Archive for the ‘Pregnancy’ Category

Gestation is one of the moments in a woman’s life when she is more nutritional vulnerable, being more subject to the consequences of a poor nutrition, right when her organism is undergoing an intense anabolism. This condition determines the need for an increase of nutritional elements in order to guarantee the fetus growth, plus the postpartum recovery and the baby’s breastfeeding. Pregnancy is a vulnerable period also for the many changing in the woman’s body because of the baby’s development. Those changing are evident in the cardio-circulatory organs, as well as in the digestive, digestive, respiratory conditions, arthritis, and metabolic changes, endocrine, hematologic and breast.

The nutritional status of women before and during pregnancy is associated with the welfare of the fetus. If the pregnant woman has lower nutritional reserves, there is greater risk for the fetus and the newborn to present deficit of neurocognitive development, congenital malformations, prematurty, weight gain and/or insufficient length, leading to the birth of a small baby for his gestational age.

Therefore, protein-energy malnutrition and deficiencies of iron, iodine, vitamin A and folate, which are the main nutritional problems in pregnancy, should be assessed on their impact not only on the mother’s body, but also on the fetus’.

In order to have a healthy lifestyle during pregnancy is important to note the proper weight gain, consumption of different foods, micronutrient supplementation and non-use of alcohol, cigarettes and other toxic substances.

The amount of energy, proteins and other nutrients are higher to meet the needs required for the fetal development and formation of the mother’s structures during pregnancy (such as placenta, uterus, mammary glands and blood), as well as the collection of deposits energy the mother to be used during childbirth and lactation. Energy requirements vary accordingly with the pre-pregnancy weight, quantity and composition of weight gain, stage of pregnancy, level of physical activity and the increase of the mother’s basal metabolism.

“The nutritional status before and during pregnancy is critical for both mother and child, determining both the well-being, it also may even affect the reproductive capacity of women for generations” (Silva, SMCS, Mura, JDP. Alimentação, Nutrição e Dietoterapia. São Paulo: Roca, 2007).

Nutritional problems such as malnutrition, overweight and obesity should be prevented and corrected during pregnancy, which shows the importance of nutritional assessment and guidance for pregnant women in prenatal care early in pregnancy.

By Livia Penna Firme Rodrigues

To evaluate the body weight, different methods have been recommended, among which stands out the use of the Body Mass Index (BMI) before pregnancy. The BMI is calculated using the weight in kilograms (kg) divided by height in meters squared. Based on a 1990 study of the National Institute of Health, the guidelines for weight gain in pregnancy are based on pre-pregnancy BMI. Currently, in terms of caloric intake, the recommendation of the Recommend Dietary Allowances (RDA, 1989) has added 300 calories to a normal diet, starting in the second quarter of gestation. As soon as the woman gets pregnant she should do an assessment of her nutritional state.

Women who start pregnancy with a low weight or are adolescent (with less of five years after their first menstruation) must increase their caloric ingestion of 300 calories since the beginning of gestation. On the other side, women who start pregnancy with more weight or are obese should not add any calories to the recommended. It‘s important to follow the gestation, which will allow to give nutritional guidance.

By Livia Penna Firme Rodrigues

The ingestion of proteins during pregnancy must be increased because of its specific contribution to the fetus growth, and because a diet poor in proteins is usually poor of other nutrients.

“The WHO suggests that the additional ingestion of proteins to be about 6grams a day during the entire pregnancy, more specifically: 1.2, 6.1 e 10.7 grams for each trimester, respectively”.

The reason of this different numbers is because the need of proteins vary during gestation, being bigger when the fetus growth is more intense. Pregnant women should ingest food from animal origin in sufficient quantity and the vegetarians should increase the ingestion of tofu (soy cheese), whole grains, nuts and seeds.

The protein deficiency can lead to gestational toxemia, decrease of the uterus muscle tonus, abortion and low infection resistance.

And about lipids, it’s important to daily ingest the acids omega-6 and omega 3.

They relate to the functioning of the uterus-placenta system, nervous system development and fetal retina. The brain is made in large part of lipid-based material. Those lipid cannot surpass 30% of the total diet calories.

By Livia Penna Firme Rodrigues

• Vitamin B2 – Riboflavin. This vitamin is involved in the energetic metabolism, which increases during pregnancy, thus, more of this vitamin is required. Main sources: cereals, eggs, cheese, dark green leafy, nuts, hazelnuts, black-eyed peas, lentils, dried beef, liver, kidney.

• Vitamin B6 – Pyridoxine. It participatse to the protein metabolism. The lack or the excess of it may cause the specific hypertension disease in pregnancy (DHEG), gestational Diabetes, convulsion, premature delivery, baby death, low Apgar scores and especially malformations. Main sources: whole grains, potatoes, liver, pork, chicken, legumes.

• Vitamin B12. Its deficiency leads to anemia and neurological disturbs. Special care is due to vegetarians pregnant women, who will need to take soy milk fortified with vitamin and supplements. Main sources: meat, eggs, dairy products, offal, sausages and seafood.

• Acid Folic. That’s necessary in great quantity in the beginning of pregnancy because it deals with the cellular division and with the protein synthesis. The first weeks are decisive for the closing of the neural tube, which lately will develop to form the brain and the spinal medulla. It’s hardly possible to supply this need only through the regular diet. It is recommended 600 micrograms of folic acid per day before conception and in the first trimester of pregnancy. Main sources: beef liver, lentils, spinach, peas, beans, wheat germ, brewer’s yeast, beets, asparagus, dark green vegetables, broccoli, spinach, cole slaw, milk, avocado, orange juice, cereals enriched.

• Vitamin C. If too small quantity, it may cause premature rupture of the placenta and premature delivery. Main sources: orange, guava, cherry, strawberry, mango, papaya, cauliflower, leafy.

• Vitamin A. The fetus has his reserves of vitamin A for his own growing and development. This vitamin is necessary for the maternal tissues and it’s important for the synthesis of steroid hormones. It’s also associated with an increase of progesterone during pregnancy. That’s one of the few nutrients that has increased intake during pregnancy. Main sources: beef liver, cheese and butter, whole milk, palm oil, pumpkin, carrot, mango, cabbage and watercress.

• Vitamin D – Calciferol. This vitamin is related to bone growth, immunity and reproductive activity. It’s essential to balance calcium and phosphorus. Main sources: egg yolk, salmon, sardines, herring, chicken liver.

• Vitamin E – Tocopherol. It works as a key antioxidant. Main sources: vegetable oils (corn, soybean, sunflower), cow’s milk, salmon, avocado and apricot.

• Vitamin K. Its deficiency produces the disease of the newborn, so it is recommended preventive supplementation at birth. Main sources: dark green leafy, cabbage, peas, beef liver, butter and cheese.