Nutrition in pregnancy, eating habits are of great importance in terms of human health. This importance increases more during pregnancy. Scientific studies show that maternal health can be maintained for a long time and positive results can be obtained in terms of healthy birth and development of baby when the mother’s nutritional status is organized. Healthy nutrition both prepares the mother for the birth and breastfeeding process in the best way and positively affects the development of baby. Poor nutrition and malnutrition are an important risk factor for problems arising during pregnancy. If you are eating healthily before pregnancy, you will be able to meet your nutritional needs during pregnancy with only minor changes.
HEALTHY NUTRITION
Every diet should contain proteins, carbohydrates, fats, vitamins and minerals. Including these four basic food groups in daily food consumption is the best way to guarantee a healthy balanced diet. The body uses all these substances for development and self-renewal.
In order to make sure that these substances are taken in sufficient amount, it is necessary to know from which foods these can be provided in the best way. Intake of these substances less than specified amount does not always mean an unhealthy diet. However, intake of these in the specified amount is the significant proof that you are eating properly.
PROTEINS
In the first three months of life, the need for protein is small, but in the second and third months of life, the need for protein increases due to the rapid growth of the baby and the burden laid on the body by the growing baby. The generation of tissue, muscle, enzyme, hormone and antibody needed by you and your baby during pregnancy requires more protein intake.
Protein requirement before pregnancy is 45 gr. During pregnancy, the mother should get 60 gr of protein. Red or white meat (beef or lamb meat , chicken, fish), egg, milk and dairy products, legumes, walnuts, hazelnuts, peanuts, bread and cereals are the main sources of protein.
CARBOHYDRATES
Carbohydrates (sugar and starch) are our main source of energy. It is found in cereal products such as bread, rice, pasta and in starchy vegetables such as potatoe and corn.
More than half of the calories we get daily should be provided from carbohydrates. Candies should not be eaten since they do not contain too many essential nutrients, and starches that provide energy and fiber should be preferred. Growth retardation is seen the babies of pregnant women who get most of their calorie needs from sugary products. Carbohydrate intake should be restricted since excessive weight gain will adversely affect pregnancy and delivery.
FATS
Fats provide high energy, but contain high amount of calories. They help the body to use carbohydrates, proteins and vitamins. As too much fat is not desired in diet, a diet that does not contain any fat will not be appropriate for a healthy life. Saturated fats are mostly found in animal products, while unsaturated fats are mostly found in herbal products.
Fats should be maximum 30% of the daily calorie intake and at least half of this should be supplied from unsaturated fats. Unsaturated fats are found in vegetable and vegetable oils, margarine and fish oil. Therefore, lean meats, fish or poultry and low-fat or fat-free milk should be preferred. Low-fat cooking methods such as grill, oven and boiling will also be useful.
VITAMIN AND MINERALS
Vitamins and minerals play an important role in the generation of bones, muscles and blood cells and in the functioning of the nervous system.
Daily Needs
| 20-40 years of age | During pregnancy | |
| Calorie | 2200 | 2200+300 |
| Protein (gr) | 45 | 60 |
| Calcium (mg) | 1000 | 1300 |
| Magnesium (µg) | 280 | 320 |
| Vitamin C (µg) | 60 | 70 |
| Vitamin B6 (µg) | 1.5 | 1.6 |
| Folic acid (µg) | 180 | 400 |
| Vitamin B12 (µg) | 2 | 2.2 |
| Vitamin D (µg) | 5 | 10 |
| Vitamin A (µg) | 800 | 800 |
| Iron (µg) | 15 | 30 |
| Zinc (µg) | 12 | 15 |
| Selenium (µg) | 50 | 65 |
During pregnancy, the body needs to produce more blood and generate the bones of your baby. During this period, more iron, folic acid, calcium and phosphorus are needed. These substances are found in meat, bean, pease, green-leafy vegetables, dairy products and cereals.
With a proper and well-balanced diet, the required minerals will be taken at a sufficient level. The only exception is iron intake. Iron is not only for the baby but also related to the mother’s increased blood volume. Because of the increased need during pregnancy, the volume of red blood cells is increased, and therefore, iron stores become depleted between the weeks 12 and 25 and anemia occurs. Iron is essential for the production of blood cells, and iron supplementation is needed since it will not be sufficient to meet the increased iron requirement in pregnancy with food intake.
Therefore, all pregnant women should use iron supplement to prevent anemia.
This amount is 30 mg per day in pregnant women without anemia. Whereas, it is 60-120 mg per day in pregnant women with anemia.
Anemia criterion
In the first and last trimesters, hemoglobin should be 11 g/dl and hematocrit should be below 33%, while, in the second trimester these values should be below 10.5 g/dl and 32%, respectively (Institute of Medicine).
Folic Acid
Folic acid (folate) deficiency may cause spinal abnormalities in babies, called neural tube defects (NTD); therefore, women planning to get pregnant should start taking sufficient amount of folic acid at least one month in advance.
Lettuce, dill, spinach, walnut, almond, broccoli, pease, melon, strawberry, avocado, banana, orange, cabbage, green pepper, bakery products and bread are a very good source of folic acid.
The recommended amount of folate intake during pregnancy is 600 μg/day. This amount is slightly above the amount that can be taken through foods. If you’re not sure that you get folic acid sufficiently, you can use multivitamin supplements containing folic acid. The vitamin you take should contain 400 micrograms of folic acid.
WATER
In general, water is not considered as one of the essential nutrients, but life without it is not possible. Water has many benefits: it provides new tissue generation, carries essential nutrients and waste products, facilitates digestion, prevents constipation and helps the ocurrence of chemical reactions.
The body loses water by means of sweating and urination. At least 8 glasses of water should be consumed per day to meet the water need of the body.
Fluid can also be taken with fruit juices, but it causes you to take extra calories. Since the consumption of coffee and tea reduces the amount of fluid in the body, they have no value to meet the amount of fluid you need to take.
CALORIE AND WEIGHT GAIN
It is normal for someone with a normal weight before pregnancy to gain 11-15 kg during pregnancy.
Women who are below their average weight should gain more weight (12-18 kg) and women who are above their average weight should gain less weight (7-11 kg).
However, an overweight woman should not try to lose weight during pregnancy. It is expected to gain 5 kg in the first 20 weeks of pregnancy, and 400 grams per week during the rest of pregnancy (500 grams per week for underweight pregnant women, 300 grams per week for overweight pregnant women).
In cases where nausea and vomiting are frequent in the first trimester, weight loss may occur. In such a case, there is no need to worry, weight will be gained when nausea ends. Do not assume that the baby will be undernourished in this period; the baby is very small in the first trimester, and even if you don’t eat anything, all of baby’s needs will meet from the mother’s body.
Required amount of weight gain during pregnancy will also positively affect the baby’s weight. Birth weight of the baby is important because low weight can be a sign of health problems both during birth and in the first months of the baby. The fact that the baby is small or has a low weight does not make the delivery easy. Therefore, the goal is ideal weight gain by considering the weight before pregnancy.
Likewise, excess weight gain during pregnancy is also an undesirable condition. Lumbar and leg pain arises with the increased load of the body. Rapid and excessive weight gain increases blood pressure, causing extra load on the heart (pregnancy toxemia-preeclampsia, eclampsia with high blood pressure may occur after 28 weeks). Excessive weight gain forms a basis for diabetes arising after 24 weeks of pregnancy. It also causes difficulties during delivery.
The distribution of weight gained during pregnancy
| Gram | |
| Baby’s weight | 3300 |
| Plasenta | 700 |
| Increased fluid | 1800 |
| Increase in uterine weight | 900 |
| Increase in breast | 900 |
| Increase in blood volume | 1800 |
| Storage of nutrients | 3200 |
| Amniotic fluid | 900 |
| TOTAL | 13500 gram (13,5 kg) |
FOR BALANCED NUTRITION
Use the 4 basic food groups to plan your meals by choosing your favorite dishes. Eat a wide range of food every day. One way to do this is to eat from each of the main food groups at breakfast, lunch and dinner, and to eat one from each group at snacks.
Especially in the last months of pregnancy, you can feel more comfortable by eating small snacks 6 times a day. Note that your meals contain the essential nutrients you need every day.
Concentrate on eating the right food instead of paying attention to your weight. You and your baby share the same foods; if you do not eat the right thing, it means that your baby does not eat too.
Do not try to lose weight during pregnancy even if your weight is too much. It means that you put your baby’s food at risk.
If you eat the right amount of food from the four basic food groups and if you avoid foods that are poor in nutrients, you won’t have to worry about getting too many calories.
Especially pay attention to consume nutrients very rich in vitamins and minerals.
Pregnant women who are prone to gain excess weight should consume fruits rich in vitamins and minerals, while paying attention not to consume sweet fruits.
LACTOSE INTOLERANCE
A person with lactose intolerance has no enzyme that breaks down lactose, leading to symptoms such as nausea, diarrhea, cramp, indigestion.
Its treatment is to eat lactose-free foods. If you have lactose intolerance, you can get the protein and calcium you need from egg and hard cheese.
If sufficient amount of calcium cannot be taken through nutrients, calcium supplement may be required.
ALCOHOL CONSUMPTION AND SMOKING
Nutritional problems during pregnancy, as well as other complications are common in women who consume alcohol. Routine alcohol consumption of the mother means that the baby also constantly consumes alcohol. It is recommended that no alcohol be consumed during the pregnancy since it cannot be certainly known whether the amount of alcohol consumed is too much or not. The babies of women who smoke during pregnancy are born with low birth weight. Therefore, smoking should be quit throughout the pregnancy.
MORNING SICKNESS
Of pregnant women, 70% have nausea in the first 12-14 weeks and 30-50% have vomiting. Although nausea mostly occurs when waking up in the morning, it may occur at any time of the day. Sufficient amount of calorie and fluid intake is important.
Nausea in early pregnancy can be partially reduced with a number of measures.
- Eating a few crackers or a plain toast in the morning before getting out of the bed and having a little rest in the bed
- Eating little and frequently
- Not staying hungry for a long time
- Liquids should be taken between meals, not with meal
- Avoiding fatty, heavy and spicy foods
- Avoiding foul-smelling areas
- Resting when feeling tired
Although severe nausea and vomiting are rare, it may cause dehydration, if occurs. If your nausea and vomiting prevent your nutrition and if you cannot gain enough weight, treatment may be required.
EPIGASTRIC BURNING
Occasional burning feeling in the chest after meals is caused by flow of what you eat back into the esophagus.
Relax, chew the food you eat well, eat slowly, eat more frequently and in small portions, avoid fatty and spicy foods. Don’t lie down right after eating and drinking something.
CONSTIPATION
Reduced motility of the gastrointestinal system during pregnancy causes constipation. As the baby develops, the pressure on the intestines in the lower part increases. Also, fluid need increases. These also cause constipation. Regular exercise, eating fiber foods (whole grain breads, cereals, raw or cooked vegetables and fruits) and taking plenty of liquids (at least 8 glasses per day) will be helpful.
Never use laxative, unless your doctor recommends.
WHAT TO EAT !
Consume fried food, fatty foods that are difficult to digest and may cause stomach burns as little as possible.
Avoid uncooked or undercooked foods such as sushi etc., salami, sausage, bologna and steak tartar a la turca. This type of uncooked or undercooked foods may contain bacteria and parasites. Bacteria and parasites are destroyed by cooking foods well.
Some vitamins may be harmful when taken too much (vitamin A and vitamin D).
Do not use anything other than vitamins and mineral supplements recommended by your doctor.
IN CONCLUSION
One of the most important things to do for yourself and your baby is to eat properly during pregnancy.
Take a look at the nutrients included in your daily diet. Pay attention to the substances they contain. Take care that the foods you eat the foods that you can supply calories and essential nutrients required for you and your baby.
If you are healthy, you do not need to make a lot of changes in your eating habits during pregnancy. There is no need to limit salt intake during pregnancy, unless otherwise stated. You will see the result of proper nutrition not only during pregnancy but also during the rest of your life.
FOR HEALTHY NUTRITION
- Use liquid oils, preferably olive oil, in your dishes.
- Use sugary products as little as possible
- Use iodized salt
- Use herbal teas instead of drinks that contain caffeine, such as tea, coffee and cola
- Do not consume raw meat (sushi, steak tartar a la turca, bologna sausage and salami) and delicatessen products
- Stay away from products containing too much additives
- Use pasteurized or sterilized milk and dairy products
- Prefer seasonal fruits and vegetables. Do not consume very sweet fruits. Take care that fruits are washed well
- Consume mussels and canned fish as little as possible.
- Do not use products made of sweetener.
- If you have weight problem, consume fat-free milk, cheese and yogurt and whole grain bread (integral/full)
- Stay away from alcohol and smoking
- Try to sufficiently benefit from sunlight
- Check your weight frequently
- Do not take medication without consulting your doctor.
A DAILY SAMPLE FOOD LIST (2100 CALORIES)
BREAKFAST
1 glass of milk (160 gr.)
2 matchbox size of cheese (60 gr.)
5 olives
1 tablespoon of molasses or jam
4 thin slices of bread
Tomato, cucumber
LUNCH
1 portion of vegetable dish with meat
Low-fat salad
1 glass of yogurt
4 thin slices of bread or 1 portion of rice, pasta
MID-AFTERNOON
2 portion of fruit (1 small apple and 1 orange)
About 1 matchbox size of cheese
2 thin slices of bread, tomatoes etc., if desired
DINNER
3 meatballs size of red meat, chicken or fish (100 gr.)
1 portion of vegetable dish
Low-fat salad
3 thin slices of bread
NIGHT
2 portions of fruit (half banana and 3 apricots)
1 glass of milk
- 1 glass of milk equals to 1 glass of yogurt.
- Instead of one matchbox size of cheese, one egg can be eaten 2–3 times a week.
- Instead of one portion of meat, one portion of legume dish can be eaten
