To-be-moms, get your diet right

Research suggests that nutritional fats in the Indian diet can have significant consequences on maternal and foetal health.

A pregnant woman should consume between 200-300 mg of DHA per day either through her diet or through supplementation.

In India, a third of women of reproductive age are undernourished, with a body mass index of less than 18.5 kg/m2. It is well known that an undernourished mother inevitably gives birth to an undernourished baby, perpetuating an intergenerational cycle of undernutrition.

WHO reported that India ranks number one in preterm births. Globally, prematurity is the leading cause of death in children under the age of five years. Preventing deaths and complications from preterm birth starts with a healthy pregnancy. Focusing on nutrition during the first 1,000 days of life — from a woman’s pregnancy to her child’s 2nd birthday — offers a unique window of opportunity to shape healthier and more prosperous futures.

Mothers and infants who get the right nutrition are 10 times more likely to overcome life-threatening childhood diseases, have healthier families of their own, and be more productive adults. Moreover, during pregnancy, the third trimester is particularly characterised by massive foetal growth and consequently a high demand for nutrients by the foetus. The amount of particular nutritional lipids reaching the placenta strictly depends on maternal diet and metabolism. Hence, the maternal diet during gestation and lactation may influence pregnancy, foetal and neonatal outcome.

India, like many other global counterparts, is riding on an unhealthy balance of nutritional fats intake and status which hinders optimal foetal development and maternal health. This is caused predominantly by the Indian diet which mostly consists of high consumption of vegetable fats such as sunflower oil which is high in omega 6 fatty acids and low consumption of fatty fish or omega 3 fatty acids-rich food sources. Especially in a vegetarian/vegan population, this unhealthy balance is a serious reason for concern during pregnancy and lactation and the developing foetus!

Why is an optimal intake of nutritional fats important during pregnancy and lactation?

Whilst edible oils like sunflower, corn and soya bean oil are rich in omega 6 fatty acids and beneficial to the human body in general, pregnant women must follow a balanced diet, where an ideal combination would consist of a balance between omega 6 and omega 3. Omega-3 fatty acids contain DHA which has proven to be essential for brain development of the newborn. A lack of balance between omega 6 and omega 3 fatty acids have also been proved to cause altered brain structure of the newborn, leading to possibly impaired cognitive function in infants and children.

Achieving the right balance is directly associated with a healthy baby and this begins at the preconception stage. Insufficient or skewed amounts can lead to preterm births, low-weight childbirth and maternal death. Lactating mothers require a healthy combination of fatty acids for normal growth and development of the central nervous system, cardiovascular and immune functions of the child.

Why isn’t the Indian diet ideal for pregnant and lactating women?

Indian dishes are usually prepared with a high amount of vegetable fats such as sunflower and safflower oils. These oils are typically high in omega 6 fatty acids. In addition, many Indians eat very little food of animal origin, which naturally provides a source of performed omega 3 fatty acids. In fact, in 2007, UN FAO statistics indicated that Indians had the lowest rate of meat consumption in the world.

Why do women of Indian descent need to be extra mindful of their fat intake during pregnancy?

Besides the fact that there is already high usage of vegetable oils rich in omega 6 fatty acids in the Indian diet, most Indians have the ability to metabolise these fats far more efficient than most other counterparts across the world. This ability, together with the low consumption of omega 3-rich foods, will create an unfavorable environment for the developing foetus, leading to premature births and low-birth weights, altered brain structure which possibly may affect cognitive abilities in infants and children, but is also inducive for maternal depression. In fact, about 50% of Indian women do report symptoms of depression during this critical period of time and according to a systemic review, about a quarter of all Indian women are diagnosed with postpartum depression.

Do women in India meet the expert recommendations for DHA?

The global guidelines are that a pregnant woman should consume between 200-300 mg of DHA per day either through her diet or through supplementation. From epidemiological studies, it’s known that Indian women do not consume these recommended intakes per day. Omega 3 DHA supplementation is, therefore, highly recommended for pregnant women in India. For vegetarians, there is a vegetarian source of DHA available.

How can pregnant women in India know about their lipid status?

A minimal invasive tool is available that can assess one’s lipid profile and DHA status in red blood cells via fingerpick and a drop of blood. 

Why is DHA important during the first 1,000 days of life?

During the third trimester until the second year of age, exactly when the brain growth is the fastest, DHA is heavily enriched in the brain and retinal tissue, making DHA critically important nutrient during pregnancy. The DHA status of newborns and breastfed infants depend on the maternal dietary intake, with short and long-term implications for neural function. A decrease in DHA leads to high risk of poor infant and child visual and neural development. However, a lack of balance between omega 6 and omega 3 fatty acids have also been proved to cause impairment of various connections in the brain of the new-born. 

(The author is a professor of pediatrics, chemistry and human nutrition, Dell Pediatric Research Institute, University of Texas, Austin)

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To-be-moms, get your diet right

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