Pregnancy is probably the one time in a
woman’s life when she is bombarded by more “old wives’ tales” and other
doubtful advice than at any other period. Conflicting dietary admonitions characterise
the advice pregnant women receive from their girlfriends, female relatives,
midwives, mothers, grandmothers and popular magazines. No wonder modern women
are confused about what they should eat to ensure that they and their
developing baby are healthy.
Recently researchers have also been giving
a great deal of attention to the lifestyles and diets of women of childbearing
age before conception, and have coined the phrase “the first 1,000 days”, which
encompass a child’s life from preconception to approximately the age of 2.
These 1,000 days include the period of 9 months of pregnancy when the baby is
dependent on the mother for all its needs.
Read: Is a preconception checkup really necessary?
According to paediatric experts, these
1,000 days can determine a child’s entire life. Dietary factors such as
exposure to toxins and malnutrition, overweight and underweight, breastfeeding
and weaning foods, combined with a variety of other factors are crucial to
giving your baby the best chance in life.
that influence pregnancy outcomes
According to Prof Kelly Tappenden, Editor-in-Chief
of the Journal of Enteral and Parenteral
Nutrition and an Endowed Professor at the University of Illinois, so many
important developments take place during the first three months of pregnancy,
that women planning to conceive should take into account the so-called “periconception
maternal factors”, which can have important effects on their baby’s development
in the womb.
The following factors have been identified
as having negative effects on the success of pregnancies:
- Extreme underweight or overweight. This maternal
factor can complicate your baby’s development and is nowadays probably one the
most important factors because such a large percentage of our female population
is overweight or obese. On the other hand, many teenagers who fall pregnant are
seriously underweight and malnourished.
- The nutritional status of both the mother and
the father is important. For a healthy baby both parents need to be well
nourished and consume a balanced diet which is not overloaded with alcohol and
stimulants such as caffeine.
- Environmental toxins in our water supply, air
and food are a constant threat to healthy cell replication. Toxins are also
found in e.g. medications and cigarette smoke, and at work or during leisure
- Folic acid plays a very important part in
preventing neural tube defects. Unfortunately the folic acid levels in staple
foods have been declining steadily as global soils become depleted. This is why
the two staple foods in South Africa, namely maize meal and wheat flour are
fortified with folic acid and 7 other important nutrients, including iron (see
below). Since the introduction of fortification of our staples, one of the most
significant improvements in the nutrient intake of women has been folic acid
and this is reflected in a decrease in the number of babies suffering from
neural tube defects reported at birth. Before fortification with folic acid,
the incidence of neural tube defects in South Africa was 14.1 per 10,000
births, and after introduction of folate fortification this rate has dropped to
9.8 per 10,000 births, a 31% reduction.
- Deficiencies of vitamin B12 and iron in pregnant
women can also have a major effect on pregnancy outcomes. Both these nutrients
prevent different type of anaemia in the mother, which in turn can prevent poor
oxygen transport to the foetus. Vitamin B12 and bioavailable iron are found in
meat and liver, egg yolk and whole grain foods. The high levels of iron in
plants like spinach are unfortunately unavailable because they are bound to
compounds called oxalates which make them insoluble.
- Excessive caffeine intake in the perinatal
period from coffee, tea and caffeinated energy drinks can have a negative
effect on conception. Studies have shown that having more than 300 mg of
caffeine a day before conception can increase the risk of spontaneous abortion
What is a “healthy pre-pregnancy weight?”
This is probably one of the most popular questions among mothers-to-be.
Read: Pre-pregnancy weight increases asthma risk in kids
Because the pre-pregnancy body mass index
(BMI) is “an independent predictor of many adverse outcomes of pregnancy”, the
best scenario is for women to have a normal BMI before they fall pregnant (i.e.
BMI = 18-25). With nearly 70% of the female population in South Africa
suffering from overweight or obesity, this requirement is going to be hard to
achieve. On the other hand, many of our young mothers are chronically
underweight with BMIs below 18.
According to Prof Tappenden, overweight
during pregnancy puts mothers at risk of short- and long-term consequences such
as obesity, heart disease and diabetes.
In 2009, the Institute of Medicine in the
USA published the following table to guide weight gain based on prepregnancy
These recommendations will probably upset
the “eat for two” brigade. For example, there is no recommendation for weight
gain per week for the first trimester! This does not mean that you should
starve yourself and your baby for those exceptionally important first three
months, but it does mean that there is no need to imagine that because you are
pregnant you suddenly need to gorge yourself, develop cravings for fatty food
(many cravings are “all in the mind” anyway), or stop eating a healthy,
balanced diet with a moderate energy content.
Read: Eating for two - don't overdo it!
Next week we will continue with the
critical subject of what pregnant mothers need to know about their diets to
achieve the best results for themselves and their babies.
Pre-pregnancy diet can affect baby
Mom-to-be? Get moving!
Menu for moms-to-be
KA (2015). Eating for Two. Best Practices for Maternal Nutrition. Paper
presented at the Nutritional Solutions CNE Event, 16 April 2015, Johannesburg.
of Medicine (2009). Report Brief: Weight gain during pregnancy: Reexamining the
Guidelines. May 2009.
Image: Eating well during pregnancy from Shutterstock
Dr Ingrid van Heerden is a registered dietician and holds a doctoral degree in Nutrition and Biochemistry. She believes that "we are what we eat" and offers free nutrition and weight loss advice via her DietDoc service on Health24.com. Read more of her articles.