Should vitamin-mineral supplements be recommended for all women with childbearing potential?

Interest in maternal nutritional status as a critical factor for prenatal development has increased. When supplemented before conception, iodine prevents cretinism and folic acid reduces neural tube defect risks. Other nutrient supplements may also reduce pregnancy complications. Thus, should supplements be advocated for all women with childbearing potential? Potential supplementation benefits include 1) improved nutritional status, 2) reduced risk of some developmental defects, 3) improved antioxidant and immune defense systems, 4) lower incidence and/or slower progression of some diseases, and 5) harmonization of government and health care professionals' dietary recommendations for optimal health. Potential questions are, will the supplement reduce a woman's motivation to maintain and/or improve dietary quality? Will the supplement result in excessive nutrient intakes and/or adverse nutrient-nutrient interactions? Will supplement use encourage the perception that all women are, by definition, well nourished? These issues should be clarified before widespread supplementation programs are implemented.