What to eat and how to get the family to eat is top of mind for all of us, isn’t it? This National Nutrition Week, we spoke to Dr Shweta Khandelwal, Associate Professor at the Public Health Foundation of India to get our nutrition facts for moms and babies right!
1. A lot of expecting mothers on BabyChakra are interested in ‘pregnancy super foods’. Does ‘pregnancy food’ as a concept even exist or is it a fad?
I am not a great believer in super foods. Usually, every natural and minimally processed food will have some good nutrients. Pregnancy is a very crucial phase and will lay the foundation for the offspring for life. So, we want to be doubly sure about everything and eat what’s best for the woman and her baby. We have evidence and even policy for enhanced intake of protein, good fats (long chain fats - PUFAs), calcium, iron, folic acid, B12 etc.
But I would still emphasize on good quality, minimally processed green leafy vegetables, legumes, whole grains, and dairy products to be included in the main meals of the day. Fruits (whole fruits rather than juices) and dry fruits also should be consumed.
All said, I would reiterate that importance of good nutrition is from womb to tomb.
Pregnancy just makes us responsible for two and thus more conscious. But women should pay attention to themselves too. Indulge in physical activity as per doctor’s advice but being active is also very important.
2. A lot of new and toddler parents on BabyChakra are worried about height and weight for their children. Do you see a critical gap in the nutrition requirements of children in urban India, especially during the developing years?
India is currently grappling with triple burden of malnutrition – underweight stunted kids on one hand, overweight obese on the other and multiple micronutrient deficiencies inflicting both forms. Urban areas are witnessing a rise in the latter forms. This is largely due to the rise in consumption of ultra-processed foods (packaged foods laden with high salt, sugar and trans-fats) coupled with decreased physical activity levels. High quality nutritious foods accompanied with physical activity are very important for growth and development of kids.
3. Could you help us with early life nutrition tips that parents need to be aware of to ensure they are raising healthy individuals?
Most parents in India feel that their kids are not eating or eating enough (“kuch khata/khati nahin hai”). However, statistics tell you that overweight obesity among children is booming!
We must realize that our foods and activity levels have changed drastically and thus we need to consciously invest in eating healthy and staying active especially during growing years as it will set the foundation for life. I emphasize on holistic development – right from getting up early, not missing breakfast, eating small meals, not over feeding, avoid junk foods and sweetened beverages to the extent possible, prefer home cooked fresh meals, snack healthy, get enough sleep, limit screen time etc. I know it sounds like a big and impossible task list at times where parents are working and not have enough time but believe me you guys are role models for your children. We can’t keep preaching - WALK THE TALK!.
4. How does the use of fertilizers and pesticides affect nutritional value of the food that we consume today, especially fruits and vegetables?
Chemicals degrade and reduce nutritional value of our fruits and vegetables. We must buy from trusted vendors, preferably registered ones (although you can never be too sure). The FSSAI also has mass awareness programs and methods to impart education on adulteration and illegal chemical use.
5. Post pregnancy weight loss is a major concern among women.
a. What are your suggestions to prevent additional weight gain during the prenatal phase without compromising on nutritional requirements of both the mother and baby?
Don’t eat like you are eating for two. Just slightly increase the frequency of eating but keep portions small. Avoid high sugar and salt products. Prefer home cooked meals with healthy ingredients. Have a lot of fiber (fruits, green leafy vegetables, whole grains) as it helps to avoid constipation and also gives satiety without resulting in unwanted weight gain.
b. What dietary recommendations would you make in case the mother has already gained those additional kilos and wants to lose them?
Exercise consciously and unconsciously. Apart from eating right also follow a disciplined life in terms of proper sleep, avoid fads and crash diets, develop hobbies which take you in sun, play with your child, walk for short distances, limit screen time if possible and aim to get to 9k-10k steps each day.
6. There is a lot of discussion around DHA supplementation these days. Is there a need for conscious additional supplementation? If yes, what are the reasons? Has this surfaced only in modern times or has always been a requirement that we are only becoming aware of now?
Supplements are useful for short periods of time to take care of their lack in diets or cure clear cut signs/symptoms of acute deficiency. However, I won’t recommend them for long duration (more than 3 months at a stretch) without doctor’s advice. I would always prefer natural sources in diet form than synthetic preparations (capsules or powders).
DHA is a type of Omega 3 fat. These are shown to be good fats which are required by human body for several reasons - the top being healthy neurodevelopment including better cognition and higher immunity. Yes, DHA demand has been an outcome of recent advances in nutrition science and our changing diets. We have huge intakes of other kinds of fats (omega 6- which we usually get plenty of from our refined cooking oils) which actually inhibit omega 3 production and absorption in our bodies. Previously, we largely consumed home-cooked meals using mustard, gingelly, groundnut oils and desi ghee etc, and traditional methods of cooking. This allowed a right mix of fats in our diets. Now, our lifestyles have completely changed - least time given to cooking and shift to packaged foods has caused a lot of deficiencies in micronutrients and fibre etc.
DHA supplementation has not shown to be associated with any adverse impact or outcome. It may not have shown benefits in some studies but no negative or harmful effect has also been noted.
About the Expert: Dr Shweta Khandelwal is an Associate Professor at the Public Health Foundation of India. She is a trained public health nutritionist and her current research (funded by the Wellcome DBT Alliance) is focused on exploring the role of prenatal omega-3 fatty acids (DHA) supplementation on neurodevelopment of Indian infants. She is also interested in studying the nutrition epidemiology of cardiovascular disease risk factors among the Indian population. She is also the lead for capacity building initiatives in Public Health Nutrition (PHN) at PHFI and CCDC. Shweta has won several awards and recognition in the area of public health nutrition.
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