By Fadhlina Jasni for Health Xchange, with expert input from the Department of Nutrition & Dietetics, KK Women’s and Children’s Hospital(KKH), a member of the SingHealth group
In Singapore, it is common for pregnant women to take special care when it comes to their diets. For example, many believe that eating specific foods will ensure optimal pregnancy outcome, as revealed in a 2013 survey of 30 staff of KK Women’s and Children’s Hospital (KKH) and their relatives.
“However, the truth is, there are no specific foods to eat for a better pregnancy outcome, so long as your diet is well-balanced,” says Ms Nehal Kamdar, Senior Dietitian, Department of Nutrition & Dietetics, KK Women’s and Children’s Hospital (KKH), a member of the SingHealth group.
Ms Kamdar sheds light on uniquely Singaporean pregnancy food myths and also shares some tips on what it means to have a well-balanced diet during pregnancy.
Myth #1: Full cream milk is more nutritious than low-fat milk.
Fact: Low-fat milk and skim milk contain the same important nutrients (namely calcium, phosphorus and protein) as full-cream milk, but with less calories and fat, especially saturated fat. Hence, low-fat milk is suitable for pregnant women and breastfeeding mums.
Myth #2: Cooling foods like kangkong, papaya, pineapple, citrus fruits, grass jelly and green bananas should be avoided as they may lead to miscarriage.
Fact: There is no documented case of miscarriage from eating these foods. There is also no scientific evidence that you should avoid “cooling” foods as well as fruits and vegetables when you’re pregnant. Remember, eating a healthy and well-balanced diet is the best way to obtain optimal nutrition during pregnancy.
Myth #3: I can replace vegetables with fruits during pregnancy.
Fact: While some of the nutrients in fruits and vegetables are the same, they are considered as two distinct food groups and are not interchangeable.
Fruits and vegetables contain compounds known as phytochemicals. Phytochemicals are not vitamins or minerals but they may help protect you from infection, cell damage and disease.
The types of phytochemicals found in fruits are different from that found in vegetables. For example, cruciferous vegetables such as broccoli, cabbage and cauliflower contain phytochemicals called indoles which may protect you against certain cancers.
As recommended in Health Promotion Board’s “My Healthy Plate” visual tool, you should have 3 servings of vegetables and 2 servings of fruits daily during pregnancy.
Myth #4: I must take vitamin and mineral supplements to meet my pregnancy requirements.
Fact: When you’re healthy, you can go through pregnancy without the need for supplements. This is because your body’s increased nutritional requirements during pregnancy can be met by a well-balanced diet that incorporates the four food groups depicted in “My Healthy Plate”.
The only exception is folic acid, which is usually taken when you are planning to conceive and in the first trimester, to reduce the risk of neural tube defects.
Supplements may also be necessary under the following circumstances:
– Teenage pregnancies
– Recent pregnancy or breastfeeding (in the past year)
– History of poor dietary habits (e.g. skipping meals)
– Restricted diet, e.g. vegan (strict vegetarian diet that omits dairy products and eggs)
It is advisable to take supplements only as recommended by your doctor or dietitian. If there are any reactions or side effects from taking the supplements, please inform your doctor immediately.
Myth #5: Eating seafood during pregnancy will cause my baby to suffer from skin rashes and other skin problems.
Fact: There is no evidence that eating seafood during pregnancy will lead to skin problems for the baby.
Seafood is a good source of protein, iron and zinc – nutrients which are important for your baby’s growth and development. Deep-sea fatty fish such as salmon, mackerel, herring, sardine and tuna are also good sources of omega-3 fatty acids, which are important for your baby’s brain and eye development.
To prevent food poisoning during pregnancy, please ensure that your seafood dishes are well-cooked and freshly-prepared before you eat them.
Myth #6: Avoiding eggs, cow’s milk, nuts and wheat when I’m pregnant will reduce my baby’s risk of developing allergies.
Fact: The evidence to date does not support the belief that avoiding these foods during pregnancy will reduce your baby’s risk of developing allergies.
Similarly, there is no evidence that consuming oranges or citrus fruits during pregnancy will increase your baby’s risk of asthma.
Myth #7: Eating bird’s nest during pregnancy increases the risk of asthma in the baby/child.
Fact: Bird’s nest allergy is unique to Asian children and can occur at any age. However, there are currently no research findings indicating that taking bird’s nest during pregnancy will put your children at higher risk of developing asthma.
As all foods should be consumed in moderation, we do not advise for or against taking bird’s nest during pregnancy.
Myth #8: Eating bird’s nest and avoiding dark-coloured foods will give my baby fair skin.
Fact: Your baby’s skin colour is genetically determined. There is no scientific evidence to show that eating bird’s nest during pregnancy can lighten your baby’s skin pigmentation. Similarly, there is no evidence that eating soybean products such as tofu and soybean milk and avoiding dark-coloured foods like coffee when you’re pregnant will affect the colour of your baby’s skin.
Myth #9: Bittergourd causes contractions and should be avoided during pregnancy.
Fact: Bittergourd juice or paste is used as a traditional method of contraception/abortion in some cultures. A few studies done on mice have shown that bittergourd juice in very large amounts may cause contractions. However, there is no evidence that bittergourd fruit itself can cause contractions during pregnancy.
Hence, bittergourd fruit may be safe to eat during pregnancy when it is taken in moderation and with a variety of other vegetables as part of a balanced diet. If you wish to avoid bittergourd fruit altogether, you may do so, as long as you are eating other types of vegetables.
Myth #10: It’s not safe to eat mooncakes during pregnancy.
Fact: All mooncakes sold in Singapore must meet the Agri-Food & Veterinary Authority’s (AVA) import requirements and are safe for pregnant women to eat.
Nevertheless, it’s advisable to eat mooncakes in small amounts and only if you do not have gestational diabetes (i.e. diabetes during pregnancy).
This is because mooncakes are packed with calories, sugar and saturated fat, and are low in nutrients that can benefit either you or your baby.
To avoid excessive weight gain and to lower your risk of gestational diabetes, high blood cholesterol and heart disease, limit yourself to a small amount e.g. 1/8 to ¼ mooncake, once or twice a week.
Myth #11: Eating herbs and tonics will make my baby more intelligent.
Fact: There is no scientific evidence to show that consuming herbs and tonics during pregnancy will help your baby become more intelligent.
Myth #12: Royal jelly can boost fertility and make my baby more intelligent
Fact: Royal jelly is said to have some fertility properties and to help women conceive. However, it has estrogenic activity and has been shown to cause a thinning of the uterine lining when injected into pregnant rats.
There is not enough reliable evidence on the safety of royal jelly in pregnant women. So, to be safe, you should avoid it. If you still wish to consume royal jelly during pregnancy, you may do so in small doses.
Myth #13: I shouldn’t drink coffee when I’m pregnant because caffeine prevents iron absorption.
Fact: Actually, iron absorption is not inhibited by the caffeine but by the tannins and polyphenols present in coffee and tea. Hence, decaffeinated coffee and tea can also inhibit iron absorption. You should limit yourself to 2 cups of regular or decaffeinated tea or coffee a day during pregnancy and consume them in-between your meals rather than with meals to reduce the negative impact of coffee and tea on iron absorption.
Myth #14: Preserved, canned and frozen foods are not safe during pregnancy.
Fact: Generally, it is best to eat foods cooked from fresh ingredients for optimum nutrients, flavour and taste. Water-soluble vitamins such as vitamin C and folate are lost during the canning process. However, nutrient losses are generally small in the case of frozen foods.
Preserved, canned and frozen foods can be safely consumed during pregnancy so long as these food safety guidelines are followed:
– Choose dried and preserved foods that are properly packaged.
– Once the packaging is opened, transfer the unused portion in air-tight containers and keep it in the refrigerator.
– Check cans for leakage, bulges, rust or dents.
– Although there are some concerns about the safety of bisphenol A (BPA) found in the lining of cans, occasional intake is unlikely to be harmful during pregnancy.
– To prevent bacteria from multiplying and causing food poisoning, thaw frozen food in the refrigerator, in cold water, or in the microwave.
Myth #15: I need to eat twice the usual amount of food during pregnancy.
Fact: Eating twice the usual amount of food is not advised when you’re pregnant as you may consume too many calories, leading to excessive weight gain.
Excessive weight gain during pregnancy can lead to an increased risk of gestational diabetes. If gestational diabetes is not detected or well-controlled, your baby can become too big, resulting in birth trauma and a higher risk of caesarean section.
Excessive weight gain also means that there is more weight to lose after delivery. This can increase your risk of weight-related complications like type 2 diabetes, high blood pressure (hypertension) and cardiovascular disease.
You may also check with this list to determine how much weight you should gain during pregnancy.
Myth #16: I am skinny so can I eat whatever I like during pregnancy.
Fact: Do not adopt the “Eating for two” attitude! Just because you were slim before pregnancy does not mean that you can eat whatever you want. You still need to ensure that your diet is well-balanced so that your baby gets optimal nutrition.
If you need to eat more than the amounts depicted in “My Healthy Plate”, eat more from each food group in proportionate amounts rather than going all out on high-fat or sugary foods and drinks. You want to avoid “empty calories”, i.e. calories without significant amounts of other nutrients.
Myth #17: I can restrict my food intake during pregnancy to prevent weight gain.
Fact: Eating too little during pregnancy is not ideal as it may predispose your baby to chronic diseases such as diabetes, hypertension, heart disease and certain cancers later on in life. Moreover, you need to build your nutrient stores for breastfeeding your baby after delivery.
Reproduced with permission from SingHealth’s Health Xchange, Singapore’s first interactive health and lifestyle resource portal. For more information, visit www.healthxchange.com.sg.