A recent review, published in the Drug and Therapeutics Bulletin, claims that taking any supplements apart from folic acid may not translate into improved health outcomes for mothers and babies. Even vitamin D, in which thousands of British women are deficient, was criticized as there were little data showing an “impact on reducing the risk of complications of pregnancy or birth”.
According to Dr Carrie Ruxton, a dietitian and spokesperson for the Health Supplements Information Service, this review will only create confusion for pregnant women and dissuade more women from improving their vitamin and mineral intakes. Commenting on the study, she said: “The authors of this study wrongly claim that vitamin and mineral supplements must produce clinical effects before pregnant women are encouraged to take them. This is absolute nonsense. Except for folic acid which does have a therapeutic role by actively preventing neural tube disorders, the role of food supplements is simply to combat dietary gaps. This ensures that more people achieve recommended intakes of vitamins, minerals and fatty acids, such as long chain omega-3s. They are not drugs so would not be expected to improve birth outcomes or treat conditions, such as pre-eclampsia, in non-malnourished populations. “Vitamin, mineral and fatty acids supplements are useful during pregnancy for women whose diets don’t accord with recommendations, such as the Eatwell Guide. Evidence from the National Diet and Nutrition Survey shows that few women eat the right diet. For example, only 30% of women eat 5 portions of fruit and vegetables daily, and just 11% of women eat oily fish, which contains omega-3 fatty acids proven in EU law to contribute to the normal development of a foetus’ brain and eye. “In addition, one in ten women don’t get enough iodine in the diet, which is vital for infant brain development, one in five women fail to achieve dietary targets for iron and potassium, and half don’t get enough selenium. Worryingly, a recent study showed that 70% of teenage girls were mildly deficient in iodine, raising concerns about the next generation of pregnant women. This work led the British Thyroid Foundation to declare that the “UK is iodine deficient. “Whether women take a multivitamin, which can be inexpensive, or take individual folic acid and vitamin D supplements as recommended by the Government, it doesn’t really matter as long as they are receiving the right amounts of nutrients to support a healthy pregnancy. There are no safety issues with multivitamins but, since pregnant women are advised not to take additional vitamin A or to eat foods rich in this vitamin such as liver, pregnancy-specific multivitamins are available. This is a responsible action of the supplements industry, not a marketing ploy as the authors of the study suggest. “In conclusion, it is unhelpful to put women off vitamin and mineral supplementation during pregnancy when so many women have inadequate diets and risk deficiency in vitamin D and iodine among other nutrients. Instead, the useful role of supplements, including fish oils, alongside dietary improvements should be recognised”. The Health Supplements Information Service (HSIS) http://www.hsis.org