Prenatal Vitamins are Kind of a Hot Mess with Helena Bottemiller Evich

  • Which prenatal vitamins may have more or less nutrients than stated on the Supplement Facts panel
  • Why there aren’t standardized guidelines about what goes in your prenatal vitamin
  • How to pick a prenatal vitamin and what the most important B vitamin is to focus on


Episode Description

How did you pick your prenatal vitamin? A new report found that prenatal vitamins might contain more or less of their stated nutrients like folic acid and iron. Helena Bottemiller Evich joins me to talk about how to choose a prenatal vitamin and why there aren’t clear agreements on what should even be in these supplements.


About the Guest

  • Helena Bottemiller Evich is a journalist specializing in food safety and food policy
  • She is a mom of 2 and the Founder and Chief Editor of the Food Fix newsletter
  • Helena recently did a deep dive on inconsistencies in prenatal vitamins

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<v SPEAKER_1>Before we get started, I just wanted to drop a happy Father's Day to all the dads out there who are doing baby-led weaning.

00:00:06.660 --> 00:00:15.280

<v SPEAKER_1>I totally get that the vast majority of our audience are moms, but there are a lot of dads who are actively involved in helping their babies learn how to start solid foods safely.

00:00:15.760 --> 00:00:18.500

<v SPEAKER_1>I remember when our twins, Gus and Hannah, were starting solid foods.

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<v SPEAKER_1>They were our sixth and seventh babies.

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<v SPEAKER_1>I'd been teaching baby-led weaning full-time for a number of years before this.

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<v SPEAKER_1>My husband would still roll into the kitchen and be like, are you sure the babies can eat that?

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<v SPEAKER_1>Are they gonna choke?

00:00:27.840 --> 00:00:29.660

<v SPEAKER_1>And I'd be like, oh my gosh, yes, they can.

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<v SPEAKER_1>They're safe.

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<v SPEAKER_1>But I loved that he would get into it.

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<v SPEAKER_1>He was so proud of all of the foods that his babies were learning how to eat.

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<v SPEAKER_1>So I just wanted to wish all of the dads out there a very happy Father's Day, especially if it's your first Father's Day.

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<v SPEAKER_1>So thank you for helping your baby learn how to eat.

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<v SPEAKER_1>And I hope you have a wonderful Father's Day.

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<v SPEAKER_1>Checking in about food allergies and introducing allergenic foods and have you done peanut with your baby yet?

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<v SPEAKER_1>Well, intact nuts and thick globs of nut butter like peanut butter are choking hazards for babies, but we want to get that peanut protein into your baby early and often in order to help lower the risk of peanut allergy down the road.

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<v SPEAKER_1>My absolute favorite way to introduce peanuts for babies is using the PuffWorks Baby Peanut Puffs.

00:01:14.920 --> 00:01:19.120

<v SPEAKER_1>So when you hear puffs, like you're probably like, oh, those starchy little puff things, like no, no, no.

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<v SPEAKER_1>Not the little ones that earlier eaters can't pick up.

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<v SPEAKER_1>Those kind of crappy puffs from the store that have added sugar and refined grains and lots of salt.

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<v SPEAKER_1>Uh-uh, the PuffWorks Baby Peanut Puffs have no added sugar.

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<v SPEAKER_1>They have just a smidge of sodium for preservatives and they are the perfect size for baby-led weaning.

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<v SPEAKER_1>They're about the size of your adult pinky finger.

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<v SPEAKER_1>So baby can pick them up, self-feed them, but they're so soft that they dissolve in your baby's mouth so you can introduce these peanut puffs even before your baby has teeth.

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<v SPEAKER_1>PuffWorks also makes a baby almond puff for the safe introduction of a separate allergenic food category, that's tree nuts.

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<v SPEAKER_1>And now finally, PuffWorks put out a combo case.

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<v SPEAKER_1>So it's half baby peanut and half baby almond.

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<v SPEAKER_1>So if you want to grab one case, then you can knock out two new allergenic foods.

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<v SPEAKER_1>We do these on different days though.

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<v SPEAKER_1>These are just the no stress, low mess way to get peanut and tree nut out of the way.

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<v SPEAKER_1>So you can get 15% off everything at puffworks.com when you use the affiliate discount code BLWPOD.

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<v SPEAKER_1>That's a new code.

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<v SPEAKER_1>It's BLWPOD, use that sucker at checkout at puffworks.com and get peanut and tree nut safely out of the way.

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<v SPEAKER_2>The prenatal vitamins that they tested, the vast majority of them had at least one nutrient that was like not at the levels it said it was.

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<v SPEAKER_2>Like they're just not very accurately labeled.

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<v SPEAKER_2>And that kind of got my wheels turning.

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<v SPEAKER_2>Like, you know, prenatals are just for such a vulnerable population.

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<v SPEAKER_2>Like I just kind of thought there would be a little bit more guardrails around them, and the more I dug into it, the more I was like, oh, not only is there not very much regulation, there's also not guidance on what needs to be in them.

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<v SPEAKER_1>Hey there, I'm Katie Ferraro, Registered Dietitian, College Nutrition Professor, and mom of seven, specializing in Baby-Led Weaning.

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<v SPEAKER_1>Here on the Baby-Led Weaning with Katie Ferraro podcast, I help you strip out all of the noise and nonsense about feeding, giving you the confidence and knowledge you need to give your baby a safe start to solid foods using Baby-Led Weaning.

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<v SPEAKER_1>How did you choose your prenatal vitamin?

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<v SPEAKER_1>Was it the branding or a doctor's recommendation?

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<v SPEAKER_1>Was it based on price or maybe was available at the store the day you were there?

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<v SPEAKER_1>Or maybe you did your research and you looked it up to see exactly how many micrograms of folic acid are recommended, and then what brand comes closest to delivering on that?

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<v SPEAKER_1>Although I doubt it, right?

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<v SPEAKER_1>Because most pregnant women pick a prenatal and trust that it will do the job.

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<v SPEAKER_1>But what are the guidelines for nutrients in prenatal vitamins?

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<v SPEAKER_1>And who sets those standards?

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<v SPEAKER_1>Is anyone really checking?

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<v SPEAKER_1>Is there oversight on this?

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<v SPEAKER_1>Well, the GAO, the Government Accountability Office, recently did a report on prenatal vitamins.

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<v SPEAKER_1>And this report and their testing showed that 11 of the 12 prenatal supplements that were tested had at least one nutrient that was above or below the levels noted on the labels.

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<v SPEAKER_1>And this could result in a person consuming too much or too little of some really important nutrients when you're pregnant.

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<v SPEAKER_1>And this GAO report caught the eye of Helena Bottemiller Evich.

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<v SPEAKER_1>So Helena is our guest today.

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<v SPEAKER_1>She's a journalist who focuses on food safety and food technology.

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<v SPEAKER_1>She's the founder and editor in chief of one of my favorite email newsletters called Food Fix.

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<v SPEAKER_1>I first started following Helena when she was in her previous job.

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<v SPEAKER_1>So she was the senior food and agriculture reporter for Politico.

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<v SPEAKER_1>And so she has a very impressive professional resume.

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<v SPEAKER_1>But Helena is also the mom of a four-year-old.

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<v SPEAKER_1>And at the time that we just recorded this interview, she was also 35 weeks pregnant with her second baby.

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<v SPEAKER_1>So the whole idea of inconsistencies in prenatal vitamins is of interest to Helena as a journalist, but of course also as a pregnant mom.

00:05:01.320 --> 00:05:03.440

<v SPEAKER_1>And I love that intersection of her work.

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<v SPEAKER_1>She's always reporting on issues that are of interest to us as consumers, but also in many veins as parents.

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<v SPEAKER_1>So Helena was previously on this podcast to talk first about the formula shortage and then the formula recall that was happening simultaneously.

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<v SPEAKER_1>She actually broke a really important part of that recall story.

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<v SPEAKER_1>And then more recently, she came on to talk about lead contamination in the cinnamon and applesauce pouch story that she was researching.

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<v SPEAKER_1>And I'll link to both of those previous episodes if you want to learn more about her work, but I'm personally a huge fan and I can't recommend her newsletter called Food Fix Enough.

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<v SPEAKER_1>I kind of recently went through and canceled a lot of my paid newsletter subscriptions.

00:05:37.200 --> 00:05:41.080

<v SPEAKER_1>They were either ones that I wasn't reading or weren't relevant or I was like, this is not worth the money.

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<v SPEAKER_1>And one of the very few that I did keep was the Food Fix Newsletter.

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<v SPEAKER_1>So if you are interested in food policy or food safety, food technology, or you don't have time to read and research GAO reports on your own, Helena definitely can.

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<v SPEAKER_1>And I really enjoyed this conversation because she opened my eyes to these gaping holes in prenatal vitamin regulation.

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<v SPEAKER_1>I know it's relevant to all of you because you are either a pregnant person taking a prenatal vitamin right now, or you're perhaps still taking your prenatal vitamin if you're postpartum on the recommendation of your own doctor, or you will be taking prenatals again for future pregnancies.

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<v SPEAKER_1>So this is important information to hear.

00:06:19.140 --> 00:06:22.620

<v SPEAKER_1>And if you're not already subscribed to this podcast, I would encourage you to do so.

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<v SPEAKER_1>Hit the follow button so that you can get notified each week when both of the episodes that I do drop.

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<v SPEAKER_1>I do a mini solo baby-led weaning training episode on Mondays and a longer interview episode like this one every Thursday.

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<v SPEAKER_1>Follow the show or follow us online.

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<v SPEAKER_1>We're at blwpodcast.com.

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<v SPEAKER_1>And with no further ado, I want to invite Helena Bottemiller Evich, the founder and editor-in-chief of the Food Fix Newsletter, on to talk about prenatal vitamins and why they're kind of a hot mess.

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<v SPEAKER_2>Thanks for having me.

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<v SPEAKER_2>I'm glad to be back.

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<v SPEAKER_1>Okay.

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<v SPEAKER_1>I know you usually focus on food, your newsletter, which I'm a huge fan of.

00:07:01.700 --> 00:07:02.020

<v SPEAKER_1>Sorry.

00:07:02.040 --> 00:07:03.040

<v SPEAKER_1>I always write back to your newsletter.

00:07:03.060 --> 00:07:04.180

<v SPEAKER_1>You're like, I love this one today.

00:07:04.200 --> 00:07:05.560

<v SPEAKER_1>And you're like, you're probably not supposed to respond.

00:07:07.760 --> 00:07:08.900

<v SPEAKER_1>It's called Food Fix.

00:07:08.920 --> 00:07:09.580

<v SPEAKER_1>So like, I get it.

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<v SPEAKER_1>Your focus is food and food journalism and food technology.

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<v SPEAKER_1>And I was kind of surprised.

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<v SPEAKER_1>It's like, oh, God, Helena doesn't normally cover supplements.

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<v SPEAKER_1>And I was interested when I saw your article, it had a very catchy headline, which was, prenatal vitamins are kind of a hot mess.

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<v SPEAKER_1>Does anyone care?

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<v SPEAKER_1>So what stoked your interest in this story, other than at the time of this recording, you're 35 weeks pregnant.

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<v SPEAKER_1>So there's a personal interest level, but what caused you to maybe make that jump from food to supplements in this case?

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<v SPEAKER_2>Yeah, it's a great question.

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<v SPEAKER_2>I mean, certainly I do have a personal interest because I am pregnant right now.

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<v SPEAKER_2>And when the Government Accountability Office put out a report that had done testing on prenatals, it came out a couple months ago, and I saw it and was like, oh, that's relevant to me.

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<v SPEAKER_2>I'm going to read it.

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<v SPEAKER_2>And what they largely found is that the supplements or the prenatal vitamins that they tested, the vast majority of them had at least one nutrient that was not at the levels it said it was.

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<v SPEAKER_2>They're just not very accurately labeled.

00:08:05.340 --> 00:08:07.460

<v SPEAKER_2>And that got my wheels turning.

00:08:07.820 --> 00:08:09.540

<v SPEAKER_2>Wait a minute, how could that be the case?

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<v SPEAKER_2>Prenatals must have some level of oversight that's a little bit more than...

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<v SPEAKER_2>I think there is some general awareness that supplements are not as regulated as other products, but prenatals are just for such a vulnerable population.

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<v SPEAKER_2>I just thought there would be a little bit more guardrails around them, and the more I dug into it, the more I was like, oh, not only is there not very much regulation, there's also not guidance on what needs to be in them.

00:08:37.160 --> 00:08:44.860

<v SPEAKER_2>And so I just started calling around and asking people about prenatals, and it kind of turned into this newsletter.

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<v SPEAKER_2>And I think I even wrote in the newsletter, like, I avoid covering supplements because it is so different than food, they have a really different set of issues, and it is kind of this, I think, unwieldy sort of separate industry that I personally, I personally kept plenty busy covering food policy and, you know, what's going on in the food world.

00:09:03.300 --> 00:09:10.520

<v SPEAKER_2>So I do tend to stay out of it, but because I am currently pregnant, I also have a four-year-old, so I took prenatal vitamins years ago.

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<v SPEAKER_2>So, you know, I've been consuming these products on and off for like several years now.

00:09:14.900 --> 00:09:17.320

<v SPEAKER_2>And so, yeah, there's a personal interest there.

00:09:17.340 --> 00:09:18.960

<v SPEAKER_2>And it's been interesting to dive into.

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<v SPEAKER_2>I'm still getting so many emails about this too.

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<v SPEAKER_2>It's so interesting because it's moms, dads, grandparents.

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<v SPEAKER_1>I think if you're a food person, like I'm a dietician, right?

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<v SPEAKER_1>I'm a practitioner of food.

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<v SPEAKER_1>I'm food first all the time.

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<v SPEAKER_1>Most of the supplements save your money.

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<v SPEAKER_1>They don't do what they say they're going to do.

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<v SPEAKER_1>It's the wild, wild west of marketing.

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<v SPEAKER_1>Unless they like literally kill you, there's never going to be a recall.

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<v SPEAKER_1>And like you and I could spit in a capsule and sell it at Costco tomorrow.

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<v SPEAKER_1>And that's totally legit.

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<v SPEAKER_1>Like most people get supplements are bogus, except they kind of have you buy the you know what when it's like, wait a minute, but I'm pregnant.

00:09:48.380 --> 00:09:54.520

<v SPEAKER_1>And there's no way you could physiologically like eat the amount of iron that your body needs when you have 50% increase in blood volume.

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<v SPEAKER_1>Like you do have to rely on these supplements.

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<v SPEAKER_1>And I think especially for moms, like it's very eye opening.

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<v SPEAKER_1>Like I thought prenatals were like pretty run in the mill.

00:10:02.000 --> 00:10:04.740

<v SPEAKER_1>And like, hang on, they're all standardized.

00:10:04.760 --> 00:10:07.960

<v SPEAKER_1>And there's at least a baseline of what quote unquote should be in there.

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<v SPEAKER_1>So what'd you find out?

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<v SPEAKER_1>Like I know you were talking to ACOG.

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<v SPEAKER_1>Tell us who they are, what they told you about like, what are the requirements for what should be in supplements for pregnant moms if there are any?

00:10:17.080 --> 00:10:20.680

<v SPEAKER_2>Yeah, I mean, I think those are all, you know, such great points.

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<v SPEAKER_2>Like, prenatal vitamins are really the only supplement that is like fully embraced by the medical establishment, right?

00:10:30.680 --> 00:10:36.800

<v SPEAKER_2>Like they're, if you generally are not going to have doctors recommending, you know, maybe they'd recommend like a vitamin D or something.

00:10:36.820 --> 00:10:43.200

<v SPEAKER_2>But, you know, there isn't a big focus on it, except for when you are trying to get pregnant or you're pregnant.

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<v SPEAKER_2>And then, look, the only question you get is, are you taking a prenatal?

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<v SPEAKER_2>So it is one of those places where the medical establishment is very much recommending and encouraging you to take it.

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<v SPEAKER_2>And I think that's the big difference.

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<v SPEAKER_2>So for prenatal vitamins, what I learned is that the American College of Obstetrics and Gynecology, which is a group we refer to as ACOG, they really only very specifically recommend that a prenatal vitamin should contain folic acid so that you need to have at least, I think it's 400 micrograms of folic acid supplemented every day.

00:11:16.500 --> 00:11:21.400

<v SPEAKER_2>And that is actually important before you are trying to get pregnant.

00:11:21.440 --> 00:11:26.340

<v SPEAKER_2>And it's more important before than it is actually during pregnancy.

00:11:26.680 --> 00:11:32.680

<v SPEAKER_2>And that is because there's very clear evidence that it dramatically reduces neural tube defects.

00:11:32.700 --> 00:11:42.380

<v SPEAKER_2>So these are really serious birth defects, and we've had a dramatic reduction in the US since we also fortify a lot of foods with folic acid to try to encourage more consumption.

00:11:42.400 --> 00:11:44.120

<v SPEAKER_2>So folic acid is really important.

00:11:44.820 --> 00:11:47.340

<v SPEAKER_2>Then from there, it gets really variable.

00:11:47.400 --> 00:11:50.220

<v SPEAKER_2>Your prenatal vitamin might contain iron, it might not.

00:11:50.540 --> 00:11:52.020

<v SPEAKER_2>It might contain choline, it might not.

00:11:52.260 --> 00:11:55.600

<v SPEAKER_2>What I was just so surprised by was how much variation there is.

00:11:56.000 --> 00:12:02.640

<v SPEAKER_2>And there really isn't any one writing guidelines about what should be included, like here are the five things, right?

00:12:02.980 --> 00:12:04.480

<v SPEAKER_2>And that just sort of surprised me.

00:12:04.500 --> 00:12:08.820

<v SPEAKER_2>I just figured there was a little more standardization, and there's really not.

00:12:09.180 --> 00:12:11.720

<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

00:12:15.980 --> 00:12:17.380

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<v SPEAKER_1>So I want to just clarify too with the folic acid, in case people, I know a lot of our audience, who's usually parents of babies six to 12 months of age, they always have iron on the brain.

00:12:58.480 --> 00:13:01.200

<v SPEAKER_1>So yes, of course, your prenatal could include iron.

00:13:01.220 --> 00:13:03.480

<v SPEAKER_1>And we'll talk about why many of them don't these days.

00:13:03.500 --> 00:13:11.600

<v SPEAKER_1>But the catch there with the folic acid is that neural tubes usually close somewhere between like 15 to 28 days following conception.

00:13:11.980 --> 00:13:14.980

<v SPEAKER_1>And a lot of times that's before you even know you're pregnant, right?

00:13:15.240 --> 00:13:22.620

<v SPEAKER_1>So the general guideline is, especially if you're on birth control, as soon as you go off of birth control, if you're trying to conceive, start taking your prenatal vitamin.

00:13:22.760 --> 00:13:29.420

<v SPEAKER_1>Because again, if you wait till your first misperiod, that is more than 30 days in many cases following conception.

00:13:29.860 --> 00:13:35.240

<v SPEAKER_1>And that really, really important window of preventing anencephaly and spina bifida, it's already closed.

00:13:35.260 --> 00:13:39.520

<v SPEAKER_1>So folic acid is of so much importance and yes, we can get some from the diet.

00:13:39.880 --> 00:13:43.020

<v SPEAKER_2>It's a preconception intervention.

00:13:43.040 --> 00:13:46.200

<v SPEAKER_1>Exactly, they should be called like preconception pills, not prenatal.

00:13:46.220 --> 00:14:00.660

<v SPEAKER_2>Yeah, and like there's probably a lot more that could be done in Medicaid and other health programs to just look at anyone who's maybe trying to get pregnant or of childbearing age should probably be more of the target because you're exactly right.

00:14:00.680 --> 00:14:03.600

<v SPEAKER_2>A lot of times you don't know you're pregnant by the time.

00:14:03.620 --> 00:14:06.180

<v SPEAKER_1>Yeah, and I know we both do a lot of work with WIC.

00:14:06.320 --> 00:14:08.440

<v SPEAKER_1>That covers you from the time you're pregnant.

00:14:08.460 --> 00:14:13.360

<v SPEAKER_1>There's no preconception unless you have another child who's five and under and you still qualify.

00:14:14.000 --> 00:14:29.600

<v SPEAKER_1>That's a huge catchment population too that, and as far as public health campaigns go, it is very well established that fortifying the food supply and recommending supplements, prenatal vitamins with folic acid has done wonders to reduce neural tube defects.

00:14:29.620 --> 00:14:39.820

<v SPEAKER_1>Now, neural tube defects were never rampant public health disaster, but if you talk to anyone with the baby's spina bifida, even the fact that even one life can be saved, but there really is a market decrease with this.

00:14:39.840 --> 00:14:41.040

<v SPEAKER_1>So this is something like-

00:14:41.220 --> 00:14:45.460

<v SPEAKER_2>It's been a dramatic decrease in the US since particularly we started fortifying food.

00:14:45.480 --> 00:14:54.700

<v SPEAKER_2>And actually in the UK right now, they're debating whether or not to fortify certain foods over there because they didn't and they still have higher rates of neural tube.

00:14:54.720 --> 00:14:55.080

<v SPEAKER_1>Interesting.

00:14:55.340 --> 00:14:58.780

<v SPEAKER_2>Really quick, in Europe, prenatal vitamins are way less of a thing.

00:14:59.340 --> 00:15:15.520

<v SPEAKER_2>So just in researching this, I kind of learned that it's much more likely for there to be emphasis on folic acid pre-conception, like we were just talking about, and there is much less emphasis on taking a supplement while you're pregnant, which I just found interesting that it's a very different approach.

00:15:15.540 --> 00:15:18.600

<v SPEAKER_1>Well, Americans love to fix things with a pill, right?

00:15:18.620 --> 00:15:20.960

<v SPEAKER_1>Like, oh, I'll just have a crappy diet and take a pill.

00:15:21.260 --> 00:15:22.460

<v SPEAKER_1>It's kind of your insurance policy.

00:15:22.480 --> 00:15:25.240

<v SPEAKER_1>And I know a lot of moms who think like that, like especially first trimester, right?

00:15:25.260 --> 00:15:27.240

<v SPEAKER_1>You have nausea, you don't feel like eating or you can't keep stuff down.

00:15:27.680 --> 00:15:33.520

<v SPEAKER_1>Like, exactly, like, hey, but the toast is fortified with folic acid in this country, as well as some other B vitamins.

00:15:33.540 --> 00:15:35.060

<v SPEAKER_1>So that's an interesting finding.

00:15:35.080 --> 00:15:37.580

<v SPEAKER_1>What did you find out about with regards to iron?

00:15:37.600 --> 00:15:43.480

<v SPEAKER_1>Because we know there's many different formulations of prenatal vitamins, some that have iron and some that don't.

00:15:43.480 --> 00:15:46.520

<v SPEAKER_1>So what's what are the recommendations from ACOG regarding iron?

00:15:47.020 --> 00:15:57.280

<v SPEAKER_2>ACOG doesn't actually say that you need iron in your prenatal, but they have some really good resources on their website about consuming enough iron.

00:15:57.680 --> 00:16:00.040

<v SPEAKER_2>You need 27 milligrams a day.

00:16:00.060 --> 00:16:01.380

<v SPEAKER_2>That's their recommendation.

00:16:01.400 --> 00:16:07.820

<v SPEAKER_2>And you could get that from lean red meat, poultry, fish, dried beans, peas, iron-fortified cereals, prune juice.

00:16:07.840 --> 00:16:08.420

<v SPEAKER_2>I don't know how many.

00:16:08.460 --> 00:16:10.540

<v SPEAKER_1>Hey, if you're constipated, you definitely be on it.

00:16:11.640 --> 00:16:20.700

<v SPEAKER_2>So they focus a lot on getting your key nutrients that you need when you're pregnant from foods, which I found interesting because my care team personally did not really talk about that.

00:16:20.720 --> 00:16:23.060

<v SPEAKER_2>And I think that's a common experience, is that.

00:16:23.120 --> 00:16:33.060

<v SPEAKER_1>It's also impossible, just so you know, like as a dietician to eat 27 milligrams of iron, like to put it in context, an eight ounce chicken breast, two times the palm of your hand, only has three milligrams of iron.

00:16:33.080 --> 00:16:34.140

<v SPEAKER_1>Like you're going to eat nine of those.

00:16:34.160 --> 00:16:35.640

<v SPEAKER_1>You're going to eat 72 ounces of chicken.

00:16:35.660 --> 00:16:40.020

<v SPEAKER_2>This is why you always have to be friends with or get your insurance to cover a dietician.

00:16:40.100 --> 00:16:40.920

<v SPEAKER_2>I didn't know that.

00:16:40.940 --> 00:16:44.700

<v SPEAKER_2>But yes, 27 milligrams is the recommendation for every day.

00:16:44.800 --> 00:16:51.500

<v SPEAKER_1>So when you're pregnant, which is wild, because we actually one of the most downloaded episodes of our podcast, because for babies, it's 11 milligrams.

00:16:51.900 --> 00:16:56.300

<v SPEAKER_1>Like babies don't even eat like 11 milligrams of actual food, let alone iron when they're starting.

00:16:56.320 --> 00:17:00.180

<v SPEAKER_1>And like the podcast episode is called, Does My Baby Really Need To Eat 11 Milligrams of Iron?

00:17:00.200 --> 00:17:04.240

<v SPEAKER_1>Because parents will look it up and be like, oh my gosh, I'm going to feed them so much.

00:17:04.980 --> 00:17:05.280

<v SPEAKER_1>Yeah.

00:17:05.300 --> 00:17:08.140

<v SPEAKER_1>And then there's so many different things, like with regards to absorption rates, right?

00:17:08.160 --> 00:17:14.600

<v SPEAKER_1>Like if you have a lot of vitamin C, then your body is more inclined to absorb that iron, or the iron from animal foods is better absorbed than plant.

00:17:14.620 --> 00:17:19.960

<v SPEAKER_1>But like at the end of the day, even as a dietician who's always going to recommend food first, don't even try to get 27 milligrams from food.

00:17:19.980 --> 00:17:22.140

<v SPEAKER_1>You have to take a supplemental source of iron.

00:17:22.480 --> 00:17:26.980

<v SPEAKER_1>And I want to ask you, because you're doing this, like does the iron nauseate you, constipate you?

00:17:27.000 --> 00:17:36.840

<v SPEAKER_1>Like are you personally seeking out a prenatal without iron because it's problematic for you, or were you looking for one that had it in there, and did your search change when you saw this report?

00:17:37.240 --> 00:17:38.620

<v SPEAKER_2>Yeah, really, really good question.

00:17:38.640 --> 00:17:49.400

<v SPEAKER_2>So personally, I always make sure any prenatal I'm taking, or any multivitamin, anything I'm taking has iron, because I know that I can get low iron and it's horrible, right?

00:17:49.420 --> 00:17:56.940

<v SPEAKER_2>Like your energy's level, and especially when your energy's really low, especially when you're pregnant, it can be really hard to recover from low iron.

00:17:56.960 --> 00:18:00.780

<v SPEAKER_2>So mine does contain iron, but the iron doesn't bother me.

00:18:00.800 --> 00:18:09.500

<v SPEAKER_2>I know a lot of moms who just get really bad, like constipation or heartburn, I mean, they just can't tolerate it.

00:18:09.520 --> 00:18:15.660

<v SPEAKER_2>So I think if you can tolerate it, it makes sense, because it's hard to get that much iron from your diet.

00:18:15.720 --> 00:18:20.000

<v SPEAKER_2>But if you look at what's actually recommended, I mean, a lot of prenatals don't contain iron.

00:18:20.020 --> 00:18:23.400

<v SPEAKER_2>A lot of them don't contain choline or different.

00:18:23.420 --> 00:18:24.620

<v SPEAKER_2>I mean, it's just variable.

00:18:24.620 --> 00:18:33.400

<v SPEAKER_2>So I think looking at whatever you're taking and sort of thinking critically about like, does this seem like it's meeting what I need is good?

00:18:33.420 --> 00:18:34.840

<v SPEAKER_2>You also do get tested for it.

00:18:34.860 --> 00:18:38.120

<v SPEAKER_2>You get your iron tested when you're pregnant a few times.

00:18:38.140 --> 00:18:43.880

<v SPEAKER_2>So you should have some sense of whether or not your iron levels are staying steady.

00:18:43.900 --> 00:18:47.540

<v SPEAKER_2>And actually, I got kind of lazy about taking mine every day.

00:18:47.560 --> 00:18:49.600

<v SPEAKER_1>Because you're supposed to do it on an empty stomach, too.

00:18:49.600 --> 00:18:50.720

<v SPEAKER_1>And it's like, that's rough.

00:18:50.740 --> 00:18:51.680

<v SPEAKER_2>It did go down a little bit.

00:18:51.700 --> 00:18:53.720

<v SPEAKER_2>Yeah, it didn't precipitously drop off.

00:18:53.740 --> 00:18:54.860

<v SPEAKER_2>But I thought, oh, you know what?

00:18:54.880 --> 00:18:56.480

<v SPEAKER_2>That may have been doing something.

00:18:56.500 --> 00:18:59.440

<v SPEAKER_2>So I've gone back to taking it much more regularly.

00:18:59.460 --> 00:19:17.300

<v SPEAKER_2>But it's just an interesting thing where I mean, I think this whole area probably needs more attention, more oversight, more standardization, just because the more we're learning about how crucial this time is, you know, we talk about the first thousand days, which includes pregnancy, right?

00:19:17.960 --> 00:19:20.860

<v SPEAKER_2>And the early years of what you're feeding your kid.

00:19:20.880 --> 00:19:24.160

<v SPEAKER_2>And so it just seems like an area that could use more attention.

00:19:24.180 --> 00:19:26.400

<v SPEAKER_1>I want to ask you about the actual-

00:19:27.440 --> 00:19:29.040

<v SPEAKER_2>With a little attention, yeah.

00:19:29.220 --> 00:19:32.120

<v SPEAKER_1>Well, I also love that you're just like cruising G-A-O.

00:19:32.140 --> 00:19:33.640

<v SPEAKER_1>What's the G-A-O put out this week?

00:19:34.180 --> 00:19:38.520

<v SPEAKER_1>I mean, that doesn't sound interesting to me until it's like, okay, prenatals, that's interesting.

00:19:38.900 --> 00:19:44.520

<v SPEAKER_1>What you read in this report is part of my ignorance, but I don't read these reports anymore because I just read your newsletter, which summarizes all this stuff.

00:19:44.540 --> 00:19:55.200

<v SPEAKER_1>But what's the problem if they tested samples and 11 out of 12 of them, I guess, had nutrient levels that were outside of the acceptable deviation from levels printed on the label, which I think is awesome.

00:19:55.540 --> 00:19:58.540

<v SPEAKER_1>You're allowed to lie on your labels, but you might have lied too much.

00:19:59.040 --> 00:20:00.640

<v SPEAKER_1>And so now we're going to report on you.

00:20:01.000 --> 00:20:02.900

<v SPEAKER_1>The labels were wrong.

00:20:03.260 --> 00:20:05.300

<v SPEAKER_1>They all hide behind proprietary blends, right?

00:20:05.320 --> 00:20:07.840

<v SPEAKER_1>So that they don't have to actually tell you what's in the supplements.

00:20:07.840 --> 00:20:09.820

<v SPEAKER_1>Supplement labels are a joke to begin with.

00:20:09.840 --> 00:20:13.500

<v SPEAKER_1>So I think this is funny that the government's like, did you know that the stuff on supplement labels is wrong?

00:20:13.520 --> 00:20:14.360

<v SPEAKER_1>Of course it is.

00:20:14.780 --> 00:20:18.580

<v SPEAKER_1>But was it problematic in the sense that they were shorting you on the nutrients?

00:20:18.700 --> 00:20:25.480

<v SPEAKER_1>Or were we erring on the other side, like possible issues of toxicity and nearing the upper limit, which is a level that scientists have found.

00:20:25.500 --> 00:20:31.400

<v SPEAKER_1>If you go above that value from a supplemental source of a micronutrient, it could be potentially harmful to you and your fetus.

00:20:31.460 --> 00:20:33.260

<v SPEAKER_1>Some of this crosses the placental barrier.

00:20:33.400 --> 00:20:35.440

<v SPEAKER_1>Was that some of the concern about this report?

00:20:35.840 --> 00:20:37.360

<v SPEAKER_2>Yeah, all really good questions.

00:20:37.380 --> 00:20:46.580

<v SPEAKER_2>I think the overall message is that they didn't find anything that was dangerous or unsafe or that would suggest that people should stop taking their prenatals.

00:20:46.600 --> 00:20:48.140

<v SPEAKER_2>That's a really key message here.

00:20:48.460 --> 00:21:02.660

<v SPEAKER_2>But to me, what this suggests is there just isn't as much control over the processes and the manufacturing to have that much variability in what's in the product compared to what's in the label.

00:21:02.700 --> 00:21:17.560

<v SPEAKER_2>And one of the things I learned is that one of the few requirements that there are on supplement makers is that they do need to be, I think it's close to or over the 100% level or 100% of whatever the level they do have on there.

00:21:17.580 --> 00:21:19.600

<v SPEAKER_2>So a lot of them are overshooting.

00:21:20.100 --> 00:21:26.680

<v SPEAKER_2>So in gummies in particular, this is a big issue because certain nutrients are not as stable in the gummy form.

00:21:26.700 --> 00:21:30.720

<v SPEAKER_2>And gummies are really popular or growing in popularity, especially for prenatals.

00:21:31.100 --> 00:21:35.120

<v SPEAKER_2>And a lot of times those don't contain iron either, because I think iron tastes kind of bad.

00:21:35.720 --> 00:21:44.520

<v SPEAKER_2>So what they're doing is they're overshooting the folic acid, sometimes by like two or three times the amount listed on the label.

00:21:44.960 --> 00:21:48.440

<v SPEAKER_2>And I don't know that there's any health issue with that.

00:21:48.460 --> 00:21:52.120

<v SPEAKER_2>Like I couldn't really find anything that would suggest that it is a health issue.

00:21:52.120 --> 00:21:57.800

<v SPEAKER_2>But as a consumer, knowing that something you buy could have like double or triple the amount.

00:21:57.920 --> 00:21:58.240

<v SPEAKER_1>Yeah.

00:21:58.640 --> 00:21:59.400

<v SPEAKER_2>It's on the label.

00:21:59.420 --> 00:22:01.840

<v SPEAKER_2>It's sort of like a red flag to me.

00:22:01.880 --> 00:22:04.460

<v SPEAKER_1>For a water-soluble vitamin, right, your body excretes it.

00:22:04.480 --> 00:22:07.040

<v SPEAKER_1>Like we always tell patients, like, hey, you're just going to have expensive pee.

00:22:07.060 --> 00:22:11.820

<v SPEAKER_1>You buy these expensive supplements with a bunch of water-soluble vitamins, you're going to have expensive urine because your body will excrete it, right?

00:22:11.840 --> 00:22:12.220

<v SPEAKER_1>It's water-soluble.

00:22:12.240 --> 00:22:13.300

<v SPEAKER_2>Is folic acid water-soluble?

00:22:13.540 --> 00:22:17.060

<v SPEAKER_1>Yes, because folic acid is a B vitamin and B vitamins are water-soluble.

00:22:17.320 --> 00:22:27.780

<v SPEAKER_1>But if we're talking about fat-soluble vitamins, for example, vitamin A, which everyone knows plays a role in the development of your baby's vision system and their immune, those are the fat-soluble vitamins.

00:22:27.780 --> 00:22:28.960

<v SPEAKER_1>Your liver retains those.

00:22:28.980 --> 00:22:33.320

<v SPEAKER_1>They can build up to potentially toxic levels because the body does not excrete them as readily.

00:22:33.340 --> 00:22:37.000

<v SPEAKER_1>So I think there's the common concept like, well, this is an over-the-counter product.

00:22:37.020 --> 00:22:38.920

<v SPEAKER_1>I don't even need a prescription to buy this.

00:22:38.920 --> 00:22:40.220

<v SPEAKER_1>It can't possibly be harmful.

00:22:40.500 --> 00:22:43.340

<v SPEAKER_1>Well, it is if you don't go above the upper limit.

00:22:43.360 --> 00:22:44.780

<v SPEAKER_1>Well, how am I supposed to know what the upper limit is?

00:22:44.800 --> 00:22:47.860

<v SPEAKER_1>Well, it's posted on the Supplement Facts panel.

00:22:48.340 --> 00:22:52.720

<v SPEAKER_1>But if that information is wrong, like, sorry, not to be, what can you really trust?

00:22:52.720 --> 00:22:55.260

<v SPEAKER_1>Because the information you're being provided is wrong.

00:22:55.280 --> 00:23:00.580

<v SPEAKER_1>And again, if you know the history of dietary supplement regulation, that's also a hot mess.

00:23:01.240 --> 00:23:17.200

<v SPEAKER_2>Yeah, I think for me, coming back to just like being a parent and someone who covers like regulatory issues, we just kind of have this assumption, I think, and maybe it's sometimes wrong, that certain things are just they have a little bit more oversight, right?

00:23:17.820 --> 00:23:19.600

<v SPEAKER_2>And actually, there's good examples of this.

00:23:19.620 --> 00:23:24.040

<v SPEAKER_2>Like cribs are regulated, like what paint you can use.

00:23:24.740 --> 00:23:27.780

<v SPEAKER_2>Also, car seats are pretty tightly regulated.

00:23:28.080 --> 00:23:29.460

<v SPEAKER_2>So there are examples.

00:23:29.480 --> 00:23:30.280

<v SPEAKER_1>But you know what's not?

00:23:30.360 --> 00:23:30.960

<v SPEAKER_1>High chairs.

00:23:31.060 --> 00:23:32.560

<v SPEAKER_1>All they have to do is pass the tip test.

00:23:32.860 --> 00:23:35.340

<v SPEAKER_1>There's no requirement that the back be flat.

00:23:35.620 --> 00:23:37.320

<v SPEAKER_1>Baby's falling backwards, opening their airway.

00:23:37.520 --> 00:23:38.960

<v SPEAKER_1>No foot rest requirement.

00:23:38.980 --> 00:23:42.200

<v SPEAKER_1>Baby's feet resting flat, which stabilizes them when they're gagging so they don't choke.

00:23:42.380 --> 00:23:43.220

<v SPEAKER_1>And parents get pissed.

00:23:43.240 --> 00:23:46.000

<v SPEAKER_1>Like, how could you possibly have sold me a high chair that's unsafe?

00:23:46.180 --> 00:23:47.580

<v SPEAKER_1>It's like, it's wild.

00:23:47.820 --> 00:23:48.780

<v SPEAKER_1>It makes parents mad.

00:23:49.000 --> 00:23:52.300

<v SPEAKER_1>And rightly so, because you would think, like, I just bought this $300 high chair.

00:23:52.320 --> 00:23:52.760

<v SPEAKER_1>Guess what?

00:23:52.820 --> 00:23:55.100

<v SPEAKER_1>Some of the most expensive ones are actually the most dangerous.

00:23:55.620 --> 00:23:56.120

<v SPEAKER_2>Really?

00:23:56.140 --> 00:23:57.620

<v SPEAKER_2>Okay, so I didn't know that.

00:23:57.640 --> 00:24:06.760

<v SPEAKER_2>But it does feel like kind of a classic American story to, like, peel back and you'll be like, some things aren't super tightly regulated and some of them are, like, not regulated at all.

00:24:06.780 --> 00:24:10.140

<v SPEAKER_2>And it's hard to tell as a parent.

00:24:10.160 --> 00:24:12.980

<v SPEAKER_2>And also, like, it feels like it requires a lot of legwork.

00:24:13.000 --> 00:24:29.640

<v SPEAKER_2>And I think, you know, one of the things I was hoping when I was looking, you know, researching prenatals was, will I find some great guide or come up with some, like, great advice on just, like, how to, you know, how to pick a prenatal, here's some, like, here are how the experts pick prenatal vitamins, right?

00:24:29.860 --> 00:24:35.320

<v SPEAKER_2>And what I found is that everyone had a different set of advice, like, look for third-party certification.

00:24:35.340 --> 00:24:39.780

<v SPEAKER_2>But then, like, I found the experts kind of disagreed about which third-party certification was the best.

00:24:39.840 --> 00:24:50.640

<v SPEAKER_2>And there's just so much variability that I didn't feel like I came to kind of a consensus on, like, how you would do the homework to sort of pick the best prenatal, which...

00:24:50.660 --> 00:24:51.760

<v SPEAKER_1>And that's saying a lot.

00:24:51.780 --> 00:24:57.880

<v SPEAKER_1>Like, you spent way more time researching it than any parent ever would, and you still kind of come up with something.

00:24:57.880 --> 00:25:00.180

<v SPEAKER_1>And how did it then inform your decision?

00:25:00.200 --> 00:25:04.200

<v SPEAKER_2>I didn't change the prenatal I'm taking, but I also, I do think it's really important.

00:25:04.240 --> 00:25:07.860

<v SPEAKER_2>I also did not come away thinking, like, oh, prenatals are dangerous.

00:25:07.880 --> 00:25:08.860

<v SPEAKER_2>I'm going to stop taking mine.

00:25:08.960 --> 00:25:09.640

<v SPEAKER_2>I did not.

00:25:10.040 --> 00:25:10.700

<v SPEAKER_1>Which is good.

00:25:10.880 --> 00:25:16.080

<v SPEAKER_2>But it was more of a realization of like, huh, like I said in the headline, does anyone care about this?

00:25:16.120 --> 00:25:16.420

<v SPEAKER_2>Right?

00:25:16.440 --> 00:25:27.000

<v SPEAKER_2>Like, is this an area that we're really looking closely at and making sure is properly labeled and, you know, that it's not having safety issues?

00:25:27.020 --> 00:25:28.440

<v SPEAKER_2>We don't see evidence of that.

00:25:28.460 --> 00:25:35.140

<v SPEAKER_2>But one of the things that was so interesting is the one of the supplement trade groups really came out strongly against this report.

00:25:35.160 --> 00:25:36.320

<v SPEAKER_2>They called it alarmist.

00:25:36.740 --> 00:25:43.300

<v SPEAKER_2>They were like, you know, arguing or basically saying that, you know, maybe GAO didn't have the best testing methods and so on.

00:25:43.700 --> 00:25:47.340

<v SPEAKER_2>But what I came to realize is there has been no independent analysis.

00:25:47.380 --> 00:25:48.920

<v SPEAKER_1>Even Consumer Reports hasn't done it?

00:25:49.440 --> 00:25:49.780

<v SPEAKER_2>No.

00:25:50.220 --> 00:25:56.360

<v SPEAKER_2>Of how accurately labeled this, you know, this sector is, it would be great if Consumer Reports did that.

00:25:56.380 --> 00:25:56.840

<v SPEAKER_1>They should.

00:25:57.280 --> 00:25:58.740

<v SPEAKER_1>Their chief scientist, he's so awesome.

00:25:58.760 --> 00:25:59.460

<v SPEAKER_1>He comes on all the time.

00:25:59.480 --> 00:26:01.480

<v SPEAKER_1>He's so interested in parents' feedback.

00:26:01.500 --> 00:26:04.520

<v SPEAKER_1>You know, they've done tuna and obviously the heavy metals and the baby food.

00:26:04.540 --> 00:26:07.520

<v SPEAKER_1>But like, I would love to see their hot take on this too.

00:26:07.980 --> 00:26:15.240

<v SPEAKER_2>Yeah, I think it's just really good to have some independent analysis because you are really relying on, you know, companies to do the right thing.

00:26:15.260 --> 00:26:20.080

<v SPEAKER_2>And thankfully, I think most of them like don't want to have an issue with the prenatal vitamin.

00:26:20.100 --> 00:26:28.920

<v SPEAKER_2>And I especially I think if they have a brand, like a brand name behind them, like they're going to be paying really close attention to like what their sourcing is.

00:26:28.940 --> 00:26:30.940

<v SPEAKER_2>You know, maybe they're going to be doing more quality testing.

00:26:30.960 --> 00:26:38.400

<v SPEAKER_2>Like it's not like I think the industry is like reckless, but it's the question of is there independent oversight?

00:26:38.740 --> 00:26:41.100

<v SPEAKER_2>And I think that's that's what we don't have.

00:26:41.400 --> 00:26:43.980

<v SPEAKER_1>Hey, we're going to take a quick break, but I'll be right back.

00:26:49.908 --> 00:26:51.608

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<v SPEAKER_1>I think what's so interesting historically, like I used to be an adult nutrition all the time.

00:27:25.928 --> 00:27:29.488

<v SPEAKER_1>Okay, if you absolutely need to take a supplement, cause like you just feel like you want to, right?

00:27:29.508 --> 00:27:31.268

<v SPEAKER_1>But it's in order to supplement your diet.

00:27:31.288 --> 00:27:33.848

<v SPEAKER_1>So I would like to look as a dietician at the base of your diet.

00:27:33.868 --> 00:27:38.428

<v SPEAKER_1>And most of your nutrition is coming from food and the supplement is intended to supplement it, not fix it.

00:27:38.948 --> 00:27:47.268

<v SPEAKER_1>But in that case, a lot of times the recommendation was go for the generic brands, like a Walgreens and a Target and a Walmart brand, Kirkland.

00:27:47.288 --> 00:27:54.728

<v SPEAKER_1>And I know Consumer Reports has done supplement studies in the past where Kirkland comes out like tip top, like you're gonna buy fish oil, just do, like they've got more to lose basically.

00:27:54.748 --> 00:27:55.188

<v SPEAKER_1>And they've got-

00:27:55.208 --> 00:28:00.408

<v SPEAKER_2>I think that's true, is a lot of, they have a lot of in-house requirements that are not-

00:28:00.428 --> 00:28:01.648

<v SPEAKER_1>Perhaps more stringent.

00:28:01.648 --> 00:28:03.128

<v SPEAKER_2>Are known to be more strict.

00:28:03.548 --> 00:28:09.788

<v SPEAKER_2>I can't speak to this supplement specifically, but on food safety, they are known to be quite strict on that stuff.

00:28:09.808 --> 00:28:11.168

<v SPEAKER_1>And that's a good recommendation to parents.

00:28:11.188 --> 00:28:25.868

<v SPEAKER_1>Like if you don't care, but sometimes parents think, especially in adult nutrition, older adults, a lot of the supplement manufacturers that they, they so unscrupulously market to older adults on limited fixed incomes, their perception is if it's more expensive, it must be better for me.

00:28:26.288 --> 00:28:28.648

<v SPEAKER_1>And we know with supplements, that's certainly not the case.

00:28:28.668 --> 00:28:39.328

<v SPEAKER_1>And so I think, you know, I would love to see your guide on like how to buy a prenatal because it doesn't need to be the most expensive, a big national brand that perhaps has more stringent oversight than the non-existent prenatal oversight, I guess.

00:28:39.508 --> 00:28:40.868

<v SPEAKER_1>I didn't even know we didn't have this either.

00:28:40.888 --> 00:28:51.028

<v SPEAKER_1>So I appreciate you looking at the source documents too, because just like looking at the way you handle this versus like your typical mom influencer on TikTok would be like prenatal vitamins are the worst thing ever.

00:28:51.048 --> 00:28:52.228

<v SPEAKER_1>It's like, that's not what you're saying.

00:28:52.248 --> 00:29:00.648

<v SPEAKER_1>You're just saying like, wow, even as a person taking this and a fairly educated person in food and supplements, like I had no idea there was no standardization.

00:29:00.688 --> 00:29:03.748

<v SPEAKER_1>And should there be just starting that discussion, like that's interesting.

00:29:04.108 --> 00:29:10.388

<v SPEAKER_2>Yeah, and there are some government agencies that are, I think this summer are going to have a meeting about prenatals.

00:29:10.388 --> 00:29:13.228

<v SPEAKER_2>I'm not sure if it was sort of sparked by the GAO report.

00:29:13.228 --> 00:29:14.968

<v SPEAKER_2>I would guess it has something to do with it.

00:29:15.508 --> 00:29:22.448

<v SPEAKER_2>And so there is going to be a little bit more conversation here in Washington just about that class of products, which I think is a good thing.

00:29:22.468 --> 00:29:24.768

<v SPEAKER_2>I mean, I don't know what the answer is here.

00:29:24.788 --> 00:29:33.688

<v SPEAKER_2>I just, I, yeah, like you said, I was just surprised to learn about sort of the lack of standardization and talking to friends too about like, what are they taking?

00:29:33.708 --> 00:29:35.548

<v SPEAKER_2>I just found it was all over the map.

00:29:35.548 --> 00:29:38.968

<v SPEAKER_2>Like what, you know, what was included versus not, which is just interesting.

00:29:39.388 --> 00:29:46.648

<v SPEAKER_2>And I personally think that like parents shouldn't be expected to do research on this kind of stuff.

00:29:46.668 --> 00:29:49.328

<v SPEAKER_2>Like you should just sort of be fine.

00:29:49.708 --> 00:29:51.588

<v SPEAKER_2>Just standardization.

00:29:52.028 --> 00:29:57.388

<v SPEAKER_2>Like you are not wondering whether or not your currency is up to code, right?

00:29:57.408 --> 00:29:57.868

<v SPEAKER_1>Absolutely.

00:29:57.888 --> 00:29:58.228

<v SPEAKER_1>You're right.

00:29:58.468 --> 00:30:03.028

<v SPEAKER_1>There should be some basic level, especially when there's upper limits that are set based on science.

00:30:03.368 --> 00:30:07.528

<v SPEAKER_1>There's RDAs and AIs for pregnant women set that are based on science.

00:30:07.888 --> 00:30:13.648

<v SPEAKER_1>There's average like household consumption level data that we can get from the USDA about what the average person is eating.

00:30:13.668 --> 00:30:15.088

<v SPEAKER_1>Like do the subtraction, right?

00:30:15.108 --> 00:30:16.988

<v SPEAKER_1>What you should be getting minus what you're probably eating.

00:30:17.008 --> 00:30:19.068

<v SPEAKER_1>And then like, let's make a range and put them in prenatal vitamins.

00:30:19.088 --> 00:30:21.368

<v SPEAKER_1>Like it's probably not that simple.

00:30:21.388 --> 00:30:25.288

<v SPEAKER_1>But your question or your statement about, okay, there's other agencies may be getting together.

00:30:25.628 --> 00:30:33.488

<v SPEAKER_1>Let me to my next question was because normally as a dietitian, for consumers who are looking to learn about supplement safety, I usually recommend go to the Office of Dietary Supplements.

00:30:33.888 --> 00:30:38.228

<v SPEAKER_1>Has ODS changed any of their guidance in response to this GAO report?

00:30:38.368 --> 00:30:47.428

<v SPEAKER_1>Or what, if any fallout, do you think this report will have on the government's ability to make safety recommendation about products that ostensibly are benign like prenatal vitamins, but apparently are not?

00:30:47.808 --> 00:30:53.668

<v SPEAKER_2>Yeah, I don't know if they've changed at all, but FDA actually was, so I think ODS is under NIH.

00:30:53.908 --> 00:31:01.168

<v SPEAKER_2>So they do a lot of the research on, what do we know versus not know about supplement evidence and efficacy.

00:31:01.788 --> 00:31:10.388

<v SPEAKER_2>But GAO actually recommended, one of their recommendations was that FDA be given information about what supplements are on the market.

00:31:10.408 --> 00:31:14.988

<v SPEAKER_2>So right now, FDA doesn't often know what certain products contain or don't.

00:31:15.448 --> 00:31:19.908

<v SPEAKER_2>And they do pretty limited inspections generally on the supplement industry.

00:31:19.928 --> 00:31:27.028

<v SPEAKER_2>But GAO was like, basically FDA needs more oversight, more authority to conduct oversight over dietary supplements.

00:31:27.548 --> 00:31:29.348

<v SPEAKER_2>And FDA agreed with that.

00:31:29.368 --> 00:31:39.268

<v SPEAKER_2>But I haven't seen any movement on Capitol Hill to be like, hey, Congress should specifically direct FDA.

00:31:39.288 --> 00:31:42.768

<v SPEAKER_1>I can't imagine it's not a top priority point for them right now.

00:31:42.788 --> 00:31:48.908

<v SPEAKER_2>I don't know how much your listeners have been paying attention, but we're having trouble keeping the lights on, right?

00:31:49.008 --> 00:31:50.488

<v SPEAKER_2>Or keeping the government funded.

00:31:50.848 --> 00:31:53.368

<v SPEAKER_2>There's just a lot of dysfunction and turmoil here generally.

00:31:53.388 --> 00:31:58.688

<v SPEAKER_2>That has nothing to do with prenatals, but it makes getting anything done really hard.

00:31:59.168 --> 00:32:04.488

<v SPEAKER_2>So I don't foresee there being like a big move on this, but it certainly got folks' attention.

00:32:04.508 --> 00:32:10.368

<v SPEAKER_2>I think the GAO report did cause some folks across the government to go, okay, like do we need to look at this?

00:32:10.508 --> 00:32:17.188

<v SPEAKER_2>I don't know if anything will come of it, but I am hearing certainly more like attention on the issue.

00:32:17.188 --> 00:32:19.568

<v SPEAKER_1>So we need consumer reports on the job.

00:32:19.588 --> 00:32:24.868

<v SPEAKER_1>I mean, once they're done with their Lunchables takedown, then we'll see if they can get on prenatal vitamins Lunchables.

00:32:25.188 --> 00:32:26.688

<v SPEAKER_2>Totally blown up.

00:32:27.168 --> 00:32:31.028

<v SPEAKER_1>Thank you for bringing your personal take on the prenatal vitamin.

00:32:31.048 --> 00:32:40.228

<v SPEAKER_1>Just to kind of summarize, we should keep taking prenatal vitamins, but just be aware that there's no set standard for what should be in them or what might be in them.

00:32:40.608 --> 00:32:40.788

<v SPEAKER_2>Yeah.

00:32:40.808 --> 00:32:45.768

<v SPEAKER_2>And I think pay special attention to whether or not you need iron in yours, cause a lot of them don't contain iron.

00:32:46.068 --> 00:32:48.868

<v SPEAKER_2>And the gummies are often overshooting.

00:32:49.088 --> 00:32:50.948

<v SPEAKER_2>So just keep that in mind.

00:32:51.468 --> 00:32:56.288

<v SPEAKER_2>Not that it's a safety issue to my knowledge at all, but just, I think it's good to know that.

00:32:56.668 --> 00:33:02.708

<v SPEAKER_2>And if you can tolerate other types that are not gummies, those are probably going to be a little bit more accurately labeled.

00:33:02.728 --> 00:33:05.048

<v SPEAKER_2>And so just, I think that's a good thing to know.

00:33:05.428 --> 00:33:08.848

<v SPEAKER_1>And at the end of the day, would you say the benefits of prenatal still outweigh the risks?

00:33:09.348 --> 00:33:09.668

<v SPEAKER_2>Yeah.

00:33:09.688 --> 00:33:16.348

<v SPEAKER_2>That was my takeaway from talking to all the experts is like, there's no evidence that we need to be moving away from these products.

00:33:16.408 --> 00:33:20.708

<v SPEAKER_2>It's just a question of like, can we do better on making sure they're accurately labeled?

00:33:21.088 --> 00:33:23.228

<v SPEAKER_2>Can we maybe standardize what's supposed to be in them?

00:33:23.248 --> 00:33:28.508

<v SPEAKER_2>But yeah, I mean, ACOG, you know, talk to any doctor, talk to CDC.

00:33:28.528 --> 00:33:37.888

<v SPEAKER_2>They're all pretty across the board on particularly making sure you're taking a folic acid, especially in that early preconception time in the first trimester.

00:33:38.068 --> 00:33:40.488

<v SPEAKER_1>I always appreciate your opinions and your insight.

00:33:40.508 --> 00:33:45.288

<v SPEAKER_1>And thank you so much for taking the time to come and talk about prenatal vitamins and good luck to you in the tail under your pregnancy.

00:33:45.308 --> 00:33:46.388

<v SPEAKER_1>I know I probably won't see you for a while.

00:33:46.408 --> 00:33:47.248

<v SPEAKER_1>So good luck with everything.

00:33:47.648 --> 00:33:48.488

<v SPEAKER_2>Thank you so much.

00:33:48.508 --> 00:33:51.248

<v SPEAKER_1>I better see you when the baby turns six months of age for baby-led weaning.

00:33:51.688 --> 00:33:52.008

<v SPEAKER_2>Yeah.

00:33:52.028 --> 00:33:52.388

<v SPEAKER_2>Oh yeah.

00:33:52.408 --> 00:33:56.368

<v SPEAKER_2>And actually I was just talking to a friend and they were like raving about your hundred foods to try.

00:33:56.388 --> 00:33:57.608

<v SPEAKER_2>Everyone thinks that's so fun.

00:33:57.628 --> 00:33:58.708

<v SPEAKER_1>So thank you.

00:33:59.188 --> 00:33:59.948

<v SPEAKER_2>Thanks for having me.

00:34:00.908 --> 00:34:04.328

<v SPEAKER_1>Well, I hope you guys enjoyed that interview with Helena Bottemiller Evich.

00:34:04.608 --> 00:34:08.108

<v SPEAKER_1>She is the founder and editor in chief of the Food Fix newsletter.

00:34:08.128 --> 00:34:11.428

<v SPEAKER_1>You can find that online at foodfix.co.

00:34:11.648 --> 00:34:16.848

<v SPEAKER_1>She's got a lot of great reporting on issues that pertain to us both as consumers and as parents.

00:34:17.088 --> 00:34:25.648

<v SPEAKER_1>I'll put everything that she mentioned in the show notes page for this episode, which you can find at blwpodcast.com forward slash four four zero.

00:34:25.948 --> 00:34:28.388

<v SPEAKER_1>And a special thank you to our partners at Airwave Media.

00:34:28.668 --> 00:34:33.708

<v SPEAKER_1>If you like podcasts that feature food and science and using your brain, check out some of the podcasts from Airwave.

00:34:33.828 --> 00:34:36.048

<v SPEAKER_1>Again, we're online, blwpodcast.com.

00:34:36.288 --> 00:34:38.348

<v SPEAKER_1>Thank you so much for listening and I'll see you next time.

00:34:38.368 --> 00:34:38.488

<v SPEAKER_1>Bye.

00:34:47.487 --> 00:34:50.887

<v SPEAKER_4>Are you looking for a podcast your whole family can enjoy together?

00:34:51.307 --> 00:34:53.407

<v SPEAKER_4>Check out Culture Kids Podcast.

00:34:53.947 --> 00:35:03.507

<v SPEAKER_4>Our adventures will ignite your curiosity for culture, traditions, languages, geography, and even pop culture with interviews from guests all over the world.

00:35:04.127 --> 00:35:11.807

<v SPEAKER_4>Through each episode, we aim to help children become empathetic, creative leaders in their communities and help them see the beauty in our differences.

00:35:12.407 --> 00:35:15.747

<v SPEAKER_4>And that's Culture Kids Podcast, wherever you get your podcasts.

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<v SPEAKER_3>Podcasts.