Nutrition during pregnancy!.

One of the most interesting issues for many women who have just learned that they are pregnant is how their diet should be.
Most women think that they cannot get a proper and balanced nutrition for the development of their baby. Even pregnant women who cannot gain weight in their first months may worry. In fact, all these worries are often unnecessary. Because nausea and vomiting and loss of appetite can naturally prevent weight gain in the first months.

Sometimes, patients are given various diets and forced to certain nutrition programs. Except for some special cases of pregnancy, such approaches have no scientific validity. It is not an acceptable approach to intimidate women and force them to consume food items that they do not like or cannot tolerate. Such diets can only be prepared by specialist dietitians, taking into account the patient’s condition, in line with the doctor’s recommendations and individually.

However, it should not be forgotten that the growth of the baby, being healthy, and developing well in terms of spiritual, physical and mental aspects are proportional to the health and balanced nutrition of the mother.

The fact that the mother has completed her physical development before pregnancy, that her food stores are sufficient and her age are the most important factors that will protect the health of both the baby and the mother. Because the baby grows and feeds by choosing and taking what is necessary for him from the mother’s food reserves and what he consumes during pregnancy.

While the mother receives enough energy and nutrients to sustain her daily life, the extra protein, energy, vitamins and minerals that she will receive naturally are the guarantee of health for both herself and the baby to be born.

In a normal pregnancy period, it is sufficient for the mother to gain about 10-12 kg in order to transfer the mother’s consumption in addition to her own needs to the baby. In order to achieve this increase, a pregnant woman should be given an additional 20 g per day compared to pre-pregnancy. protein, 15-20 mg. iron, 500mg. calcium and an average of 300 calories of energy is required.
Let’s take a look at the nutrients that should be consumed frequently during pregnancy.

CALCIUM

Calcium is a mineral necessary for the development of your baby’s bones and teeth, which begin to form from the 8th week of pregnancy.

Twice the amount of calcium you normally need is required during pregnancy. Because during pregnancy, there is a constant loss of calcium from the teeth and bones. Foods rich in calcium are cheese, milk, yogurt and green leafy vegetables.

However, since dairy products are also rich in fat, it would be better to prefer skimmed milk and yogurt.

In order to be protected from Brucella and typhoid-like diseases, make sure that the cheese and milk you consume are hygienic and well pasteurized.

PROTEINS

In order to meet the increased protein requirement during pregnancy, protein-rich foods such as red and white meat, milk and dairy products, eggs, fish, legumes (beans, lentils, kidney beans..) are recommended.

Proteins are divided into animal and vegetable proteins. Vegetable and animal proteins should be consumed in equal proportions in diets.

It is recommended that the fat in animal foods be removed as much as possible and that the meat should be consumed without fat. In addition to protein, omega 3 and omega 6 fatty acids found in fish are also substances that have a positive effect on the intelligence development of the baby. The fish consumed must be fresh and well cooked.

IRON

It is important to consume “blood builder”, that is, iron-rich foods during pregnancy, and to use folic acid iron drugs, especially after 4-4.5 months. Because, especially after these months, anemia (anemia) may occur due to iron deficiency.
In people with severe anemia, blood pills (iron pills) can also be started in the early stages of pregnancy. However, in this case, since nausea, vomiting and stomach complaints, which are common in the first months, may increase, the start of treatment may be delayed for a few weeks.

Iron deficiency in pregnant women can cause complaints such as weakness, fatigue, shortness of breath, inclination to sleep and palpitation, and it also paves the way for complications such as premature birth, failure of the baby to develop in the uterus, stillbirth and miscarriages. In addition, an advanced bloodless pregnant suffers during the postpartum puerperium period.

In order to minimize iron deficiency, blood builder; Importance should be given to consuming foods rich in molasses, raisins, red meat, eggs and legumes. In addition, fruits and vegetables rich in vitamin C will increase iron absorption from the intestines.
Iron pills, which are generally started after the 4th month, should never be taken with milk. Because milk inactivates the absorption of iron by reducing it.

The dose of the given iron pill is set individually by the physician. Severely low blood levels of the person may cause the dose of blood medication to be increased. Or, for example, in twin pregnancies, the body’s need for iron will increase, so the dose may be increased.
Some people may not be able to use iron pills during their pregnancy due to stomach complaints. In these individuals, potable (liquid) iron solutions can be used. Sometimes, iron can be loaded to patients by intravenous or intramuscular administration. In very advanced cases, blood or erythrocyte (red blood cell) transfusion (transplant) may become necessary.

If a person still has low hematocrit and hemoglobin values ​​despite intensive iron treatments, anemia other than iron deficiency anemia or intestinal absorption disorders (malabsorption syndromes) should be sought.

C VITAMIN

Vitamin C is a necessary vitamin for the absorption of iron from the intestines, increasing the immune (immune) resistance of the body against disease-causing microorganisms, and many biochemical processes in our metabolism.

Vitamin C requirement during pregnancy increased due to the acceleration of metabolism; However, it is not recommended to take vitamins in pill form in pregnant women who are fed regularly.

Vitamin C is found in many fresh fruits and vegetables, such as oranges, lemons, red and green peppers, tomatoes, strawberries, grapefruit, cauliflower, cabbage, and brussels sprouts. Since it is not stored in the body, a certain amount should be taken every day.

Most of the vitamin C is lost in foods that are stored and cooked for a long time. You should consume the foods while they are fresh, and eat the well-washed vegetables raw or boiled a little. In addition, pregnant women are not recommended for long-term, non-natural, canned and similar foods.

FOLIC ACID

For the development of the baby’s central nervous system, it is very important to take “vitamin B9”, that is, folic acid, especially from the first weeks of pregnancy. Since it is not stored in the body and more than normal is needed during pregnancy, it should be taken every day.

Fresh green vegetables are a source of folic acid, but prolonged cooking and long-term storage reduce its amount in foods. It is most commonly found in spinach, peanuts, hazelnuts, cauliflower and wholemeal bread.

Since natural foods cannot fully cover the folic acid deficit of the pregnant, it will be appropriate to take it from the outside as a pill from the first weeks of pregnancy.

It has been shown that a number of abnormalities (hydrocephalus, spina bifida, anencephaly) may occur in babies under the name of “neural tube defects” due to folic acid deficiency in pregnant women. In addition, it was observed that preeclampsia (pregnancy poisoning) developed more frequently in these pregnant women.

Women who have previously been found to have folic acid deficiency or have given birth to a baby with neural tube defect anomaly should start taking folic acid at least 3 months before they plan to conceive.

OMEGA 3

Substances called omega 3 are building blocks called polychain unsaturated fatty acids in biochemistry. They are abundant in some nutrients, especially fish. They are also in the class of essential nutrients. In other words, since they are not produced in the human body, but their existence is essential for physical and mental development, they must be taken from the outside through food.

Omega 3 is a general name given to a certain group of fatty acids. There are three main types of omega 3 fatty acids. It is thought that these 3 different species play a role in different functions in the body.

Eicosapentaenoic acid (EPA):EPA is mainly found in fish and fish oil.

Docosahexanoic Acid (DHA):DHA is the most important fatty acid for bodily functions and is mainly found in fish.

Alpha-Linolenic Acid (ALA):ALA is found mostly in dark green leafy vegetables and is first converted to EPA and then to DHA in the body.

In the last 10 years, the importance of Omega 3 fatty acids in pregnancy for both the baby and the mother has been better understood. Studies have shown that omega 3 fatty acids

brain formation and development,

The development of the retina, which provides vision,

It has been shown to play an important role in the development stages of the nervous system.

On the other hand, from the mother’s point of view, it is thought to reduce the risks of preeclampsia, preterm birth and postpartum depression, which is called pregnancy poisoning. When adequate amounts of omega 3 are not taken during pregnancy, the baby uses these substances from the mother’s stores. Since omega 3s are thought to be stored in the brain, in this case, the mother may lose some brain cells throughout the entire pregnancy.

It is accepted that omega 3 fatty acids also help the baby to grow and gain weight, thus preventing low birth weight.

It has also been suggested that the babies of mothers who take adequate amounts of Omega 3 during pregnancy have more attention-seeking abilities in the long term, and similarly, their visual development is better than the babies of mothers who do not receive omega 3. In addition, it is claimed that the babies of mothers who take Omega 3 show less behavioral problems in the future and their chances of developing breast and prostate cancer are lower.

In a study, the ability of 9-month-old babies to solve problems when faced with problems was examined and it was shown that babies whose mothers took omega 3 during pregnancy were significantly more successful in this regard than those who did not.

When should Omega 3 be started?

Ideally, in terms of your own health, you should get enough omega 3 throughout your life. In terms of your baby’s development, it is recommended to take at least 250 mg of Omega 3 per day in the last 3 months. This is the period in which 70% of the baby’s brain development takes place. In addition, the nervous system completes its development to a large extent in these last periods.

What are the sources of Omega 3?

The foods richest in omega 3s are fish. Among them, the ones containing the most Omega 3 are; Mackerel, Herring, Sardine, Anchovy, Salmon Tuna.

Among these fish, it is important to prefer small fish, since the larger ones are contaminated by some chemical environmental factors, especially mercury. From the point of view of our country, it would be appropriate to prefer small and medium-sized fish species such as anchovy, horse mackerel, geranium, bluefish, sea bass and sea bream, which are abundant in our country. Omega 3 fatty acids are also found in some other nutrients besides fish.

Dark green leafy vegetables such as purslane, spinach, collard greens

flaxseed

Sunflower seeds

Foods such as eggs, bread, fruit juice enriched with omega 3

and perhaps the most important one is Walnut.

Is it necessary to take Omega 3 during pregnancy?

There are two types of fish oil tablets produced for those who cannot meet their omega 3 needs with natural foods: those produced from the body of fish oil (fish body oil) and those produced from the liver of the fish (cod liver oil).

Especially in the first months of pregnancy, it is not appropriate to prefer those produced from fish liver, because since fish liver is a vitamin A store, these tablets contain rich Omega 3 fatty acids as well as plenty of vitamin A, and excess vitamin A can have toxic effects on the baby in the first 3 months of development in the womb.

Although it is taken through food, he may recommend you to take fish oil tablets in the second half of your pregnancy to make sure you get enough Omega 3 during pregnancy.

FOODS WITH FIBER (Foods with pulp)

Fiber (pulp) foods, which should form a large part of your daily diet, are very useful in preventing constipation and intestinal laziness, which are common during pregnancy.

Generally, all vegetables and fruits are rich in fiber. You can eat a lot every day. Wholegrain foods also contain fiber, but they should not be consumed excessively as they reduce the absorption of some other nutrients from the intestines.

Fibrous foods are most commonly abundant in wholemeal bread, oatmeal, pinto beans, whole wheat pastas, apricots, raisins, peas, leeks, brown rice, raspberries, and nuts.

FLUID TAKING IN PREGNANCY

Drinking plenty of water and fluids during pregnancy is extremely beneficial for you and your pregnancy.

Especially drinking plenty of water can be protective or therapeutic in many cases such as urinary tract infection, oligohydramnios (the baby’s amniotic fluid is less than normal), preterm labor, respiratory tract infections, constipation and diarrhea.

Tea, coffee, cola drinks and cocoa are not recommended during pregnancy. While tea causes iron deficiency with the ‘theine’ it contains, it is not recommended because it contains ‘caffeine’ and may have a negative effect on the baby. Drinking mineral water (soda) has no negative effects.

Herbal teas such as mint, lemon, linden, rosehip, chamomile, which are completely natural and do not contain any additives, can also be drunk during pregnancy. However, there are some concerns about the drinking of “cinema tea”. Therefore, it is not recommended to consume this herbal tea during pregnancy.

Alcohol is definitely harmful when used during pregnancy, as it is defined as ‘fetal alcohol syndrome’ in the baby and causes problems manifested by mental retardation and some structural abnormalities.

It is also necessary to limit unnecessary calorie consumption during pregnancy. It should not be forgotten that the important thing is not the fat binding of the mother’s belly, but the healthy and appropriate development of the baby inside. Therefore, it is necessary to avoid sugary foods and beverages, such as cakes, biscuits, jams and soft drinks, as much as possible. In addition, boiled foods should be preferred instead of oily fried foods.

It is also appropriate to avoid excessive salt consumption. Especially in the last months, with excessive salty eating, edema in the body may increase, blood pressure may increase and you may feel more uncomfortable.

Which food sources do what?

Meat, eggs, legumes: It is responsible for the development of the brain, muscles, bones and teeth, and blood production. They meet protein and iron requirements.

Milk and milk products: They are responsible for bone and tooth development and growth. They are a source of protein and calcium.

Vegetables and fruits:They provide vitamins and minerals for growth and development.

Cereals:They are important for growth and development as they contain calories and B group vitamins.

Fats and sugars:They only contain energy and close the energy gap.

These food groups, which we have to consume carefully in an adequate and balanced diet, should be consumed with the same care during pregnancy so that we can acquire the right eating habits in order to live a healthy life.

“Pregnancy is not a good time to diet”

Pregnancy should be started at a suitable weight according to our age, height and mobility. It is not right to lose weight in a pregnant woman who is very overweight, it is necessary to try to maintain her weight and not to restrict calories especially after the fourth month. It is essential to prevent excessive intake of high-calorie foods in nutrition, but to meet the needs by taking the basic nutrients necessary for pregnancy.

In pregnant women who are in adolescence or who are very active due to their life, what must be done is to maintain the weight and in addition to meet the increasing need for pregnancy.

Weight monitoring is very important during pregnancy. 0.5-1 kg in the first three months, 1.5-2.0 kg in the following months, it is appropriate to gain weight.

Low birth weight, premature birth, stillbirth, mentally and physically handicapped births can be seen in very thin pregnant women and those with inadequate and unbalanced nutrition. Anemia (anemia), bone and tooth loss, preeclampsia, water retention in the body (edema), loss of work force, and fatigue are high in the mother.

In overweight pregnant women, problems such as hypertension, diabetes, and birth difficulties can be seen. For this reason, pre-pregnancy check-ups of expectant mothers, nutrition and weight monitoring should be done every month after conception.

NUTRITION TIPS

Your meals should be frequent and in small portions. Neither stay hungry for a long time, nor fill your stomach when you eat.

-Make sure the food you buy is fresh. Take care to consume fresh and natural ingredients instead of canned foods and foods stored with additives.

– Pay attention to “diversity” in the foods you eat. In this way, you will be able to get many vitamins and minerals.

– Instead of high-fat, sweet, spicy and caloric foods, turn to foods rich in protein and carbohydrates and low in fat.
Remember that the important thing is not that you gain weight, but that the baby is adequately fed inside.

– If you have preeclampsia (pregnancy poisoning) or risk, you may need to increase your protein intake, or if you have gestational diabetes (gestational diabetes), you may need to restrict calories as recommended by your dietitian.

– Two substances that should be taken externally as pills during pregnancy are folic acid and iron. In a pregnant woman who can eat a balanced diet, it is unnecessary to take extra vitamins or minerals.

There are many drugs on the market called “multivitamins” that contain many vitamins and minerals. These are also prescribed by most physicians.

Scientific studies in recent years; It has been shown that vitamins A, C, E and trace elements such as magnesium, calcium, zinc, selenium, copper, fluorine, taken externally as pills during pregnancy, do not have any positive effects on pregnancy in those who are fed regularly.

If you have pregnancy-related leg cramps, your doctor may prescribe “Magnesium”, and if you are at risk of preeclampsia, “calcium” may be prescribed for you additionally.

Although synthetic multivitamin pills can be given as a supplement to pregnant women who cannot have a balanced diet, they will never replace natural foods.

– If your body has never encountered this parasite as a result of “Toxoplasma tests” performed in the first months of pregnancy, it is imperative that you take some precautions. Especially if this disease, which is transmitted by cat and dog feces, occurs during pregnancy, it can cause fatal or disability problems in the baby.

Toxoplasma is especially transmitted through poorly washed vegetables and fruits and poorly cooked raw meat. Toxoplasma is common in our country, especially in eastern and southeastern Anatolia regions where raw meat is consumed intensively.

To be protected from Toxoplasma;

-Wash your hands properly before meals.

-Wash vegetables and fruits for a long time before consuming them.

– If you have a cat or dog at home, do not neglect their vaccinations, do not give them raw meat and avoid close contact.

-Avoid raw or undercooked meat and meat products (such as sausage, salami, sausage, raw meatballs).

Never neglect water in your diet. Drink at least 10 glasses of water a day. In summer, this amount can be increased up to 15 glasses. Especially if you suffer from constipation in the later months, you can prevent this problem by drinking plenty of water, consuming fruits that are eaten with the peel, including vegetables and salad in every meal, and walking.

Drinking 1-2 glasses of milk a day is to replace the calcium losses that occur during pregnancy. If you cannot drink milk, consume yogurt or ayran. You can also consume cheese or cottage cheese. Make sure that milk and dairy products are pasteurized.

Use iodized salt in meals. If you have high blood pressure (hypertension), cook food with less salt. In order to reduce edema, especially in the last months, reduce salt during these periods.

A slice of cheese and a couple of grissini can provide relief in nausea that usually starts when you get out of bed in the morning. In order to protect yourself from nausea and vomiting, especially in the first trimester of pregnancy, choose solid, dry and fat-free foods during this period. Stay away from kitchen fragrances and heavy perfumes. During this period, you can cope with your complaint by buying saltine crackers, boiled potatoes, roasted chickpeas and biscuits. Remember to eat little and often.

According to a study conducted in recent years, french fries made by deep-frying at McDonald’s or similar fast foods during pregnancy and chips produced and marketed in a similar way in markets are “teratogenic” for babies in the mother’s womb, that is, they contain some toxic substances. Therefore, it is necessary to avoid consuming such substances during pregnancy. Homemade french fries do not have such a negative effect as they are fried at low temperatures.

As stated earlier, pregnancy is not a good time to diet. A certain amount of weight gain is essential during pregnancy. If you have a weak body, it would be appropriate to gain more weight, and if you have an overweight body, it would be appropriate to gain less weight.

Nutrients and Measures to be Consumed During Pregnancy

Proper nutrition makes it necessary to meet the needs from various food groups due to the characteristics of the pregnancy situation.
Nutrients perform various tasks in our body. Food groups are formed from foods that do the same tasks.
If you do not consume one of the group options, you can also eat the other and eat right.

FOOD QUANTITY
MILK AND MILK PRODUCTS 2 glasses of milk or yogurt 1 portion of cheese (2 slices) or 2 tablespoons of cottage cheese
MEAT, EGG, LEGUMES 1 Egg
1 portion of meat, fish, chicken, turkey (60-90gm.)
1 serving of legumes (120gm)
FRESH VEGETABLES AND FRUITS 2 servings of cooked fresh vegetables
3 servings of raw fresh vegetables
2-3 medium fruit or fresh juice
GRAINS 6-8 thin slices of bread
1 serving of rice or pasta
1 serving of soup
OILS 3-4 tablespoons of oil
SUGAR 1-2 teaspoons of honey, jam or molasses

SAMPLE DAILY MENU

Breakfast

1 glass of water Milk
1 boiled egg
1 slice of cheese
2 slices of bread
5 olives
2 teaspoons of honey (can also be molasses or jam)
1 cucumber
1 tomato

Snack

1 serving of fruit (could be a handful of raisins)
3-4 walnuts or 10-15 hazelnuts
1 glass of buttermilk

Lunch

1 serving of legumes
1 serving of rice or pasta
3-4 tablespoons of yogurt
1 portion of salad
2 thin slices of bread

Snack

1 glass of freshly squeezed juice
1 slice of bread
1 slice of cheese

Dinner

1 bowl of soup
1 serving of meat, chicken or fish (up to 4 meatballs)
1 serving of vegetable dish with olive oil
3-4 tablespoons of yogurt
2 thin slices of bread
1 portion of salad

Night Meal

1 serving of fruit
1 glass of water Milk (or 1 serving of milk dessert)
2 rusks

Pregnancy is a very special and responsible process to be a mother-to-be and to carry a creature similar to her husband and herself in her body.
Pregnancy, which is one of the periods in which nutrition is very important and very special in human life, gave the mother the responsibility of bringing healthy individuals to the society.

If the mother is not fed well and properly, she may face dangers such as stillbirth, premature birth, low birth weight, and physically and mentally handicapped births. He may also have anemia, blood pressure problems, water retention in the body, fatigue, and dental and bone problems.

As a result; During pregnancy, it is not right to eat too much and unbalanced so that the baby can feed well, and it is not right to eat less to easily reach the old appearance after birth.

Basic principle; It goes through proper and balanced nutrition that the baby inside will benefit enough from.

OP.DR.YUSUF ÖZTÜRK
Gynecology and Obstetrics Specialist
PREGNANCY AND NUTRITION

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