Laura Schoenfeld: let me look this up for you because I have a prenatal that I personally really like. My mom is also a functional nutritionist, I guess, dietitian, and we looked through a lot of the items on HealthWave … well, I guess it’s now Fullscript, but we looked through a lot of products. We wanted to find what prenatal had the things that we wanted in it and not the things that we didn’t want. Let me see if I can find it. For some reason, my internet is not cooperating.
Just double checking one more time, can you guys still hear me? It looks like my HealthWave is not opening. If somebody can just write in the chat box that they can hear me, that’s great. OK, great, so I’m still being heard. It’s just that my internet is going super-slow today.
All right, here we go. Let me just get my catalog open. Sorry I don’t know this off the top of my head. I have specific supplements that I’ve put in my HealthWave catalog, and I don’t always know what the names of them are. OK, so the product that I like is called Prenatal Formula by ProThera, and I can put that in the chat box if people want to look at that product. The reason that we chose this one when my mom and I were looking into prenatal vitamins is because of a few different nutrients that I get a little concerned about when certain prenatal formulas are either too low, too high, have the wrong form, and I’ll explain a few of those to you. I probably won’t remember every single nutrient that we reviewed because my mom is very into this prenatal, women’s health field, and so she was giving me some of her feedback when we were looking through the catalog.
One thing is vitamin A. This particular product has 5,000 IU of vitamin A, and 20 percent of that is from vitamin A palmitate. It’s not super high in vitamin A, and it also has some active vitamin A in it. Now, I would actually also add on some type of food source of vitamin A to this multi because 5,000 IU per day is not enough for a woman who is pregnant. In that case, maybe she has a couple of ounces of liver every week or maybe has a couple of egg yolks every day. If she’s not eating liver or egg yolks, maybe I would do a vitamin A supplement. I get a little bit hesitant to do a lot of vitamin A supplementation in pregnant women just because of the potential teratogenic effects, which just means it could potentially cause birth defects in a pregnant woman. Now, I think that concern is really overblown, but it is something that you want to be careful about, especially if the person is also taking other supplements, or if she’s eating a lot of liver, you don’t want her to be overdosing on vitamin A. I would only add in other vitamin A here if she’s not eating liver or egg yolks.
It has some vitamin D in it, about 2,000 IU per day. It also has a good mix of the B vitamins. It has the L-5-methyltetrahydrofolate version of folate, or it’s also called Metafolin, at 800 micrograms, which I think for most women is plenty for a prenatal. Sometimes you see prenatals with a milligram or higher for folate. I don’t really think that’s necessary, so I like this amount that’s in here. It does have some B12, which comes from methylcobalamin and adenosylcobalamin, which are both two really good forms of B12 that are well absorbed. It does have iron as ferrous bisglycinate chelate, 27 milligrams. I’d be careful if you have any women that have high iron, if they are taking an iron supplement. Obviously you don’t want them to be low iron, and low iron is dangerous with pregnancy, but you just want to make sure that 27 milligrams isn’t excessive. The nice thing about this particular form of iron is it tends to not be constipating, which can be an issue for some people.
This product also has 150 micrograms of iodine in it, which I think is a good amount for the average woman to be getting on a daily basis when they’re pregnant. It’s OK to get more than that, so if she’s eating a little bit of seaweed here and there or eating seafood or having dairy products, then she might be getting more iodine, but I wouldn’t want someone to be getting less than 150 micrograms of iodine when they’re pregnant because iodine deficiency can definitely cause birth defects, as well.
I’m just looking to see if there were any other ingredients in here. It does have some choline. It has about 150 milligrams of choline, which, again, if someone is eating egg yolks or liver, they’re going to be getting choline in their diet, but it’s not a bad idea to have a little extra choline because choline is really important for fetal brain development.
There’s a little zinc. There’s a little copper. Oh, the selenium was an important point that my mom brought up. The selenium in this product is only 50 micrograms, which some people may think that sounds low, and it is a little low, but I would actually be more concerned with excessive selenium intake during pregnancy, especially if somebody is on a Paleo diet and they’re getting lots of red meat and nuts and seeds and that kind of thing that are going to be higher in selenium. So 50 micrograms, I think, is fine unless you have a person that is just not eating a very good diet whatsoever, because selenium can potentially be toxic in excess, so you just want to be careful about overdosing on selenium during pregnancy.
Yeah, I think that product turned out to be one that I thought was well balanced. It does actually even have a little bit of vitamin K2 as MK-7 in it. I really like this product. I’m not saying it’s the only prenatal out there that’s a good one, and I’m sure there are lots of other options that are really good, but I just thought this one was very basic, you only have to take three a day, and there doesn’t seem to be a risk of over-supplementation, which I do get a little bit nervous if a client is taking a prenatal that has things that are just really, really high doses of certain nutrients. We don’t really know what the effect of that will be during pregnancy, and so I’d rather just have them take a prenatal like this one that gets the basics in and make sure that they’re not being malnourished during their pregnancy, but it’s not going to be having these super-high doses of nutrients that could potentially cause problems. Again, there are so many different epigenetic effects of these nutrients that we don’t know anything about from a research perspective, so I like to say better safe than sorry for prenatal supplementation.
Now, as far as any food recommendations during pregnancy, Chris has his Healthy Baby Code program that is awesome. It’s a great resource for the specific foods recommended during the prenatal period, whether that be before conception or during pregnancy. With liver, again, I don’t want to be overcautious about liver because I think that’s a fear that’s not only overblown, but it could actually be dangerous if women are too afraid of preformed vitamin A during pregnancy because we know that the baby needs the preformed vitamin A for proper development, and I think that fear around vitamin A is something that could potentially cause a woman to avoid vitamin A during pregnancy, which is not a good idea either. But on that note, you just want to be careful if the person is eating, you know, 12 ounces of liver a week. That’s probably not appropriate. I’d say 4 to 6 ounces of liver per week, on average, would be plenty. Now, I say “on average” because the vitamin A nutrient is one that gets stored, so if she had 8 ounces one week and then no ounces of liver the next week, that would balance out to about a 4-ounce-per-week average. Maybe she has a week that she eats a big portion of liver and then skips a week or two, so it doesn’t have to be, like, 4 ounces per week every single week for her to get the benefits. It can also be an ounce a day or something, or half an ounce a day. If she doesn’t really like liver and she wants to just have a little bit of liver every day to get the nutrients, that’s fine, too. You can spread it out or you can kind of batch it into two-week intervals.
There are some other nutrients that obviously a pregnant woman is going to want to get. Omega-3 fats are super important. That prenatal that I recommended does not have any omega-3’s in it, and I’m hesitant to recommend fish oil during pregnancy. I think cod liver oil would be OK, but that one doesn’t necessarily have a ton of omega-3 fats in it, so I’d say a pregnant woman should be definitely getting about four servings of some kind of fatty fish per week, whether that be salmon or tuna or trout. There’s a lot of talk about women not eating tuna during pregnancy or very limited amounts of tuna because of the mercury content, but tuna is one of those things that you could have, like, once a week and it’s fine as far as the pregnancy question is concerned. She could also have sardines. Canned salmon is a great source of omega-3 fats. Again, just try to get about four servings of that per week, or about a pound if possible.
Also make sure that she’s just getting enough food because, again, especially during that first trimester where morning sickness or even just nausea, in general, is such a big problem, it can be really easy for women to get malnourished during that time, especially if they’re on a Paleo diet because, as I’m sure a lot of you are aware, Paleo foods are not the most… Palatable is probably a good way to describe it. If you think about someone who’s nauseous, they’re not necessarily going to want to eat a steak and a sweet potato. They’re probably going to want something that’s a little bit more carb heavy, comfort food kind of things. I will say don’t let perfect be the enemy of the good here, and don’t say, if she can’t have any Paleo food, that she shouldn’t be eating at all. You definitely want to let them have some flexibility, especially if they are not dealing with any other things like autoimmune disease or any conditions that would make it dangerous for them to be eating things like gluten or dairy or something like that. Give them some leeway as far as the foods that they can tolerate during the times that they are nauseous, but make sure that you’re giving them options for things to eat to make sure that they aren’t getting malnourished during that first trimester. That’s where that prenatal is really helpful because, again, if they’re not able to eat the amount of food that they really should be to get the nutrients they need, then they can rely on that multi to make sure they’re getting the micronutrients.
One last thing I’d want to mention here is that because of that first trimester nausea situation that happens, and a lot of times women are eating less than maybe they need during that trimester. That’s why actual preconception nutrition is such an important thing. If you have any clients that are thinking about getting pregnant, even if they’re not actually pregnant or planning that month to get pregnant, you should tell them that preparing in advance is going to give them a lot better results than trying to focus so heavily on it during the actual pregnancy. There are two reasons for that. One is because, like I said before, with the nausea during the first trimester, a lot of times the diet gets a little bit harder to maintain during that first trimester, and so you want to make sure that their nutritional status is really good going into the pregnancy so that those short-term deficits of food intake don’t really affect their nutritional status.
The second reason to make sure that people are attending to this before they get pregnant is because it’s really hard to make a lot of changes at once, and if you have a client that is not eating super-well or not getting a lot of nutrient-dense foods in their diet now, you can pretty much bet that it’s not going to be something that just automatically starts happening when they’re pregnant. So if you have a female client … or a male client, too. The man’s nutrition does make an impact, as well, but for the women, you want to make sure that they’re attending to their diet at least a year out. So if they have any thoughts about getting pregnant in the next year, make sure that they are making sure their diet is micronutrient-dense, whole foods, trying to get their nutritional status as optimized as possible, checking to see if their labs have any deficiencies and getting those corrected, possibly putting them on a prenatal if that’s appropriate, and just trying to get them set up for the best outcomes possible even if they can’t eat super-well during that first trimester.
Anyway, that might have been a little bit more information than you asked for, but I think it’s important, and hopefully that was helpful.