Prenatal supplements for the modern woman: Efficient and tastier formats needed

02 Mar 2023 --- Busy, modern lifestyles can make getting the right nutrients challenging, and during pregnancy, consumers are as time-pressed as ever. At a time when women are finding more physical challenges – fighting morning sickness, sleeplessness and backaches – they are also in a critical window where nutrition is paramount.

In commemoration of International Women’s Day (March 8), NutritionInsight speaks with DSM, Gnosis and AB-Biotics on innovation that can help brands deliver the right supplement forms and dosages for mothers-to-be. 

Supplements for the modern woman 
To better understand what influences their choices for maternal supplements, DSM recently conducted an in-depth Usage and Attitude consumer survey. 

According to expectant mothers, iron, folic acid and calcium are perceived as the most important nutrients. They also express concerns about body pains, anxiety and sleep issues when it comes to their own health.

Prenatal supplements may go beyond the baby’s needs to address discomforts in the mother, such as fatigue and constipation.Yet many mothers – especially those with busy modern lifestyles – find it challenging to meet these nutritional and well-being requirements, says Kristen Finn, nutrition science advocacy lead for early life nutrition. 

“There is a clear need for complete nutritional solutions that come with strong science to address their key concerns during pregnancy.”

While standard prenatal supplements focus on vitamins and minerals, the microbiome is another area to watch for innovation. 

“We know the mother’s gut microbiota has key effects in the development of the baby’s gut microbiota – a healthy gut and vaginal microbiota will affect how the newborn’s microbiota develops,” says Sergi Audivert, executive director at AB-Biotics. 

Solutions for gut health may also alleviate some of the common pain points associated with pregnancy. 

“Dysbiosis – an imbalance of the gut bacteria – is related to a variety of diseases and conditions, including pregnancy-specific gastrointestinal diseases,” underscores Audivert. 

Some of these include intrahepatic cholestasis of pregnancy (a liver disorder), hyperemesis gravidarum (excessive nausea and vomiting) and constipation.

Pill fatigue in already fatigued women 
Taste is also a concern, with Finn pointing out that an important trigger for discontinuing supplementation is unpleasant sensory properties such as taste, size of the pill or tablet and the number of pills or tablets to be taken. 

“The majority of pregnant women still consume traditional formats such as pills and capsules, but there is a need for tasty formats that can deliver adequate nutrition in a compact and consumer-friendly way,” Finn states. 

DSM is innovating to put more nutrition in smaller formats by reducing the serving size of its DHA ingredients. 

Recommended levels of DHA in prenatal vitamins vary widely. A recent study showed 1,000 mg is effective at helping to prevent preterm birth.This year the company will launch a portfolio of market-ready solutions with “the highest dose of DHA in the smallest serving sizes,” making DHA supplementation easier to adhere to for pregnant women.

DHA is well-recognized for its importance in prenatal development and for its use in infant formula, advocated by the Food and Agriculture Organization of the UN and the European Food Safety Authority. 

However, the recommended dosage can vary widely. “Several clinical studies have shown that DHA supplementation during pregnancy reduces the risk of preterm birth,” says Finn. 

In the most recent study, 1,100 pregnant women were randomized to receive either 200 mg or 1000 mg of DSM’s algal DHA prior to 20 weeks gestation until delivery. 

They found that the higher dose (1000 mg DHA) was superior to the lower dose (200 mg DHA) for reducing preterm birth with a high degree of probability (posterior probability=0.95).

“This is an important finding as prenatal vitamins typically contain between 0-200 mg of DHA, which is not enough to optimize preterm birth risk reduction for many women,” she adds. 

Ingredient education 
As noted in DSM’s survey, folic acid is a key nutrient that expectant mothers look for. But Gnosis flags that there is still widespread and “considerable confusion” regarding the different forms of folate. 

“The terms folate and folic acid are often mistaken and used interchangeably, both by practitioners and consumers,” says Silvia Pisoni, global market manager at Gnosis. 

But she asserts there are big differences in how well the body is able to uptake the different forms. 

Folic acid is a synthetic form of folate commonly found in foods and prenatal supplements. It must be metabolized and reduced to 5-MTHF – the active form of folate – by a multi-step enzymatic process in the body. 

“However, metabolizing folic acid might not be effective in all people due to unique genetic patterns of the enzyme methylenetetrahydrofolate reductase (MTHFR). Some 40% of individuals worldwide expressing this polymorphism may have a variation in their ability to reduce folic acid.”

Folate naturally occurring in foods may be unstable due to the cooking process, therefore supplementation should be considered, flags Gnosis.Natural folates in foods also present reduced bioavailability, Pisoni warns. “They need to be hydrolyzed before they can be absorbed and converted into 5-MTHF. They are also unstable and can be oxidized during cooking.”

Pisoni suggests that fortified foods and supplements can provide a more stable source of folate. Gnosis’ solution is Quatrefolic, a glucosamine salt that can provide the biologically active form of folate (the 5-MTHF) for immediate use, without any form of metabolization needed.

Foundations for fertility
Gnosis’ Quatrefolic ingredient was recently part of a retrospective study that investigated the role of a vitamin B complex (Quatrefolic plus B vitamins) supplement compared to folic acid supplementation only. This was in relation to clinical pregnancy and live birth in infertile women undergoing homologous assisted reproductive technology (ART).

A higher percentage of women in the vitamin B complex supplemented group had a clinical pregnancy and live birth compared to the folic acid alone group.

The gut microbiome also seems to play a vital role in laying fertile ground for a healthy pregnancy -- an area where AB-Biotics has several products under development. 

“We are investigating probiotic strains that can slow down the growth of pathogenic bacteria like E.coli, which have been linked with fertility problems due to infections in the female reproductive system,” says Jordi Riera, chief business development manager of Kaneka probiotics. 

Research into restoring the female microbiome recently got a boost with the advent of the first Vagina Chip, which can replicate complex ecosystems of bacteria in a preclinical model. 

The state of the mother’s microbiome will have lasting effects on the microbiome of her child, highlights AB-Biotics.Good bacteria for a healthy bump 
Many studies highlight the importance of a healthy gut microbiota during pregnancy, since it has crucial roles in nutrient acquisition, immune remodeling and protection against infection, Riera highlights. 

“This is why it is important to study specific probiotic strains that can support gut microbiota during pregnancy, which will have benefits both for the mother and the child.”

As a human residential Bifidobacteria, B. longum KABP 041 is a proprietary probiotic strain developed by AB-Biotics, which is naturally found in breast milk and the infant’s gut. 

“It can support mothers’ health during pregnancy and contributes to the symbiotic environment of breastmilk to ensure a healthy gut microbiota development in the baby.”

The company also touts a blend of four probiotic strains called Nouri Prenatal Health. Launched in collaboration with Nouri in the US, the blend contains P. acidilactici KABP 021, L. plantarum KABP 022, L. plantarum KABP 023 and B. longum KABP 042, vitamin B6 and plant-based omega oil. 

“The strain mix has shown a unique mechanism of action with the potential to improve intestinal barrier function and intestinal permeability – two key functions that support gut microbiota during pregnancy. 

All four strains have undergone extensive research for the relief of gastrointestinal (GI) symptoms, including bloating, pain, and diarrhea and have been shown to improve sleep, energy, emotional well-being and other factors.

As mental health comes to the forefront, more mood claims could appear on prenatal vitamins. 

Gnosis notes that – in addition to preventing neural tube defects – folate is linked with mood and cognition. DHA has also been linked with aiding sleep.

By Missy Green