Recently, I was talking to a friend's wife who is a gynecologist. One of the points she told me - "We are seeing quite a number of miscarriages in the past 2-3 years. This percentage has definitely spiked up as compared to what it used to be 10 years back. Earlier, we used to advise women not to smoke or consume alcohol. Given the current eating habits, I should add a big list of items under "not to eat" category for pregnant women......"
This conversation is the trigger point of this new series of blog posts that I plan to write pertaining to pregnancy.
I'll be sharing my understanding of various nutritional needs during pregnancy and how best to meet them through real, natural foods. Will also be writing about the plethora of mother-specific health(?) drinks available in the market these days. If there are any other topics/questions you want me to address, please do comment below.
The first topic I'm focusing today is on folic acid. When you are planning to conceive, the first thing your gynec would put you on is folic acid supplements. Folic acid supplementation is prescribed to avoid neural tube defects in newborns. According to this paper,
Given that the closure of the neural tube is completed by 28 days post conception, there is a narrow window of opportunity from the time the woman finds out she has conceived and the end of the prevention window.
Folate is the natural form (Vitamin B9) whereas Folic acid is the synthetic form. If you aren't focusing much on your diet, then folic acid supplementation is absolutely essential. Also important to note that women on oral contraceptives may need higher doses of folic acid.
Along with the supplements, it is important to include folate-rich foods in your diet, even before conception. According to this source, the recommended daily dietary allowance for Folate is 600 mcg (microgm) per day.
I looked through the nutrition information provided in "Indian Food Composition Tables" (IFCT 2017) and here's the list of foods rich in Folates.
- As you can see, there are plenty of plant-based sources that are rich in folates. Eating a balanced, wholesome meal can help us meet the requirement of folates.
- Compared to rice and wheat, millets are a better source of folates. Not high enough though.
- Pulses and lentils that we use in our day-to-day cooking contain abundant folates. Including a wide variety of pulses in our daily diet will not only help us meet our folates requirement but also provide adequate protein.
- Green leafy vegetables are a good source of folates. Spinach, curry leaves, coriander leaves and mint leaves should become part of our daily diet. Prepping the greens might sound time consuming, but worth the time and effort.
- Most of the veggies that we commonly consume (capsicum, beetroot, drumstick, ladiesfinger etc) are good sources of folate.
- Condiments and spices commonly used in Indian cooking are rich in folates. Gingelly seeds (till seeds) seem to top the chart in almost every single nutrient - calcium, iron and folates. No wonder, our ancestors called till oil as "nalla ennai" (good oil). There is a common belief that sesame seeds are not to be consumed during pregnancy as it generates heat in the body and might lead to miscarriage. I'm not sure about the truth behind this belief. Given that we use very little quantity of sesame seeds in most of our dishes (podis, chutneys etc), I guess it shouldn't be a problem. If you are concerned, do check with your family elder / gynec.
I'd highly recommend that you plan out your meals based on the above list to ensure you are able to hit the 400-600 microgm per day mark. You can then discuss with your gynec and decide on the dosage of folic acid supplements if still needed.
As always, my belief is that it is best to get the required nutrients from natural sources than synthetic supplements.