Fortified and flavored waters have become a popular alternative to soda, often marketed as a healthier way to hydrate and supplement daily nutrition. For an expectant mother, maintaining proper hydration is paramount for supporting increased blood volume and fetal development. However, the safety of products containing added ingredients requires a closer examination of their components. This analysis breaks down the ingredients found in popular fortified waters to assess their use during pregnancy.
Analyzing the Key Components of Fortified Water
These flavored drinks are primarily composed of water, but they include three main categories of additives that distinguish them from plain water. The first is electrolytes, such as potassium, magnesium, and calcium, which aid in fluid balance and muscle function. These are helpful for hydration, especially when experiencing morning sickness or increased physical activity.
The second category is a blend of added vitamins, typically including water-soluble B vitamins (B3, B5, B6, B12) and Vitamin C. Some varieties also contain fat-soluble vitamins, such as Vitamin A and Vitamin E. This is an important distinction to note in the context of pregnancy, as these vitamins are frequently added in high percentages of the daily recommended intake.
The third category is the sweetener, which determines the calorie count and overall health profile of the drink. Many fortified waters contain crystalline fructose or cane sugar, often in amounts comparable to a standard soda. “Zero” or “Light” versions substitute these sugars with artificial sweeteners, such as sucralose or stevia leaf extract.
The Risk of Excess Vitamins in Pregnancy
The primary concern with consuming fortified beverages while pregnant is the possibility of vitamin overload, especially when already taking a prenatal supplement. Vitamins are divided into water-soluble and fat-soluble groups, and their handling by the body presents different risks. Water-soluble vitamins (Vitamin C and B vitamins) are not stored in the body, and any excess is excreted in the urine.
Fat-soluble vitamins (Vitamins A, D, E, and K) are stored in the body’s fatty tissues and liver. While proper intake is necessary for fetal development, excessive amounts can build up to toxic levels, posing a risk to the developing baby. This is particularly concerning with preformed Vitamin A (retinol), which is sometimes listed as retinyl palmitate.
High consumption of preformed Vitamin A during the early stages of pregnancy is associated with a risk of teratogenicity, meaning it can cause birth defects affecting the skull, face, heart, and nervous system.
The recommended dietary allowance (RDA) for Vitamin A during pregnancy is about 2,565 International Units (IU) daily. Authorities suggest a safety limit for supplemental Vitamin A at 8,000 to 10,000 IU per day. Since a prenatal vitamin already provides the necessary amount, consistently adding more from a fortified drink can easily push the total daily intake past the safe limit.
Evaluating Sugars and Artificial Sweeteners
The sugar content in many fortified waters presents a considerable dietary challenge for expectant mothers. A standard 20-ounce bottle can contain over 30 grams of added sugar, often from crystalline fructose or cane sugar. This amount is similar to the sugar content of a can of soda.
Regular consumption of sugar-sweetened beverages contributes to excessive caloric intake, which can lead to increased gestational weight gain. More importantly, it is linked to a higher risk of developing gestational diabetes mellitus (GDM), a condition of glucose intolerance. Research suggests that even moderate intake, such as five servings per week, can significantly elevate the risk of GDM.
For the “Zero” or “Light” versions, artificial sweeteners like sucralose and aspartame are used as sugar substitutes. These sweeteners are generally recognized as safe (GRAS) for consumption during pregnancy and are not associated with birth defects. Professionals recommend using them in moderation, mainly because they offer no nutritional benefit. Women with the rare metabolic disorder phenylketonuria (PKU) must avoid aspartame because their bodies cannot process phenylalanine.
Safer Hydration Options for Expectant Mothers
The best choice for hydration during pregnancy remains plain water, which supports the necessary increase in blood volume and amniotic fluid without adding unnecessary sugars or vitamins. Experts recommend aiming for around ten 8-ounce glasses of water daily. If plain water is unappealing, several simple, naturally flavored options avoid the pitfalls of fortified beverages.
Naturally Flavored Alternatives
Adding slices of fresh fruit like lemon, cucumber, or berries to still or sparkling water introduces flavor without added sugar or artificial ingredients. Unsweetened coconut water is another option, as it naturally contains electrolytes like potassium and sodium, which can be helpful for replacing minerals lost during morning sickness. Fruit juices are safe but should be consumed in small amounts or diluted with water to manage the high concentration of natural sugars.
While an occasional fortified, flavored water is unlikely to cause harm, relying on these drinks as a primary source of hydration is discouraged due to the potential for vitamin excess and high sugar load.