BALANCED DIET FOR PREGNANT MOTHERS. What to eat and What not to eat.

Pregnancy and location are two most important phases in a woman’s life where there are tremendous physiological and several other changes in the body. All these changes increases the demand on nutrients for which, during this time, proper well balanced diet is suggested for the women.

Pregnancy is a remarkable anabolic phase where a baby having body weight of 2.5 -3.5 Kg of various substance from the mother’s body – like nutrients, blood tissues, etc. after 9 months.

Physiological changes during pregnancy: - There are several physiological changes that takes place during this time. These include:

1.   CHANGES IN UTERUS :

a)    Excessive cell division occurs in the uterus

b)    Muscles tone increases

c)     Placenta is formed

2.   CHANGES IN THE ENDICRINE SYSTEM :

Endocrine or hormonal changes are the most marked during pregnancy. The hormones that are found to be active during this time are – placental hormones like HCG (Human gonadotropin hormone), HPL (Human placental lactogen) etc. oestrogen and progesterone, some pituitary hormones.

Aldosterone (glucocorticoid) secretion is increased and production of T₃ (triiodothyronine) and T₄ (thyroxin) re increased. Calcium metabolism regulating hormones are also increased.

3.   CHANGES IN METABOLISM :

a)    There is a change in carbohydrate metabolism and sometimes even gestational diabetes may be seen due to faulty glucose metabolism.

b)    Cholesterol and phospholipid increase in the plasma.

c)     There is reduction in plasma amino acid concentration.

d)    There is reduction in plasma amino acid concentration.

4.   CHANGES IN GASTROINTESTINAL SYSTEM :

a)    There is usually increased appetite

b)    Nausea and vomiting are common, which is called morning sickness.

c)     There is change in liver functions

d)    Difficulty of digestion and absorption is common resulting in heart burn.

5.   CHANGES IN CARDIOVASCULAR SYSTEM :

There is an increase in the plasma volume resulting in a fall in the RBC concentration due to this a physiological anemia develops during pregnancy.

a)    The total WBC count rises.

b)    Cardiac output rises and there is an increased blood flow to skin, breasts, gastrointestinal track, kidney as well as the uterus.

6.   CHANGES IN RESPIRATORY SYSTEM:

a)    O₂ consumption increases by 15%

b)    The shape of the chest is slightly changed.

7.   CHANGES IN KIDNEY FUNCTION :

a)    Kidney are enlarged generally

b)    Glomerular filtration rate increases by about 50%

c)     Glycosuria and proteinuria are common.

To support these changes, an additional requirement of nutrient is necessary during this time. A well balanced diet can help in –

·       Rapid growth of foetus

·       Development of placenta

·       Enlargement of maternal tissues like breast, uterus, etc.

·       Increase in the maternal circulating blood volume

·       Formation of amniotic fluid

·       Storage reserves

·       Mineralization of skeletal and bone structure of the foetus as well as tooth buds

COMPLICATION: - There are many complications during pregnancy. Those are –

1.    Morning sickness: Nausea and vomiting occurs due to the pressure of enlarging uterus on the stomach. Small, frequent meals are better tolerated. Moreover, fried and spicy foods should be avoided. Food should be eaten about 2-3 hrs. before bed time.

2.    Heart burnt: This also due to hormonal changes and the pressure of the enlarging uterus on the stomach. The diet should be similar to that of morning sickness.

3.    Oedema: Water retention due to anemia and hormonal changes lead to oedema i.e., swelling of limbs. Sometimes sodium restriction is necessary.

4.    Obesity: There are may be a sudden increase in the body weight, leading to obesity. Fried and fatty foods should be avoided, times should be maintained. Optimum weight gain = 10 to 12 Kg

5.    Pregnancy induced hypertension (PIH): This includes tauxemia and eclampsia which is seen after 20^th week of pregnancy, here the diastolic pressure is greater than 90 mmHg. Symptoms include hypertension, oedema, albuminuria etc. so high BV protein and salt restriction is necessary. Another reason for tauxemia is malnutrition.

6.  Pica: Eating of non-food items like clay, chalk, gum is referred to s pica. This can be remedied by proper nutrition counselling.

7 Muscular cramps: As the ratio and balance between calcium and phosphorus is not maintained, sudden muscular contraction occur in the hand and feet causing cramping.

8. Constipation: This is due to the enlarging pressure on the uterus on the lower portion of the uterus in addition to hormonal muscle reluctant ascent. If a pregnant woman suffers from constipation, high fiber diet with lots of fluid is suggested.

9.   Anemia: Pregnant woman is termed anemia if the hemoglobin level is less than the 10gms per 100ml blood. During pregnancy hemoglobin level does not increases at a similar rate to that of plasma volume. So the hemoglobin level falls and iron deficiency, anemia and megaloblastic anemia occurs during this time. Iron rich food, foods containing folic acid and vitamin B₁₂, and protein rich food should be included in the diet.

Effect of Nutritional deficiency on the mother:

 

Energy and Protein	·       Miscarriage ·       Complications during labour ·       Pregnancy induced hypertension
Calcium	·       Muscular contraction ·       Less calcium in breast milk ·       Osteomalacia
Iron	·       Hypochromic microcytic anemia ·       Complications during labour
Iodine	·       Goiter , Myxedema ·       Miscarriage ·       Increased chances of still birth
Vitamin D	·    Decrease in rate of calcium absorption
Vitamin k	·       Decrease in prothrombin synthesis ·       Excessive blood loss during labour
Folic acid	·       Megaloblastic anemia ·       Deformed placenta
Vitamin B12	·       Pernicious anemia
Vitamin C	·       Rupture in foetal membrane before time during pregnancy

 

Diet in pregnancy requirement:

Energy – 2500 kcal

Protein – 59 g

Fat – 55g

Meal Plan:-

Early morning – Tea with milk – 1 cup, Biscuit – 2

Breakfast – Milk – 1 cup (100 ml), cornflakes – 50 g

Or

                     Sandwich, boiled egg

Or

                      Roti – 2, mixed vegetables – 1 bowl (200 g)

Mid-morning: Fruit juice – 1 glass (250ml)

Lunch: Rice – 50g, Mixed veg dal – 1 bowl (50g) [lentils – 50g,

              Beans - 25g, Carrot – 25g], Fish – 50 g, 

              Curd – 75g(homemade)

Dinner: Roti made from Atta – 3, palak-paneer / paneer curry-75g

               Chicken – 2pcs (75g), Sweet – 1

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