Nutrition needs during Pregnancy
Eating a balanced diet is always vital, but it's crucial during pregnancy because your food is the major source of nutrients for the developing foetus. However, a lot of women don't consume adequate and appropriate nutrition. Indians are largely protein deficient, and a large part of the nutritional intake comprises of grains. Grains are all-rounders and comprise of carbohydrates, and some vitamins. However, minerals like calcium, iron, folate, Vitamin B12 or vitamin D and complete protein consisting of all essential amino acids which is necessary for the healthy growth of the foetus are not sufficiently available in grains. Excessive consumption of grains increases the risk of lifestyle diseases during pregnancy.
Reports suggest one in every five Indian women suffer from PCOS and 77 million is the diabetic population of the country, second highest in the world. PCOS women are more likely to suffer from gestational diabetes, increased chances of miscarriages at an advanced stage of pregnancy etc. These can be reduced with better nutrition and guidance. Therefore, it's critical that you consume adequate nutrition that is compatible with your genes and body type, to have healthy baby. Nutrition status of the pregnant mother plays a significant role in the long-term health of the child which includes a higher predisposition to lifestyle diseases. Studies like Dutch-winter baby syndrome proves that starvation and deficiencies hamper infant’s metabolism, results in low birth weight babies, along with higher risks of diabetes, hypertension and heart disease in adult-hood. Enjoy your pregnancy with good health and bring a healthy and strong baby into the world with long term good health.
Most women can satisfy their increased nutritional requirements by eating a balanced diet rich in fruits, vegetables, whole grains, and proteins. National Institute of Nutrition (NIN) suggests additional 350 and 450kcal in 2nd and 3rd trimester respectively. Limit grains and use more of vegetables and fruits as source of Carbohydrates. Milk, fish, meat, poultry and eggs have good quality proteins. However, a proper combination of cereals, pulses and nuts can also provide complete and adequate proteins. Mineral and vitamin requirements can be met by consuming a variety of seasonal vegetables particularly green leafy vegetables, milk and fresh fruits. Bioavailability of iron can be improved by using fermented and sprouted grams dals and foods rich in vitamin C such as citrus fruits. Milk is the best source of biologically available calcium. Though it is possible to meet the requirements for most of the nutrients through a balanced diet, pregnant/lactating women are advised to take daily supplements of iron, folic acid, vitamin B and calcium.
The first trimester begins on the first day of your last period and lasts until the end of week 12. This means that by the time you know for sure you're pregnant, you might already be five or six weeks pregnant!
During these first three months, a lot occurs. Your baby grows more quickly during this trimester than at any other. Usually, a heartbeat can be detected by week six, and by week twelve, all the bones, muscles, and organs have developed. Your baby is now known as a foetus and resembles small human being. Expected weight gain during the first trimester is 0.5 to 1.8kgs.
Insulin Resistance and Gestational Diabetes (GDM): Normally in pregnancy, there is a progressive increase of insulin resistance, compensated by an increase of insulin secretion by the pancreas. Pregnant women with lower adiponectin levels at 1st trimester have higher levels of insulin resistance and are more likely to develop gestational diabetes (GDM). Adiponectin is a hormone which helps increase the insulin sensitivity. Low adiponectin levels already present at 1st trimester are likely a reflection of pre-existing insulin resistance, which predisposes those women to develop GDM later in pregnancy if they have an insufficient pancreas capacity to respond to the increased demand related to pregnancy.
As a result, it is crucial for women to address any inadequacies in their bodies and consume wholesome meals each day in order to ensure good health for themselves as well as the unborn child.
The mother and foetus undergo a change throughout the second trimester. Typically, women start feeling better and displaying the pregnancy more. Your foetus has completed the development of all its organs and systems and is about to start expanding in size. It is important to take precautions to stay away from alcohol, tobacco, and other known dangers because harmful chemicals can also transfer down the umbilical cord to the foetus. Since there is significant development, there is also an increase in hunger, so it is crucial to eat nutrient dense foods that are high in protein and energy along with vitamins, minerals, good fats. It's important to eat right portion size of nutrient-dense meals. Maintaining healthy iron levels in the body is crucial. As the size of the abdomen grows, pressure is placed on the diaphragm, causing reflux, which increases the likelihood of experiencing heartburn and indigestion. Appropriate meal plan that supports your health challenges, taste preferences and the environment context ensure that you are able to optimise on nutrition.
Foetal macrosomia: Undiagnosed and mistreated, foetal macrosomia is a common unfavourable neonatal result of GDM. In addition to raising the risk of injuries to the stretched nerve, clavicle fractures, and shoulder dystocia (sticking of shoulders) for the baby, macrosomia also raises the number of admissions to the new born intensive care unit. The dangers of macrosomia for the mother include vaginal laceration, postpartum haemorrhage, and caesarean birth. Infants of GDM-affected mothers are more likely suffer with obesity and to go on to acquire type II diabetes as adults.
Weight gain: Pregnant women who do not gain the correct weight run the risk of having babies with less birth weight because of which they may have trouble breastfeeding which may increase the susceptibility to illness, and may show developmental problems. Overeating when pregnant is linked to having high birth weight babies which can cause problems during birth, necessitate a caesarean section, and result in juvenile obesity. You are expected to gain 10 to 12 kg overall during your pregnancy.
Eating for two, starts to seem more feasible during the third trimester. Feelings of lethargy and exhaustion—symptoms you may have believed you were done with after the end of your first trimester—come sneaking back as your belly has expanded significantly over the past few months. This is why it's so important to check that you're eating enough to maintain a healthy level of energy. Your sensation of exhaustion will only worsen if you don't eat enough (or the wrong kinds of food). You just need to eat a little bit more of the vitamins and minerals that have been crucial for optimum pregnant health up to this point. Additional calories of around 300-400 per day is required at this stage. Therefore, you must maintain consuming adequate amounts of vitamin C, vitamin K, vitamin B1 (thiamine), and fibre. A dose 600mcg of folic acid in your third trimester is important. It is crucial to have a personalised plan that takes into account your present weight and health status. You will be providing your body and your developing baby with all the nutrients they need as long as you maintain a well-balanced diet with a modest increase in calories. In doing so, you’ll also be giving yourself the best chance of giving birth to a healthy, happy baby. Not to mention that you'll be making it easier on your body throughout the postpartum time by keeping your weight gain under control.
Preeclampsia: It is denoted by high blood pressure and presence of protein in the urine. A fibre rich diet and adequate vitamins and minerals plays a major role in ensuring maintenance of blood pressure and reduced inflammation in the body.
Preterm labour and birth: Under nutrition and nutrient deficiency in mothers can cause various complications in the pregnancy like low-birth-weight babies and preterm birth. Hence, adequacy in the macro and micro nutrients from conception till birth ensures a secured health of mother and the baby. There are various studies which prove that mothers who consume consistently a diet rich in proteins and adequate fruits and vegetables are less likely to have a preterm baby.
Appropriate nutrition as per the body type, current health status and phase of pregnancy
Make meal plans as per NIN guidelines and health care provider’s recommendation.
Provide options of food that supports the budget, availability and taste preferences.
Recommend healthier options of to satisfy cravings and guidance to enjoy pleasure food appropriately to support healthy and complication free pregnancy
Provide real time support to monitor, motivate and to ensure ease of execution of the meal plan.