Eating during pregnancy is not too different from a regular diet; however, some foods should be avoided during this period.
Although eating during pregnancy can be a challenge for many expectant mothers, deep down, it is not far from a typical healthy diet, although with some “buts”. There is much talk about sausages, raw fish (such as sushi) or smoked fish, excess fats ... although it is true that in all these points things must be clarified, the reality is that we are increasingly better informed about what is what should and should not eat during pregnancy.
Today we will review all these points, taking into account both what official organizations such as the Spanish Agency for Food Safety and Nutrition say, as well as what some studies have come to affirm in this regard.
No, it is not necessary to eat twice as much during pregnancy
Recently I heard again the typical comment related to food during pregnancy: how there is a new life, “you have to eat for both of us”. This can be misinterpreted, a lot, reaching the point where excess calories in a pregnant woman have been shown to cause problems such as gestational diabetes (which usually resolves after delivery if appropriate measures are taken), obesity (which can extend beyond the pregnancy) and its respective consequences in the future baby (autism and alteration of psychosocial development, premature abortions, pre-eclampsia and even obesity and type 2 diabetes in the adulthood of future new-borns).
Yes, it is true that during pregnancy you have to eat more, but not twice as much. According to an Italian consensus document published last year 2016, the caloric needs of a woman with normal weight and without any disease prior to said pregnancy (assuming a moderately active life), should slightly increase her daily calories. By slightly I mean an increase of just 69 more kcal per day during the first trimester, about 266 more kcal per day during the second and about 500 more per day during the third and last trimester. Also, during the first six months of breastfeeding, this document also advises to continue with this additional 500 kcal daily intake, as in the third trimester.
As we can see, this is not "eating twice as much”, as a healthy diet in a healthy woman would be around 1,700 - 2,000 kcal approximately depending on her basal weight, and studies only recommend increasing intake by up to 25% and only in the third trimester and first six months of exclusive breastfeeding.
Diet during pregnancy: meat, depending on the type
During pregnancy, meat is not prohibited, not even sausages, but both things must be looked at with a magnifying glass. According to the Spanish Agency for Food Safety and Nutrition, should avoid raw meat or undercooked (we recommend reach 71ºC cooking, where the color of the center of the meat changes color), avoid meat sliced products packed (although they can be consumed if they are cooked above 71ºC, such as croquettes or pizzas for example), avoid patés that are sold refrigerated and avoid sausages and raw meat products, as the case may be.
We will stop at this last point, sausages and raw meats.
The Spanish Agency for Food Safety and Nutrition makes this recommendation in reference to toxoplasmosis, a type of parasitic infection that can have serious consequences in the new-born if the mother is not immunized. Therefore, during the first trimester of pregnancy, it is typical to perform tests for infection by toxoplasmosis (serology) and other microorganisms in the pregnant mother per protocol. If said serology tests positive, it means that the pregnant woman has antibodies against the parasite because at some point in her life she has had contact with it (in many cases without any symptoms); in this case there will be no problems with the consumption of these foods. If it is negative, and there are no antibodies , the doctor's obligation will be to recommend avoiding the consumption of sausages and raw meats in pregnancy, and to emphasize a correct washing of raw fruits and vegetables, since the parasite is transmitted through contact with cat feces and can become in these foods if they are not washed properly. Even so, currently the sanitary controls on sausages and other types of meats are increasingly strict and the risk is less and less.
Even so, the recommendation to avoid raw meat remains in force, as there are many other microorganisms to take into account that can put both mother and baby at risk. Toxoplasmosis stands out for living in sausages, but the consumption of raw meat should be avoided.
Food during pregnancy: fish, it depends
In its advice document, the Spanish Agency for Food Safety and Nutrition recommends consuming fish (especially blue fish) up to 3 or 4 times a week, as it provides a large amount of healthy fat such as omega-3 fatty acids and other essential nutrients. In fact, recently, a study affirmed that the consumption of fish is advantageous for the cognitive development of the future baby.
However, as with meat, this point also has nuances.
The government organization advises avoiding fish such as swordfish, shark, bluefin tuna and pike as part of the diet during pregnancy. All these fish stand out for containing high levels of mercury, a substance that can reach the placenta and alter the development of the baby (only a weekly serving of swordfish would already exceed the maximum tolerable intake limit in pregnancy).
On the other hand, it is also advisable to avoid the consumption of raw fish, smoked fish, marinated or fermented fish and caviar or cooked seafood. All of them are at risk of being contaminated by a bacterium, Listeria monocytogenes, which has been shown to increase the risk of miscarriage, premature birth and even fetal death. Of course, according to the Scientific Committee of the Food Safety Agency, if the fish is cooked correctly, the bacteria are deactivated.
Feeding during pregnancy: milk with care, fruits and vegetables the more the better
Regarding milk, the Spanish Agency for Food Safety and Nutrition advises the same both during pregnancy and in a normal healthy diet: raw milk should not be consumed.
Likewise, it is also advisable to avoid fresh or soft paste cheeses (including Brie, Camembert, Burgos type, mozzarella and blue cheeses) if the labeling does not assure us that pasteurized milk has been used. The same advice would apply to grated or sliced cheeses. And you must remove the rind from any cheese, including cured ones. All these recommendations respond to the prevention of congenital risks of the future newborn.
As for fruits and vegetables, their consumption is recommended as long as they are washed correctly with bleach suitable for disinfection (4 drops per liter of water, submerged for 10 minutes). It is also advised to avoid tender shoots.
Diet during pregnancy: micronutrients and supplementation
Currently the only supplementation approved and used by protocol both a few months before and during the pregnancy itself is folic acid or vitamin B9 .
On the other hand, and although pregnancy increases iron needs (iron deficiency anemia being a disease that affects 22% of fertile women in Europe, and up to 50% of fertile women in developing countries), At the moment its use in the form of supplementation is not recommended unless this type of ailment is detected by analytical tests in the successive controls that are carried out during pregnancy. Through diet it is possible to reach adequate daily doses of iron thanks to the consumption of meat and fish, legumes, nuts and green leafy vegetables.
An insufficient intake of iron can cause the aforementioned anemia (in addition to increasing the risk of delays in the development of the fetus, risk of low weight, premature delivery and postpartum hemorrhages, and even increase the cardiovascular risk in adulthood of the future baby), but an excess of iron can increase the risk of metabolic disorders and gestational hypertension. Currently the recommendations are around 30-60 mg daily.
On the other hand, we have other types of important micronutrients in pregnancy, such as iodine (present in iodized salt, fish, shellfish, fruits, vegetables, milk and eggs), calcium (present in milk and derivatives, cereals and vegetables) and vitamin D (only minimally affected by intake, since its synthesis depends largely on taking sunlight). For the time being, neither of these micronutrients requires external supplementation per protocol, unless a deficit is discovered through analytical studies.
Diet during pregnancy: little caffeine and zero alcohol
Finally, the Spanish Agency for Food Safety and Nutrition advises the obvious: avoid tobacco, alcohol and any type of drugs (likely to cause defects in the future baby), and limit the consumption of caffeine.
In this last point about caffeine, the fact that this substance is capable of crossing the placenta stands out and has been associated with some effects such as altered heart rate, high blood pressure and sleep disorders. Current recommendations limit caffeine intake in pregnancy to 200 mg daily (a cup of coffee is 103 mg of caffeine on average).
However, paradoxically, some studies such as the Spanish Collaborative Study of Congenital Malformations have not observed a clear relationship between caffeine and these birth defects, although the recommendation remains in force.
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