We are a long way from calculating the nutritional status of women before or during pregnancy, writes Sylvia Thompson
MEDICAL DOCTORS are not well educated on nutrition, and many are still unaware of women's increased need for micronutrients (vitamins and minerals) pre-conceptually, during pregnancy and while breastfeeding.
This is the view of Dr Louis Keith, retired professor of obstetrics and gynaecology and former director of undergraduate education at the Feinberg School of Medicine, Northwestern University, Chicago, United States.
Keith was in Dublin recently to promote a new range of nutritional supplements from Vitabiotics directed at women before, during and after pregnancy.
Explaining why many women need to take supplements at this stage in their lives, he says: "Our ancestors relied heavily on fresh fruit and vegetables and less meat than we do. Theirs was a more nutritionally balanced diet than ours, which contains less fruit and vegetables and far more meat and processed foods."
He describes as old-fashioned the medical advice that only suggests that women wishing to conceive should take folic acid. "Folic acid is, of course, important for the prevention of neural tube defects but vitamins B6 and B12 and other vitamins are also important for foetal development," he says.
He also mentions recent research which points to a possible role of folic acid for men, pre-conception.
Other studies have pointed to deficiencies of zinc and selenium in male infertility.
According to Keith, folic acid, B6 and B12 vitamins also have a role to play in reducing homocysteine levels during pregnancy, which in turn reduces the risk of high blood pressure and pre-eclampsia.
While he acknowledges that plenty of leafy green vegetables and fish will provide many of the micronutrients required during pregnancy, he says that it is impossible to know what an individual mother-to-be lacks.
"For years, the nutritional status of women during pregnancy was never mentioned at medical conferences. It is really only in the past five years or so that doctors are interested in nutrition before, during and after pregnancy," he says.
However, we are still a long way from calculating the nutritional status of women either before or during pregnancy.
"It's true, we don't know what nutrients women are lacking during pregnancy. To get a blood test to find out your nutritional status for the range of micronutrients contained in supplements would be hugely complicated, and we don't have clinically reliable measurements for micronutrient deficiencies," says Keith.
Regarding alcohol and pregnancy, he says that although the advice is to have one to two units per week, it's best not to drink alcohol at all during pregnancy.