Welcome back bloggers! We have some burning questions to get to the bottom of over the next few months so today we are going to begin with unpacking a controversial topic: vitamin A in pregnancy.
Why are we told to avoid beef liver in pregnancy? … and why is it in Foraged?
Now we know that organ meats are one of the most nourishing, nutrient-dense foods in the world. If you are new around here and only just learning this, please enjoy reading our blog about beef liver here. Organ meats have been treasured, savoured and even worshipped in ancient cultures because of their nutrient density. This is still common in many parts of the world, and wasn’t actually that long ago that this was still common in Western culture too. Organ meats contain high (and safe!) amounts of some of the most vital nutrients. They are nothing short of nature's multivitamins, especially beef liver. So if this is the case, why are we avoiding beef liver in pregnancy, when it’s one of the most important times to stay nutritionally replete? Well to put it simply… we aren’t!
Vitamin A from food and synthetically made vitamin A are vastly different, and in a sense cannot be compared or placed in the same category. Despite this, Vitamin A has unfortunately been demonised throughout pregnancy in recent years due to a (very flawed) study showing that very high, and almost impossible to reach, levels of a synthetic derivative of vitamin A (isotretinoin) being detrimental to foetal development in utero. Do you remember the acne medication Accutane? This drug initially started the fear associated with vitamin A, as women who were taking this synthetic vitamin A derivative sadly either miscarried or gave birth to deformed babies. This teratogenic drug however, is in incredibly high doses of isotretinoin, not the kind of vitamin A that we find in food. This is when red tape was wrapped around all forms of vitamin A and retinol, including demonising the foods it is rich in, such as beef liver.
Once this was discovered, governing bodies ripped vitamin A supplements from the shelf, removed it from pregnancy multivitamins, and said organ meats including beef liver were to be avoided at all costs. This however, is based on lack of education and understanding of the difference between synthetic vitamins and food-based nutrients (which is a world of difference in this case). Today we are going to explain to you how important vitamin A is, and bust the myth of totally avoiding vitamin A in pregnancy.
Why do we need vitamin A?
Vitamin A is a very necessary nutrient for not only conception, pregnancy, breastfeeding, and postpartum, but also required for foetal neurological, eye, and organ development. It is a key player in immune function, mucous membrane integrity, thyroid function, skeletal and soft tissue health. Vitamin A also has an integral role in preventing anaemia, as it increases haemoglobin and iron utilisation in the body. The fear around vitamin A has made many deficient in it, which as you can see, poses a large risk to both mum and bub. The value of having adequate vitamin A status in pregnancy carries more weight than the risk of toxicity (which is highly unlikely to occur through food-based consumption, anyway).
So why don’t we start to change the narrative and ask questions like…
“Why is liver safe during pregnancy? How much can I consume? What kind of risk does a vitamin A deficiency pose?”
Liver contains food-based retinol which when consumed in appropriate amounts, is incredibly nourishing whether you are pregnant or not. Liver contains co-factors that support the absorption, utilisation, and metabolism of the other nutrients present, allowing these nutrients to work in synergy. This is the beauty of using foods to meet nutritional requirements rather than isolated synthetic supplements - nature respects balance. One of many examples of this is that liver contains adequate amounts of other fat soluble vitamins such as Vitamin D and K2, which balance out vitamin A.
As previously mentioned, vitamin A is crucial for foetal development. Growth abnormalities and birth defects such as underdevelopment of the eyes, diaphragm, heart and lungs, have been observed from vitamin A deficiencies. In fact, increased findings of congenital diaphragmatic hernias have been associated with insufficient vitamin A status in pregnancy. This kind of deficiency may also put mothers at risk, as we know vitamin A plays a key role in fertility, iron utilisation, immune, eye and skin health. One could argue that this deficiency is a larger risk factor than toxicity, as toxicity is unlikely to occur via dietary intake. It sounds like a delicate balancing act, doesn’t it? Vitamin A is one of those nutrients that you need to get just right.
So, how can we get it right? How much can we consume and how do we do it safely?
Because of the risk synthetic vitamin A poses, there is an ‘upper limit’ for vitamin A intake, meaning the highest intake before toxicity occurs. Supplementation in large doses (greater than 10,000 iu) is best avoided during pregnancy and preconception. Luckily, it is very rare for someone to meet this upper limit consistently from food-based vitamin A.
Here are some of the Australian intake recommendations for vitamin A:
- RDI for women aged 14+: 700ug / 2333 iu
- RDI in pregnancy: 800ug / 2667 iu
- Upper limit: 3000ug / 10,000 iu
*ug = mcg RAE
*iu = international units
**Note: a recommended daily intake (RDI) is not an upper limit, nor is it an optimal or thriving dose. An RDI is the value associated with meeting the nutritional requirements of 97% of healthy people within a specific age group - aka, the minimum dose to get by.
When it comes to meeting these vitamin A nutritional requirements, there are various ways to do so, using dietary retinol and carotenoids. Preformed vitamin A (retinol) is only found in animal products. Plants contain carotenoids, a precursor to vitamin A that converts to retinol in the body. However, this conversion rate is very poor, sometimes as little as 10% (depending on the person), which means many plant-based diets can be deficient.
Below are some various foods rich in retinol:
- Liver
- Dairy (ghee, butter, cheese, cream)
- Egg yolk
- Seafood (sardines, mackerel, salmon, oysters, octopus)
- Meat (pork, beef, turkey)
The above foods are all great sources of vitamin A, especially the first three listed. Beef liver is the most retinol-rich food in the world, containing ~17,000 iu of retinol per 100g. This amount changes depending on the animal - lamb liver is even higher, chicken liver is lower. When eaten as a wholefood (think paté, pan-fried, grated in bolognese, etc), it is one of those things that you naturally want to eat sparingly as the flavour can be intense, making it a ‘sometimes food’ for a lot of people. Unless, you may like to eat paté every day (which we wouldn’t hold against you because it’s so damn delicious), but this could contribute to high vitamin A intake. Like anything in life, excess isn’t ideal.
Let’s go over the vitamin A content of a few foods that many of us consume on a regular basis, that you may perhaps decide to be the nourishing items that land on your pregnancy plate.
- 2 egg yolks - 431 ug / 1437 iu
- 10g ghee - 86 ug / 287 iu
- 1 serving (7.5g) of Foraged For You The Mother’s Blend - 630 ug / 2100 iu
- 1 serving (1 tsp) Rosita Cod Liver Oil - 1100 ug / 3663 iu
- 1 serving (6 caps) of beef liver capsules - 960 ug / 3200 iu *differs depending on brand
- 1 serve of paté (~30g) - 280μg / 933iu *differs depending on brand, recipe and animal liver has come from
If you ate all of these items in one day, this would be an estimation of ~3487ug / 11620 iu of food-based retinol.
So if you had ALL of these food-based items every single day, you are hovering around the upper limit. Also bearing in mind, this intake is all food-based vitamin A, which is not teratogenic and hasn't had any documented reports of toxicity. Additionally, one would rarely (dare I say never) consume this much preformed vitamin A from liver (Foraged, capsules, paté and oil) consistently, every day, whilst pregnant.
The Bottom Line
Vitamin A is a critical nutrient for overall health and wellbeing, including when trying to conceive, pregnant, or postpartum. It’s one of those nutrients you want to really optimise, without overdoing it. A deficiency of vitamin A is very common and could be considered more of a risk than toxicity, which has also not been documented from food-based sources. Vitamin A from food is safe and is not the same as the harmful synthetic derivative isotretinoin.
We hope this has brought you some peace of mind, some empowering evidence, or some new juicy, nourishing information for your pregnancy journey and has hopefully eased any concerns associated with consuming beef liver and/or The Mother’s Blend whilst pregnant.
If you have any further concerns, please discuss your individual vitamin A requirements with your preferred health professional and be sure to supplement safely.