Which foods are important for pregnancy?

DR.

MICHELLE BLUMFIELD: There’s really no magic formula for a healthy pregnancy diet. In fact, during pregnancy, the basic principles of healthy eating remain the same. Get plenty of fruits and vegetables, whole grains, lean protein, and healthy fats. However, a few new trends in a pregnancy diet deserve special attention, and here’s the one that top the list. First, we have folate, or folic acid as it’s commonly found in supplements, which is a B vitamin that is essentially in early pregnancy, because it prevents neural tube defects. Neural tube defects are serious birth defects of the brain, spine, or spinal cord, which usually occur in the first month of pregnancy, often before a woman even knows that she’s pregnant.

And because about 50% of pregnancies are unplanned, it is recommended that all women of childbearing age eat folate rich foods, in order to increase their folate intake. Women should aim for at least 600 micrograms of folate in their normal diet each day. And for those women who are planning a pregnancy, or are even in their first trimester, a folic acid supplement is also recommended. So if we take a look at some of the foods high in folate, we can see that folate is present in a wide variety of foods. Some of these foods include vegetables, such as spinach, and broccoli, and asparagus, and fruits, such as oranges and bananas, and even strawberries.

As well as legumes, like chickpeas, and dried beans, and lentils, and even yeast extracts like vegemite or marmite. Folate is also now commonly found in breads and cereals that contain folate fortified wheat flour, which has now become mandatory in most countries since 2009. If a pregnant woman can find a folic acid supplement that contains iodine, it is of added benefit, as the World Health Organization and other international government authorities have recently begun recommending that pregnant women consume a daily iodine supplement, to optimise neurodevelopmental outcomes in their children. The next nutrient of interest is iron. Iron is a really important mineral during pregnancy, because the body uses iron to make hemoglobin.

Hemoglobin is a protein found in red blood cells that carries oxygen around the body. If you don’t have enough iron in your blood, cells can become starved of oxygen. During pregnancy, iron is particularly important to produce extra blood cells to cater for the growth of the baby and the placenta. To ensure an optimal iron status during pregnancy, the recommended daily amount is doubled to 27 milligrams of iron per day. There is currently not enough evidence to support routine iron supplements during pregnancy. However, pregnant women are at high risk of low iron intakes and iron deficiency anemia, and therefore iron status needs to be regularly monitored throughout pregnancy.

Good sources of iron include animal products, such as lean red meats, fish, poultry, and eggs. Well, some vegetarian foods high in iron also can include dried beans, and peas, green vegetables, such as asparagus, and also fortified breads and cereals. Eating these plant based sources of irons with foods high in vitamin C is also a really good way to maximize iron absorption. Pregnant women also need lots of calcium to help their growing baby build strong bones and teeth. Calcium also plays a role in ensuring the circulatory, muscular, and nervous systems function normally.

The recommended daily intake of calcium for an adult woman during pregnancy is 1,000 milligrams per day, whereas pregnant teenagers need a little bit more at 1,300 milligrams per day. Good sources of calcium include dairy foods, like milk, yogurt, and cheese, calcium fortified products, such as soy, and many fruit juices, and breakfast cereals, and also to a lesser degree, green leafy vegetables, like broccoli and spinach, and also nuts. A vitamin that is currently of great interest to both the medical and research communities is vitamin D. Vitamin D is not only important in the development of healthy bones and teeth. It can promote insulin action and secretion, immune modulation, and also lung development.

Recent research is also telling us that low vitamin D status during pregnancy is associated with conditions including the development of childhood allergy, high risk of gestational diabetes during pregnancy, low birth weight babies, and other pregnancy complications like preeclampsia. The recommended dietary intake of vitamin D for women during pregnancy is between five to 10 micrograms, or 200 to 400 international units per day, depending on which countries recommendations you are following. Recommendations for vitamin D during pregnancy increase to 1,000 international units per day for women who are at high risk of vitamin D deficiency. So these are those women with increased skin pigmentation, low exposure to the sun, or have a obese body composition.

While UV radiation from the sun is necessary for the production of vitamin d in the skin, and is the best natural source of vitamin D, women really need to balance sun exposure with skin cancer risk. There are small amounts of vitamin D in some foods, such as oily fish and eggs, but it is really difficult to get enough vitamin D from foods alone. Most people only get between 5% to 10% of their vitamin D intake from foods. Eating foods fortified with vitamin D, such as milk, and cereals is also a really good way to increase vitamin D intake. Protein is also crucial for fetal growth, especially during the second and third trimesters.

The recommended dietary intake of protein during pregnancy is a one gram of protein per kilogram of body weight per day. Lean meats, poultry, fish, and eggs are great sources of protein. Other options include dried beans and peas, tofu, dairy products, and nuts. Some grain and cereal based products are also sources of protein, but they are generally not as high in protein as meat and meat alternative products. Eating a healthy diet in preparation for pregnancy and to boost fertility is one of the most powerful health changes a pregnant woman and her partner can make. Research has shown that specific changes to the diet can improve fertility, prevent recurrent miscarriage, and really support a healthy pregnancy.

Did you know that the foods you eat today impact the health of your eggs and sperms 90 days from now? And that an embryo and young fetus need specific nutrients before pregnancy can even be detected, with a deficiency in those nutrients, having the ability to cause serious birth defects?