What Should Be the Correct Use of Supplements During Pregnancy?

Dr. Wael Khattab Answered Our Questions About Using The Right Supplement During Pregnancy

Do special nutritional needs arise during pregnancy?

Nutritional needs of people differ according to conditions such as age, gender, pregnancy. Among them, pregnancy is a period when nutrition is very important for both maternal and child health. There are some micronutrients that we should take in addition to our normal diet during pregnancy. Folate is one of them. When discussing nutritional supplement needs during and before pregnancy, we need to know what the right supplement is. recommended folate
supplementation is 400 µg daily for 4 weeks prior to conception and throughout pregnancy in addition to dietary folate intake.

Can the required folate level be reached with a normal diet?

Adequate folate recommendation through diet is difficult to achieve, with diet meeting about 50 percent of the daily folate recommended by Europe.

Why is folate supplementation important during pregnancy?

Folate supplementation is necessary to prevent complications during pregnancy, the most important of which is neural tube defects. Folic acid deficiency is linked to some other adverse outcomes of pregnancy such as preterm delivery, low birth weight, perinatal mortality, and congenital heart defects.

What is the neural tube and why is it important?

neural tube:
• It is one of the first central formations of the fetal nervous system, where the brain and spinal cord will develop.

• The neural tube closes between the 22nd and 28th days after conception, during this period many women are unaware of their pregnancy.

• Without neural tube closure, such as spina bifida or anencephaly
birth defects may develop

Are folic acid and folate the same thing?

Regarding terminology, folic acid, folate, and metafolin are sometimes used interchangeably, but they are not the same. Folic acid is a synthetic compound and can be found in fortified foods, pharmaceutical products, and vitamins. Folate is natural and is the biologically active metabolite found in humans.
It is an essential vitamin that has actually been digested through the diet. Metafolin, an active folate that can be found in plasma
in the form of L-methyltetrahydrofolate (L-MTHF).

How is Folate Metabolism?

Folate metabolism in humans is a complex process. The correct functioning of this, vitamins B6, B12
It depends on the presence of the appropriate MTHFR enzyme. Apart from adequate B6 and B12, T enzyme polymorphism may also play a key role in folate metabolism as a risk factor for neural tube defects. In the Middle East, the prevalence is 57 percent for the CC variant, 34 percent for the CT variant, and 8 percent for the TT variant. Many factors play a role in this issue. For example; 9 out of 10 women do not start supplementing at the right time. In the Middle East, 95 percent of mothers of babies with NTD did not take folic acid during the first 3 months of their pregnancy. Only 2 percent of women took folic acid in the first trimester of their pregnancy. 4 out of 10 pregnancies were not planned. Also, not every woman can properly metabolize folic acid.

What is Metafolin mentioned together with folate? What are the properties of this component?

• Metafolin is the calcium salt of the biologically active form of folate L-5 MTHF.
• It breaks down into calcium and forms the biologically active folate L-5-MTHF. Major folate in maternal and umbilical cord blood
is the form. It is used directly without metabolism (unlike folic acid).
• A woman who cannot optimally metabolize folic acid due to the MTHFR C677T polymorphism.
It is particularly useful on Personalized NTDs or NTDs in a woman with only a previous pregnancy
The recommended dose for that person is 5 mg of folic acid daily when affected by his or her past.

What other micronutrients other than folate are important in pregnancy?

Iodine supports healthy fetal brain development. The World Health Organization estimates that 2.2 billion people worldwide consume iodine.
He estimates that people are at risk for AD deficiency (ID) and that it is the leading cause of preventable brain damage. Moreover, 60 percent of pregnant women in Iran do not get enough iodine. Another important nutrient for the fetus is docosahexaenoic acid (DHA). When the brain grows rapidly at approximately 22 weeks of pregnancy, large amounts of DHA must be present in the growth tissues of the child. (Depending on what maternal DHA provides). A study during breastfeeding found that the DHA content in breast milk increased by up to 90 percent with DHA supplementation, while there was a 17 percent decrease in the control group.
showed. Although the recommendation varies by country and the appropriate daily supplemental dose is different, global recommendations on DHA recognize the importance of DHA supplementation (a standard dose or a calculated dose based on body weight). Therefore, what is needed for a healthy pregnancy is a balanced diet, healthy
lifestyle and health check-up.

In addition to these, other needs during pregnancy:

• Folic acid + Metafolin supplementation before conception: as much as the baby should be at the end of the 3rd month of pregnancy (four weeks before conception).
• Folic acid + Metafolin + DHA supplementation after conception: From the 4th month of pregnancy until the end of breastfeeding.

Journal of Food and Nutrition, What Should Be the Correct Use of Supplements During Pregnancy?, 2017

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