A pregnant woman's nutritional needs are much different than nutrition needs at any other point during the lifespan and these needs are ever changing throughout pregnancy. While some may say that women are 'eating for two', the focus of truly 'nourishing for two' should be a focal point pregnant women to better pregnancy outcomes and set both infant and mom up for success at birth.
Calorie needs during the first trimester do not change from baseline; adequate vitamin and mineral intake during this time is essential to neural tube development and folate is a key role in the first trimester. Whole grains and fortified foods contain high amounts of folate and should be a normal part of a conceiving and pregnant woman’s diet. Folate needs are also higher with increased body mass and therefore should be tailored to the individual. Minimal weight gain happens during the first trimester occurs but the weight that is gained is thought to be put back in fat stores for breastfeeding. In the second trimester, calorie needs increase by an estimated 325 calories a day and weight gain is more prevalent as babies organs are in line and they begin to grow. Once a mother reaches the third trimester, calorie needs are increased by 450 calories from baseline and weight gain continues as baby grows and delivery nears.
Healthy weight gain during pregnancy has been correlated with better pregnancy outcomes and healthier offspring with both low and high weight gains being correlated with increased metabolic risk factors in offspring due to how genes may be expressed. There has been recent research however that showed pregnancy outcomes were not altered in patients with a BMI >30 kg/m2 when weight gain goals were not achieved (less weight was gained).
Aside from folate, iron, Vitamin D, DHA, calcium and protein should be the main focus during pregnancy. While most women will obtain these things from a multivitamin, some may not tolerate a multivitamin, the multivitamin brand may not truly fulfill the woman's needs or consistency in taking the multivitamin may be lacking. These are all reasons why focusing on nutritional intake should continue to be a priority despite multivitamin use.
Iron intake during pregnancy helps support a mother's increasing blood volume but will also provide baby with the iron stores they need to suffice their bodies throughout the first 4-6 months of life. It is important however that we note iron supplementation, especially during the early stages, MAY increase risk of gestational diabetes. Not to mention that iron supplementation generally does not set well on the stomach and may make morning sickness worse for some mothers. Therefore, it is important to increase iron stores before pregnancy and consider working with a dietitian to optimize iron through diet and assess for appropriate time to supplement if you have high gestational diabetes risk factors or are not tolerating your iron containing prenatal vitamin.
Vitamin D levels have been associated with fertility outcomes and should be supplemented during pregnancy and breastfeeding to help support mom’s bones and immune health. Fortified milks, salmon, and sunlight are all ways to take in vitamin D naturally.
DHA is a healthy fat that helps decrease inflammation and provides for brain development in-utero and throughout the first 2-3 years of life. Fatty fish (salmon, tuna, mussels, oysters, halibut, etc.) intake twice a week supplies a sufficient amount of DHA but additional supplementation should be considered if fish intake is lacking or absent in a pregnant mom’s diet. Algae, eggs, walnuts and flaxseed are other ways to obtain DHA for moms that do not consume fish but one will likely not be able to obtain enough DHA from these items alone. Supplementation at 1000mg/d have been associated with lower rates of premature birth in research.
Calcium intake is important for babies and mom’s bone health. Consuming dairy products, soy products, dark leafy greens, and fortified juices or milk alternatives are all great ways to consume enough calcium throughout pregnancy. It is important to consider consuming calcium containing foods 2 hours before or after an iron containing supplement to help increase absorption as calcium will bind iron and decrease its absorption.
Protein needs are increased by 25 grams per day (from baseline) during pregnancy. This helps support mom and baby’s growth. Protein from beans, green peas, chickpeas, quinoa, fish, meats, eggs, dairy products, etc. are best and protein supplementation with shakes or protein fortified foods can be considered as needed. Many times during pregnancy protien foods may sound unappealing and therefore protein pancakes, protien shakes, etc. would be a great option! Eating a high protien diet before and during pregnancy is correlated with decreased morning sickness/severity.
Nourishing you and baby is important! Many health insurances have a ‘Healthy Weight During Pregnancy’ benefit. Contact us today to see how we can help you through one of your most exciting times!
Commentaires