“FEEDING SMART RIGHT FROM START”
Nutrition in adequate amounts and food quality is important during pregnancy to ensure optimal growth outcome, offspring development and maternal health. The first 1,000 days of a child’s life – the period between conception and up to 2 years represents a once in a lifetime opportunity to lay the groundwork for optimum health, growth, and neurodevelopment throughout the child’s lifespan. While all nutrients are necessary for brain development and function, optimal overall brain development is dependent on providing adequate amounts of key nutrients during specific sensitive periods during the first 1,000 days. Protein, polyunsaturated fatty acids, iron, zinc, copper iodine, choline, folate, and vitamins A, B6, and B12 are especially important. Iron is an example of the importance of adequate nutrition during specific stages of brain development to ensure the full developmental potential is reached.
GENERAL NUTRITIONAL GUIDELINES
MACRO NUTRIENTS
- Energy
Additional energy is required to support the metabolic demands of pregnancy and foetal growth
- Carbohydrates
The RDA of CHO increases, slightly helping maintain appropriate blood glucose and prevent ketosis. 50-60% of total caloric intake should be from carbohydrates.
Intakes may be greater in women consuming more calories and priority should be given to complex carbs (whole grains, fruits & vegetables) rather than simple sugars (refined sugars, juices & sodas)
- Protein
Additional protein is required to support the synthesis of maternal and fetal tissues. This demand increases throughout gestation and is maximized during the third trimester.
For each additional fetus, at least another 25 g/day of protein is recommended, but because protein is also used as an energy source, the total may be as much as 175 g/day for the normal-weight woman carrying a twin gestation who is consuming 3500 kcal/day (Goodnight and Newman, 2009).
- Fats
The amount of fat in the diet will depend on energy requirements for proper weight gain. However, recommendations for omega-6 PUFA (linoleic acid) and omega-3 PUFA (alpha-linolenic acid) increase slightly.
| LIPIDS | RDA |
| PUFA | 6% – 11% kcal |
| Omega 6 (linoleic acid) | 2.5% – 9% kcal |
| Omega 3 (alpha linolenic acid) | 0.5% – 2.0% kcal |
| DHA (decosahexaenoic acid) | 200mg |
| EPA (eicosapentanoic acid) | 200-300mg |
- Omega 3 foods: Salmon, mackerel, tuna, flax seeds, chia seeds, walnuts
- Omega 6 foods: Soybeans, Corn, peanuts
MICRO NUTRIENTS
Iron in pregnancy
If you do not have enough iron, you’ll probably get very tired and may suffer from anaemia.
Lean meat, green leafy vegetables, dried fruit, and nuts contain iron.
If you’d like to eat peanuts or foods that contain peanuts (such as peanut butter) during pregnancy, you can do so as part of a healthy, balanced diet unless you’re allergic to them or your health professional advises you not to.
Folic acid before and during pregnancy
It’s important to take a 400 micrograms folic acid tablet every day before you’re pregnant and until you’re 12 weeks pregnant.
Folic acid can help prevent birth defects known as neural tube defects, including spina bifida.
If you did not take folic acid before you conceived, you should start as soon as you find out you’re pregnant.
Try to eat green leafy vegetables which contain folate (the natural form of folic acid) and breakfast cereals and fat spreads with folic acid added to them.
It’s difficult to get the amount of folate recommended for a healthy pregnancy from food alone, which is why it’s important to take a folic acid supplement.
FIBRE
The DRI for fibre during pregnancy is 14 g/day/1000 kcal and, if met, this will help a great deal in managing constipation that often accompanies pregnancy.
FLUIDS
The DRI for fluid increases slightly during pregnancy to 8 to 10 glasses of quality fluid daily. Water is the fluid recommended, but a woman’s body size, as well as climatic conditions, are important considerations. Optimal hydration reduces the risk of UTI, kidney stones and constipation.
EXERCISE
The American College of Obstetricians and Gynecologists (ACOG) recommends at least 30 minutes of moderate-intensity exercise. Excessive exercise with inadequate energy intake may lead to suboptimal maternal weight gain and poor fetal growth.
PREGNANCY WEIGHT GAIN RECOMMENDATION
| BMI Category | Weight Gain in kg |
| Underweight – BMI (<18.5) | 12.5 – 18 |
| Normal – BMI (18.5 – 24.9) | 11.5 – 16 |
| Overweight – BMI (25.0 – 29.9) | 7 – 11.5 |
| Obese – BMI (>30.0) | 5 – 9 |
MYTHS AND FACTS ABOUT PREGNANCY
| MYTHS | FACTS |
| Morning sickness occurs only in the morning. | Morning sickness refers to nausea and vomiting that occur during pregnancy (most commonly in the first trimester). Because of the fluctuating hormone levels, it is common to feel nauseous throughout the day. |
| Eating peanuts and dairy products can cause the fetus to become allergic to them. | Unless you are allergic to these foods, it is perfectly safe to consume them. |
| If you have heartburn while pregnant, the fetus will most likely have a full head of hair. | Heartburn is quite common during pregnancy, possibly due to pregnancy hormones and fetal growth. |
| Prenatal vitamins are only recommended for women who are deficient in vitamins or minerals. | Multivitamins for pregnant women contain minerals and supplements that help mothers to stay healthy and promote healthy fetal development. |
| Fish and other seafood consumption are unhealthy. | Seafood is a good source of protein, and omega-3 fatty acids found in many fish can help with fetal brain and eye development. During pregnancy, seafood can be a regular part of a healthy eating plan. |
| Caffeine consumption provokes premature birth. | Caffeine, in moderation, is safe to consume. Caffeine consumption should be limited to 200-300mg per day because the ability to metabolize caffeine decreases during pregnancy. |
| To avoid weight gain, pregnant women should limit their food intake. | Eating too little during pregnancy is not recommended because it can result in a huge array of pregnancy-related complications such as poor fetal growth, low birth weight, and maternal weight loss. |
| Saffron intake during pregnancy can brighten up the baby’s skin tone.
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No food can affect the baby’s complexion because skin colour is entirely determined by the parents’ genes. |
| Avoiding dark-colored foods while pregnant helps the baby to be lighter in colour. | No food can affect the baby’s complexion because skin colour is entirely determined by the parents’ genes. |
| Miscarriages are caused by papaya. | Ripe papaya is found to be essential to pregnant women. |
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Sesame seeds have been linked to miscarriage and premature labour. |
Sesame seeds are high in essential nutrients and would be a nutritious addition to every diet. |
| Cold foods such as curd, juices, and even water should be avoided during pregnancy as they will cause a delayed delivery. | Consuming cold foods is absolutely safe as pregnancy is a physiological extension of the body, not a disease. |
| Heat-inducing foods cause miscarriage during pregnancy. | Heat or warming foods, as the name implies, raise body temperature. |
NOTE :
Apart from natural foods, calcium and iron supplementation are also prescribed. Additionally oral nutritional supplements may also be prescribed.
Gestational diabetes during pregnancy needs extra care like the inclusion of complex carbs, adequate protein and good portion control.
PREGNANCY FOOD PYRAMID
Yamini A.P., MSc RD.
Team Lead- Clinical Dietician
Kauvery Hospital Chennai