Nutritional supplements and vitamins during pregnancy

Nutritional supplements and vitamins during pregnancy

 Modern recommendations

It is known that the full development of the baby requires additional nutrients, vitamins, trace elements and macronutrients. However, often a package of daily supplements and vitamins for a pregnant woman can be stacked in a serious line. They are available in a wide range without a prescription, but uncontrolled use can also have adverse effects, such as the use of more than 10,000 IU of vitamin A a day, which can lead to congenital fetal malformations.

What are the research and modern recommendations on the need for and use of various dietary supplements and vitamins during pregnancy - we will look at this in this article.

The importance of eating habits during pregnancy

A balanced, healthy and wholesome diet is of the utmost importance for the amount of nutrients ingested for the growth and development of the child. There are only a handful of supplements and vitamins that are really highly recommended during pregnancy.

Perhaps one of the arguments that sometimes suggests that we cannot do without the packaging of several multivitamins is doubts about the quality of the products available to us. However, in Latvia, with careful and prudent choice, good quality vegetables and fruits, as well as cereal products, meat and fish are available practically all year round. Pregnancy is an important time in a woman's life, when to pay more attention to the origin of food, eating habits, the way meals are prepared.

Nowadays, when obesity can be called a global epidemic, it can also cause a number of complications during pregnancy. Women with an increased body mass index (normal body mass index is 18.5 to 24.9 kg / m2) may have difficulty getting pregnant at first because their ovaries are not working properly.

Pregnant women with a body mass index above 30 kg / m2 are at increased risk of miscarriage, gestational diabetes, high blood pressure and preeclampsia, and venous thrombosis. Overweight women are more likely to have a labor and initiate cesarean section, complications associated with analgesic manipulations, and poorer healing of postpartum and postoperative wounds. It has been observed that obese mothers are more likely to have a stillbirth, congenital malformations and premature births, and conversely, a baby may have an increased birth weight and a higher risk of developing metabolic disorders and obesity later in life.

Therefore, it is especially important to achieve a normal body weight before pregnancy, balancing a healthy diet and appropriate physical activity.

Simple dietary tips for pregnant women

In order to keep the weight within the normal range, the following simple principles of healthy eating must be followed:

• Eat regularly at least three times a day (breakfast, lunch and dinner), diversifying daily meals with seasonal products, giving preference to locally sourced food. It is recommended to follow the so-called "plate principle" in main meals - half of the portion should be vegetables or fruits, a quarter of protein products (eg meat, fish, eggs, legumes, dairy products) and the remaining quarter should be reserved for carbohydrates such as cereals, potatoes. . Two to three healthy snacks, such as fruits, vegetables, nuts, dairy products, whole grain cookies, and other snacks, can be included between main meals.

• It is desirable to take about 500 grams of fruits and vegetables every day, of which at least 300 grams should be vegetables. It is recommended to eat at least half of the fruits and vegetables fresh, the diet can also include stewed, lightly fried, cooked vegetables. It is advisable to avoid canned, salted, pickled and high-fat fried vegetables;

• Four to seven servings of cereals are recommended (one serving is, for example, one slice of bread or one medium potato, 75-120 grams of brown rice or buckwheat), mainly whole grain products, potatoes. Whole grain products provide energy and are high in fiber, thus processing more slowly and creating a longer feeling of satiety;

• It is desirable to take three to four servings of dairy products a day (one serving is, for example, a glass of milk or 120 grams of cottage cheese, 200 grams of yogurt). Low-fat products without added sugar, food additives and vegetable fats should be chosen. Of particular value are sour milk products - kefir, buttermilk, yogurt, rye yen, airan - whose use also helps to normalize the intestinal microflora;

• Protein-rich products should be used regularly: lean meat, eggs, fish, legumes, nuts and seeds. The recommended amount of protein in the first trimester of pregnancy is 0.8-1.0 grams per kilogram, from the second trimester - slightly more - 1.1 grams per kilogram;

• At least once a week, fatty fish, salmon, herring, herring, sardines are recommended. The use of salted smoked, marinated meat and fish products should be avoided, with preference given to steamed, cooked, stewed, lightly fried products;

• Eat a reasonable amount of fat. Foods that contain unsaturated fatty acids, such as crude vegetable oil, fatty fish, avocados, nuts, should be adequately absorbed. Products containing trans fats, such as milk and vegetable fat blends, confectionery, sweet cheeses, fast food products (burgers, french fries, etc.), should be avoided. Cold-pressed, unrefined vegetable oils (linseed, walnut), fish oil, seeds, olive oil, nuts are recommended;

• Products high in salt and sugar should be avoided in your daily diet. No more than five grams of salt should be consumed per day, corresponding to one teaspoon, including the amount of salt already added to industrially produced products. The World Health Organization does not recommend consuming more than 25 grams of sugar per day, equivalent to six teaspoons. It should be noted that most sugar is ingested by industrial products, sweets, carbonated beverages, confectionery, etc., so sweets, savory snacks and other snacks should be eaten infrequently, except in exceptional cases on holidays;

• It is necessary to absorb two to 2.5 liters of fluid per day, of which about 1.5 liters of clean water, distributing it evenly throughout the day;

• Raw meat (including dried) and raw fish, raw eggs, unpasteurised milk and its products should be excluded from the diet. Tuna, sharks, swordfish, marlin, mackerel should not be eaten, as they may contain increased amounts of heavy metals. It is advisable not to eat soft cheeses (Brie, Camembert, etc.), meat pies, animal and fish livers. Be sure to wash your hands before cooking and eating. Berries, fruits and vegetables should also be rinsed in water before consumption. It is recommended to limit the amount of caffeine to 300 milligrams per day, that is, in coffee, tea, energy drinks and sweetened beverages, dark chocolate.

These dietary recommendations also apply to pregnancy. It is important to remember that you do not have to eat "for two" during pregnancy. A woman needs only 100 extra calories a day in the first trimester of pregnancy, and an additional 300 calories a day in the second and third trimesters (for example, 100 calories contain 150 grams of unadulterated yogurt or a large apple). If a woman has a normal weight at the beginning of pregnancy, then during pregnancy the normal weight gain is 10-16 kilograms.

What to take extra?

Studies show that most minerals and vitamins can be absorbed both during planning and during pregnancy by eating a complete, balanced and varied diet. However, the use of folic acid, iodine and vitamin D should be emphasized separately.

Folic acid reduces the risk of congenital neural tube defects in the fetus (spina bifida, anencephaly, encephalocele), and the supply of folic acid during the first weeks of pregnancy during embryonic development is especially important. Therefore, the World Health Organization recommends that women planning to become pregnant take at least 400 400g of folic acid per day during the first three months of pregnancy as a dietary supplement, which is usually available in pharmacies without a prescription. Green leafy vegetables, broccoli, spinach are also rich in folic acid.

During pregnancy, the amount of iodine in the diet is of particular importance, it promotes the successful functioning of the thyroid gland and affects the psychomotor and intellectual development of the unborn baby after birth. According to studies in both the student and pregnant population, mild or moderate iodine deficiency is observed in Latvia, therefore it is important to use at least 150 µg of iodine per day as a food supplement both when planning pregnancy and during pregnancy. Iodine-rich products are sea fish, the use of which is recommended at least twice a week, including sea cabbage, milk, eggs. In the household, it is recommended to use iodine-enriched salt when preparing meals. However, women who suffer from thyroid disease and / or take any medication that affects the thyroid gland on a daily basis should definitely consult a doctor about the addition of iodine to their diet.

Vitamin D is needed for calcium and phosphorus metabolism, as well as for the development of a child's bones and teeth. Part of vitamin D is taken in by diet - fatty fish, egg yolks, dairy products, but it is mainly formed in the skin under the influence of sunlight. Natural sunlight for five to 15 minutes three times a week (April-September) can provide enough vitamin D.

Taking into account the climatic conditions of Latvia, it would be recommended to use vitamin D 400 IU (international units) per day during the summer period, while increasing the dose to 800 IU per day during the winter period. Vitamin D levels can also be determined in the blood and the dose adjusted individually, but this is not currently recommended in routine.

Omega-3 fatty acids

In recent years, research has shown that omega-3 fatty acids play a significant role in pregnancy - they are important for fetal brain, retinal development, reduce the risk of preterm birth and preeclampsia, promote fetal growth, cognitive development, reduce the risk of cardiovascular disease, and risk of depression for the mother. You need 200-300 milligrams of omega-3 fatty acids a day, which can be eaten with at least 150-300 grams of fish twice a week. In addition, in one of these times, it is recommended fatty fish - mackerel, herring, trout. It is important to choose a healthy way of cooking, steamed, oven-cooked fish, preferably to avoid smoking. Fish oil preparations should be used with caution as they may contain high levels of vitamin A, which may adversely affect fetal development. Other products containing omega fatty acids are also recommended, such as eggs and milk, if fish is not eaten - vegetable omega-3 fatty acids (alpha linolenic acid) also contain linseed and hemp.

If the pregnant woman does not eat fish, then omega-3 supplementation may be considered.

During pregnancy, the consumption of iron, which is necessary for both the amount of maternal blood circulation and fetal hematopoiesis, increases. Important sources of iron in the diet are lean meat, fish, peas, beans, pumpkin seeds, pistachios. It should be remembered that the absorption of iron is promoted by products containing vitamin C, so it is recommended to eat meat with fresh salads and vegetables and avoid dairy sauces - calcium in dairy products interferes with the absorption of iron. Coffee, black and green tea, whole grain products also reduce the absorption of iron.

However, the use of iron supplements is generally not recommended for pregnant women, as their use may be associated with a number of unpleasant manifestations, such as liquid stomach upset or, conversely, constipation, including nausea. Both hemoglobin and ferritin, which reflect the iron reserves in the body, are reassessed during pregnancy and the choice of iron replacement therapy is made on an individual basis.

One of the myths during pregnancy is that insufficient calcium intake during pregnancy is associated with increased dental and oral health problems. At least 1000 milligrams of calcium per day is needed during pregnancy, which is related to dental health, muscle function, blood clotting reactions. Interestingly, it is during pregnancy that the absorption of calcium in the gastrointestinal tract is more efficient and better. The most important sources of calcium in the diet are dairy products, small fish (sprats, wedges), almonds, legumes, broccoli, pumpkin seeds, while its absorption is inhibited by caffeine. The addition of calcium during routine pregnancy is not recommended.

Vitamin B6 is involved in protein metabolism, it helps reduce nausea and vomiting. The main sources of diet are meat (beef, pork and chicken) and fish (tuna, salmon), as well as legumes, oats, bananas, plums, avocados and potatoes. No additional amount is recommended in the routine during pregnancy.

Vitamin B12 or cyanocobalamin is involved in various metabolic reactions in the body. B12 together with folic acid is needed for the development of the fetal brain. It is found only in animal products - meat, especially beef (also liver, but it is not recommended for pregnant women), milk and its products, fish - mackerel, herring, tuna. Seafood - mussels and oysters - is especially rich in vitamins. B12 deficiency is possible in vegans or after gastrointestinal surgery. In such cases, vitamin B12 supplementation is recommended. However, in the normal situation, no additional amount is needed during pregnancy.

Vitamin C is an important antioxidant and during pregnancy vitamin C is needed in addition to 10 milligrams a day. It is recommended to provide it with food. Important sources of vitamin C are cabbage, tomatoes, peppers, broccoli, strawberries, pineapples, citrus fruits, blackcurrants and kiwis.

Magnesium is needed in the diet in sufficient quantities to prevent leg muscle cramps. Important sources of magnesium in the diet are nuts, legumes, whole grains, dark green leafy vegetables. Magnesium-containing preparations are not routinely recommended.

Multivitamin and mineral complexes

The use of multivitamin and mineral complexes should be considered on an individual basis and may be appropriate for:

• high-risk pregnant women with reduced weight or other eating disorders (eg anemia, insufficient fetal weight gain, inadequate nutrition),

• pregnant women with addictions (use of drugs and other harmful substances),

• pregnant teenagers

• in the case of a repeat pregnancy, if the interval between births is less than two years,

• pregnant women who have had a newborn with a low birth weight or have had a multiple pregnancy.

Pregnancy is an important time in a woman's life to pay more attention to the origin of food and eating habits, because it determines both the course of pregnancy and the health of the unborn child in the near and distant future. After all, healthy eating habits can become a common practice for the whole family during the expectation period, which will be the basis of a healthy diet for the unborn child in the future.