The basics of self-care during pregnancy
Pregnancy, however well planned, still comes as a surprise. If you are waiting to change your lifestyle - to eat better, start exercising and stop smoking and drinking alcohol - after you know you are pregnant, it may be too late. There is evidence that shows that the quality of a woman's diet during pregnancy has an influence on foetal and maternal outcomes. Therefore, a healthy, balanced diet is important before as well as during pregnancy, and it makes good sense to prime your body for pregnancy.
Weigh in Right
A healthy body weight improves a woman's chances of conception. Being overweight or underweight makes it harder for a woman to conceive. Having an overweight spouse also lengthens time to conception. Starting pregnancy at a healthy weight lowers the risk of complications for you and your baby such as hypertension, gestational diabetes, caesarean-section, preterm labour and delivery, and stillbirth. Work with a dietitian or nutritionist to give your diet a makeover.
Fill the Nutrient Gaps
Many adults know about healthy eating but a close look at their regular diet reveals the nutrient gaps. Eat fresh, wholesome food such as wholegrains, fruit, vegetables, meat and milk products.
Star Nutrients to Focus On
- Folic Acid - Folic acid is one of the B-vitamins that is needed for DNA synthesis and cell division, both mechanisms that will step up as soon as you conceive. It is important to consume enough before and during pregnancy as folic acid has been shown to protect against neural tube defects (NTDs). If you are contemplating pregnancy, the current recommended daily intake of folic acid is 400 mcg a day.You can get more folic acid by eating folate-rich food or taking folic acid, a synthetic compound available through fortified food and supplements.
- Legumes, green leafy vegetables, citrus fruit and juices, and fortified ready-to-eat cereals are good sources.
- Supplementing dietary intake with folic acid has been recommended by many professional organisations because of the difficulty in obtaining the extra folate required through diet alone.
- Choline - If you are planning for pregnancy, you require 425 mg of choline daily. Adequate intake of this unique B-vitamin has been found to be associated with a reduced risk of NTDs. Good sources of choline are egg yolk, beef and baked beans. Fair amounts are found in chicken, milk, salmon, cod, cauliflower, spinach and tofu.
Maternal Nutrition and Foetal Development - The developing foetus is most vulnerable to the mother's nutritional status during the first eight weeks, typically before pregnancy is confirmed. New evidence also suggests that poor maternal nutrition may lead to changes (reprogramming) in the genetic materials within the foetal tissues and this predisposes the infant to chronic illnesses in adulthood.
- Iron - Many young women are iron deficient due to blood loss during menstruation and poor diet. Women with anaemia put their babies at risk of spontaneous prematurity and intrauterine growth restriction. To put things right, aim for an iron intake of 19 mg a day. Include adequate portions of iron-rich food daily, such as lean meat, poultry, green leafy vegetables and iron-fortified food.
- Calcium and Vitamin D - Calcium is well known for its role in bone development and maintenance. Many women do not consume enough calcium each day. If adequate bone has not been developed before pregnancy and insufficient calcium is consumed, the mother's bone is drawn upon to provide for the needs of the growing foetus. Focus on building up your calcium reserves by boosting your dietary intake. Milk and milk products such as yoghurt and cheese are great sources. Fish with edible bones such as sardines and anchovies (ikan bilis) as well as tofu and green leafy vegetables are good choices too. The goal to go for is 800 mg per day. Vitamin D supports calcium absorption and bone mineralisation. The body can manufacture vitamin D if the skin is exposed to sunlight. However, even in tropical countries, many young women are deficient in vitamin D. Fortified food such as milk, orange juice and some breakfast cereals are the better choices. Fatty fish (salmon, mackerel, tuna and sardine), egg yolk and cheese are fair choices.
- Essential Fatty Acids, DHA and AA - Essential fatty acids (EFA), linoleic and alpha-linolenic acid as well as arachidonic acid (AA) and docosahexaenoic acid (DHA) form integral parts of cell membranes and the retina. EFAs cannot be synthesised in the body and must be consumed as part of the regular diet. Essential fatty acids are found in such food as oily fish, flax seeds, walnuts and vegetable oils. While trying to conceive and during pregnancy, eat at least 360 g of fish each week.
Multi-vitamins and Minerals
If you are worried that you may not be able to meet the nutrient goals each day, take a multi-vitamin and mineral supplement in addition to eating a well-balanced diet. Studies have shown a strong link between taking multi-vitamins and minerals before and throughout the first trimester of pregnancy with healthy pregnancy outcomes and a reduction in congenital abnormalities such as NTDs, heart defects, limb deformities and cleft palate.