American Dietetic Association: Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome

Cooperative Extension, University of California, Davis, USA.
Journal of the American Dietetic Association (Impact Factor: 3.92). 04/2008; 108(3):553-61. DOI: 10.1016/j.jada.2008.01.030
Source: PubMed


It is the position of the American Dietetic Association that women of child-bearing ages should maintain good nutritional status through a lifestyle that optimizes maternal health and reduces the risk of birth defects, suboptimal fetal growth and development, and chronic health problems in their children. The key components of a health-promoting lifestyle during pregnancy include appropriate weight gain; appropriate physical activity; consumption of a variety of foods in accordance with the Dietary Guidelines for Americans 2005; appropriate and timely vitamin and mineral supplementation; avoidance of alcohol, tobacco, and other harmful substances; and safe food handling. Pregnant women with inappropriate weight gain, hyperemesis, poor dietary patterns, phenylketonuria, certain chronic health problems, or a history of substance abuse should be referred to a registered dietitian for medical nutrition therapy. Prenatal weight gain within the Institute of Medicine recommended ranges has been associated with better pregnancy outcomes. Most pregnant women need 2,200 to 2,900 kcal a day, but prepregnancy body mass index, rate of weight gain, maternal age, and appetite must be considered when tailoring this recommendation to the individual. The consumption of more food to meet energy needs, and the increased absorption and efficiency of nutrient utilization that occurs in pregnancy, are generally adequate to meet the needs for most nutrients. However, vitamin and mineral supplementation is appropriate for some nutrients and situations. This position paper also includes recommendations pertaining to use of alcohol, tobacco, caffeine, and illicit drugs.

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    • "Finally , a majority of women are currently failing to meet nutritionally recommended standards when planning to become pregnant or during pregnancy ( Hure et al . , 2009 ; Kaiser & Allen , 2008 ) . There is thus a need to further investigate the possible implications of dietary behaviors on mental health during this critical period . "
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    ABSTRACT: While maternal nutrition during pregnancy is known to play a critical role in the health of both mother and offspring, the magnitude of this association has only recently been realized. Novel, epigenetic data suggest that maternal dietary intake has permanent phenotypic consequences for offspring, highlighting the potency of antenatal diet. To date, the relationship between poor antenatal diet and maternal mental health specifically, remains poorly understood. Therefore, we aimed to systematically review evidence that has examined associations between antenatal diet quality and the experience of depressive, anxiety and stress symptoms during the perinatal period. A search for peer-reviewed papers was conducted using Medline Complete, PsycINFO, CINAHL, Academic Search Premiere and Psychology and Behavioral Science Collection. Nine studies (cohort = 4, cross-sectional = 5) published between 2005 and 2013 were eligible for inclusion in this review. A synthesis of findings revealed positive associations between poor quality and unhealthy diets and antenatal depressive and stress symptoms. Healthy diets were inversely associated with antenatal depressive and anxiety symptoms. Antenatal anxiety and postnatal depressive symptoms demonstrated inconsistent results. Given the paucity of research examining diet quality and mental health in women during the perinatal period, further sufficiently powered studies are urgently required to examine this association. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Full-text · Article · Mar 2015 · Appetite
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    • "Good maternal nutrition during pregnancy is important to ensure health for the mother and the growing fetus. This presupposes a diet with sufficient energy, with a variety of nutrients, minerals, and vitamins, and the mother's avoidance of toxins and contaminants (Kaiser and Allen, 2008; Cox and Phelan, 2009). "
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    ABSTRACT: Objective By enhancing maternal nutritional status, midwives can help women lower the risks of pregnancy complications and adverse birth outcomes as well as improve maternal health during pregnancy and in the long run. Dietary counselling is, on the other hand, not reported to be effective. Poor communication and conflicting messages are identified as possible barriers to adherence with recommendations. Midwives' experiences of providing dietary advice and counselling during pregnancy are sparsely reported. The aim of this study was therefore to explore midwives' strategies when faced with challenging dietary counselling situations. Methods Seventeen midwives from different parts of Sweden and working within antenatal health care were interviewed by telephone. The interviews were analysed using qualitative content analysis. Results Challenges were commonly experienced when counselling women who were overweight, obese, had eating disorders or were from different cultures. The midwives talked in terms of "the problematic women" when addressing counselling problems. Strategies used in challenging counselling situations were Getting acquainted; Trying to support and motivate; Pressure to choose "correctly"; Controlling and mastering; and Resigning responsibility. Conclusions The results indicate that Swedish midwives' counselling strategies' are quite ambiguous and need to be questioned and that counselling of vulnerable groups of women should be highlighted. We could identify a need for education of practicing midwives to develop person-centred counselling skills.
    Full-text · Article · Oct 2014 · Sexual & reproductive healthcare: official journal of the Swedish Association of Midwives
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    • "Overweight and obesity are linked to higher rates of cesarean sections and greater cost of obstetric care (Galtier-Dereure et al., 2000; Stotland et al., 2004; Vahratian et al., 2005). Additional complications associated with excess GWG have been described in detail (Rasmussen and Yaktine, 2009) and include increased risk of gestational diabetes, hypertension, preeclampsia, delivery complications, perinatal fatality, neural tube defects, neonatal hypoglycemia, and failure to initiate breastfeeding (Hilson et al., 1997, 2006; Galtier-Dereure et al., 2000; Kaiser et al., 2002, 2008; Thorsdottir et al., 2002). "
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    ABSTRACT: Women in the United States experience an increase in food cravings at two specific times during their life, (1) perimenstrually and (2) prenatally. The prevalence of excess gestational weight gain (GWG) is a growing concern due to its association with adverse health outcomes in both mothers and children. To the extent that prenatal food cravings may be a determinant of energy intake in pregnancy, a better understanding of craving etiology could be crucial in addressing the issue of excessive GWG. This paper reviews the available literature to corroborate and/or dispute some of the most commonly accepted hypotheses regarding the causes of food cravings during pregnancy, including a role of (1) hormonal changes, (2) nutritional deficits, (3) pharmacologically active ingredients in the desired foods, and (4) cultural and psychosocial factors. An existing model of perimenstrual chocolate craving etiology serves to structure the discussion of these hypotheses. The main hypotheses discussed receive little support, with the notable exception of a postulated role of cultural and psychosocial factors. The presence of cravings during pregnancy is a common phenomenon across different cultures, but the types of foods desired and the adverse impact of cravings on health may be culture-specific. Various psychosocial factors appear to correlate with excess GWG, including the presence of restrained eating. Findings strongly suggest that more research be conducted in this area. We propose that future investigations fall into one of the four following categories: (1) validation of food craving and eating-related measures specifically in pregnant populations, (2) use of ecological momentary assessment to obtain real time data on cravings during pregnancy, (3) implementation of longitudinal studies to address causality between eating disorder symptoms, food cravings, and GWG, and (4) development of interventions to ensure proper prenatal nutrition and prevent excess GWG.
    Full-text · Article · Sep 2014 · Frontiers in Psychology
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