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Research UpdatesDESCRIPTIONMultivitamin use during Pregnancy Phyosterols and Cholesterol Reduction Multivitamin use during Pregnancy There is considerable debate over the efficacy of nutritional supplementation before and during pregnancy and during lactation. Research regarding the use of Folic acid supplements before conception and during the first three months of pregnancy is well established, however, the use of other supplements such as fish oils and multinutrients is less well supported. Some studies suggest that using fish oil supplements or supplements containing a balanced ratio of Omega 3 and 6 fatty acids during pregnancy can reduce the risk of developing post-natal depression and can also ensure that breast milk contains adequate amounts of these vital nutrients. However, the objective of this study was to assess the independent effect of regular periconceptional multivitamin use on the risk of preeclampsia. Pregnant women (1,835 in total), enrolled in the Pregnancy Exposures and Preeclampsia Prevention Study (Pittsburgh, Pennsylvania, 1997-2001) at less than 16 weeks gestation were asked whether they regularly used multivitamins or prenatal vitamins in the past 6 months. From this the women were classified as users or nonusers of nutritional supplements. The unadjusted prevalence of preeclampsia was 4.4% in nonusers and 3.8% in users. After adjustment for race/ethnicity, marital status, parity, prepregnancy physical activity, and income in a multiple logistic regression model, regular use of multivitamins was associated with a 45% reduction in preeclampsia risk compared with nonuse. Prepregnancy overweight modified this effect. After confounder adjustment, lean multivitamin users had a 71% reduction in preeclampsia risk compared with lean nonusers. A sensitivity analysis for unmeasured confounding by fruit and vegetable intake supported these conclusions. If confirmed by others, these results suggest that regular use of a multivitamin supplement in the periconceptional period may help to prevent preeclampsia, particularly among lean women. Many scientists agree that pre-eclampsia is caused by the result of poor antioxidant intake and it is the antioxidant content of multivitamin supplements that will contribute to this effect. However other nutrients such as calcium and iron will help safeguard against deficiencies that may be caused by physiological changes during pregnancy. Am J Epidemiol. 2006 Sep 1;164(5):470-7. Epub 2006 Jun 13. Phyosterols and Cholesterol Reduction Hypercholesterolaemia is one of the main factors contributing to the appearance and progression of CVD, which is the main cause of death in the adult population of industrialized societies. By 2020, projections suggest that it will continue to hold first place, by then causing 37 % of all deaths. Therapeutic life-style changes to reduce cardiovascular risk include dietary modifications, such as the inclusion of phytosterols or plant sterols (known since the 1950s to reduce cholesterol levels). These help prevent the absorption of cholesterol and thus condition a reduction in total cholesterol and LDL-cholesterol levels, and ultimately in cardiovascular disease risk. The fat-soluble nature of these sterols rendered margarine one of the best vehicles by which to supply them in the diet. From this, margarine became the first food to contain cholesterol-reducing phytosterols to be approved by the EU (in agreement with its regulations on new foods and food ingredients, 258/97/CE). Presently, phytosterols can be emulsified with lecithin and thus delivered in non-fat or low-fat foods and beverages. Margarine and dairy products (yoghurt and milk) enriched in phytosterols have proved better at lowering total cholesterol and LDL-cholesterol levels than have enriched cereals and their derivatives, although all can be of help, depending on the characteristics of each subject. The use of phytosterol supplements has also been studied and found efficacious. The reduction in carotenoid bioavailability caused by sterols is minimized by increasing fruit and vegetable consumption. Individuals who habitually consume phytosterols should also follow traditional advice such as eating less dietary fat and increasing their physical activity. Phytosterols have been shown to be safe and effective in lowering cholesterol levels in many rigorous studies. In few areas of nutrition is there such consensus. Diet professionals should feel comfortable in prescribing phytosterols/stanols for the treatment of hypercholesterolaemia. This study also highlighted that the use of phytosterols are safe whether they are taken alone or in combination with cholesterol-reducing drugs, such as statins and fibrates. Br J Nutr. 2006 Aug;96 Suppl 1:S89-93. RELATED NEWS | 
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