Prenatal nutrition: How diet impacts maternal outcomes

Poor nutrition comes with risks such as pre-term birth, gestational diabetes, excess weight gain, hypertensive disorders and potential complications with delivery, among other issues.Good nutrition involves eating a healthy and balanced diet to ensure the body gets the nutrients it needs to function well. While nutrition is important at all stages of life, experts at the University of Alabama at Birmingham say nutrition during pregnancy is especially important and making healthier food choices every day will help keep both the mother and the baby healthy.

A staggering 70 percent of pregnant women exceed recommended intakes of added sugars, sodium and saturated fats. Additionally, more than half gain excess weight during pregnancy, risking the mother’s and baby’s health.

“This comes with risks associated with poor nutrition such as pre-term birth, gestational diabetes, excess weight gain, hypertensive disorders and potential complications with delivery, among other issues,” said Camille Worthington, Ph.D., assistant professor in the UAB Marnix E. Heersink School of Medicine Division of General Internal Medicine and Population Science.

Research suggests that, when moms engage in healthy nutrition during pregnancy, infants can become accustomed to some of these foods and flavors, which may help them accept and enjoy similar foods as they get older. This is due to flavors from the mother’s diet being transmitted to the amniotic fluid and consumed by the fetus. Following childbirth, these flavors can be transmitted through breast milk as it exposes the baby to foods, spices and beverages the mother consumes.

What to eat

According to the American College of Obstetricians and Gynecologists, women who are pregnant with one fetus should eat an additional 340 calories per day starting in the second trimester. Women who are carrying twins should eat about 600 extra calories a day, and women with triplets should consume an extra 900 calories a day.

By eating healthy foods and taking a prenatal vitamin every day, women can get the vitamins and minerals they need during pregnancy. Pregnant women should focus on eating foods with folic acid, iron, calcium, vitamin D, choline, omega-3 fatty acids, vitamin B and vitamin C.

Some of the foods that can help pregnant women get the vitamins and nutrients they need include:

• Meat such as chicken, beef, liver and pork. Avoid cured meats.
• Eggs
• Seafood such as fatty fish including salmon, sardines and anchovies. Avoid seafood with high mercury levels. This chart by the U.S. Food and Drug Administration explains which fish to eat and the amount of fish that is safe to eat.
• Beans and lentils
• Fruits and vegetables
• Enriched breads and cereals
• Milk and dairy 

How to get started

Worthington says one of the first steps moms can take when prioritizing their nutrition is to start with small changes.

“It can be hard to maintain healthy habits that you start all at once,” Worthington said. “Pick one habit that you feel you can achieve, master that habit, and then slowly add more healthy habits to your routine.”

Worthington recommends taking steps to make healthy choices easier — for example, keeping fruit on the counter instead of processed snacks or keeping water in the fridge rather than sugary drinks.

“When deciding what to eat, think about how you can add vegetables to your meal,” Worthington said. “For example, if you are eating a box of instant macaroni and cheese for dinner, add a bag of frozen broccoli to it. If you are eating a frozen pizza, add a few vegetables on top. Small changes add up.”  

Purchase produce that is in season for more affordable options, or stock up on frozen or canned produce. When purchasing canned goods, Worthington says, look for options with low sodium and no added sugars. If these are not available, just rinse the canned fruits and vegetables before use to reduce the sodium and sugar content.

When eating out, focus on switching to healthier options such as grilled chicken instead of fried chicken, water instead of soda, or a side salad or cup of fruit instead of fries or chips.

Worthington says to play around with different seasonings to add flavor to healthy dishes that are prepared at home. Avoid using seasoning mixes that are high in sodium.

Worthington transforms maternal outcomes with food delivery

In her research, Worthington is spearheading a groundbreaking initiative to transform maternal health through innovative nutritional interventions. Her project, “Use of Home-Delivered Meals to Manage Cardiometabolic Health during Pregnancy among Predominantly Black, Low-Income Women in Alabama,” focuses on the critical juncture of pregnancy, diet, maternal well-being and birth outcomes among Medicaid-eligible pregnant individuals.

“The U.S. and Alabama have some of the highest rates of pregnancy complications, poor pregnancy outcomes, and mom and baby death related to pregnancy,” Worthington said. “Good nutrition is an important part of a healthy pregnancy, but not everyone has the ability to afford or access a healthy diet.”

Worthington is currently working on a study that involves providing pregnant moms who are Medicaid-eligible with 10 free healthy meals delivered right to their homes each week to help them eat healthier, maintain a healthy weight and reduce stress. While enrollment is currently closed for the study, Worthington hopes that her research shows that providing pregnant women with healthy meals can improve pregnancy outcomes and prevent mom and baby from having pregnancy complications that result in extended hospital stays.

“Healthy meal delivery can support healthier pregnancies, which supports healthier babies and ultimately healthier communities,” Worthington said.