As a part of its Healthy Pregnancy Week – 17/2-22/2, the Ministry of Health is publishing recommendations for women’s nutrition for their pregnancy and recommendations for food safety
​Smart nutrition is fundamental for a balanced, healthy life. Smart nutrition is especially important during pregnancy: The body is preparing for the fetal development and the nursing process, the uteral and placental tissues develop, and the blood supply increases. Proper weight gain is beneficial to the mother’s and the fetus’s health, reduces the risk of complications and contributes to the well-being of the newborn baby.
it is recommended to eat three main meals during the day and, 2-3 times a day, to eat between meals. It is recommended that each meal contain a combination of at least 3 of the food groups. It is recommended that a diverse daily diet be put together, to include foods from all of the food groups. These food groups are:

  • Grains: Wheat, rice, noodles, corn, buckwheat, burghul, couscous, quinoa etc. Whole grains should be preferred, for example whole wheat bread.
  • Vegetables: lettuce, cucumbers, capsicum, zucchini, tomatoes, carrots and other vegetables, from the varieties available in the markets and stores. It is recommended to consume vegetables of different colors.
  • Fruit: oranges, pears, plums, melons, watermelons, grapes, and other fruits, from the varieties available in the markets and stores. It is recommended to consume fruits of different colors.
  • Protein rich foods such as yoghurt, milk, cheeses, buttermilk (see also paragraph 4 – calcium), eggs, legumes, soy products, turkey meat, beef, poultry and fish (see also paragraph 9 – iron).
  • Fat-rich foods such as avocado, olives, tahini, olive oil, canola oil, mayonnaise and salad dressings.

Sufficient calcium – calcium is a vital ingredient for the mother and the developing fetus. Calcium is essential for proper bone development, vascular and muscular system functions, and for the building and maintenance of healthy teeth. For all these reasons, the body’s demand for calcium increases during pregnancy. Calcium is absorbed better from animal-based foods (milk, cheeses) than from plant-based foods (almonds, sesame). Calcium-rich foods:

  • Milk and dairy products
  • Tahini
  • Almonds
  • Whole sardines (with bones)

It is recommended to eat foods low in saturated fats, low in cholesterol, and free of trans fats

From among the available foods, it is recommended to prefer those that are low-fat. Especially foods low in saturated fats, low in cholesterol, and free of trans fats. It is recommended to use low-fat 1% milkfat milk, dairy products containing no more than 5% fat, lean beef, and skinned chicken and turkey. The preferred method of cooking and baking is water-based or steamed, rather than fried foods. It is always advisable to read the nutritional information on the food packagings.

Dietary fiber

The dietary fibers help regulate the digestive functions. Fibers are found in whole grains (for example – oats, whole wheat bread), in legumes, in fruits and vegetables. It is recommended that foods rich in dietary fiber be consumed with each meal.

Water

Be sure to drink enough during the pregnancy. The fluids prevent dehydration and reduce the likelihood of premature labor. It is recommended to drink water with meals and between meals. The recommended water intake varies from woman to woman and is affected by the amount of physical activity and the ambient conditions. Light-colored urine is a good way of making sure you are drinking enough.

What food additives are recommended during pregnancy?

Folic acid

During the woman’s fertile years, every woman is advised to take a daily pill with a 400 microgram dose folic acid. Folic acid is especially important during the three months before the pregnancy and during the first trimester, since it significantly reduces the risk of Neural Tube Defect – NTD (by up to 70%). Folic acid is one of the B group of vitamins. It is vital to the development of the DNA, which is a fundamental building block of every cell in the body. During the first weeks of the pregnancy, the embryonic organs develop, including the brain. At this stage, a defect in even a few cells may develop into a full-scale systemic defect. A defect in the neural tube, from which the brain and spine develop, may result in disease, permanent disability and even to fetal death. The neural tube closes just 3-4 weeks after fertilization, and from this comes the importance of using folic acid during the three months prior to conception and in the three first pregnancy months. It is recommended to continue to take folic acid to support the proper fetal development and growth and to prevent the mother from becoming anemic throughout the pregnancy. In addition to taking folic acid pills, it is recommended that foods rich in folic acid (folate) also be consumed. For example: fresh green leaf vegetables, legumes and citrus fruits. Note that the natural folate is not a substitute to the folic acid pills.

Iron food additives

It is recommended that an iron food supplement be consumed from the third month of the pregnancy through to six weeks before the expected birth date (a combination pill of iron + folic acid can be used). During pregnancy, the woman needs a larger than usual quantity of iron, due to the increase in the blood volume and in order to provide for all of the growing fetus’s needs. Iron deficiency may result in maternal anemia and to other problems such as fatigue, weakness, headaches, respiratory difficulties and increased heart rate. Furthermore, during the pregnancy, the fetal iron reserves are created, which will serve the infant during its first months after birth. In addition to taking the iron supplement, it is recommended to eat iron-rich foods from animal and plan origin:  Animal-based foods

  • Lean beef
  • Turkey, especially red turkey meat

Plant-based foods

  • Various types of legumes
  • Oats
  • Dried fruits
  • Almonds, nuts and seeds (sunflower, watermelon, pumpkin etc.)
  • Tahini

It is important to note that vitamin C is helpful in absorbing iron additives as well as in absorbing animal-based iron, and it is therefore recommended to take the iron along with vitamin C-rich foods.  High Vitamin C content foods are: citrus fruits, melon, lettuce, capsicum, cabbage.

It is recommended to reduce intake of foods containing caffeine

Caffeine is a stimulant and diuretic. Caffeine is transmitted to the fetus through the placenta, and the fetus is unable to process it.

  • Caffeine as a stimulant – increases blood pressure, increases heart rate and may interfere with the woman’s sleep, as well as with the fetus’ sleeping routine in the womb.
  • Caffeine as a diuretic – may cause loss of fluids. 

It is recommended that espresso coffees, percolator coffees, black coffee and high-caffeine content energy drinks be avoided.  It is also recommended to limit chocolate intake and beverages containing caffeine, such as instant coffee, tea, cola and cocoa, all of which inhibit the metabolizing of the iron in the body – drink no more than 3 cups of these per day.

It is recommended to limit intake of candy, snacks and sugar-rich beverages

Candy, snacks and sugar-rich beverages provide the body primarily with sugar and fat. It is recommended to limit the intake of these foods in general, and in particular during pregnancy.

It is recommended to limit the consumption of artificial sweeteners

During pregnancy and nursing, it is recommended to limit the intake of artificial sweeteners. These sweeteners are mostly found in “diet” drinks. Saccharine and cyclamate are not recommended during pregnancy. The limitations applicable to foods containing aspartame appear on the food labels.

It is recommended to limit salt and MSG intake

Salt intake ought to be limited to no more than 5 grams per day (about 1 teaspoon or 2,300 milligrams of sodium per day), including salt present in cooked foods and prepared foods. The salt content in purchased foods appears on the food labels and is listed as sodium. Excessive salt consumption may induce hypertension. MSG contains large quantities of salt and is used in may food products. For example, in soup powders, seasonings and spice and herb blends (meatball seasoning, grill seasoning etc.). MSG is listed in the nutrition information on the food package labels as MSG, and frequently as E.621. In order to avoid using salt and MSG, foods should be seasoned with herbs and unblended spices, such as onions, garlic, pepper, paprika and cumin.

Food safety

Pregnancy is a time in which there is an increased risk of harm to the pregnant woman and to the fetus as a result of contracting food-transmitted infectious diseases. By observing the following guidelines, the risk of disease can be reduced.
Avoid eating fish which may contain mercury.  Avoid eating large fish like: tuna steaks, white tuna and albacore tuna, shark, swordfish and mackerel, since they incur higher risks of mercury in their bodies. On the other hand, it is recommended to consume from among the other locally available fish including pond fish and canned light tuna. it is recommended that the fish in the diet be varied.

It is recommended to avoid uncooked or partially cooked meat, chicken, fish and eggs

Consumption of raw meat, chicken, fish and eggs is not recommended during pregnancy. The cooking process destroys the bacteria and parasites in meat, chicken and fish. Eating raw or partially cooked meat may expose the woman to diseases such as listoriosis and toxoplasmosis, which are rare diseases, but which may severely affect the fetus. The Salmonella bacteria, too, may be found in raw poultry and egg products, and may cause severe diarrhea and even dehydration.

The following meat, chicken, fish and egg products are not recommended for consumption during pregnancy:

  • Smoked and preserved fish which have not been properly cooked in their preparation, such as: lax, smoked salmon, herring, bonito.
  • Creamed or mayonnaise fish spreads.
  • Foods which do not undergo cooking, such as: Sushi containing fish, liver pate, crab or shellfish.
  • Cold sausages and meats such as pastrami, which have not undergone a hot smoking process.
  • Raw eggs, including when it is included in foods such as puddings, crèmes and whipped egg whites.

It is recommended that good practices be observed when buying and storing fruits and vegetables, as well as when preparing salads from them

Daily consumption of fruits and vegetables is generally recommended, and especially during pregnancy:

  • Fruits and vegetables should be washed with running water.
  • Salads should be eaten freshly cut and as soon as possible after being cut.
  • It is recommended that prepared salads be bought only at licensed retail outlets, and that the salads be consumes shortly after they are bought.
  • Prepared hummus and tahini salads should be avoided. Instead, it is recommended to prepare them at home and eat them no more than two days after preparing them.
  • All types of sprouts should be consumed only after being cooked.

Avoid consumption of dairy products from unknown origins and unpasteurized dairy products

Take care to use only pasteurized milk and pasteurized dairy products from supervised sources only. Of the pasteurized milk cheeses, avoid ripe (molded) cheeses such as brie, Roquefort, and soft cheeses like feta and ricotta. These cheeses can be consumed after they have been thoroughly cooked.

Observe good practices when purchasing and storing foods

Buy foods at licensed restaurants or stores and from licensed manufacturers only, and consume the foods before their expiry date. During the pregnancy, it is recommended that fresh foods be purchased and that they be consumed close to their time of purchase and to their manufacture date. Avoid buying foods on roadsides, in farmer markets etc., as well as purchasing deli foods, juices, and ice creams which are sliced, squeezed, or sold by weight over the counter, including all kinds of cheeses and salads. Cooked foods which have been refrigerated for storage, should be consumed within two days after being prepared. Heat the food thoroughly until steam rises from the food before serving.