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Nourishment and supplementation during pregnancy impact of nutrition on the health of the offspring
Table of Contents
1. Nutritional supplementation during pregnancy
The requirement for iron significantly increases during pregnancy. For women of childbearing age, the daily need for this nutrient is 18 mg, while during pregnancy it can reach up to 27 mg per day. The most common cause of anemia during pregnancy is a deficiency of this element. Anemia can be diagnosed if the hemoglobin level falls below 11 mg/dl. However, the Polish Society of Obstetricians and Gynecologists (PTGiP) warns against routine iron supplementation in pregnant women. Iron is involved in the formation of free radicals, which may increase the risk of developing diabetes mellitus. Therefore, this nutrient should be supplemented by women whose tests have revealed a reduced hemoglobin level (Hb). However, the results of morphology should be interpreted appropriately, as not every decrease in Hb in the blood is due to a deficiency of this element. If it is accompanied by an increased MCV (mean corpuscular volume), the problem is usually a deficiency of folic acid or vitamin B12.2. DHA acid
Lipids constitute 60% of the dry mass of the central nervous system, with DHA being a particularly important component of cell membranes, influencing the flexibility of neurons and being essential for proper brain development in children. A deficiency of DHA in the diet may be linked to an increased risk of preterm birth, which is why the Polish Society of Gynecology and Obstetrics recommends supplementation of DHA for all pregnant women in an amount of 200 mg/day. Women who do not consume fish at least once a week should consider increasing their dosage to around 500 mg, while women at risk of preterm birth should take a double dose (1000 mg).3. Supplementation of Vitamin D and its salts
Taking Vitamin D supplements during pregnancy can help reduce the risk of gestational diabetes, low birth weight, and precancerous conditions. It is recommended that pregnant women take 1500-2000 IU of Vitamin D daily. In cases of obesity, following the recommendations of PTGiP, a higher dose of up to 4000 IU (after consultation with a treating physician) may be considered.4. Iodine
The iodine requirement during pregnancy increases by almost 50%. For a woman who is not pregnant, it is 150 µg daily, but for a pregnant woman, it is 220 µg. Adequate iodine intake is of utmost importance as significant deficiencies can lead to severe complications such as thyroid insufficiency, damage to the OUN in the baby, hearing loss. It is approximated that a minimum of 50% of pregnant women in Poland may potentially suffer from this elemental deficiency.5. Folic acids
A deficiency in folic acids may result in anemia, heighten the risk of miscarriages and neural tube defects. Therefore, it is advisable for women in their childbearing years to consume a diet abundant in folic acids and complement it with supplements or fortified foods (providing an additional 0.4 mg folic acids daily). During pregnancy, the following dosages are recommended: 1st trimester (up to 12 weeks) 0.4-0.8 mg folic acids per day; 2nd trimester 0.6-0.8 mg folic acids per day; For women with a history of neural tube defects, a higher dosage of folic acids, 4 mg/day, is recommended for 4 weeks before planned conception and during the 1st trimester of pregnancy, followed by a reduction to 0.6-0.8 mg. Women with a high risk of folic acid deficiency and neural tube defects are advised to take 0.8 mg/day for 3 months before planned pregnancy and throughout pregnancy and lactation. Risk factors include: pre-pregnancy diabetes, substance abuse, kidney or liver dysfunction, BMI > 30 kg/m2, bariatric surgery, diseases that can hinder nutrient absorption such as Crohn's disease, ulcerative colitis, and celiac disease.6. Caloric necessity during pregnancy
Due to fetal development during pregnancy, the need for energy increases. The recommendations for increasing energy in the diet have changed in 2020. In the latest nutritional guidelines for the Polish population, it is recommended to increase calorie intake already in the first trimester of pregnancy. Even in 2017, such a recommendation was only valid from the second trimester. Recommended increased calorie consumption at individual stages of pregnancy: - I trimester: +85 kcal, - II trimester: +285 kcal, - III trimester: +475 kcal. In the first trimester, the change is relatively small. 85 kcal corresponds to e.g. a thin slice of bread with lean meat. 285 kcal corresponds to 2 small snacks per day, e.g. a yogurt-based drink with raspberries (approx. 100 kcal), a handful of almonds (approx. 180 kcal). 475 kcal corresponds to e.g. a portion of spaghetti with whole grain pasta and poultry. It is therefore not necessary to eat for two. Additional calories should not be supplemented with worthless food - sweets, fast food. A diet rich in sugar can contribute to excessive weight gain during pregnancy, which can have negative consequences for both the mother and the child, e.g. an increased risk of gestational diabetes, pre-eclampsia, and preterm birth.7. Crucial nutrients in the diet
This component is extremely crucial, especially during pregnancy. Lack of protein in the diet can lead to low birth weight, small heart mass, and irregular blood pressure in the baby. High-quality protein comes from animal sources, however, in vegan and vegetarian diets all essential amino acids can be provided by incorporating different protein sources into the menu. Each of the main meals should include: - Dairy products which also serve as a source of calcium, - lean meat, - pulses, - eggs.8. It's a matter of fats
Fat substances are crucial mainly due to their content of DHA and EPA acids. They can be found primarily in fish, hence it is recommended that even if one takes them as supplements, one should consume at least two servings of fatty fish per week. As with any balanced diet plan, vegetable oils should also be considered, especially in raw form, such as a salad additive.9. Carbohydrates: The Cornerstone of a Healthy Diet
Carbohydrates form the cornerstone of any healthy diet. Pregnant women are advised to opt for minimally processed carbohydrate sources such as whole-grain bread, pasta, flour, various types of grains, and cereal flakes.10. Vitamins and Mineral Components
Only a diversified diet can ensure the requirement for all the necessary components. As previously mentioned, certain elements play a crucial role in fertile living, including iron, calcium, and iodine. Therefore, particular attention should be given to consuming the right amounts of these with food. Heme iron, which is best absorbed, is primarily found in red meat and offal. Non-heme iron from plant-based products is absorbed less effectively. The absorption can be significantly improved by adding vitamin C-rich products to meals.11. The iron
: its food sources are: pork liver, red meat, nuts, cocoa, barley, beans, peas, lentils.: it should be supplemented, but this does not mean that it may be lacking in a well-balanced diet. To provide iodine, include fish, broccoli, spinach, eggs, walnuts.12. Why a balanced nutrition is so crucial during pregnancy
How a mother nourishes herself has a direct impact on the development of the child and its health, even in adulthood. The process in which nutrients modulate the morphological changes and functions of the child's organs and systems is called nutritional programming. Nutritional programming can have a significant impact on the risk of diseases such as hypertension, cardiovascular disease, diabetes, obesity, allergies. For example, research by C. N. Hsu, Y. L. Tain shows that a high-fat or protein-poor diet can lead to a fatty liver in offspring. Undernourishment during pregnancy, on the other hand, can increase the risk of carbohydrate metabolism disorders, hyperlipidemia, diabetes, hypertension. All nutrients, vitamins, and minerals are essential for the growing child. The mother's nutrition should adhere to the recommendations for healthy nutrition for adults developed by IŻŻ. The pregnant woman should, in particular, take care of a balanced diet and provide all necessary vitamins and minerals as well as appropriate nutritional supplements.
