The dos and don'ts of diet for expectant mothers can seem like a minefield. One recent study claimed that sticking to a Mediterranean-style menu high in vegetables and fish could prevent children from developing asthma. Another warned that dieting during the nine months may inflict obesity. With new research often causing anxiety rather than definitive answers, it is not always clear what is and is not safe.
One of the biggest question marks about diet during pregnancy is whether or not caffeine can be harmful to the foetus. This month, one source has offered new advice on the subject. The United Kingdom's Food Standards Agency (FSA) changed its guidelines on caffeine intake, suggesting pregnant women - and those trying to conceive - consume no more than 200mg of caffeine a day. The government body had previously advised a limit of 300mg. This amendment follows findings released by scientists at Leeds and Leicester universities revealing that pregnant women who consumed more than 200mg per day were more likely to give birth to smaller babies. The study, which took place between September 2003 and June 2006, followed the caffeine intake of 2,645 low-risk pregnant women with an average age of 30.
Despite the new proposed limit in UK, the Abu Dhabi doctor El Sheikh Mohammed believes that women who are expecting or trying to conceive should avoid caffeine completely. The Corniche Hospital consultant doctor and obstetrician cited trials that indicated a lower blood supply to the placenta, which could decrease a newborn's brain weight, he said. "Consumption of caffeine even in small amounts would cause a wide variety of neurological changes. So intake of 200mg per day has a harmful effect on the offspring at all stages of pregnancy. The advice of drinking caffeine in moderation also seems reasonable but it is vague.
"Those who find it very difficult to stop drinking caffeine can resort to one or two cups of decaffeinated coffee during pregnancy." The Leeds and Leicester study is not the only one published this year on the detrimental effects of caffeine. It follows findings printed in January that claimed women who consumed more than 200mg per day doubled the risk of miscarriage compared to those who avoided caffeine completely.
The investigation, led by Dr De-Kun Li at the Kaiser Permanente Division of Research in California, tracked the intake of 1,063 women who had become pregnant within two months of each other. Researchers asked each participant to provide a detailed diary of caffeine consumption up to the 20th week of their pregnancy. They then compared how many women had miscarried by this point - a total of 172 - and found a link. Published in the American Journal of Obstetrics and Gynecology, the study claimed those who consumed up to 200mg per day had a 15 per cent risk of miscarriage. Those who drank more than the new recommended amount had a 25 per cent risk.
Caffeine, although most commonly known to be found in coffee, is also contained in cola drinks, confectionery and some energy drinks. A 300mg intake per day is the equivalent of three mugs of instant or brewed coffee, six cups of tea, eight cans of cola or eight 50g bars of chocolate. Initial concern over consumption of caffeine is due to how it affects the body's efficiency to absorb iron. As iron is essential for a foetus to develop, medical experts continue to advise pregnant women to be wary of including caffeine in their diet.
Professor Andrew Carruthers, the dean of the faculty of Health and Medical Sciences at the United Arab Emirates University, says the source of caffeine makes a difference to how healthy it is for expectant mothers. "Caffeine is caffeine, whatever the origin. However, the enjoyment and added calories vary from source to source. "Drinking regular tea within recommended amounts offers the pregnant woman the safest, most convenient, moderate caffeine source if she enjoys hot caffeinated beverages. Moreover, because of the enlarging uterus, many pregnant women experience some degree of acid reflux and heartburn that may be aggravated by coffee and less troublesome with tea." He added that women should be careful not to replace coffee with unhealthy alternatives.
High-calorie, high-sugar caffeine substitutes can result in negative weight gain and an increased possibility of gestational diabetes. "Water and fruit juices are the safest and most nutritionally sound alternatives," Carruthers said. "A good fluid intake and consumption of fresh fruit provide an added bonus of adequate hydration and fibre intake that promote healthy bowel function during pregnancy, especially in our hot UAE climate.
"There is probably less known about the risk to pregnancy of artificial sweeteners than about caffeine, but substituting non-caffeinated diet drinks in moderation appears to be relatively safe."