doesn't wish that their baby would adopt a healthy sleep pattern early on. What's interesting is that newborn's sleep and wake patterns actually provided researchers a tool for assessing the functional integrity of the central nervous system. They found sleep patterns of infants born to mothers with higher DHA levels suggest greater CNS maturity and a higher rate of quiet sleep patterns. (21) (22)
ADHD is a difficult disorder to manage, so even if the findings are preliminary, it's worth the effort to attempt to prevent it! Researchers found ADHD children had lower concentrations of key fatty acids compared to controls. And more severe symptoms were seen in kids with lower concentrations of essential fatty acids (like DHA). (23) What is unknown is if ADHD causes low DHA levels or low levels cause ADHD.
Another study found that higher DHA levels at birth was associated with lower levels of behavior problems at 7 years old. However, this association was only found with formula-fed babies. The long and short of it is that prenatal DHA status may have long-term behavioral ramifications. (24)
Yes, this was explained above, but it's worth repeating. It is impossible for pregnant women to meet their omega-3 requirements from a healthy diet. You need a supplement. It's just as important as your prenatal vitamin.
The prenatal I trust, take and recommend is Rainbow Light, Prenatal One Multivitamin.
As evidenced by the above reasons, supplementing (your already super healthy) diet with a prenatal DHA is a smart choice. In fact, it's non-negotiable. If you are trying to get pregnant, I would recommend taking a prenatal and a DHA or fish oil supplement before getting conceiving to ensure you have adequate nutrient stores for your developing baby.
I trust Nordic Naturals to give me and my baby the safest and most pure form of fish oil. I researched brands and this topic immensely and would recommend this brand to anyone. They are supported by the American Pregnancy Association, are 3rd party tested to ensure freshness and purity and they follow internationally accepted quality standards (CRN, WHO and IFOS).
2 soft gels (a daily serving) = 580mg omega-3s. Of that 580mg, 90mg are from EPA, 450mg are from DHA, and 40mg from other omega-3s. Oil derived from anchovies and sardines. Also contains 400 I.U. Vitamin D3 (a very necessary nutrient during pregnancy).
Have a happy and healthy pregnancy!
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THE INFORMATION PROVIDED DOES NOT PROVIDE MEDICAL ADVICE. All content information is intended to be for general informational purposes only. Please see your doctor with regard to information attained from the above article if you are concerned with the health of your child. The content above is not a substitute for professional medical advice, diagnosis or treatment. NEVER NEGLECT YOUR DOCTOR’S PROFESSIONAL MEDICAL ADVICE BECAUSE OF SOMETHING YOU HAVE READ.
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