It's no surprise that your body goes through a number of physical and hormonal changes during pregnancy – and the need for sufficient nourishment during this time is critical to the health of both mother and baby.
However – according to research from the University of Wollongong, 65 per cent of pregnant women in Australia aren't even aware of the Australian guide to healthy eating when pregnant.
This concerning figure may explain why so many women lack essential vitamins during this crucial time – including important B vitamins which produce healthy DNA, metabolise food to make energy, balance our nervous system and prevent heart disease and dementia from our earliest beginnings in the womb right through to old age; and iron, which is in high demand during pregnancy.
Question: How do a woman's nutritional requirements change during pregnancy?
Belinda Reynolds: During pregnancy, the requirement for additional calories grows only slightly (with additional small increases with each trimester). Pregnant women certainly don't need to be 'eating for two" when it comes to the amount of food that is consumed (there are health risks associated with becoming overweight/obese (e.g. greater risk of gestational diabetes, preeclampsia, pre-term labour)), however, there can be significant increases in the requirement for certain micronutrients (e.g. essential fatty acids such as DHA, zinc, iodine, iron, vitamin D, folate and calcium). This means that pregnant women are best to focus on nutrient-dense food, with the avoidance of less desirable foods that contain too many 'empty" calories.
Question: Are most pregnant women required to take vitamin and mineral supplements?
Belinda Reynolds: It can depend on the individual, and will be determined by a number of factors. The reality for many women can be that they struggle to meet the daily recommendations for vegetable and fruit intake due to a variety of reasons that are further complicated by pregnancy side effects (e.g. nausea leading to food aversions, severe fatigue making food preparation challenging, fear of food contamination meaning that food choices are narrowed).
If we look at some specific examples, certain women are more prone to anaemia which may worsen during pregnancy as blood volume increases. In this situation iron supplementation is often essential. For others, sufficient safe sun exposure does not occur to achieve healthy vitamin D status, or they may be in a category at greater risk of deficiency (e.g. obese, darker skin). Supplementation in these cases is important. Additionally, certain identified genetic variations can result in a greater need for specific nutrients (e.g. patients with a variation on a gene known as MTHFR may need more folate) to avoid complications.
For these reasons and others, supplements can be very useful. Some key nutrients to look for in a supplement include vitamin D, iodine, folate, calcium, iron (however does need to be avoided in certain situations), zinc and omega-3s. I must emphasise however, that supplements should never replace a healthy diet!
Question: What are the five key nutrients necessary for a healthy mum and bub?
Belinda Reynolds: That is a challenging question to answer as all vitamins and minerals are essential, and a deficiency of any could contribute to health concerns. All vitamins, minerals, amino and fatty acids are working together in symphony to support the health of both mum and bub.
If I had to choose five, I would start with folate (but this needs other nutrients such as vitamins B12, B6 and B2 to be activated in the body and to function efficiently). Secondly iodine due to its role in supporting mum's thyroid and bub's brain and nervous system development, then vitamin D and calcium for mum and bub's healthy bones but also muscles, brain, cardiovascular and immune systems. Omega 3 fats are also very important during pregnancy and breastfeeding for the growing foetus'/baby's nervous system and brain.
Iron is also a stand out for some, while CoQ10, or its active form ubiquinol, can be useful to support energy synthesis, but also maintenance of healthy blood pressure.
Question: Can you share with us, the six foods we need to be eating whilst trying to get pregnant? This can vary from person to person depending on a number of factors. The most important thing is that we achieve a healthy, balanced diet which is full of variety. Eating too much of only a limited number of foods will not ensure that we are benefiting from the full array of amazing nutrients and phytochemicals found throughout nature!
Green leafy vegetables
Green leafy vegetables are rich in many beneficial compounds including antioxidants, nutrients that support healthy detoxification pathways, fibre that supports digestion and iron for healthy blood and energy levels. Even more relevant to pregnancy health is the presence of folates. Folate is a vitamin we are familiar with as being important for preventing neural tube defects, but when you look closely at the many roles folate plays in supporting healthy DNA, mood, detoxification and foetal development, it makes sense to consume sufficient amounts. Many processed cereals are fortified with folic acid (the synthetic form of folate), however your body doesn't utilise this form as well as it does the natural forms, and therefore its a great idea to consume natural sources that also provide many other health-promoting compounds.
A healthy, balanced immune system has been found to be important for supporting fertility. Long-term inflammation is associated with reduced fertility, as are nutrient deficiencies. Prebiotic-rich foods (e.g. many high-fibre foods such as lentils, cruciferous vegetables, certain fruits (e.g. apples and bananas)) promote the growth of health-promoting bacteria within the digestive tract, which in turn supports immune balance, gut health and subsequent nutritional status (as an unhealthy gut = poor absorption of nutrients).
Iodine rich food sources
Iodine deficiency has been a growing concern in Australia, leading to the fortification of flour. Natural sources of iodine include seaweed (e.g. sushi), oysters, cranberries, salmon, eggs, also other seafood, and iodised salt. Iodine plays an essential role in supporting the functioning of your thyroid gland. Most people know the thyroid gland to play a role in maintaining metabolism, but a lesser known fact is that it has an intricate relationship with balance of other chemicals in our body, such as those involved with brain development, mood and hormones. Other factors that can interfere with healthy thyroid functioning include low selenium (so consume healthy amounts of foods rich in this trace mineral such as raw nuts (e.g. brazil nuts) and seeds, fish (e.g. tuna), eggs, chicken, spinach)
Healthy animal protein sources (e.g. eggs, lean meat) for B12 and choline
Protein provides the essential amino acids that the body utilises to create its own functioning proteins. These can include muscles, also skin and hair, enzymes that allow chemical reactions to occur and antioxidant/detoxification compounds. Meat, poultry, fish and eggs are great sources of protein, while also being foods which provide the essential nutrient, vitamin B12. Vitamin B12 is essential to support folate in doing it's job, while also supporting healthy blood, energy and nervous system function. If you're vegetarian, or especially if you're vegan, you may need to consider a supplement to avoid deficiency. Antioxidant rich foods
Bright and deep coloured fruits and vegetables are rich in a vast array of beneficial phytochemicals that provide antioxidant and anti-inflammatory benefits and also support normal, healthy detoxification pathways. These benefits result in your body functioning optimally so that hormone levels have a greater chance of being balanced to support fertility (e.g. high levels of inflammation due to an unhealthy diet may push sex hormones out of balance, while toxicity due to toxic exposure coupled with dysfunctional detoxification can interrupt hormone-producing organs).
Avoid excess caffeine and alcohol
Alcohol not only impacts your liver and contributes to inflammation and hormone imbalances, but also can lead to nutritional deficiencies that impact fertility (in both men and women). Therefore, it is best to have most days of the week alcohol-free and avoid consumption of more than 3 drinks in a day. Excessive caffeine consumption from lots of coffee or black tea can also stress the body out and result in imbalances. A couple of cups per day is OK for most people, but try to switch to natural herbal (not artificially flavoured) teas that nourish the body (e.g. white tea that is rich in antioxidants, anti-inflammatory ginger, calming chamomile).
Question: Do our nutritional requirements change again during breastfeeding?
Belinda Reynolds: They can shift a little, but like during pregnancy, the primary focus should be on consuming a healthy diet with lots of variety. Breastfeeding is nutritionally demanding for mum, just like pregnancy, and now you've added sleep deprivation to the mix! Staying well nourished to support energy levels and your mood is essential, while the need to consume omega-3 fats can increase even more. This is to ensure that breast milk is rich in the nutrients your growing bub needs, and that your nutritional needs are being met simultaneously. Staying well hydrated is very important at this stage too. It will help to support a healthy milk supply, and avoiding dehydration.
Question: Are there any specific vitamin and mineral supplements necessary for breastfeeding?
Belinda Reynolds: This is similar again to pregnancy, with a particular emphasis on omega-3 fats. If a lot of blood was lost during birth, iron supplementation will be particularly important here also. Good amounts of protein in the diet together with vitamin C and zinc can support healing after pregnancy, and also will support healthy immune function along with vitamin D.
Question: What is the -Australian guide to healthy eating when pregnant'?
Belinda Reynolds: Titled 'Healthy eating during your pregnancy", this can be found at www.eatforheath.gov.au and provides information on eating for health during pregnancy and breastfeeding. Guidelines include the recommended number of servings to consume per day of each food group, plus advice on which foods are best avoided for safety and health.
Question: Does it surprise you that '65% of pregnant women in Australia aren't even aware of the Australian guide to healthy eating when pregnant"?
Belinda Reynolds: It does surprise me, as I would expect that many women would be pointed in the direction of this information when they first visit their obstetrician, GP or midwife once pregnant. However in saying that, there is a lot of information out there that can be conflicting and confusing. If in doubt women should speak to a qualified healthcare practitioner for advice that best meets their individual needs.
Interview by Brooke Hunter
Speak to your healthcare practitioner before taking supplements and to determine the correct dose for you. Always read the label. Use only as directed. If symptoms persist, consult your healthcare practitioner.