What To Expect To Eat When You’re Expecting: A Comprehensive Review of Pregnancy Nutrition.

Pregnant? Today’s posting will offer you a thorough overview of many of the important nutritional considerations you will need to keep in mind as you progress through your trimesters all the way through until child birth. Pregnancy is a miraculous and wonderful time for most woman, but also a time that requires a little bit more attention to detail when it comes to your dietary practices. This article is not going to bombard you with drastic change, rather it will deliver important information on a few of the nutrition subtletities associated with being pregnant. I am hoping you will be relieved to find that the dietary changes that you will need to consider will not be as dramatic as you might have thought.

How did I end up deciding to write about pregnancy nutriton? Those who have followed my articles will know that I last released an article on how to encourage picky children to eat healthier. While I was writing that article, I recieved news that one of my close friends was pregnant. As soon as I found out, I knew it was time to keep the child theme going write an article on the fundamental nutrition  topics during pregnancy!

Here they are: 

The Fundamental Nutrition Topics during Pregnancy 

1) Fish: You may have heard conflicting information about fish intake during pregnancy. Fish can contain both mercury (bad) and omega-3 fatty acids (good), so it is important to be knowledgeable about the fish you are eating. I will try to simplify the issue for you by sharing these three pieces of Health Canada guidance: 

a) Eat at least two servings ( 150 grams) a week of omega-3 rich fish such as salmon, herring, char, rainbow trout, anchovy, char, shellfish ( shrimp/clam/mussels/oysters) among others. Avoid raw fish and especially raw shellfish. 

b) Eat at most two serving ( 150 grams) a month of mercury rich fush such as frozen/fresh tuna, shark, swordfish, marlin, orange roughy and escolar. 

c) Eat no more than four servings ( 300 grams) of Albacore canned tuna per week. Canned light tuna is a lower mercury option that can be consumed without this restriction. 

2) Foods to Avoid:  Due to the increased risk of foodborne illness to you and your child, there are certain foods which are important to avoid completely during pregnancy. These foods can be seprated into the following groups:

a) Seafood: Avoid raw seafood (such as sushi), raw shellfish (oysters , clams, mussels) and refrigerated smoked seafood ( such as smoked salmon).

b) Undercooked Meat: Any raw or undercooked meat or poultry, such as steak tartar or uncooked hot dogs, should be avoided. Non-dried deli meats and refrigerated pâtés/meat spreads should also be avoided

c) Raw or lightly cooked eggs:  Avoid raw and undercooked eggs and products, such as cookie dough or certain salad dressings, which may contain raw eggs.

d) Cheeses/Dairy: Avoid all raw or unpasteurized dairy products. Avoid all soft and semi-soft cheeses such as Havarti, Brie, Roquefor, Stilton and Camembert.

e) Raw Sprouts: Avoid eating raw sprouts, especially alfalfa sprouts.

f) Unpasteurized Juices: Avoid all unpasteurized juices and ciders.

3) Folic Acid/Folate: Adequate folic acid intake prior to and during pregnancy is extremely important for the prevention of neutral tube defects. The foods richest in folate include dark green vegetables ( kale, chard, spinach, broccoli, asparagus, brussel sprouts, etc), legumes ( beans,peas,lentils) and oranges. Other food items also contain folate. It is also extremely important to supplement your folic acid intake with a multivitamin both before and during pregnancy. See point #5 for specific information on supplementation. 

4) Iron: A pregnant woman needs more iron than the average woman of the same age. According to Health Canada, iron deficiency is the most common nutrient deficiency in pregnancy, occuring primarily in the third trimester. It is very important for both your health and the health of your baby that you consume enough iron during pregnancy. There are two types of dietary iron that you should be aware of:

a) Heme Iron: The iron found in meat, fish, poultry and eggs. Heme-iron is absorbed better by our bodies than non-heme iron.

b) Non-heme Iron: The iron found in plant products such as beas/peas/lentils, tofu, whole grains , enriched cereals/oats/bread and nuts & seeds. Iron found in these foods is not as well absorbed. Consuming vitamin C rich foods at the same time you consume non-heme iron rich foods can greatly increase your body’s ability to absorb non-heme iron. Numerous fruits and vegetables are high in vitamin C. It is also advisable to avoid drinking tea or caffeine during meals containg non-heme iron, as these beverages can restrict iron absorption. 

Regularly consuming a variety of the foods in both groups listed above, in addition to supplementing your iron intake ( see point #5), will help ensure you are getting enough iron. If you had anemia or poor iron status before pregnancy, do not regularly consume vitamin C containing foods or do not consume the iron rich foods listed above, you should seek further guidance from a health professional

5) Folic Acid + Iron Supplementation: In addition to eating a balanced diet and  being mindful of your folic acid and iron intake, Health Canada recommends that pregnant woman ( and those trying to get pregnant) should include a daily multivitamin with at least .4 milligrams of folic acid and 16 to 20 grams of iron. If you are not already, you should be consuming a daily multivitamin with these specifications as soon as possible.

6) Caffeine: Health Canada recommends no more than 300mg of caffeine daily for woman of childbearing age, including those who are pregnant. For more information on what 300mg of caffeine daily might look like, please review this Health Canada Caffeine Resource.  

7) Alcohol: Drinking during pregnancy puts your baby at risk. This is a gentle reminder that staying alcohol free is best for both you and your baby.

8) Nausea and Vomiting: Nausea and vomiting are most likely to appear in the first trimester and can be barriers to healthy eating during pregnancy. If you are suffering from either, I strongly advise you review the nausea and vomiting tips provided by Health Canada.

9) Constipation: Regularly consuming a balanced diet rich in whole grains, fruits and vegetables should help alleviate constipation. Drinking water regularly and exercising in whatever form you can will also help. 

10) Heartburn: Heartburn is another common food-related issue that can arise during pregnancy. One of the best ways to avoid heartburn is to allow yourself more time than usual to digest your food before lying down. Avoiding fried/greasy foods, coffee, pop and extremely large meals amy also help. If you suffer from heartburn, try eating smaller meals and taking your time to chew slowly and thoroughly, don’t rush your meals. 

11) Healthy Weight Gain: Saving the best for last I suppose. Gaining weight is an important reality of pregnancy, particularly during the second and third trimesters. Gaining a healthy amount of weight is very important for the wellbeing and development of your baby. How much is a healthy amount of weight for you? The anwser will vary depending on the person. In order to determine the appropriate amount of weight for you to gain, I recommend visiting Health Canada’s Pregnancy Weight Gain Calculator.  

How should I go about gaining this weight?  Both the quantity of food you eat, and the quality of the food you eat are important here.  Health Canada says it best; Eat twice as healthy, not twice as much. Most women will be able achieve their required weight gain goals by consuming between 2 to 3 extra Canadian Food Guide servings a day, essentially an extra snack each day on top of what they would normally eat. Want a great idea for a quick and easy healthy snack to eat during pregnancy? Take a look at my article on the Ultimate Healthy Snack.

Please keep in mind that the suggestions that I have provided here today will be most easily achieved if you are consuming a healthy, balanced diet. Not all nutrient requirements change during pregnancy, but it is still important to get enough of these nutrients on a daily basis. The best way to do this is to keep both the Canadian Food Guide and this article’s specific points in mind as you go forward through your pregnancy. 

 With that being said, I sincerely hope that today’s article has helped ease some of your concerns about nutrition during pregnancy. For more information on healthy pregnancy, I highly recommend you review Health Canada’s Healthy Pregnancy Resource. Much of the information I provided today was gleaned from this and other reliable Health Canada resources.  I would also like to congratulate my newly pregnant friend Sarah, and all the soon-to-be moms and dads out there who may be reading this. As always, I wish you the best of luck in your food and nutrition endeavours.

Until next time, Eat Up!
Andy De Santis RD MPH