Folate, Choline, Vitamin D and Iodine: How Much are Pregnant Women Getting?
Problem: Pregnant women are using prenatal supplements with the expectation that they will help to meet their increased micronutrient needs. However, there is no evidence to say that women are getting what they need from supplements. Specifically, information is lacking on intakes of folate, choline, vitamin D and iodine – nutrients essential for a healthy pregnancy. Methods: Of 1086 pregnant women enrolled in a stage III clinical trial, 809 provided dietary intake information by completing a food frequency questionnaire (FFQ) and 683 provided detailed supplement intake information. A total of 504 English-speaker subjects had both detailed dietary nutrient intake and intake from supplements for the four nutrients of focus. Nutrient intakes were compared to the Dietary Reference Intakes (DRIs). Results: Folate. Combined dietary and supplement intakes averaged 1022 μg/day, exceeding the Upper Tolerable Limit (UL). 46.7% of participants exceeded the UL with combined intakes. From dietary intake alone, just 24% were meeting the Estimated Average Requirement (EAR). Choline. Adequate Intake (AI) levels were met in only 17.3% of pregnant women who provided supplement and dietary intake data. Average supplemental choline intake was low at 3.75 (± 26.2) mg per day while average dietary intake was 331 (±334) mg/day. Vitamin D. The Recommended Dietary Allowance (RDA) was met by 37.5% of participants providing both supplement and dietary intake data, while 27% fell below the Estimated Average Requirement (EAR). Supplemental vitamin D constituted 66% of average intake. Iodine. Though dietary iodine is not available from the NDSR, 81.8% of women consumed less than the EAR through supplements, leaving a large gap for dietary intake to fill. Conclusions: For the 4 nutrients studied, prenatal supplements appear to provide excessive (folate), inadequate (choline, vitamin D), or unknown (iodine) amounts to fill the gap between dietary intake and the DRI for pregnancy.
Nutrition, Obstetrics, Choline, Folate, Iodine, Pregnancy, Prenatal supplementation, Vitamin D
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