myUpchar प्लस+ के साथ पूरेे परिवार के हेल्थ खर्च पर भारी बचत

Summary

A healthy diet is important to maintain adequate nutrition during pregnancy as it is vital for both, the mother’s and the baby’s health. Education about nutrition during pregnancy is important for a balanced diet for weight gain and energy fulfilment. Also, use of micronutrients like vitamins, minerals, and fortified foods help to meet the daily recommended nutritional needs of the mother. A healthy diet during pregnancy consists of adequate amounts of all macro and micronutrients including carbohydrates, fats, proteins, various minerals and vitamins, and water.  

  1. What is a good pregnancy diet?
  2. What to eat during pregnancy
  3. Foods to avoid during pregnancy
  4. Precautions to be taken during pregnancy
  5. Lifestyle modification during pregnancy

Eating well is essential during pregnancy. Proper nutrition through a balanced diet containing carbohydrates, proteins, fats, vitamins and minerals is required to meet the extra demands of the woman’s body and her baby. Studies have revealed that nutritional education has helped in a healthy weight gain and reduced the risk of diseases like anaemia and gestational diabetes in pregnant women, thereby increasing the newborn baby’s birth weight and reducing the chances of a preterm delivery. Studies in India have shown that nutritional deficiencies have short as well as long-term impact on the baby’s health such as anaemia, low birth weight, and increased risk of developing type 2 diabetes in adult life. Hence, adequate nutritional counselling is needed for all soon to be mothers to ensure a good fetal health and development. (Read more - Pregnancy diet chart)

Total Calorie Requirement

As the baby grows, the total calorie intake also increases during pregnancy. A pregnant woman needs a surplus of 300 kcal a day, with a minimum of 1800 kcal/day. Women with multiple babies in the womb will need 300 kcal a day extra for every baby. Thus, if a woman is pregnant with twins, the total calorie requirement would be 600 kcal a day.

The daily requirements for other nutrients and food that you can eat to fulfil them are as follows:

  1. Proteins
  2. Carbohydrates
  3. Fats
  4. Iron
  5. Folic acid
  6. Calcium
  7. Iodine
  8. Vitamins

Proteins

Proteins are the building blocks of the body and are needed for the regular repair of the wear and tear of the body tissues. They are needed for the proper growth of the baby, uterus, and placenta. Proteins also help to improve total blood volume. Proteins can be obtained from foods like meat, fish, eggs, poultry, milk, cheese, dairy, and beans. For vegetarians, tofu, nuts, and seeds are good sources of protein.

Recommended daily allowance (RDA): 0.8 g/kg/day (79 g/day) to 1.1g/kg/day (108 g/day) in the latter half of pregnancy.

Carbohydrates

Carbohydrates are of two types: simple and complex. Simple carbohydrates increase the blood sugar sharply as they are rapidly absorbed in the blood. Carbohydrates form almost 55% of the total food calorie requirement in pregnant women. Fruits, sugar, honey, and maple syrup are common examples of simple carbohydrates. As simple carbohydrates have a higher calorie count, it is best to keep away from drinks which have added sugars.

Complex carbohydrates require a longer time to be absorbed in the body, hence they provide energy for a longer period of time. Foods like bread, pasta, corn, potato, and rice contain starch and fibre. All carbohydrates are ultimately broken down into glucose, which provides energy to carry out activities. Dietary fibre is a substance found in plant sources, which cannot be digested by the body. It helps to add bulk to the stools and prevent constipation, which is a common feature in pregnancy. Women with gestational diabetes should reduce their total food calorie intake to 40%-45%.

RDA: 175 g/day.

Fats

Fats provide the much-needed energy and help to build the placenta and baby’s organs. Oils and fats, especially omega-3 fatty acids, also help in developing the baby’s brain. Essentially, fats form almost 20% to 30% of the total calorie intake, which is about 6 tablespoons a day. These fats help in blood clotting as well as aid in the metabolism and absorption of the vitamins A, D, E, and K. Fats are digested in the liver and then converted into lipoproteins, which consist of cholesterol, proteins, and fats. There are different types of fats in foods that can be broadly divided into saturated and unsaturated fats. Fats can be obtained from various oils, butter, dairy products, egg yolk, meat, nuts and more. As far as possible, saturated fats should be kept to a minimum (such as ghee and lard) and unsaturated fats should be opted for (vegetable oils of peanut, mustard, sesame, sunflower among others).

RDA: 6 to 8 tablespoons per day throughout pregnancy i.e., 20-30% of your daily calorie intake.

Iron

Iron is an essential nutrient required in the production of red blood cells, which help in carrying oxygen to the tissues and organs. It also helps fight fatigue, irritability, weakness, and depression. During pregnancy, more iron is needed to supply oxygen to the baby via the placenta. If the iron requirement is not met, it can lead to anaemia. The total iron requirement is about 1000 mg during pregnancy. Iron supplements for all pregnant women are recommended by the World Health Organization (WHO). The quantity of iron intake should be increased with multiple pregnancies. The Government of India advises 100 mg of elemental iron, along with, 500 micrograms of folic acid for at least 100 days in the latter half of pregnancy. A low iron level due to irregular iron intake can increase the risk of a low birth weight as well as preterm delivery. Iron is found in animal foods like red meat, fish, and poultry. It is also found in nuts, cereal, bread, and grains.

RDA: 27 mg of elemental iron daily.

Folic acid

Folic acid or folate is a vitamin that is particularly important during pregnancy. It is advised to take folic acid tablets at least 1 month before and during pregnancy to prevent birth defects in the fetal brain and spine. Folic acid is found in dark green leafy vegetables, orange juice, fortified bread, cereals, and grains. Since adequate folic acid may not always be obtained from food sources alone, folic acid supplements are recommended during pregnancy.

RDA: 600 micrograms daily from the time of planning the pregnancy.

Calcium

Calcium is needed for the development of bones and teeth of the baby. It is abundant in milk, dairy products, cheese among others. Various other foods like fortified orange juice, sardines, anchovies, and broccoli also are a good source of calcium for vegan and lactose intolerant mothers.

RDA: 1000 mg a day

Iodine

Iodine is essential for producing the thyroid hormone, which helps in the growth and development of the baby. Insufficient amount of iodine can increase the chances of mental impairment in the newborn. Seafood, eggs, meat, dairy, and iodized salt are good sources of iodine.

RDA: 150 micrograms daily during pregnancy and lactation.

Vitamins

  • Vitamin D
    Vitamin D and calcium work together to promote the growth of the baby’s teeth and bones. Vitamin D is also an important nutrient for healthy skin and eyes. Fatty fish like salmon, fortified milk and orange juice, cereal, and egg yolk are good sources of vitamin D. Exposure to sunlight helps to produce vitamin D in the skin. 10-15 minutes of daily exposure to the sun between 10 am – 3 pm should be able to produce adequate vitamin D in the body.
    RDA: 600 IU (15 micrograms) a day in pregnant and lactating women.
  • Vitamin A
    Vitamin A is important for the development of healthy eyesight, bones, and skin.
    • Sources: Green leafy vegetables, carrots, sweet potatoes, bell peppers, capsicum, papaya, mangoes, red and yellow coloured fruits/vegetables.
    • RDA: 770 micrograms in adult women
  • Vitamin C
    It is required to maintain healthy gums, teeth, and bones. It is a potent antioxidant.
    • Sources: Found in citrus fruits, gooseberry (“amla” is the richest source of vitamin C), strawberries, broccoli, tomatoes.
    • RDA: 85 mg.
  • Vitamin B
    It is needed for the formation of red blood cells and metabolism of fats, proteins, and carbohydrates.
    • Sources: Liver, pork, beef, bananas, whole grains.
    • RDA: 1.9 mg daily.
  • Vitamin B12
    It helps to maintain the nervous system. Besides vitamin B6 vitamin B12 also helps in forming red blood cells. 
    • Sources: Milk, fish, poultry, meat.
    • RDA: 2.6 micrograms/day.

Care must be taken before consuming certain foods as they could interfere with the growth and development of the baby. These include:

  1. Coffee
  2. Seafood and shellfish
  3. Dairy products in lactose intolerance
  4. Alcohol
  5. Vegetarian and vegan diets
  6. Unripe papaya
  7. Gluten
  8. Chinese food

Coffee

It is still not clear whether caffeine increases the risk of miscarriage or not. However, doctors mention that 200 mg of caffeine a day is safe during pregnancy. Apart from coffee, caffeine is also found in teas, chocolate, and carbonated drinks.

Seafood and shellfish

Shellfish and other seafood are excellent sources of omega-3 fatty acids, which are considered essential because they are supplied through diet alone and cannot be produced by the body. These essential fatty acids help in the development of the baby’s brain and nerves. Fish is also an excellent source of protein and it is advised to consume at least 3 servings of any seafood per week. However, some fish may contain higher levels of mercury, which has been linked to birth defects. To combat this, select fish that has low mercury content like shrimp, light tuna, salmon and sardines. Avoid mackerel, shark and swordfish, which have been found to contain higher levels of mercury.

Dairy products in lactose intolerance

Women who have trouble digesting milk and dairy are said to be having lactose intolerance. Such women can fulfil their daily calcium requirement through other non-dairy sources like coconut milk, almond milk, nuts, and soy. Nowadays, lactose-free dairy products like milk and cheese are also available. If there is any difficulty in taking the recommended amount, doctors may prescribe calcium supplements.

Alcohol

As such, there is no safe limit or safe time to consume alcohol during pregnancy. Consuming alcohol in any form is harmful including beer and wine. Alcohol in a woman’s blood passes to the baby through the umbilical cord and increases the risk of miscarriage, stillbirths, and various physical, intellectual and behavioural disabilities, which together are termed as fetal alcohol spectral disorders (FASD). Consuming alcohol in the first 3 months of pregnancy can cause abnormal facial features in the newborn. Brain development may be arrested at any time during pregnancy due to alcohol. Such children may show the following characteristics after birth:

  • A small size of the head.
  • Low body weight.
  • Lack of motor coordination.
  • Hyperactive behaviour.
  • Poor attention span and memory.
  • Learning disabilities and speech delays.
  • A low intellectual quotient (IQ).
  • Vision and hearing problems.
  • Difficulty in sucking milk.
  • Inability to understand the reasoning and analytical subjects such as maths.

Vegetarian and vegan diets

Vegans are individuals who do not consume animal products, such as meat, eggs and dairy products. Vegetarians include dairy foods in their diet. Either way, it is possible that the daily requirement of nutrients is not fulfilled. However, to get all the nutrients needed by the mother and the baby throughout the pregnancy, some extra planning may be required in such cases. It is best to reveal the information to your doctor about food preferences during the first visit itself. Vegetarians and vegans can get proteins from soy milk, tofu, and beans. Green leafy vegetables, spinach, chickpeas, and kidney beans provide a good amount of iron. For calcium, fortified orange juices, tofu, rice, and soy milk can be consumed.

Unripe papaya

A few animal studies were conducted to know the possible effects of consuming papaya during pregnancy. It has been found that ripe papaya is safe, whereas unripe papaya contains latex, which causes contractions in the muscles of the uterus similar to that caused by the female sex hormones, oxytocin and prostaglandins. Hence, its consumption during pregnancy could be unsafe. However, further studies need to be conducted to estimate this risk.

Gluten

Women who are gluten intolerant cannot eat wheat, rye, and barley. They can consume fruits, vegetables, potatoes, poultry, and beans as an alternative. There are many gluten-free foods available in stores these days.

Chinese food

A few animal studies were conducted to know the possible effects of consuming papaya during pregnancy. It has been found that ripe papaya is safe, whereas unripe papaya contains latex, which causes contractions in the muscles of the uterus, similar to that caused by the female sex hormones, oxytocin and prostaglandins. Hence, its consumption during pregnancy could be unsafe. However, further studies need to be conducted to estimate this risk. 

Reduce the risk of food-borne infections by adopting practices such as:

  • Wash hands while preparing food.
  • Keep the kitchen clean.
  • Avoid consuming contaminated food.
  • Wash fruits and vegetables thoroughly before eating.
  • Eat cooked food as much as possible.
  • Keep pets and birds away from the kitchen.
  • Store food at proper temperatures.

Exercise during pregnancy

Light aerobic exercises like walking, jogging, and swimming thrice a week for 30 minutes are safe during pregnancy. Avoid strenuous activities like horse riding, skiing, cycling, and gymnastics as these sports would hurt the baby. Light yoga asanas, Surya namaskars, and pranayamas are very helpful.

Dieting during pregnancy

Many women worry that they may put on extra weight during pregnancy and hence, eat less to avoid that. Crash dieting or cutting down on foods can be harmful and cause a negative impact on the health of both the mother and the baby. Hence, dieting during pregnancy is not recommended.

Eating during Ramadan

Islamic law exempts pregnant and breastfeeding women to fast during Ramadan. All missed fasting dates can be compensated by giving food to poor people for every missed day. Still, many women choose to fast during the Ramadan month, which is a personal choice and should depend on the stage of the pregnancy. The decision to fast should be first discussed with the doctor to identify any risks and complications to the baby. Ensure that all supplements and medications are regularly taken during the holy month.

Drink plenty of water

Liquid intake depends on every individual, but as a rule, it is essential to stay hydrated. Drinking water regularly works best along with taking juices, milk, smoothies, and milkshakes. Herbal teas, however, should be restricted to not more than 4 cups a day. 

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References

  1. World Health Organization [Internet]. Geneva (SUI): World Health Organization; Nutrition counselling during pregnancy.
  2. Prema Ramachandran. Maternal & Child Nutrition. Indian J Med Res 130, November 2009, pp 575-578
  3. American College of Obstetricians and Gynecologists [Internet] Washington, DC; Nutrition During Pregnancy
  4. Dr. Shailesh Kore et al. ANTENATAL CARE IN FIRST TRIMESTER. FOGSIFOCUS: Safe Pregnancy & Delivery
  5. American Pregnancy Association. [Internet]; Diet During Pregnancy.
  6. Center for Disease Control and Prevention [internet], Atlanta (GA): US Department of Health and Human Services; Alcohol Use in Pregnancy
  7. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Pregnancy and diet
  8. British Nutrition Foundation. Physical activity in pregnancy. Scotland [Internet]
  9. Adebiyi A, Adaikan PG, Prasad RN. Papaya (Carica papaya) consumption is unsafe in pregnancy: fact or fable? Scientific evaluation of a common belief in some parts of Asia using a rat model. Br J Nutr. 2002 Aug;88(2):199-203. PMID: 12144723
  10. Gao J et al. [Transplacental neurotoxic effects of monosodium glutamate on structures and functions of specific brain areas of filial mice]. Sheng Li Xue Bao. 1994 Feb;46(1):44-51. PMID: 8085168