#096 Makings of the Perfect Prenatal with Ayla Barmmer, MS, RD

During pregnancy, getting the adequate amount of vitamins and minerals can be hard to achieve especially in the first trimester!

In this week's episode, Ayla Barmmer schools us on the importance of building the right nutrition during preconception and postpartum recovery.

In this episode you'll learn:

* How valuable Folate and Vitamin B12 during pregnancy

* Difference between active and synthetic vitamins

* Prevention of neural tube defect on babies

* The impact of Choline and Magnesium during pregnancy

* Cautions on taking Iron and so much more

To get Full Circle Prenatal + 15% off use code "lessstressed" with our affiliate link: https://fullcircleprenatal.com/?rfsn=3717990.487058&utm_source=refersion&utm_medium=affiliate&utm_campaign=3717990.487058

Ayla Barmmer is a Registered Dietitian Nutritionist, functional medicine practitioner, and the owner of Boston Functional Nutrition, an integrative and functional nutrition practice. Ayla’s primary specialty is women’s health with a special emphasis on hormone balance, infertility, and digestive wellness. Ayla is credentialed nationally as a registered dietitian nutritionist and as a licensed dietitian nutritionist in Massachusetts.

Ayla also has advanced training in integrative and functional medicine, women’s health & herbalism and other holistic therapies. The combination of conventional & holistic training allows her to draw from the best of both worlds when working with her clients. She is the co-founder of the Women’s Health Nutrition Academy, a virtual academy that delivers cutting edge continuing education in women’s health to health professionals. Ayla is also the creator and founder of the prenatal multivitamin supplement Full Circle Prenatal.

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Transcript

spk_0:   0:00
the soon as you are thinking that kids may be a possibility for you get on a prenatal, you know, through pregnancy and then definitely, definitely postpartum, regardless of whether or not you're breastfeeding. Actually, I'm in my opinion, because postpartum recovery is so nutrient intensive of the support of a stuff, a little prenatal can be really valuable.

spk_1:   0:20
Welcome to the less stressed life podcast, where our only priority is providing those aha moments toe up level your life, health and happiness. Your host, Integrative Dietitian nutritionist Krista Bigler helps health conscious women reduce the stress and confusion around food, fatigue, digestive and skin issues at less stress nutrition dot com Now onto the show. Hey, hey, hey. This week I have some good news and some bad news, but to tee that up, I want to tell you about our current theme I saw this week in my nutrition practice, and that was people kind of beating themselves up for not being where they think that they should be or not getting all the things done that they think they should be doing. And they were shooting all over themselves. And so, actually, the bad news is that last week, I announced that the women's health minute, Alexa Flash Breaking was life. And this week, after some consideration, I've decided to put it on pause temporarily because I was also shooting all over myself. I thought I should have had that published a long time ago and that in general it would go along really well with all the woman's health podcasts over the next couple of months. But guess what? Sometimes it's just too much, and sometimes we're just especially actually, just everyone We always think we can do way more than we do. Have you ever made yourself a to do list? And then you get through, like 1/5 of that to do list? Not if that's you. Yes, anyway, I have done that, too, and it takes a long time to kind of balance are what can we realistically accomplish anyway? The point is, is that it's not essential for me to get that out to you at the moment. There's a lot of other really cool stuff going on, and I want to make sure that I'm not letting balls drop in other places, So that's the bad news. But the good news is that this is the 100th episode of the less Stress Life podcast. Thank you so much for being here. We have been alive since 2017 and I don't have anything huge for the 100th episode, although it's a great episode, although the next couple of weeks there's going to be some giveaways. Next week we're going over omega threes and we have some of Omega three testing and to give away. So if you want to stick around for that, that's awesome. But I would just feel so honored were really close to 100 reviews on the podcast Word 96 as of this recording, and I would just be honored if we get to 100 reviews for 100 episodes. So if you would join me in that request, you can scroll down. You kinda have to go back and search for the podcast name, and then usually you can find the reviews have to scroll down to the bottom. Typically to do that. So that's that. And the other thing is, please just share the podcast because this is corn of my just favorite thing. To do during the week is to share knowledge with you, So I love to hear from you. You can always drop me a note or ask a question which I would love to address in either in a episode or in another way over. At less stressed life dot com, there's a little speak. Pipe would sit in the corner. You can click on that and leave a message. That's it. I just appreciate you guys so much. I appreciate you sharing and leaving a review and just being here. You are awesome. Now onto the show. Okay today on the less stress like we have a return guest. Caleb Armor. She is a registered dietitian, nutritionist, functional medicine practitioner and is the owner of Boston Functional Nutrition in integrative and Functional Nutrition Practice. Her specialty is women's health and a special emphasis on hormone balance, infertility and digestive illness. She is really well known for this area in Boston and beyond. She has advanced training and integrated and functional medicine, women's health and herbal ism and other holistic therapies. She's the co founder of the Woman's Health Nutrition Academy, which is a virtual academy that delivers cutting edge continuing ed for women's health. Professional soap like dieticians and M. D. S and P s et cetera. So she's also the creator and founder of a prenatal multivitamin supplement, which will be talking about later. But she's here to school us on the good, the bad, the all the things prenatal, because it's a pretty wild West world out there, and she's gonna tell us what's really needed, what's important, what the right forms are. We're excited to have her educate us. Welcome, Ayla. Thanks for having me back, Chris said. Yes, so we'll just jump right into it. I should have known. I'm gonna find the past episode for them and all prompts the audience here in a little bit. But let's get into prenatal Sze So prenatal zehr often used by people not on Lee during pregnancy but also postpartum wall breastfeeding or while recovering. And then sometimes people are just taking on because of the benefits of hair skin, a nail. So let's talk about what is in a prenatal. Why do people take them in so many, like as a multi vitamin? Essentially, Yeah, so you mentioned

spk_0:   5:03
it being kind of the wild, Wild West, and it really is when it comes to supplements in general, but prenatal multi vitamins. Many might not realize that there isn't a specific regulation or specific nutrients that have to be in a prenatal multivitamin for it to be called that. So there's nothing out there that says you can. You know manufacturers can't call their products a prenatal multi vitamin. There's other specific labeling requirements and actually of, ah, just kind of sidebar. Note. Though there's some specific changes that the FDA has made for labeling come 2020 that manufacturers have to be compliant with, and so people will see some changes on labels in general. But prenatal multi vitamins Generally, you see things like folic acid full eight highlighted. Many contain iron. Mine doesn't and we could talk about why that is, and whether I think that's important at some point, you know, so you'll see that you'll see calcium highlighted typically, so it really depends. It runs the gamut, but there's, I would say, a lot of women like to take prenatal multi vitamins because they do notice, you know, a pretty significant difference, as you mentioned. Like in their hair, skin and nails. They tend to be more potent, you know, oftentimes not not always, which I definitely want to talk about and then regular multi vitamins. Or they should be, as nutrient needs are higher in pregnancy. Yeah, in really, really important for women to be taking it preconception prior to pregnancy. And I would say I mean, that starts a soon as you are thinking that kids may be a possibility for you get on a prenatal, you know, through pregnancy and then definitely, definitely postpartum, regardless of whether or not you're breastfeeding. Actually, in my opinion, because postpartum recovery is so nutrient intensive of the support of a stuff, a little prenatal can be really valuable.

spk_1:   6:53
So I want to get into some of the depth of some of the nutrients that you just mentioned full, like acid iron calcium. At first, why does a prenatal boost hair, skin and nails aside from like a multi vitamin is a higher and x y Z nutrients that do that? Yeah. I mean, really, across

spk_0:   7:09
the board. I mean, you're going to see things that help with, like, the synthesis of, you know, hair, skin and nails. You know, collagen production, like vitamin C. You know, iron is typically included. Ah, again, mind does not have that. Sometimes that helps. Sometimes that hurts. Your B vitamins are absolutely helpful for those things for the hair, skin and nails. So for all those reasons, they're going to see improvements in those areas. I mean, clearly, there was definitely, you know, I know a lot of the women that I work with that start on a good quality pre natal in my practice Will, you know, say they've got more energy to They may sleep better. We know that a lot of the B vitamins that are often found in most multi vitamins and prenatal sze will help with regulation of a lot of bodily processes, right, like they're just needed physiologically for so many things in the body. And it's very easy to become depleted in those as well as magnesium, which you should see in a prenatal, too.

spk_1:   8:04
Okay, so you talked about as soon as you're thinking about becoming pregnant, so I think that's a good lead into full of acid or fully. First of all, let's talk about why that is so necessary in Prenatal Tze and why it was fortified in our food industry what it's preventing and why it needs to be much earlier than when you're actually conceding. Yeah, I'd love to talk

spk_0:   8:27
about that. And what goes hand in hand with fully discussion is also be 12 and coleene so. But with full late, What we're seeing is there's

spk_1:   8:35
really just to kind

spk_0:   8:36
of give an overview. Here. There are the active forms of full late and also be 12. And then there's Thean act of synthetic form. So I think that's important for listeners to know. And they may have heard that before. So active forms versus synthetic forms. So when partition er's say that that what they mean is, does your body have to convert it to be usable or not? If it's synthetic, it needs conversion. If it's active, it generally doesn't and minimal requirements on your body's part to utilize it. So active forms of pole lates and B 12 are gonna be highly bio available or, like really usable by our body. When we take them again. Synthetic are going to require conversion, and that conversion really depends on genetics, your lifestyle, including stress, whether or not you know you're deficient and other nutrients in a lot of other things, too, so it's really wise to look for the active forms of vitamin B 12 and full eight versus the synthetic active forms of be troubling. I'm talking about these two together fully and B 12 as you know, because they are kind of partners in a lot of ways and really important, and we can talk about why they're important. But getting back to the forms Active forms of B 12 include meth. Oh, Kamala Hman a Dennis Ilka Ballymun hydroxy cabal Ammen Those were like the three kind of good quality ones There synthetic would be just come element the active forms of full weight which, by the way, full weight is what we find naturally in food. Right full ic acid. When every sea full like acid, that is, the synthetic form so full of acid is not found naturally in food that's synthetic. That's only supplemental. Active forms are metal tetra hydra fully that the mouthful is somehow just just called methyl full late Olynyk acid is another reduced, slightly more active form men again, the synthetic is full of acid. But what's really important about taking full late B 12 and a minute? Also lumping Colin here, which we should talk about. More specifically, preconception is it's the very early weeks of embryo development. Like before you even can get a positive pregnancy test and when you just perhaps, could get a positive pregnancy test of those very early weeks that you're needing those nutrients specifically, it has to do with methylation, a process in the body which I bet you've done. Some podcasts touched on this and other episodes before acid with methylation, which goes into overdrive as an embryo is developing, and we need those nutrients and high in plentiful amounts. And so it's so important to work to build up your stores prior to pregnancy and have that those extra nutrients available in those early weeks one of the major things. And this is a huge development for nutrition wise and preventing narrow tube day fax. You know, in babies. Introducing folic acid into the food supply definitely happens. A while ago, they started for to find the food supply, and we saw a huge reduction in neural tube defects so fully it's pretty critical for that.

spk_1:   11:41
Let's talk more about neural tube defects. If I can interrupt you like what does that mean because I think we're used to thinking of it as spina bifida. But it's actually much more than that, right? Yeah. So I mean, neural tube

spk_0:   11:51
defects can have ah, huge effect on a pregnancy. And obviously the health of the baby in minute effects the brain, the spine, the spinal cord, we do think of it is like affecting the spine spinal cord. But there's brain implications as well. I mean, it can affect whether or not the pregnancy will be taken thio term, you know, our be viable, and it's quite preventable with proper full eight, you know, taking supplementary. But again, the neural tube actually closes around Week five. You know, a pregnancy. So that's super early. So that's why taking full weight preconception is so important, you know, and I really wouldn't rely on

spk_1:   12:28
what we've done to

spk_0:   12:29
the food supply right to get to meet those needs, because what we've done is fortified, you know, more process grain products with synthetic bullock asset. And we know now that while that helps and has helped reduce the rate of neural tube defects, there's a large percentage of the population that has difficult to eat from a genetic level in for a host of other reasons. Converting that synthetic bullock acid So it's wise to Tate active full late prior to pregnancy in early on, So

spk_1:   12:58
do neural tube defects also affect predisposition to autoimmune conditions? That's a good question. I have

spk_0:   13:04
not gotten into that research. Have you seen anything to that effect

spk_1:   13:07
without ad. But I'm gonna go back up a step more because I know you're in this all the time, so I'm gonna give a widespread view really quickly. So we're talking about in the prenatal. It's really important. Have active forms a full eight b 12 the synthetic forms that you usually see you might be aware of, because if you've ever known anyone that had a B 12 shot, that's just Kabbalah. Hman and some people, actually genetically cannot convert that into an active form of you 12 either. And those people won't feel a difference from a B 12 shot Other people. It's a life changing and probably a less sees this a lot, too. I see a lot of B 12 issues with people because it has to do with digestive processes which become impaired and a lot of people say I see a lot of low B 12 which is related energy. So she talked about how metal a dentist, eel and hydroxy cabal lemon are the active form so your body doesn't have to convert into doesn't have to do a bunch of work to do right. And so that's kind of our thought processes that we don't want our body to do a bunch of work and especially this is useful in full, like acid to fully conversion. So I understand that we use synthetic nutrients because they're cheap and easy to manufacture in a lab. But, I mean, it's almost like we just invented it. We just invented folic acid, right, because it's a synthetic, whereas full ladies, what's found in nature and fully does what you need. Well, what Ayla was alluding to earlier is some people have shouldn't use this word. But a lot of people are familiar with this word. Mth fr. We're not gonna go into a long spiel about that. Some people think it's like this disaster, but it's affects a large percentage of the population that simply means that those people don't efficiently convert full of acid, a fully, so you have to consume a lot more. So you're just not getting good conversions. You might not be getting adequate nutrients. Is that a pretty acceptable thing to say there? Yeah, I think that

spk_0:   14:37
sums it up pretty well. I would just add that, I think because of the buzz around mth afar in some of the misinformation on it. And I'm not sure I would encourage people to really google it at this point because it is like a rabbit hole of the Internet. Now it's actually very complex, and there's a lot more that goes into methylation, then just them th a fart, as you alluded to. But one thing that I do want to point out is that what I think has happened is people are being diagnosed or told, you know, that they have Mt. Jafar mutation not being told to what degree, right? And just told to go take metal full later. Methyl Kamala men and I disagree. Yeah,

spk_1:   15:16
I disagree with that

spk_0:   15:16
approach of me, and I think we're on the same page of this because what can happen in those listening might have experienced this, um, and wondered why is you get a lot of symptoms by just loading up on the metal groups, so to speak, those metal forms. The main symptom that I see in practice is a lot of anxiety and just not tolerating that supplement. While so I mean in my prenatal, I do a combination of active forms and don't overload the methyl groups of that, you know, with tolerance and minds

spk_1:   15:47
and actually want to mention a couple other things, because I think this is a little confusing. While full, like acid is what we see in cereal and probably the reason my first child didn't have neural tube defects because it was quite young on. I'm pretty sure I lived on cereal for a little while in the beginning stages of that pregnancy. Folic acid is the synthetic form, but Olynyk acid is an active form. I think that's a little confusing that they look really similar now. Last week you mentioned to me that that is what the FDA there's some like label changes coming with Phil N ic acid. So now might be a good time to mention that. Yeah, I don't know how much is

spk_0:   16:19
out there yet, but I'm kind of. Obviously, as now I can't believe I'm a supple of manufacturer. That's not something I ever thought I was going to get into. Mabrouk.

spk_1:   16:26
You talk about that, too, But I have now

spk_0:   16:28
and in behind the scenes for Olynyk ass it is. It's becoming more and more difficult to get our hands on. It probably has to do with FDA regulation of it not, but it's unsafe. It's more that I believe that it might be treated. It might become more of like a prescription type of things. There might be like some drug industry influence here trying to grab that because they see the demand. So that's what I think is probably happening, but a

spk_1:   16:51
limited anticipated on supplements as much, right? Yeah,

spk_0:   16:54
well, it's gonna become very difficult for supplement manufacturers, probably to tip procure into include, And that's okay. There's other things to consider. My prenatal does have politic acid in there. Now, um, it's also listed as calcium full innate, so you'll see it listed that that's the same thing as full on that, CASS said.

spk_1:   17:13
That does get complain. I did not know that. So I want to mention one other thing because as you actually said, This is a problem we sometimes see in our industry is that people are getting this hem to each of our diagnosis, whatever. And then they're told to go on these super doses. And I just wanted to mention that sometimes I even see this in supplements. He's super doses of fully. And I mean, as far as I'm aware and people I really trust, his experts are aware and other research I've looked at there's really never need to go above, like 40 100 micrograms of holy and some things you see way higher than that. Do we want to comment on that? Briefly. So, you know, in pregnancy, I think

spk_0:   17:48
around the 800 microgram mark is appropriate for full lates. Ah, inform ethical late. And so that's something that I would recommend somewhere around there.

spk_1:   17:57
But you know, a lot of this needs to just

spk_0:   17:59
be put into context, right? S So this is why I love a really well designed multi vitamin and making sure that you're on one because it's in contact with other complementary nutrients. You know, no nutrient is metabolized by the body, like in isolation. Like there you see you look at these processes of how our body uses nutrients and it actually requires other nutrients, you know, to do it. And so context is really important. The ratio and relationship of nutrients to each other is important.

spk_1:   18:29
Thank you for saying that I am on team high quality, multi vitamin as well, Not certainly one cap today, which will get to because it's pretty impossible to actually owe. Someone asked me that the letters just like, Well, why is this 1 70 castle like? Ah, Because go look at the compare it to the old bottle. You have to go and look at the dose differences. But I was at this recent conference and I was in the food line with someone who was talking about Joe seen individual nutrients and how they got away from Maltese. And I thought I was like, Oh, I gotta step away because there are too many sin biotic relationships or complimentary relationships with Nunes that I mean, if you're not monitoring someone, then you can throw something out of range absolutely in one more thing here. So it's important to do these nutrients in advance, so we're going to get fully in our diet from darkly leafy green vegetables and B 12 comes from animal products and being able to digest those and assimilate those anything you want to add to that,

spk_0:   19:20
Yeah, I would say, you know, full light to You're also going to see that like in something like Liver and again

spk_1:   19:27
Just getting yeah, eso

spk_0:   19:29
livers with fantastic multi vitamin majors multiply.

spk_1:   19:32
Although I never want Thio portrayed my own beliefs about something, and I need to just get in, deliver a little bit more. I mean, people have ideas about how they grind it up and then hide it in different, like hamburgers and things like that. And I think that's wonderful, because all I remember as a child was my mom sent me out to the freezer to get some beef to thaw for supper, and I accidentally picked up liver because that maybe I couldn't read at that time. I don't remember. And she was like, Well, this is I thought, this is what were you Just remember it not forget that I love how those air like our flashback memories of it. Oh, yeah, I think, actually, a lot of people who have good memories of liver and that sort of

spk_0:   20:08
cloud. You know, that sort of, ah, colors, our ability. They eat it now, you know. But there are we could Lily Nichols is guts some great strategy for eating liver. And she's got her book begins in sight for that. Yeah, I had a

spk_1:   20:20
client one time who said I love liver and I was like, Oh, well, you're golden, You are perfect Just going out all the liver. No, Uh, let's go talk about Colin. Great segment and holding, which is also found in the liver about coleene and how why people don't really even know what it is because it's kind of the nuclear on the block that was always there, but it's kind of not really classified as a vitamin or mineral, but it's in the B vitamin classic. Yeah, I

spk_0:   20:45
don't know why Colleen doesn't get the attention that it should. I think it's starting to, but it's really profound the number of pregnant women who do not consume as much as they need you, and yet the impact that it has on baby. So it's about 90 to 95% of pregnant women who aren't consuming as much Colin as they should, and that levels actually defined at around the 450 milligram a day mark, which is we're finding by new research that it's our needs are actually much higher during pregnancy. That might be more like 930 milligrams. So it's

spk_1:   21:18
safe to say

spk_0:   21:19
that almost all women are not actually consuming enough coleene during pregnancy and that the problem Colleen's critical. It's required for baby's brain development. It's required for the health and the function of the placenta, which is that really amazing organ women actually develop. They develop a new organ, you know, just for pregnancy is pretty cool, but the placenta nervous is baby throughout a pregnancy, and it's needed for the function of that. It also helps to prevent neural tube defects. If you have an empty each of our mutation back to that, you know it's especially important. So if we talk about food sources mentioned liver, not a lot of people are consuming a whole lot of liver. I think there's around 113 115 somewhere around there, milligrams of coleene per ounce. There's 115 milligrams a clean per egg, typically an egg with the yolk so

spk_1:   22:09
you can kind of see

spk_0:   22:10
it's really hard to get without. Some supplement up to your Coley needs daily like that 930 milligrams Colleen is actually, I should mention to. It's interesting because our body consent the size it, but it can't synthesize enough of it during pregnancy. So that's key to remember, too. And the last thing to know, I think, really about Coleene. One of the most important things is that, and this is something that I learned in the process of making a prenatal supplements is Colin is big. It's like a really big nutrient, and so it is super hard to fit it into capsules. And what winds up happening is manufacturers just don't include it because it does wind up driving up the number of castles you have to take. So I mean, if your prenatal is a one a day, I mean, I was a huge red flag to me. There's no way that it's got enough of some of these bigger nutrients that are exceptionally critical, like there's others that we could do. We could do without, but they're missing. It would be missing that

spk_1:   23:09
about Coleene. You're basically saying that it's thought that we may need up to over 900 milligrams per day and you're getting in the 100 something, Mark, when you're getting one egg or I didn't catch him. It was like 1 50 with how much liver? So it's around 100 15

spk_0:   23:25
milligrams per egg with a joke, and it's similar to that in about an ounce of liver. So you know it doesn't take a lot of liver if you're getting a few ounces of that a week, that could really help supplement, but it's still not going to get you. I think it's really hard just with diet alone during pregnancy to get enough coleene. That's one that really, really do need some additional supplementation, wits and because of how critical it is to get then right, and for anyone who's been through a pregnancy before, right, like there's periods of that of pregnancy, you know, first trimester, where you're not, I mean, eggs. You might have an aversion eggs or you're just not maybe consuming the most balanced diet, right? So those were supplements can help, too.

spk_1:   24:07
Sure, I remember craving the crap out of eggs and my first pregnancy like it was an asparagus omelet daily thing, but nothing. I just throw this in for comedy. It's not really about funny anyway. With cold mean I like it for a lot of other reasons, and we're not talking about those reasons. But I think as a mom, these can be important to you, like it's nice to hear about, Okay, Baby's bringing development. Of course, I want my babies trying to develop well, but I think about it for, like, skin and brain liver development. And I mean, I look at it as an allergy standpoint because Colin helps clear histamines and allergy type neuro transmitters and then also it's huge for skin integrity. So, for example, like I don't make coleene very efficiently genetically, and there's times where I think it is affecting like dryness, of skin, whatever. And so it's something I kind of like use. It's pretty awesome, And I had someone message me the other day about and ask the multiple sclerosis and the importance of cooling. And actually my mom called me the other day, and she's like the person who just reads things and supplements. And so she was talking about my dad having trouble swallowing. She's like, I think it's cold and I was like, Sherman Okay, so anyway, it was kind of funny, Um, because we got into a cooling discussion and so on that topic. A lot of times people talk about Foster title Colleen or calling by Tar Trait. What do you use in your supplement? Yeah, so in mine, I

spk_0:   25:22
use coleene by tar trade. It's highly absorbable you and easy to utilize. Some of that has to do with again, just trying to. It's a great quality going, and it's also something that can reasonably fit and sheer or prenatal off fast little coleene. Very difficult to get the level of coleene that you need up and to fit it. So that's kind of ah issue there.

spk_1:   25:45
Yeah, definitely. Okay, So do we cover? Do we think all the barriers that women have to getting these nutrients needed in a prenatal? We talked about the size of them and we can talk more about that here. And some, like we talked about liver and eggs being a primary sources of calling, there are some vegetable sources. I believe as well I think, um that's like what I've seen. But they're much smaller doses, right?

spk_0:   26:05
Yeah, it's such small doses. I mean, you'll see it in peanuts, peanut butter and you know, in some different vegetables that they're kind of negligible amounts. I mean, it would be hard Thio on a daily basis. Peace enough together to get up to that level. But I do recommend for all pregnant women all women trying to conceive, You know that you do try to get in a couple of eggs. At least today you are trying to get in as many of those Colin Rich sources of can. How about

spk_1:   26:30
vitamin D? I have that on my list s when you talk about the amount of vitamin D important pregnancy, that's also I think, is that one also kind of big sometimes or not really. So it's actually

spk_0:   26:41
not, but it's for some reason. Evidence based amounts of it are not being included, you know, in a lot of pretty needles. So it's all over the map in terms of what you see for vitamin D levels in prenatal, Sze and I can't really understand why, because we actually unlike a lot of new dreams we actually have a double blind randomized clinical control trial on vitamin D and pregnancy. I mean, that's like gold standard, you know, you know, on what we should be supplemented with. And actually, that study showed that 4000 I use the day, which you know is going to sound like a lot to some people. Listening for pregnant women was safe, but also the most effective in achieving sufficiency and women and their babies, regardless of race. And even it was even looking at. There's research, even looking at that level, even in son your climate's so it kind of doesn't matter where you are. Geographically, your race that 4000 I use a day is shown to be safe and actually really, really the level where it helps keep both you and babies levels sufficient. Some people need more than that, and the reason why you really wants vitamin D levels to be sufficient and baby, especially when babies born, is that babies born with low stores of vitamin D can actually have problems with bone gross and a lot of other issues to recommend. A lot of pediatricians are recommending supplementing baby separately with vitamin D, which is a whole nother kind of topic. But, you know, getting baby off to a good start with adequate vitamin D levels. Not to mention all the ways in which vitamin D contributes to fetal development during pregnancy. That's gonna help a lot. So I'm a big proponent of getting in around the 4000. Are you Mark through pregnancy?

spk_1:   28:24
We were talking earlier about baby's brain development, and when we think of that, we often think of D. A. J or one of the kind of the animal essentially based omega threes. Talk to us about D. H. A. In the pros and cons of including it in a prenatal. Yeah, so D. H. A

spk_0:   28:39
gets really highlighted as important, and it is specifically important. It's one of the essential fatty acids, but e p. A is another essential fatty acid. L. A is another unis, and these were things that we also need. And you know, D. J is something that I really believe should be consumed in contact. So what happens is when you take a supplement with just e h a in it, I mean, you don't find just th ey in food. It's always gonna be combined with other essential fatty acids like E P I. So if we think about food, source is the most potent. One that comes to mind is, you know, fish, fish, oil. And so you're going to see D. J B in there with the P, and they're kind of there in balance with each other. That is how our body really likes to kind of consume essential fatty acids. So do you chase important? But I'm not a fan of just isolating it and throwing it in a prenatal, I think, for one, their stability issues. So I really question how stable D. H ey can be without oxidizing went in a prenatal all on its own or even just in the supplement, all of its own. So I really believe that it should be separate. We also don't know how d A J interacts with other vitamins and minerals when thrown in a capsule, right? So for those reasons and because we don't have enough evidence on that, I really feel like it's wiser to take D h. A. In the context of a fish oil supplements separately.

spk_1:   30:02
Yeah, that makes sense, especially when there's so much else needed in a prenatal. And actually, we're gonna have someone on talking about the importance of prenatal D J and its role in full term pregnancies. Um, because it's probably one of the easiest things we could do to bring pregnancies to term. And it's a something that continues to decline is gestational period. I know people don't want to have that bun in the oven forever, but it's like the longer it is in there to term, the better off everyone is. And so I'm a researcher that does specifically in that that you may want to connect with a small Leela. So yeah, well, my 12 week olds, I went to 42 weeks, so I don't know what she was. She was

spk_0:   30:40
never going awhile.

spk_1:   30:41
Yeah, I don't really know the feeling. Okay, so let's talk a little bit about minerals and also glazing you talked earlier about calcium mean sometimes important. You see it? Sometimes you don't. We also talked about iron. Let's talk about minerals that step back and talk about minerals in general and how their best absorbed because this is really a problem. Like people are constantly taking supplements and they're not really absorbing things because they're not getting the best forms of things

spk_0:   31:06
in on the time.

spk_1:   31:07
And that's a huge issue with mineral absorption as well. So let's talk about the minerals in prenatal sze iron, calcium and types. Yes, so when it comes time

spk_0:   31:15
minerals, it is something that we need and higher amounts during primacy pretty much across the board. We need more nutrients during pregnancy, right and magnesium is one of them. But if we think about the forms of minerals really matter, listeners may or may not have heard this term before. Hugh waited minerals there among mineral supplements that are really better absorbed, similar to how we were talking about active forms of B vitamins and full wakey, elated minerals are easier for our body to utilize, So key elation is basically that what that mineral is bound to. So, in my prenatal, I, for the most part chose to use. I used Q later minerals. I chose to buy into glassine so you'll see things like magnesium glass in eight. So that's accumulated form of magnesium easier to absorb. But it also provides a little more glazing, which is a conditionally essential amino acid during pregnancy, so you don't need more of it generally outside of pregnancy. But during pregnancy, we are needs increased. So that's why. And we can't make everything that we need or get everything we need just from diet. So we've got to get extra. So magnesium is a good mineral to highlight, you know, because magnesium deficiency is super super common. It's somewhere around like half of Americans, and it's also something that can prevent a ton of really scary pregnancy. Complications, at least contribute. A magnesium deficiency has been shown to increase the risk of preeclampsia and other vascular conditions. And then also, I think of, you know, and I see in practice, magnesium plays a pretty significant role in blood sugar management. So we see a relationship between a magnesium deficiency and developing just Daschle. Diabetes, too, so really important to get in enough magnesium. This is another one like Coleene. That's big eso. It's hard to fit. It's really hard to fit in a multi vitamin, so it will drive. If you got appropriate amounts in there, it's going to drive up the number of capsules,

spk_1:   33:12
and what do you think is appropriate in pregnancy and By the way, do you hear pregnant women talk about Charley horses kind

spk_0:   33:17
of later on a movie? Yeah. Yeah. That's another thing that magnesium could help with. I know. For me, it helped the ton. Um, but yeah, Charlie Horse's leg cramps. Those kind of like like just that kind of feeling in your legs like that. You know, messes with your sleep that happens at night a lot. And you definitely don't need more things messing with your sleeve during pregnancy. But magnesium and actually magnesium Glasson eight specifically can actually really help with sleep during or outside of pregnancy. But I think around the 300 milligram mark, Supplemental Lee is a really good idea. It's so safe, you know, magnesium is a pretty safe, safe mineral to be supplementing with, and it's pretty hard to overdo it. You know, with it because of how few people are getting enough. Anyway, I'm in their diet, so I like to see women supplement with at least 300 milligrams. You know, during pregnancy, some will need more.

spk_1:   34:08
Okay, so I used to pay more attention to the calcium discussion in pregnancy and postpartum because I didn't have a cavity until after my second child. And for a while the national recommendations were like, Yep, pregnancy could be related to that. And then they were like, Nope, not related. And I'm like, I think they are So, anyway, not that my opinion matters. But what do you see for calcium ranges in Prenatal zone? What do you think is appropriate? Yeah, you know, I think around the 400

spk_0:   34:34
milligram mark is appropriate and consistent with the evidence for supplementing prenatal wise. Most people are getting enough calcium in their diet. Most people, however, you know there's special dietary restrictions, and you're seeing things like dairy, a major source of calcium being restricted and a lot of people's diets for a variety of reason. So if someone's very free, I mean that will increase their needs will make it more difficult for them to be getting in calcium. Otherwise, most people are getting enough from dietary sources, believe it or not, I mean, that's one that I can say, but I'd like to see it in a nice like, balanced evidence based amount in a prenatal so around again the 400 milligram mark and because it is important for preventing pregnancy complications. It's similar to magnesium, helps with vascular health and has been shown to help prevent a clam. CIA. It's needed an increasing amounts of the pregnancy goes on. So a little bit more and third trimester and so getting in a bit supplemental Lee is good, but you don't have to go overboard. And actually, I wouldn't recommend going overboard with calcium supplementation. It's iffy. You can really. It's one similar to iron, which we haven't touched on it really important not to overdo it with calcium supplementation, cause you could do more harm than good there, Right? It'll throw

spk_1:   35:48
things out of balance. That boat, Yeah, and whatnot. So let's talk

spk_0:   35:50
about iron now. Yes, so Iron is a big, complicated subject. And there's actually what I have found is that there is not one set of diagnostic criteria, actually, that a lot of practitioners air using thio, identify iron deficiency, especially our inefficiency during pregnancy, and that this could be like maybe I'm gonna be doing a webinar one of those weapons for health professionals that iron. At some point, it might be like a good par cast topic on itself because it's kind of a beast. But iron is tricky because supplemental Lee, you really don't want to take it unless you need it. Supplemental Lee. It is always best to get iron from food. It's just it causes a lot of probably more than any other nutrients. It's the most likely one to cause tolerance issues, you know, like stomach upset and just feeling kind of gross. It's also very difficult to absorb, difficult to absorb from food, you know, never mind just from supplements. So it's one that I really like to see in the context of food and then if needed. And there are a lot of cases and a lot of pregnancies where extra iron is needed. It really needs to be dosed very individually and based on degree of deficiency. So I didn't include it in my prenatal because I don't think there's not one amount that we can say is safe and effective. And a good idea for all pregnant women to take based on my look at the evidence is what you're gonna find is it's not gonna be enough for a lot of women, and then it's gonna be too much for others, and it prevents from taking their pre natal is because you just feel like crab.

spk_1:   37:26
You know, when you do you think I'm just gonna say that like it's probably the best to avoid just for that reason, Um And actually, that's a great Segway into this question. What about the women who just feel like they need a prenatal gummy because they're so sick in the first trimester? Like, what advice do

spk_0:   37:40
you have to those people? Yeah, I hear that a lot for sure. So, I mean, first of all, that is why I think it's so important to take a high quality pre natal prior to pregnancy for as long as possible so that you're building up your nutrients stores to help you through that awful first trimester when things are a food not as appealing, and it's really difficult to get supplements down. By the way, you know if you go into pregnancy with good nutrients status, especially things like magnesium and Samir B vitamins, it'll actually help prevent air at least decrease. How nauseous and sick and grocery feel? Generally, some of that's just horrible related. You can't get around it, but it does help, so you know what you want to do is kind of limit the amount of time that you are taking, kind of Ah, lower quality. Something like a gummy. I mean, I think it can help Sort of fill in the gaps that got me. You will never have what you're really needing throughout her pregnancy, and so you can get away with it Absolutely. For periods when you just cannot tolerate taking capsules. That the idea? The best plan is to stock up, load up your stores prior to pregnancy and then return back as soon as you can. I know, you know, with a lot of my clients and this is something you have to decide on yourself, you know, practice your prize. But with my prenatal, I sometimes just have them open up capsules and put into a smoothie. And that's fine too, right? Yep. I

spk_1:   39:02
was thinking that same thing. So we covered a ton of stuff in a ton of nitty gritty and atone a specifics, but we didn't cover. We talked about a lot of what should be in a pre natal. We didn't cover what should not be in a prenatal. What are we trying to avoid in prenatal is and this is actually a problem in the supplement industry and people don't necessarily look, we don't actually realize how much of an issue this is. Yes, so huge. It is

spk_0:   39:24
now that I have manufactured a settlement. I mean, I can tell you, and the first partner I had in manufacturing the supplement in this product never made it to the market was terrible. And I know that they manufactured a lot of supplements. So I just and got a real sense behind the scenes of what Goa gone out there. And it's a little scary. We know that one thing that has been shown through independent testing and research that can be prevalent and supplements. And there was a big Canadian study looking at prenatal supplements. Specifically, is heavy metals in heavy metals or something you absolutely do not want to be consuming excessively during pregnancy, right? We need to keep that minimal. A lot of women are familiar with, you know, Mercury's. I couldn't touch on that and think, there's so much being said about, Well, don't eat too much fish, don't eat certain types of fish, you know, when really we should be looking at quality of prenatal supplements, too, because that can be a real source of heavy metals, including mercury. Many of these things passed through the placenta right to baby. So the harm you they harm baby developmental problems, a lot of things that could arise from them. So yeah, yeah, so it's a problem. And so the biggest way to avoid that is to make sure that there's a couple of things. I mean, first of all, you want to make sure that your supplement has had a thorough testing done on it, and there should be total transparency about that. You know, I believe not only testing done by the facility, but third party testing to someone who's a knot. Someone sent you an unmet lab and tested as well, and you should be able to get those results, you know. So that's one thing. The actual supplement manufacturers really should be a GMP, a good manufacturing practices certified facility on FDA certified facility. The manufacturer that I work with is,

spk_1:   41:15
but would it say on the bottle for someone so you will see you will generally

spk_0:   41:18
see a bad if a manufacturer is a GMP certified facility, then that's generally gonna be on the supplement bottle because it's something that is not necessarily easy to achieve going through that process. There's a lot of regulation on that, and so if they're GMP facility, then they're going to show it. You know, in just is a little sidebar mean GMP. It's basically it's a system for ensuring that products are consistently produced, their controlled according to quality standards. So it's really it's a quality measurement quality system, so so that's important. You want to make sure that your pre Noto has what it says, it hasn't it. It doesn't have what it should end right, and it's been third party tested for both of those things.

spk_1:   41:59
That's almost like a checklist. Plus, take it as soon as possible, at least three months before pregnancy, if possible. If you run into sickness like take a break, open up the capsules and put it in something, take a soon as you can. If I am recommending a prenatal and it's not yours, it's cooling a prenatal in a D. H. A p a a fish oil supplement. And if I'm recommending yours, that's a like if I'm able to get it. Then I'm doing your prenatal and Justin E. P H g H. Because you've already got the coleene. So that's kind of like my approach as faras nourishing pregnancy. I'm I know that part of the reason you develop this was because you saw a big hole in a good quality prenatal. So your prenatal is available. Where and what's it called? So I developed

spk_0:   42:37
this prenatal not because I wanted to be a supplement. Manufacturers really don't. It's actually a it's really difficult. But I did it because I wanted to nourish my own pregnancy if I had been looking out there at all the different options available and really just didn't feel like I feel like they all take even the professional lines some type of shortcut or make some sort of compromise. So I wanted exactly what was evidence based, you know, in just going for that perfect products. So my prenatal is called full circle prenatal, and you can find it at full circle prenatal dot com and you know I produce him in small batches. Third party tested in a GMP and FDA certified facility, a oh, California standards, even for heavy metals across the board. I made you know, out. Yep. I make all my test results available on demand. So total transparency about that. And yeah, so that's where you can find that.

spk_1:   43:33
Okay. And I think she's gonna have maybe a coupon code that will have in the show notes so you can click on the little like, um, it should be right under the podcast episode. Or there's a little like i a button where you can click and you'll be able to find that. And then also, if you love listening to a low today, she has actually way back in Episode 10 of the podcast, Talking about nourishing fertility and I having a healthy, like, healthy pregnancy outcomes and nutrition in that way. So you can go get Maur of Ayla there. L a Thanks for coming on today. Anything we forgot to include, we'll put in the show notes. Is there anything else that you'd like to have? No, just, I think for listeners.

spk_0:   44:08
And my guess is, if you're listening to this topic, you're either trying to conceive. You maybe have been struggling to conceive for a while or are you know what the deal is with that or you're already pregnant. So I think one thing that you know you should know is that no matter where you are, there's really no better time than now to improve your nutrition. You know, only we do the best we can with the knowledge that we have at any given time. So don't be hard on yourself that this is information that you're hearing for the first time. And you were like many and thought that any prenatal would work.

spk_1:   44:35
Yeah, well, And Ayla and some of her colleagues were really pioneers in trying to improve the whole education for health professionals in this area. So thank you for your work in that. And thank you so much for coming on today. Thanks for having me on Krista. Hey, me again. So I did get something done this week, which was I've got a page on the web site where we try to include always the links that people mentioned in the podcast in the show notes, which you can scroll down and get to. But I thought moving forward all of the current and future podcasts if people mentioned that there's a discount code or a link. I'm going to try to populate that all on one page, so that's over. A krista Bigler dot com forward slash shop Try to make it easy will continue to add and populate that The prenatal is over there now, but it's just sort of it. It provides codes for different sites, et cetera, so feel free to check it out if you want. If not, you can always find things in the show notes. Hope that helps have a great day. Oh, wait. Actually, another thing is, if you are not on the email list to receive the show notes to your inbox every week or other week or so, you can do that by going over the less stress life dot com and you can click on the button that says, Subscribe to show notes and get those delivered so you don't miss a thing. Okay, that's it. This time. Have a good week. One of the best gift you could give us at the less stress life is your feedback. We are paid in podcast reviews. If you enjoy this or any other episode, please leave us a review in the iTunes store or from your podcast app. Just search for less dressed life as if you're not already subscribed. Click on the banana face image scroll to the bottom where it shows the text of other reviews and write a review while you're there. Hey, make sure you hit. Subscribe for Android or stitcher users. You gotta go to the desktop site and search for less dress life and then scroll down to leave a review. Stitcher doesn't load Apple reviews on their site, so if you want, you can leave a review in both places. Your feedback means a lot to the success of the show. Thanks so much for taking the time to do that, you rock.