The Best Nutrition in Pregnancy. What to eat and what not to?

It is no doubt that no one can deny the importance of nutrition at any age. But it has to be especially important in pregnancy as a woman has to feed herself and the baby. To fulfil the physiological changes in pregnant women, their daily requirements for numerous micronutrients are higher than during other times of life. A woman may not know that her body needs more micronutrients and nutrients like vitamins and minerals. Find the best nutrition in pregnancy and how much supplementation is ideal by reading on!

Pregnant women should make eating healthily a top priority. The mother and her developing child can both benefit from a healthy diet during pregnancy. Here is a breakdown of the healthiest foods to eat to get the nutrients you require during pregnancy and beyond.

Calorie requirements? In the first trimester, pregnant women’s calorie demands are similar to those of nonpregnant women. They climb to 340 and 452 kcal per day in the second and third trimesters.

The recommended is to keep regularly eating throughout the first trimester, increasing by 350 calories per day for the second and by 450 calories per day for the third, to accommodate the growing baby.

Furthermore, a woman’s energy needs change drastically with her age, body mass index, and amount of physical activity. Therefore, it is important to tailor caloric intake to each person’s needs.

Weight Gain:

The foetus, placenta, amniotic fluid volume, and maternal tissue adaptations require about 8 kg weight gain throughout pregnancy (e.g., uterus, breast, blood volume). It’s natural to gain less if a woman is overweight or more if she is underweight before pregnancy. IOM’s recommendations for maternal weight growth during pregnancy are as follows. It’s always suggested to consult your Gynecologist for proper evaluation.

” Eating for two” may be difficult during the first trimester of pregnancy due to sickness, food aversions, and weariness.

Food Cravings & Aversions:

A woman may develop a dislike for the aroma or flavour of some meals throughout her pregnancy. It’s also possible that she willl develop an appetite for a certain dish. According to a study published in Frontiers in Psychology, between 50 and 90% of pregnant American women have food cravings. It is unclear to physicians because pregnant women have a need for certain foods or flavours. The hormones can change too quickly.

A study conducted in 2006 and cited as indicated that when women eat more meat, they are more likely to have morning sickness. Reverse food desires are food aversions. They can elicit equally out-of-the-ordinary sentiments. In most cases, pregnancy cravings and aversions to certain foods occur simultaneously.

Nutrition In Pregnancy

• Protein: To develop normally, a baby’s tissues and organs, including the brain, require protein. It also promotes the development of the foetus and the mother’s breasts and uterine tissues. In each successive trimester of pregnancy, there is a rise in the woman’s protein requirements. According to the findings of a recent study, the recommended daily allowance for protein intake by pregnant women should be adjusted even more

Compared to a non-pregnant individual, whose recommended protein consumption is 46g/d, the recommended protein intake during pregnancy is 60-75g/d. That accounts for almost 30-35% of daily calorie intake. Find out how much you need by consulting the doctor. Lean meat, poultry, shellfish, and eggs are all excellent protein dietary sources. Beans & peas, nuts, seeds, and soy goods are some more alternatives.

• Carbs: Carbohydrates, specifically the glucose they provide, are the best fuel for mom and baby’s brains. Carbs are a good supply of vitamins, minerals, dietary fibre and a slow energy source (glucose). Carbohydrates are also a good way to get the B vitamin folate, which is essential for foetal growth in the first trimester.

45-65% of daily calories should come from carbohydrates, which translates to around 6-9 servings of whole grains per day. The more complex and whole grain a carbohydrate is, the better it is.  Restricting simple carbohydrates and starches that cause a quick increase in blood sugar but offer little nourishment are recommended. Wholegrain bread and cereals, whole meal pasta, wholegrain crackers, oats, brown rice, lentils and legumes are all great choices for providing sustained energy and a full feeling during pregnancy.

• Fats: Similar to calorie needs in non-pregnant women, total fat consumption should range from 20-35% of daily calories in pregnant women. When comparing saturated and unsaturated fats, monounsaturated fats are the healthier option. Observational studies link higher saturated fat consumption during pregnancy complications (preeclampsia, gestational diabetes, premature delivery) and poor birth outcomes. Healthy options include avocados, sunflowers, olive oil, pistachios, salmon, sardines and mackerel.

• Water: Even while water doesn’t technically count as a calorie-containing nutrient, pregnant women must drink enough water.

It’s no secret that water and hydration have been proven useful in several ways. Amniotic fluid is formed around the foetus and helps with digestion. . It also helps get the nutrients, vitamins, and minerals from the food consumed, and the prenatal vitamins mother takes for a developing baby. Water helps maintain a healthy temperature, balance hormones, break down food, and absorb nutrients. UTIs, bladder infections, headaches, lethargy, constipation, and haemorrhoids may all be avoided with enough fluid intake.

The average pregnant woman needs between 8 and 12 cups of water per day (64 and 96 ounces).

Essential Nutrients in Pregnancy.

Vitamins:

Vitamin supplements designed specifically for pregnant women are called prenatal vitamins. Doctors encourage women to take prenatal vitamins before, throughout, and after pregnancy to maintain optimal nutritional levels and aid postpartum recovery. Observational studies (1) (2) (3) have proven that prenatal vitamin supplementation can lessen the likelihood of premature delivery and preeclampsia.

Some of the most crucial vitamins to take throughout pregnancy are the B-vitamins: Riboflavin (B2) 1.4mg, Niacin (B3) 18mg, Pantothenic Acid (B5) 6mg, Biotin (B7) 300mcg, Pyridoxine (B6) 2mg, Folate (B9), and Cobalamin (B12).

• Vitamin D: Vitamin D deficiency during pregnancy can lead to caesarean section, hypertension, premature delivery, congenital rickets and gestational diabetes. This vitamin boosts immunity, bone health, and cell division. Vitamin D consumption during pregnancy is recommended at 600 IU per day. To start, try increasing the consumption of foods rich in vitamin D, such as fatty fish (salmon, mackerel, herring and sardines)
  , eggs and red meat.

Furthermore, studies have shown that moderate sun exposure (typically 5-10 minutes of exposure to the arms and legs or the hands, arms, and face, 2 or 3 times per week) can be beneficial. But taking a vitamin D supplement is the simplest approach to ensure you get enough nutrients. A recent study revealed that 4,000 IU of vitamin D daily prevented premature labour/births and infections. However, the dose above had detrimental consequences on the mother’s health.  Vitamin D deficiency screening and supplementation should be discussed with your doctor.

• Vit C: Pregnancy is no exception to the rule that women require vitamin C daily.  Preeclampsia has been linked to low levels of vitamin C in the blood, therefore getting enough of this nutrient is very important during pregnancy. Vitamin C not only aids in iron absorption, but it also helps shield the body from illness and injury by boosting and building immunity.

Adult pregnant women need around 85 milligrams (mg) of vitamin C daily, while nursing mothers need about 120 mg. By combining a 6-ounce glass of orange juice with one cup of strawberries, one will get more than double the recommended daily allowance of vitamin C.

• Vitamin A: Vitamin A is crucial for healthy eyesight and immunity in the developing brain, but too much of it can be dangerous. Due to the apparent risk of teratogenicity, pregnant women have mainly avoided vitamin A, omitted it from supplement formulations, and replaced it with beta-carotene. 8000 IU/day is the maximum during pregnancy. You should be able to obtain sufficient vitamin A through prenatal vitamins and meals; extra supplementation is not recommended.
• Vitamin E: This vitamin has a wide range of physiological functions, including regulation of gene expression and immune system regulation. But extra vitamin E supplementation has not been proven to enhance outcomes for women or infants and may raise the risk of stomach discomfort and early amniotic sac rupture.

Calcium:

Most of the body’s calcium is contained in bones and teeth, with less than 1% in blood and soft tissues. In most cases, the mother and the child will receive the calcium needed through a calcium-containing prenatal supplement and by eating a diet rich in calcium-rich foods. The recommended daily dose for pregnant women 19 and older is 1 gram, preferably in two small doses of 500mg each (1,300 mg for women 18 and under) by The American College of Obstetricians and Gynecologists. That translates to four servings per day of more calcium-rich foods such as milk, yoghurt, cheese, calcium-fortified orange juice, salmon, tofu, sardines, kale and other leafy greens, broccoli, and other dark green vegetables.

It’s well accepted that pregnant women may take calcium supplements without any precautions. Constipation and bloating are just two of the side effects that can result from taking calcium supplements in excess.

Choline:

Choline, which functions in the body similarly to a vitamin, is required for several activities, including synthesising neurotransmitters (chemical messengers) in the brain. Choline is essential for the maturation of the hippocampus, the brain region responsible for memory.  Adequate choline consumption during pregnancy has reduced the likelihood of neural tube abnormalities.

It is believed that the current recommended daily amount of choline during pregnancy (450 mg per day) is insufficient and that an intake closer to 930 mg per day is ideal. Eggs, lean steak, salmon, chicken, broccoli, and cauliflower are among the best sources of choline for expectant mothers. This supplement is usually recommended separately as prenatal vitamins don’t contain it.

Folic Acid:

When it comes to the health of mother and baby during pregnancy, this is the most important vitamin to consume during the first trimester making it into the most essential nutrients in pregnancy. It has been proven essential for DNA synthesis, red blood cell creation, and normal foetal development and growth. Many women don’t eat enough folate-rich foods, necessitating supplementation. It is advised to consume at least 600 micrograms (mcg)for pregnant women and 400mcg for childbearing age women of folate or folic acid each day to lower the possibility of neural tube defects, cleft palate, and heart problems. Food sources

Since the FDA mandate, blood folate levels have increased, and neural tube defects have declined. As it has been reported in clinical studies that 6,105 women found that regular folic acid supplementation decreased neural tube abnormalities. In some cases, your doctor may recommend a greater dosage of a particular vitamin if you’ve had a child with a neural tube defect. Your doctor may recommend taking 4 milligrams (4,000 micrograms) of folic acid before and during subsequent pregnancies.

Fish Oil: 

Fish oil is on the list of most important nutrients in pregnancy as two essential fatty acids fundamental to a baby’s brain development may be found in fish oil: docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). DHA and EPA supplements throughout pregnancy may improve the baby’s brain development after birth and reduce the mother’s depression.

Consuming 500–1000 mg of fish oil per day, with at least 300 mg being DHA, is recommended by the American Pregnancy Association for pregnant and breastfeeding women. The FDA recommends not exceeding 3000 mg of fish oil per day.  To receive DHA and EPA from food, it’s suggested to take two to three meals of low-mercury seafood like salmon, sardines, or pollock every week. You may not need a supplement if you have oily fish in your weekly diet.

Iron:

During pregnancy, a woman’s blood volume rises by roughly 45%, dramatically increasing her requirement for iron. Iron is essential for oxygen transport and infant and placenta growth and development. The mother’s iron content deficiency causes anaemia, which can also result in premature birth, maternal depression, and infant anaemia.

Most prenatal vitamins provide the daily necessary 27 mg of iron. However, women of childbearing age should also take 14.8mg daily. Beginning about week 12 of pregnancy (the start of the second trimester), when the iron needs for pregnancy begin to increase, that is the best time to start the supplementation, with most of the iron accumulating during the third trimester. Good food sources include dark green, leafy veggies, eggs, citrus fruits, lean beef, chicken, and bread.

If you have iron deficiency or anaemia, your doctor will prescribe greater amounts. If you’re not iron deficient, don’t take extra iron to avoid unwanted effects such as vomiting and elevated haemoglobin are symptoms.

Iodine:

Lack of iodine during pregnancy has been linked to low levels of thyroid hormone, which increases the risk of premature birth, low birth weight, and neural tube abnormalities. Women who are trying to conceive, who are pregnant, or who are breastfeeding are encouraged by the American Thyroid Association (ATA) to take iodine supplements with 150-200μg per day. However, there is no additional requirement of iodine n prenatal vitamins. So, the iodine resources can be fulfilled via diets such as COD fish, low fat yoghurt, breads, cheese, prunes and apple juice.

To increase your iodine intake, use iodized salt in your cooking. A 1/4 teaspoon has 71 mcg of sodium, however it’s still best to keep your daily salt consumption under 2,300 mg.

Magnesium:

Humans need magnesium for literally hundreds of different body processes. It’s vitally important for healthy immunological, muscular, and nervous systems. In conjunction with calcium, magnesium relaxes and contracts muscles.

Magnesium is important during pregnancy, yet most expecting mothers don’t get enough of it. The mother and the baby might be in danger of a magnesium shortage or insufficiency during pregnancy, and the effects could last far into the child’s maturity.
In some research, magnesium supplements have been linked to a decreased threat of having a preterm baby or developing restrictions. (1) (2).

The daily intake of magnesium is 350 to 360 mg daily for women 19 and older who are pregnant (400 mg for pregnant women 18 and under).  Almonds, spinach, cashews, peanuts, black beans, edamame, peanut butter, avocado, yoghurt, and kidney beans are some of the best sources of magnesium nutrition in pregnancy.

Probiotics:

Studies have shown that taking probiotics during pregnancy is safe. Probiotics can boost folate production together with folic acid. Several studies have also indicated that taking probiotics during pregnancy may lessen the likelihood of developing diabetes, postpartum depression, and baby eczema and dermatitis. A 2020 assessment of 18 randomised control studies indicated probiotic users had longer pregnancies than placebo users. There is a very small chance of probiotic-induced illnesses, as per studies.

Taking a high-quality probiotic during pregnancy and the child’s first few months will promote a healthy pregnancy and newborn health.

Zinc:

Zinc is essential for cell growth and the development of the baby’s unique genetic makeup, both of which require enough amounts to occur throughout pregnancy. Moreover, low zinc levels during pregnancy have been associated with the delivery of kids with low birth weights. Rapid cell development during pregnancy makes zinc deficiency prevalent, thus pregnant women must take adequate zinc supplements. So having a recommended amount of zinc is essential.

Zinc intake of 11 mg per day is recommended for pregnant women aged 19 and above. Zn may be found in foods including red meat, seafood, chicken, pig, dairy products, fortified cereal, beans, and nuts.

The list of all the recommended dosage of nutrients is as below,

Precautions:

In order to protect the developing baby from harmful germs and parasites, pregnant women should avoid eating a few certain foods.

• Remember that calcium might prevent iron absorption, so you shouldn’t take it if you’re taking iron supplements. (Give yourself a minimum of two hours between taking each supplement.)
• Iron in prenatal supplements can often cause constipation. It is suggested to increase water intake and add fibre to the diet. Dr may also recommend a stool softener.
• Instead, of attempting to stuff three large meals into your day, try eating smaller, more frequent meals every few hours. Getting overly hungry or consuming too much food can also exacerbate nausea.
• The proper storage of food and the validity of the “use-by” date are additional factors to consider. Never consume a meal that you have any reason to suspect could be contaminated.

What To Avoid?

• Alcohol: During pregnancy, there is no safe threshold for consuming alcohol as Alcohol in the mother’s blood can be transferred to the foetus through the umbilical cord. The unborn baby may also have fetal alcohol spectrum disorder (FASD). Eyesight or hearing problems, attention issues, and appetite loss are potential negative effects. So, it is suggested by CDC to avoid drinking at any cost.
• Smoking: Smoking doubles pregnancy and delivery abnormal bleeding risk. It also increases your baby’s chance for birth abnormalities, such as cleft lip or palate. So better to avoid.
• Raw Foods: Various types of raw or undercooked meat, seafood, and eggs. If the sushi contains raw fish, don’t eat it (cooked sushi is safe).
• Soft Cheese: Brie, camembert, and other soft cheeses may be contaminated with Listeria. Listeria is a bacterium that has been linked to serious, even fatal, infections in pregnant women and their newborns.
• Caffeine: Caffeine isn’t only in coffee. Sodas, energy drinks, chocolate, and teas are examples. Caffeine intake should be kept to lesser than 200 milligrams (about two six-ounce cups) per day by pregnant women, as recommended by the American College of Obstetricians and Gynecologists (ACOG). More than the recommended intake can cause smaller birth size of baby and increased risks of obesity and heart diseases according to new research.

One of the best things a woman can do to help her developing child and reduce her risk of complications like anaemia, gestational diabetes, and preeclampsia is to ensure she gets the recommended daily allowance of all the nutrients her body needs. What complications can occur if she is short of any nutrients? Learn more about it and many others in our article here.

It’s important to have good nutrition in pregnancy as early as possible due to the high prevalence of birth defects in the first trimester. A healthy, balanced diet and a high-quality prenatal supplement should be sufficient to meet all the nutrients one needs throughout pregnancy. But if you’re worried about falling short, especially if you don’t consume dairy, talk to your doctor about taking a supplement.