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What is the Dispensary’s recommendation on the consumption of liver during pregnancy?

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By : Nurturing Life's Nutrition Team | Montreal Diet Dispensary
Vitamine A

In light of recent studies, the Dispensary recommends avoiding eating liver until the 12th week of pregnancy, and to limit consumption to 75 grams per week for subsequent trimesters. Chicken liver or pork liver are preferred because their retinol content (preformed vitamin A) is lower than that in the liver of other animals or fish.

The liver of animals or fish is very rich in retinol, a teratogenic substance that increases the risk of malformations in the fetus if the mother consumes too much. Pregnant women must therefore be alert of liver consumption. Note that the risk of birth defects caused by excess retinol was observed in several studies during the first trimester of pregnancy, when the fetus’s organs are forming.

After the first trimester, the consumption of a portion of liver per week (75 g cooked), that is to say the size of a palm, is deemed safe. This amount can even help fill the need in iron and vitamin A for pregnant women, especially for those at risk of deficiency in these nutrients.

Chicken and pork livers (Table of retinol content of liver French only) are those with the lowest retinol contents. As retinol is removed very slowly by the body, it is preferable to select these types of liver; those from other animals (veal, beef, fish, etc.) usually contain amounts of retinol exceeding the maximum recommended daily intake.

A study observed that pregnant women who were at risk of vitamin and mineral deficiency (low income, frequent pregnancies, multiple pregnancy or breastfeeding during pregnancy) had very low vitamin A reserves. A deficiency in vitamin A may increase the risk of maternal anemia and the risk of adverse effects in the fetus.

Two risks related to vitamin A deficiency in the fetus have recently been observed in studies: the risk that the kidneys be too small and the increased risk of congenital diaphragmatic hernia (malformation of the diaphragm causing pulmonary problems). However, it should be noted that only two studies have made these observations: more will be needed to confirm this new data.

The dispensary receives pregnant women with low incomes, often at risk of nutritional deficiencies. When nutritionists find a deficient intake of iron or vitamin A in the diet of a pregnant woman, they can recommend chicken or pork liver after the first trimester, at a rate of 75 g a week or less.

Warning: beware of products with ingredient lists indicating the presence of “poultry liver”. Behind this nomenclature can hide turkey liver, which is extremely rich in retinol. Choose products whose label reads “chicken liver”.

References

  • Beurskens, L.W.J.E., Schriver, L.H., Tibboel, D., Wildhagen, M.F., Knapen, M.F.C.M., Lindemans, J., de Vries, J. et Steegers-Theunissen, R.P.M. (2012). Dietary vitamin A intake below the recommended daily intake during pregnancy and the risk of congenial diaphragmatic hernia in the offspring. Clinical and Molecular Teratology, 97, 60-66.
  • El-Khashab, Hamdy, A.M., Maher, K.M., Fouad, M.A. et Abbas, G.Z. (2013). Effets of maternal vitamin A deficiency during pregnancy on neonatal kidney size. Journal of Perinatal Medecine, 41(2), 199-203.
  • Evira Research Reports. (2007). Intake of vitamin A, cadmium and lead via liver foods among Finnish women of fertile age – a quantitative risk assessment. Helsinki : Food Safety Authority Evira.
  • Hamdy, A.M., Abdel Aleem, M.M. et El-Shazly, A.A. (2013). Maternal vitamin A deficiency during pregnancy and its relation with maternal and neonatal hemoglobin concentrations among poor Egyptian families. ISRN Pediatrics, 2013, 1-6.
  • Les diététistes du Canada. Pregnancy: Key Practice Points. In PEN: Practice-based evidence in nutrition. Last update: 2012-11-12. Access only by subscription.
  • Santé Canada. Fichier canadien sur les éléments nutritifs – Version 2010. http://webprod3.hc-sc.gc.ca/cnf-fce/index-fra.jsp
  • Strobel, M., Tinz, J. et Biesalski, H-K. (2007). The importance of B-carotene as a source of vitamin A with special regard to pregnant and breastfeeding woman. European Journal of Nutrition, 46(Suppl 1), 1-20.
  • Thorne-Lyman A.L et Fawzi, W.W. (2012). Vitamin A and carotenoids during pregnancy and maternal, neonatal and infant health outcomes: a systematic review and meta-analysis. Pediatric and Perinatal Epidemiology, 26(Suppl. 1), 36-54.

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