Fresh fruit = vitamins & minerals!!

Question:

How many extra calories do you need in each trimester to offset the metabolic cost of pregnancy?

Answer:

First trimester — 0; Second trimester — 300; Third trimester — 500 (source: Institute of Medicine).

Keep in mind that you may also need calories for any fitness program you are doing. If you are continuing a program, the only change is due to the pregnancy.

If you begin or increase your activity, you need to take that into account. One yoga class = 100 — 150 calories. One aerobics class = 200–400 calories. Walk one mile = 100 calories.

1 slice whole grain bread = 50–100 calories

Be sure you read food labels so that you can balance your food intake and your calorie output. A small woman (under 5’3″ & 130 lbs.) probably needs about 1200 calories per day as a base. A medium sized woman needs about 1400, and a large woman (over 5’9″ & 160 lbs.) probably needs 1600 to 1800 calories. Add your activity and pregnancy needs to your base amount.

Question:

What foods are necessary for a healthy pregnancy?

Answer, part A:

PROTEIN. Lean proteins like turkey and those with omega 3 fats like ocean fish and eggs.…yes! EGGS!

Turkey is a good protein

Ocean fish 1 or 2 times/wk = good protein & omega 3 fat

Eggs are a perfect pregnancy food!

70–90 grams of protein are necessary each day, along with  adequate water.  These are needed to make an extra 40% blood volume required to support the placenta.

Answer, part B:

WATER. Two (2) quarts of water…more if you are very active…are needed to make extra blood and to prevent dehydration.

Question: What else?

Fresh vegetables also provide fiber

Answer: CARBS. Fresh, colorful fruits & veggies provide necessary vitamins and minerals, as well as fiber. Eat 5 servings a day from all the colors:  yellow, orange, red, purple and green, and you will get live vitamins all day long that help your baby develop properly! Fruits, vegetables and whole grains are low glycemic index carbohydrates — the good ones!

Dairy provides calcium

Question:

Do I need dairy products and red meat? Can I get the needed minerals in other ways?

Answer:

Calcium is needed in adequate amounts for bones and teeth. It is most easily obtained by drinking milk or eating cheese, yogurt or cottage cheese. Soy, dark green leafy vegetables and calcium fortified juice are alternatives.

Iron is necessary for red blood cells to take up oxygen. It is found in high amounts in beef,  and lesser amounts in raisins, spinach, and prune juice. Prenatal vitamins are your insurance against deficiencies of these essential minerals.

Question:

Anything else that’s essential?

Answer:

Yes! Healthy FAT!!

Avocado is an excellent source of omega 6 fat

In addition to omega 3 fats found in fish, walnuts and flax seeds, you need also need omega 6 fats, which are found in avocados, olive oil and other vegetable oils. Healthy fats help balance cardiovascular constriction and dilation, reducing the risk for hypertension.

Last Question:

What is a healthy weight gain?

Answer:

In 2009, the National Academy of Sciences revised its recommendations. It now bases desirable weight gain on pre-pregnancy BMI (Body Mass Index…google this!).

BMI less than 18.5 (low) — 28 to 40 lbs.; BMI between 18.5–24.9 (normal) — 25 to 35 lbs.; BMI 25.0 to 29.9 (high) — 15 to 25 lbs.; obese women (BMI over 30.0) — 11 to 20 lbs.

Coming Next: Avoiding Risks.

Why do you suppose the American College of Nurse Midwives and the American College of Obstetricians and Gynecologists recommend the minimum time between pregnancies to be two years? Why is it critical to eat foods high in B vitamins (including folic acid) and calcium during the childbearing years? How does your exercise regimen in the six months prior to conception affect your risk for some disorders of pregnancy, such as preeclampsia?

Answer:  Your preconception or interconception behavior affects the course and outcome of your pregnancy. As it turns out, it takes about two years for a mother’s body to replenish her stores between pregnancies. Prior to a first pregnancy, behavior in the six months leading up to conception has been shown to affect outcome.

During pregnancy, nutritional and functional resources must support two beings in one body, one of whom is growing at a very fast speed by biological standards (think cell time NOT computer time). Essential vitamins and minerals (such as B vitamins and calcium) are taken from the mother’s body — already in metabolic stress due to demands on the kidneys and liver to clear toxins and filter metabolic waste from the fetus as well as the mother.

Insuring that maternal stores of valuable nutrients are adequate to provide for both fetus and mother is a job that only the potential mother can do. By eating a balanced and colorful diet of proteins, fruits and vegetables, whole grains and essential fatty acids (omega 3’s and 6’s — fish, walnuts, olive oil, avacado, eggs), as well as adequate aerobic exercise leading up to and during pregnancy, a woman improves her odds for a healthy infant. Smart behavior reduces her risk for conditions that cause immune system and cardiovascular disorders that disturb implantation, blood pressure and blood flow to essential organs.

Further, avoiding risky behaviors that may lead to systemic infections, metabolic syndromes or malnutrition leading up to conception is an aspect of behavior known as “risk-aversion” -  the ability to avoid behaviors that have negative consequences. Infection at the time of conception (to be discussed in a future post), an extreme lifestyle (either sedentary or anorexic), toxic food choices, drugs, tobacco and alcohol are all behaviors that incur risk for poor pregnancy outcomes, including prematurity and low birth weight — outcomes  on the rise in the U.S.

As discussed in the previous two posts, behavior is intertwined with genetics and environmental influences. Having a certain gene mutation or an environmental risk may predispose a woman to possible problems in pregnancy or the development of certain cancers, but some behaviors — especially exercise — may mitigate this potential or reduce the severity or course of disease. Behavior is the area in which we have the greatest control. Exercise, healthy nutrition and risk aversion are the three areas in which women can exert control over their destiny as moms-to-be. It’s a difficult set-up. We live in a time of instant gratification of personal acts. But, motherhood is a long-term commitment to the biological and psychic wellbeing of a new human who is — and is not — us.