Pregnancy is a joyous period in an expectant mother’s life as she undergoes many new experiences in body and mind. During this period, diet plays a crucial role in the wellbeing of the mother and the foetus. The first 1000 days between the onset of pregnancy and the child’s second birthday offer a unique opportunity for the baby’s lifelong psychosomatic health. Nutrition before the first 1000 days is important in driving rapid development in the child. Since the body’s need for macro and micronutrients rises during pregnancy, this must be met adequately.
Significance of Nutrition
Vitamins and minerals play well-established biochemical roles, particularly as co-factors for various enzymes or as structural substances in tissues such as bone and blood. Inadequate nutritional status before conception and during a woman’s first trimester remains a major cause of foetal stunting.
The significance of good nutrition in pregnancy cannot be overstated. Meals should be balanced and nutritious while providing ample macronutrients such as proteins, complex carbohydrates, fibre and healthy fats, along with micronutrients such as vitamins and minerals. Calorific requirements rise moderately during pregnancy (depending on the stage), which can be met by increasing energy intake in a balanced way between macronutrients as per nutritional guidelines. One recommendation for macronutrient composition is 10-15% protein, 30% fat and 50-60% carbohydrates.
Though needed in smaller quantities, micronutrients are extremely essential for the foetus’ normal physiological function, growth and development. Micronutrient deficiencies can impact a woman’s pregnancy and health, as well as the new-born’s health. WHO recommends multiple antenatal micronutrient supplements, going beyond iron and folic acid.
According to a WHO study, the amount of protein required during the first half of pregnancy is the same as that for non-pregnant women, 0.8–1.0 g/kg per day or 10–15% of the energy required, and that during the second half of the pregnancy is 1.1 g/kg per day, on the basis of the diet in developed economies. A pregnant Indian woman’s diet should be rich in all food groups that help her stay healthy while providing the baby with the right amount of nutrition.
At this juncture, a micronutrient that needs special mention is vitamin D since studies indicate it helps in maintaining healthy immunity. Given the ongoing pandemic, one cannot ignore the implications of COVID-19 on pregnancy. Research suggests pregnant women don’t appear more likely to contract the virus than the general populace. However, the body’s response to viral infections is usually altered during pregnancy, which can occasionally be related to more severe symptoms, including COVID-19.
Consequently, vitamin D intake is required as women deficient in the vitamin may have suboptimal immune function and have higher risk to infections. As the coronavirus pandemic exacerbates the risks of perinatal anxiety and depression, support for women is to be strengthened and they should be asked about their mental health during every visit.
Brain Function and Other Benefits
As 70% of the brain growth occurs during foetal life, proper nutrition before and during pregnancy is crucial for the foetal brain’s optimal development. Nearly two-thirds of the brain weight is due to phospholipids and long-chain fatty acids. Docosahexaenoic acid (DHA) and Arachidonic acid (AA) are key fatty acids for brain growth.
WHO suggests all reproductive-age women should take 400μg of folic acid each day, besides consuming food with folate from varied sources. This can prevent major defects in the baby’s brain (anencephaly) and the spine (spina bifida).
Vitamin B12 is a vital micronutrient for red blood cells formation, which helps supply oxygen throughout the body, as well as for the proper functioning and health of nerve tissue. Then there is folate – a B vitamin found naturally in many foods. Folic acid is a form of folate used typically in vitamin supplements as well as fortified foods. Folate deficiency is a risk factor for neural defect in fetus. Pregnant women with lower levels of folate are also more likely to experience depression.
Expectant mothers should eat wholesome diets containing the sufficient amount of vitamin D. WHO notes that deficiency in vitamin D remains common among pregnant females in certain regions. In turn, this is linked with a greater risk of gestational diabetes mellitus, pre-eclampsia, preterm birth defects and other conditions.
About 80% of Indians are vitamin D deficient, including pregnant women. Expecting mothers should be educated about the significance of vitamin D deficiency and risk factors such as poor bone development and rickets. Hence, vitamin D supplements are recommended for simplicity and cost-effectiveness.
Before concluding, one must mention that adequate consumption of Omega-3 fatty acids is critical during pregnancy as these are building blocks of the foetal brain and retina. It has been suggested that sufficient omega-3 status helps reducing the risk of pre-term birth. It is believed these fatty acids could reduce prenatal depression risk. It also helps limit ADHD symptoms among children if consumed during pregnancy.
All of the above makes it evident that nutritious diets should be mandatory for women, especially those in the family way.
The writer is APAC Regional Manager, Nutrition Science & Advocacy, DSM Nutritional Products. Views expressed are personal