Nutritional Needs During Pregnancy

During pregnancy, the patient and growing fetus have specific nutritional needs to support sufficient weight gain and development.

These include increased calories; a variety of macronutrients such as carbohydrates, fats, and protein; as well as vitamins and minerals, like folic acid, iron, and calcium.

Extra calories are needed during pregnancy to provide the energy to fuel the increased maternal basal metabolic rate; to support the production and maintenance of maternal and fetal tissues, amniotic fluid, and placenta; as well as develop fat stores used for energy during delivery and breastfeeding.

By the second trimester, caloric intake should increase by about 340 calories per day, and by about 450 calories per day in the third trimester.

Weight gain during pregnancy is gradual, and patients who are not under- or overweight should gain about 1 pound per week and up to 35 pounds by term delivery.

Additional calories should come from nutrient-dense foods, like low fat dairy products, lean meats, legumes, whole grain breads and cereals, and fruits and vegetables; instead of fast food and sweets that have a lower nutritional value.

Now let’s move on to some of the specific macronutrients including carbohydrates, fats, and proteins which are needed in large amounts.

Carbohydrates are the primary source of calories used for energy. Good sources of carbohydrates are complex carbohydrates such as starchy vegetables and whole grains.

In addition to providing calories, complex carbohydrates contain additional nutrients like vitamins, minerals, and fiber.

Fiber is the non-digestible part of carbohydrates that provides bulk to stool to help prevent constipation, which commonly occurs during pregnancy due to hormonal changes that slow the motility of the intestines.

Next, fats provide fat-soluble vitamins along with calories; and they supply fatty acids that help with fetal neurological and visual development.

Sources of healthy fats include nuts, seeds, meat, fish, and dairy products. Proteins are needed for essential processes like building and repairing tissue, making enzymes used in metabolic processes, and making plasma proteins, like albumin, that help maintain fluid balance.

Sources of protein include eggs, legumes, grains, tofu, cheese, nuts, meats, and fish. Now, certain fish, like swordfish, shark, and king mackerel, contain high levels of mercury which can be harmful to the developing fetus, so these should be avoided during pregnancy and lactation.

Also, plant-based protein sources are not considered complete proteins, meaning they don’t contain all nine essential amino acids unless they’re combined with other plant-based proteins.

So, for example, lentils combined with rice, or beans combined with corn will make a complete protein. Next, folic acid, or folate, is a B vitamin that decreases the incidence of neural tube defects, such as spina bifida, and supports blood cell formation in the bone marrow.

Pregnant patients require 400 micrograms per day for the first four months of pregnancy, and then 600 to 800 micrograms per day until delivery.

Dietary sources of folate are found in foods like dark green leafy vegetables, nuts, and whole grain breads and cereals.

Dietary folate should also be supplemented with prenatal vitamins as prescribed by the health care provider. Okay, iron is an essential component of hemoglobin, which binds oxygen for transport to the body’s tissues.

As red blood cell production increases during pregnancy, increased iron intake is needed to maintain hemoglobin production.

At the same time, the fetus builds up iron stores which are used by the infant during the first 6 months of life. The recommended intake of iron during pregnancy is 30 milligrams per day and can be found in foods like red meats and organ meats, as well as whole grains and cereals and dark green leafy vegetables.

In addition, iron supplements are often prescribed to ensure adequate intake. To ensure absorption, iron supplements shouldn’t be taken with calcium-containing foods, like milk, which can inhibit iron absorption.

On the other hand, vitamin C-containing foods, like orange juice, can aid in iron absorption. Then there’s calcium, which is a mineral essential for fetal bone growth.

Maternal calcium absorption increases significantly during pregnancy, requiring 1000 milligrams per day. Pregnant patients under 25 years of age will often need additional calcium in the form of supplements, since their bones are still developing.

Calcium is largely found in dairy products. Non-dairy sources include enriched cereals, dried nuts, dried fruits, and canned salmon that contain bones.

Patients who are prescribed calcium supplements should also take a vitamin D supplement to aid absorption. Alright, as a quick recap… During pregnancy, the patient and growing fetus have specific nutritional needs to support sufficient weight gain and development.

These include increased calories; a variety of macronutrients such as carbohydrates, fats, and protein; as well as vitamins and minerals, like folic acid, iron,