Nutrition during pregnancy has been shown to impact not only the birth weight, gestational age and nutritional status of the fetus, but it also impacts chronic disease states later in the unborn child’s life. Over the years, women have been well-informed about the food com-ponents to avoid while pregnant, such as alcohol and high-mercury fish, for example. But, women need to focus on consuming many essential nutrients, rather than just increasing caloric intake.
While women are “eating for two,” their calorie needs are not based on this popular phrase. It’s commonly simplified and said that a woman should increase her calories by 300 a day. However, the new daily recommended intakes (DRIs) suggest that a woman’s addi-tional needs actually begin to increase primarily during the 2nd and 3rd trimester to 350 calories a day, and then 450 calories a day, re-spectively.
Boning up with calcium
Growing children are encouraged to drink milk for strong bones. This is even more important for the expectant mom. The stress of pregnancy on a woman’s bones places calcium at the top of the list of necessary nutrients to consume. Calcium is needed for bone and tooth formation of the fetus, blood clotting and blood-pressure regulation. Calcium needs increase as the pregnancy progresses, with 80% of the calcium needed during the 3rd trimester for fetal bone mineralization. If the mother’s diet is lacking in calcium, calcium will be mobilized from her bones to maintain serum calcium, often referred to as “bone thinning.”
A closer look at folic acid
Folate is a B-complex vitamin functioning in the synthesis of amino acids. Complications in pregnancy, such as spontaneous abor-tions, malformation of the fetus (including neural tube defects) and antepartum hemorrhage, have been linked to maternal folate defi-ciency.
Because of these concerns, the Institute of Medicine recommended in its 1998 report that “women capable of becoming pregnant consume 400 mcg of folic acid daily from supplements, fortified foods or both in addition to folate from a varied diet.” Approximately 50% of folate is absorbed from food, 85% absorbed from fortified foods and 100% absorption from a supplement.
Focus on iron
Iron is necessary throughout pregnancy, as it functions in red blood cell production, development of the placenta and fetus and main-taining maternal blood volume. The greatest demand for iron is during the 3rd trimester.
Iron-deficiency anemia can cause several complications in pregnancy, including: altered metabolism, decreased oxygen transfer to tissues, higher incidence of premature delivery and perinatal mortality. Dietary sources of iron are often not sufficient to meet the in-creasing needs. The Centers for Disease Control and Prevention, Atlanta, recommends starting low-dose (30 mg per day) iron supplements at the first prenatal visit to help combat anemia.
The new kid on the block
Research on omega-3 fatty acids is fairly new and has not conclusively shown the necessary intake for a mother during pregnancy. What we do know is, if a woman consumes a diet high in omega-3s, eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are incorporated into the fetus’ cell membranes. A correlation has also been found between DHA intake and birth weight: As the fetal and cord levels of DHA increase, so does the baby’s birth weight.
Even though research is still inconclusive, it’s an exciting emerging nutrient. Optimal intake levels have yet to be determined, but most experts are currently recommending a supplemented intake of 200 to 300 mg of DHA per day, which appears to be safe consump-tion. Good sources of DHA are found in marine oils and fish, specifically sardines, mackerel, trout, bluefish and salmon, and DHA-rich marine and algal supplements and supplemented foods are readily available.
While an expectant mom doesn’t have the calorie needs of “eating for two,” the food mom chooses directly impacts her baby’s health.
Christina Fitzgerald, M.S., R.D., L.D.N., specializes in pre- and postpartum, as well as pediatric, nutrition. She is the owner of the private nutrition practice, Nourished Nutrition and Wellness, based in Chicago, and can be reached at
christina@nourishedliving.com
.