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stringlengths 12
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listlengths 384
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the\trisk\tof\tspina\tbifida\tin\ttheir\toffspring.\tSupplementation\tduring\tearly\tpregnancy\t(at\tleast\t800\nmcg/day)\tmay\treduce\tthe\trisk\tof\tautism\tspectrum\tdisorders\tafter\tprenatal\texposure\tto\tpesticides\n(\nSchmidt\tet\tal,\t2017\n).\nWhile\tfolic\tacid\tsupplementation\tdoes\tnot\tcompletely\teliminate\tthe\trisk\tof\tNTDs,\n\tup\tto\t70%\tof
|
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up\tto\t70%\tof\nNTDs\tcould\tbe\tprevented\twith\tthe\tpericonceptual\tuse\tof\t400\tmcg\tfolic\tacid/day\t(\nACOG,\t2017b\n).\nOptimal\tlevels\tof\tother\tmethyl\tdonors\t(B\n2\n,\tB\n6\n,\tB\n12\n,\tand\tcholine)\tand\tinositol\tmay\talso\tlower\tthe\trisk\nof\tNTDs\tand\timprove\tbirth\tweight.\tThere\tis\tspeculation\tthat\tpaternal\tfolate\tdeficiency\tmight\talso
|
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] |
explain\tpart\tof\tthe\tresidual\trisk\tof\tNTDs\t(\nGuéant\tet\tal,\t2013\n).\nVitamin\tB\n6\n.\nPyridoxine\n\tfunctions\tas\ta\tcofactor\tfor\tmany\tdecarboxylase\tand\ttransaminase\tenzymes,\tespecially\nthose\tinvolved\tin\tamino\tacid\tmetabolism.\tAlthough\tthis\tvitamin\tcatalyzes\ta\tnumber\tof\treactions
|
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] |
involving\tneurotransmitter\tproduction,\tit\tis\tnot\tknown\twhether\tthis\tfunction\tis\tinvolved\tin\tthe\trelief\nof\tnausea\tand\tvomiting.\tBecause\tmeat,\tfish,\tand\tpoultry\tare\tgood\tdietary\tsources,\tdeficiency\tis\tnot\ncommon,\tand\troutine\n\tprenatal\tvitamins\tcontain\tsufficient\tamounts\t(\nHovdenak\tand\tHaram,\t2012\n).
|
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] |
Hovdenak\tand\tHaram,\t2012\n).\nRegarding\tnausea\tand\tvomiting,\tstandard\tdoses\tof\t10-25\tmg\tthree\tto\tfour\ttimes\tper\tday\t(\nACOG,\n2018b\n)\thave\tquestionable\tefficacy\tbut\tdo\tnot\tappear\tto\tbe\tdangerous.\nVitamin\tB\n12\n.\nCobalamin\tis\trequired\tfor\tenzyme\treactions\tand\tfor\tgeneration\tof\tmethionine\tand\ttetrahydrofolate.\tIt
|
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] |
is\timportant\tin\tgrowth\tand\tdevelopment,\tincluding\n\timmune\tfunction\t(\nWu\tet\tal,\t2012a\n).\tVitamin\tB\n12\n\tis\nnaturally\tfound\texclusively\tin\tfoods\tof\tanimal\torigin,\tso\tvegetarians,\tespecially\tvegans,\tare\tat\trisk\tfor\ndietary\tvitamin\tB\n12\n\tdeficiency\tand\tshould\tconsume\tfortified\tfoods\tor\tsupplements.\tAlso\tat\trisk\tare
|
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] |
those\tpeople\twith\tmalabsorption,\tincluding\tthose\twith\tCrohn’s\tdisease\tinvolving\tthe\tterminal\tileum,\nwomen\twho\thave\thad\tgastric\tbypass\tsurgery,\n\tand\tthose\tusing\tproton\tpump\tinhibitor\tmedications\n(see\t\nChapters\t26\n\tand\t\n27\n).\tPeople\ttaking\tmetformin\talso\tmay\tbe\tat\trisk.\tDeficiencies\tin\tfolate\tand\nvitamin\tB\n12
|
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vitamin\tB\n12\n\thave\tbeen\trelated\tto\tdepression\tin\tadults.\tInadequate\tamounts\tof\tfolate\tand\tB\n12\n\tmay\nnegatively\taffect\tinfant\tcognitive\tand\tmotor\tdevelopment\tas\twell\tas\tincrease\tthe\trisk\tof\tNTDs\tand\ninadequate\tfetal\tgrowth.\nCholine.\nCholine\tis\tneeded\n\tfor\tstructural\tintegrity\tof\tcell\tmembranes,\tcell\tsignaling,\tand\tnerve\timpulse
|
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transmission\tand\tis\ta\tmajor\tsource\tof\tmethyl\tgroups.\tCholine\tand\tfolate\tare\tmetabolically\ninterrelated.\tBoth\tsupport\tfetal\tbrain\tdevelopment\tand\tlower\trisk\tof\tNTDs\tand\torofacial\tclefts\n(\nZeisel,\t2013\n).\tAnimal\tstudies\tshow\tcholine\tis\tneuroprotective\tafter\tprenatal\talcohol\texposure\n(\nBlusztajn\tet\tal,\t2017\n).\tMaternal\tsupplementation
|
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] |
(\nBlusztajn\tet\tal,\t2017\n).\tMaternal\tsupplementation\n\tduring\tthe\tthird\ttrimester\twas\trecently\tseen\tin\ta\nsmall\tstudy\tto\timprove\tthe\toffspring’s\tinformation\tprocessing\tspeed\t(\nCaudill\tet\tal,\t2018\n).\tWhile\t480\nmg/day\twas\thelpful,\t930\tmg/day\tproduced\tlarger\teffects.\tPreliminary\tanimal\tdata\tshows\tprenatal
|
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] |
supplementation\twith\tcholine\tmay\tbe\thelpful\tin\tminimizing\tthe\tharm\tcaused\tby\tiron\tdeficiency\tby\nhelping\trestore\tsome\tof\tthe\tneural\tplasticity\t(\nGeorgieff\tet\tal,\t2015\n).\tCholine\talso\tappears\tto\tbe\nimportant\tin\tplacental\tfunctioning,\tincluding\tplaying\ta\trole\tin\tthe\tremodeling\tof\tthe\tspiral\tarteries,
|
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and\tmay\taffect\tmaternal\tand\tfetal\tresponses\tto\tstress.\tThe\tDRI\tfor\tcholine\tincreases\tslightly\tduring\npregnancy\tand\tthere\tare\tcalls\tfor\tit\tto\tbe\treexamined\tand\tpossibly\traised\t(\nCaudill\tet\tal,\t2018\n).\nGenetic\tvariations\tand\tconcurrent\tintakes\tof\tfolate\tand\tmethionine\n\tmay\taffect\trequirements,\tand\tde
|
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] |
may\taffect\trequirements,\tand\tde\nnovo\tsynthesis\tmay\tnot\tmeet\tfetal\tand\tmaternal\tneeds\t(\nZeisel,\t2013\n).\tCholine-rich\tfoods\tinclude\nmilk,\tmeat,\tand\tegg\tyolks,\tand\twomen\tnot\teating\tthese\tfoods\tmay\tneed\tsupplementation\t(see\nAppendix\t32\n).\tMany\tpopular\tprenatal\tsupplements\tdo\tnot\tcontain\tcholine\tor,\tif\tso,\tcontain\tvery\tlittle\n(25\tto\t50\tmg)\t(
|
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] |
(25\tto\t50\tmg)\t(\nZeisel\tet\tal,\t2018\n).\tLarge\tsupplemental\tdoses\tmay\tcause\tGI\tdiscomfort,\n\tbut\ta\tsmall\nstudy\tusing\t750\tmg\tduring\tpregnancy\tdid\tnot\tidentify\tadverse\teffects\t(\nZeisel,\t2013\n).\nVitamin\tC.\nThe\tDRI\tfor\tvitamin\tC\tincreases\tduring\tpregnancy\tand\tmay\tbe\teven\thigher\tfor\tthose\twho\tsmoke,
|
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] |
abuse\talcohol\tor\tdrugs,\tor\tregularly\ttake\taspirin.\tDaily\tconsumption\tof\tgood\tfood\tsources\tshould\tbe\nencouraged.\tLow\tplasma\tlevels\tare\tassociated\twith\tpreterm\tlabor\t(\nDror\tand\tAllen,\t2012\n),\tpossibly\nbecause\tof\tits\tantioxidant\tfunction\tor\tits\trole\tin\tcollagen\tsynthesis.\tHowever,\tsupplemental\tvitamin\tC
|
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] |
is\tnot\trecommended\tfor\tthe\tprevention\tof\tpremature\trupture\tof\tmembranes\t(PROM).\tPreviously\nsupplementation\twith\tvitamin\tC\t(1000\tmg)\talong\twith\tvitamin\tE\t(400\tIU)\twas\tpromoted\tfor\tthe\npossible\tprevention\tof\tpreeclampsia.\tHowever,\tit\tis\tnot\tcurrently\trecommended\t(\nACOG,\t2013c\n)\tand\nactually\tmay\tincrease
|
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] |
ACOG,\t2013c\n)\tand\nactually\tmay\tincrease\n\trisk\tof\tgestational\thypertension\tand\tPROM.\tVitamin\tC\tis\tactively\ttransported\nacross\tthe\tplacenta,\tso\tthere\tis\talso\tpotential\tfor\texcessive\tlevels\tin\tthe\tfetus\t(\nDror\tand\tAllen,\t2012\n).\nVitamin\tA.\nVitamin\tA\tis\tcritical\tduring\tperiods\tof\trapid\tgrowth\tand\timportant\tin\tcellular\tdifferentiation,\tocular
|
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] |
development,\timmune\tfunction,\tand\tlung\tdevelopment\tand\tmaturity\tas\twell\tas\tgene\texpression\t(\nWu\net\tal,\t2012a\n).\tLow\tvitamin\tA\tlevels\tare\tassociated\twith\tIUGR\tand\tincreased\trisk\tof\tmaternal\tand\nneonatal\tmortality,\tpossibly\tdue\tto\tthe\tprotective\trole\tof\tcarotenoids\tagainst\toxidative\tstress\n(\nZielińska\tet\tal,\t2017
|
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] |
(\nZielińska\tet\tal,\t2017\n).\tMalformations\tare\tseen\tin\tanimals\texposed\tto\tdeficiencies,\tbut\tconfirmation\nof\thuman\tmalformations\thas\tnot\tbeen\twell-established.\tHowever,\ta\trecent\tcase\treport\tdemonstrated\nthat\tvitamin\tA\tdeficiency\n\tfollowing\tbariatric\tsurgery\tresulted\tin\trecurrent\tfetal\tand\tneonatal\tlosses,
|
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] |
with\tpreterm\tdelivery,\tpulmonary\thypoplasia,\tand\tmicrophthalmia\tin\tthe\tsurviving\tfetuses\t(\nMackie\tet\nal,\t2018\n).\tAmong\twomen\tpositive\tfor\thuman\timmunodeficiency\tvirus\t(HIV),\timproved\tvitamin\tA\nstatus\tis\tassociated\twith\timproved\tbirth\tweight,\tpossibly\tby\timproving\timmunity\t(\nHovdenak\tand
|
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] |
Haram,\t2012\n).\nExcess\tpreformed\tvitamin\n\tA\tis\tteratogenic,\tso\thigh\tintake\tis\tof\tmost\tconcern\tin\tthe\tfirst\ttrimester.\nSupplementation\tis\tusually\tnot\tnecessary\tand\tis\toften\tlimited\tto\t5000\tIU/day,\talthough\tdoses\tup\tto\n10,000\tIU/day\tare\tnot\tassociated\twith\tincreased\trisk\tof\tmalformations\t(\nHovdenak\tand\tHaram,\t2012\n).
|
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] |
Hovdenak\tand\tHaram,\t2012\n).\nThe\tacne\tmedication\tisotretinoin\tis\ta\tvitamin\tA\tanalog,\tand\texposed\tfetuses\tare\tat\textremely\thigh\nrisk\tfor\tfetal\tanomalies\n\tand\tmiscarriages.\tWomen\tshould\tstop\tits\tuse\tfor\tat\tleast\t1\tmonth\tbefore\nconception.\tOther\tretinoids\t(etretinate,\tacitretin)\twould\talso\tbe\tof\tconcern\t(\nHarris\tet\tal,\t2017\n).\tBeta-
|
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] |
Harris\tet\tal,\t2017\n).\tBeta-\ncarotene\tis\tnot\tassociated\twith\tbirth\tdefects.\nAlthough\tno\tcases\thave\tbeen\tseen,\ttheoretically\tsomeone\teating\tliver\tcould\tconsume\tas\tmuch\npreformed\tvitamin\tA\tas\thas\tbeen\tassociated\twith\tfetal\tanomalies,\tso\tlarge\tamounts\n\tof\tliver,\tliver\tpté,
|
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-0.03779618814587593,
0.11759300529956818,
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0.106736920773983,
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0.11266394704580307,
0.0300943311303854,
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0.046383440494537354,
0.0872834250330925,
0.023513229563832283,
0.09355037659406662,
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] |
considerably.\tAcute\tvitamin\tA\tpoisoning\thas\tbeen\tdocumented\twith\tthe\tlivers\tfrom\tseals,\twhales,\npolar\n\tbears,\tand\tmultiple\tspecies\tof\tsaltwater\tfish,\tespecially\tfrom\tthe\ttropics\t(\nDewailly\tet\tal,\t2011\n).\nAll\tof\tthese\tlivers\tshould\tbe\tavoided.\tFish\tliver\toils\t(halibut,\tshark,\tand\tcod)\tare\talso\tvery\thigh\tin\nvitamin\tA\tand\tshould\tbe\tavoided\t(
|
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] |
vitamin\tA\tand\tshould\tbe\tavoided\t(\nMcLaren\tand\tKraemer,\t2012\n).\tLivers\tfrom\tsheep\tand\tox\tcontain\nvery\thigh\tlevels,\tas\tdo\tall\tlivers\tof\tanimals\tfed\tfeedstuffs\tfortified\twith\tvitamin\tA\tand\tall\tshould\n\tbe\navoided\t(\nScotter\tet\tal,\t1992\n).\tUsing\tdata\tfrom\tthe\tcurrent\tU.S.\tDepartment\tof\tAgriculture\t(USDA)
|
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).\tUsing\tdata\tfrom\tthe\tcurrent\tU.S.\tDepartment\tof\tAgriculture\t(USDA)\nfood\tcomposition\ttables,\tboth\tveal\tand\tmoose\tlivers\tshould\tbe\tavoided.\tLivers\tfrom\tringed\tseal\tand\nturkey\tshould\tbe\tvery\tlimited.\tLivers\tfrom\tother\tanimals\tgenerally\thave\tlower\tvitamin\tA\tcontents.
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Quantities\teaten\tshould\tbe\tlimited.\tCheck\tyour\tlocal\tfood\tcomposition\tdatabases\tfor\tdetails\ton\tthe\nlivers\tmost\tcommonly\tconsumed\tin\tyour\tarea.\nVitamin\tD.\nAccording\tto\tthe\tIOM,\tvitamin\tD\trequirements\tdo\tnot\tincrease\tduring\tpregnancy\tand\tintakes\tof\t600
|
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IU/day\t(15\tmcg/day)\tare\tsufficient\twhen\tconsidering\tbone\thealth.\tThe\tfew\tdietary\tsources\tof\tvitamin\nD\tare\tsalmon\tand\tother\tfatty\tfish,\tas\twell\tas\tsome\tfortified\tbreakfast\tcereals\tand\tmushrooms\nexposed\tto\tUV\tlight,\tand\tseal\tand\twhale\tblubber\n\tand\tpolar\tbear\tliver\t(\nHolick,\t2017\n).\tNot\tall\tdairy
|
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] |
and\tpolar\tbear\tliver\t(\nHolick,\t2017\n).\tNot\tall\tdairy\nproducts\tare\tfortified,\tbut\tliquid\tmilk\tis\ta\tgood\tsource,\tusually\tcontaining\t100\tIU/8\toz\t(see\t\nAppendix\n38\n).\nVitamin\tD\tdeficiency\tis\trecognized\tincreasingly\tin\tdark-skinned\tand\tveiled\twomen\tliving\tin
|
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] |
latitudes\twhere\tsun\texposure\tis\tlow.\tWomen\twho\tare\tat\trisk\tof\tentering\tpregnancy\twith\tlow\tvitamin\nD\tlevels\talso\tinclude\tthose\twith\tBMI\tmore\tthan\n\t30,\tthose\twith\tfat\tmalabsorption,\tand\tthose\twith\thigh\nuse\tof\tsunblock,\talong\twith\tpoor\tdietary\tintake.\tScreening\tfor\tvitamin\tD\tstatus\tis\tadvised\tfor\tthose\nwomen\t(\nACOG,\t2011\n).
|
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] |
women\t(\nACOG,\t2011\n).\nSevere\tvitamin\tD\tdeficiency\tis\tassociated\twith\tcongenital\trickets\tand\tnewborn\tfractures\tand\talso\nmay\tmanifest\tas\tseizures,\talthough\tit\tis\tunknown\tif\tcalcium\tinsufficiency\talso\tplays\ta\trole\t(\nBrannon\nand\tPicciano,\t2011\n).\tThere\n\tis\tconcern\tthat\tlow\tmaternal\tvitamin\tD\tstatus\tmay\tnegatively\taffect\tfetal
|
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] |
bone\taccrual.\tHowever,\tsmall\tstudies\thave\tshown\tthat\talthough\tmaternal\tsupplementation\tcan\nincrease\tcord\tblood\tlevels,\tthere\tis\tno\teffect\ton\tfetal\tcalcium,\tphosphorus,\tparathyroid\thormone\n(PTH),\tor\tskeletal\tparameters\t(\nKovacs,\t2012\n).\tA\trecent\tstudy\tfound\tno\tassociation\tbetween\tmaternal\nvitamin\tD\tstatus\tand\ther\toffspring’s
|
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] |
vitamin\tD\tstatus\tand\ther\toffspring’s\n\tbone\tmineral\tcontent\tat\tages\t9\tto\t10\tyears\t(\nLawlor\tet\tal,\t2013\n).\nVitamin\tD\tmetabolism\tchanges\tin\tpregnancy,\twith\tthe\tconversion\tof\t25(OH)D\tto\t1,25(OH)\n2\nD\ndrastically\tincreased\t(\nHollis\tand\tWagner,\t2017\n).\t1,25(OH)\n2\nD\tlevels\tare\t2\tto\t3\ttimes\tnonpregnant
|
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] |
).\t1,25(OH)\n2\nD\tlevels\tare\t2\tto\t3\ttimes\tnonpregnant\nlevels\tby\t12\tweeks\tof\tgestation\tand\tkeep\trising\tthroughout\tthe\tpregnancy,\tdepending\ton\t25(OH)D\navailability.\tThese\tlevels\tare\tnot\tassociated\twith\n\thypercalciuria\tor\thypercalcemia\tand\tappear\tto\tbe\ndriven\tby\tthe\tpregnancy\titself\trather\tthan\tby\tincreasing\tvitamin\tD-binding\tprotein\tlevels.
|
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] |
Mechanisms\tare\tstill\tunknown\tbut\tlikely\tinclude\tan\tuncoupling\tof\trenal\t1-alpha-hydroxylase\tfrom\nfeedback\tcontrol\tand\tupregulating\tit\ttwofold\tto\tfivefold\tfor\treasons\tother\tthan\tcalcium\thomeostasis\n(\nKovacs,\t2012\n).\tIt\tis\tassumed\tthat\thigh\t1,25(OH)\n2\nD\tvalues\tincrease\n\tdelivery\tof\tvitamin\tD\tto\tmaternal
|
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] |
2\nD\tvalues\tincrease\n\tdelivery\tof\tvitamin\tD\tto\tmaternal\ntissues\tand\tmay\tmodulate\tinnate\tand\tadaptive\timmunity,\tincluding\tpossibly\tan\timmunomodulatory\nrole\tin\tpreventing\tfetal\trejection.\tVitamin\tD\tmay\tbe\timportant\tin\tregulating\tgene\texpression\tand\tin\npromoting\tsuccessful\timplantation\tso\tpreconceptual\tlevels,\tand\ttherefore\tsupplementation,\tmay\tbe
|
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] |
important\t(\nHollis\tand\tWagner,\t2017\n).\tIt\talso\tmay\thave\ta\trole\tin\tpreventing\n\tpreeclampsia,\tpreterm\ndelivery,\tgestational\tdiabetes,\tbacterial\tvaginosis,\tand\tthe\tneed\tfor\tcesarean\tdelivery.\tIn\taddition,\tit\nmay\tbe\tinvolved\tin\tthe\tdevelopment\tof\tthe\tinfant’s\timmune\tfunction\tand\tdevelopment\tof\tallergy\tas\nwell\tas\tother\tdevelopmental\tprogramming\t(
|
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] |
well\tas\tother\tdevelopmental\tprogramming\t(\nBrannon\tand\tPicciano,\t2011\n),\tincluding\trisk\tof\ttype\t1\ndiabetes\t(\nKovacs,\t2012\n).\tHowever,\tassociations\tare\tinconclusive,\toften\tcontradictory\n\tand\nconfounded,\tand\tlack\tcausality.\tAlthough\tsupplementation\traises\tmaternal\tvitamin\tD\tlevels,\tit\thas
|
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] |
not\tbeen\tconsistently\tassociated\twith\timproved\tobstetric\toutcomes\t(\nRoth\tet\tal,\t2017\n).\tHowever,\ta\nrecent\ttrial\tfound\tthat\twomen\twho\tachieved\tblood\tconcentrations\tof\tat\tleast\t40\tng/mL\thad\tat\tleast\ta\n60%\tlower\trisk\tof\tpreterm\tdelivery\tand\tthat\tthe\trisk\treduction\twas\t78%\tamong\tnonwhite\twomen\n(\nMcDonnell\tet\tal,\t2017
|
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] |
(\nMcDonnell\tet\tal,\t2017\n).\tOptimal\tserum\tlevels\tof\t25(OH)D\tduring\tpregnancy\tare\tnot\tyet\tknown\tbut\nmust\tbe\tat\tleast\t20\tng/mL\t(50\tnmol/L)\tfor\tbone\thealth\t(\nACOG,\t2011\n).\tOther\texperts\tsuggest\tserum\nlevels\tat\tleast\t32\tng/mL\t(80\tnmol/L)\tis\tbetter\tfor\tpregnancy\tand\tit\thas\tbeen\tproposed\tthat\toptimal\nlevels\tof\t1,25(OH)\n2
|
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] |
levels\tof\t1,25(OH)\n2\nD\tand,\ttherefore,\toptimal\tfetal\toutcomes\tcan\tbe\tachieved\tonly\twith\tblood\tlevels\tof\n40\tng/mL\t(100\tnmol/L)\t(\nHollis\tand\tWagner,\t2017\n).\tOthers\tpropose\teven\thigher\tlevels\t(\nHeyden\tand\nWimalawansa,\t2018\n).\tOn\tthe\tother\thand,\tincreased\trisk\tof\tgrowth\trestriction\tat\tlevels\texceeding\t70
|
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] |
nmol/L\tand\tchild\teczema\tat\tlevels\texceeding\t75\tnmol/L\talso\thave\tbeen\treported\t(\nBrannon\tand\nPicciano,\t2011\n).\tResearch\tis\tactive\tand\tongoing\tand\tdebate\tis\tvigorous.\tVitamin\tD\tsupplementation\nmay\tbe\tneeded\tto\treach\tdesired\tserum\tconcentrations,\talthough\n\tthere\tis\tinsufficient\tevidence\tto
|
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] |
there\tis\tinsufficient\tevidence\tto\nrecommend\troutine\tsupplementation\tand\tWHO\trecommends\tagainst\tit\t(\nRoth\tet\tal,\t2017\n).\tA\tdose\tof\n1000\tto\t2000\tIU/day\tof\tvitamin\tD\tappears\tsafe\t(\nACOG,\t2011\n).\tAlthough\tsome\tresearchers\thave\tfound\nno\thypercalciuria\twith\t4000\tIU/day\t(the\ttolerable\tupper\tintake\tlevel\t[UL]),\tcaution\tis\tadvised.\tIn
|
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those\tstudies,\tonly\tspot\tchecks\tof\turine\twere\tdone,\tnot\t24-hour\turine\tcollections,\n\tand\tthere\twas\tno\nlong-term\tfollow-up\ton\tkidney\tstone\tformation\trates\t(\nKovacs,\t2012\n).\tVery\thigh\tsupplementation\n(≥1000\tmcg\t=\t40,000\tIU/day)\thas\tbeen\tassociated\twith\thypercalcemia,\tand\talthough\tvitamin\tD\tdoes
|
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] |
not\tappear\tto\tbe\tteratogenic\tin\tthe\tdoses\tusually\tgiven,\tsome\tanimal\tdata\tsuggest\tthe\tneed\tfor\nconcern\t(\nRoth,\t2011\n).\tThe\tpotency\tof\tvitamin\tD\tsupplements\tis\tvariable\tand\tmany\tcontain\tless\tthan\nthe\tlabeled\tamounts\t(\nLeBlanc\tet\tal,\t2013\n).\nCurrent\tdata\tis\tinconsistent,\twith\tsmall,\tlow\tquality\tstudies.\tIn\tan\tattempt\tto\tanswer\tcritical
|
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] |
questions,\tmany\ttrials\tare\tplanned\tor\tare\tcurrently\tongoing.\tIn\taddition\tto\tdetermining\tthe\toptimal\nserum\tlevels,\tthe\toptimal\ttiming\tof\tsupplementation\tand\tthe\teffect\tof\tdifferent\tlifestyles,\tbody\ttypes,\nbaseline\tstatus,\tthe\trole\tof\tthe\tplacenta,\tand\tgenotypes\n\t(both\tmaternal\tand\tfetal)\tare\tall\tcurrently\nunknown\t(\nHollis\tand\tWagner,\t2017\n;
|
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] |
unknown\t(\nHollis\tand\tWagner,\t2017\n;\t\nStørdal\tet\tal,\t2017\n).\nVitamin\tE.\nVitamin\tE\trequirements\tdo\tnot\tincrease.\tAlthough\tdeficiency\tis\tspeculated\tto\tcause\tmiscarriage,\npreterm\tbirth,\tpreeclampsia,\tand\tIUGR,\tvitamin\tE\tdeficiency\tspecifically\thas\tnot\tyet\tbeen\treported
|
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in\thuman\tpregnancy.\tVitamin\tE\tis\tan\timportant\tlipophilic\tantioxidant,\tbut\tsupplementation\n\tof\tvitamin\nE\t(along\twith\tvitamin\tC)\tis\tnot\tan\teffective\tstrategy\tfor\tpreventing\tpreeclampsia\tnor\tdoes\tit\treduce\nrisk\tof\tfetal\tor\tneonatal\tloss,\tSGA,\tor\tpreterm\tdelivery.\tSupplementation\tactually\tmay\tbe
|
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proinflammatory,\tpreventing\tthe\tswitch\tfrom\tTh1\tcytokines\t(proinflammatory)\tto\tTh2\tcytokines\n(antiinflammatory)\tthat\tis\tnormal\tduring\tpregnancy\t(\nHovdenak\tand\tHaram,\t2012\n;\tsee\t\nAppendix\t36\nfor\tfood\n\tsources\tof\tvitamin\tE).\nVitamin\tK.\nAlthough\tvitamin\tK\trequirements\tdo\tnot\tincrease\tduring\tpregnancy,\tusual\tdiets\toften\tdo\tnot\tprovide
|
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] |
sufficient\tvitamin\tK,\tas\tmost\tfood\tsources\t(e.g.,\tdark\tleafy\tgreen\tvegetables)\tare\tnot\tconsumed\tin\nrecommended\tamounts.\tVitamin\tK\thas\tan\timportant\trole\tin\tbone\thealth\tas\twell\tas\tin\tcoagulation\nhomeostasis,\tso\tadequate\tamounts\tduring\tpregnancy\tare\tvital\t(see\t\nChapter\t23\n).\tVitamin\tK\tdeficiency
|
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] |
Chapter\t23\n).\tVitamin\tK\tdeficiency\nhas\tbeen\treported\tin\twomen\twho\thave\thad\thyperemesis\tgravidarum,\tCrohn’s\tdisease,\tor\tgastric\nbypass,\tand\ta\tcase\treport\tdescribes\ta\tdeficiency\tassociated\twith\tintrahepatic\tcholestasis\tof\npregnancy\t(\nMaldonado\tet\tal,\t2017\n).\tSee\t\nAppendix\t37\n\tfor\tsources\tof\tvitamin\tK.\nMinerals\nCalcium.
|
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] |
).\tSee\t\nAppendix\t37\n\tfor\tsources\tof\tvitamin\tK.\nMinerals\nCalcium.\nHormonal\tfactors\tstrongly\tinfluence\tcalcium\tmetabolism\tin\tpregnancy.\tHuman\tplacental\n\tlactogen\nmodestly\tincreases\tthe\trate\tof\tmaternal\tbone\tturnover.\tAlthough\testrogen\tinhibits\tbone\tresorption,
|
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accretion\tand\tresorption\tincrease.\tMaternal\tabsorption\tof\tcalcium\tacross\tthe\tgut\tdoubles\tduring\npregnancy\t(\nKovacs,\t2016\n).\tPTH\toften\tdrops\tin\tNorth\tAmerican\tand\tEuropean\twomen\tconsuming\nadequate\tcalcium.\tIn\tareas\twith\tlower\tcalcium\tdiets\tthat\tare\talso\trich\tin\tphytates,\tPTH\tlevels\tstay\nthe
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] |
mineralization.\tFetal\thypercalcemia\tand\tsubsequent\tendocrine\tadjustments\tultimately\tstimulate\tthe\nmineralization\n\tprocess.\tThe\tplacenta\tappears\tto\tprotect\tthe\tdeveloping\tfetus\tunless\tthere\tis\nmaternal\thypocalcemia\twith\tsevere\thypoparathyroidism\t(\nKovacs,\t2015\n).
|
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] |
Kovacs,\t2015\n).\nThe\tnet\teffects\tof\tpregnancy\tand\tlactation\ton\tthe\tmaternal\tskeleton\tare\tnot\tyet\tclear.\tBone\tmineral\nis\tmobilized\tduring\tpregnancy\tand\treplenished\tstarting\tin\tlater\tlactation.\tThe\tdegree\tof\tbone\nchanges\tvaries\tconsiderably\tby\tsite\tand\talso\tbetween\tindividuals.\n\tIt\tappears\tthat\tgenetics,\tendocrine
|
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] |
It\tappears\tthat\tgenetics,\tendocrine\nresponses,\tand\tnutritional\tfactors\tare\tall\timportant.\tNo\tprospective\tstudies\thave\texamined\twhether\nthere\tis\tincreased\trisk\tof\tosteoporosis\tlater\tin\tlife\tattributed\tto\tpregnancy\tor\tlactation\tand\nretrospective\tstudies\tare\tinconsistent.\tHigher\tintakes\tare\tassociated\twith\timproved\tcalcium\tbalance
|
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when\tintakes\tare\tlow,\tbut\tsome\tevidence\tsuggests\tthat\tsupplementation\n\tmay\ttemporarily\tdisrupt\tthe\nprocess\tof\tadaptation\tto\thabitually\tlow\tintakes\t(\nOlausson\tet\tal,\t2012\n).\nApproximately\t30\tg\tof\tcalcium\tis\taccumulated\tduring\tpregnancy,\tprimarily\tin\tthe\tfetal\tskeleton\t(25
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-0.02930745668709278
] |
g),\tbut\tthere\tis\twide\tvariation.\tThe\tremainder\tis\tstored\tin\tthe\tmaternal\tskeleton,\theld\tin\treserve\tfor\nthe\tcalcium\tdemands\tof\tlactation.\tMost\tfetal\taccretion\toccurs\tduring\tthe\tlast\thalf\tof\tpregnancy,\nincreasing\tfrom\t50\tmg/day\tat\t20\tweeks\tof\tgestation\tto\t330\tmg/day\tat\t35\tweeks\t(\nOlausson\tet\tal,\n2012
|
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] |
Olausson\tet\tal,\n2012\n).\tThere\tis\tconflicting\tevidence\tregarding\twhether\tmaternal\tcalcium\tintake\taffects\ta\tchild’s\nlong-term\taccretion.\nIn\taddition\tto\tits\trole\tin\tbone\tformation,\tlow\tcalcium\tintake\tis\tassociated\twith\tincreased\trisk\tof\nIUGR\tand\tpreeclampsia\t(\nHovdenak\tand\tHaram,\t2012\n).\tCalcium\talso\tis\tinvolved\tin\tmany\tother
|
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] |
Hovdenak\tand\tHaram,\t2012\n).\tCalcium\talso\tis\tinvolved\tin\tmany\tother\nprocesses,\tincluding\tblood\tclotting,\tintracellular\tproteolysis,\tand\tnitric\toxide\tsynthesis,\tand\tit\thas\ta\nrole\tin\tregulating\tuterine\tcontractions\t(\nWu\tet\tal,\t2012a\n).\nThe\trequirement\tfor\tcalcium\tduring\tpregnancy\tdoes\tnot\tincrease.\tHowever,\tmany\twomen\tenter
|
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] |
pregnancy\twith\tlow\tintakes\tand\toften\tneed\tencouragement\tto\tincrease\tconsumption\tof\tcalcium-rich\nfoods.\tDairy\tproducts\tare\tthe\tmost\tcommon\tsources\n\tof\tdietary\tcalcium.\nMilk,\tincluding\textra\tdry\tmilk\tpowder,\tcan\tbe\tincorporated\tinto\tfoods.\tOne-third\tcup\tof\tdried\tskim
|
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milk\tis\tequivalent\tto\t1\tcup\tof\tfluid\tmilk.\tSmall\tamounts\tcan\tbe\tadded\tto\tliquid\tmilk\twhile\tmuch\tmore\ncan\tbe\tadded\tto\tfoods\twith\tstronger\tflavors.\tAlthough\tmost\tof\tthe\tdry\tmilk\tsold\tin\tthe\tUnited\tStates\nis\tnonfat,\tpowdered\twhole\tmilk\tis\talso\tavailable\tin\tthe\tethnic\tfood\tsections\n\tof\tgrocery\tstores.\tYogurt
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of\tgrocery\tstores.\tYogurt\nis\toften\twell\taccepted,\tand\tusing\tplain\tnonfat\tyogurt\twith\tfruit\tand\tminimal\tadded\tsugar\tcan\nmaximize\tnutrients\twithout\tproviding\tas\tmany\textra\tcalories.\tGreek\tyogurt,\talthough\thigher\tin\nprotein,\tmay\tcontain\tless\tcalcium\tthan\tregular\tyogurt.\tAlthough\tcheese\tcan\tbe\tused,\toften\tthe
|
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higher\tcalories\tfrom\tfat\tbecome\ta\tlimiting\tfactor.\tLactose\tintolerance\tcan\tbe\tmanaged\t(see\n\t\nChapter\n25\n).\nSoy\tmilks\tare\tfortified\twith\tcalcium,\tbut\tthis\toften\tprecipitates\tto\tthe\tbottom\tof\tthe\tcontainer.\tIt\tis
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] |
difficult\tto\treincorporate\tthe\tsludge,\twith\tthe\tmilk\tcontaining\tonly\t31%\tof\tthe\tlabeled\tamount\nwithout\tshaking,\t59%\twith\tshaking\t(\nHeaney\tand\tRafferty,\t2006\n).\tThe\tfortificant\tshould\tbe\tcalcium\ncarbonate\tfor\tbest\tabsorption.\tOther\tdrinks,\tincluding\tenriched\trice,\tcoconut,\tand\tnut\n\tmilks,\tare
|
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-0.015462182462215424,
-0.010862661525607109,
0.031569954007864,
0.056016843765974045,
0.07312885671854019,
0.08451400697231293,
-0.023936158046126366
] |
milks,\tare\noften\tlow\tin\tprotein,\tand\tcaution\tis\tadvised.\tRegarding\tvegetable\tsources\tof\tcalcium,\tthe\tconcern\tis\none\tof\tquantity\tand\tbioavailability\t(\nTable\t14.10\n;\tsee\talso\t\nAppendix\t39\n).\nTABLE\t14.10\nComparison\tof\tAbsorbable\tCalcium\tWith\t1\tCup\tMilk\nFood\nCalcium\nContent\nFractional\nAbsorption\nEstimated\tAbsorbed\nCalcium\nAmount\tNeeded\tto\tEqual
|
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] |
Absorption\nEstimated\tAbsorbed\nCalcium\nAmount\tNeeded\tto\tEqual\n1\tc\tMilk\nMilk\n300\tmg/c\n32.1%\n96.3\tmg\n1.0\tcup\nBeans,\tpinto\n44.7\tmg/0.5\nc\n*\n26.7\n11.9\n4.05\tcups,\tcooked\n*\nBeans,\tred\n40.5\tmg/0.5\tc\n24.4\n9.9\n4.85\tcups\nBeans,\twhite\n113\tmg/0.5\tc\n21.8\n24.7\n1.95\tcups\nBok\tchoy\n79\tmg/0.5\tc\n53.8\n42.5\n1.15\tcups\nBroccoli\n35\tmg/0.5\tc\n61.3\n21.5\n2.25\tcups\nCheddar
|
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] |
53.8\n42.5\n1.15\tcups\nBroccoli\n35\tmg/0.5\tc\n61.3\n21.5\n2.25\tcups\nCheddar\n\tcheese\n303\tmg/1.5\noz\n32.1\n97.2\n1.5\toz\nChinese\tmustard\ngreens\n212\tmg/0.5\tc\n40.2\n85.3\n0.55\tcup\nChinese\tspinach\n347\tmg/0.5\tc\n8.36\n29.0\n1.65\tcups\nKale\n61\tmg/0.5\tc\n49.3\n30.1\n1.6\tcups\nSpinach\n115\tmg/0.5\tc\n5.1\n5.9\n8.15\tcups\nSweet\tpotatoes\n44\tmg/0.5\tc\n22.2\n9.8\n4.9\tcups\nTofu\twith\tcalcium
|
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] |
Sweet\tpotatoes\n44\tmg/0.5\tc\n22.2\n9.8\n4.9\tcups\nTofu\twith\tcalcium\n258\tmg/0.5\tc\n31.0\n80.0\n0.6\tcup\nYogurt,\tregular\n300\tmg/c\n32.1\n96.3\n1.0\tcup\n*\nAll\tvegetables\tare\tcooked\n\tportions.\nAdapted\tfrom\tWeaver\tCM\tet\tal:\tChoices\tfor\tachieving\tadequate\tdietary\tcalcium\twith\ta\tvegetarian\tdiet,\t\nAm\tJ\tClin\tNutr\n\t70:543s,\t1999.
|
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Am\tJ\tClin\tNutr\n\t70:543s,\t1999.\nCare\tshould\tbe\ttaken\twhen\tconsidering\tthe\tuse\tof\tcalcium\tsupplements.\tAmong\tnonpregnant\nadults,\tbone\tbuilding\tis\tbetter\twith\tdietary\tcalcium\tthan\twith\tsupplements\t(\nBooth\tand\tCamacho,\n2013\n).\tOverconsumption\tof\tcalcium\tthrough\tfood\tis\tnot\tcommon.\tHowever,\n\televated\tserum\tcalcium
|
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elevated\tserum\tcalcium\nlevels\tcan\tresult\tfrom\texcess\tantacid\tingestion\tif\tthe\tUL\tis\texceeded\t(see\t\nHeartburn\n).\nCopper.\nDiets\tof\tpregnant\twomen\tare\toften\tmarginal\tin\tcopper,\tand\trequirements\trise\tslightly\tin\tpregnancy.\nIn\taddition\tto\tprimary\tdeficiency\tfrom\tgenetic\tmutation\t(Menkes\tdisease),\tsecondary\tdeficiency
|
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(from\tincreased\tzinc\tor\tiron\tintake,\tthe\tuse\tof\tcertain\tdrugs,\tor\ta\thistory\tof\tgastric\n\tbypass\tsurgery)\tis\nalso\tof\tconcern.\tCopper\tdeficiency\talters\tembryo\tdevelopment\tand\tinduced\tcopper\tdeficiency\thas\nbeen\tshown\tto\tbe\tteratogenic.\tThere\tis\tdecreased\tactivity\tof\tcuproenzymes,\tincreased\toxidative
|
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stress,\taltered\tiron\tmetabolism,\tabnormal\tprotein\tcrosslinking,\tdecreased\tangiogenesis,\tand\taltered\ncell\tsignaling\t(\nUriu-Adams\tet\tal,\t2010\n).\tCopper\tinteracts\twith\tiron,\taffecting\tneurocognitive\n\tand\nneurobehavioral\tdevelopment.\tAlthough\tnot\tcommonly\tincluded\tin\tprenatal\tsupplements,\tit\tis
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0.08023659884929657,
0.006879245396703482
] |
recommended\tthat\tcopper\tbe\tsupplemented\twhen\tzinc\tand\tiron\tare\tgiven\tduring\tpregnancy.\tGood\nsources\tof\tcopper\tinclude\torgan\tmeats,\tseafood,\tnuts,\tseeds,\tand\twhole\tgrain\tproducts.\tBecause\tof\nthe\trelatively\tlarge\tamounts\tconsumed,\ttea,\tmilk,\tpotatoes,\tand\tchicken\tare\talso\timportant\tsources\n(\nOtten\tet\tal,\t2006\n).\nFluoride.
|
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] |
(\nOtten\tet\tal,\t2006\n).\nFluoride.\nThe\trole\tof\tfluoride\tin\tprenatal\tdevelopment\tis\tcontroversial,\tand\tfluoride\trequirements\tdo\tnot\nincrease\tduring\tpregnancy.\tDevelopment\tof\tprimary\tdentition\tbegins\tat\t10\tto\t12\tweeks\tof\tgestation\nand\tthe\tfirst\tfour\tpermanent\tmolars\tand\teight\tof\tthe\tpermanent\tincisors\tare\tforming\tduring\tthe\tfinal
|
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] |
trimester.\tThus\t32\tteeth\tare\tdeveloping\tduring\tgestation.\tControversy\tinvolves\tthe\textent\n\tto\twhich\nfluoride\tis\ttransported\tacross\tthe\tplacenta\tand\tits\tvalue\tin\tutero\tin\tthe\tdevelopment\tof\tcaries-\nresistant\tpermanent\tteeth\t(see\t\nChapter\t24\n).\nMost\tbottled\twater\tdoes\tnot\tcontain\tfluoride.\tFluoride\tis\toften\tadded\tto\tthe\tmunicipal\twater\tsupply
|
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] |
in\tthe\tUnited\tStates\tto\tachieve\tthe\tintake\tlevel\trecommended\tby\tCDC.\tIn\tother\tcountries,\tsalt\tand\nmilk\tare\tcommon\tvehicles\tfor\tfortification.\tFluoride\n\tlevels\texceeding\tthe\tmaximum\tcontamination\nlevel\tof\tmunicipal\twater\tsupplies\tare\tproblematic\tfor\tbones\tand\tteeth.\tThese\televated\tlevels\talso\nappear\tto\tbe\tneurotoxic\tfor\tthe\tdeveloping\tfetus\t(
|
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appear\tto\tbe\tneurotoxic\tfor\tthe\tdeveloping\tfetus\t(\nBarrett,\t2017\n).\nIodine.\nIodine\tis\tpart\tof\tthe\tthyroxine\tmolecule,\twith\ta\tcritical\trole\tin\tthe\tmetabolism\tof\tmacronutrients\tas\nwell\tas\tin\tfetal\tneuronal\tmyelination\tand\tgene\texpression\t(\nWu\tet\tal,\t2012a\n).\tBecause\tthe\tthyroid
|
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] |
Wu\tet\tal,\t2012a\n).\tBecause\tthe\tthyroid\nhormone\tsynthesis\tincreases\t50%\tduring\tpregnancy,\tiodine\trequirements\talso\tincrease\t(\nStagnaro-\nGreen\tand\tPearce,\t2012\n).\tSevere\tiodine\tdeficiency\tis\tassociated\twith\tincreased\trisk\tof\tmiscarriage,\ncongenital\tanomalies,\tfetal\tgoiter,\tand\tstillbirth,\tas\twell\tas\tprematurity,\tpoor\tfetal\tgrowth,\tand
|
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] |
decreased\tIQ.\tInfant\tcretinism,\talthough\trare\tin\tthe\tUnited\tStates,\tis\ta\tsignificant\n\tpublic\thealth\nproblem.\tIodine\tdeficiency\tis\tthe\tmost\tcommon\tcause\tof\tpreventable\tintellectual\tdevelopmental\ndisability\tin\tthe\tworld\t(\nLeung\tet\tal,\t2013\n).\nWorldwide,\tmany\tpeople\tare\tat\trisk\tfor\tiodine\tdeficiency\tcaused\tby\tlow\tintake\tof\tmilk\tor\tby
|
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consuming\tproduce\tgrown\tin\tiodine-deficient\tsoils,\tespecially\tif\teating\tlocally\tand\tconsuming\ngoitrogens\tor\texposed\tto\tperchlorate\tcontamination.\tFish\n\tand\tseafood\tare\tgood\tsources.\tIodine\ncontent\tvaries\tbetween\tand\twithin\tspecies.\tIt\tis\thigher\tin\twhite\tfish\tthan\toily\tfish\tand\tlevels\tare
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] |
highest\tat\tand\tjust\tbelow\tthe\tskin.\tMarine\tfish\tcontain\tsix\ttimes\tthe\tamount\tfound\tin\tfresh\twater\nfish.\tOther\tseafood\tis\talso\ta\tgood\tsource.\tCooking\tlosses\tare\tmuch\thigher\twith\tboiling\tthan\twith\nfrying\tor\tgrilling\t(\nBouga\tet\tal,\t2018\n).\nAn\testimated\t70%\tof\tthe\n\tworld\tpopulation\thas\taccess\tto\tiodized\tsalt\t(\nPearce\tet\tal,\t2013\n).\tSalt
|
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] |
Pearce\tet\tal,\t2013\n).\tSalt\niodization\tis\tvoluntary\tin\tthe\tUnited\tStates\tand\tCanada.\tIodized\tsalt\trarely\tis\tused\tin\tprocessed\nfoods,\tthe\tprimary\tsource\tof\tdietary\tsodium,\tand\tmust\tbe\tlabeled\tif\tused.\tKosher\tsalt\tand\tsea\tsalt\tdo\nnot\tnaturally\tcontain\tiodine.\tWomen\tshould\tbe\tencouraged\tto\tuse\tiodized\tsalt\twhen\tcooking\tat\thome
|
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] |
and\tto\tlimit\tthe\tintake\tof\n\tprocessed\tfoods\tmade\twith\tuniodized\tsalt.\nMedian\turinary\tiodine\tvalues\tin\tthe\tUnited\tStates\thave\tdeclined,\tmainly\tbecause\tof\tthe\treduction\nof\tiodine\tin\tdairy\tand\tbread\tproducts,\tsuch\tthat\t35%\tof\tU.S.\twomen\tof\tchildbearing\tage\tnow\thave\nurinary\tiodine\tvalues\tsuggesting\tmild\tiodine\tdeficiency\tor\tinsufficiency\t(
|
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] |
Leung\tet\tal,\t2013\n).\tSimilar\nreductions\thave\tbeen\tseen\tin\twomen\tin\tother\tdeveloped\tcountries\n\tas\twell\t(\nPearce\tet\tal,\t2013\n).\tA\nrecent\tstudy\testimated\t21%\tto\t44%\tof\tU.S.\tpregnant\twomen\tin\tthe\tthird\ttrimester\tmay\thave\ninadequate\tiodine\tlevels,\tusing\ta\tnew\tquantitative\tmodeling\ttool\t(\nLumen\tand\tGeorge,\t2017\n).
|
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] |
Lumen\tand\tGeorge,\t2017\n).\nAlthough\tthe\teffects\tof\tsevere\tiodine\tdeficiency\ton\tfetal\tbrain\tdevelopment\tare\twell\testablished,\tthe\neffects\tof\tmilder\tdeficits\tare\tnot\tas\tclear.\tResults\tof\tsupplementation\tstudies\tare\n\tmixed\tregarding\nthyroid\tfunction\tand\tthe\tneurodevelopment\tof\tchildren,\tbut\tchildren\tof\twomen\twith\tmild\tto\tmoderate
|
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deficiency\tdemonstrate\tbetter\tneurocognitive\tscores\tif\tmothers\twere\tsupplemented\tstarting\tvery\nearly\tin\tpregnancy,\tthat\tis,\tby\t4\tto\t6\tweeks\tof\tgestation\t(\nLeung\tet\tal,\t2013\n).\tCurrent\tresearch\tis\nstudying\tthe\teffect\tof\tiodine\tsupplementation\ton\tobstetric\toutcomes\tand\tlong-term\tchild
|
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development.\tBecause\tof\tthe\tconcern\tthat\ta\tsubset\tof\tthe\tpopulation\tmay\tbe\tat\trisk\tfor\tmild\ndeficiency,\tthe\tAmerican\tThyroid\tAssociation\trecommends\tthat\twomen\treceive\t150\tmcg/day\tduring\npregnancy\tand\tlactation\tas\tpotassium\tiodide,\tgiven\tthe\tvariability\tof\tiodine\tcontent\tin\tkelp\tand\nseaweed\t(\nLeung\tet\tal,\t2013\n;\t\nACOG,\t2015b
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] |
seaweed\t(\nLeung\tet\tal,\t2013\n;\t\nACOG,\t2015b\n).\tA\trecent\tstudy\tin\tthe\tUnited\tStates\tfound\tthat\t61%\tof\nprenatal\tvitamins\n\tcontain\tiodine\tand\tthat\tthose\tthat\twere\tavailable\tover\tthe\tcounter\twere\tmore\nlikely\tto\tcontain\tit\t(71%)\tthan\tthose\tavailable\tby\tprescription\t(46%)\t(\nLee\tet\tal,\t2017\n).\tIodine\tcontent
|
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0.08371329307556152,
0.01592341996729374
] |
Lee\tet\tal,\t2017\n).\tIodine\tcontent\nranged\tfrom\t10\tto\t450\tmcg\taccording\tto\tproduct\tlabels,\tbut\tthe\tmajority\t(89%)\tcontained\tat\tleast\n150\tmcg.\tAnother\tU.S.\tstudy\tfound\tthat\tadult\tmultivitamins\twere\tmore\tlikely\tto\tcontain\tiodine\n(74.2%)\tthan\tthose\tlabeled\n\tprenatal\tvitamins\t(57.6%)\t(\nPatel\tet\tal,\t2018\n).\tAlthough\tthe\tadult
|
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] |
prenatal\tvitamins\t(57.6%)\t(\nPatel\tet\tal,\t2018\n).\tAlthough\tthe\tadult\nmultivitamins\tconsistently\tused\tpotassium\tiodide,\tthat\twas\tonly\ttrue\tfor\t73.5%\tof\tthose\tlabeled\tas\nprenatal\tvitamins.\tIn\taddition,\tthe\taccuracy\tof\tlabeled\tcontent\tof\tmultivitamins\tsold\tin\tthe\tUnited\nStates\tis\talso\tof\tconcern.
|
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] |
States\tis\talso\tof\tconcern.\nHigh\tiodine\tlevels\tare\talso\tof\tconcern,\tpotentially\tcausing\tthe\tsame\tsymptoms\tas\tlow\tlevels.\tThere\nis\tconcern\n\tabout\tthe\tsafety\tof\tiodine\tsupplementation\tin\tareas\tof\tiodine\tsufficiency,\tbut\tthe\tproblems\nappear\tto\tbe\ttemporary\t(\nPearce\tet\tal,\t2013\n).\tThere\tare\tindividual\tdifferences\tin\tthe\tability\tto\thandle
|
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] |
).\tThere\tare\tindividual\tdifferences\tin\tthe\tability\tto\thandle\nhigh\tiodine\tintakes\tbut\tmost\thealthy\tpeople\tadapt\twithin\ta\tfew\tdays\tand\tproduce\tnormal\tlevels\tof\nthyroid\thormones\t(\nHamby\tet\tal,\t2018\n).\tHowever,\tthe\tfetus\tand\tneonate\tare\tparticularly\tsensitive\tto\nhigh
|
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] |
).\tHowever,\tthe\tfetus\tand\tneonate\tare\tparticularly\tsensitive\tto\nhigh\n\tiodine\tlevels,\tespecially\tthe\tpreterm\tinfant,\tbecause\tthe\thomeostatic\tmechanisms\tdo\tnot\tmature\nuntil\t36\tweeks\tof\tgestation\t(\nPearce,\t2018\n).\nProblems\thave\tbeen\tseen\twith\thigh\tintakes\tof\tseaweeds.\tThe\tiodine\tcontent\tof\tseaweeds\tis
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] |
variable\tand\tdepends\tprimarily\ton\tthe\tspecies\tof\tseaweed\tbut\talso\tthe\tparts\tof\tthe\tplant\tconsumed,\nthe\tgrowing\tconditions,\tand\tthe\tpreparation\tmethods\t(\nRoleda\tet\tal,\t2018\n).\tOf\tmost\tconcern\tare\tthe\nbrown\tseaweeds,\tincluding\tkombu\tand\tkelp,\tbecause\tthey\tare\tknown\tto\tbe\tthe\tmost\tefficient\naccumulators\tof\tiodine,\tfollowed\tby\tred\tseaweeds\t(
|
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] |
accumulators\tof\tiodine,\tfollowed\tby\tred\tseaweeds\t(\nTeas\tet\tal,\t2004\n).\tFrequent\tconsumption\tof\tthese\nseaweeds\tcould\tfar\texceed\tthe\tUL\t(\nDesideri\tet\tal,\t2016\n),\teven\twhen\tcooking\tmethods\t(iodine\tis\nwater\tsoluble)\tand\tbioavailability\tissues\tare\ttaken\tinto\taccount\t(\nRoleda\tet\tal,\t2018\n;\t\nDomínguez-\nGonzález\tet\tal,\t2017
|
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] |
Roleda\tet\tal,\t2018\n;\t\nDomínguez-\nGonzález\tet\tal,\t2017\n).\tCongenital\thypothyroidism\tresulting\tfrom\thigh\tprenatal\tintake\tof\tseaweeds\nhas\tbeen\tdocumented\t(\nNishiyama\tet\tal,\t2004\n).\tVery\thigh\tbreastmilk\tiodine\tlevels\talso\thave\tbeen\nseen\tamong\tKorean\twomen\tingesting\tthe\tcustomary\tbrown\tseaweed\tsoup\tpostpartum,\tutilized\tfor\tits
|
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] |
nutrient\tcontent\tbut\talso\tthought\tto\tfacilitate\tmaternal\tweight\tloss\tand\tenhance\tbreast\tmilk\nproduction\t(\nHamby\tet\tal,\t2018\n).\nAs\n\ta\treminder,\tpostpartum\tthyroiditis\taffects\tan\testimated\t5.4%\tof\tall\twomen\t(\nStagnaro-Green\tand\nPearce,\t2012\n).\tThyroiditis\tcan\tmanifest\tas\teither\thyper-\tor\thypothyroidism,\tand\tboth\tcan\taffect\nbreastmilk\tproduction.
|
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] |
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