Nutrition is one of the most consequential decisions you’ll make in pregnancy, as proper nutrition is critical to the health of both mother and baby.
In general, prenatal supplements are designed around the Recommended Dietary Allowances (RDAs) for pregnant and nursing mothers. But unfortunately, a growing body of evidence suggests that RDAs are often insufficient, potentially leaving mother and baby without enough of the nutrients they need to thrive.
This article will explain what RDAs are, where to find them, why they are often not enough, and what other sources of information we trust when formulating our products.
What are the RDAs?
The RDAs are the estimated amount of a nutrient (or calories) per day considered necessary for the maintenance of “good health” by the Food and Nutrition Board (FNB) at the Institute of Medicine of the National Academies. The RDAs vary by age, sex, and whether a woman is pregnant or nursing, as nutritional needs are elevated during this life stage. For this reason, many nutrients have multiple RDAs.
The FNB was established in 1940 during WWII to advise the Army on guidelines for good nutrition. The FNB realized the need to develop recommendations for nutritional intake for the general public as well as the armed forces and introduced the RDAs a year later in 1941.
The FNB has subsequently revised some of the RDAs every five to ten years based on advances in research and scientific understanding. For example, the RDA for Choline was added in 1998.
The most recent RDA revision was in 2016. Additional revisions are still needed as there is room for improvement with existing RDAs as described below and not every important nutrient has an RDA like the Omega-3s DHA and EPA. There is currently an RDA for the Omega-3 ALA, but conversion into DHA and EPA is highly inefficient and numerous studies have shown that DHA and EPA intake, either through the diet or supplements, is highly beneficial, particularly in the perinatal life stage.
What about daily values?
Daily Values (%) are established by the U.S. Food and Drug Administration (FDA). DVs suggest how much of a nutrient a serving of the supplement provides in the context of your total daily dietary needs. The FDA sets a daily value for pregnancy and nursing women that closely follows the RDA for that life stage. But, because RDAs are often too low, scanning the supplement’s label and seeing that 100% of the daily value for a nutrient is provided can give you false comfort, as it may be way less than what you actually need.
Why is meeting an RDA often insufficient for optimally nourishing a mama or mama-to-be?
There are six main reasons:
1. RDAs have been set using data primarily from adult men (dating all the way back to the Army in WWII), adjusted via estimation for age, sex, and pregnancy and nursing needs. Pregnant and lactating women were included in a mere 17% of the research which informed the RDAs for this life stage.
2. A historical exclusion of women from biomedical research has led to a vast underrepresentation of women in research to date. Research specifically investigating women’s health issues is far behind the curve as well.
3. “Good health,” in the case of defining the RDAs, is anchored on the minimum nutritional amounts necessary to avoid disease conditions, such as spina bifida (a birth defect arising from inadequate Vitamin B9 (Folate)), or the onset of clear symptoms of deficiency. These minimum nutritional amounts are in many cases much far lower than amounts that are fully supportive or optimal. (Think original war-time heritage.) For example, there is a big difference between the amount of Vitamin C needed to prevent scurvy and the amount needed for an optimally functioning immune system.
4. RDAs imply a perfect condition and do not take into account the increased need for certain nutritional elements to combat stress, environmental toxins, illness, lower nutrient status due to soil depletion, morning sickness, medications, or gut problems that cause malabsorption, all of which can heighten nutritional needs.
5. RDAs don’t always account for differences between nutrient forms and how those forms are absorbed and used by the body. For example, the mineral Magnesium can be found as Magnesium Glycinate or Magnesium Citrate, along with nearly a dozen other forms. The body is able to absorb and utilize Magnesium Glycinate better than many of the other magnesium forms (especially the most common form, Magnesium Citrate). The RDA, however, does not account for this difference in absorption between the two forms as it is written for “Magnesium” in general.
6. RDAs don’t account for the ways nutrients interact with one another, and nutrients in nature do not exist in isolation, either. For example, your body cannot properly absorb Vitamin D without Vitamin K2.
7. Not every nutrient needed for optimal support has an RDA. We have highlighted the Omega-3 Fatty Acids DHA and EPA. Despite mounting evidence over decades of scientific research, official intake guidance has yet to be set.Vitamin K is another example. There is an RDA for Vitamin K1, but not for the other very important form Vitamin K2.
What can we do about it?
A radical change is needed in how we approach pregnancy and women's health, and that includes how we design a prenatal vitamin. At Needed, we select nutrient forms and dosages to fully nourish both mother and baby. In doing so, we think it’s important also to consider:
- Nutrients available in food and consumed in a typical diet (i.e., what you are likely to get outside of a supplement)
- Relevant peer-reviewed, published scientific research
- The clinical practice of health practitioners who regularly test the nutrient levels of mothers and mothers-to-be.
- The physiological mechanisms of nutrient usage, meaning how a particular nutrient form is actually used and stored by the body.
We spent 3 years considering all of these factors and designing ours from the ground up, so that women and their families can thrive, not just survive.