In regards to the basics of nutrition, the Food and Nutrition Board of the Institute of Medicine (IOM) set forth intake guidelines to use as references. These are called the Recommended Daily Allowances (RDAs). These guidelines outline the amounts of each macronutrient and micronutrient you should have daily in your diet. Most medical professionals refer to these RDAs when relating anything back to nutrition. I’m sure you’ve seen them on every nutrition label without realizing it. The percentages noted after each nutrient on the labels are percentages associated with the RDAs. When women become pregnant, many medical professionals give a brief nutritional pamphlet with these RDAs noted and say “good luck.”
^^That’s a red flag in itself (where’s the guidance in that!?)
Here’s an example of a nutrition fact label. See to the right the percentages. That’s in regards to RDAs.
**disclaimer: these are not recommended intakes for any nutrient listed; once again this is just an example!
Don’t get me wrong, the RDAs are a good rough draft to follow and it doesn’t hurt trying to get these recommended amounts (with some exceptions) into your diet.
However, RED FLAG ALERT → research shows the RDAs are underestimating multiple nutrients for pregnancy.
This means you actually need much more of select nutrients than what the RDA is set at. And a little side note, these RDAs were established from trials with adult MEN and then formulated with an elaborate equation to relate back to pregnant women… uh accuracy check?
New research is constantly evolving and new findings happen every year. But it can take up to 20+ years for recommendations to change in writing. For example, this is the reason some people are STILL warning others not to eat the yolks of eggs because of dietary cholesterol which has been proven to have no actual effect on levels of cholesterol in your blood (but that’s a tangent for another day).
So how big of a problem is this?
Firstly, if you’re pregnant and only following these guidelines, you could be missing out on key nutrient levels your baby needs for optimal growth. What’s worse is research consistently shows many pregnant women aren’t even meeting these RDAs alone. This can have huge risks for your baby’s development. When your baby doesn’t get all the nutrients they need to thrive, risks increase for neural tube defects, low birth weight, preterm birth, and other birth defects. It also puts you at risk for preeclampsia, gestational diabetes, and unhealthy weight gain during pregnancy. Furthermore, inadequate nutrients during pregnancy increase risk for your child to develop asthma, language impairments, obesity, or type 1 diabetes later on in life.
Secondly, many prenatal vitamin companies are using these recommendations when formulating their products. This allows them to write ‘100% of RDA’ on the bottle which is great for marketing, but not great for accuracy. Even though prenatal vitamins are just a supplement and shouldn’t be used to replace a real food diet, we do want them to be sufficient for when it’s tough to stomach foods (hello first trimesters!). You should have reassurance that your prenatal is giving you the nutrients you need when you’re unable to fully nourish yourself.
Some prenatal vitamins on the market are just not cutting it.
Here’s an example. Choline is an essential nutrient needed during pregnancy. It helps prevent neural tube defects and promotes normal brain development. This is vital in the first trimester of pregnancy.
The current recommendations are set at 450 mg. However, the latest data suggests that choline intake should be TWICE that (930 mg) during pregnancy. Doubling choline intake is linked to higher cognitive function in infants, better placental function, and lesser chances of preeclampsia. It’s most abundant in eggs and liver but if you refer back to the guidelines for pregnant women currently out there, liver isn’t recommended and eggs are often cautioned due to fear of runny yolks and potentially STILL that cholesterol myth. RED FLAG!
Choline is just one example of the multiple nutrients that you actually need in much higher amounts than what is currently in writing.
The research over the last decades has shown us that to grow healthy babies, we need to do better.
Here’s another example with the macronutrient, carbohydrates. The current RDA for carbohydrates during pregnancy is 45-65% of daily calories. This equates to about 9-11 servings daily and they suggest making half of them from whole grains. If you are consuming this amount in your diet, it is extremely difficult to obtain the actual required amounts of protein (which is much higher than once thought) and fat in your diet. This leads to commonly seen deficiencies during pregnancy; B vitamins, DHA, and iron which protein containing foods are all rich in. Many believe the only way to obtain enough fiber is from whole grains. This is actually not true. A half of an avocado has 7x more fiber than 1 slice of whole grain bread!
This does not mean carbohydrates are not good for you. They still need to be a part of your daily intake. But, it’s just a small example of how far the current recommendations are behind the newer research. Emphasizing carbohydrates in a diet can make it more difficult to manage your blood sugars. One study found that uncontrolled blood sugars have been shown to increase risk for heart malformations. And we all know uncontrolled blood sugars increases your risk of developing gestational diabetes.
So what do I do with this information?
This is just a brief post about the lack of knowledge currently out there and given newly pregnant women. If we want to nourish ourselves for a healthy pregnancy and have babies that optimally grow and develop we need to be doing better! Making sure your prenatal vitamin is up to ~the right~ standards and your diet is well rounded with real, whole foods is the best place to start. This is also the time when a pregnancy dietitian can help. I am so passionate about informing women that nutritional guidelines for pregnancy may be lacking. And the more women that are aware, the more healthy babies that are brought into this world.
Help me let more soon-to-be mamas out there! Like, share, and save this post!
Aparicio, Estefania et al. “Nutrient Intake during Pregnancy and Post-Partum: ECLIPSES Study.” Nutrients vol. 12,5 1325. 7 May. 2020, doi:10.3390/nu12051325
Kominiarek, Michelle A, and Priya Rajan. “Nutrition Recommendations in Pregnancy and Lactation.” The Medical clinics of North America vol. 100,6 (2016): 1199-1215. doi:10.1016/j.mcna.2016.06.004
Korsmo, Hunter W., Xinyin Jiang, and Marie A. Caudill. “Choline: exploring the growing science on its benefits for moms and babies.” Nutrients 11.8 (2019): 1823.
Mousa, Aya et al. “Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence.” Nutrients vol. 11,2 443. 20 Feb. 2019, doi:10.3390/nu11020443
Nichols, Lily. Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition., 2018.
Print.Priest, James R et al. “Maternal Midpregnancy Glucose Levels and Risk of Congenital Heart Disease in Offspring.” JAMA pediatrics vol. 169,12 (2015): 1112-6. doi:10.1001/jamapediatrics.2015.2831