![]() The UL is the highest level of daily intake that is likely to pose no risk of adverse health effects in almost all individuals of a specified life stage. The discussion below largely focuses on these recommendations for select micronutrients during pregnancy but also notes major concerns for micronutrient toxicity or teratogenicity. For most micronutrients, the RDA or AI for pregnant women is increased compared to nonpregnant women of the same age ( Table 1). ![]() The below recommendations are specific to the life stages of pregnancy and lactation. The FNB establishes an AI when an RDA cannot be determined. The RDA, which is the average daily dietary intake level of a nutrient sufficient to meet the requirements of almost all (97.5%) healthy individuals in a specific life stage and gender group, should be used in the planning of diets for individuals (12). The DRIs include the estimated average requirement ( EAR), the recommended dietary allowance ( RDA), the adequate intake ( AI), and the tolerable upper intake level ( UL). The Food and Nutrition Board (FNB) of the Institute of Medicine establishes life-stage specific dietary reference intakes ( DRIs) for each micronutrient these reference values should be used to plan and assess dietary intakes in healthy people (10, 11). In addition to folic acid supplementation, iron supplementation is generally needed to meet the increased demands for this mineral during pregnancy (see the section on Iron below). A well-balanced diet throughout pregnancy is necessary to supply the developing embryo/fetus with micronutrients. Thus, folic acid supplementation (at least 400 μg/day) is recommended for all women capable of becoming pregnant (7-9). For instance, folic acid supplementation during the periconceptional period (about one month before conception until the end of the first trimester) dramatically reduces the incidence of devastating birth defects called neural tube defects (see Folate below). Good nutritional status prior to conception is also important for a healthy pregnancy. Multiple micronutrient deficiencies commonly co-exist in pregnant women (6).ĭaily requirements for many micronutrients during pregnancy are higher to meet the physiologic changes and increased nutritional needs of pregnancy. ![]() Maternal undernutrition often refers to malnutrition caused by insufficient caloric (energy) intake from macronutrients ( carbohydrates, proteins, and lipids) during pregnancy, but micronutrient deficiencies are also a form of undernutrition. In addition, gestational undernutrition has been implicated in increasing the offspring’s susceptibility to chronic disease (i.e., type 2 diabetes, hypertension, coronary heart disease, and stroke) in adulthood, a phenomenon sometimes called Barker’s hypothesis, the thrifty phenotype hypothesis, or the fetal origin of adult disease hypothesis (4, 5). Select nutrient deficiencies have also been linked to congenital anomalies and birth defects. Maternal malnutrition during pregnancy has been associated with adverse outcomes, including increased risk of maternal and infant mortality, as well as low-birth-weight newborns (<2,500 grams) - a measure that accounts for preterm birth and intrauterine growth restriction of the fetus (2, 3). Proper maternal nutrition during pregnancy is thus imperative for the health of both the woman and the offspring. Pregnancy is associated with increased nutritional needs due to physiologic changes of the woman and the metabolic demands of the embryo/fetus. Micronutrient Requirements During Pregnancy Relative to the increased energy requirement, the requirements for many micronutrients ( vitamins and nutritionally essential minerals) are even higher during pregnancy and lactation this article discusses micronutrient needs during these life stages. In practice, most women will require only approximately 200 additional kcal/day due to reduced levels of physical activity during pregnancy and to increased lipolysis of fat stores during breast-feeding. ![]() Mathematical models predict that energy requirements increase by an estimated 300 kcal/day during the second and third trimesters of pregnancy and by 500 kcal/day during lactation (1). Nutrient needs during the life stages of pregnancy and lactation are increased relative to women who are not pregnant or lactating. Micronutrient Needs During Pregnancy and Lactation Introduction ![]()
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