What is it about?
Although the only micronutrient to be officially recommended by governments to be taken as a preconception supplement is vitamin B9 as folic acid, there is a body of research suggesting that vitamins B2 and 6, C, D, E, biotin, iron, magnesium, zinc, selenium, iodine and copper may also be problematic. Over the counter sales of preconception supplements containing all these micronutrients are available. We looked at two groups of women: 1) 6 infertile women were matched with two non-pregnant fertile controls. All 18 women completed diet diaries and supplied fasting blood samples for estimation of zinc, copper, caeruloplasmin, selenium, manganese magnesium and cadmium. 2) The periconceptional dietary intake of folic acid and other nutritional supplements was estimated in 87 pregnant women attending midwife clinics, 36 women attending an assisted conception clinic and 7 women attending a self help group for lesbian pregnancy.
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Why is it important?
In the group of six infertile subjects and 12 fertile controls, there was a non-significant trend for micronutrient intake in the controls to be higher than for the infertile subjects. Comparisons with the UK reference nutrient intake confirmed suboptimal nutrition in all subjects and some controls. Twenty-five per cent of controls and 33% of infertile subjects had subnormal serum selenium consistent with reduced antioxidant defence. There was also a non-significant trend for non- caeruloplasmin copper and cadmium to be higher in the infertile subjects. The most statistically significant datum was the ratio of blood selenium to blood cadmium. This showed that infertile women had relatively high value for cadmium and low for selenium. In the larger group of 120 women making their first antenatal clinic visit, we estimated that there was suboptimal total intake for >50% of the subjects for selenium, zinc, magnesium and iodine and borderline total intake for >50% of subjects for vitamins B12, C and E, betacarotene, iron, folate + folic acid and essential fatty acids.
Perspectives
There is inadequate research on maternal micronutrient status at conception and fetal development. I attempted to take this research one step further to carry out a double blind trial to compare preconception folic acid alone with a balanced micronutrient formulation containing most of the key micronutrients mentioned above but could not get the funding and support. Others have had more success, albeit in small scale trials. One trial in particular showed a higher success rate with the micronutrient formulation when treating women with a history of fertility problems.
Dr John Anthony Alvan Nichols
Royal Society of Medicine
Read the Original
This page is a summary of: A survey to estimate total nutrient intake at conception — Dietary and supplementary, Journal of Nutritional & Environmental Medicine, January 2008, Taylor & Francis,
DOI: 10.1080/13590840801934355.
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