The Vitamin Dilemma

Do you really need to take a prenatal multisupplement? Depends on how you eat.

By Kristine M. Napier, M.P.H., R.D.

Photography: Grace Huang

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Whatever their expectations, all parents share a common wish: for their babies to be healthy. Fortunately, you can do a lot to ensure the well-being of your newborn. What you consume, researchers say, has a profound impact on her. In fact, in one study mothers who ate nutritionally adequate diets—enough calories, protein and nutrients—gave birth to babies in superior or good health 94 percent of the time. In stark contrast, those with poor diets bore healthy babies just 8 percent of the time. One crucial issue you’re facing as a mom-to-be is whether to hedge your nutritional bets by taking prenatal vitamin and mineral supplements.

 A Shift in Thinking
“Years ago, obstetricians gave all pregnant women a vitamin/mineral supplement containing 100 percent of the RDA for all nutrients,” says J. Patrick O’Grady, M.D., professor of obstetrics and gynecology at Tufts University School of Medicine and director of obstetrical services at Baystate Medical Center in Springfield, Massachusetts. “Today, official recommendations [from the Food and Nutrition Board] advise women to concentrate on eating a healthy diet that supplies most essential vitamins and minerals, and to supplement iron and folate,” says Jennifer Niebyl, M.D., professor and head of obstetrics and gynecology at the University of Iowa College of Medicine in Iowa City. She adds that women who don’t eat milk and cheese also need calcium supplements.            
     Indeed, many experts believe that women who take one-size-fits-all prenatal multisupplements may be lulled into a false sense of security, and aren’t as likely to focus on improving their eating habits. “Getting a woman to concentrate on eating a healthy diet– with plenty of fruits, vegetables and whole grains as well as good quality protein– does more than ensure that she gets enough of most nutrients,” says Niebyl. “In the long run, it also helps prevent cancer and heart disease.”
   
That said, experts still come back to real food versus supplements. Taking just an iron and folic acid pill works only if the expectant mother eats a nutritionally complete diet. However, Niebyl admits, “The reality is that most Americans just don’t eat a healthy diet.”

    A look at the research confirms that. The National Academy of Sciences found that pregnant women typically consume less than the recommended amounts of vitamins B6, D, E and folate and the minerals iron, calcium, magnesium and zinc. Consequently, says O’Grady, many obstetricians continue to prescribe a supplement with all essential nutrients, “just to be on the safe side.”

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