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In general, nutrient recommendations like RDAs (recommended daily allowances), are designed to meet the nutrient demands of 97% of the population, and thus can be much higher than needed for any individual. Also, nutrient requirements are strongly influenced by genetic and environmental factors. For vitamin B12, for instance, genetic factors determine bioavailability and uptake, besides its dietary availability. UK Biobank data showed a poor correlation between Vit B12 intakes and plasma levels, even with intakes above the RDA almost 30% of the population showed a deficiency. Supplementation may be a simple way to address such nutrient needs, but we are starting to understand how to best achieve effective supplementation to address them.
The Nipper study conducted with the EpiGen consortium in Singapore, New Zealand, and the UK, tested a supplementation with micronutrients, myo-inositol and two probiotics starting at least 6 weeks before conception and continued during pregnancy. Women taking the supplement showed substantial decreases in the incidence of preterm birth, premature membrane rupture and postpartum hemorrhage. In addition, a lower risk of obesity associated with a lower incidence of fast growth in the children was observed. Interestingly, supplementation decreased the time to conception in overweight, but not in obese women. Also, some plasma and milk micronutrient levels showed increases over time with differences between study sites.
A large clinical study in pregnant women in Australia (ORIP) showed that a high dose omega 3 fatty acid DHA supplement was most effective in reducing preterm delivery risk in women with a low omega-3 fatty acid status (docosahexaenoic acid – DHA) but increased the risk of a preterm birth in women with high DHA status, at the start of the study. Data from this study allowed the development of an algorithm to assign an effective DHA dose based on baseline levels DHA, which is currently undergoing clinical testing.
These two clinical studies illustrate that, environmental factors, such as dietary habits and BMI affect nutrient levels and efficacy, calling for more tailored approaches.
Today, many women of reproductive age have 1 or more (micro)nutrient deficiencies worldwide. Although emphasis to ensure women have a healthy lifestyle and a healthy and balanced diet is needed, nutritional supplementation, preferable starting before conception and tailored to individual needs, is an effective way to ensure adequate nutrient status and intake. For this, there is a need to develop tools that allow designing and implementing effective supplementation to improve short- and long-term outcomes for women and their children.
Author's note
At Nestlé we develop science-based solutions to support women along their motherhood journey, preconception, pregnancy and post-natal. Our current portfolio, include multivitamin, DHA, botanicals, and probiotic supplements to support women’s nutritional, and health needs to promote a healthy pregnancy and baby development, and to support breastfeeding. Our R&D efforts allow a robust pipeline including clinically tested solutions to continuously strengthen and expand our portfolio.
Eline M. van der Beek
Head Nestlé Institute of Health Sciences, Nestlé Research
