Nurturing life Your reference in perinatal nutrition, from pregnancy to childhood

Can I take dairy products along with my prenatal multivitamin?

Published on :
By : Nurturing Life's Nutrition Team | Montreal Diet Dispensary
prendre-des-produits-laitiers-en-meme-temps-que-ma-multivitamine-prenatale

Yes. There used to be a recommendation of waiting two hours before taking a multivitamin after consuming dairy product to promote better absorption of iron in the supplement, but there is no clear evidence that calcium interferes with iron absorption.

The World Health Organization (WHO) and Health Canada recommend taking a supplement containing calcium separately from an iron supplement to prevent interference between these two minerals. However, it is not shown that calcium significantly interferes with iron absorption. The impact of calcium supplementation and the quantities that may affect iron stores are still not well known. It even seems that the impact of calcium on iron absorption in a meal context is much less important than when calcium is consumed as a supplement. Furthermore, we can consider that during a meal, the presence of other foods can either increase (vitamin C, eg peppers) or decrease (phytates, eg cabbage) iron absorption.

Thus, it is not necessary to separate the iron supplement consumption from that of dairy products or supplements containing calcium, especially since this measure can limit the intake of dairy products, especially milk, a nutritious and very favorable food during pregnancy, rich in protein, vitamins and minerals.

As for PregVit® multivitamin, which includes a blue tablet containing calcium and a pink tablet containing iron:

  • You may continue to follow the manufacturer’s instructions and avoid eating one hour before and one hour after taking the pink pill in the morning (the tablet containing iron).
  • Invert the tablets, that is to say, take the blue tablet in the morning and the pink tablet in the afternoon.
  • If forgotten, take the tablet as soon as possible.

General recommendations for prenatal multivitamins that contain calcium and iron:

  • Eat at least one good source of heme iron per day (red meat, game, poultry, fish, offal)
  • For vegetarians, prefer plant foods with a high content of non-heme iron (pumpkin seeds, tofu, legumes, iron-fortified cereal products).
  • It is especially recommended to take the multivitamin at the time it is better tolerated, which is different from one woman to another.
  • The dietary intake of dairy products (milk, yogurt, cheese), should not be limited by taking the multivitamin or eating foods rich in iron.

To learn more on ways to increase the absorption of iron, see the next edition.

References

  • Beck, KL., Conlon, CA., Kruger, R., et Coad, J. (2014). Dietary determinants of and possible solutions to iron deficiency for young women living in industrialized countries: a review. Nutrients, 6(9), 3747-3776.
  • Bendich, A. (2001). Calcium supplementation and iron status of females. Nutrition, 17(1), 46-51.
  • Gaitán, D., Flores, S., Saavedra, P., Miranda, C., Olivares, M., Arredondo, M., et Pizarro, F. (2011). Calcium does not inhibit the absorption of 5 milligrams of nonheme or heme iron at doses less than 800 milligrams in nonpregnant women. The Journal of nutrition, 141(9), 1652-1656.
  • Gleerup, A., Rossander-Hulthén, L., Gramatkovski, E., et Hallberg, L. (1995). Iron absorption from the whole diet: comparison of the effect of two different distributions of daily calcium intake. The American journal of clinical nutrition, 61(1), 97-104.
  • Grinder-Pedersen, L., Bukhave, K., Jensen, M., Højgaard, L., Hansen, M. (2004). Calcium from milk or calcium-fortified foods does not inhibit non heme-iron absorption from a whole diet consumed over a 4-d period. American journal of clinical nutrition, 80(2), 404-409.
  • Hallberg, L., Rossander-Hulthèn, L., Brune, M., et Gleerup, A. (1993). Inhibition of haem-iron absorption in man by calcium. British Journal of Nutrition, 69(02), 533-540.
  • Hallberg, L., et Hulthén, L. (2000). Prediction of dietary iron absorption: an algorithm for calculating absorption and bioavailability of dietary iron. The American journal of clinical nutrition, 71(5), 1147-1160.
  • Hurrell, R.et Egli, I. (2010). Iron bioavailability and dietary reference values. American Journal of Human Nutrition, 91(5),1461s-1467s.
  • Kalkwarf, H. J., et Harrast, S. D. (1998). Effects of calcium supplementation and lactation on iron status. The American journal of clinical nutrition, 67(6), 1244-1249.
  • National Institutes of Health. (2015). Iron: Dietary Supplement Fact Sheet. Repéré à : http://ods.od.nih.gov/factsheets/Iron-HealthProfessional/#en4
  • Miranda, M., Olivares, M., Brito, A., et Pizarro, F. (2014). Reducing iron deficiency anemia in Bolivian school children: Calcium and iron combined versus iron supplementation alone. Nutrition, 30(7), 771-775.
  • Mølgaard, C., Kæstel, P. et Michaelsen, KF. (2005) Long-term calcium supplementation does not affect the iron status of 12–14-y-old girls. American journal of clinical nutrition, 82, 98-102.
  • Orgnisation mondiale de la Santé. (2013). Guideline: Calcium Supplementation in Pregnant Women. Repéré à : http://apps.who.int/iris/bitstream/10665/85120/1/9789241505376_eng.pdf?ua=1
  • Ríos-Castillo, I., Olivares, M., Brito, A., de Romaña, DL., et Pizarro, F. (2014). One-month of calcium supplementation does not affect iron bioavailability: A randomized controlled trial. Nutrition, 30(1), 44-48.
  • Saine Alimentation Ontario. (2016). Suppléments du Calcium. Repéré à : http://www.eatrightontario.ca/fr/Articles/Elements-nutritifs-pour-les-os-%28Ca,-P,-Mg,-vitamine-D,-Fl%29/Supplements-de-Calcium.aspx#.VPnCKyhWbqU
  • Santé Canada. (2009). Lignes directrices sur la nutrition pendant la grossesse à l'intention des professionnels de la santé - Le fer contribue à une grossesse en santé. Repéré à : http://www.hc-sc.gc.ca/fn-an/pubs/nutrition/iron-fer-fra.php
  • Scheers, N. (2013). Regulatory effects of Cu, Zn, and Ca on Fe absorption: The intricate play between nutrient transporters. Nutrients, 5(3), 957-970.
  • Walczyk, T., Muthayya, S., Wegmüller, R., Thankachan, P., Sierksma, A., Frenken, L.G., ... Hurrell, RF. (2014). Inhibition of Iron Absorption by Calcium Is Modest in an Iron-Fortified, Casein-and Whey-Based Drink in Indian Children and Is Easily Compensated for by Addition of Ascorbic Acid. The Journal of nutrition, 144(11), 1703-1709.

Categories:

The Public Health Agency of Canada has contributed financially to the production of Nurturing Life.

The views expressed herein do not necessarily represent the official views of the Public Health Agency of Canada.