A healthy and balanced diet increases the chances of an easy pregnancy, without complications, and can increase the chance of giving birth to a healthy child, even reducing the risk of chronic diseases that can appear in the first years of childhood.
Although there are still many people who believe in the misconception that the fetus can take all the nutrients it needs from the mother’s body regardless of whether or not she has a proper diet, both the studies conducted and the high frequency of stunted and malformed children born during the famine of the second world war, proved the opposite. The lack or surplus of some food principles in the diet has repercussions on the development of the fetus.
Therefore, during pregnancy, more than ever, the woman must have a healthy and balanced diet; if the woman had such a diet before pregnancy, the chances of having a healthy child increase, and the pregnant woman will only have to slightly adjust her diet according to the increased needs of the pregnancy state. But, regardless of whether the pregnancy was a surprise or was expected for a long time, most women start to change their eating habits and lifestyle after finding out they are pregnant.
Research suggests that, just like other healthy habits, the correct diet during the 9 months of pregnancy influences the child’s health at birth, but also the risk of later developing certain diseases such as obesity, diabetes or heart diseases.
Appetite in pregnancy
Pregnancy requires a high consumption of both energy and nutrients, for the formation of the fetal body and for the changes in the maternal sexual organs (uterus, placenta, mammary glands, etc.). Food intake is regulated according to the body’s needs through the feeling of hunger, this regulation being coordinated by two nerve centers located in the hypothalamus. Although the mechanisms of appetite regulation are not yet well known, it is known that it is also regulated by the metabolic consequences of absorbed nutrients (the level of proteins, glucose, lipids, the state of lipid deposits, etc.); also, in humans, a series of specific social and cultural factors, preferences for a certain taste, smell, appearance of food also intervene in the regulation of food intake.
In more than half of pregnant women, there is a strong stimulation of the appetite that usually starts at the beginning of the second trimester and is maintained until the end of the pregnancy, sometimes diminishing in the last months. Changes in the pregnant woman’s tastes are also frequently observed, most often manifested by preferences for fruits, pickles, salty, and spicy foods; these preferences or cravings are explained by some authors as being determined by a need for gustatory stimulation as a result of the decrease in gustatory sensitivity that occurs during pregnancy. The aversion to certain foods that before pregnancy were eaten with pleasure can be explained by the appearance of heartburn or nausea after eating them; in rare cases, perversions of taste also occur, pregnant women, consuming inedible substances (soap, lime, coal, toothpaste, etc.).
The weight of the pregnant woman
The weight gain of the pregnant woman is one of the most useful parameters for following the evolution of the pregnancy, because variations from normal, in one sense or another, can have pathological significance. Numerous studies have been done with the aim of establishing what is the optimal weight gain during pregnancy, but these studies were hit by very large individual variations.
Many women start pregnancy with a slight weight loss, due to the intense activation of the metabolism, as an adaptive mechanism of the body to the presence of the conception process on the one hand, and on the other hand due to the fact that most of the time the woman discovers the pregnancy only from 2nd month. This fact confirms the fact that the psychological factor is of great importance in increasing the appetite of pregnant women, especially in the first trimester of pregnancy, especially since studies have shown that the weight gain of pregnant women in the first trimester is mainly based on fat deposits maternal and less due to the product of conception.
Thus, some authors established the average weight increases of pregnant women with normal pregnancy evolution in four moments:
– 650 g: in the first 10 weeks
– 4 kg: at 20 weeks
– 8.5 kg: at 30 weeks
– 12.5 kg: at 40 weeks.
This weight gain is due to several components:
– fetus: 3500 g
– placenta: 650 g
– amniotic fluid : 900 g
– uterus: 1000 g
– mammary glands: 600 g
– increase in maternal blood volume: 1200 g
– fluid accumulation, edema: 1700-5000 g
– reserves (proteins, lipids): 2500-3000g.
Thus, a pregnant woman who before pregnancy had a normal weight is recommended an average increase in weight of 12 kg; an obese pregnant woman is recommended to gain less than 10 kg, while a previously underweight pregnant woman can gain more weight.
Calorie requirement
The natural tendency of pregnant women is to overeat, due to a misconception that pregnant women must eat for two. In reality, the caloric requirement is unchanged in the first trimester of pregnancy, increasing only from the second trimester and only by 300 kcal compared to the energy requirement before pregnancy. Overall, the energy needs of an active pregnant woman, who has not interrupted her activity, are 2500-3000 kcal/day.
In order to ensure proper growth and development of the fetus, the pregnant woman must make sure that those extra calories are provided by nutrient-rich foods and less from refined sweets and fats.
A hypercaloric diet during pregnancy has as consequences, in addition to excessive weight gain and an increased frequency of complications at birth, difficulties in establishing and maintaining milk secretion, difficulties in returning to pre-pregnancy weight, increased risk of obesity, diabetes and other metabolic disorders in children.
At the opposite pole, there is maternal malnutrition: numerous studies have shown that fetal development depends to a large extent on the maternal nutritional status, there is a close relationship between the nutritional status of the mother and the weight of the child at birth. This relationship was very evident during the Second World War when long periods of famine led to a decrease in the average weight of newborns by approximately 500 g. Newborns with low birth weight, below 2500 g, have perinatal mortality 10-20 times higher than normal-weight ones, both due to the associated malformations and the increased risk of asphyxiation, meconium aspiration, hypoglycemia, pulmonary, intracranial hemorrhages, etc. There is also the risk of long-term consequences: late-onset nervous disorders, from accommodation difficulties, behavioral disorders to mental retardation, consequences of brain damage caused by intrauterine malnutrition.
To remember!
Pregnancy should not be considered as a period in which you can eat anything and everything; after all, pregnancy is not a competition for food and the goal is not to increase the mother’s fat reserves, but to ensure the necessary nutrients for a good development of the fetus. Thus, the pregnant woman needs only 300 kcal/day more than she needed before pregnancy.
Food plan during pregnancy
Each nutrient is important in the case of pregnant women for good growth and development of the fetus. That is why the key to proper nutrition during pregnancy is balance and variety. The diet must include healthy foods from all food groups: fruits, vegetables, cereals, meat, and dairy.
It does not mean that the pregnant woman must calculate the calories or how many grams of protein she consumes at a meal, but she must eat healthy, varied, in moderation and take into account the special needs of pregnancy. Thus, while the need for lipids during pregnancy is slightly modified, the need for proteins and carbohydrates increases; iron, calcium, folic acid, and vitamin D are also needed in increased quantities. Meals in small quantities but in a larger number per day are preferred, rather than small and rich meals, because in this way the nausea characteristic of the beginning of pregnancy is also alleviated and overeating is avoided.
We should not forget about dietary fibers, so important in combating constipation, which is frequent during pregnancy both due to the changes characteristic of pregnancy and due to the often recommended vitamin supplements.
Here are some ideas about what the basis of a day’s nutrition might include:
Cereals: 8 servings, such as a slice of whole wheat bread, a cup of cereal; half a cup of pasta or rice. (Try to choose cereals that have the highest percentage of fiber to avoid pregnancy constipation .)
Vegetables: 4 or more servings such as two medium carrots, one cup of chopped greens; a cup of cooked broccoli or cauliflower.
Fruits: 2-4 servings, such as a small apple, orange, pear or banana or a cup of raisins. Dairy: 3 servings, such as 250-300 ml of milk or yogurt or 50 g of cheese. Pork, beef, chicken or fish, eggs, nuts or seeds: 2-3 servings, such as 100g of cooked beef, pork or poultry or seafood. Fats, oils or sweets: very little.
The proteins
Proteins are the structural material of every cell in the body of the fetus and are part of the enzymes that participate in the body’s chemical reactions; taking into account the fact that the development of the fetus involves the formation of new tissues and organs through numerous chemical reactions that take place quickly, proteins are an indispensable element in the nutrition of pregnant women.
Protein needs during pregnancy are slightly increased, requiring a supplement of 25-30 g protein/day compared to the amount recommended before pregnancy. Or in other words, during pregnancy, a daily intake of 1.5 g/kg body protein is recommended (for a 70 kg woman this corresponds to 100 g protein/day), of which approximately half should be of animal origin: milk, cheese, yogurt, meat (poultry, beef or fish) and egg.
A low-protein diet during pregnancy restricts fetal growth and may even increase the child’s chances of developing high blood pressure later in life, according to a recent study.
Carbohydrates
Carbohydrates are an essential part of the diet and, contrary to some misconceptions according to which they should be eliminated from the diet, the need for carbohydrates is increased during pregnancy and it is recommended to consume 350-400 g of carbohydrates/day. This intake, however, must be made up of carbohydrates from whole grains, rice, fruits, and vegetables, which are also sources of vitamins from the B group, and less from refined sweets.
Even if there is a tendency for pregnant women to consume sweets in excess, especially ice cream, cakes with fatty creams and whipped cream, chocolate, etc. under the reason of “cravings” and an increased energy requirement, this attitude can be harmful, possibly increasing the risk of macrosomia in the fetus and the development of diabetes and other metabolic diseases.
When a pregnant woman feels the need for something sweet, she can choose to eat fruit or if she has a craving for a cake, she should not refuse this, if these foods are consumed in moderation. A slice of cake or a scoop of ice cream is enough to satisfy his appetite and he doesn’t need to eat a whole cake or an ice cream pan for that.
The iron
The needs of iron during pregnancy are increased due to the increase in blood volume during this period, iron being an important constituent of hemoglobin that enters into the composition of erythrocytes (blood cells) and which has a role in the transport of oxygen to the tissues. Thus, during pregnancy, the iron requirement doubles, reaching 30 mg/day. Food sources of iron are red meat, especially liver, kidneys and beef, egg yolk, nuts, beans, spinach, wheat germ, and dried fruits; iron from animal sources is absorbed much better than that from vegetable sources.
An iron deficiency during pregnancy can cause anemia in the mother, which causes a state of fatigue and can affect the fetus, increasing the risk of anemia in the newborn. Although theoretically, the medicinal supplementation of the fetus is recommended only if the mother has iron-deficiency anemia, in practice iron-based supplements are recommended to more than half of pregnant women. This is because the increased iron needs during this period are difficult to cover only from food on the one hand, and on the other hand because many women at the beginning of pregnancy start with an iron deficiency, even if it does not end up causing anemia.
Calcium and phosphorus
The child needs calcium for development, especially for bones and teeth. If the mother does not have a sufficient intake of calcium during the 9 months of pregnancy, this will affect both the development of the fetus and the health of the mother, because the fetus will try to get the calcium it needs from the mother’s body. Calcium deficiency favors the occurrence of painful muscle cramps in pregnant women and increases the risk of osteoporosis.
For good absorption, calcium must be in balance with phosphorus. Food sources rich in calcium and phosphorus are: dairy products (whole milk, yogurt), cheeses, fruits and eggs.
Excess calcium is dangerous during pregnancy because it can trigger uterine contractions. That is why medicinal calcium supplements are not indicated during pregnancy. If calcium supplementation is necessary, prenatal multivitamin supplements are preferred, specially designed for pregnant women, and in which calcium is present in appropriate doses.
Folic acid
Folic acid has an important role in the growth and development of cells and tissues, being an important nutrient during pregnancy when the need for folic acid doubles. Thus, a pregnant woman needs a daily intake of 0.8 mg of folic acid. Adequate intake of folic acid in the first months of pregnancy reduces the risk of giving birth to a child with malformations (neural tube defects), especially spina bifida.
The best sources of folic acid are green leafy vegetables: spinach, broccoli, lettuce, cabbage, asparagus along with oranges, whole grains, lentils and peanuts. Since folic acid is easily destroyed by preservation and cooking, it is recommended to consume fresh fruits and vegetables or as little as possible thermally prepared ones.
The vitamins
Due to the intense processes of growth and development of the fetus, vitamin needs are increased during pregnancy.
Vitamin A – necessary for the growth and development of cell membranes can be found in fish liver , chicken and veal, yellow and orange vegetables and fruits, green leafy vegetables, egg yolk. Avitaminosis A has been associated with the appearance of congenital anomalies such as: retinal atrophy, blindness and horseshoe kidneys. Also, the excess of vitamin A has been blamed for the occurrence of congenital malformations.
Vitamins from group B – are found in abundance in whole grains, liver and other organs, leafy vegetables, milk and eggs. Avitaminoses, especially vitamin B1 and vitamin B2, have been implicated in the appearance of malformations of the face ( Palatoschisis ), of the lower limbs and of the sternum.
Vitamin D – is necessary to regulate the absorption of calcium from food.
So, each vitamin is important and has its role in the development of the fetus and in ensuring a state of health for the pregnant woman, and the deficiency or excess of one can lead to various imbalances with consequences for both the mother and the fetus.
That is why, in most cases, doctors recommend prenatal multivitamin supplements to pregnant women, specially designed for the pregnancy period, in which the doses of vitamins and minerals are correlated with the special needs of this period. These preparations contain, in addition to vitamins, calcium, iron and other trace elements that seem to have a role in preventing some deficiencies or malformations in the fetus: zinc, magnesium, selenium, chromium, copper, potassium, etc. However, to prevent overdose, pregnant women must take only the supplements recommended by the doctor and in the doses and for the duration of time recommended by him.
The liquids
A pregnant woman needs at least 2 liters of liquid per day (approximately 10 glasses), preferably in the form of water, milk, fresh, unsweetened fruit or vegetable juices and less carbonated drinks or commercial juices.
Carbonated, acidulated commercial drinks, besides the fact that they can contain large amounts of sugar and food additives, caffeine, they can create meteorism (bloating) and abdominal discomfort.
Alcoholic drinks are completely prohibited during pregnancy because they increase the risk of physical and mental deficiencies in the child. The consumption of coffee, cola, tea and other beverages containing caffeine must also be limited. A cup of coffee or a glass of cola from time to time is not harmful, but consumed in excess can have unwanted consequences on the fetus.
Unrecommended foods
Although many people think that the placenta is a barrier, a shield that protects the fetus from the harmful substances that the mother accumulates, in reality almost everything that the mother consumes reaches the fetus in a smaller or larger proportion. Numerous researches have stated that the “barrier” function of the placenta is only relative because any substance present in the maternal blood can pass through the placenta to some extent, if it is not destroyed or modified during the passage, only that the permeability of the placenta is very selective, allowing the massive passage of some substituents and almost completely stopping the transfer of others. The quantitative or qualitative determination of the transfer of certain potentially harmful substances through the placenta is difficult, therefore the most prudent thing is to completely eliminate from the pregnant woman’s lifestyle the factors that can be harmful to the fetus, and if this is not possible, at least to reduce quantitatively.
Must be consumed with caution or avoided during pregnancy:
Pork, beef, chicken, or fish and undercooked or raw eggs. (including eggs from cake shells or creams from cakes). Food that contains insufficiently prepared meat can contain a variety of bacteria and viruses. Use special cooking thermometers to determine the degree of preparation of the meat. Fast food products containing meat, because they are often reheated several times. This type of food can cause infection with Listeria monocytogenes, a bacterium that causes listeriosis, the disease that can cause abortion in pregnant women or premature birth or other serious health problems. Also, cold cuts should be consumed with caution, due to the fact that they usually contain high amounts of salt, lipids and food additives. Swordfish, shark, catfish, mackerel, tuna. These fish contain methylmercury, a metal harmful to the growth of the child’s brain and nervous system; pregnant women, as well as pregnant women, can consume up to 200 grams of white fish as part included in a maximum of 400 grams, mixed with seafood low in mercury; you can also eat salmon, shrimp, canned tuna and catfish. Fish caught in rivers, lakes, running water or any type of water. Recreational (amateur) fishing can result in the consumption of fish contaminated with bacteria or chemicals. Therefore, check the quality of the fish caught at the local food quality control department.
Unpasteurized dairy products, including some types of milk and cheeses (feta cheese, brie, Roquefort, etc.; pâtés or refrozen meat preserves). This type of food can contain high levels of Listeria. Canned food is safer if it has already been prepared.
Unpasteurized juices, juices purchased from street vendors may contain germs including Escherichia Coli. It is good to ask beforehand if the juices are pasteurized.
The vegetables are picked green and later ripened artificially. Green, unripe vegetables are not recommended for anyone, not only pregnant women who are really more susceptible to infections due to the germs contained in these products.
Herbal nutritional supplements. Most of the time, they contain only natural components, but they are insufficiently studied to be recommended during pregnancy.
Non-potable or unverified water. It is recommended to consume only water from previously verified sources; under no circumstances will you consume water from the fountain or springs (not even from springs known for various curative effects) without boiling it beforehand.
Food products known to be allergenic. Depending on the family history, the child may inherit a certain risk of developing certain food allergies. Avoiding food products containing peanuts, strawberries, etc. during the pregnancy period, the allergenic risk can be reduced in children susceptible to developing such allergic manifestations. Before making any changes in your personal diet, it is good to ask the opinion of a nutritionist specialized in nutrition during pregnancy and advice on possible preparations with increased allergen risk.
Alcohol, tobacco, and drugs must be avoided because they can cause low birth weight and serious congenital malformations, including mental retardation.