supplements
Nutrition

Supplements in pregnancy

Eating a healthy, varied diet in pregnancy will help you to get most
of the vitamins and minerals you need, but when you are pregnant you will probably need to take some supplements as well.

You can get supplements from pharmacies and supermarkets, or your GP may be able to prescribe them for you. If you want to get your folic acid or vitamin D from a multivitamin tablet, make sure
that the tablet does not contain vitamin A (or retinol).

Do not take vitamin A supplements, or any supplements containing vitamin A (retinol), as too much could harm your baby.

It’s recommended that you take these particular supplements in pregnancy:

Folic acid

Folic acid is a B vitamin that is found in some foods as well as in supplement form. If you have enough folic acid around the time you conceive your baby, then there’s less risk of your baby being born with neural tube defects such as spina bifida.

All women who could become pregnant are advised to take a
supplement of 400μg (micrograms) of folic acid each day. When you do become pregnant, continue to take the supplement each day for the first 12 weeks of pregnancy. If you’ve just found out you are pregnant and had not been taking folic acid supplements, start them right away and continue to take them until the 12th week of pregnancy.

Folic acid supplements are available over the counter in pharmacies and some supermarkets. If you take folic acid as part of a multivitamin supplement, make sure that it contains 400μg (micrograms) of folic acid. Folic acid is also found in green vegetables, brown rice, orange juice and some breakfast cereals
(check the label). You can boost your folic acid by eating foods like these.

But you’ll still need to take a supplement to get the full amount you need while you’re pregnant.

Iron

If you are short of iron, you’ll probably get very tired and may suffer from anaemia. You need extra iron when you’re pregnant to make new blood cells for your developing baby. Be sure to eat iron-rich foods regularly throughout your pregnancy.

Lean red meat is the best source of iron in the diet. Other good sources are chicken and turkey – especially the dark meat – and oil rich fish. Liver has lots of iron too, but you should avoid eating it
while you’re pregnant because it has very high levels of Vitamin A.

Other foods that contain iron are:

  • peas
  • beans
  • lentils
  • eggs
  • wholegrain bread
  • dried fruit
  • green vegetables
  • some breakfast cereals (check the
    label)

Having some salad vegetables, citrus fruits or a glass of fruit juice with your meals will boost your iron absorption. Some women are advised by their doctor to take iron supplements during pregnancy.

Speak to your doctor if you have a history of heavy periods, have been anaemic in the past or if you’re vegetarian or vegan.

supplements

Calcium

You need extra calcium in your diet during pregnancy. This is to allow your developing baby’s bones to grow and develop, while looking after your own bones too. Dairy foods like milk, cheese and yoghurt are the best sources of calcium. Pregnant women should have five servings of dairy foods each day. One serving is a glass of milk, a carton of yoghurt (125g) or a matchbox-sized
piece of cheese. Avoid unpasteurised dairy products, soft mould-ripened cheeses like Camembert or Brie, and all blue-veined cheese because of the risk of Listeria food poisoning which is dangerous for pregnant women.
Other foods that have some calcium are:

  • Green leafy vegetables (like broccoli or cabbage)
  • Tinned fish where the bones can be eaten (like sardines or salmon)
  • Nuts
  • Soya products
  • Baked beans
  • Calcium-enriched juice drinks, breads or breakfast cereals (check the labels) 4 Vitamin D

In the UK women who are pregnant or breastfeeding are advised to take supplements containing 10 micrograms of vitamin D each day. Vitamin D is only found in a small number of foods – in fact we get most of our Vitamin D from the sun.

Fish and omega fats

Omega-3 and omega-6 fatty acids are important for the developing
baby’s brain and eyes. You’ll find these fatty acids in:

  • Oil-rich fish (like herring, mackerel, sardines, salmon, trout)
  • White fish (like cod, plaice, whiting)
  • Some vegetables oils (rapeseed, canola, flaxseed, linseed, walnut)

So when you’re pregnant, aim to eat two portions of fish each week, one of which is oil-rich. Some types of fish such as shark, marlin and swordfish (and to a lesser degree tuna) can contain levels of mercury that are too high for your unborn baby. So during pregnancy, you should note the following:

  •  Include a maximum of two portions of oily fish in the week
  • Avoid shark, swordfish and marlin
  • Limit tuna to four tins per week, or two tuna steaks per week

Vegetarian, vegan and special diets in pregnancy

A varied and balanced vegetarian diet should give enough nutrients for you and your baby during pregnancy. However, you might find it hard to get enough iron and vitamin B12. Talk to your midwife or doctor about how to make sure you are getting enough of these important nutrients.

If you are vegan (you cut out all animal products from your diet), or you follow another type of restricted diet because of food intolerance (for example, a gluten free diet for coeliac disease) or for religious reasons, talk to your midwife or GP. Ask to be referred to a dietitian for advice on how to make sure you are getting all the nutrients you need for you and your baby.

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ASK JESSICA

Q. I’m would like to start an exercise programme that will benefit my emotional health as much as my physical health, but I don’t know which type of class would be best. Should I consider choosing from yoga, pilates, tai chi, or could you recommend a class, please?

A It’s great that you have decided to get into exercise. The benefits to you are going to be great. You’ll sleep better, have more energy, better skin, reduced stressed, not to mention all the amazing physical benefits of your clothes fitting better, and looking healthy, trim and toned! My advice to you would be to try them all. Even if some don’t offer pay-as-you-go sessions, if you get in touch directly with the instructor, they will almost always let you try it out first to see if it’s for you. All of the above things that you mentioned are great for mental health, so it really will be a personal preference as to which you go for. On top of the classes you mention, all forms of exercise will give you great mental rewards so consider the not so obvious interval training sessions, bootcamp, and circuits too, as you will also feel on top of the world after a class like that.

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.