LB2882MaternalNutriti+ - Mead Johnson Nutrition

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FIGURE 1. DIFFERENCES IN VITAMIN INTAkE RECOMMENDATIONS 200% 180% 160% 140% 120% 100% 80% 60% 40% 20% 0% Vitamin C Vitamin D Vitamin E Vitamin K Thiamin Riboflavin Vitamin A Niacin Vitamin B6 Pantothenic Acid Pregnancy, 19-30 years Lactation, 19-30 years Biotin Choline Folate Vitamin B12 100% represents the DRI for non-pregnant and non-lactating women ages 19-30 years. The bar graphs illustrate the percentage of the nonpregnant/non-lactating DRI recommended for pregnant and lactating women. Specifi c recommendations for pregnancy and lactation are provided in Table 8. It is important for pregnant women to consume adequate amounts of all essential vitamins. Some vitamins that deserve special attention during pregnancy and/or lactation are highlighted. TAbLE 8. RECOMMENDED VITAMIN INTAkES FOR WOMEN DURING PREGNANCY AND LACTATION, AGES 19 TO 50 YEARS 21,79,80 Nutrient Vitamin A ac , µg RAE Vitamin C ac , mg Pregnancy Lactation IOM WHO/FAO IOM WHO/FAO 770 (2541 IU) 85 800 1300 (4290 IU) 850 55 120 70 250% 200% 150% 100% 50% 0% Vitamin D ac , µg 15 (600 IU) MATERNAL NUTRITION 14 5 (200 IU) 15 (600 IU) 5 (200 IU) Vitamin E a , mg 15 - 19 - Vitamin K bc , ug 90 55 90 55 Vitamin B1 ac (thiamin), mg 1.4 1.4 1.4 1.5 Vitamin B2 ac (riboflavin), mg 1.4 1.4 1.6 1.6 Vitamin B3 ac (niacin), mg 18 18 17 17 Vitamin B6 ac , mg Pregnancy, 1.9 19-30 years 1.9 2.0 2.0 Pantothenic Acid bc , mg Lactation, 6 19-30 years 6 7 7 Biotin bc , µg 30 30 35 35 Choline b , mg 450 - 550 - Folate ac , µg 600 600 500 500 Vitamin B12 ac , µg 2.6 2.6 2.8 2.8 a Recommended Dietary Allowance (RDA) b Adequate Intake (AI) c Recommended Nutrient Intake (RNI) Intakes are per day, unless otherwise noted. Calcium Chromium Copper Fluoride Iodine Iron Magnesium Manganese Molybdenum Phosphorus Selenium Zinc Potassium Sodium Chloride
Folate and Folic Acid Folate is a generic term for a B-complex vitamin. Folate is found naturally in plant foods while folic acid is its synthetic counterpart that is added to enriched grains and dietary supplements. 81 Folate is central in the production of cells, particularly red blood cells, for nucleic acid synthesis, cell division, and for normal serum homocysteine levels. 81,82 Adequate folic acid intake prior to conception and during the first 28 to 30 days of pregnancy is associated with a reduced risk of neural tube defects (NTDs). 11,12 Women with pre-gestational diabetes and obese women are at increased risk of having a pregnancy affected by a NTD and they may benefit from higher intakes of folic acid, though the exact mechanism as to why this occurs and the actual amount needed are uncertain. 83 Due to the importance of folate in fetal development, various approaches have been implemented around the world in an attempt to increase the folate status for women of childbearing age. These approaches include voluntary or mandatory fortification of foods and/or recommendations for folic acid supplementation for women of childbearing age with associated public health campaigns. 84 Mandatory food fortification programs are in place in many countries 85 and reports have demonstrated a decrease in the prevalence of neural tube defects associated with folic acid fortification in the US, Canada, Chile, South Africa, Costa Rica, Argentina, and Brazil. 85 The U.S. Preventive Services Task Force recommends that women of childbearing age with no history of a NTD-affected pregnancy consume 400 to 800 µg of folic acid daily from foods and/or vitamin supplements before and during early pregnancy, while women with a history of a NTD-affected pregnancy should consult with their physician about taking 4 mg of folic acid daily to prevent a recurrence. 11 Similar recommendations are in place in various countries around the world. 86 The health benefits of folic acid intake during pregnancy may go beyond those associated with preventing structural birth defects. 87,88 Periconceptionally, and throughout pregnancy, low dietary folate intake and low circulating blood folate concentrations have been associated with higher risks of preterm delivery, low birth weight, and fetal growth restriction. 82,89,90 The IOM recommends 600 µg of dietary folate equivalents (DFE) daily for pregnant women of all ages, and during lactation, 500 µg/day DFE is recommended. 81 The WHO adopted the IOM’s recommendations for pregnant and lactating women. 21 Multiparous pregnancies may require more folate but there is no established DRI for women carrying more than one fetus. 81 Vitamin B12 Vitamin B12 is necessary for healthy nerve and red blood cells and for the production of nucleic acids. 81 Vitamin B12 is found naturally only in animal foods. Vegans and others who consume few or no animal foods and insufficient vitamin B12 fortified foods may be at risk of vitamin B12 deficiency. 81 The IOM established recommended intakes for vitamin B12 during pregnancy at 2.6 µg and 2.8 µg during lactation. 81 The WHO adopted the IOM’s recommendations for pregnant and lactating women. 21 Maternal vitamin B12 deficiency can result in deficiency in the nursing infant within months after birth. Infantile vitamin B12 deficiency may cause lasting neurodisability. 91 Women at risk for vitamin B12 deficiency should include fortified foods such as breakfast cereals, soy and other plant-based beverages, nutrition bars, meat substitutes, and fortified brewer’s yeast in their eating plan, as well a vitamin B12 supplement to achieve the suggested amounts. Choline Choline is an organic compound that is usually grouped within the vitamin B complex. Choline is found in cell membrane lipids; in sphingomyelin, a component of the myelin sheath surrounding nerve fibers; and as part of the neurotransmitter acetylcholine, necessary for muscle control, memory, and other functions. Choline is also present in high concentrations in the liver. 81,92 Adequate choline intake during early pregnancy is important as availability of dietary choline during early pregnancy may influence neural tube closure, independent of folate. 13,14,93 Experimental animals supplemented with choline (in 15
Page 1 and 2: MATERNAL NUTRITION bY Elizabeth M.
Page 3 and 4: TAbLE OF CONTENTS EXECUTIVE SUMMARY
Page 5 and 6: EXECUTIVE SUMMARY A mother’s nutr
Page 7 and 8: INTRODUCTION A mother’s nutrition
Page 9 and 10: Preconception Care In 2005, the WHO
Page 11 and 12: Nutrient Needs during Pregnancy and
Page 13 and 14: During lactation, the U.S. Dietary
Page 15: The United States has not establish
Page 19 and 20: Vitamin D Vitamin D’s principal r
Page 21 and 22: Iron Iron is vital to the productio
Page 23 and 24: Table 10. WHO Recommended Nutrient
Page 25 and 26: Guidelines for Physical Activity du
Page 27 and 28: FOOD SAFETY ISSUES Fish and Seafood
Page 29 and 30: the recommendations, summarized bel
Page 31 and 32: Women are encouraged to enter pregn
Page 33 and 34: 53. Viswanathan M, Siega-Riz AM, Mo
Page 36: XXXXXX NEW 12/12 ©2012 Mead Johnso

LB2882MaternalNutriti+ - Mead Johnson Nutrition

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