Please note that the following post is a description of my personal regimen. You should always do your own research and consult with your doctor or nutritionist before adding any supplements to your diet.
Even though my diet is pretty decent and I eat lots of high-quality meats, fats, vegetables and fruits, for the better part of a year I have been following some of Robb Wolf’s supplement recommendations. These recommendations are almost universal across the Paleo community, and are believed to address many of the deficiencies of mass-produced, engineered foods and modern lifestyles. I have maintained this supplement regimen throughout my pregnancy, with certain modifications and additions, as I will address.
The following are Robb’s “top five,” with credit to his new book, The Paleo Solution, for much of the content in the explanations that follow:
Vitamin D3 (cholcalciferol) — Although the RDA for this vitamin has recently been increased to 600 IU per day (from 400) as doctors continue to realize the important role it plays in immune function, cancer and heart disease prevention, the RDA is only a bare minimum, and it is in fact likely that our ancestors (who spent much more time in the sun than we do) may have produced as much as 10,000 to 20,000 IU per day. We produce Vitamin D from sun exposure, which presents a problem for those of us who reside in cooler northern climes. Our largest food sources of Vitamin D are fortified dairy products (which most Paleo adherents do not consume), and animal liver (which is considered dangerous during pregnancy due to the teratogenic effects of animal-derived Vitamin A), so unfortunately, supplementation is essential — at least from fall through spring, unless you happen to be lucky enough to live in a place that is warm and sunny year-round. Robb recommends 2,000 to 5,000 IU per day. I was taking 2,000 per day, but upped my dosage to 5,000 due to my pregnancy and the onset of winter. At those levels, Vitamin D toxicity is not an issue unless you suffer from hyperparathyroid disease.
Omega-3 fats — They two keys to Omega-3 supplementation are the type of Omega-3 (specifically, we want to supplement EPA and DHA) and the ratio of Omega-3 to Omega-6 consumption (ideally anywhere from 1:1 to 1:2). The modern diet, replete with grains, grain-fed meats and refined vegetable oils, is plentiful in Omega-6’s, so we need to balance them out by consuming more anti-inflammatory Omega-3’s. A high-quality supplement should have a high level of EPA/DHA per serving, and as little “filler” oil as possible. When comparing prices, it is important to compare by cost per gram of EPA/DHA, not by cost per capsule or cost per manufacturer’s recommended serving size. I like Nordic Naturals or NutraSea oils (straight oil, not capsules, as it’s easier to get the full dose in one shot), or Webber Triple Strength capsules for travel. Pregnant and breastfeeding women should focus on DHA-heavy supplements, as DHA is critical for fetal and infant brain development, and too much EPA can adversely affect neurological development in children under the age of three. DHA can also be obtained from algae sources. Nordic Naturals makes a cod liver DHA supplement that is low in Vitamin A and considered by the manufacturer to be suitable for pregnancy. I presently supplement one teaspoon of oil (about 1.5 grams of combined EPA/DHA) per day, plus I eat four Omega-3 enriched eggs daily (at about 1 gram Omega-3 per egg), consume grass-fed meats, and avoid refined and seed-based oils. One very important note: it is absolutely possible to over-supplement Omega-3 if you are following a strict Paleo diet. Please see my post entitled “Too Much Omega-3?” for details on my experience with this, as well as a link to Health Canada’s guidelines on Omega-3 supplementation during pregnancy. Since reducing my Omega-3 supplementation by two thirds (from three teaspoons per day to one), I have not had any further issues with bruising and blood thinning.
Magnesium — Magnesium works synergistically with calcium and Vitamin D to aid in bone formation and increase calcium absorption; very important during pregnancy, when the fetus often leaches calcium from the mother in order to meet its needs. Magnesium also influences blood clotting, muscle contraction and nerve transmission, and has a stool softening and laxative effect (which can be very helpful during pregnancy! 😉 ). Magnesium citrate in the form of a fizzy drink is most easily absorbed by the body. I take about 400 grams per day; however, it is important to start with a very low dose and work up gradually, as the laxative effect can be particularly strong for those who are not accustomed to supplementation. Also, most people find fizzy magnesium drinks to be mildly sedative, so they are often best taken right before bedtime.
Digestive enzymes — These are not necessary for everyone, but may help people who have difficulty digesting proteins and fats. Digestion can be particularly problematic during pregnancy, and digestive enzymes may reduce gastric reflux and discomfort. It is very important, however, to stick to plant-based products only and avoid enzymes containing Pancreatin (ox bile), as this has not been proven safe for use during pregnancy and lactation.
Probiotics – Probiotics are the beneficial micro-organisms that reside in our guts and help with digestion, production of vitamins and protection from pathogenic fungi, bacteria and parasites. Before the emergence of modern hygiene, we would obtain them from dirt (there is also evidence that our ancestors consumed the contents of herbivores’ intestines — yum!). Probiotics can be obtained from fermented foods and yoghurt, though neither would be consumed in any vast quantities by Paleo adherents. Probiotics are especially helpful in staving of yeast overgrowth — a common pregnancy affliction. I take a daily supplement containing anywhere from 10 billion to 20 billion CFU (colony forming units). The supplement is most effective when taken on an empty stomach, and it’s best to switch brands frequently in order to ensure the consumption of a variety of different strains of bacteria.
In addition to Robb Wolf’s recommendations, I have also added the following:
Prenatal vitamin — Why? Because I think it’s a good “insurance policy” to make sure I’m getting all the pregnancy-specific vitamins and minerals such as folic acid, calcium, iron and copper. The most comprehensive supplement I’ve found thus far is called “The Ultimate One Expecting” from the makers of “The Ultimate One” multivitamin series (they make great multivitamins for athletes). I have found this vitamin to be much easier on my stomach than the “Active Women” formula I used to take pre-pregnancy, which occasionally upset my stomach and/or repeated on me if I didn’t take it with food.
Iron — As I mentioned in an earlier post, I have had ongoing issues with low iron levels, despite consuming plenty of high-iron foods. This is not an entirely uncommon condition for women; in particular those who are very physically active. I generally supplement 25 milligrams per day for about three months at a time, with a month break in between, and this routine keeps my iron levels in the mid-normal range. Because iron needs are substantially increased during pregnancy, I will continue to supplement throughout, with no breaks. In choosing an iron supplement, it is important to select one that uses heme iron sources (animal-based), as these are most easily absorbed and utilized by the body. Iron supplements can be very hard on the stomach and may cause constipation, but I have found two supplements in particular that seem to be easily assimilated by my body; the first being R.B.C. by Enzymatic Therapy (pictured at left), and the second being a more expensive, prescription supplement called Proferrin (worthwhile if you have prescription drug coverage). Iron levels are routinely tested during pregnancy — usually in the first and third trimesters — and most prenatal vitamins will contain the pregnancy RDA of 27 milligrams.
WEDNESDAY – Rest day
3 rounds: 1 minute of single-arm dumbell snatches (30 lbs), 1 minute rest
3 rounds: 1 minute of kettlebell swings (16 kg), 1 minute rest
3 rounds: 1 minute of box jumps, 1 minute rest
3 rounds: 1 minute of burpees, 1 minute rest
Total reps: 85 + 94 + 90 + 45 = 314 (top score in the class! :-))