Pregnancy nutrition and supplements

“Let food be thy medicine, and thy medicine be thy food”

I’ve been asked a few times about my food and supplement protocol/regime during my pregnancy and I have always hesitated to share about it because it is fairly intensive and expensive and I don’t mean to mom-guilt anyone with my sharing. The research on nutrition and supplementation can sometimes also be lacking. Apart from clear evidence backed clinical trials, some of the choices I made were gleaned from my own understanding of biochemical and physiological processes. As these choices are often personal and influenced to a certain, perhaps even large, extent by my own personal values on what health looks like, it might not be universally applicable to everyone.

Nonetheless,  instead of repeating it ad nauseam on text, I’ve decided to put it down into a post for easy reference with a disclaimer that these choices are somewhat personal and definitely not a gold standard to refer to!

The general goals were to:

1. Optimise nutrition and correct any nutritional debt

2. Detoxify and avoid any further introduction of toxins

My pregnancy nutrition and supplementation plan actually started 6 months prior to conception.

Preconception health care takes a minimum of four months to ensure the health and sperm and eggs are optimal before conception. Sperm can take up to 116 days to generate and during this time they are susceptible to damage from illness, toxins (pollutants and drugs such as cigarettes, caffeine and alcohol) and nutritional deficiencies. Similarly, the egg is vulnerable during the maturation phase, for approximately 100 days, leading up to ovulation. Therefore having at least four months of health living before conception will the improve the quality of eggs and sperm and consequently the health of your pregnancy, birth and child.

Nutrition

1. Adequate protein intake 

Pregnant or not, most people do not take sufficient protein. Protein is important for weight management, energy, satiety and building a human! I aimed for 1 gram of protein per pound of body weight per day. For example if you were 100 lbs, you would aim for 100 grams of protein a day. When calculating protein, this is the amount of protein in food and not the weight of the food itself. So for example, a piece of 85 grams of salmon has 17 grams of protein – therefore to obtain 100 grams of protein you would need to consume 500 grams of salmon. That is A LOT of food and sometimes unachievable – and so I also supplement with collagen peptides and BCAAs (more on that later in the post). 

2. Balanced Diet

Apart from protein, I try to ensure I get a good amount of complex carbohydrates and good fats in my diet. Whilst I was not concern about weight gain and ate on demand, I tried to ensure that the foods I was taking were from a good source, free from sugar, refined vegetable, bean and seed oils, food colouring and preservatives. I also limited dairy and tried to avoid processed foods.  I try to consume mostly saturated fat and monounsaturated fats avoiding polyunsaturated fats, trans fat and hydrogenated fat. 

3. Clean food source

I try my best to stay away from pesticides, herbicides, antibiotics, hormones and genetically modified food. I choose to eat only organic vegetables, which are free of pesticides and herbicides. For animal products, what the animals were fed and the conditions they were raised in impacts the fat and protein quality. My preferred choices were sustainably raised animal products as such grass-fed beef, crate-free pork, and sustainably raised or harvested low-mercury, high omega-3 fish such as salmon, sardines and anchovies. 

4. Clean water source

An often overlooked source of pesticides, herbicides, antibiotics and hormones is our water! Whilst water is treated to remove microbials, filtration and boiling does not remove chemicals from our water. At home, I have a reverse osmosis water filtration system installed to ensure water quality.

Supplements

These are the list of supplements I take prenatally. The topic of supplementation can be dicey and there are those that argue that if you have a good diet, supplementation is unnecessary.

My thoughts on this is that whilst a good, organic diet is of utmost importance, it may not be sufficient on its’ own to achieve the level needed for every aspect of fertility and baby’s growth and development. It would be ideal if you are able to test the levels in your body prior to supplementing, but there are only a few vitamin and minerals that currently have accurate testing methods. Regular testing can also be impractical for a variety of reasons like cost, needle phobia, time etc. For many vitamin and minerals, the RDI (reference daily intake) and lab reference levels (for blood or urine test) are only indicative of the amount that is considered sufficient to meet the basic requirements of most healthy individuals to survive, and not to thrive! As of writing, there is simply no good way to understand just how much vitamin/minerals/antioxidants an individual may require.

I generally avoid supplements that bioaccumulate, such as fat soluble vitamins and hormonal supplements, where excessive supplementation can result in toxicity. With the rest, I supplement as needed and pay attention to my body for feedback. My pregnancy care plan is really not gold standard! It’s just what works for me.

1. Prenatal Multivitamin

I think of a good multivitamin as something that covers my bases! When choosing a multivitamin, I look for one that has methylated forms of Vitamin B12 and Folic Acid (methylcobalamin and methylfolate). The methylated forms are the more active forms that are easily utilised by the body. I also look at the form in which the minerals come in. Mineral supplements are made by attaching a molecule of mineral to a carrier of some sort: An amino acid (glycine, arginine, taurine) or an organic acid like citrate. This helps make the mineral into a form that is recognized and absorbed by the body. Some forms are better absorbed than others. Take for example Magnesium – Magnesium oxide and Magnesium Stearate are virtually not absorbed by your body at all. Any prenatal vitamin that values their customers would not have non bioavailable minerals as part of its’ formulation.

2. Liposomal Vitamin C, Liposomal B Complex, Liquid Vit D/Vit K, Zinc, Magnesium

On top of the multivitamin I take, I supplement with extra vitamins and minerals that are most people are known to be deficient in – namely Magnesium, Zinc, B Complex and Vit D.

I added Vit C to my supplementation because of COVID and because I had tested positive for Group B Strep. Supplementation of additional Vitamin C would thus help reduce the risk that my baby would have any complications from Group B Strep.

Because I was taking these supplements separately, I was able to find the most bioavailable (the ability of your body to absorb) form – Liposomal for C and B complex and sublingual liquid D. I took zinc as Zinc Picolinate and Magensium as Magnesium Bisglycinate. You can read more about liposomal supplementation and bioavailability here.

I previously mentioned that I try to avoid fat soluble vitamins supplementation such as A, D, E and K. However Vitamin D deficiency is very common and studies have shown that you need to supplement with A LOT of vitamin D before you even start to show signs of toxicity. I take 2000 IUs/day (RDI is 600 IU) and also did a blood test to put my mind at ease.

Most people think that you only need calcium supplements for bone health. The truth is Calcium, Vitamin D and K work together for healthy bone development. One of Vitamin D main functions is to ensure adequate levels of calcium in your blood. Vitamin K promotes calcium accumulation in your bones, while reducing its accumulation in soft tissues such as blood vessels. Magnesium is also an essential mineral for absorption and utilisation of Vitamin D and Calcium. 

3. Antioxidants: Liposomal Glutathione, CoQ10

We encounter toxins daily through our food, air, water and furniture. The fetus can be more sensitive to the effect of toxins on cells due to its’ rapid development. Whilst taking steps to minimise the toxins I am exposed to in my food and environment, I also take antioxidants to aid the detoxification process and hopefully reduce cellular damage from toxins I encounter in my daily live.

My choice of antioxidants are glutathione and CoQ10. Glutathione is often called the ‘master antioxidant’ because it can be found in nearly ever single cell in the body, and it also recycle other antioxidants such as vitamin C and E. Taking Glutathione helps stretch the dollar on your vitamin C and E supplements! 

CoQ10 is also a great antioxidant especially for cardiovascular health and something I’ve been taking before pregnancy and it hasn’t been found to have any negative effects during pregnancy and thus I continued its consumption throughout my pregnancy.

4. Fish Oil

Fish oil is rich in Omega 3. The recommended ratio of omega-6 to omega-3 fatty acids in the diet is 4:1 or less and an ideal omega 6 to 3 ratio is important in prevention of chronic diseases. Omega 3 is especially important during pregnancy to support the development of baby’s brain, eyes and nervous system.  The Western diet has a ratio between 10:1 and 50:1. For most people the omega-6 to omega-3 ratio, even in very healthy eaters, are not ideal. I do take sustainably farmed salmon every other day and still fall short of the ideal omega 6 to 3 ratio. I keep my fish oil in the refrigerator, as everyone should, to prevent oxidisation by heat.

5. Alpha GPC

Choline is a water-soluble nutrient that plays a critical role during fetal brain development and choline availability during fetal brain development helps improve memory and recall. The type of choline commonly added to prenatal vitamins is choline bitartrate, which has been shown to have no acute effects on memory. The type of choline you want to take is Alpha-GPC. Choline can be found naturally occurring in foods such as eggs, liver, beef, salmon, cauliflower and brussel sprouts. While I do try to obtain my nutrients from natural food sources as much as possible, I do like to add alpha GPC into my supplement stack just in case!

6. Myo-inositol

Myo-inositol taken during pregnancy can help reduce the risk of preterm labour and the development of gestational diabetes. Clinical studies have also demonstrated that Inositol can help restore normal ovulation, improve egg quality and increase fertilisation rates in women with PCOS.

7. Acetyl-L-Carnitine

Acetyl-L-carnitine (ALCAR) is an amino acid that is naturally produced in your body to aid in generating energy. It’s most often naturally found in animal protein — especially, red meats. ALCAR is more commonly known for its’ fat burning properties and use in weight loss and fitness supplements. What is lesser known is that ALCAR is also essential for brain development (for both you and baby!) Taking ALCAR can also help reduce the risk of gestational diabetes.

8. Collagen Peptides and BCAAs

These are basically amino acids and peptides – which are the building blocks of protein. Or if you look at it from the other direction, what protein is broken down into for use by our body. I had earlier shared about the importance of protein in pregnancy and I also supplement with collagen peptides and branched-chain amino acids (BCAAs) just in case I didn’t quite get enough from my meals. Pregnancy can be quite a bit of a curve ball when it comes to appetite, food aversion and food cravings!

9. Electrolytes

The first thing I do on waking is to have a glass of warm water with a dash of sodium, potassium and magnesium salts. This often comes as a surprise to most as they have been told to reduce their salt intake during pregnancy to prevent water retention. Dare I say that, for a normal healthy individual, that it is the LACK of electrolytes that are causing the swelling (osmotic pressure and all). When we are dehydrated, the hospitals don’t give us WATER drip, they give us SALINE drip. Drips packed with sodium and chloride and all other sort of minerals. As our blood volume increases and the demand for fluid increases during pregnancy, we should be mindful to keep up the electrolyte concentration in our body too.

I had no swelling, dizziness or lightheadedness throughout the course of my pregnancy, and perhaps it was due to luck and genetics, but I like to think my electrolyte consumption had a part to play in it.

10. Prebiotics and Probiotics

Gut health has been a hot topic of late and there have been early studies to show correlation between improved outcomes for pregnancy and postpartum and good gut health. I wasn’t that well versed into the different strains and their efficacy initially and in the early weeks of my pregnancy took a broad spectrum probiotic and prebiotic. After testing positive for GBS in my 36 week, I did a deep dive into probiotics and found some evidence based strains that were useful for pregnancy and breastfeeding – L. Reuteri, L. Salivarius, L. Rhamnosus HN001, Bifidobacterium Lactis, L. gasseri, L. Fermentum, Lactobacillus Rhamnosus GG. A good prebiotic would be Fructooligosaccharides (FOS).