In practice, dietary supplement recommendations during pregnancy are not always followed

In practice, dietary supplement recommendations during pregnancy are not always followed

Although a majority of pregnant women believed they knew the recommendations for using dietary supplements, in practice the recommendations were not always followed, a study from the University of Turku, Finland shows. The comparison of four countries shows that the use of dietary supplements was most common in Finland and least common in Italy.

Photo credit: University of Turku

A questionnaire survey conducted in international collaboration between four countries Finland, Italy, United Kingdom and Poland assessed the use of dietary supplements among pregnant women, women's attitudes towards dietary supplements and their understanding of the need for dietary supplements and possible health effects during pregnancy.

91% of women who took part in the study used nutritional supplements, and the number of products used at the same time varied between one and nine.

In Finland in particular, it was common to use more than one product at a time – up to a fifth of supplement users used more than three products at a time.”

Ella Koivuniemi, PhD student, Department of Biomedicine at the University of Turku

Dietary supplement use was most common in Finland, where 98 percent of participants used dietary supplements, and least common in Italy, where approximately 83 percent of participants used dietary supplements. A prenatal multivitamin product was the most commonly used supplement type (76–91% of users across countries). First-time mothers and non-smokers were more likely to use nutritional supplements than women who had already given birth and women who smoked frequently before pregnancy.

During pregnancy, the need for energy and nutrients increases to support the growth and development of the fetus and the increased tissue growth of the mother and the growth of the placenta. A varied diet covers most additional nutritional needs during pregnancy. In most countries, it is recommended to take vitamin D and folic acid supplements during pregnancy to ensure adequate nutrient intake. In addition, certain nutritional supplements such as calcium, iron and iodine supplements are recommended for special groups of pregnant women who are at risk of inadequate dietary intake. Excessive use of supplements in higher than recommended doses can also have adverse effects on the mother and fetus.

Exceeding the recommended dose of dietary supplements is relatively common

In Finland, Great Britain and Poland, the recommended vitamin D supplement was used by 91–97 percent of supplements, but in Finland, for example, only about half of vitamin D supplement users were at the recommended dose and a third of them exceeded the recommended dose.

Folic acid as a dietary supplement recommended during pregnancy was also used by almost all women who used dietary supplements (93-98% of users in different countries). In Finland, only about half of folic acid supplement users used it at the recommended dose during pregnancy, and a third of them exceeded the recommended intake.

Exceeding recommended dietary supplements was relatively common: in Finland, a third of pregnant women exceeded the recommended intake of at least one dietary supplement. Additionally, the daily safe upper intake limit for one or more nutrients was exceeded by an average of 19% of supplement users. Magnesium supplements in particular were used in doses exceeding the maximum safe daily dose in all countries.

Varying awareness of dietary supplement recommendations during pregnancy

Most study participants responded that they knew what supplements (91%) and what dosages of supplements (87%) they needed to take during pregnancy. However, three quarters of participants believed that multivitamins are generally recommended during pregnancy, even though this is not true.

The majority of participants (81%) knew that folic acid is recommended during pregnancy. Only about 60% of participants in Finland, Poland and the UK knew that vitamin D supplementation was recommended during pregnancy in their home country, while in Italy a third of them mistakenly thought that vitamin D supplementation was recommended during pregnancy in Italy.

"Although most pregnant women in all countries believed that they were aware of the supplementation recommendations, in practice the recommendations were not always adhered to. Regarding nutrients that are recommended to be supplemented, the intake was largely sufficient, but even excessive, for a significant proportion of women," says Associate Professor Kirsi Laitinen, who heads the Early Nutrition and Health Research Group at the University of Turku led the study.

The survey data was collected using an online questionnaire. The data includes photos sent by participants of the supplements they use, as well as specific information about their dosage and frequency of use. Daily intakes of vitamins and minerals from dietary supplements were calculated based on reported dietary supplement intake.

The results highlight the importance of discussing supplement use in antenatal care so that supplement overuse can be addressed when necessary. The results also enable the development of nutritional advice that supports the recommended use of nutritional supplements during pregnancy.

Source:

University of Turku

Reference:

Koivuniemi, E., et al. (2022) Supplement Use Differs from Recommendations in Pregnant Women: A Multinational Survey. Nutrients. doi.org/10.3390/nu14142909.

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