Pregnancy (3/4)
Nutrition During Pregnancy
That's the training side taken care of. Now it's just about nailing the nutrition and lifestyle.
Nutrition plays a vital role in supporting and developing your client’s and her baby’s health during pregnancy and beyond. Research shows that nutrition and lifestyle both before and during pregnancy, as well as breastfeeding and early childhood, appear to have several health effects on children later in life, including an increased risk of developing non-communicable diseases such as obesity, diabetes and cardiovascular disease
These effects relate to what is known as ‘early metabolic programming of long-term health and disease’. And there is increasing evidence that early life health experiences may contribute to the intergenerational transmission of obesity and related health outcomes. So, how can you best support your client and her child during this time?
She doesn't need to eat for two
Managing your client’s calorie intake during pregnancy is key to avoiding excessive weight gain and its associated health risks. Evidence shows that calorie intake or macronutrient split do not need to change during pregnancy. But if your client comes to you significantly overweight and eating poorly, adjusting macronutrients, calories and food choices can positively affect her body composition and chances of a healthy pregnancy.
Furthermore, the traditional advice that pregnant mothers need to ‘eat for two’ is a myth.
According to international recommendations the suggested increase in calories during pregnancy are:
- ~ 85 kCal per day in the first trimester
- ~285 kCal per day in the second trimester
- ~475 kCal per day in the third trimester.
However, in the third trimester, your client is unlikely to feel as energised or maintain the same energy output compared to the earlier stages of pregnancy. As a result, her daily energy expenditure may decrease. Therefore, calorie intake should be adjusted accordingly to match activity levels.
Evidence suggests that calories do not need to increase above more than around 10% of pre-pregnancy needs. Having a rough idea of your client’s pre-pregnancy maintenance calories will therefore help you build a suitable meal plan during pregnancy.
Aim to maximise food quality
Nutrition during pregnancy should focus on food quality over quantity. Nutrient-dense plant foods such as green leafy vegetables, cabbage, legumes, whole grains, tomatoes and oranges are all high in folate, which, alongside supplementation, helps to significantly reduce the risk of serious birth defects, including congenital heart disease and cleft palate.
All women of child-bearing age are advised to consume at least 400 μg of folic acid per day as supplements or fortified foods and pregnant women should supplement during at least the first 16 weeks of pregnancy.
What she eats now will shape her child in decades to come
Early exposure to certain foods prenatally and in the first year of life is thought to impact children’s taste preferences in later life significantly.
While there are a complex variety of factors that influence dietary habits in children, taste preference appears to be an important component. Research indicates that bitter tastes, typically associated with dark green vegetables, are most likely to be programmed during early age.
Early introduction to these tastes may therefore increase children’s acceptance of fruit and vegetables, which improves the chances of them having a lower BMI during childhood and adolescence.
Encourage your client to maintain her intake of fruit and vegetables during pregnancy to manage her own and her baby’s health and development.
Supplement for optimal health for mum and baby
Vitamin D is a crucial micronutrient during pregnancy that helps healthy bone development in babies. Maternal vitamin D deficiency has been found to increase the risk of conditions such as rickets and osteopenia in new-borns, as well as low birth weight.
Clinicians recommend that women consume around 1,000-2,000 IU of vitamin D per day. However, because dietary vitamin D intake only accounts for around 80-60 IU (2-4 μg) per day, supplementation is advisable.
Omega-3 supplementation and regular oily fish consumption reduces the risk of pre-term birth before 34 weeks, decreases the risk of prenatal death and pre-eclampsia and results in fewer neonatal care admissions.
The recommended daily intake of omega-3 DHA is 300 mg, equivalent to eating two portions of fish per week, including at least one serving of oily fish like mackerel, salmon or sardines. If that’s not an option, clients should supplement with Omega-3 Concentrate.
*Always ensure your client consults with her doctor or midwife before taking any supplements*
Ditch the raw animal-based food products
Raw animal-based food products, such as raw or partially cooked meat, raw processed meats, raw fish and seafood, unpasteurised milk, raw eggs, and foods containing these products are best avoided during pregnancy.
It’s also important for your client to be mindful of eating foods such as pre-packaged and pre-prepared salads. Foods that are grown near the ground should be stored away from other foods and peeled and washed before consumption, as they may carry risk of infections, such as listeriosis and toxoplasmosis, which can increase the risk of foetal damage, premature birth, and stillbirth.