Tuesday, 14 June 2011

Nutrition and Diet

What are the nutritional requirements during pregnancy?

Your requirements will change over the pregnancy. It should be a healthy one with more fibre, less sugar, salt and fat. Quality rather than quantity should be the aim. Definitely dont eat for two! Freshly prepared foods are preferable to canned foods which contain preservatives. Organic would be the ideal. Avoid fried and salty meals, cut down on snacks such as cookies, pastries, ice cream. Your diet should be balanced with a fair amount of protein, carbohydrates, fat. Your sources of protein are fish, meat, poultry, nuts, beans.

As pregnancy advances, increase the protein intake and replace refined carbohydrates with complex ones such as wholemeal bread and brown rice which will provide you with energy but not cause sudden surges of glucose in your body. Vegetables such as brocolli, spinach, will provide you with folic acid, while fruits, tomatoes vitamin C which will protect against infections and build strong bones, teeth and gums. Vitamin A found in eggs, dairy, fish oils and vegetables are necessary for healthy skin, hair, nails and vision. Vitamin B found in meat, fish, eggs, cheese are necessary for brain and nervous system development. Vitamin D in fish, milk, eggs and cheese build bones. Vitamin E in cereals, vegetable oils maintain healthy red blood cells. Calcium in cheese and dairy for bones and teeth. Your calorie intake should gradually be increased from 2000 cal/day to 2400 cal/day in the third trimestor.

What is my ideal weight gain during pregnancy?

You should aim for an average weight gain of about 12 to 15 kg throughout the pregnancy. A staedy weight gain of about 0.25 to 0.45 kg /week will ensure a favourable outcome. The weight gain may not be even. In the first trimestor you may not gain so much but don not be worried as your baby will be drawing from the reserves that you have built up before you were pregnant. From 12 to 20 weeks you should gain about 2 kg and between 20 and 40 weeks, 20kg.

I weigh only 39kg and am pregnant. I have been on a diet. Will this affect my baby?

At a weight of only 39 kg you are underweight by about 10-15 kg. It has been shown that starting a pregnancy with a low weight predisposes you to an approximately threefold increase in the risk of having a low birth weight baby. Definitely do not diet during pregnancy. Your weight gain should also depend on whether your build and how active you are. Intake should be between 1800 to 3000 cal/day.

I am overweight and am pregnant. Should I diet?

Although obesity predisposes to hypertension, diabetes and more complications in pregnancy, it is not nutritionally advisable to diet. A negative calorie balance will result in the body utilising th eprotein necessary for foetal growth and development. Calorie restriction will result in in fat being broken down and the ketosis that results can be detrimental to the baby.

I am obse and am planning to get pregnant. Should I diet?

You should try to reduce to as near as possible to normal weight for your height. Obesity in pregnancy carries inceased risk of complications such as medical problems, hypertension, diabetes, bigger baby and more difficult delivery, reduced mobility. Caesarean section in an obese patient carries higher anaesthetic risks and more difficult healing of the operative wound.

Q  I am a vegetarian. Will this affect my pregnancy?

A vegetarian diet not taken to the extreme can be nutritionally adequate. The amount and quality of protein would be of importance. You will need at least 30 gms/day of protein in the form of milk, eggs, cheese, soya and beans.

My obstetrician has told me that I do not need supplements during pregnancy. Will my diet be sufficient in providing adequate vitamins and minerals?

If you start off pregnancy well nourished and with adequate stores and you follow the recommended increased requirements of calories, calcium, folic acid, and iron in your food then supplements may not be necessary. However in many asian and japanese diets intake of iron and calcium is inadequate. This is typically high in carbohydrate but low in protein which may lead to a state of deficiency in the later part of the pregnancy. Supplements are therefore highly recommended in the asian context.

What are the exact requirements during pregnancy?

The daily allowance of nutrients is only a guide. There is insufficient physiological information on the needs of women during pregnancy. As a rule the total calorie intake should be about 2300cal/day, more if you are heavier and active and less if you are small and less active. Protein should be 30-70 gm/day, calcium 1200cal/day, vitaminA 600u, vitamin D 400u, thiamin 1.5mg, nicotinic acid 15mg, ascorbic acid 50mg and folic acid 1 mg.

Do I need supplements of vitamin A and D

With a normal western diet the requirements are duly met. In some asian diets where dairy products are not readily consumed there may be insufficient vitamin A and D. As a result calcium may not be be easily absorbed. Supplementary vitamin D is then necessary. It should be cautioned that vitamin A and D in excess of the daily requirements may cause foetal abnormalities.

I have been taking Royal Jelly supplements. Can I continue this during pregnancy.

The actual nutritional and mineral value of royal jelly is unsubstantial. It however is high in sugar content. There is no harm in taking royal jelly but not in large amounts. It should also be cautioned that royal jelly may cause allergic and asthmatic reactions.

Q  Can I take birds nest during pregnancy. Will it be beneficial to my pregnancy?

Birds nest is birds saliva which contains little then a small amount ofprotein. It therefore has not much nutritional value. It is however safe to take but should not be taken with too much rock sugar.

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