Overview of multivitamin supplements available on Slovenian market for pregnant and breastfeeding women and their safe use

V času nosečnosti in dojenja se potrebe po hranilih pri ženski močno spremenijo. Iz tega razloga so zanje v veljavi prilagojeni priporočeni dnevni vnosi, trg prehranskih dopolnil pa se je usmeril v proizvodnjo vitaminsko-mineralnih kompleksov, ki pokrivajo te potrebe. Neustrezen vnos vpliva na razvoj ploda, potek nosečnosti ter nadaljnje zdravje matere in otroka. Največji poudarek je na zadostnem vnosu folne kisline, vitamina D, kalcija in železa. Namen naloge je pregled multivitaminskih prehranskih dopolnil za nosečnice in doječe matere na slovenskem tržišču, katerih ponudba in uporaba se z leti povečuje, ovrednotenje njihovih sestavin iz vidika varnosti ter primerjava priporočenih dnevnih vnosov med državami. Končni cilj je priprava kratkih priporočil glede varne uporabe le-teh. Pregledali smo sestavo 18 izdelkov in nato s pomočjo preglednic in grafov statistično ovrednotili pridobljene podatke. V nadaljevanju smo poiskali informacije o varnosti sestavin, toksičnosti, tveganjih pri neustreznem vnosu in opozorila pri jemanju. S pomočjo znanstvenih člankov iz podatkovne zbirke PubMed pa smo podrobneje predstavili pet sestavin, katerih neprilagojen vnos predstavlja največje tveganje za zdravje. Pri pregledu izdelkov smo ugotovili, da jih je največ v obliki tablet in kapsul. Njihova sestava je pretežno vitaminska, delež mineralov in drugih organskih spojin je manjši. Prav vsi izdelki vsebujejo folno kislino in vitamine D, C ter B12, v visokih deležih pa tudi vse ostale vitamine, z izjemo vitaminov A in K, ki se pojavita le izjemoma. Od mineralov pa najpogosteje najdemo selen, železo, cink, jod in kalcij. Pri številnih izdelkih je kar nekaj sestavin presegalo 100 % priporočenega dnevnega vnosa, vendar je vsebnost bila še vedno v skladu z odmerki, ki ne smejo biti prekoračeni v izdelkih, ki niso zdravila in jih v skladu z zakonom predpisujejo pristojne institucije. Največ jih je namenjenih uporabi v vseh ranljivih obdobjih, kot so načrtovanje nosečnosti, nosečnost in dojenje (27,8 %), precej pa jih je prilagojenih posameznemu obdobju, in sicer načrtovanje nosečnosti in 1. trimesečje (16,6 %), 2. in 3. trimesečje (11,1 %) ter dojenje (11,1 %). Kar nekaj sestavin, ki jih izdelki vsebujejo, lahko pri prevelikem odmerjanju škoduje. Ugotovili smo, da si referenčne vrednosti v svetu niso enotne, temveč so med njimi odstopanja. Uporaba tovrstnih izdelkov je v predpisanih odmerkih varna in v kombinaciji z raznovrstno prehrano v večini zadosti vsem potrebam, ki so takrat povečane. Večjo težavo lahko predstavlja nezadosten vnos, ki ima lahko negativne vplive tako na mater kot na plod. Pri specifičnih zdravstvenih stanjih pa je glede uporabe potreben posvet z zdravnikom.During pregnancy and lactation, a woman\u27s nutritional needs change drastically. For this reason, recommended daily allowances are adjusted to meet these needs, and the dietary supplement market has focused on the production of vitamin-mineral complexes that meet these needs. Inadequate intake affects fetal development, the outcome of pregnancy and the subsequent health of mother and child. The greatest emphasis is placed on sufficient intake of folic acid, vitamin D, calcium and iron. The main aim of this thesis is to give an overview of multivitamin supplements for pregnant and lactating women available on the Slovenian market. Their offer and use have increased in recent years. In addition, the safety of the ingredients will be evaluated and the recommended daily allowances will be compared between countries. The goal is to develop brief recommendations for safe use. We examined the composition of 18 products and then statistically evaluated the data obtained. We used tables and charts. We then examined the safety of the ingredients, toxicity, risks of inadequate intake, and looked for special warnings and precautions for use. Using scientific articles from the PubMed database, we detailed five ingredients whose inappropriate intake poses the greatest health risk. We found that most products are in the form of tablets and capsules. Their composition consists mainly of vitamins, and the content of minerals and other organic compounds is lower. All products contain folic acid and vitamins D, C and B12. Other vitamins are also present in high proportions, with the exception of vitamins A and K, which are included only in exceptional cases. The most common minerals are selenium, iron, zinc, iodine and calcium. In many products, some ingredients were above 100 % of the recommended daily allowance, but the content was still in accordance with the maximum permissible doses prescribed by law by the competent institutions. Most products are intended for use during all sensitive periods such as preconception, pregnancy, and lactation (27,8 %), and many are intended for individual periods such as preconception and first trimester (16,6 %), second and third trimester (11,1 %) and lactation (11,1 %). Many of the ingredients in products can be harmful if dosed too high. We have found that reference values are not the same all over the world, but there are differences between them. The use of these products is safe in the prescribed dosages and, in combination with a varied diet, mostly covers all the needs that are increased at that time. A bigger problem can be insufficient intake, which can have a negative effect on both the mother and the fetus. In the case of certain medical conditions, intake is possible only after consultation with a doctor