NUTRITIONAL SUPPORT DURING PREGNANCY
Share
Being pregnant is an exciting and unique time, in which you will have nine months to plan your life as a future mother and the arrival of a new member to the family. During these special months, your body goes through important anatomical and physiological changes to grow and nourish the baby. In this sense, your nutrition not only influences your health, but also has a significant effect on the short and long-term health of the baby.
It happens that sometimes it becomes complex to make sense of all the information that arrives at this stage, which can be stressful and add another task to the long to-do list of pregnancy. In this blog, we will guide you through the various changes and care that the gestation period entails, and the best way to support your health and that of your baby.
WHAT TO EAT DURING PREGNANCY
Contrary to popular belief, pregnant women do not need to "eat for two." Energy requirements do not change in the first six months of pregnancy and calorie requirements only increase by 200 calories per day in the last trimester, which is equivalent to approximately two apples.
However, it is necessary to increase the intake of micronutrients (vitamins and minerals) to meet the requirements of both mother and baby. The best way to achieve this is by consuming a diet rich in fresh vegetables and fruits, complex carbohydrates, nuts and seeds, good sources of protein such as eggs, organic grass-fed meat, and a sufficient amount of oily fish. If there is a time when eating organic foods is particularly important, it is during pregnancy as it helps reduce the baby's exposure to pesticides, agrochemicals or toxic agents.
It is essential to note that diets high in refined sugar and processed foods can cause excessive weight gain, which in turn, can increase the risk of developing gestational diabetes, hypertension and lead to complications during labor and childbirth.
NUTRITIONAL REQUIREMENTS
While your baby will benefit from a healthy supply of all vitamins, vitamin B9, also known as folic acid or folate, is of particular importance. This essential vitamin plays a key role during the first 12 weeks of pregnancy, when the brain and spinal cord develop rapidly. Supplementation with folic acid or its more bioavailable form, methylfolate, can prevent up to 70% of cases of neural tube defects, particularly spina bifida, and may protect against Down syndrome, cleft lip, cleft palate, and autism.
Methylfolate is a highly bioavailable form of folate and is more effective than folic acid at improving folate levels. Additionally, methylfolate supports a vital biochemical process called methylation, which is crucial for the creation of new cells and fetal development and which is involved in the mother's immune and mental health. Altered methylation is associated with infertility, neural tube defects, recurrent miscarriage, and preeclampsia.
Include many folate-rich foods in your daily meals: leafy green vegetables such as cabbage, kale, spinach, broccoli, Brussels sprouts, peas, chickpeas. Raw or lightly steamed, as folate is a water-soluble nutrient that is easily lost in cooking water and denatured by high cooking temperatures.
During pregnancy, blood volume expands by 35% to 50% and additional iron is required for the development of the baby's organs and the formation of red blood cells. Iron deficiency is very common during this time, usually due to inadequate food intake (especially if you follow a vegan or vegetarian diet) and low iron stores in early pregnancy (for example, if a woman has previously had heavy periods ). Make sure you eat plenty of foods rich in iron and choose a good supplement with a preventive dose such as our Nutrisorb Hiero, suitable for vegans, vegetarians and that does not cause digestive discomfort.
Sources of iron include: meats, interior foods such as “panitas” and prietas, lentils, nuts and green leafy vegetables. When consuming plant-based (non-heme) sources of iron, combine them with foods high in vitamin C such as broccoli, bell peppers, and citrus fruits to improve absorption.
Iodine regulates the function of the thyroid gland, which is important for the neurological development of the baby, before and after birth. Iodine deficiency in pregnant women is associated with lower IQ scores and cognitive deficits in their children.
Sources of iodine include: seaweed, eggs and dairy products.
It is essential to take care of vitamin D levels during pregnancy. Maternal vitamin D status is associated with the development of allergic diseases, autoimmune diseases, and infectious diseases in their offspring. An intake of up to 4,000 IU daily of vitamin D increases the chances of achieving a full-term pregnancy and reduces the likelihood of preeclampsia and neonatal hypocalcemia.
One study looked at the vitamin D levels of 1,200 women before and during pregnancy, and found that sufficient levels of vitamin D before conception were associated with a reduced risk of miscarriage.
It's a good idea to check your vitamin D before planning a pregnancy. A medical or nutritional professional will be able to guide you on the correct dosage to achieve an optimal level. If this is not possible, 1000 IU is a useful therapeutic maintenance dose.
Essential fatty acids (EFAs) play a vital role in your baby's brain development. There are two types of AGEs: omega-3 and -6. While omega-6 is widespread in the Western diet (e.g., in grains, processed foods, and vegetable oils), omega-3 is often depleted in many people's diets, as it is found in nuts. and seeds as alpha-linolenic acid (ALA) and in fatty fish such as salmon, mackerel and tuna as eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) which are consumed less frequently.
EPA and DHA support neuronal, psychomotor, retinal development and visual acuity in the fetus. They reduce the risk of miscarriages related to poor uterine blood flow. They participate in the mother's nervous system, protect cardiovascular health and have a powerful anti-inflammatory effect.
However, although the omega-3 in fish oils is very beneficial, it is not recommended to eat a lot of oily fish during pregnancy. Farmed oily fish contain mercury and PCBs, which can have harmful effects on your baby's nervous system. Therefore, it is a good idea to take a high-quality purified fish oil supplement along with a conservative dietary intake of fish.
HILL
During fetal development, large amounts of choline are needed to support rapid cell division, growth, and brain development. Choline may reduce the risk of neural tube defects.
Animal products are rich sources of choline, including beef, eggs, chicken, and fish. Nuts, legumes and cruciferous vegetables are also relatively good sources, however those on a vegan/vegetarian diet should ensure they consume a multinutrient containing choline.
Alterations in the intestinal microbiota are related to the health of the mother and baby, therefore, restoring the maternal microbiota during pregnancy can be of great help. The mother's intestinal microbiota is transferred through breastfeeding and colonizes the intestine of the newborn, thus initiating its defense mechanisms, maturation of the immune system and digestive processes.
A beneficial microbiota containing Lactobacillus and Bifidobacteria species in the mother can play a protective role in the baby by reducing the risk of infections, metabolic diseases, allergies or food intolerances.
VEGANS AND VEGETARIANS
If you are vegan or vegetarian, supplement with an algae-based omega-3 oil to ensure you get enough EPA and DHA. Choose a vegan multinutrient with sufficient levels of iron, vitamin B12 and choline to help prevent deficiencies and ensure you have a healthy, balanced plant-based diet.
Being pregnant is a special time, but it also comes with a number of challenges. Optimal preconception care through good diet, lifestyle and appropriate supplementation is important to ensure excellent baseline nutrient levels for both you and your baby. By adopting a healthy lifestyle and the necessary pregnancy nutrients while trying to conceive, you can give yourself the best chance of enjoying the experience and giving your baby the best start in life.
Do you have any questions? Write to us at nutricion@biocarechile.cl
Nutritionist Valeria Riquelme
REFERENCES
[i] NICE guidelines https://www.nice.org.uk/guidance/ph27/chapter/1-Re ...
[ii] NHS http://www.nhs.uk/conditions/spina-bifida/pages/ca...
[iii] Patterson. Folate metabolism and the risk of Down syndrome. Nutrition 2005;21:698-704
[iv] Kelly et al Use of folic acid supplements and risk of cleft lip and palate in infants: a population-based cohort study. Br J Gen Pract. 2012;62:466 – 72.
[v] Houston. Taking folic acid at the start of pregnancy seems to lower risk of cleft lip and palate. BMJ. 2012 Jul 5;345:e4614
[vi] Fruen et al. Folic Acid Intake During Early Pregnancy Associated With Reduced Risk of Autism in Offspring Biochem J 1990;270(1):119-123
[vii] Hekmatdoost A, et al. Methyltetrahydrofolate vs Folic Acid Supplementation in Idiopathic Recurrent Miscarriage with Respect to Methylenetetrahydrofolate Reductase C677T and A1298C Polymorphisms: A Randomized Controlled Trial. Matsuo K, ed. PLOS ONE. 2015;10(12):e0143569.
[viii] Lamers et al. Red blood cell folate concentrations increase more after supplementation with [6S]-5-methyltetrahydrofolate than with folic acid in women of childbearing age. Am J Clin Nutr. 2006 (84): 156-61.
[ix] Prinz-Langenohl et al. [6S]-5-methyltetrahydrofolate increases plasma folate more effectively than folic acid in women with the homozygous or wild-type 677C,T polymorphism of methylenetetrahydrofolate reductase. British Journal of Pharmacology. 2009 (158) 2014-2021.
[x] Chen H, Yang X, Lu M. Methylenetetrahydrofolate reductase gene polymorphisms and recurrent pregnancy loss in China: a systematic review and meta-analysis. Arch Gynecol Obstet. 2016 Feb;293(2):283-90.
[xi] Zhu L. Polymorphisms in the methylene tetrahydrofolate reductase and methionine synthase reductase genes and their correlation with unexplained recurrent spontaneous abortion susceptibility. Genet Mol Res. 2015 Jul 28;14(3):8500-8.
[xii] Chedraui P, Andrade ME, Salazar-Pusada D Gynecol Endocrinol. 2015 Jul;31(7):569-72
[xiii] Bath SC. The effect of Iodine deficiency during pregnancy on child development. Proc Nutr Soc. 2019; 78(2): 150-160.
[xiv] Klein RZ et al. Relation of severity of maternal hypothyroidism to cognitive development of offspring. J Med Screen 2001; 8:18-20.
[xv] Erkkola et al Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children. Clin Exp Allergy. 2009 ;39(6)
[xvi] Hollis et al. Vitamin D Supplementation during pregnancy; Double-blind, Randomized Clinical Trial of Safety and Effectiveness. Journal of Bone and Mineral Research. 2011; 26 (10): 2341-57.
[xvii] Mumford et al. Association of preconception serum 25-hydroxyvitamin D concentrations with live birth and pregnancy loss: a prospective cohort study. The Lancet Diabetes & Endocrinology. 2018;6(9);725-732
[xviii] Oken et al. Fish consumption, methylmercury and child neurodevelopment.Curr Opin Pediatr. 2008; 20: 178-83.
[xix] Jensen et al. Effects of n-3 fatty acids during pregnancy and lactation. Am J Clin Nutr. 2006; 83 (6 suppl): 1452S–7S.
[xx] Birch et al. The DIAMOND (DHA intake and measurement of neural development) study: A double-masked, randomized controlled clinical trial of the maturation of infant visual acuity as a function of the dietary level of docosahexaenoic acid. Am J ClinNutr. 2010; 91 (4): 848-59.
[xxi] Campoy et al. Omega 3 fatty acids on child growth, visual acuity and neurodevelopment. Br J Nutr. 2012; 107 (Suppl 2): S85-106.
[xxii] Lazzarin et al. Low-dose aspirin and omega-3 fatty acids improve uterine artery blood flow velocity in women with recurrent miscarriage due to impaired uterine perfusion. Fertile Steril. 2009; 92 (1): 296-300.
[xxiii] Murata et al. Effects of methylmercury on neurodevelopment in Japanese children in relation to the Madeiran study. Int Arch Occup Environ Health. 2004;77(8):571-9.
[xxiv] Shaw GM et al. Choline and risk of neural tube defects in a folate-fortified population. Epidemiology . 2009;20(5):714-719.