Optimum nutrition is of great importance for women, due to their special nutritional needs associated with physiological changes such as menstruation, pregnancy, lactation and menopause. Nutritional requirements increase tremendously during pregnancy and lactation as an expectant mother not only has to nourish herself but also for the growing foetus or the infant.
Physiological adjustments during pregnancy
- Energy metabolism ( basal metabolism increases during pregnancy due to foetal growth and development which rises by about 5% in the first trimester reaching to a high level as 12% during later stages of pregnancy.)
- Alimentary function ( there is altered gastrointestinal function during pregnancy nausea, vomiting and constipation occur which indicate reduce gastric tone motility and secretion.The efficiency of absorption of calcium, iron,vitaminB12 and certain other nutrients is increased.)
- Renal function ( the glomerular filtration rate is increased in pregnancy as are the clearances of several substances such as creatinine, urea, uric acid etc. Mild glycosuria is common. The ability to excrete water is lowered and edema in the legs and ankles is common and normal.)
- Cardiovascular and pulmonary function ( to provide for the increased cardiac output that accompanies pregnancy, slight cardiac hypertrophy occur along with an increased pulse rate. In most women blood pressure decreases during the first two trimesters because of peripheral vasodilation. In then returns to normal in the third trimester.)
- Energy ( additional energy is required during pregnancy to support the metabolic demands of pregnancy and fetal growth. The current recommendation for pregnant women should increase their energy intake by 360kcal/day in the second trimester and by 475kcal/day in the third.)
- Protein ( additional protein is necessary for the growth of foetus development of placenta, enlargement of maternal tissues, increased maternal blood volume and formation of amniotic fluid.1 gram,9 gram and 31 gram protein are required per day in the first, second and third trimester respectively to support average weight gain during the gestational period.
- Fats and EFA (an intake of 30 gram of visible fat/day during pregnancy. linoleic acid requirement during this stage is 4.5% and some of the essential fatty acid needs are meet with by invisible fat, therefore, an intake of 12.5% from visible fat( equivalent to 30 gram) has been suggested to meet essential fatty acid needs.
- Micronutrients ( expectant mothers must only increase the total calorie and protein intake , but must also enhance the vitamin and mineral intake to cope with the nutrient requirement of the growing foetus and maternal tissues, deficient of micronutrient are fairly common in pregnant women (eg. Anaemia , calcium deficiencies) iron and folic acid supplementation and a good dietary intake of essential nutrient can help prevent anaemia. Good dietary sources of folate include green leafy vegetables, yeast, mushroom, fortified cereals and certain organ meat especially liver and kidney.
‘’Balance diet for pregnant mother contain egg, fish, meat, milk and their products, soybean, sprouts, green leafy vegetables, jaggery, poha, upma, sago, pulses etc.’’