Importance of Proper Nutrition During Pregnancy – Guidelines

Expecting a baby? Congratulations! Now, let's talk about the crucial role of nutrition during this special time. Discover how the right foods can shape your pregnancy journey, ensuring optimal health for both you and your little one. Ready to learn about pregnancy nutrition guidelines?

Energy

During pregnancy, energy requirements during pregnancy increase as a result of increases in basal and activity energy expenditure and energy deposition in the newly acquired fetal and maternal tissues.

• Variation in energy expenditure between Individuals is largely attributable to differences in fat-free mass, which in pregnancy comprises the expanded plasma, high-energy-requiring fetal and uterine tissues, and moderate- energy-consuming skeletal muscle mass.

Bottom Line

It is very important to plan a balanced nutrition during pregnancy

Guidelines for Gestational Weight Gain

Obese women are more likely to have pregnancy complications of diabetes, hypertension, pre-eclampsia, arrest of labor, fetal distress and cesarean delivery

• The recognized relationship between gestational weight gain and birth weight underlies the 1990 Institute of Medicine (IOM) recommendations for weight gain on the basis of pre-pregnancy BMI
• Weight gain associated with optimal birth weights and least neonatal morbidity

Vitamin E

Vitamin E functions as an antioxidant that prevents propagation of lipid peroxidation

Vitamin C

Vitamin C functions as an antioxidant and cofactor for enzymes involved in the biosynthesis of collagen, carnitine, and neurotransmitters

• Plasma concentrations of vitamin C decrease with the progression of pregnancy, probably as a result of hemodilution.
• The RDA for Vitamin C is increased by 10 mg/day to allow for adequate fetal transfer.

Protein

Protein requirements increase during pregnancy as a result of the increase in protein turnover and protein deposition in the Fetus, uterus, expanded maternal blood volume, mammary glands, and skeletal muscle

• Whole-body protein turnover measured by leucine and glycine kinetics, is augmented in the second and third trimesters compared with first-trimester and pre-pregnancy rates
• The Egg RDA was set at twice the coefficient of variation (12%) in protein requirements or at 25g/day of additional protein

Metabolic Disorders

Discussing existing metabolic disorders may be critical to the health of both mother and infant

• Examples of disorders for which early intervention is effective are maternal phenylketonuria and type I diabetes mellitus
• Metabolic control of both diseases involves conscientious dietary manipulation well before the critical period of embryonic development

Dietary fats

Arachidonic acid (ARA) concentrations in red blood cell phospholipids decrease during pregnancy, but whether this is a normal physiologic response to pregnancy or a reflection of dietary inadequacy of omega-6 fatty acids is uncertain.

• The IOM recommended an adequate intake at the median linoleic intake of pregnant women in the United States 13 g/day, and 200 mg/day for pregnant adolescents and adults.

Assessment of Nutritional Status

Due to poor nutrition during pregnancy, underweight women are at increased risk of reproductive problems. Not only fertility is compromised, but also, the likelihood of preterm delivery and intrauterine growth restriction (IUGR) is increased.

• The condition of being underweight is potentially modifiable, because it is often related to unhealthy nutrition plan or exercise programs during pregnancy.

Herbal Teas

Most manufacturers of herbal tea products stop marketing the mixtures as medicine and simply list the ingredients on the label.

Nutrition during pregnancy

Adolescent pregnancy is associated with an increased risk of medical complications, such as low birth weight, neonatal death, maternal mortality pregnancy-induced hypertension, and sexually transmitted infections

• A low pre-pregnancy body mass index, low gestational weight gain, anemia, and a poor-quality diet are related to poor pregnancy outcomes among adolescents
• Early prenatal care, including assessment of nutritional status, is of paramount importance for pregnant adolescents

Vitamin Supplementation

A varied diet in accordance with the US dietary guidelines can meet all vitamin and nutrition needs associated with pregnancy; however, women whose dietary practices seem to be less than satisfactory may benefit from a prenatal vitamin supplement.

• Special circumstances in which specific supplements are recommended includes: Vitamin D: 10 µg(400 IU) daily is recommended for complete vegetarians (those who consume no animal products) and others with a low intake of vitamin D fortified milk; vitamin D status is a special concern for women at northern latitudes in winter and for others with minimal exposure to sunlight and, thus, at risk of reduced synthesis of the vitamin D in the skin. (e.g., vegetarians)
• Vitamin B12: 20 µg daily for complete vegetarian individuals
• Supplement of vitamin B6 may prevent nausea and vomiting in early pregnancy.

Caffeine

Research using animals indicates that excessive amounts caffeine intake increase the incidence of congenital malformations; the effects of consuming smaller quantities (eg, 3 to 5 cups of coffee per day) have not been satisfactorily studied.

• Human observational data suggested that excessive caffeine intake is associated with an increased risk of miscarriage, even accounting for concurrent smoking.

Zinc

The additional zinc requirement during pregnancy reflects zinc accretion in newly synthesized maternal and fetal tissues

• Changes in intestinal zinc absorption appear to be the primary homeostatic adjustment in Zinc metabolism, to meet the increased demand for zinc
• Factors that interfere with absorption (i.e., high dietary phytate, fiber, and calcium; high doses of supplemental iron; gastrointestinal diseases) or placental of zinc can cause a secondary zinc deficiency

Calcium

During pregnancy, the fetus accretes approximately 25 to 30mg of calcium, with maximum accretion rates in the third trimester.

• Bone resorption as well as bone formation are increased during pregnancy, as reflected in the 50% to 200% to increase in bone turnover markers. Total serum calcium concentration decreases, with a slight increase at term.

Iodine

It is an essential constituent of the thyroid hormones- thyroxine and triiodothyronine which regulate essential enzymatic and metabolic processes.

• The daily accumulation of iodine by the newborn Infant is estimated to be 100µg/day, with close to dally turnover.
• Accounting for individual variability, the RDA for pregnancy was set at 250 µg / day to prevent goiter.

Exercise During Pregnancy

In the absence of medical or obstetric complications, pregnant women who engage in a moderate level of physical activity can maintain cardiovascular and muscular fitness throughout the pregnancy.

Food Cravings and Aversions

Most women change diets during the course of pregnancy. Some changes are based on medical advice, others on folk medical beliefs, and others on changes in preference and appetite that may be idiosyncratic or culturally patterned.

• We should be aware that culturally sanctioned changes in diet may affect a woman’s willingness to follow prescribed dietary regimens.

Vitamins

Vitamin A is essential for normal vision, gene expression, reproduction, embryonic development, growth and immune function. Vitamin A deficiency in pregnancy is associated with preterm birth, IUGR, and low birth weight.

• The RDAs for vitamin A during pregnancy for Papaya and Indians are based on the accumulation of vitamin A in the fetal liver and on the assumption that the liver contains half the body’s vitamin A.

Folate

Folate functions as a coenzyme in single-carbon transfer reactions involved in nucleic and amino acid metabolism

• The term folate includes synthetic folic acid in fortified foods and dietary supplements and naturally occurring forms in food
• RDA of folate for Indians is 570 µg/day
• Women should be advised not to attempt to achieve 4000 µg dose from over-the-counter because of the risk of ingesting harmful amounts of other vitamins

Alcohol

Moderate drinkers may produce offspring fetal alcohol effects, such as spontaneous abortion, abruptio placentae, and low birth weight

• All women planning for conception should be advised to avoid consumption of alcoholic beverages
• Rehabilitation of women who are addicted to alcohol after conception may not prevent adverse embryonic development, but it may positively affect the growth of the fetus

Dietary Carbohydrate

To ensure the supply of glucose for the fetal brain and maternal brain, the estimated average requirement for available carbohydrate was the same as non-pregnant women (100 g/day), plus the additional amount required during the third trimester (35g/day).

Iron

Iron needs increase during pregnancy, even though menstruation does not occur and intestinal absorption of this mineral is enhanced

• Dietary iron requirement during pregnancy covers basal losses, deposition in fetal and maternal tissues, and expansion of hemoglobin concentrations
• When therapeutic amounts of iron (>30 mg/day) are given to treat anemia, supplementation with approximately 15 mg of zinc and 2 mg of copper is recommended, because the iron may interfere with the absorption of these trace elements

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