Nutritional status during pregnancy is one of the most important factors affecting foetal growth and development.
RECOMMENDED WEIGHT GAIN DURING PREGNANCY
Adequate weight gain during pregnancy is essential to ensure optimal growth of a baby. But how much weight should one actually gain? The following is recommended:
| RECOMMENDED WEIGHT GAIN | |
| Women with a normal weight and BMI (18.5–24.9kg/m2) | 11–16kg |
| Women who are underweight and have a BMI of less than 18.5kg/m2 | 12–18kg |
| Women who are overweight and have a BMI of more than 25kg/m2 | 6–11kg |
| Women carrying twins | 16–21kg |
VITAMINS AND MINERALS NEEDED DURING PREGNANCY
Women are encouraged to follow a healthy, balanced diet during pregnancy. It is particularly important to consume fresh fruit and vegetables as many vitamin and mineral requirements are increased during pregnancy (especially calcium, iron, folate, vitamin C).
| VITAMINS / MINERALS | FOOD SOURCES |
| Calcium | Milk and milk products, broccoli, dried beans, orange juice |
| Iron | Red meat (beef, lamb, mutton, venison, biltong), dried beans and legumes, fortified cereals, spinach, raisins
NOTE: Foods containing iron are better absorbed if eaten with foods containing vitamin C. |
| Folate | Fortified whole grain products, fortified breakfast cereals, dark green leafy vegetables, broccoli, brussels sprouts, oranges, bananas, dried beans |
| Vitamin C | Citrus fruits, strawberries, melon, kiwi fruit, broccoli, green and red bell peppers, tomatoes |
Vitamin and mineral supplementation during pregnancy may be necessary for specific individuals (speak to your dietitian or doctor about whether you need to take a supplement). Supplementation is generally recommended in the following cases:
- Poor, inadequate diet
- Pregnant with twins / triplets
- Vegans
- Iron deficiency anaemia
- Smokers
Omega-3 fatty acids
It is recommended that women consume oily fish 2–3 times per week during pregnancy. Dietary sources of omega-3 fatty acids include salmon, pilchards, sardines, snoek, mackerel and anchovies. Fish with high levels of mercury, such as swordfish, shark and tilefish, should be avoided as mercury contamination has been associated with negative birth outcomes.
Fish still remains an important part of the diet and should be not be excluded. It is recommended that pregnant women who do not eat fish take a fish oil supplement (speak to your dietitian or doctor).
Other sources of omega-3 fatty acids include flaxseeds, chia seeds, walnuts, spinach and fortified products such as eggs.
WATER, EXERCISE AND ALCOHOL
Water intake
Women should ensure that they drink enough water during pregnancy: at least 9–10 glasses per day. This requirement is usually met through increased levels of thirst. Women who exercise should ensure that they remain hydrated and drink enough water during the day, as their fluid requirements may be higher.
Exercise
Women should remain active during their pregnancy. Exercise recommendations are similar to non-pregnant women: 30 minutes of activity 3-5 times per week. Types of physical activity recommended include walking, jogging, cycling or swimming.
Alcohol
A safe level of alcohol during pregnancy has not been determined, therefore it is strongly advised that pregnant women refrain from drinking any alcohol. High amounts of alcohol have been associated with adverse effects such as foetal alcohol syndrome (FAS) which is associated with impaired mental development, inadequate growth and facial abnormalities.
DIETARY GUIDELINES DURING PREGNANCY
- Eat a variety of foods to ensure a balanced intake.
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- Introduce more fibre-rich foods into the diet, such as whole wheat breads and cereals (oats, oat bran, All Bran, Hi Fibre Bran, whole wheat Pronutro), beans and other legumes, and fruit and vegetables.
- Include more fresh fruits and vegetables into the diet, especially dark green leafy and orange-coloured vegetables.
- Drink at least 9–10 glasses of water per day.
- Cook all meat, fish and eggs completely before eating.
- Consume dairy products (milk, yoghurt, cheese) every day. Use only pasteurized milk, cheese and other milk products, as unpasteurized products may cause Listeria infection.
- Keep caffeine intake to less than 4 cups of coffee per day.
- Avoid the intake of alcohol.
- Follow good hygiene practices when working with food.
ADDRESSING COMMON HEALTH ISSUES DURING PREGNANCY
| SYMPTOM | POSSIBLE SOLUTIONS |
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Nausea and vomiting |
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Constipation |
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Heartburn |
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Changes in taste and smell |
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References:
Brown JE, Isaacs JS, Krinke UB, Murtaugh MA, Sharbaugh C, Stang J, Wooldridge NH. Nutrition Through the Life Cycle. 3rd ed. Thomson Wadsworth; 2008.
Nutrition Information Centre University of Stellenbosch. Department of Human Nutrition. PREGNANT: What should I eat and how much? http://www.sun.ac.za/nicus
Should daily calorie intake be increased to facilitate healthy weight gain, and to what extent?
Pregnant women tend to think that they should be eating for two. This is not necessarily the case, as the daily energy requirements of pregnant women tend to increase by an average of only 300kcal per day, which is equivalent to eating 2 slices of brown bread with peanut butter and a fruit. Therefore, by adding a healthy snack to their usual daily intake, pregnant women should be able to cover their increased requirements and gain the amount of weight recommended. We should bear in mind that pregnant women should listen to their appetite and not overeat just because they are pregnant.
It is of utmost importance that pregnant women monitor their weight gain. If they are not picking up enough weight, picking up too much weight or if they are unsure if their current diet is adequate, they should consider visiting a dietitian.