Dietary changes throughout pregnancy

In the United States, it is estimated that approximately 50-90% of pregnant women experience food cravings during the course of pregnancy [16-18]. Despite its prevalence, the etiology of pregnancy-related cravings is not well understood. Whereas some hypothesize that cravings are a function of cognitive characteristics of the individual [19], others claim that cravings may represent "wisdom of the body" [20]. For example, pregnant women may crave certain foods to overcome nutritional deficiencies, thereby ensuring that they consume a varied diet with enough calories to support the growth of a healthy fetus [21]. This is analogous to the embryo protection hypothesis [22-24], which proposes that nausea and vomiting during pregnancy evolved to prevent pregnant women from ingesting toxic foods that may harm the fetus.

Although the specific foods women crave may be a function of their culture or geographic location [25, 26], pregnant women generally tend to crave and eat more foods that are sweet and/or sour, with fruits and fruit juices being most commonly consumed [18, 22, 27]. Whether these dietary changes are related to taste [28] and olfactory changes [29] during pregnancy has been the focus of a few experimental studies. In the 1990s, Duffy and colleagues published one of the only prospective studies (i.e., the Yale Pregnancy Study) on taste changes during pregnancy [28]. Women were tested before they became pregnant and then during each trimester throughout their pregnancy. During each test session, women were asked to rate the intensity and hedonic value of sodium chloride (salt), citric acid (sour), quinine (bitter), and sucrose. The results indicated that bitter sensitivity increased during the first trimester, a finding that coincides with previous work [30]. These data suggest that avoidance of bitter-tasting foods such as green vegetables during early pregnancy [31] may be due, in part, to this initial hypersensitivity to bitter stimuli. As pregnancy progressed, women's sensitivity to bitter and salt tastes decreased, and their liking for bitter, salt, and sour tastes increased [28].

Regardless of the mechanisms underlying taste and presumably dietary changes during pregnancy, from the perspective of the fetus, such changes coincide with important developmental milestones. As will be discussed, this dietary information is passed through the mothers' amniotic fluid, providing the fetus with important orosensory stimulation that will modulate later food and flavor preferences.

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