Almost all women know that healthy eating is crucial during pregnancy for themselves and their babies. However, only few of them know how to eat healthy. Some women are more concerned regarding their weight gain during pregnancy, but they did not know that the pattern of weight gain is also as important as the total gain.
During the first trimester, most of pregnant women suffer from nausea and food aversions whereas in later trimester they suffer heartburn or indigestion but they do not know that eating habit can exacerbate or relieve these conditions.
To know the answers to these questions and for more information regarding healthy eating during pregnancy, read this report.
It is very important to know that good control of weight, blood pressure and blood glucose increase the chances of healthy, normal weight, term infant because alteration of these three will affect fetal and placental growth as well as maternal well being.
During pregnancy, both the quantity and quality of food intake are altered. With regard to quantity, this depends on your pre-pregnancy weight.
During the first trimester there is no need to increase your total caloric intake, however, in the second trimester 340 additional calories per day are needed and 450 additional calories recommended per day during the third trimester.
Weight gain during pregnancy varies from woman to woman. The average weight gain is between 11.5 and 16 kilograms. Usually, a pregnant woman gains 1 or 2 kilograms during the first three months, followed by approximately half kilogram each week or 1 to 2 kilograms each month during the last six months. However, not everyone follows this pattern. For example, if you are underweight at the start of the pregnancy you can afford to put on more than the average amount, or if you are overweight at the start of your pregnancy your weight gain may need to be is less than average.
Looking at the quality of the food, you should consider not only the caloric contents but also the micronutrients such as minerals, vitamins and trace elements.
If you do not get enough micronutrients this can cause low birth weight, premature birth, and other fetal problems. Micronutrients include folic acid, iron, omega-3 fatty acids, Vitamin A, calcium, Vitamin D and iodine. Table 1 shows the recommended amount of important vitamins and some minerals.
Recommended Dietary Allowance for select nutrients (Institute of Medicine, 2006)
|
Recommended
Dietary Allowance
|
Women 19 - 50 years
|
|
Non-pregnant
|
Pregnant
|
Breastfeeding
|
|
Folate (mcg/day)
|
400
|
600
|
500
|
|
Iron (mg/day)
|
18
|
27
|
9
|
|
Vitamin A (mcg/day)
|
700
|
770
|
1300
|
|
Vitamin C (mg/day)
|
75
|
85
|
120
|
|
Vitamin D (mcg/day)
|
5
|
5
|
5
|
|
Calcium (mg/day)
|
1000
|
1000
|
1000
|
|
Zinc (mg/day)
|
8
|
11
|
12
|
|
Vitamin B6 (mg/day)
|
1.3
|
1.9
|
2.0
|
|
Magnesium (mg/day)
|
310 (19 - 30 y)
320 (31 - 50 y)
|
350 (19 - 30 y)
360 (31 - 50 y)
|
310 (19 - 30 y)
320 (31 - 50 y)
|
|
Vitamin B12 (mcg/day)
|
2.4
|
2.6
|
2.8
|
The most important vitamin during your pregnancy is folic acid. It has will known advantage which is reducing the risk of having a baby with neural tube defects. Not only this but also it reduces the risk of premature birth. The recommended amount of folic acid is 0.4 milligrams (400 micrograms) per day.
In my clinic, I advise all women who are planning to be pregnant to start folic acid at least one month before getting pregnant because they may not know they are pregnant until it is too late. Folic acid present in high quantity in green leafy vegetables and in fortifies cereals.
Another crucial micronutrient is iron. Optimal iron intake associated with decreased risk of premature birth and low birth weight. Not getting enough iron could lead to anemia and subsequently could contribute to developmental delays and behavioral disturbances in the infant and poor health in the mother. It is also essential for normal infant brain development. Iron helps in red blood cell formation which is the only oxygen carrier in your body which is necessary for fetal demands and blood loss during delivery. You get iron from eating lean red meat, green leafy vegetables, and fortified breakfast cereals.
As you may know that calcium and vitamin D is crucial for strong bones and teeth. During your pregnancy vitamin D is needed for the formation of your fetal bones. It has been recommended that all pregnant women to take 10 micrograms of Vitamin D per day. Therefore, I advise you to take the milk and other dairy products as well as eggs, meat and certain fish such as salmon, trout, mackerel, sardines, and fresh tuna because all are rich in calcium and vitamin D. You also need vitamin A in small amounts to protect your fetus immune system and to prevent blindness, infections, and death, but be careful since high doses can cause birth defects. It is important also to mention here that you have to take enough iodine because it is important for brain development and if it is not sufficient it could contribute to stillbirth, birth defects, and decreased brain development of the fetus. However, iodine deficiency is very rare as we are getting enough of it from iodinated salt, cereals and other fortified food products. Recently, Omega 3 fatty acids found to play an important role in normal fetal brain development and prevention of preterm birth. It is also essential for visual development and in reducing the incidence of heart disease and heart-related death of the infant. 300 milligrams of Omega 3 per day is recommended. You can get Omega 3 from fish oil capsules, certain fish such as salmon, trout, mackerel, sardines, and fresh tuna and also vegetable oils such as sunflower, rapeseed, flaxseed, and walnut oils.
I strongly advise you to avoid all types of alcohol including all wines, beers, hard liquor, and wine coolers. This will protect your infant from fetal alcohol syndrome and other birth defects. Also, I advise you to avoid teas, coffee, colas, energy drinks, and chocolate as these kinds of food are high in caffeine which is linked to low birth weight and spontaneous fetal death.
I will give here little advice to help you in minimizing nausea and vomiting in early pregnancy and indigestion in late pregnancy. Nausea and vomiting are associated with increased levels of Human Chorionic Gonadotrophin (HCG) which peaks at 12 weeks of your pregnancy. On the other hand, indigestion is resulted from decreased digestive system motility by pregnancy hormones specialty progesterone and also by the compression effect of gravid uterus on the stomach. You should eat small but more frequent. Avoid fatty and spicy food as well as citrus, spearmint drinks and avoid caffeine. Do not drink with meal, better to drink between meals and avoid lying down after eating immediately. Walking after meals and wearing loose-fitting cloths will help you a lot.
Dr. Aml M Erhuma
Specialist Obstetrics and Gynaecology
Al Hayat Medical Center
Doha, Qatar
