An Evaluation of Food and Nutrient Intake among Pregnant Women in The Netherlands: A Systematic Review

Abstract

Nutritional deficiencies during pregnancy can have serious consequences for the health of the (unborn) child. This systematic review provides an updated overview of the available food and nutrient intake data for pregnant women in The Netherlands and an evaluation based on the current recommendations. Embase, MEDLINE, and national institute databases were used. Articles were selected if they had been published since 2008 and contained data on food consumption, nutrient intake, or the status of healthy pregnant women. A qualitative comparison was made with the 2021 Dutch Health Council recommendations and reference values. A total of 218 reports were included, representing 54 individual studies. Dietary assessments were primarily performed via food frequency questionnaires. Protein, vitamin A, thiamin, riboflavin, vitamin B6, folate, vitamin B12, vitamin C, iron, calcium, and magnesium intakes seemed to be adequate. For folate and vitamin D, supplements were needed to reach the recommended intake. The reasons for concern are the low intakes of fruits, vegetables, and (fatty) fish, and the intakes of alcohol, sugary drinks, and salt. For several foods and nutrients, no or limited intake data were found. High-quality, representative, and recent data are needed to evaluate the nutrient intake of pregnant women in order to make accurate assessments and evaluations, supporting scientific-based advice and national nutritional policies.

Vitamin A-Mediated Birth Defects: A Narrative Review

“…Vitamin A is a fat-soluble vitamin found naturally in many foods, including fruits, vegetables, and animal-based products. It is crucial for the normal functioning of many distinct functions of the human body, such as visual adaptation, immunity, and epithelial cell differentiation [ 5 ]. Once ingested, it must be metabolized into its biologically active forms, which include retinol, retinal, and retinoic acid, with the most prominent forms being 11-cis-retinal and all-trans-retinoic acid (ATRA) [ 5 ].…”

“…Once ingested, it must be metabolized into its biologically active forms, which include retinol, retinal, and retinoic acid, with the most prominent forms being 11-cis-retinal and all-trans-retinoic acid (ATRA) [ 5 ]. Each form has different roles in the human body [ 5 ]. While it may be administered topically or as an injectable, vitamin A is predominantly taken orally and absorbed by enterocytes after metabolizing it into retinol.…”

“…Once absorbed, it can be transported to other cells bound to cellular retinol-binding protein. Its main target is the liver, where it is stored as retinyl palmitate [ 5 , 6 ], and its absorption is increased with increased fat intake through the diet [ 5 ]. The kidneys eliminate vitamin A derivatives through urine or the liver through bile [ 5 ].…”

“…Its main target is the liver, where it is stored as retinyl palmitate [ 5 , 6 ], and its absorption is increased with increased fat intake through the diet [ 5 ]. The kidneys eliminate vitamin A derivatives through urine or the liver through bile [ 5 ]. Because it is fat-soluble and stored in the liver, it can take months before deficiency becomes evident.…”

“…The serum concentration of vitamin A in adults ranges from 300 to 700 ng/mL with a peak plasma time of four to five hours in oil solution or 304 hours when water-miscible [ 6 ]. Vitamin A and its levels can be impacted by estrogens and oral contraceptives, increasing retinol-binding protein levels [ 5 ]. In addition, alcohol damages the liver over time and decreases the amount of stored vitamin A [ 5 ].…”