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Diet in pregnancy
eMediNexus,  30 March 2019
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#Obstetrics and Gynecology

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Good food quality, with adequate macro- and micronutrient intake in pregnancy, is essential for the health status of the mother and child. There are specific recommendations for different types of nutrients in pregnancy. Healthy eating and physical activity are advised to prevent excessive gestational weight gain (GWG). In the undernourished population, balanced energy and protein intake are recommended to prevent LBW, SGA, and stillbirths.1

What is recommended during pregnancy?1

  • Iron and folate supplementation are given as a daily or intermittent routine.
  • Vitamin A supplementation can be restricted only to areas where vitamin A deficiency is a major public health problem.
  • Calcium supplementation should be restricted to population with low-calcium intake.
  • Vitamin B6, zinc, multinutrient supplements and vitamin D supplementation are not suggested as routine procedure.
  • Women with high caffeine consumption should avoid taking caffeine.
  • Nutrient-dense and energy-appropriate food with moderate increase of energy intake is advised during pregnancy.

Macronutrient intake during pregnancy1

  • The quantity as well as composition of protein is important in the context of diet quality. Animal protein has higher quality than vegetable protein; however, mixing different types of vegetables increases the quality of plant protein.
  • Fat has a vital place in the diet of pregnant woman, especially in terms of fatty acid composition, mainly that of docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). Omega-3 fatty acids have beneficial effects on brain development and proper functioning of the retina.
  • Carbohydrates are an essential component of a healthy diet. However, increased caloric intake with increased fat and carbohydrate consumption and adequate protein has been linked with neonatal adiposity.

Micronutrient consumption1

  • Iron is among the most vital micronutrients. Inadequate iron intake during pregnancy is linked with cardiovascular risk to the offspring in adulthood.
  • Iodine is another key micronutrient. Inadequate iodine intake during pregnancy results in increased risk of spontaneous abortion, higher mortality, birth defects, neurological disorders and brain damage.
  • Folates have a significant role in the prevention of neural tube defects.
  • BPA is used in different food packagings and as food additives and exposure to this substance has been associated with adiposity, energy balance and neurogenesis. It can thus be related to obesity and neurological disorders such as ADHD, anxiety, depression and sexual dimorphic behaviors.

Recommended intake of some micro- and macronutrients during pregnancy1

  • Energy - No additional input in I trimester; 340 kcal/day in II trimester; 452 kcal/day in III trimester
  • Protein – 10-35% of energy
  • Carbohydrates - 45-65% of energy
  • Fat – 20-35% of energy
  • Omega-6 fatty acids - 13 g/day
  • Omega-3 fatty acids - 1.4 g/day
  • Fibre - 28 g/day
  • Iron - RDA 27 mg/day
  • Iodine - RDA 220 mcg/day
  • Folate - RDA 600 mcg/day
  • Calcium - RDA 1.0–1.3 g/day

Recommended gestational weight gain (GWG)1

  • BMI < 18.5 kg/m2 - GWG 12.5–18 kg
  • BMI 18.5–24.9 kg/m2 - GWG 11.5–16 kg
  • BMI 25–29.9 kg/m2 - GWG 7–11.5 kg
  • BMI > 30 kg/m2 - GWG 5–9 kg

Reaching ideal body weight

A pregnant woman requires 350 calories/day more than the pre-pregnancy value. An average size fruit provides 50 to 75 calories. Therefore, getting the extra 350 calories does not require the consumption of a lot of food.2

How can a woman plan her diet during pregnancy?

A pregnant woman weighing 50kg, doing sedentary work, can plan her meals as follows:2

Foods

Servings/day

Total intake in a day

Cereals and grains

3

300 g raw

Pulses

2

60 g raw

Milk and milk products

2

500 ml

Green leafy and other vegetables

4

400 g

Fruits

2

200 g

Oils

-

30 ml

For non-vegetarians, 30 g pulses and 30 g egg/meat/chicken/fish are suggested.2

References

  1. Danielewicz H, Myszczyszyn G, Dębińska A, et al. Diet in pregnancy—more than food. Eur J Pediatr. 2017; 176(12): 1573–1579.
  2. Available from: http://www.nutritionsocietyindia.org/Download_files/pregnancy%20and%20lactation%20diet%20fianl%20-1%2010.4.13.pdf.
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