Nutritional needs during pregnancy change as the pregnancy progresses. The first trimester of pregnancy not much changes in the way of calorie intake, but this is the time women often experience nausea and its side effects. As the pregnancy moves into the second and third trimesters, the effects of nausea tend to disappear and the calorie needs increase. Although no two pregnancies are the same, most women find that they tend to experience many of the same symptoms from one pregnancy to the next.
This article will focus on the most common nutrition concerns women have during pregnancy – Gastro-intestinal (GI) issues, weight gain, healthy snacking, fluid consumption, vitamin and mineral intake, nonnutritive sweeteners, and mercury.
Often woman experience nausea, vomiting, food aversions, cravings, taste changes, and/or reflux during the first trimester of pregnancy. The good news is that the symptoms usually subside after the first trimester or by mid-way through the second. The not-so-good news is that you may not feel well for several weeks and may have a hard time finding foods that are appealing. In addition, you may find that certain foods are harder to digest and/or cause heartburn (such as highly acidic foods, caffeinated beverages, chocolate, spicy foods, high fat foods).
The best advice is to keep a variety of foods and beverages available and snack frequently. Often consuming small amounts of food (and beverage) six times per day will help keep energy levels high and reduce the early symptoms of pregnancy.
Healthy Weight Gain
Weight gain during pregnancy is always a top concern. The Institute of Medicine (IOM) suggests that weight gain during pregnancy be based upon pre-pregnancy Body Mass Index (BMI). Note that these are averages and weight gain may not be steady from week to week (i.e. – one week you may gain two pounds and the next week a half pound). The goal is for a steady increase over several months. For the most accurate track of weight gain, weigh yourself once a week, on the same scale at the same time of day. It is best to weigh yourself nude first thing in the morning after you void and prior to consuming any food or beverage. The consistency is important to obtaining an accurate rate of gain. Although very important, it is often harder to get consistent weight checks at your provider appointments since you are fully clothed and the appointments are rarely at the same time or on the same scale.
Institute of Medicine suggested weight gain during pregnancy based upon pre-pregnancy BMI (Body Mass Index (BMI) = weight (kg)/height (m)2):
Adding snacks to your daily routine is important, especially as the pregnancy progresses. Singleton pregnancy energy needs increase in the 2nd and 3rd trimesters adding 340 kcal and 452 kcal, respectively. For multiple pregnancies, sufficient energy and an additional 50 grams of protein per day is wise starting in the 2nd trimester.
Use your hunger level to gauge if you need to consume a light, moderate or heavy snack. Examples of a light snack would include fresh fruit, raisins, dry cereal, low-fat Greek yogurt, low-fat pudding. A moderate snack would include fruit with peanut butter, oatmeal, cereal and milk, yogurt parfait. A heavy snack would include a peanut butter or lean protein sandwich, cheese and crackers, omelet. For more information refer to Healthy Snacking 101.
Good sources of protein include: peanut or almond butter (2 TBSP = 7g), greek yogurt (5oz = 12g), milk (8oz = 8g), cheese (1oz=7g), eggs (1= 8g), beans (1/2c = 7g), chicken (1oz = 8g).
Fluid consumption is necessary to keep energy levels high and reduce the incidence of headaches, nausea, dizziness, bloating, and constipation. It is estimated that consuming 10 glasses of liquids/day in addition to the liquids in foods will keep you hydrated. This, though, may vary and thus the best way to assess your hydration status is to aim for clear/pale yellow urine.
Vitamins and Minerals
Pregnant woman should consume a variety of foods to provide the vitamins and minerals necessary for a healthy pregnancy. These vitamins and minerals are plentiful in a varied diet, but supplementation may be necessary in some cases and should be discussed with your Physician and/or Registered Dietitian.
Artificial sweeteners provide a sweet taste to foods and beverages without adding calories. Although there is no nutritional need to consume the sweeteners, you may choose to add them in your diet and should know which are safe and which to avoid.
Safe: Stevia (PureVia, Sweet Leaf, Truvia), Sucralose (Splenda), Aspartame (Equal, NutraSweet, Nutra-Taste)
Avoid: Saccharin (Sweet’N Low), Acesulfame K (Sunnett, Sweet One, Ace-K), Nectresse
*Aspartame consumption should be limited to 1-2 foods or beverages/day.
It is recommended that pregnant woman consume 8-12oz of seafood/week to boost omega-3 fatty acid intake. Some fish do contain higher levels of mercury and thus should be limited or avoided. White (albacore) tuna should be limited to 6oz/week and tilefish, shark, swordfish and king mackerel should be avoided. If you do consume seafood, it is important to refer to the Federal Drug Administration (FDA) website for updates.
Nutritional needs during pregnancy vary and it is valuable for women to be in tune with their body’s needs and understand the basic recommendations. If you feel confused or feel that your questions are not being answered to your satisfaction, make an appointment with a Registered Dietitian who can help you meet your needs for a safe and healthy pregnancy.
Stay tuned for next month’s article that will focus on the benefits of exercise during pregnancy.