In order to guarantee pregnancy and satisfactory growth of the fetus, particular attention must be paid to the woman's diet before, during and after pregnancy.
Chronic energy deficit in the mother can cause: infections, obstructed labor (painful childbirth), maternal mortality, low birth weight and even neonatal and infant mortality.
The pregnant woman will undergo physiological changes which will require additional nutritional and energy intake.
So you have to answer:
- An increase in blood volume (you will need to be vigilant about iron intake through iron-rich foods or supplementation)
- Growth of maternal tissues: uterus, mammary glands, fatty tissues
- Fetal development: intake of good quality, low-fat animal proteins.
- Loss of maternal tissues at birth: need for a reserve (which will also be used for breastfeeding)
- Preparation for lactation: intake of lipids, calcium and vitamin D, constituents of breast milk, is required
Be careful, if you need to provide more energy, you should not eat for two, but eat twice as much!
Macronutrient requirements
Carbohydrates : carbohydrate intake is similar to that of the general population, that is to say 50 to 55% of the caloric ration.
However, the intake of fast sugars must be 10% maximum, in favor of sugar with a low glycemic index (legumes, rice, pasta) to avoid hypoglycemic discomfort and excessive weight gain.
Constipation being a common problem encountered by pregnant women, fiber intake (25 g/day) is encouraged!
Proteins : Protein intake should be increased as follows:
- 1.3 g/d in the 1st trimester
- 6.1 g/d in the 2nd trimester
- 10.7 g/d in the 3rd trimester
Lipids : intakes must be the same as for the general population, i.e. 35 to 40% of the energy ration.
Particular attention should be paid to the quality of the lipids ingested, favoring a diet based on essential fatty acids, therefore mainly fish and vegetable oil rich in omega 3 (rapeseed , soya).
Micronutrient needs
Among the vitamins, some should be monitored during pregnancy:
- Vitamin D (linked to taking Calcium Ca2+ because it promotes the absorption of Ca2+ and its fixation)
- Vitamin B9 or folate
- Vitamin E , antioxidant
- Vitamin A but be careful because it can pose a problem in case of excess because it is teratogenic!
In fact, we must be careful not to supplement women of childbearing age and pregnant women with vitamin A. Particular attention should be paid to anti-aging creams that contain retinol. Vitamin A passes the skin barrier so this risks increasing its blood concentration. Note that the maximum vitamin A value is 700µg retinol equivalent per day . We also do not recommend cod liver oil which contains a lot of vitamin A. And we will pay attention to multivitamin complexes which could also contain it!
Vitamin deficiencies can lead to malformations or threatened childbirth. For example, a deficiency in vitamin B9 can lead to an abnormal closure of the neural tube: spina bifida. This is why vitamin B9 is a closely monitored element in women of childbearing age.
Nutrients of Special Interest
We will look in detail at 5 elements to watch out for especially in pregnant women:
1- Folates
- The closure of the neural tube occurs on the 14th day of pregnancy, so it is not only necessary to supplement at the beginning of pregnancy but also before pregnancy !
Thus, vitamin B9 should be taken by any woman wishing to conceive.
- Folate plays a major role in the synthesis of nucleosides in the brain.
- The ANC for vitamin B9 is 400 µg/day for primary prevention . But it is much higher, i.e. 5 mg/day, for young women particularly at risk of deficiency or based on certain medical history.
It can be difficult to obtain the daily vitamin requirements because our diet is very refined, for example we have removed the bran from wheat, which precisely contains vitamin B9.
Please note : Zinc Zn supplementation can be offered at a level of 20 mg/day in addition to folate supplementation because folic acid is not present as such in the diet, it is first found in form of polyglutamates. The latter will be transformed into folic acid by an enzyme Gamma Glutamyl hydrolase (GGH) which requires Zinc as a cofactor to synthesize folic acid .
Foods rich in folate :
-baker 's yeast and liver
-then we have the green salad
- green vegetables are also rich in folate
-whole grains are moderately rich
2- Iron
- Iron is an essential element and is necessary to support the growth of the fetus and placenta.
An adequate iron store built up before pregnancy combined with healthy eating habits will provide enough iron to meet the increased needs of pregnancy. However, if iron reserves before pregnancy remain insufficient, an iron supplement during the second and third trimesters of pregnancy, always associated with a healthy diet, is recommended.
Among the foods of animal origin rich in iron, we find beef or mutton, liver or even mussels. Plant foods that provide a lot of iron include parsley, spinach and even cocoa (hello chocolate!). Be careful, however, the so-called heme iron which is found in meat, poultry and fish is more easily assimilated unlike the non-heme iron present in vegetables (chickpeas, etc.), fruits and cereals.
The consequences of maternal anemia:
They are unfortunately numerous: maternal death, less iron for the fetus, low birth weight, neonatal mortality, reduced physical capacity and reduced cognitive faculties.
The consequences of maternal anemia are major. Today, the iron requirement for a pregnant woman is 30 mg/day in the 3rd trimester .
To conclude on iron, pay particular attention to certain factors which inhibit the absorption of non-heme iron, these are tea and coffee (polyphenols), we will therefore advise you to space out your tea or coffee one hour after the meal.
3- Calcium and vitamin D
- Pregnant and breastfeeding women need it to maintain the integrity of their bones and to ensure the development of the fetal skeleton.
However, for many women the intake of dietary calcium is insufficient because they do not consume enough milk: therefore consume more dairy products such as yogurt or cheese where the calcium is best assimilated.
Women whose dietary habits do not allow them to meet calcium needs should be supplemented.
To date, the ANC in Calcium is 1000 mg/day.
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For vitamin D, it is necessary to provide:
- 400 IU/day from 12 weeks (reminder: 40IU= 1µg)
-then 1000 IU/day in the 3rd trimester
-Finally, it is preferable to take only one dose of 100,000 IU in the 3rd trimester .
Vitamin D is a fat-soluble vitamin, so it is stored in fat and acts as a reserve.
4- AGE: Essential Fatty Acids
Essential because they are not synthesized by our body, they must be provided by our diet.
ANC increases in pregnant women:
- Omega-6 increases from 8 to 10 g/day
- Omega-3 increases from 2 to 2.2 g/day .
As a reminder, these are the precursors of DHA (docosahexaenoic acid) and AA (arachidonic acid), it is therefore necessary that the mother-to-be has a sufficient intake of these precursors in order to be able to synthesize them.
For information, DHA represents 25% of the lipids in the lipid bilayer of brain cells , it is also present in the retina.
Moreover, 75% of the brain size is formed during pregnancy, the remaining 25% is formed in the first 5 years after birth.
Deficiencies in these so-called essential fatty acids can potentially cause intelligence disorders in children.
Where to find them in food?
Fish and seafood are foods that provide both Omega-3 and DHA.
In the table below, we observe that to have 1g of EPA and DHA per day, you must consume 70 to 360g of fresh tuna, although fresh tuna is not recommended for pregnant women because it contains a high level of mercury. high, on the other hand, it is possible to consume canned tuna because the manufacturing process eliminates mercury.
