NUTRITION

THROUGHOUT
THE LIFESPAN
 PREGNANCY
Period when the fertilized
ovum implants itself in the
uterus, undergoes
differentiation, and grows
until it can support extra-
uterine life.
266 to 280
days
(37-40
weeks)

3 trimesters

Implantation,
organogene-
sis and
growth
 1st Trimester 2nd Trimester 3rd Trimester

The baby’s body The mother The mother

structure and organ experienced decrease experience
system develop. nausea and better shortness of breath,
sleep patterns. hemorrhoids,
Feeling of nausea
However, the mother
and vomiting on the urinary
experience back pain,
mother is present. abdominal pain leg incontinence,
cramps, constipation varicose veins, and
and heart burn sleeping problems
 NUTRITIONAL OBJECTIVES

• Ensure optimum nutrition before, during

and after pregnancy and during lactation
• Provide adequate nutrition to meet
increased maternal and fetal nutrient
demands
Nutrition in Pregnancy

Calorie Allowances Calcium Allowances

Weight Gain Iron Allowances

Maternal Weight Iodine Allowances

Protein Allowances Vitamin Allowances

Food Allowances
 Calorie Allowances

Total energy cost of storage plus

maintenance= 80,000 kcal

The energy cost of pregnancy then is about

300 kcal per day. The energy intake should
be 36 kcal per kg of pregnant weight per
day.
Maternal Weight Gain

Tissue Weight (Pound)

Fetus 7.5

Uterus 2.0

Placenta 1.5

Amniotic Fluid 2.0

Blood Volume 3.0

Extracellular Fluid Accretion 2.0

Breast Tissue 1.0

Fat 9.0

TOTAL 28.0
 Maternal Weight

1. Underweight
 High risk for having low-birth weight infants
 Higher rates of preterm deaths and infant deaths
2. Overweight and Obese
 High risk of complications like hypertension, gestational
diabetes and postpartum infections
 Complications of labor
 Difficulty of labor and delivery, birth trauma and cesarean
section for large babies
 Doubled risk of neural tube defects
 Recommended Weight Gain during
Pregnancy

Weight Gain Patterns

Pre-Pregnancy Weight Recommended Weight
First Thereafter
Trimester
Underweight BMI < 18.5 28-40 lbs 5 lbs 1 lb per
week

Healthy BMI 18.5- 25-35 lbs 3 ½ lbs 1 lb per

Weight 24.9 week

Overweight BMI 25.0- 15-25 lbs 2 lbs 2/3 per

29.9 week

Obese BMI >/= 30 15 lbs

Protein Allowances

The protein needs of a normal woman

are 1.1 g/kg BW; a normal pregnant
woman requires an additional 9.5
d/day or a total of 900-950 g for the 9
months gestation period.
Reasons for the additional proteins:
1. To provide for the storage of nitrogen
2. To protect the mother against many of the
complications of pregnancy
3. For the growth of the woman’s uterus, placenta and
associated tissues
4. To meet the needs for the fetal growth and repair
5. For the growth of the mammary tissues
6. For the hormonal preparation for lactation
Calcium Allowances

65% 64%

CALCIUM PHOSPHORUS
 Iron Allowances

At least 700 to 1,000 mg of iron must be

absorbed and utilized by the mother
throughout her pregnancy. Of this total
about 240 mg is spared by the cessation of
the menstrual flow. The remainder must
be made available from the diet.
 Iodine Allowances

• An inadequate intake of iodine may

result in goiter in the mother of the child.
• It can be met by the regular use of
iodized salt in food.
• Essential for the needs of fetal
development
 Vitamin Allowances

• Thiamine and niacin- increased in proportion to

the calorie increase
• Riboflavin- increased according to higher protein
level
• Vitamin D- increased during pregnancy to make
easier utilization of greater amount of calcium
and phosphorus
• Ascorbic Acid- should be increase in amount
because it is vital for tissue structure
• Vitamin A- important during
organogenesis because epithelial tissue
formation is occurring and for good
eyesight or vision
• Folic Acid and Vitamin B12- important in
RBC synthesis
• Vitamin B6 or Pyridoxine- prevents severe
nausea and vomiting associated with
childbearing
• Vitamin K- for blood clotting
 Food Allowances

1. One ounce or 30 g of meat or its equivalent and

an extra pint of milk to the normal diet.
2. Daily consumption of whole grain cereals; enrich
bread; rice; leafy green and yellow vegetables;
and fresh and dried fruits
3. Liver at least once a week
4. Egg in the daily diet
5. Fortified milk with Vitamin D or fish liver oil
6. Six to eight glasses of water daily
COMPLICATIONS OF
PREGNANCY AND
POSSIBLE DIETARY
MEDICATIONS
Rapid Weight Gain or Loss
• Weight gain of less than 500 g per month during
the first trimester and 250 g during the second
trimester can lead to low-birth weight or
premature infants and babies with brain and
nerve damage. Abortions may also occur.

• Excessive weight gain of 3kg or more per month

in the second trimester and third trimesters can
lead to eclampsia
 Toxemia

• Manifestations:
1. Rapid Weight Gain,
2. Edema,
3. High blood pressure,
4. Excretion of albumin in the urine and,
5. Convulsions
 Classifications

1. Acute Toxemia of pregnancy: onset

after the 24th week
• Pre-eclampsia- hypertension with
proteinuria and/or edema
• Eclampsia- convulsions or coma; usually
both when associated with hypertension,
proteinuria and edema
2. Chronic Hypertensive (vascular)
Disease
• Without superimposed acute
toxemia
• With superimposed acute toxemia
 Anemia
• Combined deficiency of iron and folic
acid
• Once anemia is established, it is difficult
to overcome the condition even by
raising the level or iron in diet although
its absorption can be enhanced by the
inclusion of ascorbic acid rich foods in
the same meal containing rich sources or
iron
 Diabetes
• More prone to develop pre-
eclampsia, pyelonephritis and
polyhydramnios (excess of amniotic
fluid) and her baby has a higher risk
of dying on the utero or at birth.
Rigid control of maternal
blood glucose
concentration is vital for
good prognosis of the fetus
 Constipation
• Pressure exerted by the developing fetus
on the digestive tract, lack of exercise
and insufficient bulk in the diet cause
constipation, which if chronic or habitual,
gives rise to headaches and much
discomfort.
Eating lots of fresh fruits,
vegetables, fluid and
regular exercise can
correct this disorder
 Socio-Economic and Cultural
Factors
• Unusual eating habits such as frequent snacks
rich in carbohydrates; irregular meals; special
cravings such as raw white rice and green
mangoes; and odd eating habits like chewing
cigarettes, chicken manure and soot of pots
deprive the mother wholesome food

Fallacies should
be ignored
 Alcohol, Caffeine, Nicotine

• Smoking during pregnancy lowers the

mean birth weight and increases the
perinatal mortality. It affects conversion
of dietary calories into weight gain.
• It increases the mother’s level of
carboxyhemoglobin and nicotine causing
a decrease oxygenation of the fetus.
• Excessive maternal alcohol ingestion is linked
to Fetal Alcohol Syndrome (FAS). Its major
features are CNS disorders, mental
retardation, froth deficiencies and facial
deformities.
• Caffeine crosses the placenta to the fetus very
rapidly. The dug-metabolizing ability of a fetus
is extremely limited. The fetus can metabolize
alcohol but not caffeine.
• Alcohol, caffeine and nicotine increase the
circulating level of catecholamine.
MOTHER’S AGE AND
ASSOCIATED
HEALTH CONCERNS
AND RISKS
 Pregnancy in Adolescents
(1 out of 20)

a) Iron deficiency anemia

b) Prolonged labor
c) Higher rates of stillbirths, pre-term
births and low-birth weight infants
 Pregnancy in Older Women

a) Hypertension and diabetes

b) Higher rates of premature births and
low birth weight
c) Birth defects
d) Fetal death
 RECOMMENDED AMOUNTS
FOOD GROUPS

Pregnant Women Lactating Women

5 ½ -6 cups, cooked 6-7 cups, cooked

1 cup rice, 1 cup rice cooked= 4
Rice and Rice and Others cooked=4 pcs pan pcs pan de sal (about
Alternatives de sal (about 17 g 17 g each)
each) 4 slices of loaf bread
4 slices of loaf 1 pack of 60 g
bread instant noodles
1 pack of 60 g
instant noodles
1 cup cooked 1 cup cooked
macaroni/spaghetti macaroni/spaghetti
1 small root crop 1 small root crop
(kamote) 180 g or 1 (kamote) 180 g or 1
cup cooked diced, cup cooked diced, at
at least 3x a week least 3x a week
Meat and Fish/Meat/Poultry/ At least 3 ½ servings At least 3 ½ servings
alternatives Dried beans/Nuts 1 serving cooked 1 serving cooked
meat= 30 g or about meat= 30 g or about
3 cm tube; fish= 2 3 cm tube; fish= 2
pcs medium-sized pcs medium-sized
(55-60 g each), about (55-60 g each), about
16 cm long; 1 ½ cups 16 cm long; 1 ½ cups
cooked dried cooked dried
beans/nuts beans/nuts
preferably taken 3x a preferably taken 3x a
week week

Egg 1 piece 1 piece

3-4x a week 3-4x a week

Milk 1 glass of whole milk, 1 glass of whole milk,

(240 ml) equivalent (240 ml) equivalent
to 4 tbsp powdered to 4 tbsp powdered
whole milk or ½ whole milk or ½
cupof evaporated cupof evaporated
milk diluted to 1 milk diluted to 1
glass of water glass of water
 Green leafy/Yellow ¾ cup, cooked ¾ cup, cooked
Vegetables

Others 1 cup, cooked 1 cup, cooked

1 medium-sized 1 medium-sized
fruit or 1 slice of a fruit or 1 slice of a
big fruit big fruit
Fruits Vitamin C-rich
1 medium-sized 1 medium-sized
fruit or 1 slice of big fruit or 1 slice of big
fruit fruit

Fats and Oils 7 teaspoons 7 teaspoons

Sugar 6 teaspoons 6 teaspoons

 Recommended Foods for First
Trimester
• Folic Acid- beans, citrus fruits, green
leafy vegetables and prenatal vitamin
• Calcium- dairy (milk, yogurt and cheese)
and dark leafy greens
• Iron- meat, poultry, seafood, beans and
greens
• Choline- red meat and eggs
• Vitamin B12- meat, poultry, seafood,
fortified breads and cereals
• Omega-3 fatty acids- fatty fish, chia
seeds
 Recommended Foods for Second
Trimester
• Protein- lean meat, nuts, tofu, eggs, fish
(cooked, not raw), peas, beans and lentils
• Calcium- dairy (milk, yogurt and cheese),
eggs, tofu, white beans, almonds, greens
(broccoli)
• Iron- lean meat, cooked seafood, leafy
green vegetables, nuts, beans
• Folate- black-eyed peas and other
legumes, fortified cereals, dark green
leafy vegetables (spinach, cabbage and
others), oranges, whole grains (rice)
• Vitamin D- fatty fish (salmon, tuna), fish
liver oils, beef liver, cheese, egg yolks
• Omega-3 fatty acids- oily fish, fish oil
 Recommended Foods for Third
Trimester
• Protein Rich Foods- grilled beef or pork,
soup, beans
• Eggs
• Eat plenty fruits and vegetables rich in
Vitamin C and Vitamin A
LACTATION
Nutritional Requirements

1. Calories- addition of 1000cal above the normal

allowance is needed
2. Protein- additional 20 g to the normal
allowance is needed to compensate for the
protein lost in milk
3. Calcium and Phosphorus- increase of 0.5 mg
to the normal allowance is needed to prevent
severe depletion of maternal calcium reserve
since this is used for milk production
 4. Iron- additional intake is recommended for
blood lost in parturition, for milk iron, and basal
losses
5. Vitamin A- additional 2000 IU to the normal
allowance to provide the amount of vitamin A
secreted in milk.
6. Vitamin B1- additional allowance is needed for
thiamin secreted in milk.
7. Riboflavin, Vitamin C, etc.- additional allowance
is needed for milk secretion.
8. Fluids- 8 glasses or more to increase milk
production
 Dietary Allowance for Lactating
Mothers

Body- Building Foods

Fish, meat/poultry--------5 matchbox sizes
Milk---------------------------3-4 glasses
Eggs---------------------------3-4x/week
Dried beans and nuts-----2/3 cup cooked
Energy-giving Foods
Enriched rice------------6 cups cooked
Root crop-----------------1 medium-sized or 2/3 cup,
sliced
Sugar-----------------------9 teaspoons
Fat---------------------------8 teaspoons
Regulating Foods
Green leafy and yellow vegetables----1 cup cooked
Vitamin C-rich fruits------------2 medium sized
Other fruits and vegetables---2 medium sized or 2/3
cup cooked
Meal Pattern
Breakfast
Fruit------1 slice pineapple
Cereal----2 cups rice or 1 cup rice and 2 slices
whole wheat bread or 5 pieces pan de sal
Protein dish----2 pieces frankfurters
Egg-----sunny side-up with catsup
beverage------1 glass of milk
Mid-Morning--------Milk
Lunch
Tasty noodles and vegetable soup
Protein dish
Vegetable dish
Tokwa casserole
Chopsuey
Cereal-----------1 cup of rice
Dessert---------1 regular slice cake
Beverage-------1 glass fruit punch or milk
Mid-afternoon-----------Milk
Dinner
Cream of corn soup
Protein dish-----spaghetti with string beans
Vegetable dish------hamburger with string
beans
Cereal------------------1 cup rice
Fruit--------------------2 medium-sized orange
Beverage--------------1 cup milk