Nutrition During Pregnancy - Michigan Medicine

HEALTHY EATING TIP OF THE MONTH—OCTOBER 2019Nutrition DuringPregnancy1

NUTRITION TIPS FOR PREGNANT MOMSMaking Healthy Food ChoicesFind your own style of healthy eating that includes a variety of foods from all food groups;fruits, vegetables, grains, dairy, and proteins.Fill half your plate with fruits and vegetables, include a variety of colors in both groups.Make at least half your grains whole grains; brown rice, oatmeal, whole grain breads/pastas.Have a variety of protein foods throughout the week; seafood, poultry, eggs, low-fat dairyproducts. Include plant based proteins; beans, peas, nuts, seeds, and soy products.SeafoodDaily Food Checklist2nd & 3rdTrimestersFood Group1st TrimesterFruits2 cups2 cupsVegetables2 1/2 cups3 cupsGrains6 ounces8 ouncesProtein Foods 5 1/2 ounces6 1/2 ouncesDairy3 cups3 cupsThe Omega-3 fats in seafood have manyhealth benefits for you and your baby. Eat 8 - 12oz per week of a variety ofseafood. Choose seafood that is higher inomega-3 fats and lower in mercury(salmon, sardines, trout, *tuna) *Limit intake of albacore tuna to 6oz perweek. Avoid: tilefish, shark, swordfish, and kingmackerel, as they are highest in mercury.Get a Daily Food Checklist for moms designed just for you.Go to ChooseMyPlate.gov/ChecklistPhysical ActivityMake physical activity a part of your dailyroutine! Aim for at least 2 1/2 hours per weekof moderate intensity physical activity such as: Swimming, walking, gardening, dancing. Do the activity for at least 10 minutes at atime and spread them throughout the week.*Avoid activities with a high risk of falling orInjury; talk with your doctor about what typesof physical activity are safe for you.Remember: Visit your doctor regularly Pregnant women need to avoid alcoholand smoking. Ask your doctor aboutcaffeine, dietary supplements, and druguse. In addition to a balanced diet, take aprenatal vitamin and mineral supplementcontaining folic acid. Feed your baby only human milk(breastmilk) for the first 6 months.2

MICRONUTRIENT NEEDS DURING PREGNANCYWhat are micronutrients?A large group of nutrients includingvitamins and minerals that are essential forWhy are micronutrientsImportant During pregnancy?During pregnancy you have tonearly all physiological functions. They aremeet the needs of your developing babyreferred to as micronutrients because theyin addition to your own. This is true forare required in much smaller amounts thanboth macro- and micronutrients but itthe macronutrients (proteins, carbohydrates,can be hard to know how much youand fats). While the amounts may be small,need and how to make sure you arethey play very large roles in human healthgetting the right amounts of the variousand the development of your growing baby.micronutrients during pregnancy.WHY TAKE A PRENATALVITAMIN?As you need increased amounts of certainvitamins and minerals during pregnancy, itcan be challenging to ensure you are gettingthem all through your diet. Prenatal vitaminscan act as a nutritional safety net, in combination with a balanced diet, to ensure that youare meeting your increased needs and theneeds of your growing baby.Tips for taking Prenatal Vitamins: Start taking a prenatal vitamin as soon as you findout your are pregnant. Talk with your doctor about any other vitamin ormineral supplements you are taking to make surethey are safe for you and your baby. Take only the recommended dosage of yourprenatal vitamin. Certain micronutrients can beharmful to your baby if taken in large amounts.Your doctor may be able to write aprescription for prenatal vitamins, whichcould reduce your out of pocket cost.If you experience side effects from yourprenatal vitamin, talk with your doctor aboutswitching to a different dose or brand whichmay help alleviate some of the side effects.3

MICRONUTRIENT NEEDS DURING PREGNANCYMICRONUTRIENTS OF SIGNIFICANT IMPORTANCE DURING PREGNANCYNutrientFunctionsRecommendedDietary SourcesTotal IntakeVitamin A Involved in fetal growth, tissue and boneformation and repair, and immunefunction. Vitamin A toxicity can lead toliver dysfunction and birth defects.770 (μg/day)*Avoid supplements with highvitamin A content Vitamin D Involved in immune function, brain healthand important for the absorption of calcium.15 (μg/day) Milk, yogurt, fortified cereals oily fish, mushrooms*The number one source isexposure to sunlightFolate or Adequate intake of folate before/duringFolic Acid pregnancy is key to reducing the risk ofbirth defects of the brain and spinal cord.600 (μg/day) Dark green leafy vegetablesCitrusEnriched grain productsVitamin C Component of connective tissue, keyantioxidant, important for enhancing theabsorption of iron.85 (mg/day) Many fruits and vegetablesCitrus, guava, tomatoes, broccoliCalciumEssential for bone health and development, important for muscle and nervefunction as well as enzyme and hormoneactivity.1000 (mg/day) Dairy products (milk, yogurtetc.)Dark green leafy vegetables,beans, peas, nuts, seedsIronCarries oxygen throughout the body,important for brain development,metabolism and immune function.27 (mg/day) Red meat, fish , poultryGreen leafy vegetables, beans,nuts, eggs, dried fruitSeleniumInvolved in cardiovascular and immune55 (μg/day)function, reduces harmful effects of heavymetals and is a key antioxidant duringpregnancy. Red meat, fish, poultryDairy products, eggs, oatmeal,brown rice, nuts, seedsZincImportant for enzyme activity, cell division, gene expression, wound healing,vision, neurological, and immune function. Red meat, fish, poultryMilk, nuts*While all micronutrients are important forthe health of you and your baby, this tablefocuses on the micronutrients with increasedrecommended intake during pregnancy andthose of particular importance for fetal development. 11 (mg/day)Eggs, dairy, liver, fish liver oilKale, sweet potato, carrots*The “Recommended Total Intake” values above indicate the totaldaily intake from dietary sources and supplements.*The recommended intake values included above are generalguidelines for uncomplicated pregnancies. Talk with your doctor ora Registered Dietitian Nutritionist to determine what micronutrientlevels are best for you.4

FOOD SAFETY DURING PREGNANCYWhy is Food Safety Important During pregnancy?During pregnancy yourbody goes throughimmunesystem changes. This puts youand your baby at an increasedrisk of foodborne illness such asListeria and Toxoplasma gondii,which can lead to birth defectsand pregnancy complications.Many foodborne illnesses caninfect and harm your baby even if you do not feel sick. For these reasons it is important topay extra attention to food safety practices while you are pregnant and breastfeeding.Foods to AvoidRaw seafoodMay ContainFoods to Eat InsteadParasites or bacteriaSeafood cooked to 145 FUnpasteurized juice, cider,and milkE. coli or ListeriaPasteurized versions of juice, cider, and milkare safer options.Soft/unpasteurized cheesesE. coli or ListeriaHard/pasteurized cheesesPremade deli saladsRaw sproutsListeriaMake these dishes at homeE. coli or salmonellaThoroughly cooked sproutsCold lunch meats/hot dogsUndercooked meat andpoultryListeriaReheat all deli meats to steaming hot (165 F)E. coli, Salmonella,Campylobactor,Toxoplasma gondiiMeat and poultry should all be at or abovethe USDA recommended internaltemperatureSafe Internal Cooking TemperaturesRemember Wash hands and surfaces often Keep raw meat and poultry separate from Beef, pork, veal, lamb, (roastsand chops) and fish145 FEgg dishes, ground beef, pork,veal and lamb.160 FWhole, ground, or pieces ofchicken, turkey and duck165 F ready-to-eat foods.Cook foods to the proper internal temperature Get leftovers in the fridge within 2 hours ofbeing cooked.5

WEIGHT GAIN DURING PREGNANCYWhy is appropriate weight gainduring pregnancy important?The amount of weight you gain duringStudies have found that only about1 out of every 3 women havepregnancy weight gain within therecommendations.your pregnancy is a predictor for fetal growthGainedRecommendedAmountGained Too Littleand development and maternal health. Gainingthe right amount of weight during pregnancy isessential to ensure the health of both motherGained Too Muchand baby. Gaining too little or too much can putyou and your baby at a risk for complications.Risks associated withgaining too much: Delivery complicationsCaesarean delivery (C-section)High birth weightGestational diabetesMaternal hypertensionObesity during childhoodDifficulty losing extra weightafter deliveryRisks associated withnot gaining enough: Low birth weightPreterm deliveryDifficulty breastfeedingIncreased risk of illnessDevelopmental delaysHow much weight should I gain?The amount of weight you should gain isbased on many factors, including your prepregnancy body mass index (BMI), your age, andwhether or not you are carrying multiples. Thesetables provide general guidelines for pregnancyweight gain recommendations for adult womenpregnant with one baby. Teenagers and womenpregnant with twins or more, talk with your doctor about your weight gain goals.Recommended Weight Gain for WomenPregnant with One BabyPre-pregnancyBMITotal WeightGain inPoundsWeight Gain in the2nd & 3rdTrimesters inPounds per WeekUnderweightBMI less than18.528 - 401 - 1.3Normal WeightBMI 18.5 - 24.925 - 351OverweightBMI 25.0—29.915 - 250.6ObeseBMI of 30 orhigher11 - 200.56

WEIGHT GAIN DURING PREGNANCYAre You Experiencing Weight LossDue to “Morning Sickness”?“Morning sickness” can occur atany time of day or night and varies frommild to severe nausea and vomiting duringpregnancy. If you are struggling to meetthe weight gain recommendations becauseof morning sickness, it may help to eatsmaller, more frequent meals throughoutthe day to avoid getting too hungry or toofull. It is important to stay hydrated bydrinking plenty of water or unsweetened,un-caffeinated beverages. Contact yourdoctor if you experience extreme morningsickness or significant weight loss.Are You Experiencing Rapid WeightGain?If you begin to rapidly gain weight(2 pounds or more within 1 week) youshould contact your doctor because asudden increase in weekly weight gainabove the recommended amount can be asign of preeclampsia which is a very serioushealth condition that can cause pregnancycomplications.Tips to Help You Meet the Recommendationsfor Weight Gain During PregnancyEat a balanced diet: Include all food groups and choosevegetables, fruits, whole grains, low fat dairy, lean protein,and water over processed foods and sugar sweetenedbeverages.Remember: Making healthy food choices will help youand your baby get the nutrients needed to support thegrowth and changes that occur during pregnancy and fetal development.Know your calorie needs: “Eating for two” does not meanyou should double your calorie intake. First trimester - extra calories are generally not neededduring the first 3 months of pregnancy. Second trimester - About 340 additional calories perday are needed during the second 3 months ofpregnancy. Third Trimester - About 450 additional calories perday are needed during the last 3 months of pregnancy.Track your weight gain: Document your weight at thebeginning of your pregnancy and track how much you gainthroughout your pregnancy to compare to therecommendations.Include physical activity: The goal is to maintain at least150 minutes (2.5 hours) per week of moderate intensityaerobic activity. Talk with your doctor about what types ofphysical activity are safe during your pregnancy.7