Reduce your risk of developing preeclampsia with food 

This blog was co-written by Lana Hirth, Postnatal Dietitian, and Meher Vatvani, nutritionist and student dietitian.

If you have had preeclampsia during your first pregnancy, you may be wondering “Is there anything I can do to reduce my risk of developing preeclampsia for baby #2?”

We’re here for you! This blog post breaks down what preeclampsia is and more importantly, what you can do with your food and the way you eat to reduce your risk of developing preeclampsia. 

Let’s have a refresher – what is preeclampsia?

Preeclampsia refers to a pregnancy complication caused by high blood pressure (systolic >140mmHg and diastolic >90mmHg) and protein in your urine (Brown et al. 2018). There are several categories for how severe it is – from mild, moderate, severe with either early and late-onset and usually begins after 20 weeks of pregnancy. 

It’s not entirely understood what causes it, but it seems to be related to placenta changes, inflammation, and development that occurs during early pregnancy. This may be impacted by substance use, multiple pregnancies, damage to the blood vessels, and genetics. It tends to impact up to 1 in 10 women worldwide (Duley 2009; Steegers et al. 2010)

Are you at risk of preeclampsia in your second pregnancy? 

Here are some factors that may increase your risk of developing preeclampsia:

• A medical history of preeclampsia with your first baby
• Family history or preeclampsia 
• Chronic high blood pressure (not during pregnancy)
• Diabetes (not including gestational diabetes)
• Your age (if your age over 40, this puts you at higher risk)
• Being at a higher body weight prior to falling pregnant
• Intrauterine growth restriction or still-births
• Twin (or multiples) pregnancy
• Chronic kidney disease or any other autoimmune disease 

Nutrients for lowering your risk of preeclampsia

The good news is, when it comes to nutrition, there are changes we can make to reduce your risk of preeclampsia. Let’s take a closer look at what type of nutrients might help. 

Calcium

Meeting your recommended daily intake (RDI) of 1000mg of calcium reduces your risk of developing preeclampsia (Homferyr et al. 2014; Stringer 2015). If you’re at an increased risk of developing pre-eclampsia, you may benefit from calcium supplementation and a higher dose than just the RDI. 

If you are at high risk of developing preeclampsia, ensure you’re having 2.5 serves of dairy (or calcium-fortified alternatives). Here are some calcium-rich foods you may want to consider including such as::

• Dairy products such as milk, cheese and yoghurt (or calcium-fortified dairy alternatives)
• Lentils and beans
• Almonds
• Calcium fortified tofu 
• Sardines, canned salmon (with bones) and shrimp

If you are not consuming enough calcium, this is an area you’ll want to focus on by consuming enough calcium through food or with additional supplements. 

Sodium

Did you know that eating too much salt increases your risk of developing high blood pressure? BUT during preeclampsia (high blood pressure during pregnancy), a low sodium diet doesn’t necessarily reduce your risk of preeclampsia (Gillon et al. 2014). However, another study in Denmark looked at 569 pregnant women and found that consuming more than 6 grams of sodium (3 tsp of table salt) increased their risk of developing preeclampsia (Birukov et al. 2019). So while the evidence isn’t conclusive, being mindful to reduce or limit your sodium intake may be worthwhile.

To reduce your sodium intake, here are some tips for you:

• Consume more vegetables, wholegrains and fruit 
• Consume less processed food 
• Opt for low sodium alternatives such as low salt tomato sauce, low salt stock powders, salt reduced stock solutions, and low salt pasta sauces. 
• Instead of using salt, use herbs, garlic, onion and spices such as oregano, chilli flakes, asafoetida (a Southern Iranian spice) , turmeric, paprika and coriander to infuse flavour into your meals. 

Vitamin D

Not consuming enough Vitamin D could increase your risk of developing preeclampsia. Studies (Hyppönen et al. 2013) have shown that pregnant women who received Vitamin D supplements during early pregnancy had a lower risk of developing preeclampsia compared to those who did not. 

Are you wondering how to get enough Vitamin D in your diet? Here are some tips for you:

• Get some sunshine. Go for a walk outside for at least 15-30 minutes a day when it is bright outside. 
• Expose your mushrooms to some sunlight for at least 2 hours before cooking or eating them. You read that right! Mushrooms can absorb Vitamin D, just like humans do, converting it to the active form of the vitamin.
• Include foods rich in Vitamin D such as liver (limit to a maximum of once per week during pregnancy), eggs and oily fish.
• Consider including supplements if you’re deficient. Be sure to consult your dietitian or health care professional for individually tailored supplement advice. 

CoQ10

Coenzyme Q10 (CoQ10), also known as ubiquinone, is an antioxidant that plays an important role in reducing inflammation to reduce your risk of developing preeclampsia. A study with 235 women of childbearing age looked at women who either consumed a CoQ10 supplement with those who didn’t (Teran et al. 2009). Of the supplements group, 14.4% developed preeclampsia, compared to the placebo group where 25.6% developed preeclampsia. This shows that CoQ10 does play a role in reducing your risk of developing preeclampsia. Remember, you need to ensure this is a safe option for you, so be sure to consult a dietitian or your health care professional. 

Omega 3 fatty acids

There is limited evidence on the role that Omega 3 has in reducing your risk for preeclampsia, although we know it is vital for other functions like mental health, reducing inflammation, and reducing the rate of preterm birth. There have been some studies (Williams et al. 1995) that investigated women who consumed lower amounts of Omega 3 fats in their diet. They found they were seven times more likely to develop preeclampsia compared to those who consumed more omega 3 fats. However, more recent research doesn’t show a clear link. While the evidence is lower for pre-eclampsia specifically and shouldn’t be relied upon to reduce your risk of preeclampsia, the benefits of its impact on other aspects of pregnancy should not be underestimated.

Omega 3 fats can be found in:

• Oily fish such as salmon, tuna, mackerrell, sardines and herring 
• Chia seeds and flaxseeds (but these don’t convert well to the active form that our bodies need)
• Extra virgin olive oil
• Nuts including walnuts and brazil nuts 

Aim to eat oily fish 2-3 times a week to make sure you’re getting enough Omega-3. If you struggle to include fish in your diet, Omega-3 supplements are an excellent way to help you meet your nutrition requirements. Be sure to check with a health care professional before starting.

What does this mean for you? 

There are things you can do with the way you eat in your second pregnancy to reduce your risk of preeclampsia. Filling your plate with plenty of foods that contain these nutrients like calcium and vitamin D is a great way to start. If you are deficient in any of these nutrients, it is important to consult a dietitian to receive personalised advice on what foods and supplements to include. 

Want to reduce your risk of pre-eclampsia? Book in to see Lana Hirth, an expert prenatal and postnatal dietitian, in the virtual clinic to get personally tailored nutrition advice.

This blog was co-written by Lana Hirth, Postnatal Dietitian, and Meher Vatvani, nutritionist and student dietitian.