Dietitian Shares: Mental Health During Pregnancy: 4 Easy & Yummy Diet Tips

Mental Health During Pregnancy - Tian Wei Signature

Depression and anxiety are common among pregnant women. It is multifactorial, and the core reasons for one’s depression can differ from one person to the other. Interestingly, there is more and more research on how impactful a diet is for our mental health. It hypothesised that how well you eat can impact your mental health. 

Balanced diet

First and foremost, a balanced diet is the foundation of any healthy diet. How, then, should you try to achieve this, you might ask? You can always use the “quarter, quarter, half” rule. This rule should be your bread and butter concept whenever you are at the dining table. This helps you gauge how much of each main group you should eat on a plate. Your plate should be filled a quarter with your choice of staple, another quarter of the plate should be filled with your choice of animal or plant-based protein and one-half of the plate should be filled with vegetables! This simple daily practice would help ensure you take sufficient macronutrients from your diet and minimise deficiency of certain micronutrients. 

Fish twice a week

How many of us are aware of our fish intake? Are you keeping in mind how often you consume Omega 3-DHA-rich fish weekly? You may have never thought about this before. Still, the recommended fish intake to support mothers during pregnancy for a healthy diet and mental health is two servings of low-mercury fish per week, such as Salmon, Skipjack Tuna, Saba fish or Cod fish, to name a few. Fish like these are also rich in Omega 3-DHA!

Omega 3-DHA is anti-inflammatory, which interacts with mood-related molecules in the brain that helps to relieve depression. Besides that, Omega 3-DHA intakes also help with the fetus’s brain development during pregnancy too! Talk about killing two birds with one stone!

Fiber from fruits and vegetables

Yes, yes, this may sound boring to you, but it is true! Fruits and vegetables are good for you! Beyond merely providing you fiber to ensure smooth bowel movements, the different colours of fruits and vegetables carry phytochemicals that benefit good health! How so? These phytochemicals are anti-inflammatory and are important in reducing the risk of incidence and mortality from heart diseases and stroke. Besides that, a higher intake of fruits and vegetables is associated with a lower risk of depression. The nutrient content of these fruits and vegetables, like Beta-carotene, Vitamin C and Vitamin E, has been reported to be effective antioxidants. It was also hypothesised that folate which can be found in fruits and vegetables, is involved in neurotransmitters in the brain that are related to mood.

Having vegetables in your diet is now more important than ever. Aside from all its vitamins and minerals, dark leafy greens like kale, spinach, and kai-lan are packed with fiber to help you fight against pregnancy constipation. Furthermore, according to the American Journal of Clinical Nutrition, vegetables are linked to a lower risk of low birth weight.

Berries

Some of the best berries during pregnancy are goji, strawberries, raspberries and blueberries. You can eat berries, sprinkle them on top of your yoghurt, or make smoothies with berries. Being low in calories, berries are also packed with goodness like vitamin C, fiber, antioxidants, and healthy carbs to boost your and your baby’s health during pregnancy. Other than berries, a similar option is fresh red dates. Having red dates during pregnancy gives you energy, potassium and fiber while giving you a lower increase in blood sugar levels in your body.

Avocados

Avocados are packed with a healthy fat called monounsaturated fatty acids and are high in B vitamins, vitamin K, potassium, copper, vitamin E, and vitamin C. In particular, its healthy fats, folate, and potassium benefit your pregnancy the most. Your baby needs healthy fats to build skin, brain, and tissues. Meanwhile, folate helps to prevent neural tube defects and developmental abnormalities of the brain and spine. As for potassium, it helps to relieve leg cramps, which is a common pregnancy discomfort for most mothers.

Vitamin-D-rich foods

Vitamin D has been a key topic in many health discussions these days. During the Covid pandemic, doctors were finding Covid patients with lower Vitamin D status levels have a higher mortality risk. In Singapore, it was found that more than 40% of mothers during pregnancy had suboptimal levels of Vitamin D. This is worrying as there is growing evidence of the inverse association between Vitamin D levels and the risk of depression during pregnancy and postpartum. Vitamin D provides a protective effect on the brain from depression.

Unfortunately, Vitamin D-rich foods are very limited. Vitamin D is mainly obtained from exposure to the sun on our skin. Despite living in such a tropical country where we are blessed to enjoy the sun all year round, many of us are working from home or stuck in tall office buildings from dawn to dusk.

This lifestyle and working environment put many of us at risk of Vitamin D deficiency or inadequacy. Thus, many of us need to obtain our healthy dose of Vitamin D from more sun exposure and vitamin D-rich foods.

If all is lost, we should consider discussing with our healthcare professionals to assess your risk and the need to be supplemented appropriately if we are recommended to obtain 10 mcg of Vitamin D per day during pregnancy. Some sources of vitamin D-rich foods available easily in Singapore’s supermarkets are fortified soy, fortified orange juice, fortified dairy milk, sun-exposed shiitake mushrooms, salmon tuna, sardines and eggs!

As little as it may seem, an egg contains a tiny amount of almost all your daily essential nutrients. Eggs contain high-quality protein and various vitamins and minerals. Most importantly, eggs are excellent sources of choline, which plays a crucial role in your baby’s brain development and helps minimise the risk of brain and spine development abnormalities. We hope this guide has given you a better idea about the importance of good nutrition during pregnancy.

Lean Meat 

During pregnancy, your body needs higher amounts of iron and protein. Lean meat like chicken, lean beef, and lean pork are great sources of high-quality protein and iron. Protein is essential for your little one to develop tissues, especially brain tissues. It also helps your breast and womb tissues to grow during pregnancy. Meanwhile, iron in lean meat is more bioavailable than iron in plant based foods. Iron rich foods are important to have during pregnancy to reduce risk of being iron deficient anaemiaessential during your third trimester to supply oxygen throughout your body by developing red blood cells.

Bonus tip: fermented foods

In certain cultures, traditional cuisines would have fermented foods such as Kimchi in Korean cuisine, fermented soy in Japanese cuisine and Sauerkraut in German cuisine. Researchers have found such fermented food may be beneficial in promoting beneficial strains of bacteria in our gut. Researchers know now that the more diverse your gut, the more optimal your gut can work for you! Regarding mental health, it seems like specific strains of certain beneficial microbiomes can provide some neuroprotective effects against depression in people. Some researchers may suggest it’s not just about the beneficial bacteria in foods like fermented soy in Japanese cuisine. It is also due to the spectrum of bioactive compounds like isoflavones, lignans and sterols, which may directly affect the gut-brain axis. 

So if you are used to having such traditional foods during mealtime, it is okay to incorporate them into your diet periodically. Alternatively, foods like yoghurt, kefir and cultured milk are safer options you can try during pregnancy if you want to include some fermented foods. This is because these commercialised products like yoghurt, kefir and cultured milk are often pasteurised before fermentation, which is done in a more controlled environment where only the beneficial bacteria thrive. 

Why a Good Diet Is Important During Pregnancy

Prevent Congenital Disabilities

The health of your baby depends on the food you consume. During pregnancy, you need high quantities of vitamin C and folic acid. You will get these from fruits and vegetables. Folic acid will promote the development of a healthy fetus and prevent any neural tube defects.Your sources of folic acid will include green leafy vegetables, legumes and some black beans.

Vitamin C will help you fight infections; you wouldn’t want to keep taking medication during pregnancy. Vitamin C is also part of forming collagen, the skin, gums, tissues and teeth. Additionally, Vitamin C will facilitate the absorption of iron. Take four servings of vegetables and three servings of fruits or more to get adequate Vitamin C from them.

Increased Caloric Needs

Pregnancy is a gruelling journey. The nine months will take a toll on you. Thus, you need the calories to support the pregnancy and continue your regular activities. As the pregnancy advances, you are likely to feel tired and weak.

Take your carbs, especially from whole grains. Talk to your Dietitian for advice on your daily caloric requirements, such recommendations are very individualised depending on many factors; one of which is your weight before pregnancy. 

Adequate Calcium

As the fetus grows, its bones tend to weaken. The unborn child requires higher levels of calcium for proper bone formation. Therefore, the fetus draws all the calcium needed no matter how little your dietary calcium intake is, leaving you exposed to little calcium for your bones.

Without replenishment, this may lead to back pains and leg cramps as the pregnancy advances. Apart from the bones, calcium is also essential for normal blood clotting and nerve and muscle function. You will require at least 1 to 2 serving of calcium rich foods daily to meet these needs. Sources of calcium include green vegetables, cheese, milk, yoghurt, dried peas and seafood.

Proper Cell Development

A protein diet will help your developing baby build cells and soft tissues. She requires slightly higher protein levels for your baby to form nails, hair, bones and other essential organs. Your body needs to adjust and accommodate the growing baby such as your breasts which continues to develop to form the milk in preparation for breastfeeding. Get your protein sources from lean meat, poultry, and fish.

7 Diet Tips for a Smooth Pregnancy

1. Don’t forget breakfast

Everyone knows that breakfast is the most important meal of the day. It is not good leaving your stomach empty as you will be light-headed throughout the day. How do you plan an easy breakfast meal? You could always try fortified ready-to-eat or cooked breakfast cereals with fresh-cut fruits. Fortified cereals have added nutrients like calcium and folic acid. You can also add some flax and pumpkin seeds as they contain healthy fats. Such a delicious treat in one scoop of cereal. 

2. Eat foods with fiber

Eating foods with fibre helps your healthy gut microbiome thrive. You can choose a variety of vegetables and fruits, like carrots, cooked greens, bananas, and melons. Fruits also provide a wide range of health-boosting antioxidants, including flavonoids. Eating a diet high in fruits and vegetables can also help constipation during pregnancy. 

Constipation starts as early as progesterone levels rise, around the second to the third month of pregnancy. It may get worse as pregnancy progresses and your uterus grows. Therefore eating more beans, whole grains and brown rice with sufficient fluid intake could help your bowel problem.

3. Choose healthy snacks

Who says snacking is bad? Snacking can be fun and healthy, depending on what you choose to snack on. Try low-fat or fat-free yoghurt with cut fruit for extra sweetness for your sweet tooth. Other than that, there is always the choice of whole-grain crackers with fat-free or low-fat cheese that could be just the right touch when watching a movie or reading a book on the weekends. 

4. Take a prenatal vitamin with iron and folic acid  as prescribed

Supplements are an additional add-on for a healthier diet to fill the gap of nutrients and vitamins in our bodies. It is also noted that not all supplements are necessary. The benefits of giving them should outweigh the risk. That said, do not self-prescribe. Always take supplements only after discussing the safety and dosage with a doctor. 

Determining how much nutrients or vitamins you could gain from what you eat is hard. It is advisable to take prenatal vitamins with iron and folic acid as prescribed. Iron requirements can be higher during pregnancy due to increased volume in blood by 30%. Thus, many women are at higher risk to be iron deficient anaemia during pregnancy. As for folate, folate requirements are so much higher as this nutrient plays apart in the development of the brain and the spine. It is almost impossible to achieve all your folic acid requirements via food only. Supplements are needed. Research has shown that taking folic acid supplements as early as preconception can significantly reduce the risk of defects in your baby’s brain and spine. 

5. Eat up to 12 ounces a week (2 average meals) of fish or shellfish

You need to eat at least two average meals of fish or shellfish. The omega-3 fatty acids in many fish, including docosahexaenoic acid (DHA), also can promote your baby’s brain development. A three-ounce serving is about the size of a deck of cards. Try to avoid fish and shellfish with high levels of mercury. Do not eat shark, swordfish, king mackerel, or tilefish. If you do fancy tuna, try to choose those canned light tuna. Common kinds of fish or seafood that are low in mercury include shrimp, salmon and catfish.

6. Stay away from soft cheeses and raw meat

There are both good food and bad goods that might harm your pregnancy journey, unless it’s pasteurised, try to avoid some foods like soft cheese such as feta, brie and goat cheese. Uncooked or undercooked meats like sushi could also hurt your baby as some foods may contain harmful bacteria, Listeria, and parasites. You may enjoy some foods like hotdogs, but it has to be well-heated until it’s steaming hot, similar to deli meat. If not, avoid deli meats to prevent consuming bacteria that could harm you and your baby.

7. Limit caffeine and avoid alcohol

Whoever is a coffee lover should take a break from it during this period.The World Health Organization (WHO) recommends restricting caffeine intake to reduce the risk of pregnancy loss and the low birth weight of your baby. The standard recommendation is to keep it below 200mg daily and about one to two cups of coffee daily. Alternatively, you could try drinking decaffeinated coffee or tea. Choose water or seltzer instead of soda and sweetened drinks. 

Also, do not drink alcohol. Drinking alcohol, especially in the first three months of pregnancy, increases the risk of miscarriage, premature birth and your baby having a low birth weight. Alcohol intake during pregnancy also poses a higher risk of your child having fetal alcohol spectrum disorder, which has a range of lifelong physical, behavioural and intellectual disabilities. 

You can also make your healthy tea at home. One of the examples would be red date tea for confinement, which can benefit pregnant women too! Red dates help replenish and nourish your blood, thus improving blood circulation. This can lead to better liver and digestive function, the balance of inner body energy (‘qi)’ and improved immunity.

Here’s to a better and healthier pregnancy that does not stop you from enjoying good food. You can still enjoy some foods you crave so long as it does not harm you or your body. So take good care of mummies and enjoy the delicious confinement food journey! Also, don’t forget to hop on to MumChecked to get the maternity or baby supplies you might need—a convenient e-commerce web store with just a click away.

Good Nutrition Goes Beyond Pregnancy

Whether it’s the food during pregnancy or food for confinement, a balanced diet is a foundation for good physical and mental health. Awareness of the frequency of intake of specific foods rich in Omega 3-DHA, Vitamin D, and fermented foods should come second in line to make your meals during pregnancy and postpartum ideal for supporting your mental health!

A similar concept should be applied to confinement foods. These days, there are so many choices of confinement food in Singapore. Pick one that will support you in eating a healthy and balanced diet as you recover during confinement.