Your Pregnancy Nutrition Essentials: Folate, Calcium, and Choline

Pregnancy Nutrition Essentials

You have a lot on your plate during pregnancy. And with your pregnancy cravings and extra nutritional needs, you can take that sentence literally and figuratively. What you eat and your nutrition during pregnancy can be a little overwhelming. How much weight should you gain from week to week? Which foods should you avoid? What kinds of food should you eat more of? Which prenatal supplement should you choose?

Your body is going to do everything it can to help you grow and deliver a healthy baby—but it is up to you to give your body what it needs to do so. There are many different vitamins, minerals, and other micronutrients you will need to support your health and the health of your developing baby. And you should do everything you can to get those nutrients.

Overview of nutrition during pregnancy

A healthy diet during pregnancy is a must. But beyond eating fruits and veggies, you will need a quality prenatal supplement to fill any nutritional gaps you might have. You may already eat a diet that has a good amount of nutrients like folate, calcium, choline, iron, and zinc. But you need more than the average person because you are carrying another person.

This is where a prenatal supplement comes in. Unfortunately, most women have diets that do not meet the needs of the growing baby and the changes that come with pregnancy—maternal undernutrition contributes to 800,000 neonatal deaths annually due to low birthweight. And nutrient deficiencies underlie approximately 3.1 million child deaths every year. The importance of prenatal nutrition cannot be understated. As such, The American College of Obstetricians and Gynecologists, the National Institutes of Health, and the Center for Disease Control all recommend that a woman should start taking a prenatal vitamin BEFORE she becomes pregnant.

The first six weeks of pregnancy are a crucial development period. It is during this time that your nutritional well-being will make a huge impact on your baby’s development. Yet, most women do not even realize they are pregnant until after six weeks. The Center for Disease Control reports that 45% of all pregnancies in the US are unintended. By taking a prenatal vitamin before you conceive, your baby is better protected against defects and deficiencies.

What are some of the most important nutrients?

Prenatal nutrition is not just hearsay. In a study conducted by the University of California Davis’ MIND Institute, researchers found that women who did not take a prenatal prior to and during the first month of pregnancy had nearly twice the risk of having a child on the autism spectrum. And according to the Center for Disease Control reports that 1 in every 33 babies in the US is affected by a birth defect.

Birth Defects

Of the many nutrients you will need, there are three that should be at the top of your list. They are absolutely essential—folate, calcium, and choline. These nutrients play an integral role in your pregnancy and recovery after childbirth and are critical for the development of your baby. These three nutrients help reduce birth defects and risk of complications during and after pregnancy. With that, you need to know their powerful effects, where you can get them, and the risks of being deficient.

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Folate is a B vitamin that is one of the most critical vitamins during pregnancy. It is also referred to as folic acid (the synthetic form of folate). While you are pregnant, your body requires extra blood volume in order to support your baby. Folate helps support this increase, as well as cells needed for fetal development. It is essential for DNA formation and new tissue growth.

You will hear a lot about folate before and during your pregnancy. Your OBGYN will tell you to make sure to get folate from your prenatal supplement. It is an essential pregnancy nutrient. You need 800 mcg/day during pregnancy.

Folate vs. folic acid

Folic acid and folate are both forms of vitamin B9. Folate occurs naturally and is readily available in food. Folic acid is the synthetic form of vitamin B9 and is not as readily absorbed. However, some women have a gene mutation that makes them unable to use folic acid—and many of these women are unaware of this mutation. As such, folate is the recommended form of vitamin B9 pregnancy. Taking folate will better ensure you receive its protective effects.

Folate deficiency

But one of the biggest things folate is known for is in relation to birth defects. When taken before and during the first trimester, folate helps prevent neural tube defects—a defect of the spine, spinal cord, or brain). Some of these defects are known as spina bifida, anencephaly, and encephalocele.

Spina Bifida: This is the most common neural tube defect, affecting 1,500 babies every year1. If a child has this condition, his/her spinal cord pokes through the spine. In serious cases, surgery is required and children may suffer paralyzation.

Anencephaly: This is not the most common but the most severe. It affects 1,000 babies every year. Babies with anencephaly are missing parts of their brain, skull, and scalp1—they typically only survive a few hours after birth.

Encephalocele: About 375 babies are born each year with this condition. With this condition, part of the brain pokes out of the skull and surgery is required to put the brain back in place1.

Again, the best way to protect your baby from your these birth defects is to prepare yourself nutritionally before pregnancy.

Where you can find it

Folate can be found in a variety of foods. Dark, green vegetables like spinach are quality sources of folate. Recently, many flours and pasta are enriched with folate. Other excellent sources of folate include2

  • Chickpeas, beans, lentils
  • Broccoli, asparagus, Brussel sprouts
  • Beets, potatoes, turnips
  • Avocado, papaya
  • Sunflower seeds, soy nuts

Eating these foods will pregnancy will help fill your folate needs. However, you will also need a prenatal supplement that contains 800 mcg of folate. Again, begin taking this supplement before you become pregnant.

Source of Folate


When you think of calcium, you think of strong bones and teeth. Calcium is the most abundant mineral in the body and fulfills many purposes. It is an essential part of bone health and helps prevent osteoporosis. During pregnancy, calcium supports the development of your baby’s skeletal and other essential systems.

Calcium deficiency

A calcium deficiency during pregnancy can cause a lot of problems for mother and baby. Preeclampsia is a complication that occurs during pregnancy that is characterized by extremely high blood pressure—causing hypertension and even kidney damage. This condition sadly accounts for up to 40,000 maternal deaths each year. And maternal hypertension is the leading cause of neonatal and infant death. However, calcium supplementation has powerful properties that can help reduce the risk of preeclampsia significantly. To do so, pregnant moms need to receive 1,000 mg of calcium each day.

Aside from preeclampsia, calcium deficiency can have multiple negative effects on the baby including

  • Improper development
  • Premature birth
  • Low birth weight
  • A calcium deficiency can even lead to osteoporosis for the mother.

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Where you can find it

Dairy is a well-known source of calcium, including cheese, yogurt, and milk. But, there are many other sources. Other options include beans and lentils, leafy greens, and calcium-fortified foods such as cereal and orange juice.

Your prenatal supplement should also be one of your top sources of calcium. And especially make sure that the prenatal you choose includes 1,000 mg of calcium. Anything less will not give you the right amount. Even if you believe you receive enough calcium from your diet, most women still fall short. In fact, women are less likely than men to get the calcium they need from food alone.

Calcium Each Day


You may not be aware of the benefits of choline during pregnancy. But they are astounding. And just as important and folate or iron. Though often overlooked, choline is essential for your baby during and after pregnancy. This micronutrient supports the development of their spinal cord, brain, and central nervous system. It plays an integral role in the mental health of your child throughout childhood and into adulthood. And going hand-in-hand with folate, choline can help prevent neural tube defects.

Recent studies demonstrate that choline supplementation during pregnancy and lactation can reduce the risk of

  • Schizophrenia,
  • Autism,
  • ADHD, and
  • Mental illness.

Outside of pregnancy and breastfeeding, choline plays a vital role. Choline is essential for

  • Metabolism and liver function
  • Development of the nervous system
  • Preventing anti-inflammatory issues

Choline deficiency

A choline deficiency can cause a lot of problems. Unfortunately, 90% of adults do not get the recommended amount in their diet3.  First, a deficiency can cause poor cognitive development throughout the pregnancy and even beyond. A deficiency can cause cognitive damage and brain delay at any point during the pregnancy as your baby’s brain is constantly developing. Additionally, inadequate choline can affect the nutritional value of your milk supply.

Choline deficiency can cause other conditions such as fatty liver disease. Not all prenatal supplements include choline, so make sure your supplement does.

Where you can find it

Animal foods are a richer source of choline than plant foods but choline can be found in both. In one egg yolk, there are 115 mg of choline. If you can, try to include eggs in your diet as often as you can—especially for breakfast.

Here are some nutritious recipes that contain eggs:

Cobb Salad
Veggie Frittata
Egg Salad Sandwich

Beef liver is another great source (but most pregnant women aren’t antsy to eat this during pregnancy). Cruciferous vegetables, such as cabbage and cauliflower, contain up to 65 mg of choline per cup. And legumes, such as garbanzo beans and almonds, contain up to 70 mg per cup.

Try this recipe that contains almonds and lots of protein: Almond Chicken. Almonds are easy to toss in a salad or in yogurt or in a trail mix.

The prenatal supplement you take should include choline—no excuses. During pregnancy, you need 450 mg of choline. And you need 550 mg while you are breastfeeding. Even if you eat a lot of eggs and nuts, you should still get choline from your prenatal supplement.

Choline Deficiency

Things you should consider when choosing a prenatal

Choosing a prenatal supplement may not seem like a big deal. But it is. Here are a few things to consider:

A prenatal needs more. The prenatal you choose needs to have more than just a couple of ingredients. Yes, your prenatal needs folate and iron. But it also needs

Choline: for cognitive development
DHA: for brain development and health
Zinc: for lactation and fetal development
Calcium: for bone health and protection from preeclampsia
Vitamin C: for immune system health
Copper: for bone, nerve, and lung health
Vitamin K: essential for blood clotting

Choose one early. The earlier you choose a prenatal, the better off you will be. There are many benefits. For one, starting a prenatal early can help reduce nausea. It will not stop you from getting morning sickness but it can reduce nausea caused by taking a prenatal vitamin.

Don’t cut corners. Read the ingredients. Make sure there are not any fillers. Do research on the brand you choose. And make sure they include the right nutrients in their proper amounts.

Folate, calcium, and choline are integral to a prenatal diet and fetal development. Achieving a balance of nutrients will require a balance of healthy foods and a prenatal supplement. Be in close contact with your physician about your nutritional status and that of your growing baby.

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