Diet in Pregnancy

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DIET IN PREGNANCY

 During pregnancy fetus is entirely dependent on the mother like a parasites for all its needs. The Mother’s health and lifestyle would determine that the baby would attain their full biological potential or not.

To ensure the appropriate growth and development of the fetus and for her own health and wellbeing, it is mandatory that the mother eats a healthy nutritious diet.

Pregnant mother needs additional 300 kilo calories and an extra 20 grams of proteins per day. However, due to the pressure of distending uterus on the intestines, reducing their capacity along with the reduced intestinal peristalsis and increase transit time under the influence of hormonal changes, the mother finds it difficult to take enough food.

So to cater to the increased needs of nutritious and balanced food it is advisable for her to take frequent small meals at regular intervals.

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Components of Diet

1- Carbohydrates –

Carbohydrates are the main components of diet and they get break down into small glucose particles. According to the ease of their glucose release, the carbohydrates are classified as simple and complex carbohydrates.

The fetus is entirely dependent on the Glucose for its energy requirements, since it is easily metabolized, while the mother has to depend on proteins and fats for her requirements. The unconsumed glucose gets stored in the form of glycogen and fats for future needs.

The main source for carbohydrates includes sugar, grain, starch, tapioca, milk, fruits, potatoes and other vegetables

Though the simple carbohydrates provide required glucose easily, they increase the risk of gestational diabetes in pregnancy.

2- Proteins-

Proteins are the most important component of diet that plays an important role in body building and participate in virtually every process within the body. The pregnant mother needs additional 20 grams of proteins per day. So, the total proteins requirements in pregnancy are 1.5 gram per kilogram bodyweight per day.

Proteins are made up of Nitrogen containing 20 Amino acids. The nine amino acids that cannot be manufactured in the body are called as essential amino acids.

Milk, milk products such as cheese, yogurt, egg and meat are qualitatively rich source of proteins and are called animal proteins as they are derived from animals.

Pulses, Wheat, Cereals, Soybeans, Barley, Millet, Dry fruits, are rich source of plant proteins. Qualitatively the plant proteins are considered inferior to the animal proteins. It is advisable to mix 100 grams of soybean and black gram each into 1 kilogram of wheat flour to meet the additional requirements in vegetarian diet.

3-Fats-

A balanced diet should contain around 20 percent of fats component. The fats are synthesized from cholesterol containing fatty acids chain. The fatty acids chains are classified into mono saturated and polyunsaturated chains. The fatty acid forms the myelin sheath of nervous system. Fats are also required for the absorption of fat soluble vitamins – Vitamin A, D, E and K.

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4-Minerals-

Minerals and salts are very important for the proper functioning of the body.

Certain salts, such as calcium, potassium, sodium, iron, etc., that are required in large amounts are called as Macronutrients, whereas the salts such as zinc, selenium, etc., which are required in small quantities are called micronutrients.

a. Calcium:

Calcium is vital for the formation, strength and functions of bones and muscles. It participates in virtually every process within the body. The intercellular spaces maintain calcium balance between blood, bones, intra and extracellular compartments of the body.

During pregnancy, Fetus is dependent for its Calcium requirements on maternal blood and later after delivery on the breast milk. Hence to maintain the adequate concentration of calcium in blood and milk, the mother is advised to eat calcium rich foods such as Milk and milk products, eggs, fresh fruits and green leafy vegetables, dry fruits etc.

Vitamin ‘D’, ‘C’ and Phosphorus increases its absorption while Tannin and Oxalate present in tea, coffee and other foods reduce its absorption.

Vitamin D in synthesized in subcutaneous fat under the influence of ultraviolet rays in sunlight. Hence it is advisable to take sunbath at least for 15-20 minutes per day in gentle sunlight.

Citrus fruits such as lemon; tomatoes etc. are rich source of calcium and vitamin C. Considering the poor absorption of only 10-15 %, the daily requirement of calcium is 1 to 2 grams per day. The oral calcium supplements may lead to constipation, gastric trouble and ulcers.

The deficiency of Calcium and vitamin D leads to excessive weakness, fatigue, irritability, muscle pain and spasms in the groin and calf. Some women may have desire to consume soil and chalk (pica).

b.Iron:

Hemoglobin, a vital protein carries the oxygen in blood. It is made up of two components, protein Globin made up of amino acids and Heme molecule made up of Iron. Hemoglobin provides blood its red color. Iron is also essential component of muscle protein, myoglobin.

The degradation of iron containing proteins releases iron that is stored in liver, spleen and bone marrow and is recycled for future use. Nutritional deficiency, gastric and intestinal ulcers, hemorrhoids, worm infestations, bleeding disorders, heavy bleeding during menstrual cycle etc. leads to iron deficiency anemia.

In addition to the preservation of iron due to 9 months amenorrhea, the pregnant mother needs additional 10 mg of iron per day.

Green leafy vegetables, sprouts, molasses, dry fruits, tomatoes, grapes, beet roots, barley, ground nuts, soybeans, and non vegetarian diet are considered rich source of iron. Since absorption of iron is insufficient, the women need additional 100 milligrams of iron per day from 12 completed weeks onwards. Hence, iron supplements are recommended in pregnancy.

The oral iron supplements may lead to metallic taste in mouth, gastric ulcers, abdominal pain, constipation or diarrhea, thin black tarry stools etc.

Iron supplements when taken with meals may cause fewer side effects, but it reduces its absorption also. Acidic environment and vitamin C increase the absorption of iron in the small intestine, while Tannin and Oxalate present in tea, coffee and other foods reduce its absorption.

However, intravenous injections of iron-sucrose molecules are better alternative to meet the requirements quickly without significant side effects.

In addition to Iron, the other components required for the synthesis of Hemoglobin are Folic acid, Vitamin B12 and erythropoietin hormone that is synthesized in kidneys. The deficiency of any of these components may lead to nutritional anemia.

Anemia leads weakness, easy fatigability, irritability, nervousness, mood swings, palpitations, dizziness, desire to consume soil (pica) etc.

Anemia in pregnancy predisposes to infections, premature delivery, low birth weight baby, miscarriage, post partum hemorrhage, stroke, and sudden death of the infant or the mother.

5-Vitamins-

Vitamins B and C are water-soluble, while vitamins A, ‘D’, ‘E’, ‘K’ are fat soluble vitamins.

  • Vitamin A helps form and maintain healthy teeth, bones, soft tissue, mucus membranes, thyroid gland and skin. In vegetarian diet, milk, butter, green and yellow vegetables, carrots, oranges, while in non vegetarian diet, meat, fish, poultry and mutton are rich source of vitamins. The oral vitamin A supplements that contain retinoids are contraindicated in pregnancy due to the risk of teratogenecity.
  • Vitamin B-1 (Thiamine) plays vital role in physical development, calorie production and proper digestion and milk production. The grain, wheat, gram, milk, peanuts and meat are rich source of it.
  • Vitamin B-2 (Riboflavin) plays vital role in regulating the body’s immunity and brain development. The grain, wheat, gram, green vegetables, milk, eggs and meat are rich source of it.
  • Vitamin B-5 (Pantothenic acid) maintains the flexibility, elasticity and integrity of red blood cells. The grain, wheat, milk, cheese, seeds, vegetables, poultry and mutton are rich in it.
  • Vitamin B-12 (Methylcobalamin) along with folic acid and iron synthesizes hemoglobin. It also regulates nervous system. It requires and Intrinsic factor present in terminal ileum for its absorption. It’s mainly present in meat and scarcely in milk. Hence majority of vegetarian population suffer from its deficiency. It’s deficiency may lead to megaloblastic anemia, paresthesia, numbness, neurological weakness etc.
  • Vitamin B-9 (Folic acid or vitamin M) is the most important vitamin in association with pregnancy. It helps in the synthesis of DNA, hemoglobin and development of fetal nervous system. It prevents structural and developmental disorders in fetus and protects mother from development of pregnancy induced hypertension, miscarriage and abruption. Hence its preconception supplement along with throughout gestational period is advocated. Its main source include green leafy vegetables, sprouts, fresh fruits and goat liver.
  • Vitamin C (Ascorbic acid) helps in the formation of collagen fibers, regulates immunity and healing, plays vital role in absorption of iron and calcium, etc. The citrus fruits, lemon, gooseberry, raspberry, green vegetables, potatoes and tomatoes are rich source of it.
  • Vitamin D is synthesized in the subcutaneous fat under the influence of ultraviolet rays present in sun light. The inactive form gets active in lungs and kidneys. It main function is to maintain the balance of calcium and phosphorus and strengthen bones. It deficiency can leads to muscle cramps especially leg cramps at night. Milk, eggs, fish and goat liver are its other rich source.
  • Vitamin E plays a vital role in regulating immunity, maintaining integrity of skin, calorie production etc. Its deficiency may lead to pregnancy induced hypertension, nocturnal leg cramps, hair fall, coarse skin texture etc. The wheat, gram, green vegetables, pulses and fish are its rich source.
  • Vitamin K regulates the synthesis of blood clotting factors in liver. It is mainly present in green leafy vegetables.

To ensure the well being of both mother and fetus it is advised to take balanced nutritious diet in small meals regularly at frequent small intervals.  

Pregnancy-Plate

The advisable diet chart that can help in pregnancy-

TIME

MEALS

7    AM 1 glass of milk with toast or crackers
9    AM Breakfast (Veg.Upma, Idli, Sandwich, Sprouts)
11  AM Fresh fruits like apple, banana, citrus fruits should be preferred.

Excessive sweet fruits like grapes, mango, custard apples, and watermelon should be avoided.

1    PM Lunch:

2-3 Chapatis without butter.

1-2  Bowl Green leafy vegetables.

1-2 Bowl Dal.

More of salads and sprouts.

Less oil, ghee, sweets and rice.

4    PM Fresh fruits
8    PM Dinner
10  PM

Milk


Some precautions-

  • Avoid eating outside.
  • Wash your hands before every meals.
  • Cut finger nails short.
  • Always carry a water bottle and some eatables from home while going out, so that you can avoid taking food outside.

Disclaimer:

The information is shared to create awareness towards Pregnancy and Childcare to reduce maternal and child deaths. Atmost care has been taken by the author to include the verified information from authentic sources. However, kindly discuss the same with your health care provider before implementation.