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Pregnancy has a profound impact on digestion and intestinal function, prompting the woman to contact the doctor frequently to alleviate the symptoms, often of low severity, but definitely uncomfortable (heartburn, abdominal swelling, colicky pain, more or less obstinate constipation , alternating with constipation moved bowel, intestinal cramps evacuation, etc.).
Pregnancy, thanks to these “problems” offers an excellent opportunity to identify appropriate nutritional behaviors and to identify latent gastrointestinal disorders made evident by the pregnancy itself.
Acquiring good eating habits during pregnancy could then have long-term effects, well beyond the 40 weeks of gestation itself, for the mother and the whole family.
The objective of the maternal-fetal medicine must go beyond the simple balance then the elements of the diet (carbohydrates, proteins and fats), mechanically geared to maintaining a healthy weight standard, and as such is not the same for everyone.
Let’s just make two examples to understand the difference between the goal “weight” and the goal of “health” of mother and child.
Calories are too often considered in an abstract and wrong way as if the body was a motor that always runs at the same speed and “calories” gasoline: if we take more fuel than “consumption” it becomes fat. Nothing could be far away from the truth. It is easy to understand for non-expert that 300 calories -70 grams of sugar in the form of marzipan-are rapidly absorbed from the intestine and pass into the blood causing a rapid increase in the amount of glucose in the blood. The amount of sugar-glucose in excess of 110 120 mg / ml as a cascade passes through the placenta to the fetus that is so immersed in a world of sugar, which is not really typical for the human metabolism. The fetus “get used” to such a metabolism based on high level of glucose that he will become prone to hunt for sugar, a potential future obese individual. Now imagine an amount pf two times more calories at breakfast, with fruit, for example, two pears or half pineapple, whole grain bread with a little jam with no added sugar on a layer of butter, perhaps soy butter, grapefruit juice , a great cup of tea or filter coffee with a tablespoon of honey, a low-fat yogurt or soy yogurt. Intestinal absorption is slower because a more complex food requires hours to be digested by the stomach, then the presence of fibers makes absorption of complex sugars slower, fructose and inositol abundantly present in fruits stimulate function of insulin, facilitating the rapid absorption of calories into the cells. All this occurs at the start of the day when you have more energy needs for professional work or home work. We have taken twice as many calories, but there are no “peaks” of high blood glucose damaging the fetus, and as they enter the blood sugars are taken up by cells that use them for energy.
A second example is the mythical calcium requirements for growth of bone tissue of the fetus. Ideal for the regular intake of calcium in the diet. The main source of calcium are milk and dairy products, but if she is lactose intolerant as in reproductive age in 20% of women of Caucasian origin , and the intake of milk induces swelling, colicky pain, often bowel immediately moved? Or if, as happens so frequently, the excessive presence in food of dairy products causes an intolerance to milk protein (non-allergic food hypersensitivity ) resulting in poor digestion, chronic colitis, constipation, swelling, minor illnesses recurrent minor infections such as cystitis, vaginitis, etc.. Instead of thinking of these simple medical diagnosis, most doctors will probably treat the symptoms with drugs, instead of prescribing simple healthy nutritional alternatives. Unfortunately, this wrong way to consider nutrition affects about two out of ten pregnant women.
A little of recent history of nutrition
Not long ago, until the 50s of last century, the nutrition was regulated by local cultures spontaneously developed in previous centuries and millennia, and impact of climate on crops.
The advent of refrigeration, the availability of fertilizers, energy in agriculture etc. has led to major changes in the diet of men who live in Europe and North America (eg the availability of non-seasonal vegetables, meat throughout the year, the widespread intake of fresh milk and dairy products). Large agro-industrial concentrations have therafter introduced artificial flavors and induced needs (eg. Refined sugar, polyunsaturated fatty acids used as preservatives, animal fat) until the current globalized diet with food from all around the world which can be found in any supermarket.
The most immediate consequence of the loss of a local nutritional culture has to do primarily with the loss of aroma and taste, replaced by sweet or salty strong flavors and fat. The second well-known effect of the global competitive agro-industrial complex are imbalances and excesses caused by nutritional marketing strategies aimed particularly at vulnerable groups of consumers, such as children and low incomes segment of population.
The less obvious, but probably more important for its impact on human health, is represented by the profound effects of nutritional components on the immune system, and subsequent chronic inflammatory processes . In fact, the various components of a “globalized” unbalanced diet, and the added chemicals and pollutants that we assume, interfere dramatically with the genome of individuals and their inherited gut microbiome.
In a nutshell we can say that the genome is a kind of library of possible responses to the external environment and inside our body, ie the genome is much more than the sum of individual genes, such as an orchestra is more than the sum of individual instruments. Likewise, we can say that a person delivered vaginally and natural breastfed by natural mother, the microbiome is the complex of “friendly” bacteria that live with us, and thanks to which we are healthy and are not immediately exterminated by the bacteria and viruses that are “enemies” of our cells. Nutrition is not simply a matter of taste or excesses, but interferes with the immune system and commensal bacteria inherited within the family through these strains and by this interference can cause health or disease.
Gastro-intestinal disorders of pregnancy are welcomed if they can become an occasion for neglected problems and a possible new reason for an healthy diet.
Professor E. Ferrazzi, Board of Directors Fondazione Giorgio Pardi, Chairman of the Department of the Woman, Mother and Neonate – Medical School Department of Clinical Sciences, Buzzi Children’s Hospital Milano.