Calcium and phosphorus are vital to the structure of bones and teeth. The last trimester is when skeletal growth is highest. The fetus draws calcium, like iron, directly from the mother's stores. Milk and milk products are the chief sources, but are not limited to those. Calcium is also found in dark, leafy green vegetables. Phosphorus is very widely available in most fresh meats, processed meats, snack foods, and carbonated drinks. Zinc is very important in the synthesis of DNA and RNA, protein synthesis and cell development. Zinc may increase fertility in men and women, while lack of zinc in the diet may lower fertility. Another side effect of zinc deficiency was shown in a study with 400 pregnant women. Low birth weight babies were born eight times more to the women with the lowest levels of zinc compared to the women with the highest levels of zinc.

I could go on for hours about the special roles vitamins and minerals play in our everyday functioning. It is amazing to think that something so small can be so vital to our health. In addition, many of the vitamins and minerals interact together and cannot perform their daily functions if we are deficient in even one. Yet, the question still remains: Are pregnant women in need of a multi-vitamin and mineral supplement? I learned the RDA, Recommended Dietary Allowances, are based on the best available evidence from metabolic balance studies and from indirect estimates to determine the amount of energy and selected nutrients needed. Body size, activity and health states all are factors in determining appropriate levels and if supplements are beneficial. The RDI, Reference Daily Intakes, sets the standard for vitamins and minerals used on food labels as part of the daily values. The right amount for supplements should be at 100-200 percent of the RDI. Supplements are generally recommended for those who suffer from lactose intolerance, vegetarians, smokers, and women having twins. As a nutritionist, I have to state that watching what you eat and living a healthy lifestyle are by far the most effective steps in preventing birth defects. I also suggest learning as much as you can about nutrition's role in pregnancy. The more you know, the better your food choices will be. In the end, after reading articles from the Journal of the American Medical Association, the Journal of the American Dietetic Association, and four other books on nutrition, I could not find any one article that said supplements are not recommended. However, they did stress supplements should never replace good eating habits. Supplements will never fix your nutrient deficiencies, only help you get back on your feet. By getting the proper nutrients, your body will have an easier time adjusting to the demands placed on it, and you will reduce the risk of your baby being born with birth defects.

Eating for two (or more!) is not about consuming as many calories as possible, it's about the vitamins and minerals found in those calories! My new theory is supplements are okay for pregnant women. In a perfect world everyone would have wonderful eating habits and would exercise four times a week, but I know how hard it is to get to the gym on some days. I have to be realistic -- it is difficult for people to change their habits. I still don't believe that one little pill will solve all our health problems, but I do believe it can be a viable step in helping us get the vitamins and minerals we need.