DEAR DR. BLONZ: My partner and I are planning to start having children. My diet is fairly healthy, but far from ideal. I don't always eat all the fruits and vegetables I am supposed to every day, and I'll admit to occasional cravings for sweets and fast foods. (I am not yet pregnant, so I can't blame my cravings on that.) Which vitamins, minerals and nutrients play the most important roles during pregnancy? -- A.P., El Cerrito, California
DEAR A.P.: The simple answer is "all of them." The developing fetus depends upon mom to have all the essential nutrients in her body so they can be appropriately used as needed during gestation. That means your intake must be sufficient for you and your future bundle.
That said, there are a few standout nutrients.
One of the first parts of the body to develop is the nervous system, and folate -- also called vitamin B9 or folic acid -- plays a key role. The catch is that this nutrient must be present during the first few weeks after conception -- a time when most women are unaware they're even pregnant. Lack of folate during this time can lead to spina bifida, a birth defect in which one or more of the spinal column vertebrae fail to develop properly. As many as 75% of all cases of spina bifida are attributable to a folate deficiency during those first few weeks of pregnancy. That explains why the U.S. Public Health Service recommends that all women of childbearing age who are capable of becoming pregnant should consume at least 400 micrograms of folate per day.
There is also a particular need for iron, since the mother needs to expand her blood supply and the fetus needs to make its own. There also must be sufficient iron stores for the first months of a baby's life, during which the main food source could be iron-poor breast milk. This helps to explain why the RDA rises from 18 to 27 milligrams per day during pregnancy. (Most prenatal vitamins have an increased amount of iron.)
Calcium and vitamin D also stand out, as they are needed for bone development. Calcium absorption doubles during pregnancy, and vitamin D is needed for calcium absorption and utilization.
A final key: water, and fluids from any healthful source. Throughout pregnancy, a woman's blood volume increases by 50%, with the extra water helping to transport nutrients and oxygen to the developing child and carry waste materials away from the amazing construction project.
There are many informational resources on this topic available from health professionals, but also a mix of voices in social media. Avoid "unusual" takes on this most natural of processes, sticking instead with sources from academically trained experts. Check the information pages from the Office of Disease Prevention and Health Promotion (b.link/ess7e9) and from the American College of Obstetricians and Gynecologists (b.link/pnbr8y).
All the best to you both as you move forward during this beautiful time.
Send questions to: "On Nutrition," Ed Blonz, c/o Andrews McMeel Syndication, 1130 Walnut St., Kansas City, MO, 64106. Send email inquiries to email@example.com. Due to the volume of mail, personal replies cannot be provided.