Knowledge Sharing

2013.01.29

Healthy diet during pregnancy

Lecturer, Chung Shan Medical University, WENG YU QING

Pregnancy is a great and hard process. What a woman eats and drinks during pregnancy is her baby’s main source of nourishment, so a mother-to-be should learn how to organize her diet to provide the important nutrients a baby needs for growth and development.

Pregnancy as a whole is a very exciting thing. Once got pregnant, the birth of a healthy baby is the greatest hope of all prospective mothers.Many people have the concept of healthy diet nowadays due to the improvement of education and knowledge. The prospective mothers can fully understand that diet during pregnancy provides the nutrients not only to themselves, but is key to their babies’ healthy growth and development.

Therefore, one of the major questionsa mother-to-be cares about is "Am I eating healthily or not? Is it enough to supply the growth of my baby?" One big myth around eating in pregnancy is that you need to “eat for two”. What the prospective mother eats indeed affects the nutrition for the fetus, however, it is simply not true if it is interpreted as consuming twice. Eating lots of extra food during pregnancy will not help the baby, and will leave the mother-to-be with extra weight that she may suffer from higher risks of hypertension, gestational diabetes and hyperlipidemia, difficult of delivery due to fetus with overweight, and struggle to lose when the baby is born. Therefore, a balanced diet during pregnancy is recommended.


Nutrition intake
How to plan the diet during pregnancy? The nine months of pregnancy are usually divided into three trimesters (approximately three months per trimester). According to the dietary recommendations published by the Department of Health, Executive Yuan in 1992, in the first trimester, basically maintain the same intake of calories as before pregnancy (appropriate increase in calories is allowed for the mother-to-be is underweight before pregnancy). A small increase in protein and vitamin B6 and B12, double the intake of folic acid, and maintain the intake of other nutrients as before pregnancy.

In the first trimester, the nutrition demand is satisfied without increasing the total calories, as long as more animal internal organs, peeled chicken, fish, eggs, dark green vegetables and whole grains are consumed, and no imbalanced diet. In the second and third trimesters, there is a significant increase in calories, protein and various vitamins and minerals (see Appendix 1). In terms of total daily calorie intake:An increase of 300 calories is recommended for both second and third trimesters (appropriate increase in calories is allowed for the mother-to-be is underweight before pregnancy). This calorie recommendation can help pregnant women to achieve moderate rate of weight gain (approximately 0.35 to 0.4 kg per week).
 
  • Protein
Protein intake is very important since there is a great amount of protein synthesis in both mother and fetus during pregnancy. As compared to unpregnant stage, there should be 6 and 12 grams increase in protein intake in the second and third trimester, respectively, from approximately 1 and 2 lean meats (one lean meat is about half the size of a palm). The increased amount of protein can be used for fetal development and the growth of maternal uterus and mammary gland. It is recommended that more than two-thirds of the daily protein intake are of animal origins, such as chicken, pork, braised pork, eggs, and milk, that is, don't rely too much on legumes as a protein source, which ma result in poor protein quality and decrease the utilization rate. Insufficient protein intake or poor quality of protein intake during pregnancy affects the absorption and utilization of calcium, phosphate, iron and vitamin B group, and may also result in increased risk of complications during pregnancy, such as edema, preeclampsia, anemia, and poor uterine contraction, abortion, and low immunity.
 
  • Iron
Iron intake during pregnancy is also very important; it supplies fetal growth and iron requirement within 3 months after birth. Insufficient iron due to originally low maternal iron storage or insufficient iron intake during pregnancy leads to anemia in both mother and fetus. Studies have also found that iron intake cannot be overlook because it influences the development of intelligence of the children. In the third trimester there are more pregnant women with iron deficiency anemia, which leads to the recommendations of daily supplementation of 30mg iron salts. Iron deficiency can be prevented by increase the consumption of iron-rich foods such as livers, egg yolk, whole grains, dark green vegetables, peaches, prunes, and raisins, etc.
 
  • Iodine
Iodine-rich foods such as iodine-containing iron, seaweed, wakame and kelp, must also be supplemented. (Please refer to Table 1 and 2 for the requirements and sources of various minerals during pregnancy)
 
  • Vitamins
There are different recommended increases of intake for various vitamins in the three trimesters (For the requirements and sources of various vitamins during pregnancy, please refer to Table 1 and 2). Insufficient vitamin supplement will affect fetal development and maternal health. For example, low levels of folic acid can cause megaloblastic anemia and affect fetal neural tube development. Vitamin B6 deficiency can result in anemia and cramps.


Some nutrition factors that affect the success of pregnancy
  1. Nutritional status before pregnancy
    Many studies have indicated demonstrated less frequent complications and premature but healthier babies delivered forthose who get proper nutrition before pregnancy. Therefore, a mother-to-be should pay attention to get balanced diet for pregnancy. On the other hand, there are also many studies pointed out the major effects of maternal obesity as irregular ovulation, decreased pregnancy rate, higher occurrence of fetal macrosomia, and increased risk of complications at the time of labor and delivery. Therefore, for women with obesity, proper weight loss is also one of the important issues before pregnancy.
     
  2. Smoking
    The smoking rate for women has increased significantly in recent years. Studies in the United States and Canada have pointed out that approximately 20 to 40% of babies born underweight are caused by the maternal smoking. The more cigarettes smoked during pregnancy, the greater the risk of having a low-birth-weight baby. Exposure to nicotine and the combustion products, i.e., carbon monoxide, in tobacco smoke,may contribute to fetal hypoxia and abnormal development, maternal smoking also increases the abortion rate and newborn death. Previous studies have shown that smoking less than one pack per day during pregnancy led 25% risk of complications such as uterine bleeding, the incidence of bleeding elevated to 92% in heavy smokers, i.e., daily consumption of more than one pack of cigarettes. Taken together, we highly recommended pregnant women avoid smoking or minimize the amount of smoking.
     
  3. Drinking
    Fatal alcohol syndrome (FAS),the leading alcohol injury in the Western world, occurs in about 30% to 40% of babies born to chronic alcoholics. Infants with FAS are characterized by abnormal prenatal and postnatal growth (usually underweight and growth retardation), impaired skull development, mental impairment, small head circumference, small dyes, a short, unturned nose, and a smooth skin surface between the nose and upper lip, etc. Based on the fact that there is so far no definitive safe amount of alcohol consumption, we highly recommend any mother-to-be avoid drinking to ensure the fetal health.
     
  4. Caffeine
    What’s the impact of foods and drinks high in caffeine, e.g., coffee, tea, cola, chocolate, etc., on fetal development after consumed by the pregnant women and passed quickly through the placenta to the fetus? Animal studies have shown that high dose of caffeine resulted in defective newborn mice, whereas moderate caffeine did not. In a study of 12,000 people, no association was found between the intake of caffeine and newborns with abnormalities or underweight.However, in order to eliminate unnecessary risks, it is still recommended that pregnant women minimize their consumption of caffeine.
     
Pregnancy nutrition is not only related to maternal health, postpartum physical fitness and recovery of body shape, but also contribute to smooth delivery, normal mental and physical development of the fetus, and the health of baby after birth. Therefore, nutrition during pregnancy is indeed an unneglectable issue.

Adequate nutrition and the development of a healthy body are established by a normal and balanced diet and healthy daily habits. Seeking for folk medicine while ignoring the basics may result in regrets difficult to compensate. In summary, we highly recommend here that every pregnant mother-to-be and who are preparing to conceive, plan their diet as soon as possible to get healthiest condition for conception.