Nutrition in the early stages of life can affect the health of the fetus later in life. Grasp nutrition during pregnancy and eat reasonably. Scientific nutrition, control of reasonable weight gain during pregnancy, early nutritional monitoring and early intervention during pregnancy are necessary. Through this lesson, participants should master the relationship between nutrition and fetal health during pregnancy, principles of nutrition during pregnancy and balanced nutrition in early, middle and late pregnancy, and be familiar with the characteristics of fetal development during pregnancy. I. Purpose of nutrition and current status Everyone needs nutrition to maintain life, which is the primary goal of nutrition. The second goal is to provide the metabolism of organs and the needs of human growth and development. The third goal is the storage of energy. For example, adequate nutrition for a pregnant mother is to provide for the maintenance of her own life, to provide energy for the growth and development of her baby, and to store energy to prepare for childbirth and postpartum breastfeeding. Modern nutrition is no longer an economic issue; as our country develops and society progresses, nutrition has become a conceptual issue. Our attention to nutrition during pregnancy is a key to improve the quality of our entire nation, because our babies are the future of our country, and for this reason it is important to guide pregnant women to eat properly. Good nutrition during pregnancy will improve the health of the baby in the following areas: performance and skills during school age, physical strength and endurance, learning skills, resistance to infection, and during adolescence, especially for girls. A healthy adult life coupled with adequate nutrition during pregnancy will result in a very healthy child for life, and with healthy offspring, the country’s productivity and economic income will be greatly improved. Second, nutrition and fetal health during pregnancy (a) principles of nutrition during pregnancy Malnutrition during fetal period includes two aspects, one is insufficient nutritional intake of pregnant women, and the other is excessive nutritional intake during pregnancy. If malnutrition during pregnancy, the fetus is at an elevated risk of developing chronic diseases in adulthood. After the fetus is stimulated by the signal of malnutrition, metabolic and endocrine changes will occur. In the uterine cavity of the pregnant woman, the fetal organs are permanently adjusted to the nutritional imbalance in the uterus. This can result in low birth weight babies or huge babies. After birth, these children will have a very poor ability to adapt to the rich food intake later in life, resulting in obesity, hypertension, hyperlipidemia, and abnormal insulin secretion, which will greatly increase the risk of chronic diseases such as cardiovascular disease, stroke, diabetes, and breast cancer. At present, Professor Barker in the UK has proposed a new medical concept – DOHaD concept. The DOHaD concept is the study of the developmental origins of health and disease. It is mainly about genetic diseases, some chronic diseases that a person gets in adulthood, and most of the views in the past believed that they are caused by genetic factors and incorrect lifestyles in adulthood. Professor Barker builds on these two factors. If a child experiences adverse factors, such as poor nutrition or environmental stimuli, during the developmental process, that is, in early life, including fetal life and infancy, it will increase the risk of developing chronic diseases such as obesity, diabetes and cardiovascular disease in adulthood. In other words, Professor Barker has studied the relationship between nutrition and other environmental factors in the earliest stages of life and the development of chronic diseases in adulthood, and concluded that a poor environment during fetal conception can affect the development of chronic diseases in adulthood. The critical window of healthy fetal development includes two periods, one is the fetal period, i.e., the gestational period of the pregnant woman. The second period is the infant and toddler period, mainly from 0 to 3 years old. The nutritional status of the fetus during this critical window determines the lifelong health status. The quality of the environment in which the fetus develops and its chronic morbidity in adulthood can be represented by a smile chart. If a pregnant woman is malnourished or over-nourished during pregnancy, the risk of chronic disease in the fetus in adulthood is greatly increased. Therefore, balanced nutrition throughout pregnancy is necessary to ensure the health of the fetus in adulthood. Nutrition principles during pregnancy: meals should be light and palatable. Special attention should be paid to the daily consumption of dairy, soy or soy products. Always eat the right amount of fish, poultry, eggs and lean meat, and eat a moderate amount of vegetables and fruits. Food should be varied, cereal-based, and eat more potato foods. When it comes to nutrition during pregnancy, we should talk about energy-related knowledge about heat. Heat energy is the source of power to maintain our body’s life activities, and is also the energy source for the growth and development of our fetus. The source of caloric energy is mainly from the three major nutrients in the diet. The ratio recommended by the World Health Organization is 55%-65% carbohydrates, 20%-30% fats and 11%-15% proteins. The energy requirements of different groups of people are also different. The daily energy requirement of a normal woman is 30-38 kcal per kg of body weight, and the energy requirement does not need to be increased during early pregnancy. In the middle and late stages of pregnancy, the daily energy requirement is an additional 200 kcal on top of that of early pregnancy. The formula for calculating the daily energy requirement during pregnancy is: Early pregnancy, (height – 105) x 35. Since the energy requirement of a normal pregnant woman is 30-38 kcal, an average value of 35 kcal is taken. The daily energy requirement of a pregnant woman in mid- to late-pregnancy is an additional 200 kcal on top of this. In the case of twin pregnancies, an additional 200 kcal per day should be added to the mid- to late-term requirement. The increase in energy for the whole pregnancy is 80,000 kcal. Here’s what you need to know about food exchange. We divide common foods into seven categories: cereals, cereals and potatoes, vegetables, fruits, soybeans, dairy products, meat and eggs, and fats and oils. The protein, fat and carbohydrates contained in the same type of food within a certain weight are similar. In other words, we call these foods that contain similar protein, fat and carbohydrates in a certain weight the same kind of food. Each serving of food it is different in weight. But it can provide 90 kilocalories, the same kind of things are interchangeable. But cereals and potatoes can not be exchanged with meat, because it is not the same kind of food. The total energy needed by a pregnant woman during pregnancy divided by 90 kilocalories is the number of servings of food needed by a pregnant woman every day. (B) Balanced nutrition in early pregnancy Pregnant women are affected by the secretion of progesterone in early pregnancy and will experience some symptoms of the digestive system, such as nausea, vomiting and loss of appetite. At this time, her nutritional needs should be light in taste, eat less and more meals to ensure adequate intake. If the intake is insufficient, the pregnant woman will break down the fat in her body to provide calories, and in the process of fat decomposition and metabolism, ketone bodies will be produced, which will have an impact on the fetal nervous system if they exist in the mother’s body for a long time. Therefore, during early pregnancy, it is important to make sure that the food supply is adequate, especially the carbohydrate supply. Early pregnancy is an important period for the formation of fetal neural tube differentiation, so pregnant women should pay attention to consume more folic acid-rich foods to supplement folic acid. A balanced diet in early pregnancy is characterized by light and less oily food, fewer meals, and more carbohydrate-rich foods and folic acid-rich fruits and vegetables. By the time the fetus grows and develops to two to three weeks, the blood circulation system begins to establish, and the thyroid, kidneys, eyes and ears have begun to form. The nutrition he needs is just a balanced nutrition. At 4-5 weeks, his limbs begin to develop, his brain, spinal cord, mouth, and digestive tract begin to form, his brain nerves begin to appear, and the nerves in the muscles begin to be distributed, and the nutrients he needs at this time are calcium, iron, copper, vitamin A, fat, protein, and vitamin D. The sources of these nutrients in food are fish, eggs, milk, animal liver, fat, cod liver oil, and red, yellow and green vegetables. When the fetus grows to 6-7 weeks, the skeleton begins to form, the muscles begin to develop, the mouth and nose are developing, the trachea and bronchi begin to appear, his sexual organs are differentiated, and the nutrients most needed for the growth and development of the baby at this time are calcium, phosphorus, magnesium, copper, iron, vitamin D, vitamin A, vitamin B foods, nutrients. The sources of nutrients food are fish, eggs, milk, cheese, cod liver oil, malt, rice bran, liver of animals, beans, egg yolk, yellow and green vegetables. By the time the fetus reaches 8-10 weeks, fingernails and toenails are starting to grow, lips and ears are forming, and the bladder is starting to grow. The nutrients he needs most at this time are protein, calcium, and vitamin A. Food sources for these nutrients are eggs, milk, fish, meat, beans, and red, yellow, and green vegetables. By 12 weeks, the lungs have taken shape and the thyroid gland is ready to secrete hormones. The nutrients that the baby needs at this time are vitamin A. Food sources of vitamin A are in milk, cheese, liver, egg yolks and yellow and green vegetables. Pregnant women need 15-20g of vegetable oil, 6g of salt, 200-250g of milk and milk products, 50g of soybeans and their nuts, 150-200g of fish, poultry, eggs, meat, and animal offal per day, of which fish, poultry and eggs should be 50g each, which means that you should make sure you have an egg every day. The base of this pagoda is cereals and potatoes, which should be eaten 200-300g per day, that is, 4 to 6 taels of food. Note that the weight of the food here refers to the raw weight of the food. Pregnant women generally need to drink 1200ml of water per day. The main role of folic acid is to prevent embryonic neural tube abnormalities and congenital heart malformations and to reduce the occurrence of pregnancy complications such as hypertension and pre-eclampsia. Food sources: Folic acid is mainly in the form of folic acid salts, like animal liver, oranges, and dark green vegetables, strawberries, peanuts and beans all contain folic acid salts, but its absorption and utilization rate is relatively low, only 50%. Folic acid tablets taken in the first trimester and early trimester of pregnancy are synthetic and used as supplements and fortified foods, which are very stable in nature and have an absorption rate of almost 100%, so supplementing folic acid in this early pregnancy period makes it easy to correct the deficiency of folic acid in the body. l Time: Start supplementation in the first 3 months of pregnancy and continue throughout pregnancy. Supplementation method, dosage: 400ug daily to maintain the appropriate level of folic acid in the body (if the organism is deficient take 4 weeks to get improvement) The role of iodine is to synthesize thyroxine, promote the synthesis and metabolism of protein, sugar, fat, vitamins, water and salt; promote the fetal brain cells DHA content and the growth of the number of brain cells. Iodine deficiency can cause premature birth, stillbirth, congenital malformations, etc. The source of iodine is iodized salt, which contains 30 mg of iodine per 1000 g. Foods rich in iodine are seaweed, sea fish and shrimp. The metabolism of iodine in the body is characterized by eating more, eating less, and not eating. Therefore, iodine supplementation should be done on a daily basis and not too much. As iodine is volatile, iodized salt should be preserved by buying it with food and keeping it under cover, and adding salt after the food is ready. (C) Balanced nutrition in mid-pregnancy The physical changes of pregnant women in mid-pregnancy are an obvious increase in food consumption and a feeling of fullness, because the growth and development of the fetus is accelerated and the energy required by pregnant women increases accordingly. For nutritional needs, we should eat more food rich in high-quality protein, iron and calcium; at the same time, in order to cope with the feeling of fullness, we should eat less and more meals and consume some vegetables and fruits in moderation. At the same time, because the fetus is developing very rapidly in the middle of pregnancy, the bones begin to grow faster. The nutrition required by the fetus is sufficient protein, high quality protein, calcium, iron and polyunsaturated fatty acid rich food. Characteristics of balanced diet in mid-pregnancy: cereals and potatoes, mixed legumes, foods rich in calcium, iron and vitamin D and dairy products and other high quality proteins are needed more than in early pregnancy. Important nutrients in mid-pregnancy include: high quality protein, calcium, iron and vitamin D. At 16 weeks, the fetus begins to grow its central teeth and hair begins to appear, the nutrients needed at this time are calcium, fluoride, sulfur and protein. Food sources of these nutrients are fish, eggs, milk, legumes, seafood, as well as cereals and red and green vegetables. By the time the baby reaches 24 weeks, the eye development is complete and the nutrients needed at this time are protein and vitamin A. The food sources for these two nutrients are fish, eggs, milk, cheese, and yellow-green vegetables. Important nutrients in mid-pregnancy include: high quality protein, calcium, iron and vitamin D. The following highlights some knowledge about iron and calcium. Iron has many roles in promoting growth and development, participating in the synthesis of hemoglobin, preventing anemia, increasing resistance to disease, and it is a building block for enzymes in the body and is involved in energy production. The main sources of iron in food are animal foods, such as animal blood, lean meat, seafood, and liver. Iron is present in the form of heme iron and is relatively well absorbed and utilized. Another source of food is plant foods, such as cereals and green leafy vegetables, which exist in the form of non-heme iron and have a lower absorption rate. The recommended amount of iron is 15mg per day in early pregnancy, 25mg per day in middle pregnancy, and 35mg per day in late pregnancy, and the following issues should be noted when taking iron supplements: take iron supplements mainly from animal foods; do not take them with milk or calcium supplements; drink less tea and coffee when taking iron supplements; adequate protein and vitamin C can increase the absorption and utilization of iron; iron supplements should be taken with meals to reduce gastrointestinal reactions. Learn nutrition, control reasonable weight gain during pregnancy, to carry out early nutritional monitoring and early intervention during pregnancy.