The Pregnancy Vitamins and Nutrients Advice from Nutritionist of Obstetrics & Gynecology

    In addition to a healthy diet during pregnancy, many pregnant women are curious about how to supplement their nutrition during pregnancy, because vitamins and minerals play a key role in maternal and fetal growth. Most moms-to-be care about their dietary intake. However, do you understand the nutritional needs at different stages of pregnancy? The Pregnancy Vitamins and Nutrients Advice :   Trying To Conceive Period: The most important nutrient for women who are trying to conceive is folate. The recommended daily intake of folate is 600-800 μg. Some people have a genetic mutation that hinders their body from properly and efficiently converting supplemental folic acid (a synthetic version of folate) to its usable form. Therefore, an activated form of folate is the best choice at this stage. Studies have confirmed that the absorption rate of active folate is 98% higher than the synthetic folic acid. For the same intake of folate, the efficiency of active folate is much better. The key points for pregnant women to choose folate : ❯ Choose the active coenzyme form of folate (Methyltetrahydrofolate Glucosamine Salt). Differed from artificially synthesized folic acid, the active coenzyme form of folate can be used directly in the body. ❯ Choose the easy-to-swallow capsule form, which is more natural and no additives. ❯ The recommended daily amount of folate for women who are planning pregnancy is 600-800 μg a day, and should not exceed the upper limit of 1,000 μg. First Trimester : The first trimester is when the mom-to-be enters the first stage of welcoming a new life. It’s a very important time for the development of the fetus. During these first few months of pregnancy, your body would go through a lot of changes and might feel uncomfortable. Taking right dietary supplements could effectively help moms-to-be to pass the difficult period of time. In the first trimester, in addition to supplement folate, vitamin B-complex is also recommended by American Pregnancy Association. Here are some tips for selecting vitamin B-complex : The key points for pregnant women to choose vitamin B-complex : ❯ Choose the vitamin B-complex contains active folate, which can support the healthy development and growth of fetus. ❯ Choose the vitamin B-complex contains vitamin B12 (Methylcobalamin) in the form of an active coenzyme, which can improve the health of the nervous system. ❯ Choose the vitamin B-complex includes a higher amount of vitamin B6, which can help pregnant women to get through the tough stage of the first trimester better. American Pregnancy Association recommends to supplement 25-50 mg of vitamin B6 daily. As for the upper limit of vitamin B6, do not exceed 100 mg per day. ❯ Choose the vitamin B-complex includes Choline. Choline has been confirmed by many researches that plays an essential role in supporting the development of fetus. Choline exists in many foods, but studies have found that the daily supplement of it is still not enough via diet. Thus, moms-to-be can take a choline supplement alone, or choose the vitamin B-complex containing choline, which should be more convenient. Normally during the first trimester, iron supplementation is not recommended. Because iron might worsen the symptoms of discomfortness to some pregnant women. You can have iron-rich diet instead, including red meat such as beef, lamb or spinach. Unless you don’t like to eat meat, especially if you don’t eat red meat at all, it is suggested to take iron supplement in an appropriate amount. Second Trimester : At the beginning of the second trimester, the fetus begins to grow up, and the weight of the mom-to-be starts to rise slowly at the same time. It is recommended to increase the weight by 5 kg during the second trimester. During this trimester, in addition to continuing to supplement the vitamin B group, calcium and vitamin D3 should be added as well. Many pregnant women may suffer from gastrointestinal discomfort; in this case, some of them may easily have gas or other conditions if calcium carbonate are taken. Hence, calcium carbonate is generally not recommended. Although seaweed calcium is from natural source, it is also the same form as calcium carbonate. Pregnant women should choose according to their personal conditions. The calcium intake is recommended to be more than 1000 mg per day. However, we recommend that only 2/3 of your calcium supplementation is supplemented by dietary supplements (approximately 600 mg). And the other 1/3 should be taken via food sources, including 1-2 cups of milk daily or eat foods rich in calcium, such as cheese, tofu or dried fish. Moreover, it should be paid attention that calcium intake should not exceed 500 mg at one time. When it exceeds 500 mg, the absorption rate will be reduced. In short, calcium is best absorbed when it’s taken in smaller doses; it’s better to split it into two or more doses over the day. The key points for pregnant women to choose calcium : ❯ Choose New Zealand bovine bone calcium. The form of bovine bone calcium is the same as the structure of human bones; as a result, the absorption rate is better. Bovine bone calcium also contains type 1 collagen, various minerals, bone protein and growth factors. Proven by clinical studies, it is the optimal calcium choice with best efficacy. ❯ A good calcium supplement should contain the ingredients of vitamin D3 and K2. Vitamin K2 can promote bone calcification. The key of selecting K2 is to choose the MK-7 form of vitamin K2 instead of vitamin K1, because vitamin K1 is less effective. As for the content of vitamin K2, by Dietary Reference Intakes announced by Health Promotion Administration, it is recommended that women and pregnant women should take at least 90 μg per day. As for the beginning of the second trimester, vitamin D3 is also recommended to supplement daily. It is recommended to supplement 600 IU daily. In addition to helping calcium absorption, vitamin D3 also has many effects on pregnant women. Therefore, some experts or doctors even suggest mom-to-be who is at risk of vitamin D3 deficiency can supplement 1000-2000 IU a day. However, it’s better to consult professional medical professionals beforehand. According to the information from American Pregnancy Association and the National Institutes of Health (NIH), the daily nutrient upper limit (UL) of vitamin D is recommended to be relatively safe within 4000 IU daily. Third Trimester : In addition to calcium, the most important nutrient added during the third trimester is iron. Iron plays very important role in the third trimester and breastfeeding period. Therefore, the recommended intake will be higher than that in the first and second trimesters. Studies have shown that iron supplementation during the second and third trimesters of pregnant women is often overlooked. The Dietary Nutrient Reference Intakes (DRIs) in China suggest that 45 mg of iron should be supplemented a day during the third trimester and lactation. However, regarding iron supplementation, its form and intake amount at a time will have a great impact. If a high dose is taken at one time, it may cause conditions such as gastrointestinal discomfort, and can also lead to a lower absorption rate. In terms of the form of the iron, Ferrous Bisglycinate is often recommends. Ferrous Bisglycinate is an amino acid chelate iron, especially the US Albion® patented Ferrochel® is considered as the best source of raw materials for iron supplement. Its effect is better than the general ferrous fumarate and ferrous citrate; it will not cause constipation. The key points for pregnant women to choose iron : ❯ Ferrous Bisglycinate is the top choice because it is less likely to cause constipation and other conditions. ❯ The recommendation of iron supplement is low-dose at a time and divide into several times a day, 15 mg of Ferrous Bisglycinate at one time, plus a day can be supplemented with iron of about 30-45 mg. You could adjust according to individual conditions, or suggestion from your obstetricians or medical professionals. ❯ The optimal formulation of iron is recommended to also contain ingredients of vitamin C, B6, folate and vitamin B12. Vitamin C can promote iron absorption. Meanwhile, it is advised to contain vitamin B12 and folate to help the formation of red blood cells. Moreover, vitamin B6 can contribute to the formation of porphyrin in red blood cells and helps red blood cells to maintain healthy form. Including these ingredients in the iron formula can enhance the efficacy greatly. In terms of Omega-3, it is advised to supplement throughout the whole pregnancy. As for the choice of Omega-3, it is recommended to take the kind contains more than 200-300 mg of DHA and also a small amount of EPA daily. Many doctors and experts have confirmed EPA is a safe ingredient for pregnant women; EPA is especially important for older pregnant women. EPA can support the delivery and absorption of DHA. However, it is generally not recommended to consume fish oil with too high EPA content. It’s better to control within 200 mg per day. All in all, DHA is the main focus regarding Omega-3 supplementation in pregnancy. During the lactation period, postpartum moms must continue to pay attention to the supplementation of calcium, iron, and fish oil. The supplement of vitamin B complex can enrich nutrients in breast milk. Moreover, taking care of newborns is not an easy task, vitamin B-complex can help strengthen the physical strength, energy and nutrition after childbirth. Lecithin is also an ingredient that many women use to supplement in postpartum period. Although there is no direct clinical evidence to prove that it is helpful, many new moms do feel its effect. A small amount of 1000 mg lecithin can be supplemented daily during the third trimester and 3000 mg daily after delivery. However, lecithin is a selective nutrient. If you feel like to take or wonder how much to take, it is recommended that you consult your obstetrician, gynecologist, nutritionist, medical professionals or pharmacists. By the way, one of the most important nutrient supplements for infants and young children is vitamin D3. Both Taiwan and the American Academy of Pediatrics recommend that breastfed babies or the babies mixing formula with breast milk are suggested to supplement vitamin D3 400 IU daily to help developmental needs. As for the daily upper limit of vitamin D supplementation for infants and young children, it is recommended not to exceed 1000 IU a day.  
2020-12-09

孕期營養五階段怎麼吃? 婦產專科營養師教你全攻略,完整版孕婦營養建議

    懷孕期除了健康的飲食之外,很多孕媽咪最好奇的就是孕期營養品如何補充,尤其寶寶的成長只有一次,因此很多孕媽咪都很注重每日食用的保健品,但是針對不同孕期,最重要的是補充甚麼樣的營養品呢 ?  完整版孕婦營養建議 :   備孕期: 在備孕期,準備懷孕的孕媽咪最重要的就是葉酸的補充,一天建議攝取量是 600-800 微克,但由於有些人有基因部分影響,因此食用一般營養品中的人工合成形式葉酸 (Folic Acid) 也無法利用,所以這階段活性葉酸是最好的選擇。活性葉酸的吸收率經過研究證實也比一般人工合成葉酸高出 98%。同樣食用葉酸,當然選擇活性葉酸效果較佳。 孕媽咪葉酸挑選重點: ❯ 活性輔酶形式葉酸 (甲基四氫葉酸葡萄糖胺鹽),不同於人工合成的葉酸,可以供人體食用後直接利用。 ❯ 挑選膠囊形式易吞嚥,此外,膠囊較為天然,無添加物。 ❯ 每日葉酸建議攝取量 600-800 微克,上限不要超過 1000 微克。 第一孕期: 第一孕期開始就是孕媽咪邁入迎接新生命的第一階段,這時候的寶寶發育非常重要,加上有些孕媽咪在第一孕期會經歷相當不舒服的過程,因此挑選適合的營養品,可以有效幫助孕媽咪度過最辛苦的第一階段。在第一孕期,重點補充除了葉酸之外,這時候維生素 B 群開始扮演著重要的角色,美國孕婦協會 (American Pregnancy Association) 也建議孕媽咪要補充維生素 B 群,但維生素 B 群應該怎麼挑? 孕媽咪挑選 B 群重點: ❯ 含活性葉酸的 B 群,有助胎兒的正常發育與生長。 ❯ 含活性輔酶形式的維生素 B12 (甲鈷胺),能增進神經系統的健康。 ❯ 含較高量維生素 B6,可以幫助孕媽咪度過第一孕期較為不適的階段,美國孕婦協會建議每日可補充 25-50 毫克的維生素 B6。至於維生素 B6 的上限,每日不要超過 100 毫克。 ❯ 膽鹼 – 膽鹼在研究上已經證實對於寶寶的發育扮演著非常重要的角色,膽鹼存在於許多食物中,但研究發現每日的攝取量還是不足夠,因此孕媽咪可以選擇單方的膽鹼來補充,或是選擇含膽鹼的維生素 B 群,更為方便。 至於在第一孕期,我們較不建議鐵的補充,因為鐵的部分,有些孕媽咪反而會加重不適的症狀,可以正常食用含鐵的食物,包含牛肉、羊肉等紅肉,或是菠菜等即可。除非是不愛吃肉,尤其是沒有吃紅肉的孕媽咪,那就建議要適量補充鐵質。 第二孕期: 第二孕期開始寶寶開始發育長大,孕媽咪的體重也開始慢慢上升,第二孕期體重建議增加 5 公斤為宜。而在第二孕期的重點除了持續補充 B 群之外,開始要加入鈣以及維生素 D3。在孕期,很多孕媽咪可能因為懷孕等影響會有腸胃較不舒服的狀況,因此若食用碳酸鈣等鈣質,有部分孕媽咪可能容易引起脹氣等狀況,因此一般較不建議碳酸鈣。海藻鈣雖然是天然來源,但形式上也是碳酸鈣,所以孕媽咪食用上可以依個人狀況選擇。 此外,鈣質部分,在攝取量一天會建議 1000 毫克以上,但我們對於鈣質的補充,建議 2/3 由營養品補充 (大約是 600 毫克),另外 1/3 由食物來源攝取,包括一天 1-2 杯的牛奶,或是食用含高鈣的食物,包括起司、豆腐、小魚乾皆可。另外要注意的是,鈣質攝取,單次不要超過 500 毫克,因為超過 500 毫克,吸收率就會降低,因此建議分次食用效果較好。 孕媽咪挑選鈣重點: ❯ 選擇紐西蘭牛骨鈣,牛骨鈣的形式與人體骨骼結構相同,因此吸收率好。此外,牛骨鈣還含有第一型膠原蛋白、各種礦物質、及骨蛋白和生長因子,是臨床研究上具有相當好成效的鈣質來源選擇。 ❯ 好的鈣質補充品,除了維生素 D3 之外,還需要添加維生素 K2,維生素 K2 可以促進骨質的鈣化,挑選的重點在於選擇 MK-7 形式的維生素 K2,而不是維生素 K1,因為維生素 K1 效果較差。至於維生素 K2 的含量,在衛生福利部國民健康署公布的國人膳食營養素參考攝取量 (DRIs) 建議女性及孕婦一天最少要 90 微克以上。 至於第二孕期開始,維生素 D3 也會建議開始加入日常補充,每日建議補充 600 IU,維生素 D3 除了對於鈣的吸收有幫助之外,對於孕媽咪還有很多的功效,因此有些專家或醫師甚至會建議有缺乏風險的孕媽咪可以補充 1000-2000 IU,但建議您是在專業醫療人士建議與評估後才能食用較為高量的維生素 D3。根據美國孕婦協會以及美國國家衛生研究院 (NIH) 的資料指出,維生素 D 的每日營養素上限值 (Upper Limit; UL) 建議 4000 IU 以內都是相對安全的含量。 第三孕期: 第三孕期除了鈣之外,加入最為重點的一個營養素就是鐵,鐵在第三孕期和哺乳期,都是非常重要的礦物質,因此建議攝取量也會比第一和第二孕期來的更高。而研究也顯示,孕媽咪在第二與第三孕期的鐵質補充,也是常被忽略的營養素。在國人膳食營養素參考攝取量 (DRIs) 建議第三孕期與哺乳期一天要補充 45 毫克的鐵,但鐵的補充,形式和單次食用量會影響甚大,若單次食用高劑量,可能會導致腸胃不適的狀況,也會導致吸收率較低。而在形式上,鐵的選擇一般建議甘胺酸亞鐵 (Ferrous Bisglycinate),甘胺酸亞鐵是屬於胺基酸螯合鐵,尤其以美國 Albion® 專利甘氨酸亞鐵 Ferrochel® (Ferrous Bisglycinate Chelate) 為最佳原料來源,效果比一般的反丁烯二酸亞鐵及檸檬酸亞鐵等效果來的更好,也不會導致便秘等狀況。 孕媽咪挑選鐵重點: ❯ 甘胺酸亞鐵是首選,因為較不易導致便秘等狀況。 ❯ 單次低劑量,一天分多次食用,單次建議 15 毫克的甘胺酸亞鐵,一天可以補充鐵質 30-45 毫克左右,依照各人狀況或是婦產科醫師及醫療專業人士建議調整。 ❯ 鐵的配方選擇,建議要同時含有維生素 C、B6、葉酸與維生素 B12。維生素 C 可促進鐵吸收。 此外,建議含有維生素 B12 與葉酸,有助於紅血球的形成。維生素 B6 有助於紅血球中紫質的形成,有助於紅血球維持正常型態。在鐵的配方中含有這些輔助成分,可以加強食用後的成效。 在 Omega-3 部分,我們會建議全期都可以食用,至於選擇,建議每日含有 200-300 毫克以上的 DHA,並且含有少量的 EPA。EPA 對於孕媽咪是安全的成分,很多醫師及專家也都證實此一論點。而 EPA 對於高齡的孕媽咪更為重要,EPA 可以協助 DHA 的運送與吸收。但通常不建議食用太高 EPA 含量的魚油,建議大約 200 毫克以內較佳。DHA 仍然是孕媽咪補充的重點。 在哺乳期,產後的媽咪須持續重視鈣、鐵、魚油的補充及維生素 B 群的食用,仍然可以幫助乳汁中含有更豐富的營養。此外,產後的媽咪要照顧小孩更為辛苦,維生素 B 群可以幫助增強體力、精神旺盛、產前產後之補養。卵磷脂則是許多產後媽咪會食用的成分,雖然在臨床上沒有直接的研究證據顯示有幫助,但確實很多媽咪覺得有感。在第三孕期可以每日少量補充 1000 毫克,產後可以每日 3000 毫克,但卵磷脂屬於選擇性營養素,是否需要食用或要食用多少,建議您也可以詢問您的婦產科醫師、營養師、藥師等醫療專業人士。 再者,嬰幼兒最重要的營養素補充之一就是維生素 D3,台灣及美國兒科醫學會都建議,全母乳或半配方奶寶寶每日建議補充維生素 D3 400 IU,以幫助寶寶每日所需。至於嬰幼兒維生素 D 補充每日上限則建議不要超過 1000 IU。  
2020-12-08

孕期營養五階段怎麼吃 ? 婦產專科營養師教你全攻略,完整版孕婦營養建議

    懷孕期除了健康的飲食之外,很多孕媽咪最好奇的就是孕期營養品如何補充,尤其寶寶的成長只有一次,因此很多孕媽咪都很注重每日食用的保健品,但是再不同孕期,最重要的是補充甚麼樣的營養品呢 ?  完整版孕婦營養建議 : 孕期 週數 媽媽體重 需補充營養品 備孕期     活性葉酸 (必須) 第一孕期 0至12週 增加1–2公斤 活性葉酸 (必須) 維生素B群 (必須) 維生素B6 (必須) 膽鹼 (必須) 魚油–高DHA&低EPA (必須) 第二孕期 13至28週 增加5公斤 維生素B群 (必須) 膽鹼 (必須) 鈣 (必須) 維生素D3 (必須) 魚油–高DHA&低EPA (必須) 益生菌 (選擇性) 第三孕期 29週至生產 增加5至6公斤 維生素B群 (必須) 膽鹼 (必須) 鈣 (必須) 鐵 (必須) 維生素D3 (必須) 魚油–高DHA&低EPA (必須) 益生菌 (選擇性) 卵磷脂 (選擇性) 哺乳期     鐵 (必須) 維生素D3 (必須) 鈣 (必須) 維生素B群 (必須) 魚油-高DHA&低EPA (必須) 益生菌 (選擇性) 卵磷脂 (選擇性) 備孕期: 在備孕期,準備懷孕的孕媽咪最重要的就是葉酸的補充,一天建議攝取量是 600-800 微克,但由於有些人有基因部分影響,因此食用一般營養品中的人工合成形式葉酸 (Folic Acid) 也無法利用,所以這階段活性葉酸是最好的選擇。活性葉酸的吸收率經過研究證實也比一般人工合成葉酸高出 98%。同樣食用葉酸,當然選擇活性葉酸效果較佳。 孕媽咪葉酸挑選重點: ❯ 活性輔酶形式葉酸 (甲基四氫葉酸葡萄糖胺鹽),不同於人工合成的葉酸,可以供人體食用後直接利用 ❯ 挑選膠囊形式易吞嚥,此外,膠囊較為天然,無添加物 ❯ 每日葉酸建議攝取量 600-800 微克,上限不要超過 1000 微克。 第一孕期: 第一孕期開始就是孕媽咪邁入迎接新生命的第一階段,這時候的寶寶發育非常重要,加上有些孕媽咪在第一孕期會經歷相當不舒服的過程,因此挑選適合的營養品,可以有效幫助孕媽咪度過最辛苦的第一階段。在第一孕期,重點補充除了葉酸之外,這時候維生素 B 群開始扮演著重要的角色,美國孕婦協會 (American Pregnancy Association) 也建議孕媽咪要補充維生素 B 群,但維生素 B 群應該怎麼挑? 孕媽咪挑選 B 群重點: ❯ 含活性葉酸的 B 群,有助胎兒的正常發育與生長 ❯ 含活性輔酶形式的維生素 B12 (甲鈷胺),能增進神經系統的健康 ❯ 含較高量維生素 B6,可以幫助孕媽咪度過第一孕期較為不適的階段,美國孕婦協會建議每日可補充 25-50 毫克的維生素 B6。至於維生素 B6 的上限,每日不要超過 100 毫克。 ❯ 膽鹼 – 膽鹼在研究上已經證實對於寶寶的發育扮演著非常重要的角色,膽鹼存在於許多食物中,但研究發現每日的攝取量還是不足夠,因此孕媽咪可以選擇單方的膽鹼來補充,或是選擇含膽鹼的維生素 B 群,更為方便。 至於在第一孕期,我們較不建議鐵的補充,因為鐵的部分,有些孕媽咪反而會加重不適的症狀,可以正常食用含鐵的食物,包含牛肉、羊肉等紅肉,或是菠菜等即可。除非是不愛吃肉,尤其是沒有吃紅肉的孕媽咪,那就建議要適量補充鐵質。 第二孕期: 第二孕期開始寶寶開始發育長大,孕媽咪的體重也開始慢慢上升,第二孕期體重建議增加 5 公斤為宜。而在第二孕期的重點除了持續補充 B 群之外,開始要加入鈣以及維生素 D3。在孕期,很多孕媽咪可能因為懷孕等影響會有腸胃較不舒服的狀況,因此若食用碳酸鈣等鈣質,有部分孕媽咪可能容易引起脹氣等狀況,因此一般較不建議碳酸鈣。海藻鈣雖然是天然來源,但形式上也是碳酸鈣,所以孕媽咪食用上可以依個人狀況選擇。 此外,鈣質部分,在攝取量一天會建議 1000 毫克以上,但我們對於鈣質的補充,建議 2/3 由營養品補充 (大約是 600 毫克),另外 1/3 由食物來源攝取,包括一天 1-2 杯的牛奶,或是食用含高鈣的食物,包括起司、豆腐、小魚乾皆可。另外要注意的是,鈣質攝取,單次不要超過 500 毫克,因為超過 500 毫克,吸收率就會降低,因此建議分次實用效果較好。 孕媽咪挑選鈣重點: ❯ 選擇紐西蘭牛骨鈣,牛骨鈣的形式與人體骨骼結構相同,因此吸收率好。此外,牛骨鈣還含有第一型膠原蛋白、各種礦物質、及骨蛋白和生長因子,是臨床研究上具有相當好成效的鈣質來源選擇。 ❯ 好的鈣質補充品,除了維生素 D3 之外,還需要添加維生素 K2,維生素 K2 可以促進骨質的鈣化,挑選的重點在於選擇 MK-7 形式的維生素 K2,而不是維生素 K1,因為維生素 K1 效果較差。至於維生素 K2 的含量,在衛生福利部國民健康署公布的國人膳食營養素參考攝取量 (DRIs) 建議女性及孕婦一天最少要 90 微克以上。 至於第二孕期開始,維生素 D3 也會建議開始加入日常補充,每日建議補充 600 IU,維生素 D3 除了對於鈣的吸收有幫助之外,對於孕媽咪還有很多的功效,因此有些專家或醫師甚至會建議有缺乏風險的孕媽咪可以補充 1000-2000 IU,但建議您是在專業醫療人士建議與評估後才能食用較為高量的維生素 D3。根據美國孕婦協會以及美國國家衛生研究院 (NIH) 的資料指出,維生素 D 的每日營養素上限值 (Upper Limit; UL) 建議 4000 IU 以內都是相對安全的含量。 第三孕期: 第三孕期除了鈣之外,加入最為重點的一個營養素就是鐵,鐵在第三孕期和哺乳期,都是非常重要的礦物質,因此建議攝取量也會比第一和第二孕期來的更高。而研究也顯示,孕媽咪在第二與第三孕期的鐵質補充,也是常被忽略的營養素。在國人膳食營養素參考攝取量 (DRIs) 建議第三孕期與哺乳期一天要補充 45 毫克的鐵,但鐵的補充,形式和單次食用量會影響甚大,若單次食用高劑量,可能會導致腸胃不適的狀況,也會導致吸收率較低。而在形式上,鐵的選擇一般建議甘胺酸亞鐵 (Ferrous Bisglycinate),甘胺酸亞鐵是屬於胺基酸螯合鐵,尤其以美國 Albion® 專利甘氨酸亞鐵 Ferrochel® (Ferrous Bisglycinate Chelate) 為最佳原料來源,效果比一般的反丁烯二酸亞鐵及檸檬酸亞鐵等效果來的更好,也不會導致便秘等狀況。 孕媽咪挑選鐵重點: ❯ 甘胺酸亞鐵是首選,因為較不易導致便秘等狀況 ❯ 單次低劑量,一天分多次食用,單次建議 15 毫克的甘胺酸亞鐵,一天可以補充鐵質 30-45 毫克左右,依照各人狀況或是婦產科醫師及醫療專業人士建議調整。 ❯ 鐵的配方選擇,建議要同時含有維生素 C、B6、葉酸與維生素 B12。維生素 C 可促進鐵吸收。 此外,建議含有維生素 B12 與葉酸,有助於紅血球的形成。維生素 B6 有助於紅血球中紫質的形成,有助於紅血球維持正常型態。在鐵的配方中含有這些輔助成分,可以加強食用後的成效。 在 Omega-3 部分,我們會建議全期都可以食用,至於選擇,建議每日含有 200-300 毫克以上的 DHA,並且含有少量的 EPA。EPA 對於孕媽咪是安全的成分,很多醫師及專家也都證實此一論點。而 EPA 對於高齡的孕媽咪更為重要,EPA 可以協助 DHA 的運送與吸收。但通常不建議食用太高 EPA 含量的魚油,建議大約 200 毫克以內較佳。DHA 仍然是孕媽咪補充的重點。 在哺乳期,產後的媽咪須持續重視鈣、鐵、魚油的補充及維生素 B 群的食用,仍然可以幫助乳汁中含有更豐富的營養。此外,產後的媽咪要照顧小孩更為辛苦,維生素 B 群可以幫助增強體力、精神旺盛、產前產後之補養。卵磷脂則是許多產後媽咪會食用的成分,雖然在臨床上沒有直接的研究證據顯示有幫助,但確實很多媽咪覺得有感。在第三孕期可以每日少量補充 1000 毫克,產後可以每日 3000 毫克,但卵磷脂屬於選擇性營養素,是否需要食用或要食用多少,建議您也可以詢問您的婦產科醫師、營養師、藥師等醫療專業人士。 再者,嬰幼兒最重要的營養素補充之一就是維生素 D3,台灣及美國兒科醫學會都建議,全母乳或半配方奶寶寶每日建議補充維生素 D3 400 IU,以幫助寶寶每日所需。至於嬰幼兒維生素 D 補充每日上限則建議不要超過 1000 IU。  
2020-12-08

How to Choose Vitamin D Supplements? What is The Safe Range Regarding The Recommended Daily Intake?

    – The difference between vitamin D3 and vitamin D2 is that animals can synthesize vitamin D3 whereas plants synthesize vitamin D2. – When choosing vitamin D supplements, for the optimal result, vitamin D3 is the best choice. Recommended Vitamin D Intake There is no doubt about the benefits of vitamin D to our health, but there is still no unified recommendation for how much we should take for the ideal amount. In 2010, the Institute of Medicine (IOM) recommended a daily dose of 600 IU for adults. However, some studies pointed out that this is not enough. A study found that even 2000 IU per day may not be able to maintain normal blood levels. In addition to increasing the recommended intake to 600 IU, the Institute of Medicine also increased the Tolerable Upper Intake Levels (UL) to 4000 IU per day; meanwhile, IOM has also increased NOAEL (No Observed Adverse Effects Level) (the highest consumption without observing toxicity) value to 10,000 IU per day. In the light of a study by JAMA Internal Medicine, 77% of people in the United States have vitamin D deficiency, which may be more severe in winter. According to a statistical survey conducted by Chi Mei Hospital in Taiwan, more than 60% of Chinese people are vitamin D deficient. Vitamin D supplements on the market can be divided into two main categories, vitamin D2 and vitamin D3, but which vitamin D is more effective? A study published in the Journal of Clinical Endocrinology & Metabolism in 2011 indicated that for 33 testing subjects, it was found that vitamin D3 performed 87% better than vitamin D2 in increasing vitamin D content in the body (Robert P. Heaney, 2011 ). Vitamin D3 is also more efficient for storing fat cells in the body. Base off of another study published in the European Journal of Clinical Nutrition in 2015 (Beatriz Oliveri, 2015), compared to the testing subjects who take vitamin D2, those who take vitamin D3, even after they stop the supplementation, the effect could remain high for 77 days in their body. Sources of Vitamin D in Food Common food sources containing vitamin D3 are egg yolks, beef liver, deep-sea fish rich in fat (such as salmon, sardines). Common food sources containing vitamin D2 are mushrooms, nutrient-fortified breakfast cereals or milk. Advice for Vitamin D Supplementation It is difficult to obtain enough vitamin D from a normal diet. Synthesis through sunlight cannot meet daily needs either, because it is affected by the season, climate, exposure time and specific wavelengths of sunlight. If you want to supplement vitamin D, vitamin D3 is the best choice. It’s recommended 600 IU daily for adults, and the recommendations for children including infants and young children is 400 IU per day. If you are extremely deficient in vitamin D and want to supplement a higher dose, it is recommended to consult a physician, nutritionist or professional first.  
2020-10-22

該如何挑選維生素 D 補充品? 每日建議量,多少才是安全範圍?

    – 維生素 D3 與維生素 D2 的差異在於動物可以合成維生素 D3,而植物合成維生素 D2 – 當選擇含維生素 D 補充品時,為了能有最佳效果,維生素 D3 是最好的選擇 維生素 D 建議食用量 : 維生素 D 對於健康的助益,已經無庸置疑,但是應該食用多少才是理想用量,仍然尚無統一的建議。在 2010 年,美國國家醫學院 (IOM, Institute of Medicine) 針對成人建議用量為每日 600 IU。然而,有些研究指出這是不夠的。在一研究發現,即使每日 2000 IU 仍可能無法維持正常血液中濃度。除了建議食用量提升至 600 IU 外,美國國家醫學院 (Institute of Medicine) 同時將每日食用上限攝取量 (Tolerable Upper Intake Levels. UL) 提高到每日 4000 IU,以及將 NOAEL (No Observed Adverse Effects Level) (未觀察到毒性的最高食用量) 數值提高到每日 10,000 IU。 根據 JAMA Internal Medicine 的研究,美國有 77% 的人維生素 D 不足,而冬季可能更為嚴重。台灣根據奇美醫院的統計調查,國人則有超過六成維生素 D 不足。市面上維生素 D 補充品主要可分為兩類,維生素 D2 與維生素 D3,但哪一種維生素 D 效果比較好呢? 在 2011 年發表於 Journal of Clinical Endocrinology & Metabolism 期刊的研究指出,針對33名的受測者,發現維生素 D3 對於提升體內維生素 D 含量的效果,比維生素 D2 高了 87% (Robert P. Heaney, 2011)。 維生素 D3 對於儲存在體內脂肪細胞的效率也較高。根據 2015 年發表於 European Journal of Clinical Nutrition期刊的另一篇研究發現 (Beatriz Oliveri, 2015),食用維生素 D3 的受測者,即使停止補充後,比食用維生素 D2 的人相比,可以維持體內較高濃度達 77 天。 食物中維生素 D 來源 : 含維生素 D3 的常見食物來源 : 蛋黃、牛肝、富含油脂的深海魚,例如鮭魚、沙丁魚。 含維生素 D2 的常見食物來源 : 菇蕈類、營養強化的早餐穀片或牛奶。 維生素 D 補充建議 : 光從正常飲食中,很難獲取足夠的維生素 D,而經由日曬合成,也無法滿足每日所需,因為這跟季節、氣候、日曬時間和陽光特定波長有關。如果你想補充維生素 D,維生素 D3 是最好的選擇,成年人建議每日補充 600 IU,兒童包含嬰幼兒建議每日 400 IU。若你是維生素 D 極度缺乏者,欲補充較高劑量,建議可以先諮詢醫師、營養師或專業人員。    
2020-10-21

What is The Difference between Yeast B-Complex and Active Form B-Complex?

    How to tell if your dietary supplements are natural or not? Does so-called “nature” mean original food type? In fact, this is a concept that is easy to get confused. At present, according to the regulations of the Taiwan Food and Drug Administration, nutritional supplements can no longer be directly marked as "natural". After all, many raw materials are derived from food, but in order to extract or maintain stability, other ingredients have to be added in the making process. As a result, it is currently prohibited in Taiwan to announce being “natural” directly. You might wonder if the supplements claim to come from food types really easier to absorb? In fact, this statement is tricky. To determine whether the nutrients are absorbed well, and whether they are consistent with the natural food pattern, the form of the ingredient must be checked. For example, rumor has it that the vitamin B complex contains quinoa or yeast fermentation has better absorption rate due to the natural food origin. As the matter of the fact, this view is both right and wrong. Correct Understanding : The absorption rate is better when the ingredients derived from nature. Explanation : For example, Methylcabalamin is the natural form of vitamin B12 found in food, whereas Cyanocobalamin is the synthetic form of vitamin B12. According to researches and studies, the loss of synthetic form after consumption is 3 times faster than the natural form. Normally, the price of the natural active form of Methylcobalamin is more than 100 times higher than the synthetic Cyanocobalamin. Folate is another vitamin component that can be distinguished immediately. When only Folic Acid is written on the label, that is a synthetic form. Currently, the scientific name of the active Folate type approved by the Ministry of Health and Welfare in Taiwan is (6s)-5-methyltetrahydrofolic Acid Glucosamine Salt [(6s)-5-Methyltetrahydrofolic Acid]. In a study conducted by the University of Bonn in Germany in 2009, it was also confirmed that compared with traditional synthetic Folic Acid, active Folate is 98% more absorbable than traditional Folic Acid after 8 hours of consumption. (r prinz-langenohl, s brämswig, o. 2009) Vitamin E is also a good example we could look into. On the supplement facts label, you could not tell if the ingredient is natural and synthetic by Chinese description; however, English scientific names would give you the fact. The scientific name of the natural form of vitamin E is “d-alpha-tocopherol”, which is easily absorbed by the human body and is a biologically active form. On the contrary, the synthetic form is called “dl-alpha-tocopherol”. Next time, when you want to purchase vitamin E supplements, remember to check on the label to know is it “d-“ form or “dl-“ form. Misconception : Coming from yeast means it’s certainly a natural form? Explanation : Made from yeast or quinoa refers to the source used to cultivate and produce vitamin Bs during fermentation. However, most of the common vitamin B12 in this kind is the synthetic form, which is cyanocobalamin. As a result, coming from yeast doesn’t not equal to be the natural form, nor represent high absorption rate. If on the label of the supplement you purchased only marked vitamin B12 in Chinese, it is likely that it is mainly in the form of artificial synthesis. Otherwise, you have to have the vendor provided the CoA from the raw material suppliers, then you would be able to tell the form of the vitamin B12. Key Point : Natural-sourced yeast fermentation ≠ active form. The active form is the guarantee of the highest absorption rate. Natural origin or artificial synthesis has always been a topic of hype. However, the actual form existence in food or human body can only be determined by the English scientific names of the ingredients. This is a must-learn topic for consumers if you want to shop smart; otherwise, you could be fooled by some unscrupulous manufacturers. The active form can really achieve the best results after consumption. If a product cannot achieve the expected benefits after consumption, no matter how cheap it is, it is actually a waste of money. Next time, before you buy any dietary supplements, take your time and read the label clearly. Be a wiser shopper for your own health.    
2020-10-19

錯把 ”天然” 當成 "高吸收率" ? 營養品宣稱天然食物型態的陷阱?

    營養品如何判斷天然呢? 天然就是食物型態嗎? 其實這是很容易混淆的觀點。目前根據衛福部食藥署的規範,營養補充品不能再直接宣稱「天然」兩字,畢竟很多原料雖然來自食物,但為了萃取或是維持穩定性,還是會添加其他成分,因此直接宣稱天然其實目前在台灣是禁止的。 但號稱來自食物型態的營養品確實好吸收嗎? 這句話其實隱藏陷阱。要判斷營養成分人體是否好吸收,是否與天然食物型態相符合,必須要看營養成分的型式。舉例而言,維生素 B 群在坊間有號稱來自藜麥或是酵母發酵的 B 群,並宣稱來自食物好吸收。其實這一觀點既正確但又錯誤。 正確觀點:來自天然吸收率較高 說明:例如食物中存在的天然活性型式維生素 B12 是甲鈷胺 (Methylcabalamin),而合成型式的維生素 B12 是氰鈷胺 (Cyanocobalamin),根據研究文獻,其食用後,合成型式流失是活性形式的 3 倍快。而通常活性型式的甲鈷胺與合成的氰鈷胺原料也價差百倍以上。也因為活性維生素 B12 的絕佳成效以及特性,所以在美國無論是網購主要品牌或是醫療線品牌,其實也都是將甲鈷胺的維生素 B12 列為維生素上的使用首選。 葉酸,也是另一個可以立刻判斷的維生素成分。當營養品標示上只寫葉酸,或是 Folic Acid,這都是人工合成的型式。目前在台灣衛福部核准的活性葉酸型式學名是 (6s)-5-甲基四氫葉酸葡萄糖胺鹽 [(6s)-5-Methyltetrahydrofolic Acid]。而在 2009 年德國波昂大學的研究上,也證實活性葉酸跟傳統的合成葉酸相比,食用 8 小時後,比傳統葉酸還要多出 98% 的吸收量。(r prinz-langenohl, s brämswig, o. 2009) 此外,如維生素 E,中文無法區分來自天然或人工合成。但看英文學名就一目了然。天然型式的維生素 E 學名是 d-alpha-tocopherol,人體好吸收,是具生物活性的型式。人工合成型式則是 dl-alpha-tocopherol。看清楚了嗎? 所以下次要補充維生素 E,記得看清楚是 d-型式還是 dl-型式。 錯誤觀點:來自天然酵母就一定是活性型式?! 說明:來自酵母或藜麥,是指發酵時用來培養與製造 B 群的來源。但其裡面大部分常見都還是合成型式的葉酸 (Folic Acid) 或維生素 B12,也就是氰鈷胺 (Cyanocobalamin),所以來自酵母不等於是活性型式,當然,天然來源已經比人工合成的效果較佳,也不代表吸收率是最高的,但把天然來源跟活性形式的高吸收率畫上等號,是常發生的誤解,即使有些專業人員也常誤會。所以實際上必須確認是哪一種型式的維生素,才能判定。若您購買的產品彩盒上,只有標示中文維生素 B12,那很有可能就是人工合成型式為主,或是請廠商公佈原料商所提供的 CoA 證明其維生素 B12 的型式,才能判斷。 重點:天然來源酵母發酵 ≠ 活性形式。活性形式才是最高吸收率的保證。 天然來源或人工合成,一直是被拿來炒作的議題,也常常被廠商拿來當神主牌,但卻容易誤導消費者。真正存在於食物中或是人體的型式,還是必須要看英文的成分學名才能判斷,這是消費者必須學習的課題,不然就只是一直被有心的廠商消費。活性型式才能真正達成食用後的最佳成效,一個產品若無法達成食用後預期的成效,那無論多便宜,其實都是浪費錢。下次記得挑選您食用的營養補充品時,停下來多看一下營養標示,聰明選擇您所食用的營養品。    
2020-10-16

How Much Weight Gain is Considered Normal during Pregnancy?

    Pregnancy is a painstaking process. Due to the changes in hormones, some women gain appetite and feel bottomless hunger all the time while pregnant; others suffer from nausea and vomiting and experience appetite loss in contrary. Meanwhile, some pregnant women believe they can temporarily enjoy food and eat whatever they want, which could lead to a continuing increase in weight. This eating behavior could not only cause abnormal blood sugar, obesity during pregnancy may also cause other complications. Besides, it would make your weight back to original slim figure more difficult after delivery. As for how much weight gain is considered normal during pregnancy? According to the recommendations from the National Health Administration of the Ministry of Health and Welfare, during pregnancy, the weight of pregnant women should be adjusted appropriately according to their pre-pregnancy weight. A healthy range of weight gain is between 10-14 kg; and please pay attention to the rate of weight gain. In addition, it is not suitable to think of weight loss during pregnancy. Moms-to-be can use the following charts as reference : BMI Before Pregnancy * Suggested Weight Gain (lb) Weight Gain Per Week during The Second and Third Trimester of Pregnancy : kg/week (lb/week) <18.5 12.5 – 18 (28 – 40) 0.5 – 0.6(1 – 1.3) 18.5 – 24.9 11.5 – 16 (25 – 35) 0.4 – 0.5 (0.8 – 1) 25.0 – 29.9 7 – 11.5 (15 – 25) 0.2 – 0.3 (0.5 – 0.7) ≥ 30.0 5 – 9 (11 – 20) 0.2 – 0.3 (0.4 – 0.6) *Metric Units: BMI = weight (kg) ÷ height2 (m).  US Units: BMI = (weight (lb) ÷ height 2 (in)) * 703.  Source : The American Congress of Obstetricians and Gynecologists, ACOG Expected Number of Births Suggested Weight Gain (lb) Weight Gain Per Week After 12 Weeks of Pregnancy : kg/week (lb/week) Twins Weight 15.9 – 20.4(34 – 45) 0.7 Triplets Total Weight 22.7(50)   Source : American Dietetic Association, ADA In terms of daily calories and the calorie intake during pregnancy, based on the Dietary Reference Intakes (DRIs) recommendations, from the second trimester, 300 calories should be added from the daily diet. However, the total calories per person per day should be adjusted according to the age, activity level, health status and weight gain of the pregnant woman.
 As for the calorie needs during lactation, it is recommended to increase 500 kcal per day. If you have any need or concern regarding diet during pregnancy, it is recommended to consult a dietitian, who is specialized in obstetrics and gynecology, for dietary advice.    
2020-09-14

懷孕增加多少體重才算正常?

    懷孕是一個辛苦的歷程,因為賀爾蒙的改變,有些孕媽咪會食慾大增,彷彿無底洞般的飢餓,有些孕媽咪則是反胃嘔吐,一點食慾都沒有,初期反而瘦了好幾公斤。也有些孕媽咪因為懷孕,認為可以暫時享受美食盡情大吃,而導致體重直線上升,此舉不僅可能會導致血糖異常,孕期肥胖也可能導致其它併發症,並且在產後更難將體重回復到原本曼妙的身材。 至於孕期增加多少體重算是正常呢?根據衛生福利部國民健康署的建議指出,懷孕期間,孕婦體重應依懷孕前體重做適當調整,以增加 10-14 公斤為宜;且須注意體重增加的速度。此外,懷孕期間不適合減重。孕媽咪可以參考以下標準: 懷孕前的身體 質量指數(BMI)* 建議增重量 公斤(磅) 孕期第二和三期每週增加重量 公斤/週(磅/週) <18.5 12.5 – 18 (28 – 40) 0.5 – 0.6 (1 – 1.3) 18.5 – 24.9 11.5 – 16 (25 – 35) 0.4 – 0.5 (0.8 – 1) 25.0 – 29.9 7 – 11.5 (15 – 25) 0.2 – 0.3 (0.5 – 0.7) ≥ 30.0 5-9 (11 – 20) 0.2 – 0.3 (0.4 – 0.6) * 身體質量指數 BMI = 體重(公斤)/身高 2(公尺 2) 資料來源:美國婦產科學會 (The American Congress of Obstetricians and Gynecologists, ACOG) 懷孕胎數 建議增重量 公斤(磅) 12 週後每週增加重量 公斤/週(磅/週) 雙胞胎 體重 15.9 – 20.4(34 – 45) 0.7 (1 – 1.3) 三胞胎 總重 22.7(50)   資料來源:美國營養學會 (American Dietetic Association, ADA) 而在每日熱量部分,孕期的熱量攝取,依據國人膳食營養素參考攝取量(Dietary Reference Intakes, DRIs)建議,自懷孕第二期起,每日飲食需增加 300 卡的熱量。但每個人每天的總熱量,則視孕婦的年齡、活動量、健康狀況及體重增加情形,而再加以調整。 至於在哺乳期的熱量需要則建議每日增加 500 大卡為佳。若在孕期飲食上有任何需求,也建議找婦產科專科營養師諮詢飲食建議。    
2020-09-14

The Need for Iron during Pregnancy? How to Supplement Iron during Pregnancy?

    According to the National Taiwan University National Nutrition Survey commissioned by the Ministry of Health and Welfare, the nutritional deficiencies, particularly folate, vitamin B1, B2 and iron, etc. were discovered by the blood analysis of 2346 pregnant women. In addition, the deficiency increased along with the process of pregnancy. Especially in the third trimester (≧ 25 weeks), the prevalence of folate deficiency was about 4%, the prevalence of vitamin B1 deficiency was 37%, and the prevalence of vitamin B2 deficiency was 14%; furthermore, the iron deficiency has reached the prevalence of 50%. The need for vitamin B complex and iron during pregnancy is essential. As your baby grows gradually, the demand cannot be overlooked. The iron requirement during pregnancy is the same as that for general women in the first and second trimester – 15 mg per day. However, in the third trimester and also breastfeeding period, it is recommended to add an additional 30 mg everyday in order to reach the 45 mg daily requirement. However, clinically, doctors often hear complaints from pregnant patients about the feeling of nausea and vomiting in early pregnancy, which could be aggravated by the consumption of iron-containing multivitamins. Therefore, in the early stages of pregnancy, we usually recommend pregnant women to take iron-free multivitamins or B-complexes. As for the demand of iron in the meantime, we suggest to supplement by normal diet, such as eating more red meats (cattle, sheep, pork, etc.). When it comes to the second trimester of a pregnancy, you do need to increase the supplementation of iron. Generally speaking, the common source of iron for pregnancy is Ferrous Fumarate or Ferrous Sulfate, both are popularly used in clinic for iron treatments. However, studies have confirmed that these types of iron can easily cause side effects such as stomach discomfort and even constipation, so the acceptance is not high. In contrary, Ferrous Bisglycinate has been clinically proven to have the lesser side effects, and the lower amount requirement of doses will hardly cause discomfort. Meanwhile, taking low-dose supplement multiple time per day is more effective than a single high-dose. Besides, the absorption rate of Ferrous Bisglycinate is higher than the other forms of iron, so the consumption is relatively smaller. In short, if a pregnant woman has red meat often and have no symptoms of iron deficiency, they can start to supplement 15 mg of Ferrous Bisglycinate once a day in the second trimester of pregnancy. During third trimester and the breast-feeding period, please take 15 mg of Ferrous Bisglycinate twice a day. If you eat less red meat, or if you are diagnosed with iron deficiency by a medical professional, you should supplement 45 mg of Ferrous Bisglycinate daily. However, it is recommended to take iron supplements in divided doses, which can increase iron absorption and reduce the potential discomforts.    
2020-09-14