August 30, 2014

Eating for Two?

Recently I have had the privilege of developing a Nutrition Plan for a client in her fifth month of pregnancy. Her first trimester was a rough one, filled with lots of nausea and unfortunately, vomiting.  She was also only craving foods that are on the not-so-healthy-side, such as fast food, potato chips, and soda. Between persistently getting sick and eating high-sodium, high-fat foods, she managed to gain just the right amount of weight, but now in her second trimester and feeling much better, was eager to get back on track and begin eating better for her health and the health of her baby.

Many women get excited at the prospect of “eating for two” and the freedom to indulge in whatever one wants during pregnancy. But their doctor (or dietitian) should gently remind them that all that is needed for a growing fetus (as well as the momma) is an average 300 extra calories a day. The important thing to note here is that those extra calories should be from fruits, veggies, whole grains, lean meats and dairy, NOT sweets, salty snacks and fast food. Why is this so important? Because a pregnant woman’s needs increase for very specific nutrients such as Vitamin A (770ug), Vitamin C (85mg), all the B vitamins including Folate (600mg), Iron (27mg-from foods and supplements), Phosphorous (1,250mg in the first trimester, 700mg in the second and third trimester), as well as protein (1.7g per kilogram of body weight) and fiber (25-30g). A daily multivitamin is encouraged to help fill in any nutrient gaps a woman may be lacking, but taking mega-doses of certain vitamins as well as herbal supplements is strongly discouraged during this time.

Pregnant women should take care to eat every three to four hours to prevent sudden drops in blood sugar, and although research is mixed on the use of caffeine, the general recommendation is no more than two cups of coffee per day (about 200mg of caffeine). I tell my clients to monitor their intake of tea, sodas, and chocolate, as all of these contain caffeine in varying amounts. Keeping oneself well-hydrated is also important, and eight to twelve eight-ounce glasses of fluid a day (mainly from water) is recommended, especially since protein and fiber intake will be increased.

Other issues of particular concern for the mommy-to-be is avoiding intake of shark, swordfish, tilefish and king mackerel due to their excessively high levels of mercury, which can be harmful to the fetus. Canned tuna is okay, but limit the albacore to just six ounces per week (light canned tuna has even less mercury). Foodborne illness can be especially deadly to a mother and her unborn child. Pregnant women should not eat deli meats (like bologna or hot dogs) unless cooked to steaming hot, or ready to eat foods from the store such as potato, chicken, egg, and tuna salads due to increased risk of listeriosis. Also avoid raw and unpasteurized foods such as sushi, hollandaise sauce, and fresh juices.  Cheeses such as brie, feta, queso fresco, and camembert should also not be eaten due to possible pathogenic bacteria present.