Great Expectations
Nutrients for a Healthy Pregnancy
By Marie Fortin, MEd, RD
If this article has captured your attention because you’re contemplating a pregnancy or expecting a little one, congratulations! Pregnancy is an exciting time to focus on healthy eating because the outcome is so richly rewarding. I have clients in my practice whose pregnancies inspired diet and exercise changes that stayed with them for years.
The 40 weeks of pregnancy bring about tremendous changes to an expectant mother’s body – changes that require adjustments in the amount and types of fuel she supplies it. Countless nutrients are involved in supporting critical transformations in the expectant mother’s body, as well as the extraordinary growth and development of her baby. Below is a discussion of nutrients that deserve special attention during the prenatal period.
Protein
During the first trimester, protein requirements remain unchanged from your pre-pregnancy diet. In the second and third trimesters, aim to add 25g of extra protein to your daily diet to support the growth of the placenta, and to supply amino acids, zinc and vitamin B6 which will help form your baby’s tissues.
What to Do:
• Read nutrition labels to help you find an extra 25g of protein to add to your daily diet. Trail mix, nut butters, dairy products and bean-based soups are all protein-rich.
• 25g of extra protein is the amount you’ll find in 3 ounces (90 grams) of cooked lean meat, poultry or fish.
• Vegetarians can find 25g extra protein in one cup (8 ounces) of soy milk, along with ¾ cup cooked legumes.
Folate/Folic Acid
Supplementing with folic acid (a B-vitamin known as folate when it occurs naturally in food) during pregnancy can reduce the risk of having a baby with a neural tube defect (NTD) by 70%. The neural tube is a structure that eventually becomes the baby’s brain and spinal cord. NTDs occur when the neural tube fails to close properly during the early weeks of pregnancy, resulting in abnormalities of the baby’s spine, brain or skull. Because the neural tube fuses before most women realize they are pregnant, it is important to take supplemental folic acid before achieving pregnancy.
What to Do:
• Start taking a multivitamin supplement when there is any chance that you may become pregnant, and at least three months before planning a pregnancy. Choose a product that contains at least 400mcg (0.4mg) of folic acid.
• Once your pregnancy is confirmed, switch to a prenatal multivitamin that contains 1mg (1000mcg) of folic acid. If nausea or stomach upset makes it difficult to swallow a prenatal multivitamin, simply take one small folic acid pill (1000mcg or 1mg) each day.
• Eat plenty of foods naturally rich in folate, such as legumes (lentils, chickpeas, kidney beans, baked beans), peanuts, sunflower seeds, oranges and orange juice, dark green vegetables (spinach, Romaine lettuce, asparagus, broccoli, green peas) and bran cereal.
• Some expectant mothers should get even more folic acid to reduce the risk of NTDs and other types of birth defects. Speak to your doctor about whether you meet the criteria for supplementation with 5mg (5000mcg) of folic acid per day.
Iron
During pregnancy, a woman’s iron requirements increase by 50% in order to support her expanding blood volume and contribute to the formation of her baby’s red blood cells and bones. It is extremely challenging to attain the recommended intake of 27mg of iron with food alone, which is another reason to consider a prenatal multivitamin supplement. For example, a 3-ounce serving of beef contains only 3mg of iron, while a 3-ounce serving of chicken or pork contains a mere 1mg. Many prenatal multivitamin pills contain 27mg of iron.
Though fatigue is normal in pregnancy, be sure to tell your doctor if you’re feeling exceptionally drained and lethargic – this could be a sign of iron deficiency anemia. Remember that your body is perfectly programmed to ensure your growing baby’s needs are met first; as a consequence, your body’s stores of key nutrients may become depleted if your diet doesn’t supply adequate amounts. If you are found to be iron deficient or anemic, you will be advised to take higher doses of iron, as an untreated deficiency can negatively affect your baby’s development.
What to Do:
• Besides taking a prenatal multivitamin, try to include many iron-rich foods in your diet. The best-absorbed sources of iron include clams, liver, oysters, iron-fortified cereals and animal protein (beef, pork, chicken and fish). Other good sources of iron include legumes (such as kidney beans, chickpeas, lentils), soybeans and tofu, and grains (such as amaranth, quinoa, enriched breads and pastas).
• Vitamin C enhances iron absorption. Eat vitamin C-rich foods (citrus fruits, strawberries, papaya, melon, kiwi, bell peppers, parsley, broccoli, potatoes, Brussels sprouts, kale) each day.
• Certain foods block iron absorption. Coffee, tea and calcium supplements are known to interfere with the body’s use of iron. Wait one hour between consuming a high-iron food or supplement, and foods or supplements known to block iron absorption.
Calcium and Vitamin D
Calcium and vitamin D work together to build your baby’s bones and teeth. If an expectant mother can’t obtain enough calcium through her diet, her bones begin to dissolve in order to provide a source of calcium. Vitamin D helps the body absorb and use calcium.
What to Do:
• Increase your intake of calcium-rich foods such as milk, cheese, tofu made with calcium sulphate, yogurt, sesame seeds, fortified milk alternatives (example: soy milk, rice milk, almond milk), canned sardines and canned salmon, including the bones.
• Your calcium requirement is 1000mg per day. To achieve this, choose three to four servings of calcium-rich foods listed above (a serving of milk or alternative is 1 cup, a serving of yogurt is ¾ cup, and a serving of cheese is 1 ½ ounces). A standard prenatal multivitamin will supply an extra 200-300mg of calcium.
• If your diet consistently falls short of meeting your calcium requirement, you may consider a calcium supplement that provides 300-600mg of elemental calcium per tablet. Look for a supplement with added vitamin D. If you are experiencing indigestion or heartburn, you may find that calcium citrate supplements are gentler on the system.
Essential Fatty Acids
Essential fatty acids such as DHA and ALA (also known as omega-3 fats) are crucial for your baby’s brain development and nerve function. Research indicates that deficiencies in these precious fats are linked to learning disabilities and memory problems in children. New studies also suggest that mothers with a higher intake of DHA have a lower risk of postpartum depression.
What to Do:
• On a regular basis, choose foods rich in essential fatty acids such as cold-water fish (salmon, trout, sardines, herring, mackerel), ground flaxseed and flax oil, canola oil, walnuts and walnut oil, non-hydrogenated margarines and foods enriched with omega-3 fatty acids.
• Women should choose fish that have low levels of contaminants and high concentrations of omega-3 fats, including anchovies, mackerel, Atlantic Pollock (Boston bluefish), herring, lake whitefish, rainbow trout, salmon, sardines, smelt.
• Access York Region’s Guide to Eating Fish for Women, Children and Families at: www.york.ca/fishguide
Marie Fortin, MEd, RD, a Registered Dietitian, runs a busy nutrition consulting practice in Markham, where she coaches clients of all ages to better health and vitality. Visit her at www.mariefortin.com
2600 John Street, Unit 207, Markham, ON L3R 3W3 T: 905.475.5222 F: 905.475.6369
