The diet during pregnancy is a determining factor to guarantee the good health of the pregnant woman and the embryo / fetus.
Diet
Calories
Because it is essential to establish the right calories
Without going into too much detail, let us remember that:
- The weight trend is an element of primary importance in the verification of a correct evolution of the pregnancy
- The underweight is considered predisposing to various nutritional defects and possible irreversible complications of the child
- Overweight is considered predisposing to pregnancy-induced diabetes, which can become chronic after birth, and to irreversible complications of the unborn child
- An underweight woman must take more calories than normal (to increase the total body mass to the normal range)
- In reverse. an overweight woman is required to eat less than the norm (to avoid increasing further).
- In gestation the weight reduction must NOT be pursued under any circumstances
- The calorie increase in the diet is especially important from the second month onwards
- If pregnancy requires total rest, the caloric increase is lower than normal.
How many calories should you take?
On average, the daily caloric needs during pregnancy increase by about 200 kcal. These extra calories, which can change depending on the specific case, must be added to the normal daily energy demand.
To be clear, if the normocaloric diet of a healthy woman corresponded to 2, 000 kcal / day, in pregnancy the same person should introduce about 2, 200 kcal / day.
The evaluation of energy needs in pregnancy is slightly more complex than normal. The phases necessary for an empirical calculation of the caloric demand in gestation are summarized below, exclusively for information purposes.
It is also advisable to consult your doctor for a personalized evaluation.
How to accurately estimate calories?
- Previous weight and body mass index : it is first of all necessary to evaluate the starting nutritional status, recording the weight at the moment of conception. In relation to height, weight is necessary to calculate the initial body mass index (according to the formula = Weight in kg / Height in meters squared). Also called IMC or BMI, this value serves to contextualize the spannometrically the adequacy of the weight in a measurement scale referred to the average population:
- Underweight: <18.5
- Normality: 18.5 - 24.9
- Overweight: 25.0 - 30.0
- Obesity:> 30.0
- Estimate of normal energy expenditure : indicates the amount of energy needed by the body to maintain constant weight, guaranteeing the supply of essential and necessary nutrients. This estimate is made as follows:
- Calculate the previous desirable physiological body mass index (what the healthy woman should have before gestation)
- Consequently, calculate the desirable physiological weight and - considering the age - the basal metabolism (MB)
- Estimate the level of physical activity (LAF coefficient), which for the pregnant woman should NEVER be heavy or provide for the execution of desirable intense (sport or fitness)
- Finally, get the overall energy expenditure.
- DESIRABLE weight gain forecast : for the reasons we have seen above, it is necessary to optimize the weight gain throughout the pregnancy as follows:
- Underweight: 12.5-18.0 kg increase (average 15.3 kg)
- Normal weight: increase of 11.4-16.0 kg (average 13.7 kg)
- Overweight: increase of 7.0-11.5 kg (average 9.3 kg)
- Obesity: increase <7 kg
- Assignment of the appropriate caloric increment : having a clear idea of the nutritional condition of the pregnant woman, the time has come to choose how many more calories (compared to the total energy expenditure) to assign to obtain the desirable increase in the farm:
- Underweight: + 365 kcal
- Normal weight: + 300 kcal
- Overweight: + 200 kcal
- Obesity: + 200 kcal
- In case of complete rest :
- Underweight: + 365 kcal
- Normal weight: + 200 kcal
- Overweight: + 100 kcal
- Obesity: + 100 kcal
Examples of increased energy
Once it was said that during pregnancy it is necessary to eat twice as much; nothing could be more incorrect, even if in fact we are feeding more to satisfy the nutritional demands of two organisms.
Let's take some practical examples to get an idea of how many more foods should be consumed while respecting "more or less" the nutritional balance and suitable food choices for gestation:
- 365 kcal: whole wheat pasta 60 g, tomato sauce 100 g, grana 20 g (1 cube), extra virgin olive oil 10g (2 teaspoons)
- 300 kcal: 75 g whole wheat bread (3 slices), pickled tuna 50 g (1 drained box), extra virgin olive oil 5 g (1 teaspoon)
- 200 kcal: boiled beans 80 g, chicken breast 50 g, extra virgin olive oil 5 g (1 teaspoon)
- 100 kcal: 250 g partially skimmed milk yogurt (2 jars) or 250 ml semi-skimmed milk (1 cup).
Automatic calculator
It is possible to use the following calculation form to obtain an INDICATIVE estimate of how many calories the diet will provide in pregnancy.
Protein
How many proteins should you take?
The diet for pregnancy requires a protein intake slightly higher than that estimated for normality.
This is because the "protein deposition value" (quantity of peptides actually used by the organism for biological functions) corresponds to 70% (above the norm).
However, considering that the average population assumes a much higher protein proportion than normal, it is often not necessary to increase it further.
However, it is advisable to add 6 grams of peptides per day to the normal intake, which corresponds more or less to 13% of the global energy.
To give an example, in a 2000 kcal diet, 13% of proteins correspond to 260 kcal, or 65 g; adding 6 g a protein fraction of 71 g is obtained.
6 grams of protein are contained, for example, in just under two glasses of semi-skimmed milk (150-200 ml).
To ensure an adequate biological value (quantity and ratio of essential amino acids) it would be appropriate for at least 1/3 of the proteins to come from foods of animal origin.
Grassi
How much fat should you take?
The percentage of fat in the diet for pregnancy is the same as normal, or 25% on total calories.
To give an example, in a 200 kcal diet, 25% of lipids correspond to 500 kcal, or 55-56 g; of these, the majority must be unsaturated and only 7-10% composed of saturated, hydrogenated fats in trans conformation.
In 90-93% of the unsaturated, it is FUNDAMENTAL that it includes a 0.5-2.0% of essential and semi-essential polyunsaturated fatty acids omega 3 and a 4-8% of essential and semi-essential polyunsaturated fats omega 6.
Because of their importance in fetal development, it is necessary that among the omega 3 there should be at least 250 mg of EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) + another 100-200 mg of DHA per day.
In healthy women, the cholesterol content of the daily diet must be less than 300 mg / day.
There are no indications regarding phytosterols and lecithins.
Carbohydrates and fibers
How many carbohydrates and fiber should be taken?
Once the amount of protein and fat has been established, the carbohydrate intake is simple to calculate; represents all remaining energy.
For example, in a 2, 000 kcal diet, total carbohydrates make up 1, 216 kcal or 324 g (60%).
The percentage of simple sugars must be approximately 12% (240 kcal or 64 g); it can be higher ONLY if it consists of fructose and the naturally present lactose of foods (milk, fruit and vegetables).
It is essential that in the event of hyperglycemia or pregnancy-related diabetes the glycemic load is reduced (up to a percentage of carbohydrates equal to 45%, but only on the advice of the attending physician) and the glycemic index of meals.
In the pregnancy diet, at least 30g / day of fiber is indispensable; due to some normal but "annoying" changes (pressure and slight displacement of the colon) an alteration of the bite may occur.
By drinking a lot of water and increasing the fibers (especially soluble or viscous) the faeces can be softened, improving the regularity of the evacuations.
Minerals and vitamins in the diet for pregnancy
How many minerals and vitamins should be taken?
It depends on the specific nutrient.
The intake of certain minerals and vitamins does not change significantly during pregnancy; others instead take on a decisive role.
We see the most important, or those most involved in the growth of the embryo / fetus:
- Minerals:
- Iron: it must be supplied above all from foods of animal origin (meat, egg yolk and fishery products) to guarantee its bioavailability. Reasoning exclusively in food terms, we could say that, in respect of the general nutritional balance, it is necessary that the pregnant woman takes as much as possible (it is almost impossible to reach 22-27 mg / day with diet alone).
- Calcium: it is recommended to ensure about 800-1, 200 mg / day (it is mainly contained in milk and derivatives).
- Vitamins:
- Thiamine or vitamin B1: 1.2-1.4 mg / day
- Riboflavin or B2: 1.4-1.7 mg / day
- Niacin or PP: 17-22 mg / day
- Pyridoxine or B6: 1.6-2.0 mg / day.
- Ascorbic acid or C: 70-100 mg / day
- Retinol equivalents or A: 500-700 μg / day
- Folic acid: 520-600 μg / day
- Cobalamin or B12: 2.2-2.6 μg / day
- Calciferol or D: 1.0-1.4 μg / day.
Water in the diet for pregnancy
How much water should you take?
In addition to the one present in foods, it is advisable to drink at least 2 liters of water per day.
Foods to Avoid
Sweeteners: do they hurt?
Sweeteners common in Italy are considered safe.
The general recommendation is always to use as little as possible.
However it is advisable not to exceed 7 g / day.
Alcohol: does it hurt?
Small quantities, equivalent to about 100-150 ml of wine or beer a day, drink A MEAL are considered safe. It would however be better to completely avoid the consumption of alcoholic beverages, especially in the first trimester of pregnancy.
Caffeine and other nervini: do they hurt?
The global recommendation remains not to exceed and to evaluate the total content of stimulants in food and beverages.
Better not to exceed the 300 mg / day of caffeine, that is the content of 3 coffees.
What foods are to be avoided completely in the diet for pregnancy?
Toxoplasmosis and foodborne diseases
In pregnancy it is important to exclude raw or undercooked foods of animal origin from the diet, including sausages (due to the risk of toxoplasmosis and other food diseases that are very dangerous for the fetus, such as listeriosis).
Pay particular attention to meat purchased directly from the small breeder for personal use, given that often these meats are not subject to the same controls as farm animals.
General rules to prevent foodborne illnesses in pregnancy
- Avoid raw meat such as cold cuts and carpaccio; eat only well cooked meat.
- Heat prepared foods such as hot dogs, sausages and other meat products to the boil. Avoid eating the products for which heating is impossible (for example, cured ham or salami).
- Do not eat raw eggs or sauces prepared with raw eggs (eg mayonnaise)
- Wash your hands with warm water and soap after touching the above foods for at least 20 seconds. Even cutting boards, plates and cutlery must be washed thoroughly after use.
- Avoid soft cheeses such as feta, brie, gorgonzola, camembert etc. Instead, you can eat hard, processed cheeses based on cream, yogurt, etc.
- Do not eat raw fish or smoked fish (eg salmon, trout, tuna, mackerel, etc.), unless it is contained in a well-cooked dish (eg baked pasta). Canned fish can be eaten.
- Avoid pate or spreadable meat, if refrigerated. They can be consumed only if sterilized (canned).
- Do not drink raw or unpasteurized milk and do not eat foods derived from it, such as unpasteurized cheese (check the label).
- In general it is good practice to wash fruits and vegetables thoroughly before eating them. Avoid contact with potentially infectious material (eg faeces of animals or dead animals). Do not use untreated manure to fertilize vegetables.
- Wear gloves when gardening or any other activity that requires touching the ground or objects that may have come into contact with the feces of wild animals (mice, pigeons etc.) or domestic animals (especially the cat).
Other Tips
- Although during pregnancy it is important to maintain a high fiber intake with the diet, through the consumption of a wide range of plant-based foods, we do not recommend the use of supplements such as bran, in order not to excessively hinder the absorption of some mineral salts. Furthermore, if taken in excess, the fiber could even cause diarrhea, meteorism and flatulence.
- According to individual predisposition, all those foods, such as legumes, will therefore be limited, which in predisposed subjects favor the appearance of meteorism and abdominal colic.
Needs increase
What nutritional needs should we treat most in pregnancy?
As we have seen, during pregnancy the need for some nutrients increases significantly.
In particular, during this delicate and happy period of life it is important to take with the diet the right doses of folate, iron and calcium.
During pregnancy, the need for proteins and other vitamins, such as C (ascorbic acid), A or retinol, B6 (or pyridoxine), B12 (cyanocobalamin) and D (calciferol) slightly increase.
Due to the increased demand for folic acid, it is therefore important during pregnancy to include a wide variety of vegetables in the diet, especially raw, but without neglecting the hygienic aspect.
| Recommended and adequate intake for the population - Italian Society of Human Nutrition - SINU, 2014 | ||||||||
| Football | Phosphorus | Potassium | Iron* | Zinc | Copper | Selenium | Iodine | Vit.B1 |
| (Mg) | (Mg) | (Mg) | (Mg) | (Mg) | (Mg) | (Mg) | (Micrograms) | (Mg) |
| 1200 | 700 | 3900 | 27 * | 11 | 1.2 | 60 | 200 | 1.4 |
| Vit.B2 | Niacin (NEITHER) | Vit.B6 | Vit.B12 | Vit.C | Folic Acid ^ | Vit.A (RE) ° | Vit.D |
| (Mg) | (Mg) | (Mg) | (Mg) | (Mg) | (Mg) | (Mg) | (Mg) |
| 1.7 | 22.0 | 2.0 | 2.6 | 100 | 600 * | 700 * | 1.4 |
Note:
* The intake of iron during pregnancy, which corresponds to lower fetal and neonatal morbidity and mortality, is such that it cannot be easily covered with a balanced diet, so a supplement is recommended.
^ An increase in folate intake in the diet during the periconceptional period is a protective factor against spina bifida in the unborn child.
° In pregnancy, due to the known teratogenic effects linked to possible excessive doses, vitamin A supplements should only be taken on the advice of the doctor, and in any case with doses that do not exceed 6 mg of RE
Increase iron intake
Iron Rich Foods
| Food | Iron [mg / 100g] | Food | Iron [mg / 100g] |
| Spleen, bovine | 42, 00 | Flour, soy | 6.90 |
| Liver, pig | 18, 00 | Soy, dry | 6.90 |
| Tea, in leaves | 15, 20 | Lung, bovine | 6.70 |
| Unsweetened cocoa powder | 14, 30 | Chickpeas, dried, raw | 6.40 |
| wheat bran | 12, 90 | Cashews | 6.00 |
| Liver, sheep | 12, 60 | Frog | 6.00 |
| Sturgeon, eggs (caviar) | 11, 80 | Oyster | 6.00 |
| black pepper | 11, 20 | Mussel or mussel | 5.80 |
| Wheat germ | 10, 00 | Muesli | 5.60 |
| Mint | 9.50 | Lupins, soaked | 5.50 |
| Borlotti beans, dry, raw | 9.00 | Basil | 5.50 |
| Liver, equine | 9.00 | Redfish | 5.50 |
| Cannellini beans, dry, raw | 8.80 | Apricots, dehydrated | 5.30 |
| Dried beans from the eye | 8.80 | Heart, pig | 5.30 |
| Liver, bovine | 8.80 | Oatmeal | 5.20 |
| Rosemary | 8.50 | Rocket or rocket | 5.20 |
| Beans, dried, raw | 8.00 | Shelled dried broad beans | 5.00 |
| Lentils, dried, raw | 8.00 | Apricots, dried | 5.00 |
| Kidney, bovine | 8.00 | Heart, equine | 5.00 |
| Green radicchio | 7.80 | Heart, sheep | 5.00 |
| Pistachios | 7.30 | Dark chocolate | 5.00 |
Increase folic acid intake
Foods Rich in Folic Acid
| VERY HIGH | HIGH | MODERATE | BASS | VERY LOW |
| 250-300 µg | 90-180 µg | 50-89 µg | 20-49 µg | 1-19 µg |
| Bran or corn flakes Wheat germ Soy Brewer's yeast 1250 µg | Asparagus Red beets Biete Broccoli each Frozen artichokes Catalonia Brussels sprouts Green broccoli cabbage Dried mushrooms Soybean sprouts Endive Rocket salad escarole spinach Dried chickpeas Fava beans Dried beans lentils | Artichokes Green cabbage Cauliflower Fennel Lettuce Leeks Zucchini Fresh beans Fresh peas Fresh chestnuts peanuts walnuts Pine nuts | Cardi Red cabbage Fennel Chiodini mushrooms Mushrooms ova Porcini mushrooms Yellow peppers Green radicchio radishes Celery Frozen vegetables and pulses oranges Clementine Raspberries Kiwi Mandarins blue raspberry Orange or grapefruit juice Potatoes Canned peas | carrots Cucumbers Chicory Belgian chicory onions Sauerkraut Eggplant Salad tomatoes Peeled tomatoes Red radish Rape yellow pumpkin Canned chickpeas Canned beans apricots Pineapple Banana Caki cherries Watermelon Dried dates figs strawberries Lemon Apple Melon Medlar, currant Pear, plums Fishing Grapefruit |
CONTINUE: Example diet during pregnancy »
