A HEALTHY START | Enlighten

 A Healthy Start; The Importance of Nutrition Before, During, and After Pregnancy

Since the beginning of mankind one thing, one miracle has always been the center of our attention…. the birth of new life.

This one occurrence is a leading factor in helping our existence flourish.

Although no scientific evidence has been deemed to show this true, yet.

Two common assumptions have been stamped into our minds associated with pregnancies.

1. whatever the baby(fetus) needs will be pulled from maternal stores despite the eating habits of the mother (the parasite theory).

2. whatever the fetus needs the mother will instinctively crave (the maternal theory).

Given today’s status of women, most of us are extremely malnourished (lacking sufficient nutrients within the body). 

How can this be true!?!

Just because you are able to overconsume foods doesn’t mean your body is getting all the right nutrients it needs.  Nowadays this is for a number of reasons.

1. our soil quality is not what it used to be, the over-growing and over-chemically fertilizing has left a lot of our foods with half the vitamins and minerals it used to have.

2. the use of chemical pesticides has dramatically changed how our body utilizes the nutrients it takes in.

3. we’re able to overconsume food that is not nutritionally dense (i.e sugary foods, processed foods, fast foods, etc.).

 When it comes to pregnant women over the past decade information on pregnancy has been based more on culture-driven traditions rather than scientific information.

New advances show the positive advantages of adequate nutrition during pregnancy each year.

Things we do know…

It has been documented that mortality is decreased in infants with birth weights of 7lbs 11oz – 9lbs 14oz.

Things that have been known to affect the infant's birth weight

1. The mother’s preconception of weight and nutritional status

2. Weight gain and nutritional status during pregnancy

Maternal weight gain is affected by these elements;

1. nutrition

2. lifestyle factors

3. environmental factors

4. genetics

 Many of these factors can be controlled by the pregnant woman.

Fetal Damage has mostly been centered around malnutrition of the fetus while in utero. This can be because of the mother’s preconception nutritional status, undernourishment during pregnancy, lifestyle behaviors, environmental factors, or genetics.

(A common misconception is that being overweight means you are not malnourished however if the majority of your excess calories come from non-nutritious foods, you are still as at risk as someone who is underweight or for that matter at a “normal” weight!!!!)

Scientific Studies have concluded 

1. The fetal origins hypothesis supports the notion that nutrition during gestation or lack thereof sets the stage for chronic disease in adulthood.

2. The development of cardiovascular disease, hypertension, obesity, type 2 diabetes, metabolic syndrome, and gestational diabetes,  among other diseases has been shown in the offspring of animals for which maternal dietary intake of macro and micronutrients have been manipulated as well as in human epidemiologic studies of the relationship between infant anthropometric measurements and adult disease incidence. 

3. The infant's body size, shape, and weight measurement indicated maternal nutrition.

4. Nutritional insults that occur during critical stages of embryonic and fetal development are most harmful, leading to future disease risk.

5. Evidence has shown and continues to show that maternal nutrition is critically important for both mother and newborn

6. Nutrition is a huge piece in the fundamental foundation for the successful outcome of pregnancy  (a healthy mother and infant).

Several vital factors determine the nutritional requirements of the woman during her pregnancy.

Factors increasing nutrient needs

1. age plays a huge role in the healthy growth of a fetus; in teenage girls, her growth and maturation are compromised by the growing needs of a fetus

2. the number of pregnancies and the number of viable offspring

3. the time interval between pregnancies greatly influences a woman’s nutrient reserves, her increased nutrient needs, and the outcome of pregnancy.

Three distinct  biological entities are involved in gestation

1. the woman

2. the fetus

3. the placenta

Weight gain during pregnancy

1. normal BMI 20-25 (1lb per week starting in the 2nd and 3rd trimester)

2. underweight BMI <19.8  (1.5lb per week in the 2nd and 3rd trimester)

3. Overweight BMI 26-29 (.66lbs per week in the 2nd and 3rd trimester)

Total Weight Gain

1. Low BMI <19.8 a total of 28-40lbs

2. Normal BMI 19.8-26.0  a total of 25-35lbs

3. High BMI 26-29 a total of 15-25lbs

4. Twins 35-45lbs 

 Gains of less than 1lb per month for obese and less than 2lb per month for normal weight require further evaluation.

Gains greater than 6.5 lbs per month may also benefit evaluation, especially after 20 weeks.

This should not be viewed as a reason to decrease food intake.

1. check measurement or recording errors

2. differences in clothing or time of day

3. accumulation of fluids

 Provide counseling to moderate food intake and physical activity.

But who knows how a person’s nutrient stores add up?

While there are tests to manually check your nutrient “balances” no one wants to feel like a lab mouse all the time. so the best thing we can do is “be conscientiously aware of the food we eat, learning to fuel our body as good as we can”. 

Knowing that what goes in comes out in benefits we can’t deny it.

Dietary Intake and Nutrient Supplements

1. Consider food as the optimal source for providing quality nutrients

Special attention to these during pregnancy

1. protein

2. folate

3. iron

4. zinc

5. calcium

6. others that may exert toxic effects if taken in large doses 

 Data suggests that on average dietary intake by pregnant women is less than the Recommended Daily Amount for these 8 key nutrients

1. Vitamin B6

2. Vitamin D

3. Vitamin E

4. Folate

5. Iron

6. Zinc

7. Calcium

8. Magnesium

Remember that your nutritional status is important for all women of childbearing age. This helps to get pregnant, stay pregnant, and have healthy outcomes for mother and baby, LONG TERM!!

References

     Edelstein, S., Sharlin, J., (2009) Life Cycle Nutrition An Evidence-Based Approach, Chapter 2, Prenatal to the adolescent,

    Institute of Medicine (1990) Nutrition During Pregnancy, Weight Gain and Supplements, National Academy Press. Washington, D.C

    Shils, M., Young, V. (1988) Modern Nutrition in Health and Disease, 7th Edition, Lea and Febiger, Philadelphia

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