Background: Use of dietary supplements during pregnancy may give an important contribution to nutrient intake, and for nutrients like folate and vitamin D supplements are recommended. Our objective was to study use and contribution of dietary supplement to nutrient intake among women participating in the Norwegian Mother and Child Cohort Study (MoBa). Methods: This study is based on 40,108 women participating in MoBa which is conducted by the Norwegian Institute of Public Health. The women had filled inversion 2 of the food frequency questionnaire in MoBa between February 2002 and February 2005. Results: 81% reported use of one or more dietary supplements. The most commonly used category was cod liver oil/fish oil supplements (59%) followed by singular folic acid supplements (36%) and multivitamin/multimineral supplements (31%). The nutrient contribution of the dietary supplements varied from 65% for folate and vitamin D to 1% for potassium among supplement users. The dietary intake of vitamin D, folate, iodine and iron did not reach the Nordic Recommendations for pregnant women. Conclusions: Use of supplements improved the intake of folate, iron and vitamin D, but not sufficiently to reach the recommended amounts.
© 2008 S. Karger AG, Basel
- Dietary supplements
- Nutrient intake
- Fatty acids
- Vitamin D
- Godfrey K, Robinson S, Barker DJ, Osmond C, Cox V: Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. BMJ 1996;312:410–414.
- Godfrey K, Robinson S: Maternal nutrition, placental growth and fetal programming. Proc Nutr Soc 1998;57:105–111.
- Oken E, Ning Y, Rifas-Shiman SL, Rich-Edwards JW, Olsen SF, Gillman MW: Diet during pregnancy and risk of preeclampsia or gestational hypertension. Ann Epidemiol 2007;17:663–668.
- Barker DJ, Gluckman PD, Godfrey KM, Harding JE, Owens JA, Robinson JS: Fetal nutrition and cardiovascular disease in adult life. Lancet 1993;341:938–941.
- Clausen T, Slott M, Solvoll K, Drevon CA, Vollset SE, Henriksen T: High intake of energy, sucrose, and polyunsaturated fatty acids is associated with increased risk of preeclampsia. Am J Obstet Gynecol 2001;185:451–458.
- MRC Vitamin Study Research Group: Prevention of neural tube defects: results of the Medical Research Council Vitamin Study. Lancet 1991;338:131–137.
- Milman N, Bergholt T, Byg KE, Eriksen L, Graudal N: Iron status and iron balance during pregnancy. A critical reappraisal of iron supplementation. Acta Obstet Gynecol Scand 1999;78:749–757.
- Helland IB, Smith L, Saarem K, Saugstad OD, Drevon CA: Maternal supplementation with very-long-chain n–3 fatty acids during pregnancy and lactation augments children’s IQ at 4 years of age. Pediatrics 2003;111:e39–e44.
- Oken E, Kleinman KP, Olsen SF, Rich-Edwards JW, Gillman MW: Associations of seafood and elongated n–3 fatty acid intake with fetal growth and length of gestation: results from a US pregnancy cohort. Am J Epidemiol 2004;160:774–783.
- Jensen CL: Effects of n–3 fatty acids during pregnancy and lactation. Am J Clin Nutr 2006;1452S–1457S.
- Morris CD, Jacobson SL, Anand R, Ewell MG, Hauth JC, Curet LB, Catalano PM, Sibai BM, Levine RJ: Nutrient intake and hypertensive disorders of pregnancy: evidence from a large prospective cohort. Am J Obstet Gynecol 2001;184:643–651.
- Rumbold AR, Crowther CA, Haslam RR, Dekker GA, Robinson JS: Vitamins C and E and the risks of preeclampsia and perinatal complications. N Engl J Med 2006;354:1796–1806.
- Maats FH, Crowther CA: Patterns of vitamin, mineral and herbal supplement use prior to and during pregnancy. Aust N Z J Obstet Gynaecol 2002;42:494–496.
- Tsui B, Dennehy CE, Tsourounis C: A survey of dietary supplement use during pregnancy at an academic medical center. Am J Obstet Gynecol 2001;185:433–437.
- Radimer KL: National nutrition data: contributions and challenges to monitoring dietary supplement use in women. J Nutr 2003;133:2003S–2007S.
- Magnus P, Irgens LM, Haug K, Nystad W, Skjaerven R, Stoltenberg C, MoBa Study Group: Cohort profile: The Norwegian Mother and Child Cohort Study (MoBa). Int J Epidemiol 2006;35:1146–1150.
- NNR Project Group: Nordic Nutrition Recommendations 2004, ed 4. Copenhagen, Nordic Council of Ministers, 2004.
- Brantsæter AL, Haugen M, Alexander J, Meltzer HM: Validity of a new Food Frequency Questionnaire for pregnant women in the Norwegian Mother and Child Cohort Study (MoBa). Matern Child Nutr 2008;4:28–43.
- Brantsæter AL, Haugen M, Hagve T-A, Aksnes L, Rasmussen SE, Julshamn K, Alexander J, Meltzer HM: Self-reported dietary supplement use is confirmed by biological markers in the Norwegian Mother and Child Cohort Study (MoBa). Ann Nutr Metab 2007;51:146–154.
- Meltzer HM, Brantsæter AL, Ydersbond T, Alexander J, Haugen M, The MoBa Dietary Support Group: Methodological challenges when monitoring the diet of pregnant women in a large study; experiences from the Norwegian Mother and Child Cohort Study. Matern Child Nutr 2008;4:14–27.
- Lauritzen J: FoodCalc. www.ibt.ku.dk/jesper/FoodCalc/Default.htm; accessed October 2005.
- Rimestad AH, Borgerjordet A, Vesterhus KN, Sygnestveit K, Løken EB, Trygg K, Pollestad L, Lund-Larsen K, Omholt-Jensen G, Nordbotten A: The Norwegian Food Table. Oslo, Statens Råd for Ernæring og Fysisk Aktivitet, Statens Næringsmiddeltilsyn, Institutt for Ernæringsforskning, 2005.
- Arkkola T, Uusitalo U, Pietikainen M, Metsala J, Kronberg-Kippila C, Erkkola M, Veijola R, Knip M, Virtanen SM, Ovaskainen ML: Dietary intake and use of dietary supplements in relation to demographic variables among pregnant Finnish women. Br J Nutr 2006;96:913–920.
- Hess SY, Zimmermann MB, Torresani T, Burgi H, Hurrell RF: Monitoring the adequacy of salt iodization in Switzerland: a national study of school children and pregnant women. Eur J Clin Nutr 2001;55:162–166.
- Braekke K, Staff AC: Periconceptional use of folic acid supplements in Oslo. Acta Obstet Gynecol Scand 2003;82:620–627.
- Nilsen RM, Vollset SE, Gjessing HK, Magnus P, Meltzer HM, Haugen M, Ueland PM: Patterns and predictors of folic acid supplement use among pregnant women: the Norwegian Mother and Child Cohort Study. Am J Clin Nutr 2006;84:1134–1141.
- Forster DA, Wills G, Denning A, Bolger M: The use of folic acid and other vitamins before and during pregnancy in a group of women in Melbourne, Australia. Midwifery DOI 10.1016/j.midw2007.01.019.
- Cnattingius S, Bergstrom R, Lipworth L, Kramer MS: Prepregnancy weight and the risk of adverse pregnancy outcomes. N Engl J Med 1998;338:147–152.
- Olsen SF, Mikkelsen TB, Knudsen VK, Orozova-Bekkevold I, Halldorsson TI, Strom M, Osterdal ML: Data collected on maternal dietary exposures in the Danish National Birth Cohort. Paediatr Perinat Epidemiol 2007;21:76–86.
- Olafsdottir AS, Skuladottir GV, Thorsdottir I, Hauksson A, Thorgeirsdottir H, Steingrimsdottir L: Relationship between high consumption of marine fatty acids in early pregnancy and hypertensive disorders in pregnancy. BJOG 2006;113:301–309.
- Morley R, Carlin JB, Pasco JA, Wark JD: Maternal 25-hydroxyvitamin D and parathyroid hormone concentrations and offspring birth size. J Clin Endocrinol Metab 2006;91:906–912.
- Mannion CA, Gray-Donald K, Koski KG: Association of low intake of milk and vitamin D during pregnancy with decreased birth weight. CMAJ 2006;174:1273–1277.
- Javaid MK, Crozier SR, Harvey NC, Gale CR, Dennison EM, Boucher BJ, Arden NK, Godfrey KM, Cooper C: Maternal vitamin D status during pregnancy and childhood bone mass at age 9 years: a longitudinal study. Lancet 2006;367:36–43.
- Hypponen E: Vitamin D for the prevention of preeclampsia? A hypothesis. Nutr Rev 2005;63:225–232.
- Halhali A, Villa AR, Madrazo E, Soria MC, Mercado E, Diaz L, Avila E, Garabedian M, Larrea F: Longitudinal changes in maternal serum 1,25-dihydroxyvitamin D and insulin like growth factor I levels in pregnant women who developed preeclampsia: comparison with normotensive pregnant women. J Steroid Biochem Mol Biol 2004;89–90:553–556.
- Dahl L, Meltzer HM, Opsahl JL, Julshamn K: Iodine intake and status in two groups of Norwegians. Scand J Nutr 2003;47:170–178.
- Glinoer D: The regulation of thyroid function during normal pregnancy: importance of the iodine nutrition status. Best Pract Res Clin Endocrinol Metab 2004;18:133–152.
- Delange F: Iodine deficiency in Europe and its consequences: an update. Eur J Nucl Med Mol Imaging 2002;29(suppl 2):S404–S416.
- Glinoer D: Clinical and biological consequences of iodine deficiency during pregnancy. Endocr Dev 2007;10:62–85.
- Petrakos G, Panagopoulos P, Koutras I, Kazis A, Panagiotakos D, Economou A, Kanellopoulos N, Salamalekis E, Zabelas A: A comparison of the dietary and total intake of micronutrients in a group of pregnant Greek women with the Dietary Reference Intakes. Eur J Obstet Gynecol Reprod Biol 2006;127:166–171.
- Rothman KJ, Moore LL, Singer MR, Nguyen US, Mannino S, Milunsky A: Teratogenicity of high vitamin A intake. N Engl J Med 1995;333:1369–1373.
- Bonham M, O’Connor JM, McAnena LB, Walsh PM, Downes CS, Hannigan BM, Strain JJ: Zinc supplementation has no effect on lipoprotein metabolism, hemostasis, and putative indices of copper status in healthy men. Biol Trace Elem Res 2003;93:75–86.
- Yates AA, Schlicker SA, Suitor CW: Dietary Reference Intakes: the new basis for recommendations for calcium and related nutrients, B vitamins, and choline. J Am Diet Assoc 1998;98:699–706.
Department of Food Safety and Nutrition, Division of Environmental Medicine
Norwegian Institute of Public Health, PO Box 4404
NO–0403 Oslo (Norway)
Tel. + 47 210 765 63, Fax +47 210 762 43, E-Mail firstname.lastname@example.org
Received: November 19, 2007
Accepted: March 26, 2008
Published online: July 22, 2008
Number of Print Pages : 9
Number of Figures : 1, Number of Tables : 5, Number of References : 43
Annals of Nutrition and Metabolism (Journal of Nutrition, Metabolic Diseases and Dietetics)
Vol. 52, No. 4, Year 2008 (Cover Date: September 2008)
Journal Editor: Elmadfa I. (Vienna)
ISSN: 0250–6807 (Print), eISSN: 1421–9697 (Online)
For additional information: http://www.karger.com/ANM
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