Download Vitamin and Mineral Requirements

Vitamin and Mineral
Requirements
And
Supplements During
Pregnancy

Introduction

Micronutrients requirements during pregnancy

Vitamin requirements during pregnancy
o
Vitamin A
o
Folate
o
Vitamin B12
o
Vitamin C
o
Vitamin D
o
Vitamin K

Other vitamins

Mineral requirements during pregnancy

o
Iron
o
Calcium
o
Iodine
o
Zinc
o
Magnesium
o
Selenium
o
Other minerals
Essential fatty acid requirements during pregnancy
o
Omega-3
Introduction
Poor nutrition during pregnancy is associated with
a range of health risks for the pregnant women
and her developing foetus. In can also affect the health of the child
in the long term. A woman who is poorly nourished during
pregnancy is more likely to give birth to a low birth weight infant.
Low birth weight is associated with an increased risk of poor
childhood growth and development, as well as chronic health
issues (e.g. diabetes) later in life. Ensuring adequate nutrition
during pregnancy is therefore an important health goal.
To avoid poor nutrition, individuals must consume enough
macronutrients to give their body energy (e.g. proteins and
carbohydrates) as well as a range micronutrients, to maintain
specific body functions. For example, an individual requires calcium
for deposition in bone tissues to help bones grow and maintain their
density. Vitamin A is required to maintain the health of the eyes.
Micronutrients requirements during pregnancy
Micronutrients requirements change in response to changes in the
body and increased periods of growth. During pregnancy, when
the woman's nutritional intake also provide for the growing foetus, a
woman's requirement for numerous micronutrients increases. In
Australia most women can consume adequate amounts of these
micronutrients in their diet.
However it is important for women to seek nutritional advice from
a health professional about their micronutrient requirements before
and during pregnancy, as well as the types of food which are
goods sources of these micronutrients. Health practitioners may
also be a good source of information about micronutrient
supplements for women who are unable to meet their demands for
particular micronutrients from their diet.
It is important that pregnant women are aware that many
micronutrients are interrelated in function, so a deficiency in one
micronutrient
might
affect
the
utilisation
of
other
micronutrients. For example, vitamin K influences the absorption
of calcium; the absorption of iron from plant sources is increased
when more vitamin C is available; and vitamin B12 is involved in
converting folate to the form in which it can be absorbed by the
body, known as methyl-tetrahydrofolate.
While pregnant women should obtain the majority of their
micronutrients from dietary sources (the food they eat), in some
cases it is necessary for a pregnant woman to take vitamin or
mineral supplements, in addition to eating a healthy balanced diet.
Vitamin requirements during pregnancy
Vitamin A
Function
Vitamin A plays an important role in developing and maintaining eye
health. It also regulates cell growth and protects fertility and the
immune system.
During pregnancy, vitamin A is particularly important for ensuring
optimal eye development in the embryo (a fertilised egg in the very
early stages of pregnancy, before it takes on human
characteristics). Vitamin A regulates the way in which cells
differentiate to form different parts of the eye including the:

Conjunctiva - the mucous membrane which covers the front of
the eyes and the eyelids;

Cornea - the front section of the eye;

Photoreceptor rod cells (rod shaped
cells in the eye's retina which sense
dim light and help individuals to see at night); and

Cones cells (cells in the eyes which sense bright light and are
important for seeing in daylight).
It also plays an important role in regulating the development of the
spinal cord, vertebrae, limbs, heart and ears of the embryo.
Health effects
Vitamin A deficiency is uncommon in developed countries where
prevalence of malnutrition is low. However, it is associated with a
range of adverse health outcomes including eye and skin disorders,
infection and respiratory disorders.
Keratomalcia (night blindness) is a common early symptom of
vitamin A deficiency and is most common in pregnant women who
are vitamin A deficient.
Vitamin A deficiency during pregnancy is also associated with an
increased risk of the following conditions/complications:

Iron-deficiency anaemia - evidence suggests that combined
vitamin A-iron supplementation is most effective in reducing
the incidence of iron-deficiency anaemia during pregnancy;

Maternal mortality - although further research is needed, one
study also showed that women who took vitamin A
supplements while they were pregnant were 40% less likely to
die during pregnancy or childbirth than those who did not take
the supplements;

Premature birth;

Intrauterine growth retardation;

Low birth weight;

Bleeding during pregnancy due to premature detachment of
the placenta from the wall of the
womb (abruptio placentae).
Requirement
In Australia it is recommended that
pregnant women ≥ 19 years of age consume 800μg of vitamin A
retinol equivalents daily compared to 700μg for non-pregnant
women. Pregnant women aged 14-18 years should consume 700μg
of vitamin A retinol equivalents per day, the same quantity which is
required by non pregnant women of their age.
It is important to note that consumption of excessive quantities of
vitamin A may lead to acute or chronic toxicity. During pregnancy
this increases the risk of miscarriage, stillbirth and birth defects in
the infant. Individuals who use vitamin A containing products
(including skin creams for the treatment of skin disorders such as
acne) should not use vitamin A supplements at the same time.
Dietary sources
Vitamin A in the form of provitamin A caratenoids is found in plants
sources including:

Plant oils (e.g. canola oil);

Darkly coloured vegetables such as spinach; and

Yellow vegetables such as squash, pumpkin and carrots.
Preformed retinoids are found in animals sources including:

Dairy products;

Fish;

Liver;

Kidney; and

Eggs.
Supplements
Routine vitamin A supplements are not recommended for pregnant
women in Australia.
Folate
Function
Folate is an essential micronutrient involved in DNA synthesis,
which means that without adequate levels of folate, cells cannot
divide and replicate and growth is restricted. At times of increased
cell growth (e.g. pregnancy), an individual's folate requirement
increases.
Health effects
Folate deficiency during pregnancy increases the risk of neural tube
defects in the infant. An estimated 70% of neural tube defects could
be prevented by ensuring that women consume adequate amounts
of folate before and in the first trimester of pregnancy.
Folate deficiency may also cause haemolytic anaemia (anaemia or
a lack of red blood cells caused by the premature death of these
red blood cells) in pregnant women.
Requirement
A woman's folate requirement increases by 50% during pregnancy
and is particularly high in the first trimester of pregnancy. The
recommended daily intake of folate for all pregnant women is
600μg, compared to 400μg for non-pregnant women.
It is important to note that this requirement does not include the
additional folate necessary to prevent neural tube defects, as folate
intake prior to becoming pregnant largely determines the risk of
neural tube defect. This is because the neural tube is formed in the
very early stages of pregnancy, before the woman realises she is
pregnant. It is therefore also important for women of childbearing
age who are planning a pregnancy or might become pregnant to
ensure they consume the recommended quantities of folate for at
least one month pre-pregnancy.
Dietary sources
Good dietary sources of folate include:

Breakfast cereals fortified with folic
acid;

Other cereals or cereal based foods
(e.g. bread);

Yeast extract (e.g. vegemite);

Beans and legumes;

Orange juice fortified with folate.
Supplements
Because a woman's folate requirement increases substantially
during pregnancy, many pregnant women fail to consume adequate
dietary folate. Thus folate supplements are routinely provided to
pregnant women in Australia. The standard dose is 0.5mg daily,
however for women with an increased risk of delivering an infant
with neural tube defects, a 5.0mg daily dose is recommended.
These women include individuals:

Taking anticonvulsant medication;

With
pre-pregnancy
diabetes
mellitus;

With haemolytic anaemia;

With a multiple pregnancy;

With a neural tube defect or a partner
with a neural tube defect;

With a family history of neural tube defects;

With child who has a neural tube defect.
As the neural tube develops before most women know they are
pregnant, women planning a pregnancy should take folate
supplements for at least a month before they become pregnant.
Folate supplements can also be given later in pregnancy, however
there is evidence of an association between folate supplementation
during late pregnancy (weeks 30-34) and an increased risk of
childhood asthma.
It should also be noted that too much folate can be dangerous and
folate intake should not generally exceed 1000μg per day for
women aged >19 and 800μg per day for women aged 14-18.
Vitamin B12
Function
Vitamin B12 is essential for DNA synthesis (production of new
DNA) as well as maintaining normal blood and neurological (brain)
function.
Health effects
Vitamin B12 deficiency has a range of adverse health effects for
pregnant women including:


Anaemia and symptoms of anaemia, for example:
o
Skin pallor;
o
Low energy;
o
Fatigue;
o
Reduced exercise tolerance;
o
Shortness of breath;
o
Palpitations.
Neurological complications including:
o
Sensory disturbance (altered sensations) in the arms and
legs;
o
Motor disturbance (disturbed movement);
o
Memory loss;
o
Mood change;
o
Visual disturbances;
o
Impaired bowel and bladder control.
Requirement
A woman's vitamin B12 requirement increases during pregnancy in
relation to the requirement of the growing foetus. The
recommended daily intake of vitamin B12 for all pregnant women is
2.6μg, compared to 2.4μg for non-pregnant women. A woman's
vitamin B12 requirement rises to 2.8μg per day whilst she is
breastfeeding. There is no evidence that consuming too much
vitamin B12 is unsafe.
Dietary sources
There are only a few plant sources of
vitamin B12, and humans obtain this vitamin mostly from animal
products. Red meat provides about 25% of dietary vitamin B12,
while dairy products provide about 30% of an adult's and 50% of a
child's requirements of vitamin B12.
The bioavailability (extent to which it is available and absorbed by
the body) of vitamin B12 varies, depending on the source. For
example, 11% of the vitamin B12 contained in liver is readily
absorbable, compared to some 60% of that in chicken or mutton.
Good dietary sources of vitamin B12 include:

Red meat;

Dairy products;

Fish;

Chicken;

Eggs;

Pork.
Supplements
Pregnant women will typically obtain sufficient vitamin B12 from
dietary sources and vitamin B12 supplementation is not routinely
provided to pregnant women in Australia. However, for vegan or
vegetarian women who do not consume most dietary sources of
vitamin B12, supplements are essential.
Vitamin C
Function
Vitamin C is a water soluble vitamin, also
called ascorbate or L-ascorbic acid. Unlike
most other animals, humans and primates
cannot produce vitamin C in their bodies, and must therefore obtain
their requirement from dietary sources.
Vitamin C is an antioxidant which may protect us from some
diseases and ageing. It is also important for the production of
collagen (a component of skin) bones, cartilage, muscles and blood
vessels. Vitamin C is an essential micronutrient for ensuring good
dental health for the pregnant woman and her foetus, as it plays an
important role in the development of healthy gums. Adequate
vitamin C intake also increases an individual's absorption of nonhaem iron.
Vitamin C is found in all body tissues, but is found in high
concentrations in the adrenal and pituitary glands (hormone
producing glands), body fluids, leukocytes (small white blood cells),
eye and brain tissues. However, it cannot be stored in body tissues
for long periods of time, and must therefore be consumed every
day.
The concentration of vitamin C in a woman's blood declines
progressively and by up to 50% during pregnancy. This is due to
the vitamin C which is used by the foetus and hemodilution (a
process through which the blood is diluted by incorporating more
fluid).
Health effects
Vitamin C deficiency causes scurvy which has severe and
sometimes fatal consequences if not treated. Further research is
needed to determine whether or not there are associations between
vitamin C deficiency and maternal complications including preeclampsia (hypertension during pregnancy) and abruptio placentae
(premature detachment of the placenta from the womb).
Requirement
During pregnancy, women require an
additional 15mg of vitamin C per day. Women aged 14-18 should
consume 55mg of vitamin C (compared to 40mg when they are not
pregnant). Those aged ≥18 years of age should consume 60mg per
day (compared to 45mg per day pre-pregnancy).
Dietary sources
Vitamin C is derived mainly from plant sources, including:

Citrus fruits such as oranges;

Soft fruit including black currants and kiwi fruit;

Leafy green vegetables including sprouts and broccoli.
It is important to note that cutting, heating or bruising fruit and
vegetables may reduce their vitamin C concentrations.
The proportion of dietary vitamin C which is absorbed by the body is
usually 70-90%. However when an individual consumes more
vitamin C than their daily requirement, the amount which is
absorbed reduces by up to 50%. The rate of vitamin C absorption is
also reduced in smokers.
Supplements
Vitamin C supplements are not routinely recommended for pregnant
women in Australia. Supplementation during pregnancy may
increase the risk of preterm birth.
Vitamin D
Function
Vitamin D has an important function in
assisting the body to absorb calcium and
phosphorus. It is also an important nutrient for optimal immune
function, maintaining healthy skin and muscle strength.
Health effects
Vitamin D deficiency in a pregnant woman is an important risk
factor for the development of osteoporosis later in life. In the foetus
it can lead to childhood rickets (a disease which retards skeletal
development and causes weak bones).
Requirement
A woman's vitamin D requirement of 5.0μg daily does not increase
during pregnancy. Most women will obtain their vitamin D
requirement through sun exposure alone, although women with
limited sun exposure will require Vitamin D supplements.
Dietary sources
Vitamin D is mainly obtained through exposure to sunlight and most
individuals can obtain sufficient vitamin D through sun exposure
rather than dietary sources. There are also a number of dietary
sources of vitamin D, including:

Vitamin D fortified margarine; and

Fatty fish such as salmon and herring.
Supplements
There is insufficient evidence to determine whether or not vitamin D
supplementation improves maternal or foetal health. Some women
with high risk of deficiency may be tested for vitamin D levels with a
view to providing vitamin D supplements, including women who:

Wear a veil;

Always wear sunscreen;

Are obese;

Are of South Asian, Carribean, African or Middle Eastern
descent.
In England, where exposure to sunlight is much lower than
Australia, vitamin D supplementation is recommended routinely
during pregnancy.
Vitamin K
Function
The most important role of vitamin K is in regulating blood clotting. It
regulates both coagulation (thickening of the blood) and anticoagulation (thinning of the blood).
Health effects
Vitamin K deficiency can lead to bleeding disorders, in particular
increased clotting time, which may be particularly dangerous during
delivery. Low vitamin K intake is also associated with an increased
risk of hip fracture.
Requirement
There is no evidence that a woman's vitamin K requirement
increases above the usual 60μg daily during pregnancy.
Dietary sources
Dietary sources of vitamin K which are
suitable for pregnant women include:

Spinach;

Brussel sprouts;

Green salad vegetables;

Broccoli;

Plant oils (e.g. canola oil).
Supplements
Vitamin K supplements are not routinely recommended during
pregnancy and should only be given in the late stage of pregnancy,
to women:

With choleostasis (excessive bile production) of pregnancy
due to reduced vitamin K absorption;

Taking anticonvulsant medication.
Other vitamins
There is currently insufficient evidence to recommend routine
supplementation with other minerals, including vitamin E during
pregnancy. There appears to be no additional benefits associated
with
multi-micronutrient
supplementation
compared
to
supplementation with folate and iron only.
Mineral requirements during pregnancy
Iron
Function
Iron is a component of a number of essential
proteins, including haemoglobin which is essential
for transporting oxygen in the blood.
Health effects
Inadequate iron intake can lead to a range of iron deficiency
disorders, from low iron stores at the mild end of the spectrum to
iron deficiency anaemia at the severe end. Symptoms of these
disorders include fatigue, jaundice and reduced work capacity.
Requirement
A woman's iron requirement increases considerably during
pregnancy. It is recommended that women consume 27mg/day
during pregnancy, compared to 18mg/day for non-pregnant women.
Ensuring adequate iron availability is particularly important in the
third trimester of pregnancy, as this is the stage in which iron
deposition in the foetus occurs most rapidly.
Dietary sources
Dietary sources of iron include both plant and animal based foods.
However, the iron found in animals foods (also known as haemiron) is absorbed much more readily by the body than the iron found
in plant food (non-haem iron). Iron absorption is also influenced by
the availability of other micronutrients (e.g. vitamin C).
Good sources of iron include:

Red meat;

Fish;

Chicken

Grains;

Legumes;

Leafy green vegetables like spinach.
Supplements
Iron supplements are not routinely given to pregnant women in
Australia. However, all pregnant women should have their
haemoglobin (molecule which transports oxygen through the blood
and is an indicator of iron deficiency) level checked at the
commencement of antenatal care and again at 28 weeks gestation,
to check whether or not they require iron supplements. Women with
anaemia should also be tested to ascertain whether or not iron
supplementation is necessary.
Women at particular risk of iron deficiency, who are more likely to
need iron supplements than others, include:

Vegetarian and vegan women; and

Women with a multiple pregnancy.
Calcium
Function
Calcium's key function is to ensure the proper growth and structure
of teeth and bones.
Health effects
Low calcium intake throughout life, and
particularly in periods of rapid growth such
as pregnancy, increases the risk of
osteoporosis later in life, particularly after menopause.
Requirement
A woman's calcium requirement does not increase during
pregnancy, as the rate of calcium absorption naturally increases
during gestation. Thus for most women, 1,000mg of calcium is
required during pregnancy. However, pregnant women who are
under 18 years of age require 1,300mg of calcium daily, as their
own bodies are still growing and depositing calcium. Women should
not consume more than 2,500mg of calcium daily.
Dietary sources
Calcium is primarily found in dairy foods, although bony fish,
legumes and fortified foods are also sources of calcium. Calcium is
more readily absorbed from dairy than other sources. For example
compared to milk, the rate of calcium absorption from dried beans is
about 50% and from spinach is about 10%.
Good sources of dietary calcium include:

Milk;

Cheese (although pregnant women should only eat hard
yellow cheeses);

Yoghurt;

Calcium fortified soy products; and

Legumes.
Supplements
Routine calcium supplementation during pregnancy is not
recommended in Australia, where most women will obtain sufficient
calcium from dietary sources. Women who may be at risk of
calcium deficiency and require supplementation include:

Women with vitamin D deficiency;

Women who avoid dairy products and do not substitute dairy
with calcium enriched soy products.
In women with a high risk of calcium deficiency a doctor may
recommend calcium supplements.
Iodine
Function
Iodine is an essential trace element which assists in growth,
metabolism and tissue development. Iodine also plays a role in the
body's energy production and oxygen consumption.
Health effects
Iodine deficiency can result in a range of adverse health effects
collectively referred to as iodine deficiency disorder. In the
foetus/infant of an iodine deficient woman, these include:


Poor foetal outcomes including:
o
Miscarriage;
o
Stillbirth;
o
Congenital abnormalities;
Poor infant outcomes including:
o
Higher rates of infant mortality;
o
Neurological cretinism (a congenital condition of impaired
thyroid
hormone
secretion
which
impairs cognitive development);
o
Mental deficiency with deaf mutism;
o
Spastic diplegia (spastic paralysis of
the limbs) and squint;
o
Myxoedymateous cretinism (a type of
cretinism
in
which
physical
development is impaired) and dwarfism
(very short stature;
o
Psychomotor effect (movement effects).
In adults these include:

Goitre (enlargement of the thyroid gland);

Hypothyroidism (lack of hormones produced by the thyroid
gland);

Impaired mental and physical development.
Requirement
During pregnancy a woman's iodine requirement increases from
150μg daily, to 220μg daily.
Dietary sources
The availability of iodine in plant foods varies considerably
depending on the availability of iodine in the soil in which the plants
are grown. The best dietary sources of iodine are marine products
(e.g. fish, oysters). In past decades Australians have received a
considerable proportion of their iodine through iodine fortified salt,
however due to declining salt use in the Australian population,
iodine deficiency is now an increasing issue.
Supplements
Iodine supplements are provided routinely in areas where there is a
regional deficiency, for example due to low iodine levels in the soil
in that region. Doctors may also recommend iodine supplements to
other women if they suspect a deficiency, because of the critical
importance of avoiding iodine deficiency during pregnancy.
Zinc
Function
Zinc is a micronutrient which plays a role in maintaining the
structural integrity (normal form) of proteins and regulates gene
expression (how genes and genetic traits are replicated in the
DNA). It is mainly stored in bones and muscle tissues.
Health effects
Zinc deficiency during pregnancy is associated with an increased
risk of pregnancy complications, including:

Pre-eclampsia (high blood pressure and urinary protein
concentrations during pregnancy);

Premature rupture of membranes (when a woman's amniotic
sac/pregnancy
water
contractions); and

Preterm delivery.
breaks
before
she
experiences
It is also associated with foetal
abnormalities including growth retardation
and other congenital abnormalities.
Requirement
The recommended daily intake of zinc rises during pregnancy.
Women aged 14-18 require 10mg of zinc per day (compared to
8mg pre-pregnancy), while those aged ≥ 19 years requiring 11mg of
zinc per day (compared to 8mg pre-pregnancy).
Dietary sources
Zinc is found in a wide variety of foods. The majority of zinc in the
diet comes from animal products, especially meat, fish and poultry
but also vegetables and dairy products. The bioavailability of zinc
varies markedly depending on the availability of protein in the diet,
and zinc from protein rich animal foods is absorbed as much as
50% more readily than zinc from vegetables sources. Dietary intake
of large quantities (e.g. quantities similar to those found in
supplements) of iron and possibly other minerals and vitamins can
also affect zinc absorption.
Supplements
Zinc supplements are not routinely provided to pregnant women in
Australia. However, women who are vegetarian or vegan may be at
risk of zinc deficiency during pregnancy because the zinc in their
diet is absorbed less efficiently than in women who consume meat
and dairy products.
Magnesium
Function
Magnesium is a micronutrient which works
with more than 300 enzymes involved in
energy generation and glycolysis (break
down of sugars and carbohydrates). It
also plays a role in regulating the function
of other minerals including calcium and
potassium. About half the magnesium in the human body is found in
bones and a further third is stored in muscle and soft tissues.
Health effects
Maternal magnesium deficiency increases the risk of pre-eclampsia
and pre-term delivery. There is also some evidence of an
association with low birth weight. Moderate-severe deficiency is
also associated with an increased risk of hypercalcaemia
(excessive levels of calcium in the blood).
Requirement
A woman's magnesium requirement during pregnancy increases in
comparison with pre-pregnancy requirements and varies with age.
Women aged:

14-18 years require 400mg of magnesium per day;

19-30 years require 350 mg per day;

≥31 years require 360mg per day.
Dietary sources
Magnesium is present in a wide range of foods. Rich sources
include:

Green vegetables;

Legumes;

Peas, beans and nuts;

Some shellfish;

Some spices.
It is also present in lower amounts in unrefined grains but not in
refined cereal such as flour.
Absorption varies widely depending on an individual's magnesium
intake, with as little as 25% of magnesium consumed being
absorbed by individuals with high intake compared to 75% by
individuals with low intake. Absorption also varies depending on the
availability of other constituents of the diet, with high zinc or fibre or
a combination of high calcium and sodium intake decreasing
absorption. Low protein intake also decreases absorption.
Supplements
Routine magnesium supplementation is not recommended for
Australian women.
Selenium
Function
Selenium is a trace mineral which is an antioxidant and plays an
important role in regulating the function of the thyroid (a gland which
produces hormones which regulate the metabolism).
Health effects
During pregnancy selenium deficiency increases the risk of low birth
weight and pre-eclampsia. Selenium may be toxic at high levels and
result in fever, gastro-intestinal symptoms and even death.
However it is not known how much
selenium is needed to cause toxicity.
Requirement
It is recommended that pregnant women consume 65μg of
selenium per day (compared to 60μg per day for non-pregnant
women).
Dietary sources
There are numerous dietary sources of selenium, however
concentrations in plant foods vary considerably depending on
selenium concentrations of the soil in which they were grown. The
main sources of dietary selenium in Australia are:

Seafood;

Poultry; and

Eggs.
Plant foods (including grains, nuts, alfalfa, garlic and radish) may
also contribute dietary selenium depending on the selenium soil
concentration in the area in which they were grown. Between 5570% of selenium in the diet is absorbed by the body.
Supplements
Routine selenium supplementation is not recommended for
pregnant women in Australia.
Other minerals
There is currently insufficient evidence to recommend routine
supplementation with other minerals, including fluoride during
pregnancy. There appears to be no additional benefits associated
with
multi-micronutrient
supplementation
compared
to
supplementation with folate and iron only.
Essential fatty acid requirements during pregnancy
Omega-3
Function
Omega-3 is an essential fatty acid. It cannot be produced by the
body and therefore people must consume their omega-3
requirement. Omega-3 fatty acids are important components of cell
membranes (including the membranes of cells which form the eye)
and the central nervous system.
Health effects
Further research is needed to determine the affect of omega-3
intake on pregnancy and foetal outcomes. There is some evidence
that women who take omega-3 supplements maintain their
pregnancies for a slightly longer time than women who do not.
Evidence also suggests that women who eat more fish (the best
source of omega-3) give birth to larger babies and have a lower risk
of pregnancy complications.
Requirement
During pregnancy women require 1.4g of omega-3 fatty acids
compared to 1.1 g pre-pregnancy.
Dietary sources
Fish is a particularly good source of
omega-3 fatty acids. However, pregnant
women should not eat too much fish
because of the risk of mercury contamination associated with high
fish intake during pregnancy. Women of childbearing age should be
try to eat 12 ounces of fish each week. Some breads are also
fortified with omega-3.
Supplements
There is currently insufficient evidence to determine the effect of
omega-3 supplementation on pregnancy outcomes. In the absence
of evidence, omega-3 supplements are not recommended.
More information
For more information about pregnancy, including
preconception
advice,
stages
of
pregnancy,
investigations, complications, living with pregnancy and
birth, see Pregnancy.
For more information on nutrition, including information
on types and composition of food, nutrition and people,
conditions related to nutrition, and diets and recipes, as
well as some useful videos and tools, see Nutrition.
Reference
1. Nutrient reference values for Australia and New Zealand:
Calcium [online]. Canberra, ACT: National Health and Medical
Research Council; 2006 [cited 22 August 2009]. Available
from: URL link
2. Chapter 5: Energy. In: Dietary reference intakes for energy,
carbohydrate, fiber, fat, fatty acids, cholesterol, protein and
amino acids (macronutrients) [online]. Washington: National
Academies Press; 2005 [cited 6 June 2009]. Available from:
URL link
3. Improving the health and nutrition of pregnant and
breastfeeding mothers and children in low-income households
[online]. London: National Institute for Health and Excellence;
March 2008 [cited 22 August 2009]. Available from: URL link
4. Dietary guidelines for Australian adults [online]. Canberra,
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