Help Increase Awareness about B Vitamin Requirements During Pregnancy and Lactation
Pregnancy is a unique window of opportunity. Nutrition during pregnancy, and up to the child’s second birthday, shapes the life of a child – including the ability to learn, to grow, and long-term health. Two new studies emphasize the importance of maternal nutrition during pregnancy. More importantly, they also demonstrate the need for education, and sometimes changes in policy.
During the first month of pregnancy, the brain, spine and spinal cord of a child develops. If pregnant women are not consuming adequate amounts of folic acid (FA), a B vitamin, numerous types of neural tube defects (NTDs) can leave a child with permanent loss of function. To reduce the risk of NTDs, the CDC recommends women who might become pregnant consume 400 µg folic acid daily. In 1998, the US Food and Drug Administration mandated food fortification of cereal-grain products which has led to a significant decrease in the incidence NTDs and saved US taxpayers $300 million annually.
The Japanese government issued the same recommendation (400 µg FA daily) in 2000 but they have relied upon education rather than mandatory fortification. The odds ratio (OR) of a child being born with spina bifida wasn’t known. Konda and colleagues report that the incidence of spina bifida has steadily increased from 2.3 in 1978-82 to 5.7 per 10,000 births in 2008-12.
Why? Because only 30% of women are using folic acid supplements periconceptionally. Although the proportion of women using folic acid supplements periconceptionally from 10% prior to 2000 to 30%, the authors write, “the recommendation is a public health failure, and mandatory food fortification with FA is urgently required and long overdue in Japan.”
Vitamin B12 is a co-factor for FA metabolism and essential for neurologic processes. Bae and colleagues investigated the impact of pregnancy and lactationon maternal vitamin B12 status. Healthy pregnant women (n=28) and non-pregnant (n=21) were recruited and fed a controlled diet for 10-12 wk. They received ~8.6 µg vitamin B12 and 200 mg docosahexaenoic acid (DHA) daily. During the study, all women maintained sufficient vitamin B12 status (> 148 pmol/L). Vitamin B12 status increased ~23% in the control women (p<0.009) and did not change in pregnant or lactating women over the study. At the study end, lactating women had serum vitamin B12 concentrations which were 26% and 60% higher than control and pregnant women, respectively (p<0.001). Pregnant women excreted ~75% and 124% more urinary homocysteine than control and lactating women. The authors conclude, “women in these reproductive states (pregnancy and lactation) may benefit from vitamin B12 intakes exceeding current recommendations.”
These studies confirm the need for research refining nutrient requirements during pregnancy and lactation. In addition, there is an even greater need to increase public awareness of the importance of vitamins during pregnancy and lactation.
Kondo A, Morota N, Date H, Yoshifuji K, Morishima T, Miyazato M, Shirane R, Sakai H, Pooh KH, Watanabe T. Awareness of folic acid use increases its consumption, and reduces the risk of spina bifida. 2015 Br J Nutr doi: 10.1017/S0007114515001439
Bae S, West AA, Yan J, Jiang X, Perry CA, Malysheva O, Stabler SP, Allen RH, Caudill MA. Vitamin B12 status differs among pregnant, lactating, and control women with equivalent nutrient intakes. 2015 J Nutr doi: 10.3945/jn.115.210757