Pregnant women today face a constant pressure to have a happy and health pregnancy. The following is a brief review of four diet and nutrition topics that may be especially important when working with pregnant women. Vitamin D, folic acid, fish consumption, and recommendations about the proper amount of weight to gain during pregnancy are all important diet and nutritional considerations. While some guidelines are still uncertain (e.g. Vitamin D supplementation), more is known about fish consumption and appropriate weight-gain recommendations. In terms of nutrition and health, it is clear that Vitamin D supplementation is necessary for most women as Vitamin D is not found naturally in the foods we eat, and most people do not obtain adequate amounts from sun exposure. It is also clear that consuming fish during pregnancy is not as large of a concern as it has been in the past, with recommendations in place about fish to eat and fish to avoid now being prominent and well-researched. Finally, when it comes to diet, it is hard to avoid talking about weight gain in pregnancy, and the Institute of Medicine (2009) has provided guidelines for pregnant women to follow based on their weight at the time of conception.
Introduction
Pregnant women today face a constant pressure to do the best they can to ensure a healthy and happy pregnancy. One concern for many pregnant women is finding information about the proper diet and nutritional recommendations, especially given the vast array of information that is available. The following is a brief review of three diet and nutrition topics that may be especially important when working with pregnant women. Vitamin D, fish consumption, and recommendations about the proper amount of weight to gain during pregnancy are all important diet and nutritional considerations.
Vitamin D Intake
A paper by Hollis and Wagner (2006) noted the lack of appropriate vitamin D intake recommendations for healthy babies. In fact, they reported that a recent Cochrane review (Mahomed & Galmezoglu, 2000) came to rather inconclusive findings about the appropriate amount of vitamin D that a woman should consume during pregnancy. Vitamin D consumption levels may be particular important for pregnant women because a lack of vitamin D in the diet can lead to smaller, and lower-birth weight babies. Furthermore, vitamin D plays a role in bone metabolism, cardiovascular health, brain development, and immune system functioning. Moreover, because vitamin D is not found in foods that humans naturally eat, supplementation and/or sun exposure is essential; thus pregnant women may need to be more aware of their intake. Although this lack of knowledge of the appropriate amount of supplementation was noted years ago, researchers like Kaushal and Magon (2013) are still conducting research in order to make appropriate vitamin D recommendations to pregnant women. They reported that there is little evidence to support the use of 600 International Units per day.
Fish and Possible Mercury Exposure
Another diet and nutritional concern that may arise for pregnant women is curiosity about the appropriateness of fish consumption during pregnancy, particularly given concerns about mercury exposure. Mercury is a known neurotoxin and it can have negative effects on the development of children’s brains. In terms of the effects of low-dose in utero exposure to mercury, there have been long-term epidemiologic studies which have provided information about the effects in a naturally occurring instance of toxin exposure. In these populations, children had lower IQ scores and performed poorly on tests of memory, attention, language, and spatial skills (Bose-O’Reilly, McCarty, Steckling, & Lettmeier, 2011). In particular, the Food and Drug Administration (2015) has set forth guidelines to make this decisional process easier for women who are pregnant. The Food and Drug Administration (2015) recommends eating a variety of fish each week that are known to be lower in mercury. Those fish that tend to be lower in mercury are salmon, tuna, tilapia, catfish, shrimp, pollock, and cod. In terms of fish to avoid, the Food and Drug Administration warns against eating tilefish from the Gulf of Mexico, swordfish, shark meat, and king mackerel.
Pregnancy and Weight Gain
Another topic that is often of interest for pregnant women who are interested in diet and nutrition advice is the amount of weight that should be gained in order to maintain a healthy pregnancy. According to the American Congress of Obstetricians and Gynecologists (2013), the amount of weight gained during pregnancy can affect the health of both the pregnant woman, and the health of the baby. As is well-known in the United States, the rates of obesity have increased greatly over time and the number of women who are either overweight or obese when they are conceiving has increased as well; this presents problems from the start, as the women already face health risks due to excess weight. As a result of noticing these trends, organizations like the Institute of Medicine (2009) altered their recommendations to more closely fit the perceived needs of the medical community and of the population. In fact, the Institute of Medicine (2009) recommended different weight gain amounts for underweight women, normal weight women, overweight women, and obese women, as defined by their body masses. For those in the underweight group, with Body Mass Indices less than 18.5, the Institute of Medicine recommended a total weight gain of 28-40 pounds. For those with a Body Mass Index of 18.5 to 24.9, a weight gain of 25-35 was considered healthy. For overweight women, with a Body Mass Index of 25-29.9, a gain of only 15 to 25 pounds was deemed permissible. Finally, for obese women with Body Mass Indices of 30 and greater, the amount of weight that they were to gain was between 11 and 20 pounds.
Folic Acid
According to the World Health Organization (2016), pregnant women should consume 0.4mg of folic acid per day through supplementation. This organization states that folic acid needs increase in pregnancy because the cells of the fetus are so rapidly dividing that they require more folic acid, and it is especially important in the first 28 days to prevent neural tube defects.
Conclusion
In conclusion, pregnant women face a wealth of information about diet and nutrition. While some guidelines are still uncertain (e.g. Vitamin D supplementation), more is known about fish consumption, folate supplementation, and appropriate weight-gain recommendations. In terms of nutrition and health, it is clear that Vitamin D supplementation is necessary for most women as Vitamin D is not found naturally in the foods we eat, and most people do not obtain adequate amounts from sun exposure. It is also clear that consuming fish during pregnancy is not as large of a concern as it has been in the past, with recommendations in place about fish to eat and fish to avoid now being prominent and well-researched. Finally, when it comes to diet, it is hard to avoid talking about weight gain in pregnancy, and the Institute of Medicine (2009) has provided guidelines for pregnant women to follow based on their weight at the time of conception.
- Bose-O’Reilly, S., McCarty, K.M., Steckling, N., & Lettmeier, B. (2011). Mercury exposure and children’s health. Current Problems in Pediatric and Adolescent Health Care, 40(8), 186-215.
- Food and Drug Administration. (2013). Fish: What pregnant women and parents should know. Retrieved from: http://www.fda.gov/Food/FoodborneIllnessContaminants/Metals/ucm393070.htm
- Institute of Medicine. (2009). Weight gain during pregnancy: Reexamining the guidelines. Washington, DC: National Academies Press.
- Kaushal, M., & Magon, N. (2013). Vitamin D in pregnancy: A metabolic outlook. Indian Journal of Endocrinology and Metabolism, 17(1), 76-82.
- Mahomed, K., Gulmezoglu, A.M. (2000). Vitamin D supplementation in pregnancy [Cochrane Review]. Cochrane Database of Systematic Reviews, 2, CD000228.
- World Health Organization. (2016). Daily iron and folic acid supplementation during pregnancy. Retrieved from: http://www.who.int/elena/titles/guidance_summaries/daily_iron_pregnancy/en/
