A woman who is not overweight at the start of her pregnancy, should gain between 25 to 35 pounds by the end of the nine months
A pregnant woman needs to
ensure that her diet provides enough nutrients and energy for her baby to
develop and grow properly, and also to make sure that her body is healthy
enough to deal with the changes that are occurring.
For a healthy
pregnancy, the mother's diet needs to be balanced and nutritious - this
involves the right balance of proteins, carbohydrates and
fats, and consuming a wide variety of vegetables and fruits. If you are
pregnant and your diet may be impacted by ethical beliefs, religious
requirements, or health conditions, you should check with your doctor.
A pregnant woman's calorie
intake grows during pregnancy. However, this does not mean she should eat for two, i.e. her calorie consumption does not
double, it just goes up.
Weight gain, if the
mother is carrying just one baby, varies considerably. According to the
Institute of Medicine, USA, a woman whose body mass index (BMI) is between
18.5 and 24.9 should gain from 25 to 35 pounds (11.4-15.9 kilograms) during the
nine months. A woman who is overweight at the start of pregnancy should gain
between 15 to 25 pounds (6.8 to 11.4 kg).
Weight
gain recommendations may also vary, depending on the woman's age, fetal
development, and her current health.
Excessive or insufficient weight gain can undermine the health
of both the fetus and the mother. (Up
to the eighth week of pregnancy the baby is called an embryo, after that, when
its major structures have formed, it is called a fetus)
What should I eat during pregnancy?
Plenty of fruits and vegetables are essential for a healthy pregnancy
As
mentioned above, the mother should follow a varied, balanced, and nutritious
diet, and it must include:
Fruit and vegetables
Aim for five portions of fruit and/or veggies per day. They may
be in the form of juice, dried, canned, frozen, or fresh.
Fresh and frozen (if frozen soon after picking) produce usually
have a higher vitamin and other nutrient content.
Starchy carbohydrate-rich foods
Starchy
carbohydrate-rich foods include potatoes, rice, pasta, and bread.
Protein
Good
animal-sourced proteins include fish, lean meat and chicken, as well as eggs.
Vegan mothers should consider the following foods as good sources of protein:
Quinoa (known as a "complete protein", it is said to have all the
essential amino acids), tofu and soy products. Beans, lentils, legumes, nuts,
seeds and nut butters are also good sources of protein. (Beans, lentils and
legumes are also rich in iron)
Eating seafood reduces anxiety during pregnancy - British and Brazilian researchers reported in the journal PLoS ONE(July 2013 issue) that
pregnant women who regularly ate seafood had lower levels of anxiety compared to their counterparts who did not. Pregnant mothers who
never consumed seafood had a 53% greater risk of suffering from high levels of
anxiety, the authors wrote.
Fats
Fats should not make up more than 30% of a pregnant woman's
daily calories.
Researchers from the University of Illinois reported in the Journal of Physiology that a high-fat diet may genetically program the baby for future
diabetes.
Team leader, Professor Yuan-Xiang Pan, said "We found that
exposure to a high-fat diet before birth modifies gene expression in the livers
of offspring so they are more likely to overproduce glucose, which can cause
early insulinresistance
and diabetes."
The typical Western diet, containing about 45% fat is the kind that can cause
these changes.
Prof.
Pan noted that in recent years, the Western diet has included more and more
high-energy, high-fat, cafeteria-type fast foods.
A team at the Complutense University, Madrid, Spain, reported in
the European Journal of Clinical
Nutrition that a balance of fats, proteins and carbohydrates are important
for the developing baby's current and future good health. They wrote that
"(in their study) more than half of women have low quality diets that include a high
amount of animal products rich in saturated fats yet a low amount of carbohydrates from vegetables and pulses.
Furthermore, more than a third of women displayed eating habits that differ
greatly from the Mediterranean
diet."
In the journal Endocrinology, a team from Oregon Health & Science University explained
that a high-fat diet during pregnancy raises the risk of stillbirth because the blood flow from the mother to the placenta is
reduced.
§ the
amount of fat a woman eats before becoming pregnant depends on each person, who
should receive an individualized nutritional assessment. For the majority of
women, no more than 10% of their daily calorie consumption should come from
saturated fat, less than 10% from polyunsaturated fat. Monounsaturated fat is
the best.
§ during
pregnancy fat should make up between 25% and 35% of a woman's daily calories.
This depends on her carbohydrate goals. Monounsaturated fats are preferable to
saturated fats.
Examples
of foods high in monounsaturated fats include olive oil, peanut oil, sunflower
oil, sesame oil, canola oil, avocadoes, and many nuts and seeds.
Fiber
Wholegrain foods, such as whole meal (wholegrain) bread, wild
rice, wholegrain pasta, pulses, fruit and vegetables are rich in fiber. Women
have a higher risk of developing constipation during pregnancy; eating plenty of fiber is effective in
minimizing that risk. Studies have shown that eating plenty of fiber during
pregnancy reduces the risk (or severity) ofhemorrhoids,
which also become more common as the fetus grows. Fiber can also help prevent
obesity; something the mother should try to avoid.
Calcium
It is important to have a healthy daily intake of calcium. Dairy
foods, such as milk, cheese, milk and yoghurt are rich in calcium. If the
mother is vegan, she should consider the following calcium-rich foods,
calcium-fortified soy milk and juices, calcium-set tofu, soybeans, bok choy,
broccoli, collards, Chinese cabbage, okra, mustard greens, kale,
and soynuts.
Zinc
Zinc
is a vital trace element. It plays a major role in normal growth and
development, cellular integrity and several biological functions, including
nucleic acid metabolism and protein synthesis. Since all these functions are
involved in growth and cell division, zinc is important for the growth and
development of the fetus.
The best sources of zinc are chicken, turkey,
ham, shrimps, crab, oysters, meat, fish, dairy products, beans, peanut butter,
nuts, sunflower seeds, ginger, onions, bran, wheat germ, rice, pasta, cereals,
eggs, lentils, and tofu.
If
you are concerned about your zinc intake, talk to your doctor who may advise
supplements.
Why do I
need extra iron?
Iron
makes up a major part of hemoglobin. Hemoglobin is the oxygen-carrying pigment
and main protein in the red blood cells; it carries oxygen throughout the body.
Iron also delivers oxygen to the muscles, so that they can function properly.
Also, iron increases our resistance to stress and disease.
A woman's body absorbs iron more efficiently when she is
pregnant, so she has to consume more of it to make sure that both she and her
baby have an adequate oxygen supply. During pregnancy, the amount of blood in
the mother's body increases by almost 50% - she needs more iron to make more
hemoglobin for all that extra blood, as well as for the growing placenta and
the developing baby. Healthy levels of iron will also help prevent depression,
weakness, tiredness, and
irritability during pregnancy.
Most
women start their pregnancy without adequate stores of iron to meet the
increasing demands of their bodies, particularly after the third or fourth
month. If iron stores are inadequate, the mother may become anemic.
According to the United Nations, approximately 47% of
non-pregnant females and 60% of pregnant females have anemiaglobally.
If iron deficient women without anemia are included, the figure is 60% of
non-pregnant and 90% for pregnant women. In rich nations, approximately 18% of
non-pregnant and 30% of pregnant women are iron-deficient. In industrial
nations, figures are higher among those with lower incomes.
If
the pregnant mother is iron-deficient, there is a higher risk of:
§ Preterm
delivery - the baby is born early, a premature baby
§ Delivering
a low-weight baby
§ Stillbirth
- the baby dies before it is delivered
§ Newborn
death - the baby dies soon after it is born
§ Tiredness,
irritability, depression (in the mother) during the pregnancy
§ If the
mother is anemic later in the pregnancy, there is a higher risk of losing a lot
of blood when she gives birth
§ Some
experts say there is a higher risk of post-natal depression(postpartum depression). This has to be
scientifically proven with further studies.
§ The
brain of the developing baby could be profoundly affected if the mother has an
iron deficiency, experts found in a study; the consequences can have a
long-lasting impact. The risk is there even if the anemia is not severe, and
occurs early in the pregnancy, researchers from the University of Rochester
Medical Center reported in the journal PLoS
One. They added that their findings are important, because obstetricians may not detect or treat mild/moderate iron
deficiency, especially if it occurs during early pregnancy.
Following
an iron-rich diet can help prevent the problems and complications related to
anemia during pregnancy.
The
following foods are rich sources of iron:
§ Dried
beans
§ Dried
fruits, such as apricots
§ Egg
yolk
§ Some
cereals, if they are fortified with iron
§ Liver
is rich in iron, but doctors and most nutritionists advise pregnant women to
avoid liver. Liver is very high in vitamin A, excess vitamin A may harm the
baby during pregnancy.
§ Lean
meat
§ Oysters
(make sure they are cooked if you are pregnant)
§ Poultry
§ Salmon
§ Tuna
§ Lamb,
pork and shellfish also contain iron, but less than the items listed above
§ Legumes
- lima beans, soybeans, kidney beans, dried beans and peas
§ Seeds -
Brazil nuts and almonds
§ Vegetables,
especially dark green ones - broccoli, spinach, dandelion leaves, asparagus,
collards, and kale.
§ Wholegrains
- brown rice, oats, millet, and wheat.
Non-animal
sources of iron, even though their iron-content may be high, are less easily
absorbed by the human body. Mixing some lean meat, fish or poultry with them
can improve their absorption rates by up to threefold.
Some
teas, such as commercial black tea or pekoe teas have chemicals that bind to
iron and make it much harder for the body to absorb the iron.
Do I need to take any supplements?
The types of food that contain folic acid
The information below should
never supersede what your doctor tells you.
Iron and folic acid
Before a woman is pregnant, she should be consuming
approximately 18 mg (milligrams) of iron each day, during pregnancy this
increases to 27 mg per day. The majority of women can get adequate amounts if
they follow a healthy diet. Some, however, may need iron supplements to prevent
iron deficiency.
Some women may experience heartburn,
nausea or constipation when taking iron supplements. In order to avoid these
problems, they should take their pills with meals, start off with smaller doses
and then work their way up to the full dose slowly, switch brands if one seems
unsatisfactory, and avoid taking their supplements when they go to bed.
The
National Health Service (NHS), UK, recommends that supplements in the form of
folic acid should be 400 mcg (micrograms) per day up to the 12th week of
pregnancy. Ideally, women should have been on them before becoming pregnant,
the NHS says.
Vitamin D
Guidelines in the UK say that a pregnant woman should take
supplements containing 10 mcg of vitamin D daily. Summer sunlight is a good
source of vitamin D (the light does not have the vitamin, but triggers the skin
to synthesize it) - however, exposure should be limited because too much
sunlight on the skin can cause burning and raises the risk of developing skin
cancer.
Zinc
A study published in the Food and Nutrition Bulletin reported that observational studies have shown that "zinc deficiency during pregnancy may cause adverse pregnancy
outcomes for the mother and fetus." After assessing several
studies they found that pregnant women on zinc supplements were 14% less likely
to have a premature delivery.
They
also found that more underweight women who were also zinc-deficient and had
taken zinc supplements were more likely to have infants of normal birthweight.
Zinc supplementation did not appear to influence infant birthweight among
pregnant mothers of normal weight.
Avoid vitamin A supplements
This
includes high dose multivitamins. Unless your doctor tells you otherwise. Avoid
cod liver oil supplements, unless your doctor tells you otherwise. Pregnant
women should avoid having too much vitamin A, as this may harm their baby.
Foods to
avoid during pregnancy
The
following foods are best avoided during pregnancy:
§ Soft
mould-ripened cheese, such as blue-veined cheese, Brie or Camembert. There is a
risk of listeria infection.
Listeria is a group of bacteria that can cause potentially fatal infections to
pregnant women and their babies.
§ Any
type of pate, be it vegetable or meat based - the risk here is also of listeria
infection (listeriosis).
§ Uncooked
or undercooked ready-prepared meals. It is crucial that ready-prepared meals
are cooked through until they are piping hot. The risk of listeriosis exists,
as well as infection from other pathogens.
§ Raw
eggs, including any foods with raw or partially-cooked eggs in them. Eggs must
be well cooked through. The risk here is of salmonellosis (salmonella
infection).
§ Uncooked
or partially cooked meat should be avoided. Make sure it has cooked right
through.
§ Gardening
- wear gloves and wash hands afterwards. There is a parasite in the soil that
can cause an infection, called toxoplasmosis, which can harm the unborn baby.
Cat feces may also have this parasite; so, use gloves when cleaning the cat
litter.
§ Uncooked
shellfish - there is a risk of bacterial or viral contamination which can cause food poisoning.
§ Mercury
in some types of fish - shark, swordfish and marlin should be avoided, or kept
to an absolute minimum. They are at the top of the food chain an can have high
levels of mercury. Many experts say that tuna should be limited to one serving
per week.
§ Empty
calorie foods - cakes, biscuits, cookies and candy should be kept to a minimum.
They are high in sugar and fat, have little nutritional content, and may
undermine a pregnant woman's efforts at maintaining a healthy body weight.
Should I stop drinking alcohol completely?
Public
health authorities throughout the world have been progressively reducing the
maximum amount of alcohol a woman should drink each week.
When
a woman consumes alcohol, it passes from her blood, through the placenta and to
the baby. A fetus' liver is one of the last organs to completely develop - it
does not fully mature until well into the second half of pregnancy. A fetus'
liver cannot process alcohol anywhere nearly as well as an adult's can. Too
much exposure to alcohol can seriously undermine the baby's development. Most
healthcare professionals advice pregnant mothers to avoid alcohol altogether.
The
UK National Health Service says that if a pregnant mother does choose to drink
alcohol, she should have no more than two units of alcohol once or twice a
week. NICE (National Intsitute for Health and Clinical Excellence), UK, advises
pregnant women to avoid alcohol completely during the first three months of
pregnancy, otherwise their risk of miscarriage is increased.
Heavy
drinking during pregnancy may harm both the mother and the baby. There is an
increased risk the baby will develop FAS (fetal alcohol syndrome), which may
include restricted growth, behavioral disorders later on, as well as learning
problems - there is also a greater risk of facial abnormalities.
Should
pregnant women avoid caffeine?
If a pregnant mother consumes too much caffeine during her
pregnancy, there is a raised risk of giving birth to a low birth weight child,
which can lead to health problems later on. There is also a higher risk of
miscarriage. Many foods and drinks contain caffeine, not just coffee. Examples include some sodas (fizzy soft
drinks), energy drinks, chocolate and tea. A number of cold and flu remedies also contain
caffeine. A pregnant woman should talk to her doctor, nurse or pharmacists
before taking a remedy.
Most
health authorities around the world say that coffee does not need to be cut out
completely, but should not exceed more than 200 mg per day. A standard mug of
instant coffee contains 100 mg of caffeine, a mug of filter coffee 140 mg, a
mug of tea 75 mg, one can of coke 40 mg, an energy drink can 80 mg, a 50 g bar
of milk chocolate about 25 mg, and a 50 g bar of dark (plain) chocolate about
50 mg.
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