Essential nutrients for pregnancy

1. Essential nutrients
In this series on pregnancy diets, we look at essential nutrients such as vitamins, minerals, trace elements and essential fatty acids and the protective role they play in prenatal development. These nutrients can also have a long-term effect on your baby's health.

2. Vitamins
The diets of pregnant moms should contain plenty of vitamins, particularly those of the B-group, and vitamin C. A balanced, normal diet should provide for sufficient amounts of these nutrients.

However, if you are eating poorly, or vomiting a great deal, or think that you have unbalanced eating habits, you need to take a supplement that contains vitamin C and the B-complex vitamins (thiamin or B1, riboflavin or B2, niacin or B5, pyridoxine or B6, pantothenic acid, B12, biotin and folic acid).

Folic acid
Folic acid is one of the most important vitamins during pregnancy. It prevents birth defects such as spina bifida and neural tube defects. Some authorities believe that women should start taking additional folic acid in the months before they actually fall pregnant to ensure that their babies are not malformed.

Folic acid is one of the vitamins that is sensitive to certain drugs, including oral contraceptives. If a woman has been taking oral contraceptives for a number of years, her folic acid reserves may be low. In such cases, taking folic acid before you fall pregnant makes good sense.

Pregnant women can take a supplement of 200 microgram folic acid a day. In some countries legislation makes it mandatory to supplement staple foods such as flour with folic acid to prevent folic acid deficiencies and congenital malformations.

In South Africa a plan to fortify staple cereals such as maize meal and bread with nutrients like folic acid is reaching fruition and the fortified foods should soon be available.

Vitamin B6
Evidence is also accumulating that women who take pyridoxine (vitamin B6) supplements during pregnancy have babies that are more alert and get a higher Apgar score immediately after birth. The recommended daily intake of B6 during pregnancy is 2,6 mg a day.

Vitamin C
The following foods are excellent sources of vitamin C: citrus (oranges, grapefruit, lemons, tangerines and naartjies), pawpaw, sweet melons, guavas, blackcurrants, strawberries, green peppers, the cabbage family (including broccoli, Brussels sprouts, cauliflower), spinach and tomatoes.

B-complex
The B-complex vitamins are mainly found in wholewheat grains, nuts, peas, beans and foods made with yeast (breads), meat, fish, milk, eggs, and liver (especially vitamin B12 and folic acid).

3. Minerals and trace elements
Argentinean researchers found that the children of mothers who took extra calcium during pregnancy were less likely to have high blood pressure compared to the children of mothers who did not take any additional calcium.

These exciting results indicate that mothers should take calcium supplements during pregnancy – not only to ensure that their children do not suffer from hypertension, but that they themselves don’t get high blood pressure which is linked to a condition called preeclampsia during pregnancy.

Calcium
Milk and milk products such as yoghurt, cottage and other cheese, and maas (an African fermented milk drink), are the richest sources of calcium in our diets. One glass of milk supplies 300 mg of calcium. Pregnant moms need between 1 200 and 2 000 mg of calcium a day. It is advisable to use skim or low-fat milk and dairy products to obtain the calcium you need without the extra kilojoules, saturated fat and cholesterol.

Iron
Many women throughout the world suffer from iron deficiency. If you are pregnant and have a low blood iron test result, you need to take an iron supplement for the rest of your pregnancy.

Nowadays, iron supplements for pregnant women are more easily absorbed and do not cause tummy upsets. So take your iron tablets, they will make you feel more energetic, prevent you from getting anaemic and will ensure that your baby gets sufficient iron to build up a good body store. This is important because mother’s milk, which is the best food you can give your baby for up to two years, is not rich in iron.

Iodine
Iodine is another trace element that can prevent babies from being born with brain defects. In many parts of the world where there is a lack of iodine in the soil and plants, and fish (the richest source of iodine in the diet), is not eaten frequently, women and men develop a condition called goitre due to iodine deficiency. If a woman with iodine deficiency has a baby, the child may suffer from cretinism (mental deficiency, deafness, spasticity, dwarfism, and an enlarged thyroid gland).

To prevent goitre, countries like South Africa, have made iodisation of table salt compulsory. Iodine deficiency should therefore not be a problem in this country anymore. If you do not use any salt at all or live in an area where the soil is deficient in iodine, check with your doctor or clinic staff if you should start using iodised salt. (Just keep in mind that excessive use of salt at any time, including pregnancy, is not wise.)

4. Essential fatty acids
Then there are the essential fatty acids - omega-6 and omega-3. Women who lead a western lifestyle, which contains soft margarines and sunflower, canola or other plant oils, generally don’t have an omega-6 fatty acid deficiency.

But omega-3 fatty acids are mainly found in fatty fish, which many people don’t eat on a weekly basis, so omega-3 deficiencies are common. These omega fatty acids are important for prenatal brain and nervous system development. Moms need to eat plenty of fatty fish to provide the omega-3 fatty acids their babies require. Instead of fish, you can also take salmon oil capsules every day.

So let’s recap: pregnant women need to eat the following foods to keep their babies healthy for the rest of their lives:

• Sufficient energy, protein and carbohydrate to form part of a well-balanced diet
• Vitamins C and the B-complex, especially folic acid and vitamin B6
• Minerals and trace elements, particularly calcium, iron, and iodine
• Essential fatty acids, especially omega-3 fatty acids

– (Dr I V van Heerden, DietDoc)

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