Most of the concern about the safety of nitrates has arisen from epidemiological data on their potential to form N-Nitrosamines; these are thought to be cancer causing and also responsible for causing “blue-baby” syndrome. However, one must be careful in evaluating the data and when drawing any conclusions. Let us review the data for both these concerns. i) Blue-baby syndrome (methemoglobinemia) One case back in the 1950’s caused considerable sensation when a baby’s hemoglobin was thought to be compromised by supposedly excessive nitrates in well water and converting the hemoglobin to a form that was not able to transport oxygen easily.
Congratulations! If you’re already expecting or planning to conceive, a healthy diet is important now more than ever. Pregnant women have unique nutritional requirements. Adequate nutrients, vitamins and minerals essential to support the growth of a baby and keep mom healthy. Below are dietary and nutritional recommendations as outlined by Health Canada.
Overall Dietary Recommendations:
- Increase caloric intake – but don’t ‘eat for two’
In order to provide enough nutrients and energy for fetal development, most women need to increase their caloric intake. Try not to fall into the ‘eating for two’ trap. An increase of anywhere between 200-500 extra calories per day is adequate, depending on the woman. Try to get most of those calories from nutrient dense foods such as vegetables, fruits, leafy greens, whole grains, and lean meats.
- Make sure you’re eating enough protein – aim for approximately 60 grams per day
Pregnant women need to increase their protein to ensure that they are providing adequate amino acids and energy for fetal growth and development. Try to include at least two to three servings of lean protein per day. This can include poultry, lean meats, fish and vegetarian sources of protein such as nuts, beans and lentils.
Important Nutrients, Vitamins and Minerals In Pregnancy:
1) Folate (also known as Folic Acid)
- Why you need it: Folic acid is utilized in the synthesis of DNA and amino acids. Folic acid helps decrease the prevalence of neural tube defects and other brain and spinal cord abnormalities during pregnancy, including spina bifida. It is especially important to supplement for folic acid in the pre-conception period and during first trimester of pregnancy when the neural tube closes.
- Health Canada Recommendation: Start taking a folic acid supplement when preparing to conceive and continue throughout pregnancy. Try to find a folic acid supplement that contains L-5-MTHF, the active form of folic acid. Most other folic acid supplements need to be converted to this form to work. MTHF is the trusted form to prevent neural tube defects, and support normal early development of the fetal brain and spinal cord. Foods high in folic acid include leafy greens, lentils, black beans, fortified grains, asparagus, avocados and sunflower seeds. Be sure not to take in more than 1000 micrograms of folic acid per day.
2) Omega-3 Fatty Acids
- Why you need it: Omega-3 fatty acids cross the placenta and are utilized in fetal brain development and overall growth. Two components of Omega-3 fatty acids are EPA and DHA. DHA is specifically found in the brain and is important for healthy growth of the fetal brain. Post-pregnancy, DHA is transferred from mom to baby through breast milk during breastfeeding to continue healthy brain development. Omega-3’s are found in fatty fish and other animal sources. Studies have shown that there is an association between fish intake in pregnancy and fetal neurodevelopment.
- Health Canada Recommendation: A good quality Omega- 3 supplement will contain both EPA and DHA. Health Canada suggests eating at least 150 grams (or 5 ounces) of cooked fish each week (while being mindful of sustainable fishing practices and eating seafood lower in mercury).
- Why you need it: Iron is important in pregnancy for healthy blood and brain development. Iron is a component of red blood cells which transfers oxygen around the body.
- Health Canada Recommendation: Most pre-natal supplements will contain iron however, iron supplementation is especially important for vegan and vegetarian women and women who have low iron or do not eat a lot of red meat. For women who are vegan and vegetarian, AOR offers a iron supplement obtained from a vegan source. Iron is found in dark leafy greens, red meat, beans and wholegrain breads.
4) Vitamin D
- Why you need it: Vitamin D is a fat soluble vitamin that is important in the fetal development of bones, teeth and the immune system. Low maternal vitamin D status has been correlated with increased asthma in children.
- Health Canada Recommendation- 600-1000 international units (IU) per day: Vitamin D supplements are important if low vitamin D status is suspected. As vitamin D is a fat soluble vitamin, be sure to use a vitamin D supplement that is in a oil/fat carrier and have vitamin D levels tested before supplementing. Other sources of vitamin D include fatty fish, fortified milk and eggs.
What to Avoid During Pregnancy
Caffeine crosses the placenta and makes its way into fetal circulation. As the fetal liver is not yet mature, it cannot process the caffeine at the same rate as an adult. This can lead to birth defects, premature labour and low birth weight in pregnancy. Health Canada recommends no more than 300 mg of caffeine per day during pregnancy. This equates to approximately 1-2 small (200 mL) cups of filtered drip coffee per day. One cup of green tea contains approximately 35-70 mg of caffeine. Caffeine can be found in foods as well; 2 oz of dark chocolate contains 40-50 mg of caffeine!
2) Raw fish, undercooked meats and unpasteurised dairy
Both raw fish and undercooked meat are at risk of bacterial contamination that can pose a threat to fetal development. It is important to ensure that all fish and meat are cooked thoroughly and that all dairy (including cheeses) and honey are pasteurised to reduce this risk.
It is well known that alcohol can lead to many problems during pregnancy and after babies are born. Alcohol use can lead to Fetal Alcohol Syndrome, low birth weight and premature delivery. No alcohol whatsoever is recommended during pregnancy.
4) Lunch/Deli Meats
Deli meats are at risk of being contaminated by Listeria, which can cause many problems in pregnancy. Abstaining from eating deli meats or heating meats up to 165°F before consuming is recommended.
Disclaimer – these lists are not exhaustive. Always check with your health care practitioner before making any changes in your diet or supplements.
AOR. Product Details BioFolate. (2017). AOR. Retrieved 6 June 2017, from http://www.aor.ca/product/biofolate.
Health Canada. Prenatal Nutrition Guidelines for Health Professionals: Fish and Omega-3 Fatty Acids. (2009). Health Canada. Retrieved 2 June 2017, from http://www.hc-sc.gc.ca/fn-an/pubs/nutrition/omega3-eng.php
Health Canada. Prenatal Nutrition Guidelines for Health Professionals: Folate Contributes to a Healthy Pregnancy. (2009). Health Canada. Retrieved 2 June 2017, from http://www.hc-sc.gc.ca/fn-an/pubs/nutrition/folate-eng.php
Mayo Clinic. Pregnancy diet: Focus on these essential nutrients – Mayo Clinic. (2017). Mayo Clinic. Retrieved 2 June 2017, from http://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/pregnancy-nutrition/art-20045082
Public Health Agency of Canada. Healthy Pregnancy – Calcium and Vitamin D. (2012). Public Health Agency of Canada. Retrieved 2 June 2017, from http://www.phac-aspc.gc.ca/hp-gs/know-savoir/calcium-eng.php
Public Health Agency of Canada. Iron – Healthy Pregnancy – Public Health Agency of Canada. (2012). Public Health Agency of Canada. Retrieved 2 June 2017, from http://www.phac-aspc.gc.ca/hp-gs/know-savoir/iron-eng.php
Public Health Agency of Canada. Prenatal Nutrition – The Healthy Pregnancy Guide – Public Health Agency of Canada. (2012). Public Health Agency of Canada. Retrieved 2 June 2017, from http://www.phac-aspc.gc.ca/hp-gs/guide/01_pn-np-eng.php