New year, new... prenatal vitamins?
That may sound silly, but this is a good time to take a fresh look at your prenatal vitamins and make sure that your prenatals can fully meet your needs before, during and after pregnancy. Here are the top 3 pointers on how to find the best prenatal vitamins for you, from Ovaterra scientific team. A bonus 4th one at the end, too!
1. Don’t forget choline.
Ask any women on the fertility journey what the most important nutrient in a prenatal vitamin is, and most will say folate (or its more commonly known, synthetic form, folic acid). This B vitamin is well known as the key vitamin that supports the baby’s brain development and helps prevent neural tube defects.
Another nutrient, choline, plays a comparable role in the baby’s brain health. However, because our knowledge about choline’s physiological role is relatively new, it's much less talked about.
Choline is necessary for the baby’s brain development in utero. Like folate, choline also helps prevent neural tube defects, one of the most common group of preventable birth defects that affect the baby’s brain and spine.
As a key building block of a neurotransmitter called acetylcholine, choline is also considered important for the baby’s neurological and cognitive development after birth. Rebecca Fett’s extensively researched book on the topic “Brain Health from Birth” explains choline’s importance in depth.
Most women are low on choline
To fully support the baby’s brain health, pregnant women need at least 450 mg of choline each day. The requirement goes up to 550 mg/day when nursing. Unfortunately, it’s safe to assume that you are not meeting the daily requirements for choline. 90-95% of pregnant women aren’t, according to some estimates.
Because choline is not as well known as folate, many brands of prenatal vitamins skip this key nutrient entirely, or only deliver 1/10 – 1/5 of the daily requirement, potentially not enough to make a real difference.
So, the best prenatal vitamins should contain enough choline. Here’s more information on how choline helps the baby’s brain health, and how to figure out how much choline you may want from your prenatal vitamins.
2. Make sure the doses can make a difference.
Many brands of prenatal vitamins prominently show “full daily value of folic acid” on the label. This is a good sign – but you want to make sure your prenatal vitamins have good amounts of other nutrients, too.
It’s reasonable for prenatal vitamins to not include full daily values of all key prenatal nutrients; a healthy diet should cover a significant portion of those daily needs.
Cost and convenience are a factor here, too: Including the full daily amounts of all the key prenatal ingredients inevitably make prenatal vitamins out of reach for many women. It can’t be done with the popular one-a-day format, either. You’d need multiple capsules – typically 5 or more a day, which can feel overwhelming for some women.
That said, your prenatal vitamins should still deliver meaningful amounts of important nutrients, especially those that are difficult to get from diet.
Some nutrients – like Vitamin C, Thiamin and Riboflavin – are relatively easy to meet the daily needs just with diet. So, the likelihood of being low on these nutrients is fairly low in the United States. Other prenatal nutrients, though, are more difficult to get a full amount from diet only, and many women are deficient. So, for nutrients like Iodine, Vitamin D (especially in sun-deprived winter!), Calcium and Zinc, it’s a good idea to make sure your prenatal vitamins can fully bridge the gap.
More isn't better
One important note: The best prenatal vitamins aren't necessarily the ones that contain the largest amounts of nutrients. One well-known example is Iron. This mineral is necessary to carry oxygen to the growing baby, but too much of it can cause gastrointestinal issues and other more serious problems.
Another example is Vitamin A; it supports the development of multiple organs of the baby, but too much preformed Vitamin A can be teratogenic (can cause birth defects). Here is more on how your prenatal vitamins can deliver enough Vitamin A during pregnancy and avoid risks of over-supplementation.
3. Go for better forms.
Most vitamins and minerals have multiple forms. Some forms are considered more bioavailable than others – meaning they are easier for the body to absorb and use. The amount of scientific research into the biological impact of different forms varies from nutrient to nutrient, but for some nutrients, scientists have enough evidence to suggest that one form is better than others.
For example, folic acid, a synthetic form of Folate, needs to be converted into active methylfolate in the body before it can support the baby’s brain development. Many women – up to 1 in 4 Hispanic women – have a genetic variation of the gene that controls this conversion process (called the MTHFR gene), which makes them at risk of not having enough methylfolate when they rely on prenatal vitamins that use folic acid.
So, if you have this and other genetic variants of the MTHFR gene, it can be a good idea to look for prenatal vitamins that use the methlfolate form, instead of the more commonly used folic acid.
Chelated minerals are another example. By binding minerals like iron and zinc to an organic molecule (like amino acids), we can make minerals easier to absorb. This is still an emerging area of research, but an important one, as in some cases, less than 1% of the minerals in our diet may be absorbed and utilized by the body.
4. (Bonus!) Add an Omega-3 supplement.
Omega-3 fatty acids are a group of healthy fats. EPA, DHA and ALA – the three major types of Omega-3s – have been suggested as key to both preconception and prenatal health.
Omega-3s are building blocks of phospholipids, which are necessary for cell membranes. Our brains contain large amounts of Omega-3 fatty acids, leading scientists to hypothesize that these healthy fats have roles to play in brain and cognitive health, including the healthy development of the baby’s brain. There is also some research on Omega-3s' involvement in the reproductive process itself, reporting on a correlation between the serum Omega-3 levels and pregnancy and live birth rates.
During pregnancy, many OBGYN doctors recommend Omega-3 supplements, in addition to prenatal vitamins. Some ingredients in prenatal vitamins can accelerate the oxidation of Omega-3s, which can reduce their effectiveness. So, it’s generally better to take a separate Omega-3 supplement than look for prenatal vitamins that contain Omega-3s.
Looking for the best prenatal vitamins for you?
Prenatal vitamins are a key tool before, during and after pregnancy to support your – and the baby’s – health and well-being. Whether you are starting a new fertility journey in the new year or picking it back up after a much-needed break, we recommend:
- Taking a fresh look at your prenatal vitamins;
- Making sure they meet your unique needs; and
- Getting started on prenatals a few months before you plan to get pregnant.
And if you are over 35 and trying to get pregnant, what you need in your prenatal vitamins may be different. Here's a look at what should be in your prenatal vitamins when you are 35+.
Please reach out if you have any questions about how to select the best prenatal vitamins to support your preconception, prenatal or postnatal health. We are with you.
