Question

Compare the recommended level of intake of

energy sources, protein, and key vitamins and

minerals during pregnancy and lactation.

• Give examples of the food sources that provide

the nutrients required for optimal maternal nutrition during pregnancy and lactation.

• Examine the role of nutrition supplements during pregnancy.

• List five nutritional risk factors during pregnancy.

• Compare the dietary needs of adolescent and

mature pregnant women.

• Give examples of cultural food patterns and

possible dietary problems for two ethnic groups

or for two alternative eating patterns.

• Assess nutritional status during pregnancy

Answer 1

Nutritional requirements Increases tremendously during pregnancy and lactation as the expectant or nursing mother not only has to nourish herself but also growing fetus and the infant who being breast fed.

• Examples of the food sources that provide the nutrients required for optimal maternal nutrition during pregnancy and lactation are :-

* More whole grains, sprouted grams and fermented foods

* Take milk / meat / eggs in adequate amounts

* Plenty of vegetables and fruits

* Combination of cereals, pulses and nuts

* Seasonal vegetables particularly green leafy vegetables, milk and fresh fruits provide minerals and vitamins

* Sprouted grams and food rich in vitamin C such as citrus fruits

* Milk is the best source of biologically available calcium

* Plenty of fluids ( 8-12 glass of water per day)

* Iron obtaining through meat, fish and poultry products

• Role of nutrition supplements during pregnancy :-

Pregnancy is a period of great physiological stress for women as she is nurturing a growing fetus in her body. Mother has to nurture the fetus , health of the newborn depends on nutritional status of the mother during and prior to conception. A well nourished women suffers fewer complications during pregnancy and there are few chances of premature births. Maternal diet during pregnancy has a direct influence on fetal growth, size and health of newborn. So, nutrion supplements are very important during pregnancy period. Poor diet during pregnancy affects mother's health, a malnourished mother provides nutrients to the fetus at the expense of her own tissues and it will Increases the risk of complications such as prolonged labour and even death. Supplemental nutrition is needed throughout the pregnancy. Additional 300 Kcal of energy is required during 2nd and 3rd trimester of pregnancy.

• Five nutritional risk factors during pregnancy are :-

1. High blood pressure

2. Diabetes

3. Epilepsy

4. Thyroid disorders

5. Heart/ blood disorders

• Dietary needs of adolescent and mature pregnant women

	Adolescent	Pregnant
Kcal	2200	2500
Protein	50 gm	60 gm
Iron	18 mg	40 mg
Calcium	500 mg	1000 mg
Follic acid	200 mg	400 mg
Vitamin B12	2 microg	2 microg
Vitamin A	5000 IU	6000 IU

• Cultural food patterns and possible dietary problems:-

Cultural background and customs largely determine what is eaten. Culture consist of values, attitudes, habits and customs, acquired by learning which starts with the earliest experiences of childhood, much of which is not deliberately taught by anyone. In many cultures, food has a social or ceremonial role.

Some cultural food patterns are :-

* Indians and Alaska natives

- Many diverse groups

- Groups all have a spiritual devotion to the land

- Food has a great religious and social significance

- Food differs according to what can be grown locally, harvested or hunted on the land or fished from local waters.

* Jewish

- Different dietary laws depending on orthodox/ conservative/ reform beliefs

- Meat should come only from animals that chew their cud and have cloven hooves, no pork or birds of prey

- Meat and milk products are not mixed

- Shellfish and crustaceans are avoided

* Muslim

- Dietary law dependent on restriction or prohibition of some foods, promotion of other foods.

- Milk products are permitted

- Fruits, vegetables are permitted unless fermented

- Breads, cereals are permitted unless contaminated

- seafood, land animals are permitted

- Pork and alcohol are prohibited.

Unhealthy eating habits can affect our nutrient intake including energy, protein, carbohydrates, essential fatty acids, vitamins and minerals as well as fibres. Some cultural practices will cause nutritional deficiencies and deficiency disorders in that group. Poor nutrition can also contribute to stess, tiredness and developing illness and other health problems such as

- being overweight or obese

- tooth decay

- high blood pressure

- high cholesterol

- type w diabetes

- osteoporosis

- some cancers

- depression

- eating disorders

• Nutritional status assessment during pregnancy

A pre-tested general assesment quilestionnaire , validated food frequency questionnaire and anthropometric measurements were used to collect information. Nutritional status was determined using body mass index ( BMI ) , weight gain and haemoglobin levels. Nutrient intake data were compared with recommended daily allowance ( RDA) for pregnancy.

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