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  • Dina Cohen

Were You Expecting THAT?

Updated: Feb 19


by Dina Cohen, MS RDN CEDRD


Pregnancy is a great time to focus on good nutrition, because what you eat now impacts your baby’s health as well as your own. You may be familiar with the basics of eating well during pregnancy, but here are some tips that may be new to you.  


1. ADVENTUROUS EATING SCORES POINTS


For Baby: You can help your baby avoid pickiness later in life by doing your best to be an adventurous eater right now! Research shows that early exposure to various flavors helps to decrease picky eating, and when I say “early”, I mean before your baby is born! Taste preferences have a strong innate component, but these can be modified, and your job starts now, while you’re still expecting. Many kids shy away from foods with more intense flavors, such as fish and some bitter veggies, and it is so beneficial to expose your child to these foods early in the game. Aim to include a variety of flavors in your meals and snacks (as tolerated, of course), and you can help set the stage for lifelong adventurous eating.


For You: Making sure your house is stocked with plenty of nutritious options makes it more likely that you will find something that appeals to you when you’re feeling nauseous. If you discover a few foods that seem to work well, don’t get stuck in a rut. You might get so bored of eating those same few items that at some point it may seem easier to not eat at all…which is not a good idea. Allowing your stomach to get too empty will make you feel even more nauseous. By having a wide range of options to choose from, you can help ensure you stay well-nourished even during the tricky times. Having a well-stocked kitchen also makes it easier to find healthy snacks that will help keep your energy levels up, which is essential because of the fatigue that so often accompanies pregnancy.


2. DON’T RELY ON YOUR PRENATAL VITAMIN


For Baby: The invention of the prenatal vitamin is a good one. It can be hard to eat everything you need every single day, especially when nausea and fatigue are present, and so it’s nice to know that popping a pill can help you improve your nutrition. But if you think your prenatal vitamin will cover your bases, think again. It’s good for filling in some of the gaps in your diet, but it’s not a magic solution. It definitely doesn’t help you meet your macronutrient (carbohydrate, protein, and fat) requirements which is pretty much your most basic task when it comes to nourishing your baby. Studies show a link between low maternal weight gain and premature delivery as well as small-for-gestational age babies. Another risk of a prenatal diet that is too low in calories is a baby with a “thrifty phenotype”, which refers to changes in metabolism that occur to help the baby capture every bit of available energy in order to ensure growth in the womb. After birth, the ability to hold on to every calorie continues, but in an environment with plentiful food, this is no longer helpful and is associated with an increased risk for excess weight gain, type 2 diabetes, and cardiovascular disease. Bottom line: no pill can provide your baby with the basics. (Those basics increase substantially if you are expecting multiples, in which case I recommend reading When You're Expecting Twins, Triplets, Or Quads 4th Edition: Proven Guidelines for a Healthy Multiple Pregnancy by Dr. Barbara Luke.)

Your prenatal may not even meet your micronutrient needs. Folic acid gets a lot of press for its role in preventing neural tube defects, and you can be sure your prenatal will help you meet your folic acid requirements, but it may not contain nearly enough choline, which is a lesser-known nutrient that is also really important during pregnancy. 90% of Americans don’t get enough choline, and this is an especially big deal for women during pregnancy, because a low choline intake can raise the risk of neural tube defects and lead to decreased cognitive function. The requirements of choline during pregnancy are 450 mg/day (compared to 400 mg for a woman who is not pregnant) but prenatal supplements routinely provide only 0-55 mg choline. Substantial amounts of choline are found in egg yolks, liver, beef, and soybeans, but it’s from your diet alone, so supplementing with additional choline (350 mg) is advisable until we see some new-and-improved prenatal supplements on the market. Bear in mind that choline requirements increase to 550 mg during lactation, so if you decide to take a choline supplement, you will want to continue if you choose to nurse your baby.


FOR YOU: Pregnancy places a lot of demands on the body. Many women report having more energy, as well as healthier hair and nails, when they take a prenatal, but it’s going to take more than a pill to help you feel your best. You will need balanced meals and regular snacks to feel your best. And while a prenatal vitamin may supply you with some of the nutrients found in those all-important fruits and veggies, you won’t be getting fiber in there. Some of the digestive woes that often accompany pregnancy can be alleviated by making sure to get enough fiber in your diet, which means eating plenty of fruits, veggies, legumes, and whole grains. A prenatal also won’t cover your bases in terms of calcium, which means you’ll need to get plenty in your diet to meet your 1000-mg requirement. If calcium intake is too low, the body will take calcium from the bones to support the developing fetus, which can lead to osteoporosis. Adequate calcium intake also helps reduce the risk of hypertensive disorders during pregnancy. If your diet is low in calcium, a supplement may be necessary. So keep your prenatal, but consider giving it some company in your vitamin cabinet.


3. EAT FISH AND REEL IN THE BENEFITS


For Baby:  You may have heard that eating fish isn’t safe during pregnancy because of the risk of mercury contamination. It is true that there are some limitations on fish consumption during pregnancy, but it’s a real shame to cut out this very healthy food unnecessarily.  Fish is rich in omega-3 fatty acids, specifically EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid), which are essential for neurological development and good vision. Numerous studies have shown that fish consumption during pregnancy benefits the neurocognitive development of the baby. So eat your fish, but just watch the quantity. Due to risk of environmental contaminants, the FDA recommends entirely avoiding mackerel during pregnancy and limiting intake of salmon or light tuna to 2-3 servings (4 oz each) or per week and albacore/white tuna to 1 (4 oz) serving per week. I recommend eating wild salmon instead of farmed salmon during pregnancy, as farmed salmon is higher in contaminants. If it is difficult to find fresh or frozen wild salmon, you can buy canned wild salmon. If you don’t like fish, it’s a good idea to supplement with fish oil capsules.

For You: Eating fish during pregnancy is good for you, too. Your health matters and the omega-3 fatty acids benefit your health as well! And we’re not just talking about physical health, but emotional health, too, so if you still need another reason to include fish in your diet, consider this: women who eat more fish during pregnancy have a lower incidence of anxiety and depression.


4. PROTEIN REALLY IS POWERFUL


For Baby: the word “protein” comes from the ancient Greek term proteos, which means “primary”, or “most important”. Protein is critical for the growth, functioning, and repair of the human body and it is vital to your baby’s growth. While most people don’t have trouble meeting their protein needs, it’s worth being mindful to include adequate protein in your prenatal diet.  Animal sources of protein are generally higher-quality sources than plant-based proteins (although plant foods have a heap of benefits for other reasons). In addition to fish, as mentioned above, lean meat and poultry are also great protein sources and also provide vitamin B12 and iron, which is important in helping to prevent anemia and its complications. Another great protein source is eggs, which are actually the gold standard by which all other protein foods are judged. This is because eggs provide all the essential amino acids in sufficient amounts. Eggs contain vitamins A, D, E, and B vitamins as well as the antioxidants lutein and zeaxanthin, which are important for eye health. Eggs are also one of the few good sources of choline. Take note: many of the nutrients that make eggs such a powerhouse are found in the yolk, so that egg white omelet isn’t doing you nearly as much good.


For You: Foods high in protein help stabilize blood sugar levels and increase the satiety factor of meals and snacks. That means that including a protein source at mealtime can help you feel satisfied and energized. If your meals will be more than 4-5 hours apart, include protein at snack time (not just during pregnancy, but especially during pregnancy).


5. A LITTLE EXERCISE GOES A LONG WAY


For Baby: Even you’ve never been particularly active before, pregnancy is a good time to start. Your baby can benefit from your improved fitness even before birth! A recent study revealed that babies born to moms who exercised during pregnancy had lower heart rates and greater heart rate variability a month after birth, which are indicators of heart health seen in people who exercise. Thirty minutes a day of moderate activity most days of the week is a great number to aim for, but the thirty minutes can be added up throughout the day, and less than that is still definitely beneficial. In the study mentioned earlier, the more mom exercised, the greater the effects on the baby’s heart, but less exercise still had a significant effect on fetal heart health. Every bit really does count.


For You: Exercising during pregnancy can help improve your sleep, digestion, mood, and energy. It can lower blood pressure and reduce the risk for, as well as treat, gestational diabetes, and it can help reduce bloating and swelling. It improves muscle tone and strength, both of which come in handy during delivery and recuperation from childbirth. That’s a whole lot of benefits! However, be sure to discuss exercise with your doctor. There are some forms of exercise that need to be avoided during pregnancy, and the intensity and frequency should be cleared with your doctor as well. Exercise may need to be modified or avoided at various times throughout your pregnancy, particularly if you are experiencing any complications. Make sure you are drinking enough to stay well hydrated and that you are balancing your exercise with enough food to ensure a healthy rate of weight gain. And one more thing – choose exercise that’s enjoyable to you. If you’re already devoting the time and energy to it, you should definitely be having fun!

Pregnancy is a time in which balanced, mindful nutrition is especially important because there’s someone else on board, but you were really worth it all along - and you’ll continue to be a good cause even after delivery. After you’ve welcomed your new arrival, remember to take care of yourself too. Better yet – expect to!