pregnancy & nutrition
The best time to think about eating well in pregnancy is before you conceive, but if your pregnancy, like many women's, is unplanned, what would have been ideal is no longer an option. It is, however, never too late to put healthy lifestyle modifications into practice, so instead of fretting about what can't be changed, change what you can now.
This article will provide you with information about some dietary essentials in particular, the vitamins and minerals readily supplied by fruits and vegetables, which are significant ingredients in this book. The information is based on the latest research data, enabling you to make healthy choices of drinks as you plan to have a baby, as well as when you're pregnant or breastfeeding.
ENERGY - CALORIES
It comes as a surprise to many that the amount of energy (calories) you need when pregnant does not really increase until the last trimester. So it is not a case of having carte blanche to eat for two for nine months, and if you do so, you will gain additional weight you'll find hard to lose again. You only need an additional 200 calories in the last three months, because your body becomes very efficient at using energy and nutrients from stored tissue.
One source of calories is carbohydrates. These are usually starches and sugars. Most food and drinks, even those made from fresh ingredients, contain a high proportion of sugars, The way the body handles these sugars is not very different from the way it handles table sugars, so beware of adding extra weight through drinking too many juices and smoothies, and pay attention to dental hygiene too. However, these fresh ingredients also contain a myriad of other dietary essentials which pure white sugar doesn't, and these can make a significant contribution to your pregnancy diet.
If you are overweight or obese at the start of pregnancy, you need to take special care with what you eat, so that you don't gain weight too quickly. Rapid weight gain may increase your risk of preeclampsia and developing gestational diabetes.
However, even if you are very overweight when you start pregnancy, it is not a good idea to try to lose weight now. It is important to ask your midwife or doctor for help in choosing foods wisely.
Breastfeeding is energy intensive, so additional calories are important to enable you to produce enough milk. This is the time when nutritional food, soups and other energy-rich drinks can be really helpful as your fluid and energy requirements are high. Making batches of soups during pregnancy, and freezing them in portions for one or two people can be a great help at this time, as breastfeeding a baby can be very tiring and you may not have much time or inclination to be in the kitchen.
Found in all your body cells, protein is needed for the growth of your baby. Most women in the UK consume more than enough protein so easily meet their pregnancy and breastfeeding needs.
In pregnancy it is especially important to keep things moving through your digestive system. An advantage of soluble fibre found in oranges, apples and pears, as well as beans, peas and lentils and some cereal grains - is that it helps you feel fuller for longer, which can be useful if you are tempted to snack unhealthily. Insoluble fibre, found in fruits and vegetables - and wholegrain cereals - helps prevent constipation by keeping waste moving through the gut.
Smoothies contain a little dietary fibre because the whole fruit is pureed but juices which are pressed out of the fruit contain very little. This is the reason smoothies count as two portions of fruit and vegetables (of your recommended five a day) and juices as only one.
Although calcium is essential for the proper growth and development of your baby's bones and teeth (your baby's first and adult teeth are present at birth!) as well as a healthy heart, muscles and nervous system, your calcium needs in pregnancy don't increase. Your pre-pregnancy diet, however, does have an effect on the calcium stores in your bones. If you start pregnancy with low amounts, you are more likely to be calcium deficient, which in turn raises your risk of preeclampsia. In the last trimester, your baby lays down a lot of bone and if you don't have adequate calcium from drinks (and foods), he or she will take it from your bones, leaving you with a greater risk of osteoporosis in later life.
Calcium requirements increase considerably for breastfeeding mums.
The good news is that it is not difficult to get enough calcium in the diet as milk and dairy products are excellent sources. Strict vegetarians and women who are intolerant of dairy products need to be especially careful, as although calcium is found in dark green leafy vegetables, almonds and tofu, the body tends to absorb it best from dairy products. Using calcium-enriched soya drinks instead of milk will help, but do seek professional advice about appropriate supplements if you think your intake is low.
Calcium works in conjunction with vitamin D, and a supplement may be recommended in pregnancy as few foods supply it and you can't always rely on sunshine to generate enough of your own.
This bone-building nutrient is little discussed, largely as a deficiency is unlikely because it is found in many foods, particularly those that are rich in protein. Your needs don't increase during pregnancy, but almost double when breastfeeding so ensure you are eating a healthy balanced diet to obtain plenty of phosphorus.
POTASSIUM AND SODIUM
Both of these minerals are essential for health and are found in all body cells and fluids including blood and lymph. Having the correct balance of fluids, particularly in your blood, is crucial to your health. However, excess sodium (salt) increases your blood pressure, which is a risk factor for circulatory problems generally and hypertension in pregnancy.
If you start your pregnancy with high blood pressure, you need to be careful not to increase the amount of sodium (salt) you have in your diet. One way of helping control your blood pressure is to increase the amount of potassium you eat. Many fruits and vegetables are potassium-rich.
This mineral plays a huge number of roles in your body, pregnant or not. It assists with making protein and DNA for cells and tissues, the correct functioning of the nervous system and bone formation. It is also involved in regulating glucose and insulin metabolism, ensuring your blood sugar levels are kept constant. Your diet should contain plenty of magnesium as all of these functions affect your health and therefore that of your growing baby. Like calcium, magnesium is stored in your bones, so if your pre-pregnancy diet was poor, you will start to deplete your stores. There is also some evidence that low levels of magnesium are linked to leg cramps and preeclampsia.
In the UK, magnesium recommendations don't rise until you are breastfeeding, but it is worth eating magnesium-rich seeds, nuts and green leafy vegetables, and drinking milk, once you have conceived. Nibbling some seeds or nuts alongside a drink is a good way to maintain your levels.
Essential for the manufacture of blood cells needed for the rapid increase in blood volume during pregnancy and for placental growth, iron supplementation is not generally advised in the UK for women who eat a nutritious diet. However, many women go into pregnancy with low iron stores, especially if the pregnancy is unplanned, or they've had a baby within the last eighteen months and/or don't eat red meat or other iron-rich foods. The likelihood of low iron stores increases even
more if you are still a teenager. Having low iron stores increases your risk of developing iron deficiency anemia, and although your baby's need for iron will take precedence over your own, there is more chance he or she will be born underweight.
Developing iron deficiency anemia in early pregnancy increases your risk of having a smaller placenta, which may influence the size of your baby. Becoming anemic in your second trimester can increase your risk of giving birth prematurely and therefore of having a low birth weight baby. Recent studies have also found that there is a link between iron deficiency anemia in the last trimester of pregnancy and schizophrenia in later life.
Your breast milk supplies iron to your baby and your ability to absorb iron from food improves after pregnancy. In the UK, there is no additional requirement for iron for breastfeeding mums.
Only some limited foods actually contain sufficient iron to meet your needs. However, many fruits are rich in vitamin C and will therefore increase your body's ability to absorb iron if you eat or drink them when you eat high-protein foods.
Critical in pregnancy, vitamin A helps with the growth of all cells and is essential for the development of your baby's organs and circulatory, respiratory and nervous systems. It also helps boost your immune system so you can fight disease and infection, as well as maintain your vision and help the healthy development of your baby's eyes.
Vitamin A is a global term for retinol (found in animal foods) and carotenes (found in plant foods). The most commonly found carotene is beta-carotene which the body converts to retinol - six units of beta-carotene make one unit of retinol. In pregnancy, your need for vitamin A rises.
Studies have shown the importance of eating well prior to pregnancy as it seems that low intakes of some micronutrients, including vitamin A, before you are pregnant not only influence your pregnancy but can also affect the quality of your breast milk.
A B-group vitamin (B2), riboflavin has a role in energy release, and your requirements increase throughout pregnancy and when breastfeeding. If your diet doesn't contain sufficient riboflavin-rich foods when you are breastfeeding your milk will also be lacking in riboflavin. Dairy foods are a great source of this vitamin and many of the recipes provide this essential vitamin. A yogurt-based smoothie or hot milky drink when breastfeeding will help supply your needs.
If you don't eat dairy foods, consider enriched soya alternatives.
Also known as vitamin B1 thiamin plays an important role in releasing energy from food. Your requirements only increase in the last trimester and when breastfeeding.
Pyridoxine is a vitamin which can be depleted with Jhe long-term use of the contraceptive pill. It is not readily stored in the body, so having a pregnancy diet rich in this nutrient is important. Your baby needs B6 for the normal development of his or her central nervous system and brain. It is also an important antioxidant, protecting against cellular damage and helping your immune defences.
This vitamin plays a crucial role in making red blood cells and genetic material, and is only found in algae or animal foods, meaning that strict vegetarians need to ensure a supply from a pregnancy supplement or fortified foods. Vitamin B12 (and folic acid) helps reduce levels of homocysteine, a potentially harmful substance which can increase your risk of circulatory and nervous system problems. It also increases the risk of birth defects, especially neural tube defects, premature birth and low birth weight.
The synthetic form of folate, folic acid, is more usually known to women planning a pregnancy or newly pregnant. Folate is an essential nutrient as it is known to help reduce the risk of having a baby with neural tube defects (NTD). Taking a supplement of 400 micro grams a day from before conception to the twelfth week of pregnancy is essential, and for women who have already had a baby with an NTD this increases to 4 mg a day. It is known that low folate status in pregnancy can increase the risk of premature delivery.
Folates in foods are very susceptible to nutrient destruction, so it is important that food sources, of which the highest are vegetables, are carefully prepared and cooked to minimize losses.
Perhaps the best known of the antioxidant vitamins, vitamin C or ascorbic acid plays an important role in protecting cells against damage, keeping your immune system working correctly and ensuring the proper development and functioning of the placenta. Ascorbic acid helps the gut absorb iron from food, so it is an essential part of a pregnancy diet, especially as only tiny quantities can be stored in the body.
Vitamin C is found in many fruits and vegetables but can be destroyed by heating.