Nutritional status before and during pregnancy affects fetal growth and development and general maternal health.
The incidence of maternal obesity is increasing worldwide, across Europe and in the United Kingdom. However, studies examining micronutrient intake during pregnancy tend to focus on undernourished women rather than obese women.
Obese women are often thought to be ‘overnourished’, but a recent observational study conducted in the United Kingdom showed that the majority of obese women had baseline intakes of iron, vitamin D, iodine and folic acid. It was reported to be below the intake (RNI). .
Folic acid and folic acid play an important role in preventing neural tube defects (NTDs). Because the neural tube closes within four weeks of conception, the UK Department of Health recommends that women supplement with 400 µg of folic acid daily before conception and up to 12 weeks’ gestation.
However, maternal obesity has been shown to be associated with increased risk of NTDs, and in the United States, despite the implementation of a cereal folic acid fortification program in the United States in 1998, increased maternal BMI was associated with serum It was associated with decreased folic acid status.
In the United Kingdom, the Royal College of Obstetricians and Gynecologists (RCOG) recommends that obese women (body mass index (BMI) ≥ 30 kg/m2) should consume a high dose of 5 mg folic acid daily. increase.
In addition to folic acid, vitamin D and iodine are micronutrients important for fetal brain and skeletal development during pregnancy.
A recent observational study conducted in Plymouth, UK involved collecting data on weight gain, diet, physical activity, sleep, and infants in a cohort of obese pregnant women. OBJECTIVES: To investigate dietary and supplement intake of the key nutrients folic acid, iodine, and vitamin D in this population, and to explore associations between supplement use and key maternal demographic characteristics. was.
The study found that 96% of women were taking folic acid at any point during their first trimester of pregnancy, but those who took the higher dose of 5 mg recommended for obese women in the UK. Only 26% of women met the UK RNI for vitamin D and iodine, respectively.
This study is unique in that it focuses on three major micronutrient supplementation trends of concern among obese pregnant women.
“We hope that our findings will help health professionals involved in dietary counseling of women before conception and in the first trimester of pregnancy. We also hope that interventions promoting supplementation may have the greatest impact on the group of women who may be most impacted. I hope to emphasize the the author concludes.
method
From January 2015 to December 2017, pregnant women aged 18 to 40 years were recruited at Deliford Hospital, Plymouth, UK.
At 12 and 14 weeks of gestation, participants completed a baseline questionnaire asking about their demographic characteristics and preconception supplement habits. Participants were also given a food diary and asked to record in as much detail as possible all food and drink consumed within 4 days after each study visit. Subjects were also asked to record dietary supplements.
The results of this observational study showed that while 46% and 96% of obese pregnant women took folic acid supplements before conception and early in pregnancy, respectively, only 26% of women took a dose of 5 mg, which is higher than the RCOG recommends. For vitamin D and iodine, 56% and 52% of women met the UK RNI, respectively.
Among women not supplemented with these two micronutrients, none achieved an RNI for vitamin D and only 16% achieved an RNI for iodine. Maternal age was positively associated with intake of any type of supplement and intake of 5 mg folic acid supplements, whereas parity was inversely associated with both outcomes.
Of the women not supplemented with iodine in the current study, only 6 women (16%) met a dietary RNI. The authors note that iodine supplementation is not currently recommended in the UK and, unlike vitamin D, may be a cause for concern. and folic acid, iodine are not included in NHS Healthy Start Her Vitamins, which are available free of charge to low-income women in the UK. The majority of other brands of multivitamin products marketed to pregnant women in the UK, sold in supermarkets and high street pharmacies, contain iodine.
A limitation of this study was that the women were all of Caucasian origin, so we were unable to examine whether race or ethnicity predicts supplement use in obese women. that some women may have underreported their dietary intake based on reported average energy intake per day, which may have led to an underestimation of dietary intake of micronutrients. I also admit
Researchers conclude: “In the UK, 5 mg folic acid supplements are only available by prescription, so GPs and midwives should be aware of higher dose recommendations for obese women and consult women before conception if possible. It is essential. na
“This is especially important for low-income women who may be eligible for the free NHS Healthy Start Vitamin, which contains 400 µg of folic acid instead of the higher 5 mg. Iodine.” status and iodine supplementation during pregnancy to improve pregnancy and infant outcomes.”na
sauce: nutrientsna
2022, 14(23), 5135; https://doi.org/10.3390/nu14235135 (DOI registration)
“Relationships between intake of folic acid, vitamin D, and iodine in early pregnancy and supplement use and demographic characteristics in obese white white women in the United Kingdom.”na
Redfern, KM; Netherlands, HJ; Welch, CR. Pinkney, JH.Leith, Georgia