Rankings: the best prenatal vitamins of 2018

Being pregnant drastically changes your body meaning you need to eat differently.

In addition to your body growing, you also have to fuel hormone changes, and support the baby growing in your belly.  Plus, there are hormonal changes occurring during pregnancy that can lead to anemia, morning sickness, and other unpleasant side effects.

Luckily, you can easily supplement and make minor changes to what you eat to deliver a healthy baby, keep your energy soaring, and avoid excess weight gain.

1. Folic acid is key for healthy baby growth.

Folate actually comes in two forms. The naturally occurring folate and the synthetic folic acid. Although, sometimes a teeny bit of folic acid can form in food naturally, for the most part it is synthetically produced and luckily folic acid is more stable than folate and absorbed 1.67 times as well (1).

Folate is essential for cell growth and working with B12 to make red blood cells. Red blood cells that deliver oxygen to you and your baby, making this necessary for both of your lives. Most notably, folate prevents neural tube defects, such as anencephaly and spina bifida, by 50-70% as well as reduces autism spectrum disorders developing in children (2,3).

Aside from a prenatal vitamin prescribed by your physician, folate is found in all enriched grains and cereal products, also legumes, leafy greens, broccoli, and asparagus (4).

2.  You’re likely to be deficient in Vitamin B12 leading to anemia and fatigue.

Having an abundance of folate can mask a B12 deficiency and lead to anemia making you feel tired, slow, and lousy (6).

Vitamin B12 is unique in a few ways.

First, it can only be absorbed with a cofactor in your stomach called intrinsic factor (5).

Second, it is stored in your liver.  Meaning, it is needed so badly for nervous system and red blood cell function that your body has adapted to hold on to it. Because of it’s unique absorption vegetarian and meat eaters alike are lacking in this vitamin. Fortunately, only 2.4 micrograms daily will set you right and the liver can store extra B12 for years (5).

3.  Iron is your key for energy.

The key function for iron in forming a healthy baby is actually to keep you healthy because iron forms the functional part of hemoglobin (7).

Too much science?

Then picture each blood cell as a taxi picking up and dropping businessmen and women- always in a rush- to your cells. Having no iron is like having no seats! There’s no place for Ms. Oxygen or Mr. Carbon to sit and travel to their destination.

The issue here is that you begin to produce another type of hemoglobin while your pregnant called fetal hemoglobin. It’s exactly like Uber. Much more convenient for Ms. Oxygen to ride in travel all the way to your growing baby.

Unfortunately, that means your taxi’s have competition!

Without enough iron in your diet you can become anemic because your body prioritizes your growing baby’s oxygen demands. Iron is found in many dark red foods such as red meat. But there are plenty plant based sources such as red kidney beans, beets, and dark leafy greens.

4.  Focus on dietary iron too.

One is known as heme iron and the other as nonheme iron. The former is absorbed easily into the body, and is found only in meat. But that’s not the whole story!

Approximately 40% of the iron in meat is heme iron. That means 60% of it is nonheme (8).   Adding vitamin C to your dishes will increase iron absorption as well to help you up your intake of nonheme iron (9).

5. Calcium, your key for hormone signalling cascades and a healthy skeleton.

Calcium has hundreds of roles in the human body. Actually, you can probably double that when you’re pregnant. Calcium plays a hand in bone growth, cell signalling, muscle contractions, and even blood clotting- just to name the main functions.

Having enough calcium for yourself can make sure you stay strong, prevent cramps, and keep your heart healthy.

In terms of your baby’s health, calcium works with phosphorus and vitamin D to build up the skeletal system.  As a fun fact, the first bone that forms in your growing baby is going to be their clavicle! The weight of your body is about 1.7% calcium. It’s the most abundant mineral in your body with 97% of that calcium stored safely in your bones (10).

6.  Mono-ortho-calcium phosphate keeps your body alkaline.

Despite its big fancy name, all it does is make sure your blood stays in the perfect spot between too acidic and too alkaline. When you metabolize the food you eat and it increases the acidity in your body, you end up having to make more of that mono-ortho-calcium phosphate stuff to keep in check (11).

Where do you think that extra calcium comes from? If you guessed your bones- you’re 100% correct!

So how do you know if food will turn acidic in the body?

Foods like citrus seem acidic on the outside, but can have alkalizing effects once you eat and metabolize them, so the answer isn’t easy enough to guess at. Researchers developed the Potential Renal Acid Load, or PRAL, score for occasions just like this. Essentially this number boils down to: PRAL = protein and phosphorus – magnesium, potassium, and calcium So if the PRAL is positive the food you’re eating is…

1) taking calcium out of your bones

2) reducing your lean muscle mass

3) slowing down your metabolism

4) doing the same for your baby (12)

Dairy and meats have positive PRAL scores as a group, with meats being around 10 and dairy around one (12). On the other hand, fruits and vegetables have negative average PRAL scores (12).  When you eat various foods assembled together in a dish, the PRAL scores are added up to create a total effect.

For example, If you have a plate of chicken and broccoli with rice, the PRAL score can be overall negative by having an ounce of chicken, half a plate of broccoli, and a cup of rice. On the other hand, having a small section of broccoli on the plate with an overwhelming majority of the dish covered in chicken is going to lead to a positive PRAL score.

Eating positive PRAL meals over time can lead you to have a chronically acidic cellular environment. While this isn’t life threatening enough for your doctor to pick up, it can lead to more serious health issues over time, notably osteoporosis.

It would be ideal to replace foods that leech nutrition from your body with foods that flood your body with nutrition, but you can form meals to keep your acid balance in check. No need to go crazy like other nutrition coaches recommend and keep your body super alkaline because that has its health risks as well. The key is to keep your body in balance.

7.  You may need zinc and copper too for optimal health.

With taking over 30 mg of iron a day, you may lose out on absorbing enough zinc and copper for all of the manual labor your cells are performing to build up your baby (13).

Your intestines are picky that way. Different combination of nutrients and factors change what passes into your body and what keeps going through.

With that much iron, it’s recommended to have 15 mg of zinc and 2 mg of copper (13). Naturally with any supplementation during pregnancy I highly recommend you talk with your doctor first as each pregnancy is slightly different.

8.  Boost your fiber intake to avoid excessive pregnancy weight gain.

Fiber does wonders for your body. First, fiber helps you avoid excess weight gain. Eating foods high in fiber slows down your digestion.

When you eat a high-fiber meal, your enzymes have trouble breaking down all your food with all those tough strands of uncuttable fiber in the way. The more time it takes to break down your food, the less of a rise you will have in your blood sugar and the longer you will feel full after eating.

It’s a win-win situation! You eat less because you stay fuller longer as well as keep your blood sugar steady to avoid excess weight gain. You may have noticed that animal products do not contain fiber. This means the more fiber you eat, the more vegetables you end up eating as well.

9.  A higher fiber intake guarantees a healthy baby.

Fiber intake is seen to increase the odds of your baby being born a health weight 4-5 fold compared to those who rarely eat fiber (14).  Is it a coincidence that fiber is only found in plant-based foods such as vegetables, fruit, whole grains, and legumes?  Be sure to eat these foods daily for even better baby health and development.

10.  Fiber feeds your “good” gut bacteria.

This bacteria can actually break down the fiber you eat and turn it into by-products that improve your weight and help prevent chronic disease (15). It’s a classic case of mutualism, biology’s favorite win-win situation. You pat their back and they break down your fiber into powerful nutrients to boost your health.

11.  Probiotics assist with constipation, food cravings, and provide more vitamin K in your system.

Along with your big baby, you’ve been carrying billions of microscopic babies inside of you you’re entire life!

Everyone has a bacterial flora- research shows the type of bacteria in your gut is as unique to you as your set of fingerprints. As I hinted at when talking about fiber, some of these bacteria love to chow down on fiber. There’s also the so called “bad” gut bacteria that feeds off of sugars and produces gas as a result (16). While gut bacteria can provide the body with vitamin K, vitamin B12, protein, and nutrients that fight cancer or reduce inflammation they play an interesting role with your cravings (15).

12.  It turns out that your gut bacteria can influence the food cravings you have.

If you have more of the sugar-loving bacteria you tend to crave more sugary foods (16).

On the other hand, with more fiber-loving bacteria you’re steered to eat more plant based foods (15).

There are probiotic supplements you can purchase, but by eating more fiber-filled foods you’ll naturally feed and grow the bacteria in your gut. For certain situations, like after taking antibiotics or with a history of dysbiosis (frequent yeast infections), it may make sense for you to call in the troops and invest in a probiotic supplement.

Again, your bacterial flora is unique to you, so picking a probiotic supplement that sorts out your health issues can be tricky.

Three excellent general recommendations for you to start are:

13. Look for a probiotic with the lactobacillus acidophilus strain.

Overall, people react positively to this strain the most (17).  This makes lactobacillus acidophilus bacteria an excellent supplement to start with to focus on improving your health, your baby’s health, and vitality.

14. Find probiotic blends for top-notch health.

One bacteria strain does not a microbiome make! Probiotics containing mixtures of strains seem to work synergistically (18).  This may take experimentation to find the combination of probiotics that work the BEST for you based on your individual biochemistry.

15. Find the highest probiotics count you can.

Over 30 billion at least per capsule (19).  I know, 5 billion sounds like a big number too. And you’d be right if the bacteria in the capsule didn’t degrade and die over time from temperature, time, and even though stomach acid.

16.  Vitamin A is toxic in high amounts especially for pregnant women.

That’s right, vitamin A helps turn that bundle of cells into a little person with arms, legs, a heart, eyes, and even ears.

The tricky part here is that vitamin A is fat soluble. This means that if you take in too much vitamin A it isn’t easily gotten rid of through urine, like the B vitamins. It is stored in the fat cells in your body and can lead to damage to the DNA (20).

17.  Essential fatty acids build healthy brains and nervous systems.

Essential fatty acids are not produced by the body, meaning it’s essential to eat them in our daily diet.  Makes sense, right?

What doesn’t make sense is that prenatal vitamins typically don’t include these essential fatty acids!

Especially since the two long-form fatty acids, DHA and EPA, are needed to build up your baby’s brains, eyes, and nervous system (21).  Now, you can find these fats in fish- but fish can also be contaminated with BPA and heavy metal.  In turn, you don;t want to be consuming too much fish during a pregnancy (21).

The best solution here is to consume a high quality fish oil to ensure you get all the essential fats you and your baby need.

18.  Supplement with ginger to alleviate morning sickness.

The best hypothesis out there is the hormonal changes from estrogen and human chorionic gonadotropic hormone leading to vomiting and nausea. In extreme cases, you may actually have hyperemesis gravidarum. This is as rare as it is dangerous where you have vomiting to the extent of weight loss and electrolyte balance.

Don’t worry, if you do have morning sickness you’re not alone. About 80% of pregnant women experience throughout nausea during the day mostly between the 6th and 12th week of pregnancy (22).

While you can’t reverse the hormone changes your pregnancy is causing, you can take steps to reduce the severity of morning sickness. The number one food to add to your routine to fight morning sickness is ginger.

In stores you can find ginger chews and other supplements, but I recommend the real deal.  A simple way to do this is to grate a tablespoon of ginger and pour a cup of boiling water over it in a mug. Cover the mug and let the ginger infuse for 10 minutes before enjoying.

19.  Vitamin D is necessary in the 3rd trimester for healthy bones.

Another important vitamin for expecting mothers is vitamin D.  Vitamin D has many roles in the human body, but to summarize it is best known for assisting to direct and build a healthy skeleton, especially in the third trimester for (23).

I know, I know, we talked earlier about calcium being used for skeletal health and now we need vitamin D too?

Yes we do!

While calcium is the material that builds up our skeleton vitamin D works to transport and guide calcium to our bones and throughout the body.  Otherwise, it’s the same as having your home hooked up to electricity but have no wiring to guide that electricity to your lights!

20.  An ideal prenatal supplement ONLY needs calcium, vitamin D, iron, and folic acid.

We’ve talked all about the different types of vitamins or supplements you can include or a healthy pregnancy- over 11 so far!

No, you don’t have to take 11 distinct pills to ensure your best pregnancy ever.  In fact keeping track and buying all those pills would be a waste of your time and money. 

Instead, you just need 3:

To start, you need a prenatal vitamin that contains vitamin D, calcium, iron, and folic acid.

Calcium, iron, and folic acid are the three essential vitamins 99% of all women need for their pregnancy and vitamin D will support proper calcium metabolism (24).

Next, many prenatal vitamins lack the essential fatty acids you need for optimal brain and nervous system formation in your growing baby, so a quality omega 3 fatty acid supplement containing EFA and DHA is number two here (24).

Lastly, probiotics make the cut because during pregnancy you are likely to suffer from constipation and increased risk of infection.  Having probiotics in your system helps to strengthen your immune system and supports regular bowel movements (25).

Now, there are more types of prenatal supplement formulations that I have hairs on my head!

Depending on your price range, desires, and individual biological needs you can choose from more than this bare-bones recommendation.

However, this is the ideal place to start when searching for prenatal supplementation.

21.  When should I start to take a prenatal vitamin

At this point you’re all set to find the BEST prenatal vitamin out there to boost your energy, health, and have the best baby ever…

… but you might just have one more question.

When should I take this prenatal vitamin??

You can start taking a prenatal vitamin as early as 3 months before conception because the time for critical growth of your baby is a few weeks right after conception as you go from the 1st to the 2nd trimester (26).  If you start taking it after conception just know that it’s never too late to start improving your nutrition! 

Even after you have your baby it is still ideal to stay on your prenatal supplements to support healthy breastfeeding, which can burn hundreds of calories a day and drain you of as many nutrients as your third trimester (26).

Summary

Being pregnant places a big strain on your body, which makes sense because you’re supporting yourself AND your growing baby.  It’s essential to work with your OBGYN to determine the best supplements to support your health, your sanity, and your energy, however, increasing the amounts of vegetables, fruit, whole grain, and legumes support your metabolism while reducing the side effects of pregnancy.

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