Nutrition and Pregnancy (3): Iron and Sweeteners

Nutrition and Pregnancy (3): Iron and Sweeteners

Dr. Claude Allouche, Gynecologist
Ahuza Clinic, Raanana
058 726 02 64

Iron: How to Avoid Iron Deficiency?

Why is iron important?
Iron (barzel in Hebrew - ברזל) is crucial for the body as it helps in the production of red blood cells. During pregnancy, iron needs increase significantly because the fetus uses the mother's iron reserves to produce its own blood and red blood cells.

Iron also plays a role in:

The formation of hemoglobin in red blood cells, which manages oxygen exchange.
The creation of myoglobin, a muscle component.
Cell growth.

Sources of Iron
Iron comes from two main sources:

Animal: Red meats, organ meats, shellfish.
Vegetable: Cereals, legumes, vegetables.

Note: Plant-based iron is less well absorbed than animal-based iron, but absorption is improved with vitamin C (ascorbic acid) intake.

Factors that inhibit iron absorption:

Tannins (found in black tea).
Oxalates (in rhubarb, spinach, Swiss chard).
Calcium.
Zinc.
Some fibers.

Symptoms of iron deficiency:
Symptoms such as fatigue, lower resistance to infections, lack of appetite, and dry skin may appear. Consult your doctor if you experience any of these signs.

Iron monitoring during pregnancy:

First trimester: Blood tests measure hemoglobin to detect any pre-existing anemia (Complete Blood Count or Sfirat dam in Hebrew - ספירת דם).
Second trimester: Between 24 and 28 weeks, a new test is done to check iron reserves, along with gestational diabetes screening.
Third trimester: Iron levels are rechecked between 32 and 36 weeks.

Treatment for iron deficiency:
If significant deficiency or anemia is detected, oral iron supplements are prescribed. If oral supplements are not well tolerated, iron infusions may be arranged at the hospital.

Recommended iron intake:

Adult women (menstruating): 14 mg/day.
Pregnant women: 25 mg/day.
Breastfeeding women: 20 mg/day.

Foods rich in iron include:

Red meat: 3-4 mg/100g.
Black pudding: 8 mg/100g (non-kosher).
Organ meats: 8-10 mg/100g (liver, kidneys).
Legumes: 7 mg/100g (before cooking).
Nuts and seeds: 2-4 mg/100g (pistachios, almonds, flaxseeds).

Recommendations:
A balanced diet is the best way to avoid iron deficiency.

Are Sweeteners Dangerous During Pregnancy?

Sweeteners: What's the story?
There have been controversies around sweeteners for decades. Sweeteners replace sugar without adding calories or with very few calories. They are extremely sweet, even in small amounts.

Most common sweeteners include:

Aspartame:
Discovered in 1965, it is 200 times sweeter than sugar and is used in low-calorie foods, drinks, and medications.
Saccharin:
Discovered in 1859, it is 300-400 times sweeter than sugar but has an unpleasant metallic aftertaste. It contains no calories.
Stevia:
A plant from South America, its leaves are 300 times sweeter than sugar. It has become increasingly popular in foods to reduce calorie intake.

Sweeteners during pregnancy:
Around 72% of pregnant women consume sweeteners without exceeding the acceptable daily intake (INSERM study, 2006). The safety of aspartame and other sugar substitutes is still debated.

What does research say?
There are no studies analyzing the effect of sweeteners on pregnant women’s weight or gestational diabetes. Currently, no scientific evidence supports any nutritional benefits of sweeteners during pregnancy, nor have any harmful effects on the mother, fetus, or newborn been identified. However, more research is needed.

Aspartame and safety:
A complete reassessment of aspartame's safety is ongoing by the European Food Safety Authority (EFSA).

Recommendations:
Sugary products should not be consumed regularly; they are considered "extras." Synthetic sweeteners are not essential for a healthy diet, and until more conclusive data is available, it is safer not to consider them entirely harmless.

Source: https://acteurdemasante.lu/.../mon-alimentation-les.../