As I enjoy my fourth pregnancy in my mid-thirties I realize that this is the first time that I am really into health and wellness in my pregnancies. Before I really didn't care or had any interest in health but since now I do I decided to learn more, take some courses and be more intentional about how I take care of my body and nourish it so I can have a healthy and safe pregnancy.
Compared to the need for energy aka how much more food you need, the need for many vitamins and minerals increase is considerably more. The average energy requirements of pregnancy increase by only 10%. In contrast, the average dietary needs for some critical nutrients, such as folic acid and iodine, increase by as much as approximately 50%. Still, others only increase slightly or not at all. I knew about folic acid, it is the one most talked about but iodine is barely heard of.
It is, therefore, crucial to enhance the nutrient density of your meals, and the quality of the diet, rather than increasing the portion size or the energy content.
Drug stores, pharmacies, and supermarkets offer a wide variety of multiple micronutrient supplements for pregnant women. And they also advertise the use of micronutrient
supplements during gestation, but it is very important to remember that obtaining nutrients from foods should always be the main source. The composition of these supplements varies greatly depending on the country and the brand.
However, basically, all of the supplements tend to contain the key micronutrients folate, calcium, iodine, vitamin D, and vitamin B12. It is generally agreed that iron is also vitally important during pregnancy. But generally should only be prescribed by doctors, when a deficiency has been confirmed by blood analysis.
FOLIC ACID
It is universally agreed that every pregnant woman should supplement folic acid. This is important not only because of the physiological role that folic acid has but also because the increased needs are unlikely to be met with the diet alone.
Folate supports cell growth, it supports growth processes, and most importantly, it is very effective in reducing the risk of neurological defects. Consuming a diet poor in folate or having a family history of neurological defects poses an additional risk and emphasizes supplementation even more.
You should have Folic acid supplementation on top of a selection of folate-rich foods, such as:
- green leafy vegetables
- legumes: beans, peas, lentils
- folate-enriched flour or salt
- supplements
FOLATE
- asparagus
- beets
- citrus fruits
- brussels sprouts
- broccoli
- nuts and seeds
-papaya
-bananas
-avocados
-fortified grains
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Folic acid supplementation should start already before conception with at least 400 micrograms of folic acid per day. And it should be continued at least until the end of the last trimester, with at least 400 to 600 micrograms of folic acid per day.
IODINE
In many countries, pregnant women are advised to take iodine supplements on top of consuming iodine-fortified food products such as iodized salt.
This is because even a mild deficiency of iodine during pregnancy can cause adverse effects in the child. In particular, impaired brain and cognitive development. Iodine is needed to support fetal and placental growth, as well as for the increased blood volume of the mother, particularly during the second and third trimesters.
Iodine is not only important for the mental development of the offspring, but it also plays an important role in fertilization. And it is vital for meeting the increased demand for thyroid hormones during pregnancy. In this context, it has been found that the thyroid hormone T4, which plays a crucial role in neuronal differentiation and development. Is reduced in its levels in the fetus, even when there's only a mild iodine deficiency and the mother still can be classified as being euthyroid.
Sources of iodine:
- a combination of supplements
- the use of iodized salt
- consumption of commercially fortified food products.
- wholegrains
- green beans
- courgettes
- kale
- spring greens
- watercress
- strawberries
- organic potatoes with skin.
Before pregnancy, a daily intake of 150 micrograms of iodine a day is advised. However, women during pregnancy should increase their intake to 220 micrograms per day.
IRON
Iron deficiency during pregnancy has been associated with an increased risk of low birth weight and preterm delivery. The need for iron supplementation should be assessed individually for every woman based on medical consultation that includes a medical history and blood tests, for example, a measurement of cell ferritin levels.
All women should aim at consuming food sources that contain adequate amounts of highly biodegradable forms of iron. Dark vegetables are rich in iron but the iron from the plant foods is much less well absorbed unless is consumed along with vitamin C-rich foods, for example, orange juice.
Good sources of iron for vegetarians and vegans are:
- pulses
- dark green vegetables
- wholemeal bread
- fortified breakfast cereals (with added iron)
- dried fruit, such as apricots
- white beans
- quinoa
- spinach
- white button mushrooms
- squash
- pumpkin seeds
- leeks
- cashew
In order to meet physiological needs, the recommendations, for example, in the United States, Australia, Germany, and also from the Global Federation, FIGO., the recommended daily allowances are from 15 to 18 milligrams for non-pregnant women and as much as 27 milligrams for pregnant women.
Other recommendations in contrast, for example by the European Food Safety Authority in the UK, do not change the recommended iron intake for pregnant women as compared to non-pregnant states.
CALCIUM
The recommended intake of calcium for pregnant women does not differ from the recommendations for the general population. However, in pregnancy, it's even more important to actually achieve the recommended intakes.
An adequate maternal status can be achieved by an intake
of 1000 to 1300 milligrams of calcium per day, both before and during pregnancy.
The best sources of calcium are:
- green leafy vegetables
- fortified soy products
- cereals
- pulses
- fortified unsweetened soy, rice, and oat drinks
- brown and white bread
- calcium-set tofu
- sesame seeds and tahini
- dried fruit
Also some traditional foods such as nixtamalized or calcium hydroxide-soaked
maize flour can be an important source of dietary calcium.
VITAMIN D
In terms of bone mass development, calcium can only exert its action in conjunction with vitamin D. Vitamin D contributes markedly to the formation of stable bones by enhancing calcium absorption in the gut and by supporting calcium deposition in bone.
The vitamin D requirements during pregnancy increase because the fetus is totally dependent on the maternal pool of vitamin D. The main source is the androgynous production of the skin
in response to sunlight exposure.
A recent review including 17 studies around the world in pregnant and lactating women has shown that vitamin D deficiency is highly prevalent, even in areas with high sun exposure around the year. Vitamin D status has been found to be even more reduced in obese women, compared to normal-weight women. Therefore, they are considered another high-risk group.
Food sources include:
- fortified soy milk
- vitamin D
- mushrooms
- fortified cereals
- fortified orange juice
- fortified almond milk
- fortified rice milk
- sunshine
Because vitamin D is found only in a small number of foods, it might be difficult to get enough from foods that naturally contain vitamin D and fortified foods alone. All adults, including those who are pregnant and breastfeeding, should consider taking a daily supplement containing 10 micrograms of vitamin D, particularly during the winter months (October until the end of March).
VITAMIN B12
Vitamin B12 deficiency is of concern in women who follow a vegetarian, and particularly, those who follow a vegan diet. Vitamin B12 is essential for the formation of red blood cells and it's also required for normal neurological function. This vitamin is contained in appreciable amounts only in animal products.
Having followed a vegan diet for several years can lead to severe and long-lasting
damage to the child's nervous system, unless vitamin B12 is supplemented. Also in malnourished communities, vitamin B12 deficiency is a matter of concern.
Sources Of Vitamin B12
- nutritional yeast
- marmite + yeast spreads
- fortified soy + almond milk
- plant-based meats
- fortified cereals
- tempeh
- chlorella
- nori seaweed
- cremini mushrooms
It is recommended to consume an RDA of 2.6 micrograms per day during pregnancy.
CONCLUSION
In conclusion, the increase of some micronutrients is much higher than the additional energy requirements in pregnancy. This is why it is very important to consume nutrient-dense foods
rather than simply increasing energy intake or just eating more foods.
DOWNLOAD THE FREE GROCERY LIST OF ALL THE FOODS RICH IN ANY OF THESE 6 ESSENTIAL NUTRIENTS
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