Nutrition During Pregnancy
A healthy diet is an important part of a healthy lifestyle especially if you’re pregnant or planning a pregnancy. Undoubtedly it is one of the most vital parts of this journey but less spoken about so let’s discuss pregnancy and nutrition.
Why do we think nutrition is so important during pregnancy?
Pregnant women should start thinking that the kitchen is a high above target. That means like a pharmacy you know it is prepared, drugs are made, produced and all that and the food should become the medicine that is why nutrition is very very important during pregnancy. A lot of women, while they are planning for pregnancy, read a lot about the pregnancy and diet in books. In addition to that it’s very important to consult a dietitian while you’re planning for pregnancy. If that is not done at least the early prenatal visit is very very important. It gives you ample time to get to know about what exactly is a well-balanced diet. It will help you to understand the importance of maintaining optimal body weight and the importance of exercise. Also it will help you to correct certain lifestyle habits.
If someone already has a history of diabetes or blood pressure they can get these under control before entering pregnancy so it’s very important to consult a dietitian so that the nutritional assessment can be done right from the beginning and they can be on the right track.
Do you think women should concentrate on nutrition only once she knows that she’s pregnant or well before that?
Now a lot of women are empowered and they have professionals and they plan so well about the profession and finances and they plan pregnancy only once they are confident with their profession and finances. But they are not at all conscious about their health and this is very very important once you plan your pregnancy like you think that you want to become pregnant only after one year you have a very good one year time to plan as doctors has already told that if the body reserve with nutrition is well balanced then your pregnancy also will result a healthy baby and healthy pregnancy and you yourself also will have a very healthy system.
What is healthy weight gain during pregnancy?
Most of the women worry about weight gain and all those issues but pregnancy is the only time in life of the women where weight gain is most welcome and it is desirable so but it depends upon your pre-pregnancy weight. What we say is when you are below 18 your BMI then you have to gain about 16 to 18 kg 11 to 18 kgs and if it is between 19 and 26 then you have to weigh mean your increase in weight gain is 11 to 16 and then if your BMI is more than 26 or 28 then your BMI is 18 mean 29 to more than that then your weight gain should be restricted maybe 7 to 10 kgs only so this is what you have to learn about the weight gain because now GDM that is diabetes in pregnancy is on the rise and we see lot of women with these issues.
Weight gain during pregnancy and recommended different diet plans to different women falling on a different weight category:
Doctors calculate the pre-pregnancy BMI and we tell them that look during these nine months this is what is your weight gain goal usually for a healthy lady she’s expected to gain weight around 11 to 12 kg during those nine months when we monitor their weight when they are referred to dieticians by the doctors what dieticians tell them is there is a minimal weight gain in the first trimester thereafter from the fourth month it is 1.5 to 2 kg on an average if dieticians notice the weight gain is less than 1 kg or more than 3 kg in a month then that’s a signal where dieticians re-evaluate and it should be done by the doctor as well as by the dieticians where she’s going wrong.
If it is in terms of diet we tend to correct it and medical aspects are taken care by the doctor and when dieticians talk about excess weight gain and in relation to diet dieticians tell them to cut down on those calorie dense foods you know we all are dependent on convenience ultra processed foods so which are small in size these packaged foods but huge in terms of calories so dieticians also train them to read the nutrition label understand the portion size control the food portions read the calories and always diet has to be tailor-made as how you stitch your clothes.
It has to be individualised taking many factors into consideration so dieticians educate them on those calorie dense foods and portion control and how best they can make healthy choices and meet up the requirement. Normally the weight gain is in pregnancy is because of various changes in the body of the women like placenta is formed so it will add weight then the fluid in the amniotic fluid also adds and the uterus grows to a big size and that also add and the baby weight and even the women also has changes in the system like the blood volume increases and the other systems also changes and all this will add to around 11 000 grams so this is the natural weight what they gain of due during pregnancy so because of this doctors always say that weight gain is should be more appropriate.
Can obese people lose weight during pregnancy and is it safe?
Because most of the time in our country even today even among the educated lot still it is unplanned pregnancy and because of that these issues have to be tackled during pregnancy so when the weight is more they have to consult to the doctor and the dietitian so both together can help them because the weight during pregnancy has lot of side effects mean not side effects but they have effect on the baby and the mother most importantly as we have discussed diabetes then second thing is high blood pressures then thyroid levels and difficulty in delivery so more caesareans and all these will add when the weight is more so it is very important to see that how we can bring down first thing doctors make it very clear to the patient that no fat diets should be followed during pregnancy.
Pregnancy is not a time to be on a low calorie diet you need to get all those required nutrients as dr german elaborated what are the major developments that takes place in your body whether it is the breast tissue formation or the amniotic fluid or the placenta is formed there is blood volume increase and for all these developments definitely there is extra nutrition that one needs and that can come from a well-balanced diet as we have emphasised earlier as well preconception dietary counselling is important what we do during preconception is we do the body measurements check their pre-pregnancy BMI give them the weight gain goal apart from that also review certain lab tests also check their physical signs and symptoms whether a lady is anaemic or any micro nutrient deficiencies and of course diet recall is important we take into consideration what she’s been eating all do all through these years and try to correct within what is uh feasible and realistic so you know pregnancy cravings are very very common so we give them low calorie nutritious alternatives and try to help them so that they will not gain too much of weight during pregnancy in the first trimester actually there is a organ formation of the baby and this is the most important part of the pregnancy wherein the mother’s health plays a big role because the mother’s health should be at the best and she should not have any deficiencies like folic acid deficiency or iron deficiency or vitamin d or calcium and her sugar levels should be correct i mean to the normal and thyroid if she has should be controlled and should be in within the normal limits and these will benefit the formation of the baby and as we know that folic acid is very important during first trimester of the pregnancy and it is better taken before well before the pregnancy is planned because the congenital defects are prevented because of folic acid absolutely ma’am so talking about fat diets can a carb free diet harm an unborn baby absolutely we don’t advise low-carb diets during pregnancy because there is a minimum amount of carbohydrates that are required in their diet we usually tell them that very clearly 150 grams of carbohydrates in a daily diet should always be there otherwise it can lead to dangerous conditions like foetal hypoglycemia and can have adverse effects on the pregnancy outcome as well because when they have a low carb diet the cortisol is released in the mother’s blood and that will pass to the baby and that will lead to affect the baby and later on in the adulthood once the baby is born after they are born in adult life or in the middle age they may develop high blood pressure and this is very very important not to have low carb diets.
What diet to be followed when ladies have high blood sugar?
When they come to doctors, they tell them about appropriate weight gain is important because increased weight gain can put them at high risk for developing gestational diabetes if they already have and they come with increased blood sugars doctors educate them on the different types of carbohydrates one is the complex carbohydrates which come from less processed cereals fresh fruits and vegetables which are healthy sources doctors tell them to avoid or rather limit the simple sugars which come in form of ultra processed packaged foods and also tell them about glycemic index where you categorise the food depending upon the ability of the food to increase blood sugar level.
Doctors tell them that you need to cut down on those foods which have high glycemic index also tell them about glycemic load what is the impact of the dietary carbohydrate on blood sugar levels and definitely doctors educate them on the portion size because doctors don’t want too much of food at the time so timing quality of the diet quantity all these are the aspects that have to be looked into so that sugar levels are well maintained individual with diet alone or at times there could be some medicine that has been prescribed by the doctor or at times insulin so we need to see that the meal timing and medicine are well coordinated so that they wouldn’t be any hypoglycemia or hyperglycemia for example white bread has you know high glycemic index or polished rice has high glycemic index so these are the more processed foods which are easily digestible like you know we have corn flakes which have high glycemic index eating a corn on the cob is a healthy option when it comes to glycemic index but refined foods have more glycemic index when you are pregnant and your diabetic there are lot of issues like baby will have low growth mean the weight of the baby may reduce doctors call it as iugr or you may go in for a preterm labor and in the early pregnancies there may be abortions and sometimes they may be congenital for anomalies also or the baby may grow oversized and because of that we may have to go for a cesarean section and chances of high blood pressure doctors call it as pih these are also increased so it is very important that diabetes should be under control during pregnancy and for this medical nutritional therapy by the dietitian plays a major role and along with that now we are giving medications also to control diabetes.
What are the other medical disorders that have a direct impact on the woman’s health as well as the baby’s health?
Now iron is very very important what are the foods available in our kitchen which are rich in iron eat iron rich foods to prevent nutritional anaemia and produce whereas from plant sources so what best we can do if someone is a vegetarian while animal foods these con update try to have a vitamin c rich food so that it will enhance iron absorption and typical hyderabadi habitated they’re having a chai or you know after your breakfast these habits should be discontinued because tannins and oxalates in tea will inhibit with iron absorption so rather than taking to your coffee if you have a habit try to postpone and keep at least one hour gap after a meal and it is best to have a vitamin c rich fruit so that it can enhance iron absorption and calcium supplements and it can be taken during pregnancy.
What are the foods to avoid during pregnancy and can food like salad or sushi be taken?
Salads are healthy provided they are prepared at home because when we are at home we wash the vegetable grate it and cut it and prepare it in a hygienic manner but when you are an outside in a restaurant it’s best to avoid certain foods such as sushi can be when we talk about foodborne illness. It’s best to prevent football numbness during pregnancy so try to have more of home food only hygienic outlets if you’re going outside take extra care and drink pasteurised milk and well cooked meat when it comes to meat it has to be cooked to appropriate temperature so that you can prevent all these food bone infections.
Similarly is coffee safe during pregnancy and if so how much coffee can one consume in a day?
Caffeine inhibits the absorption of iron so it is better to cut down probably three cups in a day. It is okay not beyond that and it is better to take milk without sugar if you can, that is you know adequate and better.
First trimester of pregnancy with severe nausea and vomiting so what foods to consume and what foods to avoid nausea and vomiting are very common during pregnancy?
For some women morning sickness if they come to doctors with this kind of issues simple tips that doctors tell them is have small frequent meals stay well hydrated drinking adequate amount of water is important handy otherwise they become dehydrated another thing is the best thing that you can have when you have this nausea feeling is dry biscuits or dry food that can suppress the nausea feeling also sniff lime you can have ginger tea and always having meals in a well ventilated room where there is inflow of fresh air you know also decreases nausea and avoid those kitchen smells which can trigger nausea so apart from nausea and vomiting even constipation is one of the most common problem faced during pregnancy.
Whatever reason there is constipation so doctors tell them about high fibre diet at least 25 grams of fibre per thousand kilo calories and how do you get this dietary fibre or roughage from various fruits especially those with edible skin lot of vegetables in your diet that’s why we say five a day minimum two fruits and three servings of vegetables and vegetables could be in form of raw salads which are a good source of fibre again at least have one meal which comes from unprocessed cereal so out of three meals one could be from unprocessed cereal which is a good source of fibre and also drinking adequate amount of water is equally important.
Calcium is really very important during pregnancy and if women have to think about this and most of the women say that i can’t drink milk i’m not used to yoghurt or curds.