Nutrition in Pregnancy: What and how much to eat

Estimate the Weight

So let’s start by remembering and underlining some fundamental rules to follow, and some basic criteria to respect.

Initial assessment and calculation of weight gain

First of all, it is necessary to pay attention to the initial measurements of the pregnant woman – called pre-pregnancy – and calculate the Body Mass Index (BMI) or Body Mass Index (BMI).

The BMI or BMI is a reference value which, in the context of a rating scale, offers the possibility of understanding whether the weight is too low (< 18.5), normal (18.5 to 24.9), excessive (25 to 29.9) or dangerously high (> 29.9). Note : 1st grade obesity from 29.9 to 34.9, 2nd grade obesity (severe) from 35 onwards.

The formula to use is very simple: just divide the weight expressed in kilograms (kg) by the height expressed in meters (m) squared: kg / (mxm).

For example, a woman 1.7 m tall and with an initial weight of 65 kg corresponds to a BMI of 22.49 [65 / (1.7 x 1.7)], i.e. normal (normal weight ). During the nine months of pregnancy, the weight should physiologically increase from 11.5 to 16 kg.

If the initial weight had been 50 kg, the BMI would have been less than 18.5 (more precisely 17.3), indicating underweight . Therefore, a higher than normal weight increase during pregnancy , between 12.5 and 18 kg, would be recommended for the subject.

On the contrary, if the initial weight had been 85 kg, the BMI would have been higher than 24.9 (more precisely 29.4) indicating an overweight . Therefore, a lower than normal weight gain during pregnancy , between 7 and 11.5 kg , would be recommended for the subject .

Finally, if the initial weight had been 105 kg, the BMI would have been higher than 29.9 (more precisely 36.3) indicating severe obesity . A weight gain of 7 kg or less during pregnancy would therefore be recommended for the subject .

Normal weight and health

Why is weight control important?

Those previously provided are of course indicative data, which however are valid as a reference and highlight a very important theoretical concept: weight gain during pregnancy cannot and must not be left to chance. This is as important for the well-being of the mother as it is for the baby, and therefore for the healthy development of pregnancy, childbirth and the subsequent puerperium .

In fact, excessively gaining weight during pregnancy does not only mean changing from an aesthetic point of view, but increasing the risk of possible complications which can be simple and boring lumbosciatica in pregnancy (in the third trimester, when posture and walking problems inevitably become more consistent) but also dangerous macrosomias of the newborn (with the risk of lacerations, fetal suffering, operative deliveries, etc.).

Nonetheless, insufficient or incomplete nutrition can cause other discomforts, such as premature births , the birth of underweight, underdeveloped or even miscarriages babies.

Weight trend

Weight trend in pregnancy

The second concept to be developed is that of the distribution – physical and temporal – of the weight to be gained during the forty weeks of gestation.

In the meantime, it should be remembered that weight gain is much higher in the second half of pregnancy (from the twentieth week onwards) than in the first 4-5 months. Therefore, having maintained a good weight in the first twenty weeks should not become the pretext for letting go in the next phase.

Furthermore, we must bear in mind that this weight increase is not attributable solely and exclusively to a corresponding increase in body fat (including essential fat such as the breast ), but also to the fetus – which at the end of gestation will weigh about three kilos on the scales. and a half – to the placenta (about 500 g), amniotic fluid , uterus , blood volume , etc.

Many pregnant women also have to deal with problems – more or less intense – of water retention ( edema and swelling ), especially in the lower limbs; however annoying, these represent the inevitable and necessary effect of the hormonal transformations typical of this phase .

Postpartum weight

Weight restoration with breastfeeding and the puerperium

The positive figure, if we want to define it that way, concerns the post-partum period.

Obviously the kilos due to the fetus and appendages such as the placenta will be lost immediately after the birth of the child. Similarly, except for particular pathological conditions, water retention problems will be resolved rather quickly.

Instead, the real kilos of adipose tissue accumulated during pregnancy will remain to be “used” . That’s why a controlled increase in gestational weight will make later recovery easier. On the other hand, even the recovery of post-partum physical form will have to respect precise times and methods. Some, somewhat provocatively, even claim that pregnancy lasts 18 months instead of nine. The first nine are used to form, develop and deliver the child; the latter, on the other hand, would serve to bring the mother back to conditions similar to the pre-pregnancy ones. All in all, it is a possible goal but one to be pursued in a controlled way and without risky impatience.

The puerperium and breastfeeding are delicate phases, which require – both in terms of food and physical activity – tranquility and attention. Pregnancy and childbirth put a woman’s whole body to the test and, in particular, some of her more delicate structures such as the pelvic floor . Recklessly undergoing premature and incorrect training, of the abdominal muscles for example, means risking the appearance of various problems such as prolapse and urinary incontinence .

What to eat

What to eat in pregnancy?

During pregnancy it is necessary:

• Eat properly
• Constantly keep your weight variations under control, knowing how to recognize and interpret them
• Carry out adequate preparatory physical activity.

Of course, in this context, the help and expertise of operators will be precious, sometimes indispensable, from the gynecologist to the midwife, up to the nutritionist. In any case, it will be first of all the expectant mother who will have to document herself, then putting her awareness and responsibility to good use in everyday life.

How many calories to eat during pregnancy?

It is important to bear in mind that the energy requirement of pregnant women increases proportionally to the starting conditions. Therefore – based on the criteria seen previously – if you are of normal weight, the additional caloric requirement will be approximately 250 kcal per day. If, on the other hand, the woman is underweight, this intake will also rise to 350 kcal. Finally, if the woman begins pregnancy overweight, the requirement should not exceed 200 kcal per day.

Obviously each of these will be contextualized in a subjective way, based on the individual characteristics of the person in question; for example, evaluating the entity of excess or defect weight, the level of motor physical activity, etc. Adequate nutrition should in fact always be accompanied by proper physical exercise.

It should also be remembered that the nutrients in meals serve the mother as much as the fetus. The latter, in the third trimester, will need about 100 kcal / kg of weight. Therefore, even at the end of the pregnancy, he won’t need more than 350 Kcal per day; but more or less the caloric equivalent of two or three yoghurts and certainly not pizzas , cakes or french fries .

Beyond the mere counting of calories, it will also be essential to qualitatively guarantee the unborn child all the essential substances for its healthy formation and complete development.

Which Foods

Which foods to choose?

A correct diet will be varied, balanced and nutritious.

High biological value proteins will be needed , which are obtained from meat , fish, eggs , milk and derivatives; all essential amino acids can also be obtained from cereals and legumes , taken in roughly equal quantities.

Also not to be overlooked is the intake of carbohydrates, which constitute our main source of energy, but avoid exceeding them; the foods that provide complex ones are cereals, legumes and tubers , therefore also bread and pasta , while foods rich in soluble sugars are fruit and honey .

Speaking of fats, it is necessary not to overlook the contribution of essential and semi-essential elements, especially of the omega 3 group : alpha linolenic acid (in some seeds and oils), eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), from fish and algae .

And again, the supply of all vitamins must be guaranteed , including those of fruit and vegetables ; for example folic acid , vitamin C , provitamin A and vitamin K. Vitamin D is instead contained in eggs and fish. The vitamins of group B , as well as in foods of animal origin, are also contained in cereals and legumes.

Minerals also play a key role. The bioavailable iron of eggs, meat and fish is very important ; but also calcium and phosphorus , from dairy products , potassium and magnesium , in fruit and vegetables, iodine , in sea fishing products , zinc and selenium , in dried fruit and molluscs , etc.

Note : the liver as a food is a real reservoir of nutrients, including those normally more difficult to take in with a balanced diet.

Iron and folic acid deserve further study. The former is essential for the formation of hemoglobin and therefore of red blood cells . Often, pregnant women who are deficient in it (since pregnancy leads to a huge growth in its need) are prescribed a real cure based on supplements . The same applies to folic acid and cobalamin ( vit B12 ), especially necessary in the first part of pregnancy for the synthesis of nucleic acids and to reduce the risk of spina bifida .

Finally, adequate hydration is also essential. Still water, milk, smoothies and centrifuged juices are certainly indicated throughout pregnancy; pay attention to herbal teas , which may contain herbs with an effect that is not always indicated during pregnancy. Drinking a couple of liters a day overall is certainly a guarantee of well-being, before, during and after childbirth.

The important thing, both in terms of nutrition and hydration, is to distribute food and drink in a balanced way throughout the day. It is recommended not to overeat. Rather, eat and drink little but often. For example, three main meals and two or three snacks , mid-morning, mid-afternoon and in the evening. The same goes for fluid intake, with a healthy glass of water always ready by your side, without necessarily waiting for your mouth to dry.

Where and when possible it will also be advisable to consume fresh foods – both in terms of meat and fish and fruit and vegetables – rather than preserved foods; a good compromise is freezing . Better to avoid too many sweeteners and other additives .

It is advisable to pay attention to the information contained on the labels of the different products, their composition and their nutritional values . After all, pregnancy can also become an opportunity to discover and experiment with new and healthy dishes and change one’s incorrect daily habits.