Sunday, December 04, 2005

Nutrition and Pregnancy

Women who eat healthily, nutritionally, during pregnancy birth healthier babies. And not only are you giving your baby and yourself a good beginning, but babies who are nurtured with a wholesome diet during pregnancy are also healthier throughout life! It is amazing that you can positively impact the life of your child by eating food that is good for you!

What to eat: protein, fat, carbohydrates and calories

It is important to remember that having good nutrition does not mean how much you eat, but what you are eating. Often we eat too much of things that are limited in their nutritional value. For example, if you are craving a bagel, it might be a good idea to grab the whole wheat one because it is higher in protein. Or if you are feeling like you need a snack, why not snack on carrots or apples, rather than a bag of chips?
Protein is required for the increase of blood volume in your body. The health of your body, your uterus, and your growing baby depend on this wonderful substance. You will need about 60 to 80 grams of protein during the first half of pregnancy and about 80 to 100 grams during the second half. Most women get about 60 grams of protein a day. Vegetarians should try and eat on the higher end of the scale (70-80 grams during the first half and 90-100 during the second half of pregnancy).
Some protein sources: Cheese, eggs, fish, meat, organ meats, poultry, milk, yogurt, black beans, quinoa, rice, bulgur, chickpeas, lentils, tofu, almonds, and split peas.
Fat is where you build up and store your energy. These reserves will help you support the growth of your baby and provide you the resources you need to breastfeed during the first weeks following the birth. Fat is very important to the pregnancy diet. It helps regulate and produce hormones and helps you use important vitamins. You will need about 60 grams of fat per day, or about 30% of your calorie intake. It is generally easy to get fat in your diet and therefore it is encouraged that you eat low-fat foods. Additionally, eating foods that are high in omega-3 and omega-6 oils is important and highly recommended. Omega-3 and omega-6s are found in fish (anchovy, bluefish, salmon, and swordfish), cod liver oils, flaxseed oil, and some in walnut oil, wheat germ oil, and soy products. The easiest place to get omegas is from fatty fish or cod liver oil.
Some fat sources: Avocados, cheese, milk, egg yolks, meat, nuts, olives, vegetable oil, and poultry skin.
Some fat sources to try and avoid: It is important to avoid trans-fatty acids or trans fats. These fats have been hydrogenated, that is they have been chemically changed from a liquid to a solid. An example is margarine and vegetable shortening. These fats lead to coronary disease and increase the risk of heart disease.
Other sources of hydrogenated, trans fats are: coconut oil, some peanut butters (that do not have to be stirred), palm oil, and shortening.
Sources of saturated fat and cholesterol are: butter, cheese, meat, whole milk, beef, and liver.
Some better sources of fat: Unsaturated fats include canola oil, flaxseed oil, corn oil, safflower oil, sunflower oil, and olive oil (olive oil is actually monounsaturated and may have cholesterol reducing properties).
Carbohydrates should make up the largest portion of your caloric needs. They are found in two forms, simple and complex. Simple carbs are found in fruits, sugar, and sweets like candy. Complex carbs are found in vegetables, beans, whole grains, and potatoes. Both are the fuel your body needs for energy and is also the primary source of energy and fuel for your baby. Carbohydrates breakdown into glucose and glucose is what the developing baby needs. Not getting enough carbs can negatively impact the nervous system of the baby. You should try and eat more complex carbs than simple carbs. These generally have more nutritional value and may be high in important vitamins, minerals, and fiber, all essential for your pregnancy. Simple carbs like candy and cookies do not have other nutritional value and should be eaten in limited quantities. Fruit, although a simple carb is also high in nutrients and fiber.
Calories: You will need about 2,000-2,400 calories per day during your pregnancy. Essentially you need an additional 300 calories a day while you are pregnant and 500 additional calories per day while breastfeeding. However, the amount of calories needed depends upon your age, height, and weight. If you are concerned about the number of calories you should be getting, it might be a good idea to discuss at a prenatal so your calorie intake can be determined.

What should you avoid?
The most important things to avoid during pregnancy and while breastfeeding are alcohol, drugs and cigarette smoke (including second hand smoke). Both of these have negative effects on your own personal health and the health of your growing baby. Additionally, consuming caffeine from soda, coffee, and tea inhibits your absorption of important nutrients and may increase dehydration.

Where does the weight go?
Fluid retention: 2-3 pounds
Increased blood volume: 3-4 pounds
Breast growth: 1-2 pounds
Uterus growth: 2-3 pounds
Amniotic fluid: 2-3 pounds
Baby: 6-9 pounds
Placenta: 1-2 pounds
Fat stores: 4-6 pounds

During the first trimester weight gained is generally not very much (but remember that every individual is different and every pregnancy is different, so you may have your own special version of what is considered “general”). You may gain between 3 and 6 pounds. During the second trimester weight gain is about 6 to 12 pounds, about ½ to 1 pound per week. You may notice increased growth during one week and less during another, this is very common. Each woman has her own weight-gain and baby growth pattern. During the third trimester weight gain is again between 6 and 12 pounds.
The recommended weight gain for “normal” weight women is between 25 and 35 pounds. If you are eating healthily and getting plenty of fluids, calories, and protein, you should do just fine!
Women under the age of 19 should gain more weight, about 30-45 pounds
If you are carrying twins you will probably gain more weight. You are going to be making two babies, two placentas, and carrying more amniotic fluid. It is good to try and gain 35-45 pounds.
If you have concerns about how much weight you are or want to be gaining bring those questions to your next prenatal.

Snacking
Snacking is a great way to obtain calories, protein, and nutrients. If you are always on the go, prepare some lunch bags of snacks you will enjoy ahead of time. Always have some snacks on hand. Keeping a box of crackers in your car or a bag of nuts, for example, is a great way to ensure that you have food on hand for that unexpected moment of hunger.
Food that is great to snack on includes:
Fruit: Apples, oranges, bananas, grapefruit, melon, mango, peaches, blueberries, raspberries, pears, peaches, plums and pineapple.
Dried fruit: Prunes, dates, figs, pineapple, apples, unsulferated apricots, and raisins.
Seeds and nuts: almonds, peanuts, hazelnuts, pecans, pumpkinseeds, sunflower seeds, cashews, and walnuts.
Breads and grains: bagels, trail mix, granola, whole grain breads, and granola or protein bars.
Dairy products: (it is preferable to eat organic dairy when possible) cottage cheese, yogurt, goat cheese and goat milk, low-fat ice cream, frozen yogurt, low-fat cheeses.

Supplements/Prenatals

Supplements or prenatals provide vitamins and minerals you might not be getting from your food sources. Calcium, iron, vitamin C and D, folic acid and B vitamins are all extremely important. Many of these come from your diet, especially if you are eating a lot of dark, leafy vegetables. However, even if you are eating a diet high in nutrients, absorption of these nutrients can be difficult for some individuals. Therefore, it is recommended that everyone take some form of a supplement or prenatal vitamin.
Prenatals are generally expensive, but getting a prenatal that was made, by people who are truly invested in doing good research is important. I recommend a few types of prenatal vitamins and can help you find one that suits your nutrient needs and budget. I am also happy to review with you any prenatal you are currently taking or considering using.

Nausea and Vomiting
Nausea and vomiting can present a challenge during pregnancy. Some women find that eating small, frequent amounts of bland carbs, like bread and potatoes is helpful, while other women can only consume liquids. In all cases it is important to stay well hydrated. Drinking tea that has fresh ginger, lemon balm, raspberry leaf, and nettle leaf may be helpful as well as making sure you are getting enough of the B vitamins.

Herbs and pregnancy: What herbs are safe, and which ones to avoid
If you are taking any herbal supplements or drinking any herbal teas make sure you discuss them at a prenatal. Certain herbs may stimulate early labor or even cause miscarriage. However, there are some herbs, like raspberry leaf, nettles, alfalfa, lavender, chamomile, lemon balm, and mint are considered safe.

Organic foods
Organic foods are grown without the use of harmful pesticides and chemicals. They are also grown on land that has not been exposed in at least three years prior to the harvest to synthetic chemicals or other prohibited substances which are considered harmful. Buying organic is important, not only because you are protecting your body from synthetic chemicals and pesticides, but also your baby. The baby gets exposed through your blood stream and the placenta. Important foods to buy organic are apples, bananas, celery, carrots, squash grown in the U.S., fresh peaches, grapes, U.S. grown beans, U.S. dairy products especially milk, and meats. If you buy food at the local farmers market ask if they are an organic farm. Some farms may be “transitional” meaning that they follow all or most of the organic standards, but have not yet been approved as an organic farm, sometimes for financial reasons.

Fluids
It is very important to stay well hydrated during pregnancy. Women should be drinking 8 glasses of water or juice a day. I recommend drinking at least half the amount in water. Herbal teas and carbonated beverages are considered ok, but liquids with caffeine are not. If you are drinking coffee, soda, or teas with caffeine, I recommend that you drink a glass of water before or after that caffeinated beverage. This way you will stay hydrated. Dehydration can lead to numerous problems in pregnancy, including constipation, fatigue, headaches, rapid pulse, and fetal heart tone variations.
You can tell if you are dehydrated by examining the color of your urine. If your urine is light yellow or clear, with no or little odor you are well hydrated. If your urine is a darker yellow or amber with or without odor you are dehydrated and should drink more water.

Some helpful ideas
Always carry snacks and water with you. Keep crackers or fruit in your purse and car.
Buy a 32 ounce water bottle and fill it up through out the day. Drink a larger amount before you leave the house in the morning, that way you start the day off well hydrated.
Buy produce that is in season and buy organic. Examples might be apples, oranges, bananas, carrots, cabbage and onions. If it is July and berries are in season
Buy frozen fruits and vegetables or freeze produce as you buy it.
Buy products that are on sale
Buy things you know you can make, don’t be overly ambitious
Buy in bulk. Buying sugar, flour, nuts, rice, oatmeal, cereals, and dried fruit in bulk will save you money. Remember that you pay for packaging and if you buy in bulk you can purchase the exact amount you need.
Shop at food warehouses for basic needs such as pasta. Household items are often cheaper here too, and the money you save could be spent on food items at other stores
Buy local. Shop at your farmer’s market. This is a great way to support your local community, buy food that is in season, and save some money
Grow your own
Think leftovers. Always make more and freeze it small containers or bags.
Raid the cupboards and the refrigerator before you go buy groceries. You may be surprised at how much is already in your kitchen
Make soups. Soups are a great way of using up the vegetables in your house and can easily be frozen for a later date.
If you have time to chop vegetables or fruit today, spend a few extra minutes chopping or preparing food for tomorrow.
Buy fortified foods, such as cereal, for an extra, nutrient boost.

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