By Cindy Anderson
Babies depend on their mothers to provide a healthy environment for them to grow and develop during pregnancy. Nutrition has always been considered an important factor in the health of the developing infant, but did you know that it could influence more than birth weight? It is well accepted that the quality of the maternal environment that the infant develops in is central to health and disease later in life.
So what can childbearing women do to create the best environment for the health of their babies, now and in the future? Even before pregnancy, women can prepare themselves to have a healthy pregnancy. Healthy body weight is important in reducing health risks for both mothers and babies. Normal weight is considered to be between 18.5-24.9 kg/m2. Before becoming pregnant, overweight women should select a food and exercise plan that results in the burning of more energy than the amount taken in by diet, leading to weight loss. Underweight women should select healthy foods with more energy taken in, compared to energy lost in physical activity, in order to gain weight. The Institute of Medicine recommendations for weight gain in pregnancy are based on prepregnancy weight, so it is important for women to talk to their doctors or nurse practitioners early in pregnancy about the right amount of weight to gain for a healthy and safe pregnancy.
During pregnancy, it is important to eat foods that provide all of the nutrients required for the increased needs of mothers and babies during pregnancy. While the “eating for two” standard is not recommended, it is important to take in enough calories, vitamins and nutrients to support the growing baby and to meet mothers’ demands experienced as a result of pregnancy. A healthy diet is the best way to assure good nutrition. While most moms want to eat a healthy diet, they may not know what choices are best for them. A great resource for pregnant moms is the USDA MyPyramid for Moms (http://www.mypyramid.gov/mypyramidmoms/pyramidmoms_plan.aspx). MyPyramid for Moms provides an interactive, individualized guide to healthy nutrition during pregnancy and lactation. Recommendations for nutrient intake (grains, vegetables, fruits, milk and meat/bean servings) are based upon age, height, pre-pregnancy weight and level of physical activity. There is even a MyPyramid Menu Planner for Moms to help incorporate the recommendations into meals, making food choices a little easier.
Good nutrition in pregnancy involves more than calories alone. Pregnancy increases the demand for protein, amino acids, omega-3 fatty acids, folic acid, iron, copper and other minerals. While food sources are the best way to get the additional nutrients, vitamin and mineral supplements are often required to help mothers reach the recommended levels. Prenatal vitamins contain recommended nutrient levels needed during pregnancy. Ideally, women should begin taking a multivitamin or prenatal vitamin at least one month prior to pregnancy. This is particularly important to ensure intake of folic acid which reduces the risk of spina bifida and other similar complications. Recent studies also stress the importance of vitamin D during pregnancy, a particular concern for women in the northern plains. Vitamin D is not found naturally in most foods, so must be taken in foods that are fortified. Because of the health benefits of vitamin D and the high rate of vitamin D deficiency in many people, vitamin D is found in an increasing number of food products. Good sources of vitamin D fortified foods include milk, certain types of yogurt and juice, fortified cereals and breakfast bars.
The maternal nutritional environment can have lasting consequences for maternal health and can influence the future health of babies. Maternal undernutrition may result in babies who are born small. Low birth weight can lead to complications in the early newborn period and are also associated with increased risk for chronic conditions later in life, including coronary heart disease, hypertension and type 2 diabetes. Obesity is a risk factor for serious complications of pregnancy, gestational diabetes and hypertension in pregnancy. Women who develop these conditions during pregnancy are at risk for the development of type 2 diabetes and heart disease later in life. In addition, babies born to mothers with obesity, gestational diabetes and preeclampsia have a higher risk of developing similar conditions themselves as they age into adulthood.
Because maternal nutrition is a critical factor for risk of developing health complications during pregnancy and in the future, steps should be taken to optimize body weight through healthy nutrition and physical activity prior to pregnancy and continued during pregnancy and lactation. The benefits will last a lifetime (or two)!