Healthy Eating During Pregnancy

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Margaret Connor

Margaret Connor, MPH, CHC

Q: I’ve always had a pretty healthy diet but now that I am pregnant, what vitamins, minerals and other nutrients are critical to include for optimal health for me and my baby?

Response from Margaret Connor, MPH, CHC, The Wellness Pantry

A: It sounds like you have already helped yourself and your baby by eating healthy before your pregnancy began, which is terrific. Now let’s examine how our metabolic needs do increase during pregnancy. The following vitamins and minerals play a special role in your health and that of your child’s during pregnancy (and often postpartum as well). One exciting detail to consider is that the absorption of nutrients across our intestinal barrier typically increases during pregnancy, so eating good sources of these vitamins and minerals will go a long way towards keeping you equipped with the necessary nutrients.

FOLATE – You’ve probably heard your OB mention this as a valuable supplement that you might have been taking even before you became pregnant. The evidence that folate reduces the risk of neural tube defects is so compelling that the U.S. started fortifying grains with folate in 1998. The current recommendation is for women with child-bearing potential to be taking 400 micrograms/day and for pregnant women to take 600 micrograms/day. Good dietary sources of folate include broccoli, spinach, lentils and other beans. FUN FACT: Did you know that folate is actually Vitamin B9?

IRON – This is the most common deficiency we see in pregnancy and it typically appears in the second or third trimester. During the first trimester, your body’s increased metabolic demands for iron are balanced out by the fact that you are no longer menstruating each month. However, your body’s demands for iron will increase during your pregnancy and as such, your doctor will likely be keeping a close eye on your levels. On average, 13-40 mg/day of iron supplementation is recommended. Most prenatal vitamins (which we actually take during pregnancy) contain about 30mg. If you are found to be iron-deficient, or anemic, your doctor will place you on a higher dose and recommend that you continue supplementation postpartum. The best dietary sources of iron are read meat, poultry, fortified cereals and beans. Iron is best absorbed from food when it is eaten with foods containing Vitamin C.

CALCIUM –  Calcium is required for your baby to grow healthy bones and teeth. Some studies have also shown  that calcium supplementation during pregnancy can lower your risk for pregnancy-induced hypertension and preterm delivery due to preeclampsia. It is recommended that pregnant mamas get 1000mg of calcium per day. The average daily intake for most women is about half that amount. As a result, most prenatal vitamins provide calcium supplementation. Good dietary sources of calcium include dairy products, sardines, collard greens, sesame seeds and tofu. To be honest, with the exception of dairy (which I don’t tolerate) that can be a tough list of foods to find palatable during pregnancy. Just do what you can.

VITAMIN D – This fat-soluble vitamin works in conjunction with calcium to help your baby’s bones and teeth develop properly. Unless you are considered high-risk for a Vitamin D deficiency, your doctor may not screen you for one. At-risk groups consist of vegetarians, women living in areas with limited sun exposure or those with darkly pigmented skin. Typically, women, pregnant or not, need 600 IUs of Vitamin D per day – though some doctors will recommend doses higher than this. If you are found to be deficient, the recommended daily supplementation level will go up to 1000-2000 IUs each day. Vitamin D is also crucial for healthy fetal skin and eyesight development. Good dietary sources are fortified milk or juice, eggs, salmon and of course, cod liver oil (another tough one to take while pregnant but some folks don’t mind it).

MAGNESIUM – Recommendations for magnesium supplementation are mixed though metabolic demands for magnesium do increase during pregnancy. Some doctors recommend 500mg per day for pregnant women, though most prenatal vitamins contain 50mg or less. Check with your doctor if you have concerns about your magnesium levels. Good dietary sources? Leafy green vegetables, beans, nuts seed and wait for it, wait for it . . . . .CHOCOLATE.

ZINC – Another nutrient that your body needs more of during pregnancy, zinc plays a role in the development of immune and digestive systems, among others and influences your ability to smell and taste. In fact, I have had several clients with picky eaters who turn out to have a zinc deficiency. With a little supplementation, their palate begins to broaden. Zinc is a relatively common deficiency in the US but supplementation must be monitored. Studies suggest that zinc supplementation, when needed, can assist in achieving a full-term birth and (appropriately) increased birth weight at term. Dietary sources of zinc include pumpkins seeds (my favorites), shellfish, meat, nuts and beans.

 EPA/DHA – There is so much good research linking omega 3 fats to benefits for you and your baby. Studies show that omega 3s have been linked to longer gestation, eye and brain development and even reducing postpartum depression. Currently the American College of Obstetricians and Gynecologists recommend 1 or 2 servings of fish or shellfish weekly during pregnancy and breastfeeding. As I mentioned in my last post, be mindful of your mercury exposure, making sure not to eat long-living fish like shark, swordfish, mackerel or tilefish. Also limit white albacore tuna to one serving per week. Of course, fish oil supplements can offer omega 3s without the risk of mercury. Check your fish oil supplement to make sure if has been “third party tested” for metals.

I am not a medical doctor, so be sure to check with your physician before changing any of your current medicines or supplements. Please keep in mind that the recommendations shared above are standard and do not take into account unique risk factors you may be managing.

Sources: The American Congress of Obstetricians and Gynecologists, Katz, David: Nutrition in Clinical Practice (2008)

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