Saturday, February 20, 2010

Health and Nutrition for Indian Woman, What to eat during pregnancy, Guide for pregnancy

What to eat during pregnancy

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With the increased requirement of all nutrients in your body it is important to eat a well balanced diet. Your daily diet should consist of a variety of food from different food groups.
  1. Milk and dairy products: skimmed milk, yogurt, buttermilk, cottage cheese –that are high in calcium, essential amino acids and Vitamin B-12. Talk to your doctor if you are lactose sensitive. 
  2. Cereals, whole grains, dals, pulses: they are good sources of protein. 
  3. Vegetables: these provide vitamins, minerals and fibre.
  4. Fruits: eat fresh/seasonal fruits and avoid processed /canned fruits.
  5. Meat/Fish/Poultry: these provide the essential animal proteins. Vegetarians need to consume about 1.5 ounces of nuts and 2/3 cup of legumes for proteins. One egg, ½ ounce of nuts, or ¼ cup of legumes is considered equivalent to 1 ounce of meat, poultry, or fish.
  6. Fluids: Keep yourself well hydrated by drinking lots of fluids, especially water and fresh fruit juices. Make sure you drink clean filtered water – if you need to go outdoors carry your own water or buy bottled water from a reputed brand -– most diseases are caused by waterborne visurses. Therefore ensure that you are consuming clean water both at home and outdoors. Go easy on the commercial and packaged juices as they have a very high sugar content.
  7. Fats and Oils: Special attention needs to be paid to cooking fats and oils. Ghee, butter and coconut milk/oil are high in saturated fats and are best avoided. Vanaspati and Dalda are both high in trans fats, equally as bad as saturated fats.
  8. Green, Leafy vegetables such as collard greens, swiss chard and spinach - these are loaded with vitamins A, C, K, folic acid and iron and are good for growing healthy tissue. Leafy greens are also high in magnesium and vitamin B12. Before conception, mothers can add a folic acid supplement as well as add leafy greens to their diet plan to help prevent neural tube defects.
  9. Sweet Potatoes -Sweet potatoes are a healthier substitute than white potatoes. They contain large amounts of vitamins A and C as well as a good amount of dietary fiber.
  10. Blueberries-These healthy berries contain vitamin C, manganese and are chock full of antioxidants. Blueberries are versatile and are an easy addition to yogurt, ice cream, and cereal for snacking or to add to any meal of the day.
  11. Apples - An easy fruit to throw in your bag for quick snacking, apples contain fiber and vitamin C. You might consider eating an apple a day since apples have just been shown to reduce the incidence of asthma in children when mothers ate 4 or more apples each week.
  12. Lean Organic Chicken Breast - With 87% of your daily recommended amount of protein in just one cup of cooked chicken breast, you will also be getting plenty of selenium, niacin and vitamin B6 when you add lean organic chicken to your pregnancy diet plan. Chicken also contains some omega 3 and omega 6 fatty acids.
  13. Nuts- These are a quick protein source to take with you during the day. Choose almonds since they are high in vitamin E and manganese and cashews for their magnesium.
  14.  Lowfat Organic Yogurt - One of the best sources of calcium that your baby needs for his or her bone development, organic yogurt is also rich in protein. Organic yogurt contains good bacteria and is the perfect food to add to your diet if you are taking antibiotics. 
  15. Whole Grains - Look for breads that are high in fiber (4-5grams per slice) and enriched with folate or folic acid.
  16. Cereals - Find cereals that are low in fat, high in protein and fiber (at least 5gm per serving) and enriched with folate to be sure you are getting plenty of this crucial mineral to prevent neural tube defects.
  17. Beans and Legumes - Beans such as pinto, red and black beans as well as lentils are packed with fiber, protein, folate and tryptophan. These beans also contain a little known mineral called molybdem which helps to detoxify sulfites (a substance often added to processed foods such as deli meats and salads.)

 Some foods are no-nos

During pregnancy your should try to avoid:
  1. I know Papaya is strict NO NO during pregnancy.
  2. Avoid Vitamin A supplements as too much may harm your baby growing inside.
  3. Avoid white breads and foods prepared with white flour (maida).
  4. Avoid too much sugar and foods containing sugars.
  5. Raw seafood, such as oysters or uncooked sushi
  6. Cheeses with a white, 'mouldy' rind, such as Brie and Camembert, and blue-veined cheeses like Stilton.
  7. Avoid consuming unpasteurised milk (buffalo or cow's milk from the local vendor).
  8. Pate, raw or undercooked meat, poultry, and eggs (cook all meat until there are no pink bits left and eggs till they are hard). All are possible sources of bacteria that can harm your unborn child. 
  9. Liver and liver products (pate, liver sausage) should be avoided, too, because they may contain large amounts of the retinol form of vitamin A, too much of which could be bad for your developing baby.
  10. For some women, it is also important to avoid peanuts and foods that contain them. If you, your partner, or any of your other children (if you have any) have a history of allergies such as hayfever, asthma, or eczema, avoiding peanuts during pregnancy and breastfeeding may reduce your baby's chances of developing a potentially serious peanut allergy. 
  11. Many women choose to avoid alcoholic drinks during pregnancy, too. Drinking too much alcohol can cause physical defects, learning disabilities, and emotional problems in children, so many experts recommend that you give up alcohol while you are pregnant.
  12. If you smoke, it is best for you and your baby to give up, the sooner the better. But, of course, this is often easier said than done.
  13. You might want to cut down on caffeine, too. This may be easy for women who are suddenly revolted by the stuff during their first trimester, but not so for everyone. Why is caffeine a potential problem? Research has linked consuming more than 300mg of caffeine a day with an increased risk of miscarriage and low birth weight. To be on the safe side stick to no more that two mugs of instant coffee or three cups of tea or two cans of cola per day. Or, although there is no evidence that moderate amounts of caffeine will harm you or your baby, you may want to switch to decaf hot drinks and fresh juices or coconut water, instead.
  14. Take a suitable antenatal vitamin-mineral supplement - In an ideal world - free of morning sickness or food aversions - a well-balanced diet would be all an expectant mum ever needed. But in the real world, a vitamin-mineral supplement may be good insurance that a pregnant woman will be able to meet her nutritional needs. Ask your doctor whether you should take a vitamin supplement. Folic acid is one supplement that is particularly important to take before you conceive -- and for the first three months or so of pregnancy. A lack of this B vitamin has been linked with neural tube birth defects such as spina bifida. The Ministry of Health recommends that women should take 0.4 mg (400 micrograms) of folic acid in a supplement at least until the 12th week of pregnancy. Later on in your pregnancy most women may need to take iron or calcium supplements to make sure you're getting enough of these key minerals. Your iron levels will be checked periodically during your pregnancy, and your doctor will advise you about your individual needs. If you are a strict vegetarian, have a medical condition such as diabetes, gestational diabetes, or anaemia, or if you have a history of low-birthweight babies, do talk with your doctor about any special supplements you might need. Remember, though, that more is not always better: Vitamin A supplements which contain retinol, the animal form of vitamin A, can be toxic to unborn babies in large quantities. Megadoses of most vitamins and minerals could be harmful to your developing baby. Avoid self- medication and always check with your doctor before taking any antibiotics, antacids and painkillers.
  15. Don't try to lose weight while you're pregnant - Dieting during pregnancy is potentially hazardous to you and your developing baby. Some diets can leave you low on iron, folic acid, and other important vitamins and minerals. Remember, weight gain is one of the most positive signs of a healthy pregnancy. Women who eat well and gain the appropriate amount of weight are more likely to have healthy babies. So if you're eating fresh, wholesome foods and gaining weight, relax: you're supposed to be getting bigger!
  16. Gain weight gradually - Weight gain varies amongst individuals and depends on many factors. The average weight gain during pregnancy seems to be between 8 kilos and 15 kilos. Concentrate on eating a healthy diet: plenty of carbohydrates, lots of fruits and vegetables, reasonable amounts of protein, and just a little in the way of fats and sugars. However, if you are over 90 kgs or under 50 kgs, your doctor may advise a diet customised for you. When you put on weight may be as important as the total amount. Most women gain the least weight during the first trimester and steadily increase, with the greatest amount being put on in the third trimester when the baby is growing the most.
  17. Eat small meals every few hours - Even if you're not hungry, chances are your baby is, so try to eat every four hours. And if morning (or all-day) sickness, food aversions, heartburn, or indigestion make eating a chore, you may find that eating five or six small meals, rather than the usual three larger ones, is easier on your body. Remember, your developing baby needs regular sustenance, and you need to keep up your energy levels, so try not to miss meals. 
You don't have to give up all your favourite foods just because you're pregnant. But processed or canned foods and snacks and sugar-packed desserts shouldn't be the mainstay of your diet, either. So as far as snacks are concerned, try a banana rather than luxury ice cream, or badam / kesar milk instead of a gajjar halwa dripping with calories. But don't feel guilty if you fancy the occasional chocolate. Enjoy every bite!

Do you wonder how it's reasonable to gain 25 to 35 pounds (on average) during your pregnancy when a newborn baby weighs only a fraction of that? Although it varies from woman to woman, this is how those pounds may add up:
· 7.5 pounds: average baby's weight
· 7 pounds: extra stored protein, fat, and other nutrients
· 4 pounds: extra blood
· 4 pounds: other extra body fluids
· 2 pounds: breast enlargement
· 2 pounds: enlargement of your uterus
· 2 pounds: amniotic fluid surrounding your baby
· 1.5 pounds: the placenta

1.2.1 Folic acid
During the first three months of pregnancy (and preferably before becoming pregnant) a woman needs folic acid. This is one of the B-group vitamins and is also known as vitamin B9. It is important during pregnancy for the creation of the baby's nervous system.
Folic acid can help prevent neural tube defects such as spina bifida and other congenital malformations such as cleft palate or cleft lip.
Good natural sources of folic acid are barley beans, fruit, green vegetables, orange juice, lentils, peas and rice. It is recommended that all pregnant women take a daily 400 microgram supplement of folic acid a day for two months before conception and three months into their pregnancy.
The dosage of the supplement should be larger - 5mg per day - if a woman has previously given birth to a child with a neural tube defect, if she or her partner has spina bifida or a family history of neural tube defects, or if she has coeliac disease (or other malabsorption state), diabetes mellitus, sickle-cell anaemia, or is taking antiepileptic medicines. She should discuss this matter with her doctor.

During pregnancy, a woman's body needs more iron than usual to produce all the blood needed to supply nutrition to the placenta. Good sources of iron are green vegetables such as broccoli and spinach, strawberries, muesli and wholemeal bread.
Iron is more easily absorbed if it is taken in conjunction with vitamin C - either as a supplement or in citrus fruit or juice. Tea and coffee can interfere with the body's absorption of iron.
It is often recommended that all pregnant women take an iron supplement every day from the 20th week of pregnancy. This is not necessary if a woman has a good diet and routine blood tests show that she is not anaemic. Iron supplements may cause constipation.

The minerals zinc and calcium are also needed for the development of the embryo. However, it is usually possible to obtain enough zinc and calcium by following a varied diet.

What foods should be avoided during pregnancy?
It is important to avoid vitamin A during pregnancy because it may cause damage to the embryo. Foods containing large amounts of vitamin A include liver, and should be eaten on an occasional basis only. Unpasteurised cheeses, blue-veined cheeses and pâté are also not recommended because of the possible risk of transmission of infectious diseases such as Listeria.

How to avoid constipation
Constipation during pregnancy can be caused by hormonal changes that cause the intestines to move less. Iron supplements can also cause constipation.
To avoid constipation, eat lots of fibre-rich foods such as fruit, vegetables, wholemeal bread and cereal, prunes and prune juice. Drinking 2 to 3 litres of water each day will also help prevent constipation by keeping stools moist.
Regular exercise will also help get the intestines moving. About 20 to 30 minutes' swimming or brisk walking two to three times a week is a good level of exercise to aim for.
A pharmacist will be able to provide advice about over-the-counter preparations that are safe to use during pregnancy to relieve constipation.

How much weight should a woman gain during pregnancy?

It is considered normal to gain 10 to 12kg (22 to 26lb).
For practical reasons the pregnancy is divided into three periods:
the first period runs from week 0 to 12 where it is normal to gain 1 to 2kg (2 to 4lb).
the second period runs from weeks 12 to 28 in which it is normal to gain 300 to 400g (10 to 14oz) a week.
the third period runs from weeks 28 to 40 and it is normal to gain 1 to 3kg (2 to 6lb) a month.
It is not necessary to be obsessive about your weight during pregnancy. Many obstetricians have stopped weighing women other than at their first visit because the information is of little use in detecting problems with the mother or her baby.
However, excess weight gain is probably best avoided since most women will want to return to the same dress size within a few months of delivery.

Where do the extra kilos come from?

A total weight increase of about 11.2kg (24lb) is normal.
A baby weighs approximately 3.5kg (7lb 11oz) before birth.
The uterus grows to approximately 900g (1lb 14oz).
The placenta weighs approximately 650g (1lb 6oz).
The amniotic fluid weighs approximately 800g (1lb 12oz).
The woman's breasts grow by approximately 400g (14oz).
The weight of the extra blood is approximately 1.25kg (2lb 12oz).
Water retained in the body tissues weighs approximately 2kg (4lb 6oz).
The layer of fat beneath the skin weighs approximately 1.7kg (3lb 11oz).

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