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From planning a pregnancy through to birth: the essential micronutrients

In 2016, the figure for the number of live births per woman in France was 1.93, the highest in Europe. In the same year, 785,000 babies were born in France1. The average age to become pregnant has been increasing steadily and in 2016 stood at 30.4. Almost ¼ of all babies born are now to women aged 35 and over2. As a result of having children later in life, women face more difficulties when conceiving and higher risks during the pregnancy itself. This article reviews the essential micronutrients to take before and during pregnancy.

As soon as a couple decide to try to conceive, a pre-conception consultation should be arranged

Pregnancy is an important step for any woman; the transition from being in a couple to having a family has seismic consequences! Putting in place proper support is very important for women when preparing their body for the changes which await them. Supporting a pregnancy should not be put off until conception is confirmed; it should be considered when first planning a pregnancy. In this way, every stage of conception (implantation, placental development, etc.) can be prepared for in advance to ensure that the conditions are optimal.

    Valuable information for couples

    Since 2009, the French national health authority (HAS) has recommended that couples should arrange a pre-conception consultation. Subjects discussed at this consultation should include : 

    • the state of health of the future parents so as to increase the chances of successful conception, 
    • ensuring that the process advances smoothly and that the future health of the child is supported as well as possible, notably by obtaining nutritional advice tailored to individual requirements.
    couple information

    Assessing the health of the future parents is essential, as soon as a pregnancy is planned. The future mother’s nutritional and micronutritional intake and levels are critically important, since any inadequacy could lead to her child facing a lifetime of greater vulnerability to cardiovascular disease, high blood pressure, diabetes and metabolic syndrome. The consequences may even be seen prior to the birth.

    The father’s micronutritional status 

    The father's micronutritional intake and levels are just as important.

    Carnitine, for example, is a particularly valuable micronutrient. It supports the generation of energy within the sperm (a cell whose energy metabolism levels are extremely high). 

    dad

    Why assess the micronutritional status of the future mother?

    Let’s look at the example of neural tube closure (an early indicator of the status of the baby’s nervous system). This step occurs 28 days after fertilisation. At this stage, many women do not even know that they are pregnant. However, suitable maternal intake and levels of vitamin B9 are essential to ensure that this phase proceeds as it should. Any women planning a pregnancy should therefore have their micronutritional status assessed as early as possible. The pre-conception consultation can ensure that appropriate measures are taken.

    The micronutrients to prioritise before and during pregnancy

    Although there is evidence of the benefits of prioritising certain micronutrients from conception through to the end of pregnancy, further work is required to determine which ones are most important. 

    Iodine, an essential mineral

    Although iodine is contained in only small quantities in the body, it is nonetheless essential. It plays a dominant role in the correct functioning of the thyroid gland and is essential for the manufacture of the future baby’s thyroid hormones, which play a critical role in the baby’s development. An iodine deficiency can have consequences on the development of the baby’s brain.

    • Dietary sources: well-cooked crustaceans, saltwater fish, eggs, milk and dairy produce

    Vitamin B9 for the development of the embryo’s nervous system

    Folates (also known as vitamin B9) play a very important role in the development of the embryo’s nervous system by participating in the closure of the neural tube. 

    • Dietary sources: offal, legumes and some green vegetables (broccoli, lettuce, spinach, asparagus, etc.)

    Vitamin D, combined with calcium, essential for the mineralisation of the foetal skeleton

    Vitamin D plays a major role in the mineralisation of the foetal skeleton. It is needed to assimilate and fix calcium. Low levels of vitamin D may be a risk factor in pre-eclampsia, a syndrome specific to pregnancy, which affects 3 to 7 % of first pregnancies in the developed world. 

    • Dietary sources: cod liver oil, oily fish (salmon, herring, sardine, mackerel etc.), egg yolk

    Iron to avoid fatigue and boost immunity

    Pregnancy increases the future mother's iron requirements. Pregnant women with low iron levels will be more tired, less resistant to infection and more susceptible to mood disorders.
    Caution : too much iron can have serious consequences. It promotes an increase in oxidative stress, which in turn favours certain pathologies in newborn babies, such as diabetes. It is important to follow the advice provided by healthcare professionals.  

    • Dietary sources: offal (liver, kidney), red meat, poultry and seafood

    DHA: the essential, essential fatty acid!

    This fatty acid can rebalance an imbalanced omega-3/omega-6 intake; an issue faced by a significant percentage of the French population (SUVIMAX study). DHA is involved in the development of the foetus’s nervous system and retina.

    • Dietary sources: camelina, walnut, rapeseed and soya oil and oily fish (salmon, herring, sardine, mackerel, etc.)

    Other micronutrients

    Women of child-bearing age often consume an insufficient intake of other micronutrients which might compromise the smooth progression of the pregnancy. Of these, calcium, magnesium, zinc and vitamin E should all be monitored closely.

    • Calcium: the calcium intake of approximately 62% of French women is less than the recommended dietary intake. This might increase the risk of high blood pressure during pregnancy, pre-eclampsia and post-natal depression.
    • Sources: milk and dairy produce
    • Magnesium: although the requirements during pregnancy have been estimated to be 400 mg/day, the intake of 80% of pregnant French women is less than 300 mg.  Low levels of magnesium may cause fatigue, mood disorders and cramps. 
    • Sources: plain chocolate, fruit and nuts with a high oil content (walnuts, cashews, pecans, hazelnuts, pine nuts, etc.)
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