The importance of nutrition in pregnancy and lactation: lifelong consequences

Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be “eat better, not more.” This can be achieved by basing diet o...

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Published inAmerican journal of obstetrics and gynecology Vol. 226; no. 5; pp. 607 - 632
Main Authors Marshall, Nicole E., Abrams, Barbara, Barbour, Linda A., Catalano, Patrick, Christian, Parul, Friedman, Jacob E., Hay, William W., Hernandez, Teri L., Krebs, Nancy F., Oken, Emily, Purnell, Jonathan Q., Roberts, James M., Soltani, Hora, Wallace, Jacqueline, Thornburg, Kent L.
Format Journal Article
LanguageEnglish
Published United States Elsevier Inc 01.05.2022
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Abstract Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be “eat better, not more.” This can be achieved by basing diet on a variety of nutrient-dense, whole foods, including fruits, vegetables, legumes, whole grains, healthy fats with omega-3 fatty acids that include nuts and seeds, and fish, in place of poorer quality highly processed foods. Such a diet embodies nutritional density and is less likely to be accompanied by excessive energy intake than the standard American diet consisting of increased intakes of processed foods, fatty red meat, and sweetened foods and beverages. Women who report “prudent” or “health-conscious” eating patterns before and/or during pregnancy may have fewer pregnancy complications and adverse child health outcomes. Comprehensive nutritional supplementation (multiple micronutrients plus balanced protein energy) among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight. A diet that severely restricts any macronutrient class should be avoided, specifically the ketogenic diet that lacks carbohydrates, the Paleo diet because of dairy restriction, and any diet characterized by excess saturated fats. User-friendly tools to facilitate a quick evaluation of dietary patterns with clear guidance on how to address dietary inadequacies and embedded support from trained healthcare providers are urgently needed. Recent evidence has shown that although excessive gestational weight gain predicts adverse perinatal outcomes among women with normal weight, the degree of prepregnancy obesity predicts adverse perinatal outcomes to a greater degree than gestational weight gain among women with obesity. Furthermore, low body mass index and insufficient gestational weight gain are associated with poor perinatal outcomes. Observational data have shown that first-trimester gain is the strongest predictor of adverse outcomes. Interventions beginning in early pregnancy or preconception are needed to prevent downstream complications for mothers and their children. For neonates, human milk provides personalized nutrition and is associated with short- and long-term health benefits for infants and mothers. Eating a healthy diet is a way for lactating mothers to support optimal health for themselves and their infants.
AbstractList Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be "eat better, not more." This can be achieved by basing diet on a variety of nutrient-dense, whole foods, including fruits, vegetables, legumes, whole grains, healthy fats with omega-3 fatty acids that include nuts and seeds, and fish, in place of poorer quality highly processed foods. Such a diet embodies nutritional density and is less likely to be accompanied by excessive energy intake than the standard American diet consisting of increased intakes of processed foods, fatty red meat, and sweetened foods and beverages. Women who report "prudent" or "health-conscious" eating patterns before and/or during pregnancy may have fewer pregnancy complications and adverse child health outcomes. Comprehensive nutritional supplementation (multiple micronutrients plus balanced protein energy) among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight. A diet that severely restricts any macronutrient class should be avoided, specifically the ketogenic diet that lacks carbohydrates, the Paleo diet because of dairy restriction, and any diet characterized by excess saturated fats. User-friendly tools to facilitate a quick evaluation of dietary patterns with clear guidance on how to address dietary inadequacies and embedded support from trained healthcare providers are urgently needed. Recent evidence has shown that although excessive gestational weight gain predicts adverse perinatal outcomes among women with normal weight, the degree of prepregnancy obesity predicts adverse perinatal outcomes to a greater degree than gestational weight gain among women with obesity. Furthermore, low body mass index and insufficient gestational weight gain are associated with poor perinatal outcomes. Observational data have shown that first-trimester gain is the strongest predictor of adverse outcomes. Interventions beginning in early pregnancy or preconception are needed to prevent downstream complications for mothers and their children. For neonates, human milk provides personalized nutrition and is associated with short- and long-term health benefits for infants and mothers. Eating a healthy diet is a way for lactating mothers to support optimal health for themselves and their infants.
Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask what a healthy diet for a pregnant woman should look like. The message should be “eat better, not more.” This can be achieved by basing diet on a variety of nutrient-dense, whole foods, including fruits, vegetables, legumes, whole grains, healthy fats with omega-3 fatty acids that include nuts and seeds, and fish, in place of poorer quality highly processed foods. Such a diet embodies nutritional density and is less likely to be accompanied by excessive energy intake than the standard American diet consisting of increased intakes of processed foods, fatty red meat, and sweetened foods and beverages. Women who report “prudent” or “health-conscious” eating patterns before and/or during pregnancy may have fewer pregnancy complications and adverse child health outcomes. Comprehensive nutritional supplementation (multiple micronutrients plus balanced protein energy) among women with inadequate nutrition has been associated with improved birth outcomes, including decreased rates of low birthweight. A diet that severely restricts any macronutrient class should be avoided, specifically the ketogenic diet that lacks carbohydrates, the Paleo diet because of dairy restriction, and any diet characterized by excess saturated fats. User-friendly tools to facilitate a quick evaluation of dietary patterns with clear guidance on how to address dietary inadequacies and embedded support from trained healthcare providers are urgently needed. Recent evidence has shown that although excessive gestational weight gain predicts adverse perinatal outcomes among women with normal weight, the degree of prepregnancy obesity predicts adverse perinatal outcomes to a greater degree than gestational weight gain among women with obesity. Furthermore, low body mass index and insufficient gestational weight gain are associated with poor perinatal outcomes. Observational data have shown that first-trimester gain is the strongest predictor of adverse outcomes. Interventions beginning in early pregnancy or preconception are needed to prevent downstream complications for mothers and their children. For neonates, human milk provides personalized nutrition and is associated with short- and long-term health benefits for infants and mothers. Eating a healthy diet is a way for lactating mothers to support optimal health for themselves and their infants.
Author Hay, William W.
Roberts, James M.
Purnell, Jonathan Q.
Oken, Emily
Wallace, Jacqueline
Barbour, Linda A.
Catalano, Patrick
Hernandez, Teri L.
Friedman, Jacob E.
Abrams, Barbara
Thornburg, Kent L.
Christian, Parul
Krebs, Nancy F.
Marshall, Nicole E.
Soltani, Hora
Author_xml – sequence: 1
  givenname: Nicole E.
  orcidid: 0000-0003-3105-555X
  surname: Marshall
  fullname: Marshall, Nicole E.
  organization: Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR
– sequence: 2
  givenname: Barbara
  orcidid: 0000-0001-7190-7193
  surname: Abrams
  fullname: Abrams, Barbara
  organization: School of Public Health, University of California, Berkeley, CA
– sequence: 3
  givenname: Linda A.
  surname: Barbour
  fullname: Barbour, Linda A.
  organization: Department of Medicine, University of Colorado School of Medicine, Aurora, CO
– sequence: 4
  givenname: Patrick
  orcidid: 0000-0003-3291-3034
  surname: Catalano
  fullname: Catalano, Patrick
  organization: Department of Obstetrics and Gynecology, Mother Infant Research Institute, Tufts University School of Medicine, Boston, MA
– sequence: 5
  givenname: Parul
  surname: Christian
  fullname: Christian, Parul
  organization: Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
– sequence: 6
  givenname: Jacob E.
  surname: Friedman
  fullname: Friedman, Jacob E.
  organization: Department of Physiology, Harold Hamm Diabetes Center, University of Oklahoma Health Sciences Center, Oklahoma City, OK
– sequence: 7
  givenname: William W.
  surname: Hay
  fullname: Hay, William W.
  organization: University of Colorado, Denver, CO
– sequence: 8
  givenname: Teri L.
  orcidid: 0000-0002-7024-5017
  surname: Hernandez
  fullname: Hernandez, Teri L.
  organization: Department of Medicine, College of Nursing, University of Colorado Anschutz Medical Campus, Aurora, CO
– sequence: 9
  givenname: Nancy F.
  surname: Krebs
  fullname: Krebs, Nancy F.
  organization: Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO
– sequence: 10
  givenname: Emily
  orcidid: 0000-0003-2513-3339
  surname: Oken
  fullname: Oken, Emily
  organization: Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA
– sequence: 11
  givenname: Jonathan Q.
  surname: Purnell
  fullname: Purnell, Jonathan Q.
  organization: Department of Medicine, Knight Cardiovascular Institute, Bob and Charlee Moore Institute of Nutrition and Wellness, Oregon Health & Science University, Portland, OR
– sequence: 12
  givenname: James M.
  orcidid: 0000-0002-2671-3207
  surname: Roberts
  fullname: Roberts, James M.
  organization: Department of Obstetrics and Gynecology and Reproductive Sciences, Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA
– sequence: 13
  givenname: Hora
  surname: Soltani
  fullname: Soltani, Hora
  organization: Department of Maternal and Infant Health, Sheffield Hallam University, Sheffield, England
– sequence: 14
  givenname: Jacqueline
  surname: Wallace
  fullname: Wallace, Jacqueline
  organization: Rowett Institute, University of Aberdeen, Aberdeen, Scotland
– sequence: 15
  givenname: Kent L.
  surname: Thornburg
  fullname: Thornburg, Kent L.
  email: thornbur@ohsu.edu
  organization: Department of Medicine, Center for Developmental Health, Knight Cardiovascular Institute, Bob and Charlee Moore Institute of Nutrition and Wellness, Oregon Health & Science University, Portland, OR
BackLink https://www.ncbi.nlm.nih.gov/pubmed/34968458$$D View this record in MEDLINE/PubMed
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Issue 5
Keywords fetal and neonatal nutrition
lactation
pregnancy
vitamin supplementation
macronutrients
micronutrients
gestational diabetes mellitus
maternal nutrition
adolescent pregnancy
nutritional requirements
developmental origins of disease
Language English
License This is an open access article under the CC BY-NC-ND license.
Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.
This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
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Snippet Most women in the United States do not meet the recommendations for healthful nutrition and weight before and during pregnancy. Women and providers often ask...
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SubjectTerms adolescent pregnancy
developmental origins of disease
Diet
Female
fetal and neonatal nutrition
gestational diabetes mellitus
Gestational Weight Gain
Humans
Lactation
macronutrients
Male
maternal nutrition
micronutrients
nutritional requirements
Nutritional Status
Obesity
Pregnancy
Vegetables
vitamin supplementation
Weight Gain
Title The importance of nutrition in pregnancy and lactation: lifelong consequences
URI https://dx.doi.org/10.1016/j.ajog.2021.12.035
https://www.ncbi.nlm.nih.gov/pubmed/34968458
https://search.proquest.com/docview/2615919830
https://pubmed.ncbi.nlm.nih.gov/PMC9182711
Volume 226
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