QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Picciano, M. F. Search for Related Content PubMed PubMed Citation Articles by Picciano, M. F.

---

Supplement: Dietary Supplement Use in Women: Current Status and Future Directions

Pregnancy and Lactation: Physiological Adjustments, Nutritional Requirements and the Role of Dietary Supplements

Office of Dietary Supplements, National Institutes of Health, Bethesda, MD 20892

²To whom correspondence should be addressed. E-mail: PiccianM{at}OD.NIH.GOV.

Nutritional needs are increased during pregnancy and lactation for support of fetal and infant growth and development along with alterations in maternal tissues and metabolism. Total nutrient needs are not necessarily the sum of those accumulated in maternal tissues, products of pregnancy and lactation and those attributable to the maintenance of nonreproducing women. Maternal metabolism is adjusted through the elaboration of hormones that serve as mediators, redirecting nutrients to highly specialized maternal tissues specific to reproduction (i.e., placenta and mammary gland). It is most unlikely that the heightened nutrient needs for successful reproduction can always be met from the maternal diet. Requirements for energy-yielding macronutrients increase modestly compared with several micronutrients that are unevenly distributed among foods. Altered nutrient utilization and mobilization of reserves often offset enhanced needs but sometimes nutrient deficiencies are precipitated by reproduction. There are only limited data from well-controlled intervention studies with dietary supplements and with few exceptions (iron during pregnancy and folate during the periconceptional period), the evidence is not strong that nutrient supplements confer measurable benefit. More research is needed and in future studies attention must be given to subject characteristics that may influence ability to meet maternal and infant demands (genetic and environmental), nutrient-nutrient interactions, sensitivity and selectivity of measured outcomes and proper use of proxy measures. Consideration of these factors in future studies of pregnancy and lactation are necessary to provide an understanding of the links among maternal diet; nutritional supplementation; and fetal, infant and maternal health.

KEY WORDS: • pregnancy • lactation • nutritional requirements • dietary supplements

This article has been cited by other articles:

				E. P. Gunderson Breastfeeding After Gestational Diabetes Pregnancy: Subsequent obesity and type 2 diabetes in women and their offspring Diabetes Care, July 1, 2007; 30(Supplement_2): S161 - S168. [Full Text] [PDF]

				H. F Saadi, A. Dawodu, B. O Afandi, R. Zayed, S. Benedict, and N. Nagelkerke Efficacy of daily and monthly high-dose calciferol in vitamin D-deficient nulliparous and lactating women Am. J. Clinical Nutrition, June 1, 2007; 85(6): 1565 - 1571. [Abstract] [Full Text] [PDF]

				P. C Papathakis, N. C Rollins, C. J Chantry, M. L Bennish, and K. H Brown Micronutrient status during lactation in HIV-infected and HIV-uninfected South African women during the first 6 mo after delivery Am. J. Clinical Nutrition, January 1, 2007; 85(1): 182 - 192. [Abstract] [Full Text] [PDF]

				A. Khambalia, M. E. Latulippe, C. Campos, C. Merlos, S. Villalpando, M. F. Picciano, and D. L. O'Connor Milk Folate Secretion Is Not Impaired during Iron Deficiency in Humans J. Nutr., October 1, 2006; 136(10): 2617 - 2624. [Abstract] [Full Text] [PDF]

				B. S. Muhlhausler, C. L. Adam, P. A. Findlay, J. A. Duffield, and I. C. McMillen Increased maternal nutrition alters development of the appetite-regulating network in the brain FASEB J, June 1, 2006; 20(8): 1257 - 1259. [Abstract] [Full Text] [PDF]

				T. Jiang, P. Christian, S. K. Khatry, L. Wu, and K. P. West Jr Micronutrient Deficiencies in Early Pregnancy Are Common, Concurrent, and Vary by Season among Rural Nepali Pregnant Women J. Nutr., May 1, 2005; 135(5): 1106 - 1112. [Abstract] [Full Text] [PDF]

				D. L. O'Connor, M. E. Latulippe, C. Campos, C. Merlos, S. Villalpando, and M. F. Picciano Folate Deficiency Does Not Alter the Usefulness of the Serum Transferrin Receptor Concentration as an Index for the Detection of Iron Deficiency in Mexican Women during Early Lactation J. Nutr., January 1, 2005; 135(1): 144 - 149. [Abstract] [Full Text] [PDF]