Increased Vitamin Needs

The extra amount of vitamin B-6 and other B-vitamins (except folate) needed in the diet is easily met via wise food choices, such as a serving of a typical ready-to-eat break-fast cereal and some animal protein. Folate needs, however, often merit specific diet planning. Because the synthesis of DNA requires folate, this nutrient is especially crucial during pregnancy. Ultimately, both fetal and maternal growth depend on an amplesupply of folate. Red blood cell formation, which requires folate, increase during pregnancy. Serious megaloblastic anemia can result if folate intake is inadequate. The RDA for folate increases during pregnancy to 600 ug DFE/day. This is a critical goal in the nutrional care of a pregnant woman. Folate deficiency at conception and thereafter has been associated with birth defects specifically, neuraltube defects, such as spina bifida. Still about 30% of these birth defects arise from genetic and other reasons unrelated to folate intake.

Increasing folate intakes to meet 600 ug DFE/day for a pregnant woman can be achieved through either dietary sources or supplemental folic acid, or a combination of both. Choosing a diet rich in synthetic folic acid, such as from ready-to-eat breakfast especially helpful. Otherwise, the use of a supplemental form is advised. Recall from Chapter 10 that folate is generic term for the vitamin as it is found naturally in foods. Because of extra glutamates found on the vitamin’s tail, food folate is only about 50% bioavailable. Folic acid (the synthetic form of folate) has a monoglutramate tail and is 100% biovailable if consumed on an empty stomach. Folic acid from supplements or fortified foods is absorbed from a meal 70% better than naturally occurring folate. In addition to consuming a diet high in naturally occurring folate, pregnant women should also seek out sources of synthetic folic acid for optimal nutrition.

Women who have previously given birth to an infant with a neural tube defect should consult their physician about the need for folate supplementation; an intake of 4mg of synthetic folic acid per day approximately 8 weeks prior to conception is advocated, but must be taken under a physician’s supervision.

Meeting folate needs during pregnancy may be a problematic practice for women who have taken oral contraceptives for extended periods because this can inhibit folate absorption. A recent history of an inadequate diet or oral contraceptive use necessitates careful attention to folate intake during pregnancy. Ideally, the woman would begin a folate-rich diet (or take a supplement containing folic acid) approximately 8 weeks before conception.

www.rajagiriworld.com

[IMG]http://www.rajagiriworld.com/happy.gif[/IMG]