Nutrition
in pregnancy:
During pregnancy there should be an increase in all
nutrients to meet the physiologic demands of maternal changes and fetal growth.
The amount of increase in essential nutrients for each woman depends on a
number of factors, such as
· the
general nutritional status before pregnancy,
1.
current health status, age and
parity,
2.
time interval between pregnancies
3.
height, weight and activity level
Adolescents
who are pregnant before the cessation of their own growth do not have the
physiologic maturity to withstand the additional stresses of pregnancy. They
need greater nutritional requirements then do adults.
Calorie increase:
Calorie requirements must be increased between 10 and 15
percent during pregnancy to meet the increased energy demands of the women' s
body and the development of the fetus. The total energy cost during pregnancy
is approximately 80,000 calories. Therefore, an increase of about 300 calories
(kcal) per day is needed during pregnancy.
A well balanced diet
consisting of about 2500 calories a
day
will meet the nutritional demands of pregnancy.
A Protein:
Protein should be increased from 45
to 50 gm per day in the non-pregnant women to 60 gm per day for the pregnant
women. For adolescent pregnancy, the protein requirement is 1.5 g per kilogram
of body weight.
Protein
is needed to provide additional amino acids
1.
to support rapid fetal and placental
growth
2.
growth of the breasts and uterus
3.
expansion of maternal blood volume
and
4.
to meet the demands of labour, birth
and lactation.
Sources of complete proteins:
Milk, cheese and eggs, meet, fish,
poultry, grains, legumes and nuts. Vegetable proteins can be combined with
complete proteins, (or) two vegetable proteins that complement each other' s
amino acid deficiencies can be eaten together to make a complete protein.
Example: Milk and cereal. Rice with beans.
B Carbohydrates and fats:
The role of carbohydrate and fats during pregnancy are to
contribute to the total calorie intake required for maternal and fetal growth.
Sources of carbohydrates and fat:
Fruits, whole grains cereal, milk
and bread. Fats are found in butter, cheese, oil and nuts.
C Vitamins:
Vitamin intake should be maintained
or increased during pregnancy and lactation. This intake should be obtained
through a well balanced diet. The role of vitamins in the diet is to maintain
the normal cell structure and function and to support the growth of new
tissues.
The fat-soluble vitamins A, D, E and K are stored in the
liver in moderate amount. They are absorbed along with the dietary fats eaten.
1. Vitamin A:
Vitamin A is essential for cell
development, tooth formation and bone growth. It plays a role in the metabolism
of carbohydrate and deficiency causes night blindness.
Sources:
organ meat, egg yolk, butter, yellow
fruits and vegetables, green leafy vegetables.
Excessive amounts of vitamins A are toxic and during
pregnancy could be teratogenic, causing congenital fetal malformations. Hence
usually pregnant women are not given vitamin A supplements.
2. Vitamin D:
Vitamin D is needed to enhance the absorption and use of
calcium and phosphorus, which are needed for fetal skeletal and tooth
formation.
Sources:
Liver, egg yolk, milk, fresh fruits
and vegetables. Sun exposure causes Vitamin D synthesis in the skin.
3. Vitamin E:
The
primary function of vitamin E is as an antioxidant. It takes on oxygen so that
the substance will not undergo chemical change.
Source:
Vegetable fats and oils, whole grains, greens and eggs.
4. Vitamin K:
It is essential for blood
coagulation and prevention of hemorrhage. The RDA for pregnant women is 65 mg/day. Intake of
vitamin K is usually
adequate in a well-balanced diet.
5. Vitamin B Complex:
The entire B complex of Vitamin B1 (Thiamine),
B2
(riboflavin), B6 (pyridoxine), B12 (cobalamin) , niacin and folic acid have the
important function in metabolic function and energy metabolism. Therefore the
Vitamin B requirement increases as calorie intake increases to meet metabolic
and growth needs.
Vitamin B1:
Vitamin B1 requirements
increase from 1.1mg/day to 1.5mg/day.
Sources:
pork, liver, milk, potatoes, bread and cereals.
Vitamin B12
Vitamin B12 requirement 1.6 mg/day.
Sources:
Milk, liver, eggs, bread and cereals.
Vitamin B6:
Vitamin B6 is associated with
protein metabolism, so that if the protein intake is higher than average,
vitamin B6 intake should be higher.
Vitamin B6 plays a vital role in the
development of baby' s central nervous system. Requirement is 2.2mg per day.
Source:
Fish, liver, port, potatoes, wheat germ, and yeast.
Vitamin B12:
Vitamin
B12 is found only in animal source and it is essential for formation
red blood cells.
Sources:
Milk, meat, liver, eggs and cheese. 2.2 mg per day
Deficiency leads to pernicious anemia
Niacin :
Niacin requirement of pregnant women is 17mg/day.
Sources:
Meat, poultry, fish, liver, whole grains, bread, cereals and
nuts.
Folic acid:
It is important for the promotion of
adequate fetal growth. Requirement during pregnancy is 400mg/day.
Sources:
Fresh green leafy vegetables, organ
and bananas, kidney, liver, meat, dried bean. 80 percent of folic acid is lost
in cooking.
Deficiency of the Folic acid leads
to spontaneous abortion, fetal malformations neural tube effect.
Supplementation of folic acid 400mg / day, is recommended during antenatal period.
Vitamin C:
During pregnancy, Vitamin C aids in
the formation and development of skin and vascular system of fetus. It enhances
the absorption and storage of iron.
The Requirement is 70 mg/day. Deficiency of Vitamin C:
causes scurvy.
Sources:
A well balanced diet provides the required amounts of
vitamin C. Food rich in Vitamin C include citrus fruit, strawberries tomatoes,
potatoes, and green leafy vegetables.
D Minerals:
1. Iron:
Iron is essential in the synthesis of hemoglobin in maternal
and fetal red blood cells. Unfortunately most Indian women enter pregnancy with low iron stores. Deficiency leads to iron
deficiency
anaemia.
Women
at risk for iron deficiency anaemia are
1.
Women with frequent childbirth.
2.
Women with multiple gestations.
3.
Women with poor diets.
Requirement
for pregnant women is 60 mg per day
Sources:
meat, liver, eggs, green leafy vegetables, bread and
cereals. The absorption of iron from vegetables sources can be
enhanced
by combining them with vitamin C sources. Pregnant women absorb only about
15-25 percent of available iron in food. A well-balanced diet with good iron-
rich food will provide only about 15 to 18mg of iron per day. Therefore, a
supplement of iron such as ferrous gluconate, ferrous fumarate or ferrous
sulphate is needed.
2. Zinc:
Zinc is essential for normal fetal
growth and development and uterine contractility for the initiation of labour.
The RDA for Zinc during pregnancy is 15mg/day
Sources:
Liver, wheat bran, milk.
Deficiency:
Deficiency leads to infection, fetal
malformation, low birth weight, and intrapartum hemorrhage.
3. Copper:
Copper is essential in the absorption, storage and release
of
iron.
The RDA for copper in the
non-pregnant women is 3mg/day. The exact requirement for pregnant women is not
known.
Sources:
Liver,
meat, oysters, nuts, corn oil and dried legumes and drinking water.
3. Calcium:
Calcium
is essential in pregnancy
1.
For the fetal skeletal formation
2.
Teeth formation and
3.
Regulation of nerve and muscle
activity.
The RDA for calcium during pregnancy
is 1200 mg per day. The RDA for pregnant teenager is 1600 mg per day.
Sources:
Milk and milk products, green leafy vegetables, whole grains
and bread.
4. Phosphorus:
Phosphorus is necessary for the rapid division and growth of
new fetal cells.
The RDA during pregnancy is 1200 mg per day.
Sources:
Meat, chicken, eggs, milk and cheese.
5. Magnesium:
Magnesium is important during pregnancy for cellular
metabolism and structural growth.
The RDA for pregnancy is 320 mg per day.
Sources:
Milk, whole grains, legumes, nuts and tea.
6. Iodine :
Iodine is needed for the regulation of the metabolism.
Source:
Sea foods including fish and oysters
Iodine deficiency of a pregnant woman may lead to cretinism in infant.
E Water:
Fluid
intake is an important component of a well-balanced diet to support the
physiological changes taking place. An adequate
intake
helps by assisting with digestion and in prevention of constipation
Requirement
of water: 2000-2500ml per day.
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