Sunday, August 25, 2013

Registered Dieticians' TOP FIVE NUTRITION RECOMMENDATIONS for PREGNANT WOMEN!


We are VERY lucky to have a guest post by Joe Hagloch, R.D., he specializes in pregnancy and infant nutrition (and recently had his own cute little baby)! THIS IS A MUST READ!!!!!!!!!! 


Pregnancy can be an exciting and very overwhelming time for a woman.  Exciting because you’re having a baby!  And overwhelming because you want everything –and I mean everything— to be perfect, from the color of the baby’s room all the way to eating the “right” foods for you and your baby.  Eating a healthy diet seems impossible at times because of how complex it can all be.  As a Dietitian, and having worked with pregnant and breastfeeding women, I have been asked many times what my top recommendations are.  So here I’ve outlined my top 5 things every woman should know about maternal nutrition.

1. Stop playing the guilty game with food. During pregnancy, many women experience cravings for certain foods that aren’t necessarily “healthy choices,” and often feel guilty for eating them. Some women have been told that cravings are your body’s way of telling you when you’re deficient in something.  For example, you might think if you’re craving a cold treat, you are low in calcium and you, ahem, NEED Triple Chocolate Fudge ice-cream. In reality, cravings are most commonly brought on by low blood sugar. Studies show that women who go long periods without eating during pregnancy actually have more cravings for sweets than women who eat as soon as they feel the urge. And since pregnant women use carbohydrates at a greater rate, both at rest and during exercise, than do non-pregnant women, blood sugars can become low quickly.  This is a common occurrence during pregnancy and can be combated by snacking frequently— fruits, veggies, pretzels and nuts—and reducing your stress level. So before you send your husband to the store for some ice cream, just relax and drink a glass of orange juice, wait 15 minutes and see how you feel.  If you still have the craving, by all means-- send that husband running at 2 am.  The most important thing to remember is this: There are no good or bad foods, only foods you should eat more often and foods you should eat less often. Never deprive yourself of the occasional sweet, and remember that dieting is never ok during pregnancy.


2. Pack on the protein.  Protein is the building block of every single cell in the human body. Several studies have confirmed developmental delays, both physically and mentally, in infants who do not receive adequate amounts of protein before and after birth.  Simply put, an infant will not grow or develop properly without protein, no matter how many calories you pump into them.  Protein seems like a very redundant theme for pregnant women and can be confusing at times. As a general recommendation, you’ve probably heard that you need about 70 grams of protein. However, protein intake should be proportionate to your body size before pregnancy. For example, someone who weighed 100 pounds will need less protein than someone who was 150 pounds. But who really reads those labels at every meal, every day? What a pain! To make it easier on you, here’s a simple and effective strategy: Aim to eat the same way you did before becoming pregnant, and then add an extra 25 grams of protein on top of that.  Here is a list of meals and snacks that have around 25 grams of protein, plus the extra calories you need to help your baby grow: 1 peanut butter and jelly sandwich with 1 cup of milk, 3oz of cheese on saltine crackers, 1 can of light tuna fish or canned salmon on saltine crackers, light tuna fish or salmon sandwich using ½ of the can, or 1 cup of cottage cheese with fruit.  There are many websites out there that can tell protein content of food.  Whatever you do, make sure you get your extra protein every day. And do it with foods you already like, so it will be that much easier.  Women who get enough protein during and after pregnancy are able to maintain greater amounts of lean muscle (you’ll need it for D-Day!) and reach their pre-pregnancy weight faster.  Add good exercise, and you’ll punch that leftover pregnancy weight right in the face (or should we say thighs?)!


3. Double your DHA.  Docosahexaenoic acid, or DHA, is an omega-3 fatty acid that the human brain, cerebral cortex, skin and retina are mainly made of. It is also vital for proper development of a growing fetus.  It is so important, in fact, that the mother’s body will give up its DHA stores in order to provide for proper development of the fetal eyes, brain, and spinal cord. You’ve heard of “Baby Brain,” where you can’t remember things or think straight? It’s a real thing! Your baby is most likely leeching your brain DHA. In addition, higher DHA consumption has been shown in several studies to reduce the incidence of postpartum depression.  Maternal intake of DHA during pregnancy and lactation may be favorable even for later mental development of children.  Natural food sources of DHA are mainly fish. Many women avoid eating fish during pregnancy because they are afraid of mercury contamination.  One way to avoid mercury contaminated fish is to eat fish lower on the food chain, like Freshwater Trout, Herring, non-farm raised Salmon, Sardines, or Tilapia, and avoid fish higher on the fish food chain like King Mackerel, Shark, Swordfish, Tilefish and Albacore Tuna.  Note that regular canned tuna fish is not a significant source of DHA, but it is not incredibly high in mercury and still a great option for protein. It is perfectly fine to eat canned light tuna once a week, but I wouldn’t suggest more than that. If you can, try canned salmon instead of tuna fish. It’s healthier all around, and you can eat it more often. If fish is not your thing, or you are vegan or vegetarian, Algal DHA might be a great option for you, since it is DHA extracted from algae instead of fish.  Pregnant and breastfeeding women should shoot for 300-500 mg DHA daily. That’s about 8-12 oz of fish per week. Since the FDA doesn’t regulate supplements the same way as food or drugs, fish oils and DHA supplements may be contaminated with hard metals that can be toxic to you and your baby. Only choose from brands of fish oil or DHA supplements that are of the highest quality.  Any reputable manufacturer should be able to prove third party documentation of the purity of their supplement.  The quality standards that exist for fish oil and DHA supplements will be printed with a seal on the side of the bottle and include the Norwegian Medicinal Standard, the European Pharmacopoeia Standard and the voluntary U.S. Standard established by the Council for Responsible Nutrition. DHA will help you keep your brain running strong (literally), and help your baby Einstein grow just like you want him to.


4. Fill up on fiber.  Constipation is a fairly common problem during and immediately following pregnancy.  And as much as we don’t like to talk about it, it affects around half of all women at some point during or following pregnancy.  It’s thought to occur from a variety of things, like hormones that slow down digestion and pressure from the growing fetus on the digestive tract. One fairly inexpensive and key step to prevent constipation is to increase your fiber intake. If you currently have a low fiber diet, you should start out slow.  Increase the amount you eat a day by 2-3 grams until you reach 25-35 grams.  By doing this you will help avoid serious cramping, bloating and abdominal discomfort associated with a significant jump in fiber intake.  Although fiber is found in grain products, whole grain doesn’t always equal high fiber.  If you eat bread or cereal try to find bread that has 3 or more grams per slice and cereal that has 5 or more grams per cup.  Other great sources of fiber are whole fruits and vegetables. Also, make sure you’re getting plenty of water with your fiber. (And as a hint, TAKE the stool softener if your hospital offers it after birth, up to a couple weeks postpartum. I ran to the store at midnight to get prune juice for my wife because she didn’t think she needed “the little red pills.” Trust me—you don’t want to get to that point.)


5. Hydrate your home.  In addition to the extra fiber, your body will also need extra water. Lots and lots of extra water.  To help with the increased blood volume during pregnancy, your water intake should increase at the same rate your blood volume increases.  Before pregnancy you should have been drinking 1 milliliter of water for every calorie of food eaten.  So for a 2000 calorie diet you should be drinking 8 cups of water.  That’s where the old “8 cups of water a day” comes from.  This should then be increased by 50%.  So for a 2000 calorie diet a pregnant women should be drinking about 12 cups of water a day.  This can be very challenging, especially during the second and third trimesters when the baby is pushing down on your bladder making you want to go to the bathroom every 10 seconds.  The best way to combat this is to spread your drinking habits throughout the day.  Always have a water bottle available to drink.  You could try filling up several bottles of water and storing them in your fridge or somewhere around the house if cold water doesn’t sound appealing. You could even mark them with a time you should drink them. For example, have five 20 oz bottles of water marked with 7-10 am and another with 10am-1pm, etc.  Fill these up at the end of the day and start your routine again the next day.  Keep in mind you will need extra water on the days you exercise. And though all those trips to the bathroom will surely use up more time (and TP), never NOT drink water to cut down on a few trips. It’s really not worth it. In fact, I might recommend setting up a nice little retreat in your bathroom-fresh flowers, fancy soap, cashmere hand towels, the works!—so you have more motivation to drink plenty of water and go in there often. Enjoy it! And remember, the feeling of a constantly full bladder won’t last forever…


There are a number of other things with high importance during pregnancy. Of honorable mention are intake of iron and folic acid. But these are abundant in US food supplies—both are fortified in cereals, breads, pastas… basically all grain products. So as long as you are taking your prenatal vitamin and eating a variety of good foods, these shouldn’t ever be an issue in your pregnancy. Do these 5 things for a healthier pregnancy and baby, and you’ll feel as healthy and beautiful as you deserve to be. Congratulations and good luck during this special time of your life! Babies are the best! My wife and I just had a little boy of our own. J

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