Nutrition During Pregnancy


What to Avoid.

Along with making sure that you intake enough calories and nutrients from your foods, it is also important to avoid certain foods. Obviously, you will want to avoid foods that cause digestive discomfort. You may also want to limit or avoid artificial sweeteners until there are more studies done regarding their safety. In addition there are some questions regarding the safety of nitrates used in most cured and smoked meats and fish and some insecticide residue on fruits and vegetables. Their effects on the newborn are still unknown so it is wise to avoid highly processed foods and make sure that you wash all fruits and vegetables thoroughly. Although it is advised to cut down or eliminate salt, most pregnant women do not need to change their seasoning habits if they are in good health. In fact, studies have shown that salt is very important in a pregnant women's diet. The compulsive eating of non-food substances such as dirt, clay, cornstarch is called "pica". Pica and unusual food cravings seem to be more common among pregnant women. Pica may also occur in patients with an iron or zinc deficiency and is found more frequently among certain cultural groups.

It is important to try to avoid the following foods

1. Soft cheeses like Brie, Lamerbert, Feta and Roguefort as they have been associated with Listeriosis
2. Raw Milk-which is also associated with Listeriosis and various other food-borne illnesses
3. Raw seafood such as sushi and raw oysters
4. Fried eggs with a runny yoke. May contain Salmonella. Do not eat sunny side up eggs. Boil eggs for at least seven minutes; poach for 5 minutes and fry for 3 minutes on each side to make sure they are fully cooked. Avoid dressings and sauces made with raw or undercooked eggs. For example: hollandaise sauce, eggnog, home made ice cream and Caesars salad dressing.
5. Undercooked chicken
6. Anything that contains raw milk, undercooked ground beef or undercooked eggs
7. Hot dogs and cold cuts directly from the package. Cook them before eating. A recent study found that a relatively large number of hotdogs on the retail market test positive for Listeria Monocytogenes.
8. Olestra used in no fat potato chips
9. Limit the amount of seafood, especially sword and sharkfish. Limit tuna to one can a week.

Pregnancy is a very nutritionally demanding period of a woman's life. The gestation involves rapid cell development. It is important to have an adequate supply of nutrients to support this rapid fetal growth. Many of your requirements for certain nutrients double during pregnancy and your calorie demands increase about fifteen percent. Pregnancy woman should choose foods high in nutrients and for many women this may require some improvement in their current eating habits.

Calories - The average number of calories in the beginning of the pregnancy should be around 2200-2400 and towards the end they should be increased to about 2600 calories a day. Calories should be increased by an average of 300 calories a day. This is about the same amount of calories as in 2 _ cups of low fat milk, one cup of ice cream, a bagel with cream cheese or a tuna fish sandwich. This increase may seem very small but this extra energy is essential to support the growth of the fetus. You do not need to "Eat for Two". This practice is likely to result in excessive weight gain.

Liquids - You need to drink about two quarts or eight glasses of liquid a day. Take some milk mixed with other foods, and then supplement your milk intake with water. Clear soups, fruit juices and anything you drink counts as a liquid. However, do not include alcohol, coffee, or tea as part of your liquid intake. All alcohol should be avoided during pregnancy. Coffee and tea should be limited. Drink water or juice with your meals, as milk, coffee, tea and soda can interfere with the absorption of important nutrients like iron.

Protein - Both the mother and the baby need increased amounts of protein. It is recommended that pregnant woman consume 60 grams of protein a day, about 10 more grams than non-pregnant women. This 10 grams of protein is equivalent to 1 _ ounces of meat of 1 _ cups of milk. Since most Americans usually consume more protein than required, it may not be necessary to consciously increase their protein consumption. Lean meats, poultry and fish are good sources of protein and they also supply other nutrients. Other great sources of protein are beans, lentils, nuts, eggs and cheese. Since protein can easily be provided through your diet, there is no need to use high protein drinks or powders. Excessive protein supplementation can be detrimental to the developing fetus and can result in delayed growth or preterm delivery. For vegetarian mothers, it is especially important to make sure that you are obtaining your protein needs.

Calcium - During pregnancy your calcium requirements are about 1220 mg a day or a 50 percent increase over pre-pregnancy. Women who are not pregnant usually only consume only about 75 percent of the recommended amount of calcium so most pregnant women need to add more calcium to their diet. It is especially important for those women under 25 whose bones are still in the process of increasing in density. Some good sources of calcium are milk, yogurt, frozen yogurt, ice cream, ice milk and cheeses. Non-fat and low fat dairy products supply equal amount of calcium but have fewer calories. Green leafy vegetables, tofu and canned salmon are also good sources of calcium. For those women who do not eat dairy products, calcium fortified foods such as orange juice and breakfast cereals are good choices. Pregnant women should consume at least four servings of calcium-enriched foods a day or the equivalent to one quart of milk. For those women unable to consume the four servings of calcium a day and are consuming closer to one serving a day should consider taking calcium supplements. These are best utilized if taken with a meal. Pregnant women should not take calcium supplements such as bone meal and dolomite. These products have substantial amounts of lead.

Iron - Iron needs double during pregnancy. Previous requirements are 15 mg a day are now 3o mg a day. This additional iron is needed as the result of increased blood supply. Babies will also store enough iron to last through their first few months of life. Pregnant women should know which foods are iron enriched and strive to consume them on a regular basis. Liver and red meat and really rich in iron. Other meats such as fish and poultry are also good. For those who do not consume meat, enriched and whole grain breads and cereals, green leafy vegetables, legumes, eggs and dried fruit will provide the needed iron. It is important to note that iron in fruits, vegetables, cereals and eggs are not absorbed as efficiently as iron from meat, fish and poultry. You can enhance their absorption by eating them with foods high in Vitamin C such as orange juice. A normal diet will usually provide a woman with 12-14 mg of iron a day and as a result iron stores are often depleted during pregnancy. Many women enter pregnancy with low iron reserves therefore risking the development of anemia. It is recommended that 30-mg a day of iron should be taken as a routine supplementation. Most prenatal vitamins supply this dosage. For best absorption, prenatal vitamins should be taken between meals, with liquids other than milk, coffee or tea. To reduce the chance of gastric irritation, take them at bedtime. Our office has brochures available on good food choices to increase your iron. Ask for one if you like at your next appointment

Folic Acid - Folic Acid is important due to the rapid development of cells. It has been suggested that taking folic acid before and during pregnancy can reduce the risk of spina bifida and other neural tube defects. It is recommended that all women of childbearing age should consume 400mdg of folic acid daily. It is important to make good food choices to assure adequate consumption. Good sources included dark leafy green vegetables, legumes, citrus fruits and juices, peanuts, whole grains and some breakfast cereals. Because most women do not consume enough folic acid in their diet and may not even know they are pregnant when their need for folate is most critical, it is advised that all women, pregnant or planning on becoming pregnant, take a multivitamin containing folate daily.

Although it is possible to meet the requirements of most nutrients through a balanced diet, it is recommended that pregnant women still take a prenatal vitamin or a daily vitamin supplement containing folic acid and iron as a safeguard.

Supplementation - It is very important that you take a vitamin that will assure that you obtain 300 mcg of folic acid daily. It is especially important for those who are vegetarians, smoke cigarettes or are carrying twins. Supplementation should included:

  • Iron 30 mg
  • Folic Acid 400 mcg
  • Calcium 250 mg
  • Vitamin C 50 mg
  • Vitamin B12 2 mcg
  • Vitamin D 5 mcg
  • Copper 2 mg
  • Zinc 15 mg
  • Vitamin B6 2 mg
  •  

Strict vegetarians should take an additional amount of Vitamin D and 2 mcg of Vitamin B12. Excessive levels of Vitamin A and Vitamin D can be toxic to the fetus and is often adequate through diet, therefore Vitamin A supplementation is not recommended during pregnancy.

Caffeine Consumption - Studies over the past decade have found no association between birth defects and caffeine consumption. It has been indicated that even moderate consumption of caffeine does not predispose the mother to a spontaneous abortion or preterm labor. But studies have proven that drinking more than 2 o 3 servings of caffeine a day can increase the chances of a low birth weight baby. As with all foods, pregnant women should use caffeine in moderation and not to exceed 300 mg a day.

Sodium Requirements - Sodium requirements increase during pregnancy, but the average diet often is adequate for expectant mothers, therefore additional salt is not required.

Good nutrition during pregnancy depends on a variety of wholesome foods, such as whole grains, vegetables, and fruits. Calories should be increased to meet the needs of the developing fetus. Here are some good food sources:

For Protein include:

  • Eggs
  • Dairy Products such as milk, cheese and yogurt
  • Tofu
  • Beans
  • Lean Meats

For Calcium include:

  • Dairy products such as milk, cheese and yogurt
  • Fish

For iron include:

  • Lean meats
  • Legumes such as lentils and chickpeas
  • Green leafy vegetables such as spinach and kale
  • Dried fruits such as apricots and raisons
  • Eggs
  • Prune Juice
  • Molasses

For Folic Acid Include:

  • Green leafy vegetables
  • Eggs


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