Diet Services
Diets for Healthy Pregnancy

In today's fitness-conscious world, gaining weight is a major cause of concern for most pregnant women. But weight gain is a normal and healthy part of pregnancy - and it is necessary to nurture the growing baby. While obesity in women can cause serious pregnancy-related complications, women who are not eating enough during pregnancy are more likely to have babies who are small and weak at birth. Most pregnant women are anxious to know what the ideal weight during pregnancy is. However, in reality, there is no ideal weight as the necessary weight gain varies from woman to woman. Here are a few guidelines that are generally followed as the standard for healthy weight gain during pregnancy: -
  • If your weight was normal before getting pregnant - you should gain about 9 to 13 kg throughout the pregnancy.
  • If you were underweight before pregnancy - you need to gain more weight (approx. 12-18 kg).
  • If you were overweight when you conceived, you will still need to gain about 6 to 11 kg.
  • But if you are carrying twins or multiples, you may have to gain around 20 kg or more depending on the number of babies you are carrying.
Here's a list that roughly shows the distribution of that extra weight: -

Baby 3.4kg
Placenta 0.68kg
Extra fluid 1.36kg
Increased blood 1.25kg
Amniotic fluid 0.8kg
Uterus 0.9kg
Fat deposits 3.18kg
Breasts 0.5kg
Total Gain 12.02kg
Pregnancy

Adverse outcomes associated with maternal overweight and obesity are: -
  • Birth defects, especially neural tube defects
  • Infertility
  • Labor and delivery complications
  • Fetal and neonatal death
  • Maternal complications (e.g. hypertension, gestational diabetes, preeclampsia)
  • Delivery of large-for-gestational-age (LGA) infants
Maternal obesity is also associated with preterm births (PTB) because obesity increases the rates of medical complications (such as hypertension and diabetes) contributing to PTB. Other adverse health outcomes associated with obesity and overweight are cardiovascular disease, stroke, some types of cancer, diabetes, respiratory problems and arthritis. Underweight women (low pre-pregnancy weight) are also at increased risk for adverse pregnancy outcomes, including PTB and baby with low birth weight (LBW).

For these reasons, all pregnant women should be encouraged to maintain or work towards a healthy body mass index (BMI). BMI is calculated by dividing weight in kilograms by height in metres squared. BMI = weight (kg) / Height (mt2).

BMI cut offs: -
BMI < 18.5 - Underweight
BMI 18.5 to 25 - Ideal
BMI 25 to 30 - Overweight
BMI 30 to 40 - Obese
BMI > 40 - Severely obese

Wise selection of food: -
With the increased requirement of all nutrients in your body during pregnancy, it is important to eat a well balanced diet. Your daily diet should consist of a variety of food from different food groups.

Milk and dairy products: skimmed milk, yogurt, buttermilk, cottage cheese –that are high in calcium, essential amino acids and Vitamin B-12.

Cereals, whole grains, dals/pulses: they are good sources of protein.

Vegetables: they provide vitamins, minerals and fiber.

Fruits: fresh/seasonal fruits provide an abundance of nutrients, including vitamins, minerals, antioxidants, fibre, and anti-inflammatory substances.

Meat/Fish/Poultry: they provide animal proteins. Vegetarians can consume nuts and legumes instead.

Fluids: Keep yourself well hydrated by drinking plenty of fluids especially water. Lassi, buttermilk, lemon water and coconut water are healthy drinks. Go easy on the commercial and packaged juices as they have high sugar content.

Fats and Oils: Special attention needs to be paid to cooking oils and fats. Ghee and butter are high in saturated fats where as vanaspati, dalda and margarine (hydrogenated oils) are high in trans fats and should be avoided.

No Dieting Please: -
Dieting during pregnancy is potentially hazardous to you and your developing baby. Some diets can leave you low on iron, folic acid, and other important vitamins and minerals. Remember, weight gain is one of the most positive signs of a healthy pregnancy so long as you're eating fresh and wholesome foods and a little in the form of fats and sugars.

Remember that eating five or six small meals, rather than the usual three larger ones, is easier on your body. As your developing baby needs regular sustenance, and you need to keep up your energy levels, try not to miss meals.

Diet During Pregnancy

Pregnancy is physiologically and nutritionally a highly demanding period. Extra food is required satisfying the needs of the foetus. It is the time when the organs and systems develop within. The energy used to create these systems comes from the energy and nutrients in the mother's circulation, and around the lining of the womb, such is the reason why correct nutrient intake during pregnancy is so important.

The pregnant woman’s diet should provide for the needs of the growing foetus, maintenance of the mother’s health, physical strength required during labour and successful lactation.

Protein foods essential for the growth of the foetus are milk, eggs, fish poultry and meat. Vegetarian women will need to have different cereals, a lot of pulses and nuts.

Iron is needed for hemoglobin synthesis, mental function and body defence. Deficiency of iron leads to anemia. Anemia in pregnancy is a condition with effects that may be deleterious to the mother and the foetus. Iron deficiency during pregnancy increases maternal mortality and low birth weight in infants. In children, it increases susceptibility to infection and impairs learning ability. Plant foods like legumes, dried fruits and green leafy vegetables like spinach, fenugreek (methi), mustard (sarson), bathua, coriander and mint contain iron and so do jaggery, ragi, bajra, wholegrain flour and sesame seeds. Fruits rich in iron include pomegranates, apricots, (especially when dried or semi dried), plums, bananas, and black grapes. Meat, liver, kidney, fish and poultry are also rich sources of iron with good bioavailability of the mineral as compared to plant foods. Fruits rich in vitamin C like amla, guava and citrus fruits improve iron absorption from plant foods. Beverages like tea bind dietary iron and make it unavailable. Hence they should be avoided before, during or soon after a meal.

Folic Acid is essential for the synthesis of hemoglobin. Its deficiency leads to macrocytic anemia. Pregnant women need more of folic acid that increases birth weight and reduces congenital anomalies (birth defects). Green leafy vegetables, legumes, nuts and liver are good sources of folic acid.

Calcium is necessary for making the baby’s bones and teeth. The best source of calcium is milk. Calcium is also present in ragi, bajra, sesame seeds, beans and green leafy vegetables.

Here are few nutritional recommendations for the pregnant woman:
  • She must drink a minimum of 8-10 glasses of water daily.
  • Intake of caffeinated beverages should be limited.
  • It is always better to avoid carbonated fluids.
  • Fibrous fruits, grains and leafy vegetables should be included in the diet to avoid constipation.
  • Avoid tobacco and consumption of alcohol during pregnancy. The  World Health Organization recommends that alcohol should be avoided entirely during pregnancy as it crosses the placental barrier and can stunt fetal growth or weight, create distinctive facial stigmata, damage neurons and brain structures, and cause other physical, mental, or behavioral problems.  Fetal alcohol exposure is the leading known cause of mental retardation in the Western world.
Healthy Recipes for a pregnant woman: -
Date and Almond Rice Pudding
Good source of iron, Vitamin E, riboflavin, magnesium, potassium, calcium and dietary fibre

Ingredients
  • Almonds (badaam) - 8 to 10
  • Dates (seedless)- 10
  • Milk - 4 cups
  • Rice - 2 tbsp
  • Jaggery – 3 to 4 tbsp
  • Cardamom powder - ½ tsp

Method
  • Soak rice in 2 cups of water for about half an hour.
  • Soak the dates in 1 cup of warm milk for about an hour.
  • Soak almonds in hot water for fifteen minutes and peel.
  • Drain the rice and grind to a paste along with the peeled almonds and soaked dates (reserve the milk) adding a bit of the milk to make it a liquid paste.
  • Boil the remaining milk, reduce the flame and add some of the milk to the almond rice paste. Then add the whole paste slowly to the milk stirring constantly so that it doesn’t form lumps.
  • Add the reserved milk from the dates to the mixture.
  • Cook for about 10 minutes till the rice is completely cooked and loses the raw taste.
  • Add the jaggery and cook till it melts completely.
  • Add the cardamom powder and remove from flame. Serve warm or cold.
Rajma tikki
Rich in iron, copper, potassium, zinc protein and carbohydrates

Ingredients
  •  Kidney beans (rajma), soaked overnight - ½ cup
  • Potato (boiled and mashed) - 1 small
  • Chilli powder - ½ tsp
  • Cumin powder - ¼ tsp
  • Chopped coriander - 4 tbsp
  • Roasted peanuts (crushed) - 1 tbsp
  • Salt to taste
  • Lemon juice - 1 tsp
Method
Cook the rajma in a pressure cooker for about half an hour in plenty of water till soft. Drain the water and mash rajma. Mix the mashed rajma with potatoes, spices, coriander, peanuts, salt and lemon juice to form thick dough. Divide into equal sized balls and flatten slightly to form a cutlet or tikki. Heat 1 tbsp oil in a skillet (tava) and put 6-7 tikkis on it and shallow fry drizzling about a tbsp of oil one teaspoon at a time and turning halfway through to brown both sides. Serve warm with green chutney.
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