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My Pregnancy Journey: Diet & Supplementation Recommendations

I’m in my 39th week of pregnancy now.  I’ve been thinking a lot about these past 9 months and how I can use my experiences to help others throughout their pregnancy.  I wanted to share some diet, supplement, and exercise guidelines I tried to follow along with some of the physical, mental, and emotional changes that I went through in hopes that it will bring some guidance and peace of mind.  No, I wasn’t perfect with my diet and workouts; and yes, I had emotional breakdowns and often complained about being pregnant.   But, I learned a lot about myself and this amazing thing a woman gets to go through.

 1st Trimester

2013-09-11 09.29.05-2As we all know, this is the trimester most women feel sick and fatigued.  I definitely had my moments of not feeling well, but I did notice this was often associated with my diet.  I went into pregnancy aiming to eat the “perfect pregnancy diet” (if there’s such a thing).   I truly believe this is THE most important time to eat healthy.  Not only are we giving our bodies nutrients to be healthy and strong enough to create a healthy baby, but these are also the foods our baby is taking in and using to develop.  Some excellent resources for pregnancy dietary guidelines include: 1) Healthy Baby Code by Chris Kresser, 2) The Better Baby Book by Lana and Dave Asprey and 3) The Nourishing Traditions Book of Baby and Child Care by Sally Fallon

Diet

A couple things I focused on throughout my pregnancy included:

1.  Real, unprocessed foods as much as possible.

2.  Animal protein (beef, chicken, turkey), organic when possible.  Protein aversion is common during pregnancy because urea (by product of protein) synthesis is decreased.  It is important to listen to your body if you are having aversions.  It is likely telling you that it can’t keep up with the elimination of protein.  Also consider other protein sources, such as whey protein or full-fat dairy if animal protein sources don’t sound good.

3.  Fish: 6 oz 3x/week.  Fish is high in DHA, which is incorporated into the rapidly developing brain during pregnancy and through the 1st 2 years of infancy.  Unfortunately, a fear of eating too much fish during pregnancy has been engrained into female’s heads.  However, the benefits of eating quality sources of fish outweigh the possible cons.  One of the cons is the mercury content but, mercury that is only a problem in fish that don’t contain equally high levels of selenium.   Selenium basically binds to mercury, preventing the adverse effects of mercury toxicity.  Most ocean and fresh water fish do not have more mercury than selenium

  • Best sources: salmon, mackerel, sardines
  • Exceptions (fish to avoid): pilot whale, tarpon, marlin, swordfish, and some shark

 

4.  Organic Eggs: I ate >2/day almost every single day during pregnancy. Egg yolks contain choline, which is particularly important during pregnancy because it helps protects against neural tube defects and plays and important role in baby’s brain development. Eggs also contain DHA, glycine, B12, and other nutrients that are important during pregnancy.

5.  Healthy fats: organic butter or ghee, coconut oil, avocados, olives, coconut (including full-fat coconut milk).  Fat is the most important thing to eat, especially during pregnancy.  Here are a couple reasons why:

^Our biology has evolved to THRIVE on fat.  In fact, throughout the vast majority of evolutionary history, in most cases fat was between 50-80% of calories (Chris Kresser, Healthy Baby Code).

^Breast milk, the perfect food for infants, is actually 55% fat

^It is the preferred energy source for our body.  Like a car, if you give it quality gas it will function better.  Same with our bodies.  They function better on healthy sources of fat, especially saturated fat.   Saturated fat is what provides structure to every single cell in our body

^Fat does not make us fat.  I know gaining excess weight during pregnancy is a common and important concern, but cutting down on fat is not the way to prevent this.

^Fat helps us absorb nutrients found in fruits and veggies.  Many nutrients are fat-soluble, so they need fat to be absorbed and utilized.

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6.  Bone broth. Contains healthy amino acids (break down of proteins), including proline and glycine, which support the nervous system, endocrine system, digestive system, and brain function. Consuming it during pregnancy helps the forming fetus develop new organs, which grow rapidly and need a great deal of nutrients to form correctly.

7.  Fermented vegetables: raw or “live” sauerkraut, pickles, kim chi.  To be considered “live,” they should be found in the refrigerated section at the grocery store.  Bubbies is a common brand found at Whole Foods and other super markets.

8. Fermented dairy: kefir or yogurt. There are not may truly fermented dairy options sold in grocery stores or even health markets.  You would ideally want to make your own.

9.  Veggies, especially dark green leafy veggies, such as kale, spinach, collards, beet greens and mustard greens.  Along with folate, these are also good sources of vitamin K.  Vitamin K is particularly important during pregnancy as it plays an important role in bone health (for both baby and mom).  Deficiency in vitamin K is very common and can cause crooked teeth, underdevelopment of the face, jaw, and sinuses, and can increase the susceptibility to cavities.

10.  Starchy tubers: potatoes, sweet potatoes, yucca, taro, plantains.  These are good sources of carbohydrates.  They provide a less toxic sources of carbohydrate, glucose, which our body needs to function well. Keep in mind we don’t need as much carbohydrate as typically recommendations promote.  We only need ~400-600 calories from glucose, which equates to ~100 grams including that which comes from non-starchy vegetables. Our bodies are actually more insulin resistant during pregnancy.  Throughout history, glucose and sugar containing foods were scarce.  In order to respond to the glucose needs of the baby, the mother’s body naturally responded by becoming insulin resistant.   This allowed sugar that was taken in to stay in the blood so it could cross the placenta and reach the fetus, as opposed to being packed away into cells.  This, along with the high recommendation and consumption of carbohydrates is likely why gestational diabetes is so common.

 

Supplementation

Although getting your nutrients from food is best, this isn’t always possible, especially during pregnancy when appetite is limited.  Here is a list of the supplements I took throughout most of my pregnancy.

thorne prenatal1.  Prenatal Multivitamin. Most prenatal multivitamins out there are not pure or even effective.  Many of them contain added fillers, preservatives, and colorings.  Many do not contain the optimal form of nutrients.  The nutrient that is particularly important before and during pregnancy is folate.  Most prenatals contain a form of folate (such as folic acid) that the majority of people do not convert to it’s active form.  It is important to look for a prenatal that contains the already active form of folate (such as L-5-Methyltetrahydrofolate, methylfolate and folinic acid).  Like I mentioned, there are very few out there, so I HIGHLY recommend Thorne’s Basic Prenatal (use my code to order: HCP1062798).  It is also formulated to decrease the likelihood of causing nausea and stomach upset

2.  Fish oil and/or cod liver oil.  Both contain omega-3 fats, EPA and DHA, and cod liver oil contains the additional benefit of having a naturally balanced source of vitamin A and vitamin D.  Vitamin A is important during pregnancy because it promotes full-term pregnancy, development of the face, kidneys and lungs, and prevents prolonged labor, deafness and internal organ displacement.

3. Desiccated Liver.  I put this under supplement because I didn’t want to cook liver while I was pregnant.  Liver is probably the most nutrient-dense food.  It has a ton of fat-soluble vitamins, like vitamin A (benefits mentioned above), absorbable iron (helps prevent miscarriage and anemia), B12, zinc, and folate.

4.  Probiotics.  Babies’ actually culture their beneficial gut bacteria from what they receive from their mother when passing through the birth canal and from nursing.  Adequate beneficial gut bacteria can help decrease the risk of ear infection and illness in the first few years of life.  Taking probiotics while pregnant can also decrease the chance of getting sick, having common digestive issues, such as constipation, and may reduce the risk of Group B strep, which is tested for at 36 weeks.

5.  Vitamin D.  Vitamin D, along with calcium and phosphorous, are required to help the fetal skeleton grow and for proper bone and lung development.  Vitamin D deficiency is very common with about ½ of Americans being deficient.  Then on top of that, during pregnancy, the rapid skeletal growth taxes the mother’s vitamin D, causing levels to drop even more over the course of the third trimester.  Sunlight is a great way to get vitamin D, but often is not enough, making supplementation recommended.

6.  Magnesium.  Taking magnesium during pregnancy is important as it the most commonly deficient mineral (up to 80% of the population is deficient).  Magnesium deficiency can lead to poor fetal growth, preeclampsia, and even fetal death.  Magnesium also helps with proper tissue growth and recovery for mom during pregnancy.  Lastly, certain forms of magnesium, such as magnesium citrate can help relax bowels to improve constipation, which his a common symptom during pregnancy.

7.  Vitamin B6:  I took additional vitamin B6 during the 1st trimester as it can help with nausea.

Caveats and Tips

So, like I mentioned in this beginning of this blog, I was not perfect.  I think it’s really important to listen to your body’s signals and respond in the healthiest way possible, but while giving yourself some slack.   Looking at my journal I tried to keep during pregnancy, at 9 weeks I wrote about wanting grilled cheese and tomato soup. I remember I made it with some gluten free bread (Udi’s brand) and some grass-fed cheese and got some organic tomato soup.  The list above is guidelines, but not rules.  Everyone is different and will thus respond differently to pregnancy.  Here are a couple of things that helped me during he 1st trimester.  They may or may not work for you.

1.  Eat right when you wake up.  For me this was gluten-free oatmeal.  This helped bring my blood sugar back up after an overnight fast.  I would then I would have a larger breakfast later.  Here was one of my favorites: of eggs, chicken sausage (Applegate Farms), spinach, hot sauce, and a One Minute Muffin.

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2.  Eat something before going to bed.  This should ideally be something with a little carbohydrate plus fat and/or protein.  You don’t want to do carbohydrate by itself, such as fruit, as this will cause a rise and then a drop in blood sugar, which can wake you up in the middle of the night.  For me, this was goat’s milk yogurt with some protein powder and some times some nuts.  Sometimes I would have some gluten free oatmeal here too

3.  Have some healthy carb choices around.  Although pregnancy is not a time to go crazy on carbs, I found that I did need a little bit more during the 1st trimester.  I had some gluten free Nut Thins and fruit around to supplement my diet when I felt I needed more carbs.  Potatoes and squash are good options to add to meals and plantain chips can be a nice snack higher carb snack.  I really didn’t crave sweets.  I was actually repulsed by them during the 1st trimester.  I know some say you crave more sweets when it’s a girl and more salty foods when it’s a boy.  But, I also think it has to do with how well you are doing at balancing your blood sugar.  Eating high sugar foods is not the way to balance it.  It will give you that initial relief from low blood sugar, but the spike will quickly produce a drop, causing a vicious cycle of wanting more and more sweets.

4.  Give yourself some slack on planning meals.  Although I didn’t have a lot of cravings, some foods sounded good at certain times.  My breakfast remained pretty stable, but lunch and dinner often depended on what I felt like.  Whole Foods salad/hot food bar was my best friend (although not financially).  It allowed me to choose what I wanted at that time.

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5.  Give yourself some slack with workouts.  I was often not up to heavy, high intensity workouts.  However, just getting out for a short walk helps relieve fatigue.  The FitBit helped give me that little extra push to get my steps in.  In addition to feeling more fatigued,  I felt breathless/shortness of breath during the 1st trimester.  This happens because your body becomes more sensitive to levels of carbon dioxide that you breathe out, allowing it to process oxygen and carbon dioxide better.  The result though is that you breathe much more deeply each breath, which causes the breathless feeling.

Bottom line: do something light each day, such as walking, but don’t worry if you can’t workout the way you used to.  It will get better during 2nd trimester.

I hope these recommendations and tips helps you during your first trimester and throughout pregnancy.

 

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My True Health R.D. 2011 Andrea Mc Daniel, R.D.