Nutrient needs typically increase more during pregnancy than during any other stage in a woman's adult life. Additional nutrients are required during gestation for development of the fetus as well as for growth of maternal tissues that support fetal development. The materials required for this rapid growth and development depend on supply from the maternal diet. However, because of the differing roles nutrients play in tissue development and growth as well as nutrient-specific changes in maternal homeostasis during pregnancy, nutrient requirements do not increase uniformly. Changes in the efficiency

From: Nutrition and Health: Handbook of Nutrition and Pregnancy Edited by: C.J. Lammi-Keefe, S.C. Couch, E.H. Philipson © Humana Press, Totowa, NJ

of absorption from the gastrointestinal tract and excretion by the renal system, as well as changes in maternal storage or tissue reserve, are examples of homeostatic mechanisms that must be considered in establishing nutrient requirements during gestation. Because the demand for some nutrients is great relative to others, care must be taken in selecting the optimal diet during pregnancy.

The purpose of the first section of this chapter is to describe the Dietary Reference Intakes (DRIs) for pregnancy, outline how they compare to the DRIs in the nonpregnant state, and explain the physiological reasons for adjusting nutrient requirements during pregnancy. Emphasis is on nutrients with relatively high increases in demand relative to prepregnancy. This does not imply that other nutrients are not critical for a healthy pregnancy outcome, but that if increased intake for nutrients with the largest relative demand is achieved, and a mixed diet is consumed, then it is likely that the needs for other nutrients will be met as well. In the subsequent section of the chapter, nutrient requirements are translated into foods according to the most recent dietary guidelines.

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