Pregnancy is a time of development where your body meet lots of physiological changes.Nutrition plays a pivotal role during this development period and because it is a determinant of a life time risk of disease, it is potentially a modifiable risk factor. This makes Nutrition counselling a cornerstone of prenatal care in all pregnant women.
Focus should be on quality, not on quantity. “EAT GOOD, NOT MORE”.
A healthy diet during pregnancy contains adequate energy, protein vitamins and minerals .Dietary patterns before and during pregnancy should be higher in vegetables, fruits, whole grains, nuts, legumes, fish and vegetable oils and lower in meat and refined grains. This will reduce the risk of GDM and PIH.
Healthy diet means avoid simple sugars, processed foods and trans and saturated fats. Eat healthy often means changing the amounts of different foods you eat, so that your diet is varied, rather than cutting out all your favourites.
A diet that severely restricts any macronutrient class should be avoided specially the ketogenic diet that lacks carbohydrates; the Paleo diet because of dairy restriction and any diet characterised by excess saturated fats.
Maternal nutrition during pregnancy regulates the offspring’s metabolic homeostasis including insulin sensitivity and the metabolism of glucose and lipids. Metabolic changes in the foetus during pregnancy caused by maternal nutrition not only influence foetal growth and development but also have a long- term or even life -long impact for the offspring.
Maternal nutrition and Maternal pre-pregnancy metabolic condition regulate foetal placental gene expression, organ structures, metabolism and growth during critical periods of development, affecting offspring’s risk of CVS, metabolic, respiratory, immunologic, neuropsychiatric and other chronic conditions starting during childhood development and into adulthood with and without LBW…
The regular consumption of multivitamins and mineral supplements that contain optimal amounts of folic acid, among other micronutrients is recommended for all reproductive age women to augment a balanced diet, starting at least2-3 months before conception and continuing throughout pregnancy until the cessation of lactation or at least 4-6 weeks after delivery.
- Recommended protein intake during pregnancy is 60g/day which represents an increase from 46/ day in non-pregnancy women.
- Carbohydrates should comprise 45-64 % of daily calories. Starchy foods are an important source of energy. These foods should make up just over a 3rd of the food you eat, choose whole grain or high fibre options such as whole wheat pasta, brown rice or simply leaving the skin in potatoes.
- Total Fat intake should comprise 20-35% of daily calories similar to non-pregnancy state.
- Eat at least 5 portions of a variety of fruits and vegetables every day, these include fresh, frozen, canned, dried or juiced. Always wash fresh fruit and vegetables carefully.
- Prominent folate [Vitamin B9] deficiency is connected with the NTDs, iodine deficiency with congenital hypothyroidism & neurocognitive deficiencies, iron deficiency causes sideropenic anaemia and increases risk of LBW, Premature labour and Perinatal (and maternal) mortality…
- Folate deficiency is present in 5% of general population. The levels are 2-4fold higher in foetus than in maternal circulation. Transport of folate across the placenta is a complex process, may be compromised by diet (polyphenolic compounds present in alcoholic & non-alcoholic beverages, some methylxanthines found in coffee & black tea), therapeutic agents (xenobiotics), life-style factor (smoking, drug abuse & alcohol consumption).
So, what you should be including in your diet in your pregnancy? Things you should be careful in your pregnancy diet.
Here are few tips at all, Pregnant women are advised to;
- Exclude all food sources which may contain potential teratogens such as food supplements with increased concentration of Vitamin A, Medication’s containing retinoids.
- Exclude foods which may be bacteriologically unsafe and sources of infection such as listeriosis (soft cheese, pates, unpasteurised milk), toxoplasmosis (undercooked meat, contaminated vegetables), salmonellosis (raw or soft cooked eggs, mayonnaise, under cooked meat & chicken).
- Use only Iodized salt. Use Iodized table salt instead of Himalayan rock salt which is low in iodine.
- Limit caffeine intake 200mg/day (2 cups of coffee).
- Use Lactose-free milk & dairy products if lactose deficiency is diagnosed.
- Exclude consumption of alcohol, stop smoking & exposure to Nicotine smoke (passive smoking).
- Due to potential danger of contamination by methyl-mercury (and toxic threats from polychlorinated biphenyls and other lipophilic contents) which can cause foetal damage, pregnant and lactating women should avoid eating shark, swordfish, tilefish and king Mackerel (big oily fish with potentially high content of methyl mercury). Intake of oily fish low in mercury such as sardines, herring, and salmon should be limited to two portions in a week. Contrary to oily (contains up to 30 % fat in the tissues), white fish (cod, haddock and flat fish) contain far less fat (1-4 %) & the fat is deposited exclusively in the liver.
- Deficiencies in vegetarian/vegan diet need to be corrected by choice of appropriate natural and/or enriched food and supplements.
- Vit D dose 5-10 microgram (200 – 400 IU/day).
- Iron 48.6 mg /day (individual assess is required).
- Folic acid (400 – 800 micro gram/day).
- Total intake of Vit B 12 is 2.6 micro gram/day.
- Calcium supplements in doses of 500 mg/day.
- Zinc supplementation in doses of 15 mg if the natural sources (legumes, nuts & whole grains) are not present in diet.
In Obese & Overweight women, safety of calorie – restricted diet is concerning as it may lead to lipolysis and relative ketonemia which can impair mental function of offspring. The relative ketonemia could be prevented by nutrition plan dominated by intake of high carbohydrate low glycaemic index diet (suppression of lipolysis being achieved by the increase of insulin sensitivity induced by such diet regimen).
The same diet plan could also help in preventing the onset of gestational diabetes in obese or overweight pregnant women…
Current evidence suggests that nutrition can influence epigenetic modifications which are implicated in various health outcomes, including development disorders and chronic diseases.
Pregnancy being a vital time of development, Maternal nutrition significantly influences the future health of both mother and baby.
Nutrition plays a vital role, So, consult your doctor.