Preconception & Pregnancy Nutrition

 
Proper and essential nutrition is a highly debated topic. Nearly on a daily basis we see reports in the news that tell us about new research which has concluded that something that was previously thought to be good for us is now bad, or vice versa. There are possibly hundreds of books and cooking guides which all profess to be the key to healthy eating, each of them contradicting the next. The point is that proper nutrition and healthy eating is a complex issue; one that will likely not be made simple or conclusive in the near future. Amid such uncertainty surrounding healthy eating and proper nutrition, there are a number of guidelines that the mother can fallow before, during and after pregnancy that will ensure that she is eating a healthy and balanced diet, while at the same time providing her body and the baby's with the essential nutrients and energy needed to survive a pregnancy in good health. Proper nutrition will help the baby develop properly and will also help minimize some of the symptoms of pregnancy in the mother's body such as mood swings, fatigue, and aches.

As already mentioned, during pregnancy the mother should attempt to gain weight slowly and gradually. This is done by monitoring her food consumption and controlling her caloric intake from trimester to trimester. Weight should be gained not by eating fattier foods, but by slightly increasing the mother's caloric intake from trimester to trimester. Proper nutrition during pregnancy does not however require calorie counting. Following various food guides such as the Food Guide Pyramid, developed by the U. S Department of Agriculture and approved by the Department of Health and Human Services, can provide the mother with an easy way of supplying her body with proper nutrients while consuming the correct amount of food each day. Other dietary guides can be found which will provide suggestions about optimal foods and the amount of each that should be consumed. This section will outline what such a guide may look like by introducing the mother to the types of foods that should be consumed, how much of each should be consumed daily, their importance to the mother's body and the baby's development, and examples of foods which meet these requirements.

There are essentially four basic food groups which must be consumed daily to ensure proper nutrition. It is typically difficult to meet all the requirements in one sitting. Thus, three meals with healthy snacking between, or six small meals a day are recommended in order to ensure that the mother has met all of the daily requirements. Food which is as close to its original state is the highest quality food with the greatest nutritional value. Eating high quality food throughout pregnancy should be the mother's goal. Avoiding canned foods - with some exceptions such as fish - and refined products such as white bread, white flour, and sugars will provide the mother with optimal nutrition. A simple rule to remember is that the fresher and less refined a food, the better it is. Each of the food groups will contain foods that are better for the mother and those that are worse. Applying this rule will help the mother distinguish between the two.

Basic Food Groups

1. Breads and Cereals

This group includes grain foods, pasta, rice, cereals, and breads. This group is the largest of the four and requires a large quantity be consumed each day to ensure that an adequate supply of vitamins, minerals, and fiber are present in the mother's body. Most high quality grains are characterized by being low in fat and high in nutrients. This group is the staple of a healthy diet. Excessive or rapid weight gain should not be controlled by reducing consumption of this food group, but rather the toppings added to the group should be restricted. When it becomes necessary to increase caloric intake from trimester to trimester, this is the food group that should ideally be increased to meet the additional caloric demands of the mother's body. Because this group is a staple and provides the mother with such a large quantity of her daily caloric intake, she must ensure that she is consuming high quality carbohydrates and avoiding those that are of lesser nutritional value. It is typically best to stick with complex carbohydrates which are gained from the starches contained in grains, potatoes, lentils, beans, and peas. As noted earlier, the mother's best choice is unrefined products and whole grains.

RECOMMENDED DAILY SERVINGS: 6 - 11 servings

What counts as a serving?

- ½ cup of cooked cereal, pasta or rice

- ½ a bagel or bun

- 1 ounce cold cereal

- 1 slice of bread

2. Fruits and Vegetables

Fruits and vegetables comprise the second largest component of the mother's diet. They are an essential source of vitamins and minerals which are needed by the mother's body and the baby. Fruits and vegetables also provide a good source of fiber and simple carbohydrates (sugars). The mother should attempt to eat one food from this group that is high in vitamin A and one high in vitamin C. Leafy green vegetables, yellow and red vegetables, and fruit supply vitamins A, E, B6, iron, magnesium, and zinc.

RECOMMENDED DAILY SERVINGS: 2 - 4 servings of fruit, and 4 or more servings of vegetables.

What counts as a serving?

- 1 medium sized piece of fruit

- ¾ cup of vegetables or fruit juice

- ½ cup of vegetables, raw or steamed

- 1 cup raw salad greens

- ½ canned fruit

3. Proteins

Proteins include dairy products (cheese, milk, yogurt, etc. ) and meat products (also eggs, nuts, and beans). Typically proteins come from animal sources. Dairy foods are an important source of protein as well as calcium. Meat, poultry, beans, eggs, nuts and seafood are primary sources of iron, zinc and protein. Although meat based products provide essential nutrients, a healthy and complete diet can be attained without their consumption. Vegetarian and vegan diets will be discussed elsewhere. Protein is likely the most essential nutrient for the baby as the amino acids found in it are essential to the production of cells. They are the building blocks of the baby. They form the cells and tissue that form organs, bones, muscles and connective tissues. The amount of protein found in food varies widely. Unfortunately the greatest sources of protein are typically the most expensive as well. This includes fish, meat, and poultry.

RECOMMENDED DAILY SERVINGS: 3 - 4 servings of dairy, and 3 servings of meat

What counts as a serving?

- 2 tablespoons of peanut buttert

- 1 egg

- ½ cup of cooked beans or peas

- 2 -3 ounces cooked lean meat, fish or poultry

- 1 ½ ounces of cheese

- 1 cup milk or yogurt

4. Fats and Sugars

Fats and sugars are also essential to the mother's health and the development of the baby. However, they should be consumed sparingly and obtained from quality sources. A well-balanced diet must contain small amounts of fat. The mother's best source of fat is from lean meat, and low-fat dairy products. Dressings and spreads usually contain a relatively large quantity of fat with little or no additional nutritional value, thus they should be used sparingly or eliminated from the mother's diet completely. Sweet foods such as candy, honey and syrup contain sugars and have little or no additional nutritional value. Thus they should be avoided when possible.

Fluid Intake and Prenatal Vitamin Supplementation

Beyond these four essential food groups there are two other considerations for a healthy diet that expectant mothers cannot ignore: fluids and prenatal vitamins/ supplementation. Fluid consumption during pregnancy is vital. With the mother's blood volume expanding by nearly 50% throughout the pregnancy, fluid intake is essential. Water is the best choice for fluids, but can be substituted with unsweetened fruit juices. Fluid consumption is also important in preventing urinary tract infections. During pregnancy many women complain about water retention leading to swelling in their hands and feet. Fluid consumption must be maintained despite this. Swelling is normal during pregnancy and foregoing fluid intake will not reduce it.

Vitamin and mineral supplementation is a highly debated issue. While many believe that eating a well-balance diet which follows the guidelines given above is enough to provide mother and child with all the essential nutrients and vitamins necessary, others believe that supplementation is needed to complete a diet that cannot possibly provide enough nutrients and vitamins. While studies show that prenatal vitamins taken early in pregnancy can aid in the prevention of birth defects, others claim that excess vitamin intake can have dangerous effects on the unborn baby. So, amid this contradictory evidence, is there a correct answer?

Pregnant women need more of all vitamins and minerals. Obtaining these from a well-balanced diet is very difficult. Thus, many doctors prescribe prenatal vitamins which are specifically designed to supplement a balanced diet by providing pregnant women with additional vitamins that are necessary but difficult to consume. Prenatal vitamins are not replacements for poor diets; they are supplements, meaning that they provide what a healthy, balanced diet typically cannot attain. Traditionally, prenatal supplements contain many vitamins and minerals that are meant to eliminate dietary deficiencies. The most important components in the supplements are folic acid, iron, and calcium. Each of these is especially hard to consume in the required quantity even through a balanced diet, and are essential to the growth of the baby and to the mother's own health.

Folic acid is essential in reducing the chances of birth defects, particularly neural tube defects as it is critical to the development of the baby. This vitamin is vital in the production of red blood cells and fetal growth, especially during the first three months of pregnancy. It is ideal to begin folic acid intake prior to conception and maintain it throughout pregnancy. This is however impractical considering that many pregnancies are not planned. Folic acid supplementation should thus begin as soon as pregnancy is confirmed. Four weeks after conception, the neural tube is closed, making folic acid supplementation rather extraneous after that point.

Iron is a vital mineral during pregnancy. It is recommended that pregnant women consume double the amount of iron recommended for non-pregnant women. It is nearly impossible to consume the recommended 30 milligrams of iron each day through a complete diet, making supplementation a necessity. Iron is essential to the production of hemoglobin - the oxygen carrying part of blood cells. Since the mother's blood volume increases by nearly 50% during pregnancy, increased and constant iron intake is needed during pregnancy to ensure that the mother and the baby are healthy. A lack of iron may lead to iron-deficiency anemia which causes fatigue, a lack of energy, and increased susceptibility to infections.

Calcium is also an essential mineral during pregnancy. Women who enjoy dairy products and are capable of consuming them should have no trouble meeting their daily recommended intake of calcium. For women who cannot eat or do not eat dairy, supplementation is necessary. Calcium is vital to the development of the baby's bones and to the maintenance of the mother's health. Calcium carbonate and calcium citrate are the ideal types of calcium supplements as they are the most readily absorbed.

One final note regarding prenatal vitamins should be made here. Supplements are most important during the early stages of pregnancy, when the mother is most likely to experience nausea. Thus, the mother may have trouble keeping the supplements down or they may make the mother sick. If the mother is not able to keep the supplements down due to morning sickness or if their consumption makes her sick, she should contact her physician so alternative measures can be initiated.

Essential Nutrients during Pregnancy

There are over 50 nutrients that are essential for promoting good health and development during pregnancy. This list covers what are seen as the key nutrients:

NutrientFunctionKey Sources

CarbohydratesProvides the mother and the baby with energy; helps protein be utilized in tissue growthRice, Pasta, Potatoes, whole-grain breads and cereals, vegetables, fruits

FatFat deposits provide long term energy used in growth; key to development of fetal brainLean meat, poultry, fish, eggs, nuts, beans, oils, butter

ProteinProvides energy reserves needed for labor; building block of the baby's cellsLean meat, fish, poultry, peas, beans, eggs, milk

FluidsNeeded for amniotic fluid; prevents constipation; increases fluid volumeWater and juice

Vitamin AAids in healthy skin, bone growth and eyesight in the mother and the babyDark leafy greens, carrots, cantaloupe

Vitamin CAids iron absorption; helps form healthy bones and teeth in fetus; helps keep the mother's tissue healthyCitrus fruits, citrus juice, broccoli, peppers, tomatoes

CalciumAids in strong development of bones and teethMilk, cheese, yogurt, salmon, kale

Folic AcidAids blood cell and hemoglobin formation; helps prevent fetal neural tube defectsDark leafy green vegetables, whole -grain breads and pastas, beans, citrus fruits

IronPrevents fatigue in the mother and develops red blood cells in the babyLean red meat, beans, cereals, tofu, spinach

Foods to Avoid during Pregnancy

There are many foods that should be avoided during pregnancy largely because they are empty calories - food with little or no nutritional value. Typically these foods contain nothing more than sugars and refined carbohydrates. Regular consumption of these foods during pregnancy can lead to excessive weight gain which is bad for the health of the mother and the baby. Some foods to avoid during pregnancy include:

- ice cream that contains added sugar

- sweetened breakfast cereals

- artificial creamers

- candy and chocolate bars

- any form of sweetener; artificial and natural

- soft drinks

- cookies, cakes, doughnuts, pastries, jams, pies

- canned fruit in syrup

Food Cravings and Pregnancy

Food cravings are very normal during pregnancy and are experienced by almost all women. There is no reason why the mother cannot satisfy these cravings. However, if the cravings are for foods that provide the mother with empty calories and prevent the mother from later consuming nutrient rich foods, she should attempt to find an alternative way of indulgence. Pregnant women sometimes also crave non-food items such as paint chips, clay, dirt, ice, and laundry starch. This is known as pica, and is thought to be a sign of anemia (iron deficiency). Pregnancy can also lead to food aversions. Foods that the mother once found enjoyable and craved my make the mother nauseous just thinking about them or smelling them.

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