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Showing posts with label Vital Nutrients in Pregnancy. Show all posts
Showing posts with label Vital Nutrients in Pregnancy. Show all posts

Foods to Avoid During Pregnancy

by Dr Tan Thiam Chye
Obstetrician and Gynaecologist
KK Women’s and Children’s Hospital, Singapore
from the best-selling “
The New Art and Science of Pregnancy and Childbirth

Food safety is extremely important during pregnancy. This is because bacterial toxins and certain harmful chemicals such as alcohol and methylmercury can pass from mother to baby, and cause undesirable outcomes.

The list below lists the foods to be avoided :-

Unpasteurized milk; soft cheeses e.g. Brie, feta, Camembert and
Roquefort; liver pates; and uncooked hot dogs, ham and luncheon meats.

These foods are prone to Listeria monocytogenes, a bacteria that causes listeriosis, which may result in miscarriages and stillbirth.

Raw or undercooked meat; poultry; seafood e.g. raw oyster, cockles, sashimi and sushi; and eggs.
Raw and undercooked animal foods contain a variety of food-borne bacteria and viruses. Changes in your metabolism and circulation during pregnancy may increase the risk of bacterial food poisoning, and your reaction may be more severe than if you weren’t pregnant. Avoid raw or half-boiled eggs.
Avoid swordfish, shark, tilefish and king mackerel. Limit canned albacore tuna.

Herbal supplements- Herbal products have not been studied enough to be recommended during pregnancy. Black cohosh, blue cohosh, Chinese angelica (Dong Quai) and ginseng are among the herbs which have the potential to harm a developing foetus when used in a concentrated formulation.
Alcohol- Mothers who drink alcohol have a higher risk of miscarriages and stillbirth, and excessive alcohol consumption may result in fetal alcohol syndrome, including facial deformities, low birth weight and mental retardation. Limit to 2 glasses of wine a week.
Unwashed salad and raw vegetables sprouts, including alfalfa, clover, radish, and mung bean.
Unwashed salads may be contaminated with bacteria from the soil, while raw vegetables sprouts contain high levels of germs, which can be harmful to health.



Extracted from best-selling “The New Art and Science of Pregnancy and Childbirth” published in January 2008.
More information on "The New Art and Science of Pregnancy and Childbirth", visit http://www.worldscibooks.com/medsci/6674.html


Nutrition During Pregnancy - Eating Right for Two

by Dr Tan Thiam Chye
Obstetrician and Gynaecologist
KK Women’s and Children’s Hospital, Singapore

Eating healthy before conception and throughout pregnancy is one of the best things you can do for yourself and your baby. Good nutrition optimizes the growth and development of your baby and at the same time safeguards your own health.

During pregnancy, your energy requirement increases by about 300 kcal a day, which is not much compared to the average non-pregnant Singapore woman’s requirement of 1700 kcal a day. On the other hand, requirements for other nutrients (e.g. protein, folate, calcium, vitamin D and B vitamins) may be significantly higher than in the non-pregnancy stage. As such, you should make smart choices by choosing a variety of nutrient-dense foods, rather than just eating more food! This is especially so if you now experienced a smaller appetite.


Essential nutrients for pregnancy
More than 40 different types of nutrients are needed to sustain good health and promote your unborn child’s growth and development. Yet, certain nutrients are especially important to ensure optimal pregnancy outcomes.


Folate (also known as folic acid)
Folate is vitamin B, which is essential for cell division and organ formation. This nutrient helps prevent neural tube defects (malformations of the brain and spinal cord) in your developing baby and anaemia in pregnant woman. Due to the severe nature of neural tube defects, we strongly advise adequate folate intake of at least 800 microgram daily before conception and throughout the first 3 months of pregnancy.

Dark green vegetables, for examples, spinach, broccoli and asparagus; citrus fruits and juices, yeast extract, liver, dried beans and fortified breakfast cereals foods are rich in folate. Care should be taken however to avoid overcooking the vegetables as folate is easily destroyed by heat.


Iron
Iron is needed for the formation of red blood cells, and inadequate iron intake may lead to anaemia. This is because, during pregnancy, your blood volume expands to accommodate the changes in your body. Moreover, your unborn baby also needs to store adequate iron for the first 6 months of life before he starts solid foods.

There are 2 forms of iron in foods, heme and non-heme. Heme iron is better absorbed by the body than non-heme iron. Sources of heme iron include red meat, liver, chicken and fish. Sources of non-heme iron include egg yolk, green leafy vegetables, iron-fortified breakfast cereals, dried fruits and nuts.

To enhance the absorption of non-heme iron, consume vitamin C-rich foods (namely, fruits and vegetables) at the same meal or take vitamin C supplement.


Vitamin B12
This vitamin is required for blood formation. It is only found in foods of animal origin, namely, meat, poultry, fish, milk and eggs. Vegans (vegetarians who do not any animal products including eggs and milk) must take vitamin B12 supplement in order to meet the daily requirements.


Omega-3 Fatty Acids
DHA (Docosahexaenoic acid), one of the omega-3 fatty acids, found in coldwater deep-sea fish, is important for brain and eye development. Studies have shown that pregnant women who eat coldwater fish have babies with higher IQ and better vision than pregnant women who don’t.

Unfortunately, large deep-sea fishes may contain methylmercury, a heavy metal that is toxic to the developing foetus’s neurological system. Hence, the US Food and Drug Administration recommends that pregnant women eat a maximum of 12 ounces (3 servings) of a variety of cooked fish or shellfish per week, and avoid shark, swordfish, king mackerel (known as ‘batang fish’ locally) and tilefish (also called white snapper). Although tuna is a good source of DHA, albacore tuna (found mainly as canned white tuna) is higher in methylmercury than other types of tuna (e.g. Skipjack, Bigeye and Yellowfin, commonly used for canned light tuna), hence pregnant women are also advised to limit albacore tuna to 1 serving a week. Safe DHA-rich sources include salmon, sardines, herring, halibut, canned light tuna and omega-3 fortified eggs. Alternatively, you can ask your doctor to recommend a suitable DHA supplement. For example, NeuroGain PB or NeuroGain S which provides a balanced intake of omega 3 Docosahexaenoic Acid (DHA), omega 6 Arachidonic Acid (AA) and omega 9 Oleic Acid (OA) fatty acids.


Vitamin A
The function of vitamin A is to promote growth of cells and tissues, and prevent night blindness. However, excessive intake of vitamin A above 10,000 IU daily in the first trimester can cause birth defects. Hence, in the first trimester, pregnant women should obtain their vitamin A from food rather than from supplements, and limit liver intake to 2 tablespoons (50g) per week. Good sources include eggs, milk, deep-red and yellow fruits and vegetables (for example, papaya, mango, pumpkin, carrots) and dark-green leafy vegetables (for example, spinach and broccoli).


Calcium
Both you and your baby need calcium for strong bones and teeth. Excellent sources of calcium are milk, cheese and yoghurt. Other foods that contain calcium are beancurd (‘tauhu’ and ‘tawkwa’), green leafy vegetables, ladies fingers, small fish with edible bones such as ‘ikan bilis’ and sardines, and calcium-fortified soymilk and fruit juice.

If you have lactose intolerance (i.e. bloatedness, wind, diarrhoea after drinking milk), you can consume low-lactose or lactose-free milk, calcium-fortified soymilk, cheese or yoghurt as alternatives to milk. Your doctor can also prescribe a calcium supplement.


Table 1: Recommended daily dietary intake of calcium

Groups ---Recommended daily intake (mg / day)
Pregnant women ---1000 mg/day
Breastfeeding mothers---1000 mg/day

Source : National Academy of Science 2000



Vitamin C
Vitamin C is required for collagen formation in bones, muscles and blood vessels. The Singapore RDA for vitamin C intake in pregnancy is 50 mg a day, whilst the US recommendation is 85 mg a day. It is recommended that pregnant women obtain their vitamin C from food rather than from supplements, as there have been reports of rare cases of ‘rebound scurvy’ occurring in infants born to mothers taking 400 mg or more of vitamin C throughout their pregnancy. “Rebound scurvy’ occurs when the infant becomes tolerant to the high dose of vitamin C from the mother during pregnancy, hence it develops symptoms of scurvy or vitamin C deficiency after birth.

Both our Healthy Diet Pyramid for Pregnancy and the Health Promotion Board’s Healthy Diet Pyramid for Adults recommend 2 servings each of fruits and vegetables, which can meet the requirement for pregnancy.



Table 2 : Vitamin C content per serving of some local fruits and vegetables

Fruit/Vegetable --Vitamin C (mg)
Papaya, 1 wedge-- 93mg
Orange, 1 small-- 88mg
Watermelon, 1 slice-- 11mg
Banana, 1 medium --8mg
Yellow Pear, 1 small-- 6mg
Apple, 1 small --6mg
Broccoli, cooked, ¾ mug-- 65mg
Cauliflower, cooked, ¾ mug --44mg
Cabbage, cooked, ¾ mug --20mg
Lady’s finger, cooked, 100g -- 16mg
Spinach, cooked, ¾ mug --10mg


Vitamin D
Vitamin D helps with calcium absorption. Food sources include fortified milk, margarine and cold water deep-sea fishes e.g. salmon and sardine. Apart from foods, our bodies can also synthesize vitamin D when exposed to sunlight. Spending 10 to 15 minutes twice a week outdoors is sufficient for our bodies to synthesize enough vitamin D to meet our requirements.

Extracted from best-selling “The New Art and Science of Pregnancy and Childbirth” published in January 2008.

Vital Nutrients needed in Pregnancy

To ensure that your baby develops in a healthy environment, you should keep your body as fit and well nourished as you possibly can. Eating a good variety of the right foods that are rich in the enssential nutrients is important.
If you are deficient in any part of your diet, this may affect not only your health but also how well you can support the pregnancy and nourish your baby. You also need to be aware of the risks posed by nicotine, alcohol and drugs as they can have a detrimental effect on the growth and well – being of the baby.

Vital nutrients needed in pregnancy
Protein – your protein requirements increase by about 50% when you are pregnant. Protein can be gained from eggs, milk, fish, lean meat or cheese which contains the essential amino acids.

Calories – you will need about 500 more calories per day during pregnancy than the usual requirement of 2000 – 2500, especially when you are having a baby within a short time of a previous one, underweight or under stress. However, you should not be counting the calories deliberately, as you will get sufficient calories if you eat a varied diet.

Fibre & Fluids –There is a tendency to develop constipation as your pregnancy progresses. Overcome by eating plenty of raw fruits and vegetables, wholegrains, beans and fibrous foods everyday. Water is the best drink, it helps to keep your kidneys working well and avoid constipation.

Vitamins – The value of a varied and balanced diet of wholesome food is that you will take in high enough levels of vitamins without resorting to vitamin supplements. However, there are other women who doctors consider may benefit from supplements.

Minerals – If you eat a good diet, you are not likely to be deficient in minerals. Having said that, calcium and iron intakes need to be maintained and some doctors/ clinics routinely prescribe dietary supplements of iron and folic acid. Women who are nutritionally vulnerable, however, will certainly benefit from appropriate supplementation.

Calcium – Sufficient quantity of about twice your pre-pregnant intake is important from the time of conception because baby’s form teeth and bones from weeks 4-6. The calcium requirement will increase with your baby growth. Sources of calcium include dairy foods, leafy vegetables beans,lentils and nuts. Calcium cannot be absorbed efficiently without Vitamin D. Vitamin D is not found in great quantities in many foods and the best source is sunlight. Our body can make its own Vitamin D with the help of the sun! Calcium supplements will be useful if you are allergic to cow’s milk.

Iron – The large increase in blood volume means that extra iron is needed to make haemoglobin for the increased number of red blood cells. The more haemoglobin the blood contains, the more oxygen it can carry to the various tissues, including the placenta. Your iron reserves will also be needed by the baby to have in reserve for after the birth, because breast milk contains only traces of iron. Iron is quite difficult for the body to absorb. If women are iron-deficient when they become pregnant or develop a deficiency later on, iron tablet may be prescribed to prevent anaemia developing. If you suffer from indigestion and take medication, be careful about your iron intake; antacid medicines limit iron absorption. Be aware, that food cooked in iron pots absorbs iron, increasing the food’s iron content by some three to 30 times.

Folic Acids – is essential for the supply of nucleic acids needed by the dividing cells of the embryo. Our body cannot store folic acids and in pregnancy excretes 4 – 5 times the normal amount. Green leafy vegetables and nuts contain folic acids, however folic acid supplements should ideally be take for 3 months before you become pregnant and throughout pregnancy.

Salt – Maintain a sensible salt intake! Any excess salt in your blood is diluted during pregnany by the increase in body fluids.