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Diet & Health : Children & Women Last Updated: Apr 20, 2011 - 9:38:09 AM


Practical Nutrition for a Healthy Pregnancy
By Bekah Sealey
Dec 4, 2008 - 10:58:57 AM

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Did you know that you can control your odds of experiencing some pregnancy related complications?  Everyone knows that nutrition has some importance during pregnancy.  As soon as others know you are pregnant, you start getting the comments ranging from "eating for two" to "don't gain too much weight," but what is the full story about nutrition and pregnancy?  Most American women do not get much guidance on this topic from their doctors.  The practical reason for this is that nutrition is not a subject given a lot of attention during medical school, which is largely focused on treating problems after they occur.  But many pregnancy related problems can be avoided or reduced through excellent prenatal nutrition. 

Anemia

Most women believe they need to supplement their iron intake during pregnancy.  It is true that pregnancy can exacerbate a borderline deficient woman.  Why is that?  During pregnancy, a woman's total volume of blood increases throughout pregnancy by as much as 50% to be sure that both she and the baby are getting sufficient volumes of oxygen and nutrients.  This expansion requires an increase in the number of red blood cells, impacting the levels of the woman's iron stores.  But contrary to popular belief, it is good to see a slight lowering of iron levels, sometimes to as low as a hemoglobin measurement of 10-12 g/dl especially at around 28-30 weeks of pregnancy, the time of the most rapid blood volume increase, as this signifies that the blood is expanding as it should.  Of course, there are times when iron levels drop too low, leaving a mom feeling tired, depleted and out-of-breath.  If your levels are not at least 10 g/dl, you and your caregiver should definitely give some thought to the best method of supplementing.  Often prescription iron is not readily absorbed, but your odds can be increased by avoiding calcium around the time of taking your iron pills, taking them with vitamin C, and eating lots of dark green leafy vegetables, at least 2-3 servings per day.  There are also natural supplements.  Many women have better success taking liquid chlorophyll, usually a byproduct of alfalfa, found in either liquid or capsule form. 

There are other types of anemia that can affect pregnant women, some more common than others.  Vegetarians, especially vegans, must be aware of vitamin B12 deficiency anemia.  B12 is an animal-derived vitamin, so if she has not eaten any animal products for many years, and has not supplemented, she may find this vitamin level is low.  This can be remedied through supplementation, but the rule about supplementing B vitamins is that they must be supplemented in balance.  To increase levels of B12, take a complete B-complex along with the extra B12.  Folate, another B vitamin especially critical during pregnancy, can also be a source of vitamin deficiency anemia.  Other anemias are associated with diseased cell structures, such as sickle cell disease or aplastic cells.  These are usually a concern to individuals of particular genetic heritages, like those of African descent. 

All women can make a preventative effort at avoiding anemia, and offering her baby the highest levels of oxygen and nutrients to grow by eating 2-3 servings of leafy green vegetables every day, the darker the better.  Alfalfa, spinach, kale, artichokes, and other similar greens are wonderful sources of iron, while legumes like beans and lentils are great sources of B-vitamins. 

Gestational Diabetes 

Gestational Diabetes (GD) is a disease of degrees.  It is natural for pregnant women to become somewhat insulin resistant, which means that her body is not as receptive to insulin breaking up and removing excess sugar as it usually does when not pregnant.  The reason for this is that growing another living being requires the extra energy from sugar to be available for longer.  But in Gestational Diabetes, there is too much blood sugar circulating.  The result of this can be a large baby with many of the same risks of Type 1 or Type 2 Diabetes, which include such frightening extremes as shoulder dystocia, where a baby gets stuck during birth, or sudden fetal death.  Women are usually tested for GD late in their second term, and if a positive result, are sent to a nutritionist to learn how to control blood sugar levels through diet.  Some women will also be put on insulin for the remainder of her pregnancy. 

By the late second term of pregnancy, dietary changes may be difficult to adjust to, and results may be minimal.  For the best possible health of mom and baby, there is no reason to wait until such a late date to embark on a blood sugar friendly diet.  Avoiding processed foods, white flours, white rice, high sugar foods, especially those sweetened with high fructose corn syrup, and refined carbohydrates, like prepared bread products, excepting whole grain or sprouted breads, will go a long way towards keeping your blood sugar in proper balance.  Focus on eating foods as close to their natural state as possible, increasing vegetables, whole fruits, and proteins.   

A significant piece to the blood sugar puzzle is what you eat at what time of day.  When high sugar foods are eaten and digested, the blood sugar rises rapidly, followed by a plunge.  The body, seeking to regain balance, craves another sugar jolt.  You can short circuit this cycle by planning your meals carefully.  Start the day with protein, like eggs, peanut butter on whole grain toast or muffin, or cottage cheese with whole fruit.  Be cautious about fruit juices, which can cause a quick jolt to the metabolism, due to the processed state of the fruit sugars without the good fibers to go with it.  A nice alternative to both soft drinks and straight fruit juice is a fruit spritzer, prepared with 50% fruit juice mixed with 50% seltzer water.  If you simply must indulge those sweet cravings, save them for the end of the day when the subsequent fall in blood sugar will not set you up for increased sweet cravings throughout the day.  It is very important not to deprive yourself to such an extent that you cannot maintain your good eating habits.  One possibility is making Sunday "reward day", indulging in your favorite treat after dinner time.

Toxemia

Metabolic Toxemia of Late Pregnancy goes by a variety of names: pre-eclampsia, eclampsia, pregnancy-induced hypertension and HELLP syndrome.  These are all aspects of the same disease process, but for simplicity we will call it Toxemia.  There has been much debate about the cause of toxemia over the last several decades.  Dr. Brewer, who researched this phenomenon for many years, became convinced that it is the result of poor nutrition, and had great success even in women of the most modest social circumstances in preventing the disease.  Toxemia is a disease affecting several of the body's major organs, which in its advanced state can be remedied only through delivering the baby.  As we mentioned above, the pregnant woman's blood naturally expands to accommodate the growth and development of the baby within her.  If, for some reason, the blood does not expand, a high degree of stress is put on the mother's body systems, as she tries unsuccessfully to maintain nutrition for herself and the baby.  The resulting symptoms are extreme swelling, high blood pressure, protein in the urine, and hyper reflexes. 

The body requires a balance between many nutrients to function at its best.  The natural increase in blood supply is dependant on several factors, protein intake, salt intake and fluid retention.  Blood includes a protein, known as albumin.  The body can make some of its proteins itself, but must also have an adequate source of dietary protein to supplement what it cannot make.  If a woman's protein intake is too low, the body will not be able to produce the necessary albumin to support the expansion of the blood volume.  Additionally, the body needs enough fluid to make the blood flow properly.  This requires the adequate intake of both water and salt.  Why salt?  That sounds counterproductive!  On the contrary, salt is needed to keep the fluid where it belongs, in the blood supply.  The body has a mechanism by which fluid is attracted to salt, so if there is enough salt in the blood supply the fluid will remain there.  If there is low salt in the blood supply, other tissues will have a higher salt content, causing the fluid to move from the blood supply to those tissues.  This causes the extreme swelling that is symptomatic of toxemia.  The thickened blood due to lack of fluid and the low supply lead to high blood pressure as the body works harder to get the blood where it is needed.  This is a simplification of a highly involved process, but identifies the key factors we can affect nutritionally.

Dr. Brewer created a dietary plan for his patients to follow, which has been widely popularized through his books and through the Bradley Method and other alternative methods of childbirth education.  His recommendations are for 80-100 gms of protein every day, particularly protein derived from eggs and high quality meats, though complete proteins can also be derived from legume and grain combinations for vegetarian moms, one quart or equivalent of dairy, 1-2 servings of dark green leafy vegetables along with a citrus fruit (which we are already eating to prevent anemia, right?), 3 servings of complex carbohydrates in the form of whole grain or sprouted bread, or tortilla, other fruits and vegetables including at least one yellow vegetable a week, one whole potato including skin every week, lots of water (aim for 32 oz. per day), and salt all food to taste or eat a truly salty food every day.  You can see how this particular plan incorporates all of the other recommendations for prevention of anemia and keeping the blood sugar in balance, as well. 

Excellent prenatal nutrition not only provides the best start for baby, but keeps mom feeling healthy, too, by preventing these and other common complications of pregnancy.  Use your pregnancy as a time to experiment with new foods for their nutritional value.  You may find some new favorites to add to your family's menu.

For more information, check out these resources:
About the author:

Bekah Sealey
AAMI #1885 NC7
Doula, Midwifery student in WI
http://www.newbirthcs.com/
http://valleybirthnetwork.com/
Share your baby's Home Birth story: http:// morebabiespreferhomebirth.com/




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