Diet in Early Pregnancy: Focus on Folate, Vitamin B12, Vitamin D, and Choline

Publication: Canadian Journal of Dietetic Practice and Research
12 September 2019

Abstract

Purpose: Prenatal multivitamins are recommended in pregnancy. This study assessed food and supplement intakes of folate, vitamin B12 (B12), vitamin D, and choline in pregnant women living in Southern Ontario in comparison with current recommendations.
Methods: Women recruited to the Be Healthy in Pregnancy RCT (NCT01693510) completed 3-day diet/supplement records at 12–17 weeks gestation. Intakes of folate, B12, vitamin D, and choline were quantified and compared with recommendations for pregnant women.
Results: Folate intake (median (min, max)) was 1963 μg/day dietary folate equivalents (153, 10 846); 90% of women met the Estimated Average Requirement (EAR) but 77% exceeded the Tolerable Upper Intake Level (UL) (n = 232). B12 intake was 12.1 μg/day (0.3, 2336); 96% of women met the EAR with 7% exceeding the EAR 100-fold (n = 232). Vitamin D intake was 564 IU/day (0.0, 11 062); 83% met the EAR, whereas 1.7% exceeded the UL (n = 232). Choline intake was 338 mg/day (120, 1016); only 18% met the Adequate Intake and none exceeded the UL (n = 158).
Conclusion: To meet the nutrient requirements of pregnancy many women rely on prenatal vitamins. Reformulating prenatal multivitamin supplements to provide doses of vitamins within recommendations to complement a balanced healthy diet would ensure appropriate micronutrient intakes for pregnant women.

Résumé

Objectif. Les multivitamines prénatales sont recommandées lors d’une grossesse. Cette étude a comparé l’apport, par les aliments et les suppléments, en acide folique, vitamine B12 (B12), vitamine D et choline chez des femmes enceintes vivant dans le sud de l’Ontario aux recommandations actuelles.
Méthodes. Les femmes recrutées pour l’essai clinique randomisé Be Healthy in Pregnancy [Une grossesse en santé] (NCT01693510) ont noté leur consommation d’aliments et de suppléments durant trois jours entre les semaines 12 à 17 de leur grossesse. L’apport en acide folique, en B12, en vitamine D et en choline a été quantifié et comparé aux recommandations pour les femmes enceintes.
Résultats. L’apport en acide folique (médian [min, max]) était de 1 963 μg/jour d’équivalent d’acide folique alimentaire (153, 10 846); 90 % des femmes respectaient le besoin moyen estimatif (BME), mais 77 % dépassaient l’apport maximal tolérable (AMT) (n = 232). L’apport en B12 était de 12,1 μg/jour (0,3, 2 336); 96 % des femmes respectaient le BME et 7 % dépassaient l’AMT de 100 fois (n = 232). L’apport en vitamine D était de 564 UI/jour (0,0, 11 062); 83 % respectaient le BME, alors que 1,7 % dépassaient l’AMT (n = 232). L’apport en choline était de 338 mg/jour (120, 1 016); seulement 18 % atteignaient l’apport suffisant et aucune ne dépassait l’AMT (n =158).
Conclusions. Afin de respecter les besoins nutritifs liés à la grossesse, bon nombre de femmes se fient aux vitamines prénatales. La reformulation des suppléments multivitaminiques prénataux afin de fournir des doses de vitamines conformes aux recommandations pour compléter une saine alimentation équilibrée permettrait d’assurer des apports en micronutriments adéquats chez les femmes enceintes.

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Source of financial support: Canadian Institute of Health Research
Conflicts of interest: The authors declare no conflict of interest.

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cover image Canadian Journal of Dietetic Practice and Research
Canadian Journal of Dietetic Practice and Research
Volume 81Number 2June 2020
Pages: 58 - 65

History

Version of record online: 12 September 2019

Authors

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Caroline J. Moore BSc (Hons)
Department of Pediatrics, McMaster University, Hamilton, ON
Maude Perreault RD, MSc
Department of Pediatrics, McMaster University, Hamilton, ON
Michelle F. Mottola PhD, FACSM
School of Kinesiology, Western University, London, ON
Stephanie A. Atkinson PhD, DSc (Hon), FCAHS
Department of Pediatrics, McMaster University, Hamilton, ON

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2. Vitamin D, Folate, Vitamin B12, and Iron Status in Pregnant/Postpartum Old Order Anabaptist Women in Southwestern Ontario

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