The importance of nutrition during pregnancy
Written by Charlotte Hales (BSc Nutrition student)
Instagram: @nutrichar_ / LinkedIn: https://www.linkedin.com/in/charlotte-hales/
During pregnancy, a mother’s nutrition intake needs to be sufficient to meet the demands of both the growing baby and the changes that happen to mum’s own body during this time. Baby is fully dependent on mum to meet all of their nutritional needs. During the first trimester, mum’s nutrition intake affects embryo development, organ formation and brain development, and during the second and third trimesters, baby stores nutrients for after birth. Poor nutrition intake is associated with abnormal growth patterns in infants, which are linked with an increased risk of chronic disease in later life. Whilst all nutrients are important to support a healthy pregnancy, some are especially so.
What are some of the key nutrients?
Folate
Folate is perhaps the most well-known nutrient in pregnancy. A combination of increased demand and low intake of folate-rich foods means pregnant women may be at risk of deficiency. Folate is required for the synthesis of DNA, protein metabolism, to make new red blood cells, and for neural tube development, which requires adequate amounts of folate in the first 28 days following conception.
Sources of folate: dark green leafy vegetables (such as spinach and cabbage), liver, some fortified foods such as cereals, brassica vegetables (including broccoli and brussels sprouts), kidney beans and chickpeas.
Omega-3 fatty acids
During pregnancy, omega-3 fatty acids are needed for the development of the central nervous system and overall growth, and maternal omega-3 intake has been associated with improved brain function and vision in infants. Recent evidence also suggests that maternal omega-3 status during pregnancy and breastfeeding, specifically DHA (docosahexaenoic acid), may impact baby´s development of chronic diseases in later life. Due to the inefficient conversion of plant omega-3 to DHA, direct intake via animal sources or supplementation is recommended to ensure sufficiency.
Sources of omega 3: Animal sources are mainly oily fish and seafood. Plant sources include flax, pumpkin and hemp seeds, walnuts, dark green leafy vegetables, soya beans and seaweed.
Take note: Oily fish is very nutrient dense, however, it is advised to limit intake to one-two portions per week during pregnancy due to the associated exposure to toxins, such as mercury.
Iron
Iron is required for growth and development, and the formation of new red blood cells needed to increase blood volume to accommodate baby´s needs. Requirements increase as pregnancy progresses and baby stores iron to use after birth. Meeting requirements may provide an advantage in terms of cognitive development.
Sources of iron: meat, liver, beans, nuts, dried fruit, wholegrains, fortified cereals, dark green leafy vegetables and seafood.
Top tip: Whilst there is evidence to suggest that iron absorption is naturally enhanced during pregnancy (how clever is that!), to further increase absorption, consume iron-rich foods alongside those rich in vitamin C, such as citrus fruits and peppers.
Vitamin D
In pregnancy, vitamin D plays an important role in the formation of the skeletal system, supporting bone formation and helping to regulate calcium levels. Vitamin D may also be involved in the development and functioning of baby´s immune system.
Food sources of vitamin D are limited, but include: eggs, mushrooms, dairy and fortified alternatives, cod, oily fish and liver.
Choline
Choline is an essential nutrient for brain development and signalling between cells. Needs are higher during pregnancy and insufficiency may impact brain and spinal cord function, increasing the risk for neural tube defects (NTDs). Evidence suggests that adequate maternal choline during pregnancy can have long-term beneficial effects on infant cognition.
Food sources: fish, beef, poultry, eggs, dried soya beans, and brassica vegetables.
Should any supplements be considered?
Folate
Guidelines recommend supplementing with 400mcg daily of folic acid (synthetic folate) from pre-conception to 12 weeks´ gestation. A higher dose may be advised in certain individuals, such as those with diabetes or a history of NTDs, and there is evidence to suggest obese women may also benefit. This should be discussed with a healthcare professional.
Vitamin D
Guidelines recommend supplementation of 10mcg (400IU) daily from September to March for the whole population. Pregnant and breastfeeding women are at particular risk of vitamin D deficiency, and a higher dosage may be needed to begin with to increase levels sufficiently. Again, this should be discussed with a healthcare professional.
As well as the above, those on vegetarian and vegan diets may be low in vitamin B12, omega 3, iodine, iron and choline, and individuals may consider supplementation. Iron is the most common deficiency in pregnancy, and deficiency can be tested for easily - speaking to a GP is the first port of call. Iodine and omega 3 may also be considered for individuals who do not consume fish or seafood for other reasons. Ultimately, it is important to remember that everyone is unique; this information is providing an overview and should not be taken as personalised advice. Qualified health professionals such as a Registered Dietitian, Registered Nutritionist and GP can help with this.
In summary…
Many nutrients play vital roles in baby´s growth and development, and it can be difficult to know how much of each nutrient we are getting from our food. Whilst there are some supplements that are either recommended for all (as with folic acid and vitamin D) or may be considered for certain individuals, by aiming to incorporate as much variety as possible into our diets, we provide our bodies with a wide range of nutrients that help contribute to a happy, healthy pregnancy for both mum and baby.
References
Beluska-Turkan, K., Korczak, R., Hartell, B., Moskal, K., Maukonen, J., Alexander, D.E., Salem, N., Harkness, L., Ayad, W., Szaro, J. and Zhang, K., 2019. Nutritional gaps and supplementation in the first 1000 days. Nutrients, 11(12), p.2891.
Food Standards Agency, 2004. Advice on fish consumption: benefits and risks. [pdf] Food Standards Agency. Available at: <https://cot.food.gov.uk/sites/default/files/cot/fishreport200401.pdf> [Accessed 20 May 2023].
Moran, V. and Robinson, S., 2017. Pregnancy and lactation. In: C. Geissler and H. Powers, ed. 2017. Human Nutrition. Oxford: Oxford University Press. Ch.15.
Human Nutrition textbook (ed. Geissler and Powers), Ch. 15 Pregnancy and Lactation Moran, V and Robinson, S.
Marshall, N.E., Abrams, B., Barbour, L.A., Catalano, P., Christian, P., Friedman, J.E., Hay Jr, W.W., Hernandez, T.L., Krebs, N.F., Oken, E. and Purnell, J.Q., 2022. The importance of nutrition in pregnancy and lactation: lifelong consequences. American Journal of Obstetrics and Gynecology, 226(5), pp.607-632.
NHS, 2023. Vitamins, supplements and nutrition during pregnancy. [online] Available at: <https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/> [Accessed 20 May 2023].
van der Windt, M., Schoenmakers, S., van Rijn, B., Galjaard, S., Steegers-Theunissen, R. and van Rossem, L., 2021. Epidemiology and (patho) physiology of folic acid supplement use in obese women before and during pregnancy. Nutrients, 13(2), p.331.
Wallace, T.C., Blusztajn, J.K., Caudill, M.A., Klatt, K.C., Natker, E., Zeisel, S.H. and Zelman, K.M., 2018. Choline: the underconsumed and underappreciated essential nutrient. Nutrition Today, 53(6), p.240.