Nutrition in Pregnancy

Pregnancy is a very important time for a woman. The feeling of a new beating heart inside her body and experiencing the change of her body day by day is definitely amazing. Every pregnancy experience is like a fingerprint, even for the same woman, from one pregnancy to the next. The symptoms range from being temporary and mild within the period of the first few months, or a mother’s discomfort may continue up to birth. Managing the symptoms and sustaining health is mostly related to getting enough nutrition support.

Pregnant women also feel some aversions and cravings for special foods. Chocolate, starch, potatoes, pizza and spicy foods are some more commonly craved foods for pregnant women. Some pregnant women experience nausea and vomiting. When she is dealing with these early symptoms, an expectant mother can eat a small piece of ginger to help to stop nausea. Also, eating dry, salty things or eating before getting out of bed in the mornings can also help in dealing with morning nausea. During the first months of pregnancy, as a result of changes in her hormone balance, women may encounter some appetite problems, like feeling irritation with the odors of cooked foods, like red meat. This can affect the consumption of red meat negatively, and iron deficiency may occur. 

In pregnancy, the body needs additional energy, nutrients, vitamins and minerals. It does not mean “eat for two”, and while her nutritional requirements may vary, it should not be that much. Poor eating habits affects a baby’s development negatively, and as a result of not getting enough nutrition, a baby may encounter birth anomaly. Additionally, excess weight gain is also a huge health risk for both mother and baby. The mother may develop gestational diabetes because of excess calorie intake. This condition threatens the baby’s growth. It may also cause growth retardation, congenital anomalies, and premature birth. Most pregnant women are concerned about their weight gain during pregnancy, and their concern is never getting back to their pre-pregnancy body. Recently, the ketogenic diet has been a very popular diet, which is mostly used for weight loss. In pregnancy, trying to lose weight is an unhealthy approach because growing a body needs extra energy for the second and third trimester. The weight gain should be between 20-40 pounds up to the delivery, depending on the weight of the mother before pregnancy. If a woman is very overweight, her doctor may want her to lose weight before planning a pregnancy. 

Nutritional needs also change in the pregnancy period. When we consider the development of bones, mother should consume dairy products, which provides important minerals, like calcium and phosphorus. Dairy products also contain vitamin B and zinc, which is very crucial for the mental development of the baby. Some fermented dairy products like Greek yogurt or kefir are excellent sources of probiotics, which have regulatory functions on the digestive system. Iron is used by your body to make a substance in red blood cells that carries oxygen to your organs and tissues. During pregnancy, women need more iron than she did before pregnancy. This extra iron helps the pregnant woman’s body make more blood to supply oxygen to the baby. Not having enough iron is called iron deficiency anemia. Anemia increases the risk of certain problems, including preterm delivery and having a low-birth-weight baby.

Red meat and poultry are very good sources of protein, iron, and choline. Eating foods rich in vitamin C, like oranges, bell peppers, and berries increases the absorption of iron from meals. Eggs are also an excellent source of protein, iron, and zinc. Egg protein is a high quality protein, which means all of it is useable for making body proteins. It includes choline, which is very important for the body and the baby’s brain and nervous system development. Insufficient choline intake during pregnancy may increase the risk of neural tube defects. A single whole egg contains roughly 113 mg of choline, which is about 25% of the RDI for pregnant women (450 mg). 

Carbohydrates must be a main source of energy in a pregnant woman’s diet. Before it is metabolized by cells, it’s broken down into simple sugars, like glucose, which pass easily across the placenta and provide energy to feed growing the baby during pregnancy. Low carb diets, like ketogenic diets, are detrimental  because the fetal brain requires glucose for function and development. Forcing the developing brain to convert to a ketone energy supply has potential adverse effects. The ketogenic diet is mostly a fat based diet, which means at least 90% of dietary intake is fat. When babies are growing, they need macros differently. They need 55-60% carbs, 12-15% protein, and 25-30% fat. Ketogenic diets are very restrictive diets in which you can not eat enough fruits and vegetables, which is very important for a healthy baby.

Mice studies showed that low carb diets in pregnancy were associated with preterm birth and low birth weight. These diets also negatively affects development of organs, which causes cardiovascular diseases later in life of the fetus. Around a third of daily food intake should be starchy carbohydrates. Oat, whole wheat breads, rice, maize, breakfast cereals should be chosen instead of refined carbohydrates (white) such as pasta and noodles. Women should consume high fiber foods, like whole grain bread, whole wheat pasta, and brown rice.

When we think about the mental development of the baby, omega 3 fatty acids are very essential. The mother should consume two portions of fish a week with one portion being oily fish like salmon, sardines, or mackerel.  Some types of fish are harmful for pregnant women, like shark, swordfish, and marlin. These fishes may contain higher amounts of mercury, which is very harmful for brain and nervous system development. The FDA (Food and Drug Administration), the EPA (Environmental Protection Agency), and the 2015-2020 Dietary Guidelines for Americans recommend that pregnant women eat 340 grams of a variety of seafood lower in mercury a week. That’s about two servings. Also, when a woman is planning a pregnancy, she should avoid consuming these fish more than two times a week. It can accumulate in tissues. Legumes are an excellent source of fiber, protein, and folate. Folate vitamin B9 is an essential nutrient which is required for DNA replication and as a substrate for a range of enzymatic reactions in amino acid synthesis and vitamin metabolism. During pregnancy, demands for folate increased because it’s also required for development of the baby. Folate deficiency is associated with abnormalities in both mother (Anemia, neuropathy) and fetuses (congenital abnormalities, like neural tube defects in the spine or in the brain).

Moms should be aware of the importance of folate supplementation in the first months of pregnancy and before pregnancy. Pregnant women need at least 600 micrograms of folate. Nuts, dark leafy vegetables, and eggs are good sources of folate. WHO (World Health Organization) recommends daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron and 400 µg (0.4 mg) folic acid for pregnant women to prevent maternal anemia, puerperal sepsis, low birth weight, and preterm birth.

 One of the most common problems for a pregnant women is constipation. Due to changing hormone levels in early pregnancy, intestinal movement slows down the movement of stool through the bowel. Mother should increase her fiber consumption, which mostly comes from leafy vegetables and fruits. Five portions of fruits and vegetables are recommended for them, with at least 2 portions of vegetables and 3 portions of fruit. Drinking enough water and increasing liquid consumption is another solution for constipation.  

In summary, pregnant women should be aware of her healthy nutrition pattern during pregnancy. Poor nutrition in pregnancy threatens both mother and baby’s health.  Staying active is also important for general health, reducing stress, boosting mood, and sleeping better. Pregnancy exercise class or 20 min walking at a moderate pace may be enough. If you are planning a pregnancy, just focus on healthy nutrition with daily exercise and enjoy the journey! 

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