How to support pregnancy:
Being pregnant is a special time of your life which needs particular attention. Good health and nutrition are crucial for the health status of the mother and the development of the child. It is therefore important for pregnant women to embrace a healthy and balanced diet which includes plenty of fruit and vegetables, meals that are based on starchy foods, moderate amounts of beans, fish, meat and eggs, and moderate amount of dairy.
In addition to this, pregnant women should increase their dietary energy intake by 10% of their normal energy requirements. During the first semester, they should add extra 70 kcal/day; during the second semester extra 260 kcal/day and during the third semester extra 500 kcal/day. However, it is typical to find women that believe in the concept of “eating for 2” during pregnancy and consume too many calories leading to gestational weight gain (GWG). Excess intake of calories has been associated with miscarriage and gestational diabetes. Moreover, women that adhere to unhealthy lifestyles, characterised by poor quality diets, low levels of physical activity, smoking and excessive alcohol consumption, are at a higher risk of having neural tube defects and developing long-term health conditions such as cardiovascular disease, cancer and diabetes.
Nutritional recommendations:
During pregnancy, there are some micronutrients that require a higher intake such as folate, iron, calcium, vitamin D and iodine.
Folate: Plant-based foods including green leafy vegetables, cabbage, beetroot, legumes, whole grains, tomatoes and oranges are a very good source of folate, but additional supplementation is strongly advised. Supplementation of at least 400 µg of folic acid per day is recommended before conception up to 12 weeks of pregnancy to lower the risk of neural tube defects such as spina bifida, anencephaly or encephalocele.
Iron: the body needs extra iron during pregnancy to ensure the baby has sufficient blood supply and receives necessary oxygen and nutrients. Rich sources of iron such as beans, nuts, eggs, spinach, dried fruit and fortified cereals are encouraged during pregnancy. Furthermore, vitamin C rich foods such as oranges, red peppers, goji berries are also encouraged, as they increase iron absorption. Some women take an iron supplement, but this is not necessary, because it has been increasingly recognised that the body becomes more efficient at absorbing iron as the pregnancy progresses.
Vitamin D and calcium: vitamin D has many functions in the body, including helping in the absorption of calcium and supporting the formation of healthy bones. It is mainly absorbed from the sun rays, but it is also possible to get vitamin D from foods such as oily fish, eggs and fortified products. Calcium is found in milk and milk products, cheese and yogurt. However, unpasteurised milk and cheeses like cheddar, parmesan, cottage cheese, mozzarella, feta, halloumi and goats cheese need to be reduced during pregnancy, since they may contain Listeria bacteria which can cause an infection called listeriosis. The infection can often lead to miscarriage or make your newborn baby more susceptible to the flu.
Iodine: this is an essential mineral needed to maintain a normal function of the thyroid hormones and to ensure brain development during childhood. It is found in seaweed, iodised salt, seafood and eggs. Research studies have shown that iodine deficiency is associated with postpartum hyperthyroidism or increased risk of spontaneous abortion, higher mortality, birth defects and brain damage.
Foods to avoid:
While being pregnant, it is very important to be aware of micronutrients and foods to increase, but also those to decrease. Particular concern exists regarding vitamin A, as it has been associated with liver dysfunction and birth defects. Vitamin A is found in many fruits and vegetables like carrots, green leafy vegetables and oranges. It is good to consume vitamin A in moderation but not to take a supplement. Liver and liver products are also best avoided when pregnant, as they contain high levels of vitamin A.
Other foods to avoid are unpasteurised milk and cheeses, raw or undercooked eggs, raw or undercooked meat and cold cuts such as Parma ham, chorizo, pepperoni and some type of fish. For instance, shark, marlin and swordfish contain high levels of mercury that can stop the development of the nervous system of the child.
Post-pregnancy nutrition & exercise:
After childbirth, there is no need to follow a special diet. However, it is important to embrace balanced and healthy dietary patterns to:
- Replenish body stores for future pregnancies
- Help with weight management
- Overcome any postnatal problems (e.g., constipation, anemia)
- Help meet additional nutritional requirements for breastfeeding
A healthy diet includes plenty of fruit and vegetables, starchy foods such as bread, pasta and rice, protein such as lean meat and fish, eggs, nuts, a small amount of dairy including milk, cheese and yogurt and plenty of fluids. Another important consideration after pregnancy is to exercise. Exercise not only help to relieve stress and improve energy and sleep levels, but it also contributes to reverse weight gain, which is very common after pregnancy. Common exercises that are recommended after pregnancy are postnatal exercise classes, swimming and brisk walks.
Pregnancy and post-pregnancy times are life moments to make changes to your dietary lifestyle and acknowledge which food to eat and which food to avoid in order to support the pregnancy and meet your nutritional needs in the pre and postnatal period.
References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5682869/pdf/431_2017_Article_3026.pdf
https://www.karger.com/Article/PDF/496471
https://pubmed.ncbi.nlm.nih.gov/33143058/
https://www.bradford.gov.uk/media/1905/4-nutrition-guidelines-postnatal.pdf