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How Your Diet Affects Your Pregnancy:  Nutritional Deficiency in Common Diets

1/30/2018

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Many women are familiar with the increased calorie requirements (right to indulge!) associated with pregnancy:  no increased requirements in the first trimester, 340 calories per day in the second (about 7 and 1/2 Oreos), 450 calories (10 Oreos) in the third trimester.  I was originally going to use Twix Bars, because I love Twix bars, but with two sticks in a package, the math got kind of complicated, and my degree is in biology.  Regardless, these additional calories are not only easily obtained, but quite often exceeded.  So, today, we’ll focus on what’s often missed in common diet trends in the U.S. and how these deficiencies can affect your pregnancy.

A recent study published earlier this month was the first to suggest a potential link between low-carb diets and an increase in neural tube defects in babies born to women.  Low carb diets can include Atkins, Paleo (hello fellow Crossfitters!), and ketogenic diets, among others.  These are often effective methods of weight loss, and hence, pretty popular among women looking to lose weight.  The issue appears to come into play with reduced folic acid intake from fortified grains, so for women participating in a low-carb diet, be sure to begin a prenatal vitamin several months prior to conceiving to help offset the potential deficiency that may occur in a carb-restricted diet.  Some food sources of folic acid are dark, leafy green vegetables and some fruits.

Gluten-free dietary advocates can also be deficient in folic acid.  These products generally aren't enriched with the same vitamins that gluten-containing ones are, so supplementation is important.  This is especially true for those with celiac disease as leaky intestinal cells are less efficient at nutrient absorption.  In this case, you may require higher amounts of vitamin intake to reach the recommended levels.  Fiber can also be an issue for those adhering to a gluten-free diet, and pregnancy generally predisposes to constipation anyway, so be sure to supplement your diet with extra fruits, vegetables and water to help keep bowel movements regular.


Another group at risk for nutritional deficiency in pregnancy are vegetarians.  The American Pregnancy Association recommends 75-100 grams of protein per day during pregnancy.  One of the highest concentrations of protein for vegetarians is in soy beans at 29 grams per cup of boiled soy beans.  3 cups of beans per day is a lot, and would also involve taking in about 30 grams of fiber.  Alternatively, protein supplements may be reasonable to help attain your protein goals.  Other potential deficiencies for vegetarians include Vitamin B12 (only found in animal products, so supplement would be recommended) and calcium, especially for vegans.  In the absence of dairy, dark green vegetables do contain some calcium as can calcium-enriched or fortified products.  Omega 3 fatty acids, like DHA, can be deficient in vegetarians as the best sources include fish and eggs, but walnuts, soy and canola oil, and flaxseed also contain Omega 3 fatty acids.  Lastly, iron deficiency affects as many as 40% of pregnant women, but because the recommended iron intake in vegetarians is roughly double that of non-vegetarians, they are particularly susceptible because iron is tougher to absorb from plant sources.

The last group to mention today involve women following the DASH diet.  This diet focuses on reducing sodium intake in order to help lower blood pressure.  In the U.S., iodized salt is the primary source of iodine, which plays a critical role in thyroid function.  That means if sodium restriction is severe, then thyroid function of mom and baby may be affected.  In turn, thyroid dysfunction can affect fetal growth and development as well as maternal miscarriage risk and cardiovascular concerns for pregnancy and beyond.  In addition to supplementation, shellfish are also a good source of iodine.

So, there you have it.  While we framed today’s blog on how pregnancy can be affected by deficiencies in various diets, the non-pregnant can still suffer from nutritional deficiencies and benefit from their correction.  Diet is important not only to help you have the healthiest possible pregnancy, but it affects weight, energy, and risk of chronic disease (like heart disease and cancer) after pregnancy as well.  Good luck to all of those who have made healthy diet a part of their New Year, and congratulations to those who have stuck with their resolution so far!  Only 2 days until February and getting the first month under your belt :)

Dr. Nick
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