KELLY'S CORNER: For Nutritional Guidance and Goodness

Nutrition is important during every stage of pregnancy. The first stages, both before and during the first trimester, are crucial to an optimally healthy baby! Once you are pregnant, all the baby's major organs and body parts begin to develop, meaning nutrition is of utmost importance at this time. Taking prenatals in addition to a healthy, balanced diet with exercise is key. More specific recommendations and guidelines will be determined with your doctor to help you feel comfortable and confident about your pregnancy.

Here are the nutrition basics for what to focus on from day one throughout the remainder of your pregnancy, with a few first trimester specifics.

1.    What to get enough of:

·         Folate – the most vital nutrient before conception and during the first 6 weeks of pregnancy. This B Vitamin reduces the risk of neural-tube defects, such as spina bifida.

o   Food sources – beans and legumes, citrus fruits, whole grains, dark leafy veggies, poultry, pork, fish, and shellfish. Folate from foods is not as well absorbed as folic acid, so be sure to have a prenatal for extra assurance.

·         Calcium and Vitamin D – plays a key role in bone and tooth development. While it is a bigger focus in the second and third trimester as your baby’s bones reach its peak, you want to be sure to get enough to protect your own bones, too. Don’t forget that other vitamins and minerals like Phosphorus, Magnesium, and Vitamin D are also important for bone health, too

o   Food sources - dairy, leafy greens, salmon, and fortified foods are a few calcium rich foods. Almond, rice, soy, and coconut milk can help you get enough calcium, too.

·         Iron – you want to be sure to get enough on a daily basis to meet your requirements. Prenatals will help with this! To help increase absorption, combine iron-rich foods with vitamin C sources (spinach salad with red bell peppers or apple chunks!)

o   Food sources – leafy greens, animal proteins, seeds, grains, liver, etc.

·         Zinc – requirements increase by 50% to 15 milligrams per day when pregnant! A deficiency can contribute towards your risk of birth defects, restricted fetal growth and premature delivery.

o   Food sources – nuts, whole grains, legumes, meat, and seafood.

·         Fiber – is important for your overall health. It helps alleviate or reduce constipation and unfortunate and common occurrence in pregnancy. Aim for 25 to 35g/day.

o   Food sources – fruits, veggies, whole grains, nuts and seeds, supplements if needed

Key note: A healthy, balanced diet that is rich in vegetables, fruits, whole grains, healthy fats, and lean proteins with your prenatal vitamin will help you meet your nutritional needs for a healthy pregnancy.

2.       You are not REALLY eating for two:

·         This is a common misconception that has been debunked a while ago. We know by now that the maximum additional calories we need to consume during pregnancy is 500 calories and that isn’t until the third trimester!

·         For your first trimester of pregnancy stick to a healthy balanced diet that reflects weight maintenance and incorporates the key nutrients for healthy fetal growth. No need for additional calories yet.

3.       Don’t decide to diet when you’re pregnant!

·         Dieting during pregnancy can be dangerous. If you are following a low calorie plan you can be putting your baby at risk for missing out on a substantial supply of nutrients like iron, folic acid, etc.

·         Weight gain is a positive sign of a healthy pregnancy. As long as you are eating fresh, clean, wholesome foods and slowly increasing your weight, you are doing great!

·         You should gain the least amount of weight during your first trimester (anywhere from 1-5 pounds) and then gain roughly a pound a week in the second and third trimesters. That being said, if you are underweight or overweight going into your pregnancy the guidelines may be slightly altered to reflect a bit more or less gain for a healthy pregnancy. Your doctor will help you decide what’s the best course of action.

4.       What to avoid:

·         Raw fish – while many fish are safe to eat when fully cooked, you should avoid anything raw or partially cooked as it is more likely to contain parasites or bacteria than cooked fish. Fish can contain traces of mercury, which can be transferred to the growing fetus and cause serious health problems The USDA recommends that pregnant women limit their fish consumption to 12 ounces of cooked fish per week which is roughly the equivalent of 2 servings. Most mothers choose to err on the side of caution and skip it altogether.

·         Alcohol – can cause physical defects, learning disabilities, and emotional problems in children.

·         Deli meat – can contain bacterium listeria monocytogenes and cause foodborne illness listeriosis. Pregnant women have weakened immune systems, which makes them more susceptible to contracting the infection. While there may not be grave results for mother, the bacterium can infect the placenta, amniotic fluid, and baby, causing miscarriage or stillbirth. Babies who survive are likely to be born premature.

·          Cheese- any unpasteurized milk and cheese made from unpasteurized milk soft cheeses, like Brie or Camembert, and Mexican cheeses like queso can also cause listeria and pose the same complications as seen with deli meat deli meat

·         Caffeine – while studies are now showing that a cup of coffee per day is safe, most women still prefer to be safe and skip it altogether. Caffeine has the ability to increase chances of miscarriage while large amounts have been linked to slightly lower birth weight and even stillbirth in serious cases.

Kelly O’Hara, RD, LDN

Pregnancy Nutrition

Second Trimester

If you haven’t noticed an increase in appetite yet, the second semester is generally when it starts to kick in! Good thing your calorie needs increase during this time, too. That doesn’t mean you have a free pass to get a McFlurry, though! Remember you are still eating to fuel your babies needs as well as your own - and making the right food choices are important!

Key Points:

1. Calorie requirements: Calorie needs increase by about 250-350 calories - not as much as we’d probably hope! Baby is still itty bitty and therefore doesn’t require a ton of additional energy. These extra calories equate to a couple small snacks or one more nutrient dense snack during the day. Here are a few examples:
1. Apple slices with 2 tablespoons of peanut butter
2. ½ turkey sandwich with carrots and hummus
3. Baked sweet potato with 1 tbsp butter and cinnamon
4. 1 small handful almonds, 1 cheese stick, 1 serving pretzels
5. Plain greek yogurt with 1 tsp honey, ½ cup berries, and ⅓ cup low-sugar granola
2. Weight Gain: At this point you should be aiming to gain 1 to 2 pounds per week, unless your doctor has other guidelines for you in respect to your pre pregnancy weight (underweight/overweight, twins). This might seem like a lot to ask considering the first trimester you may have gained anywhere from 1-4 pounds but don’t worry - a lot of growth is starting to take place now!
1. If you want to be sure your weight gain is slow, steady, and healthy, consult with a Registered Dietitian to help you meet your calorie and nutrient needs.
3. Focus on the Macros: Getting adequate protein, carbs, and fats are essential.
1. Protein: your requirements increase during pregnancy to helps create new tissue for your baby. Shoot for 75-100g, but consult with a Registered Dietitian if you want to know what your specific needs are for your weight.
1. Food sources - meat, poultry, eggs, low-fat dairy, nuts and seeds, soy, etc.
2. Carbohydrate: supply the bulk of our energy needs. Plus, the fiber helps to avoid or alleviate constipation!  Whether it’s exercising, thinking, reading, carbs are the preferred source of fuel. 40-50% of your total calorie intake from carbs is sufficient. Some sources are definitely better than others, though! Steer clear of anything refined, processed, or white.
1. Food sources -  whole grain varieties (brown rice, quinoa, whole grain bread), starches (squash, sweet potatoes, beans), fruits and vegetables.
2. Having trouble with blood sugars? Be sure to never eat carbs alone! Pair them with a protein and or fat to blunt the glycemic response. Consult with a Registered Dietitian to help create a meal plan that will help control your blood sugars.
3. Fat: by now fats are starting to recover from their bad rap in the 90’s. We now know that the right fats are essential for health and fat free products are  big no-no. Fats regulate healthy hormone function, protect our organs, and offer a great deal of satiety and satisfaction at meals. 25-35% of total calories from fat is the general recommendation. Get plenty of heart healthy mono and polyunsaturated fats (foods with omega 3 and omega 6 fatty acids). You need saturated fats as well, but only in small amounts (10% or less of total calories).
1. Food sources - mono and polyunsaturated (omega 3 and omega 6) food sources include plant/seed oils (cold/expeller pressed, virgin varieties), avocados, nuts and seeds, fatty fish, olives, etc.
2. Our culture tends to be heavy in omega 6 fats and lacking in omega 3 fats when ideally the two should be flipped. Omega 3’s are anti - inflammatory and super important for the brain, eyes, and nervous system. Fatty fish contain omega 3 sources DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid).
3. If you are avoiding any fish during your pregnancy  you should consider taking an omega 3 supplement with DHA and EPA. Consult with your doctor to discuss supplementation. Always be sure that your supplement states somewhere on the bottle that it is free of mercury to know it is a purified source.

Third Trimester

Pregnancy Nutrition

You’re in the home stretch - hurray! Believe it or not, your baby will more than triple in size these last few months of your pregnancy. As your belly expands at a more rapid rate, you may begin to feel more uncomfortable and have a difficult time with full meals. That being said, it is important for you to maintain your nutrition and eat healthfully! Read on to find out what to focus on and how to get the nutrition you need at this stage of your pregnancy:

Weight Gain: You may gain between 10 and 18 pounds during this trimester, or  roughly 1 pound per week. Your total weight gain should be anywhere from 25-35 pounds (considering you are a healthy pre pregnancy weight and are not carrying twins). It sounds like a lot, but you are gaining a lot more than just baby now! Baby, placenta, amniotic fluid, increased blood and fluid volume, and added tissue are all contributors now.

Protein: to complement growing muscle tissue

Calcium :  In addition to it’s side kick magnesium,  to ensure healthy bone development.

Omega-3 fatty acids, DHA and Zinc : for rapid brain development during the third trimester.

Iron: to keep up with  your own needs as well as your baby’s. Blood volume increases during your third trimester, which mean iron will need too, too.

Taking a prenatal in addition to following a healthy, balanced diet will help you obtain all the essential nutrients you need for a healthy pregnancy. Consulting with a Registered Dietitian can help you feel more confident that you are eating for an optimally healthy pregnancy.

Drink up!  You may feel like you have to take a bathroom break every 5 minutes with the little one pressing on your bladder. Do your best to keep drinking, though, if you want to avoid constipation and be properly hydrated. Shoot for around 10 cups of fluids per day (water, unsweetened tea, milk, etc).

Exercise as able: Discuss with your doctor what exercise you are able to do at this point to keep you moving. Anything that can help you stay fit for birth and after is very important!

What to avoid: Aside from foods that pose health risks (raw fish, deli meat, certain cheeses, etc), be sure to stay away from the following foods to decrease uncomfortable physical symptoms: Acidic foods - like chocolate and too much citrus.

Eat smaller meals: Meals you once ate may seem impossible to finish now that so much of your belly is occupied! Tried having mini-meals instead. Do you usually have yogurt with fruit and a piece of whole grain toast and butter for breakfast? Try having the toast first, and save the yogurt and fruit for later. Going for 5-6 small meals a day instead the  usual 3 may easier to tolerate at this stage of the game!

Eating a nutrient-rich diet will also help you recovery after giving birth. Stock up on colorful produce, lean proteins, healthy fats, and low-fat dairy sources as often as you can!