Nutrition and Diet during pregnancy

Healthy eating is important at all stages of life, but especially during pregnancy. Your choices of what to eat and drink at this time can affect your health and the health of your baby for many years to come. There is only a small increase in

the amount of food you need to eat while you are pregnant. However, you do need more of certain nutrients, so it is very important that you make good choices for a nutritious diet. This is important so you and your baby get all you need for healthy growth and a healthy pregnancy.

Weight gain

The amount of weight to gain during pregnancy will depend on what your weight was before you became pregnant. You need to calculate your body mass index (BMI) (a measure of your weight for height) to help you work this out. BMI = kg/ m2

All women can expect to gain one or two kilograms in the first three months of pregnancy. From the second and thirdd trimester, your ideal weight gain will depend on your pre-pregnancy BMI.

It is important to keep your weight gain in this range for both your health and the health of your baby. Not gaining enough weight means your baby may miss out on some important nutrients. This can cause problems later in life. Insufficient weight gain is also linked with preterm birth. Gaining too much weight during pregnancy can also cause problems such as high blood pressure, gestational diabetes, complications in delivery, and longer hospital stays for you or your baby. These problems can be harmful to both you and your baby.

What should be on my plate?

Before you eat, think about what and how much food goes on your plate or in your cup or bowl. Include foods from all food groups daily: vegetables, fruits, whole grains, fat-free or low-fat dairy products, lean protein foods and healthy oils.

Make half of your plate fruits and vegetables

• Choose a variety, including dark green, red and orange vegetables, beans and peas
  
• Choose fresh fruit, rather than fruit juices, as you may miss out on valuable fibre
  
• Examples of vegetables to choose: spinach, kale, broccoli, beetroot, carrots, tomatoes
  
• Examples of fruit to choose: blueberries, apples, kiwis, nectarines, watermelon, papaya
  

Make at least half your grains whole

• Choose whole grains in place of refined grains
  
• Examples of whole grain/high-fibre choices: brown rice, quinoa, whole grain pasta, whole grain/seeded breads, chapatti made with whole grain flour, high-fibre cereals, oats, sweet potato with the skin
  
• Minimise your intake of refined carbohydrates, such as cakes, biscuits, sweets, chocolates, donuts, desserts, white breads, pastries, soft drinks and ready-made juices
  

Switch to low-fat milk

• Choose fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages

Vary your protein food choices

• Choose seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds

Use vegetable oils to replace solid fats where possible

• Healthy oils include olive oil and canola oil. Aim to use 1-2 teaspoons of oil per meal
• Try walnut oil or avocado oil for a salad dressing
• Always remove the visible fat from meat and the skin from the chicken

Make choices that are low in “empty calories”

• Empty calorie foods add extra calories to your diet, without providing other healthful nutrients, such as vitamins and minerals
  
• Examples include candy, desserts, chocolate, biscuits, soft drinks, crisps, etc.

How much should I have from each food group?

The plan below shows slightly greater amounts of food during the second and third trimesters because you have changing nutritional needs. This is a general plan. You may need more or less than the plan.*

*Eat this amount from each group daily

* If you are not gaining weight or gaining too slowly, you may need to eat a little more from each food group. If you are gaining weight too fast, you may need to cut back by decreasing the amount of “empty calories” you are eating.

Important nutrients during pregnancy:

• Folic acid/folate
• Iron
• Calcium
• Vitamin D
• Protein

Folate or Folic acid

Folate (or folic acid) is needed for the growth and development of your baby. It is especially important in the month before you fall pregnant and the first trimester (three months) of pregnancy. A good intake of folate reduces the risks of your baby being born with some abnormalities such as spina bifida (a disorder where the baby’s spinal cord does not

form properly). Dietary sources high in folate include green leafy vegetables such as broccoli, spinach, bok choy and salad greens, as well as edamame, artichokes, beans, peas and lentils.

All women planning a pregnancy and in the early stages of pregnancy should eat a variety of folate-containing foods (listed above). You should also take a folic acid supplement of 400 micrograms per day at least one month before and three months after you become pregnant.

Iron

Iron is needed to form the red blood cells for you and your baby. It helps carry oxygen in your blood and is needed for your baby to grow. During pregnancy you need a lot more iron than when you are not pregnant. It is best to get the iron you need from your diet. Iron from animal food sources is absorbed more easily than iron from plant foods. The best sources of iron are lean meats (especially red meat), some vegetables (especially green leafy ones), soy beans, legumes and fortified cereals. If you are vegetarian or vegan, talk to your dietician or midwife to make sure you are getting enough iron from your diet.

What you eat or drink may stop your body absorbing iron from your diet. You should limit your intake of these. They include:

• drinking tea or coffee with meals
• taking your iron supplement with a meal that includes milk, cheese or yogurt
• eating more than two tablespoons of unprocessed bran

You can help your body absorb iron from the food you eat or drink by:

• including vitamin C with meals (e.g. citrus foods, tomato, capsicum/sweet peppers, strawberries, kiwis)
• including animal protein with green leafy vegetables at a meal
• using antacids sparingly

Calcium

You and your baby need calcium for development of strong bones and teeth. It also helps to keep your circulatory, muscular and nervous systems running properly. The best sources of calcium include milk and dairy products, as well as fish which contains edible bones. Almonds and broccoli are also sources of calcium, and many breakfast cereals and fruit juices are enriched with calcium. Keep in mind that the calcium in these products is not absorbed as well as the calcium in diary products. If you are lactose intolerant or have a dairy allergy, be sure to include a calcium and vitamin D-fortified dairy alternative, such as soya milk, soya yogurt, rice milk or almond milk, in your diet.

Get at least three servings of dairy products or fortified alternative daily. 1 serving is equal to:

• 1 cup low-fat milk
• 1 cup low-fat yogurt
• 1 cup low-fat laban
• 45g (1.5oz) of cheese
• 1 cup soya/almond/rice milk which should be fortified with calcium and vitamin D

Vitamin D

Vitamin D helps your body to absorb and use calcium. Together vitamin D and calcium build your baby’s skeleton. You generally cannot get enough vitamin D from diet alone. Sunshine helps your body to make its own vitamin D. Foods which have a small amount of vitamin D are fish (like salmon, sardine, trout, herring and mackerel), egg yolk and some fortified margarines. If you spend a lot of time indoors, have darker skin or are covered up, your vitamin D levels may be low. Talk to your doctor or dietician about whether you should take a vitamin D supplement.

Protein

Protein is essential for growth and development of the fetus. Make sure that you get enough protein by eating meat, chicken, fish, eggs, milk and dairy products, as well as plant protein from sources such as dried beans, peas, lentils and soya, daily. Other good sources of protein include tofu, low-fat/fat-free cottage cheese and peanut butter.

Foods to avoid or be careful with

Take extra care with the foods in the table below due to their possible risk to the unborn baby.

What about fish?

Fish is an important part of healthy eating. It is an excellent source of protein, is low in saturated fat, high in omega 3 fish oils and a good source of iodine. Omega 3 oils are important for growth of your baby’s brain and eye development.

Even though it is recommended to eat fish during your pregnancy for the excellent nutrients that they offer, you need to be careful about the fish you choose. Some fish may accumulate mercury, which may be harmful to your baby’s developing nervous system.

The FDA has released guidelines for women who are pregnant and women who are trying to become pregnant. These guidelines state that no more than 12oz (360g) of low mercury fish should be consumed weekly. “Highest” mercury fish should be avoided and “high” mercury fish should be kept to only three 6-oz (180g) servings per month.

Source: American Pregnancy Association 2013