Pregnancy: Your Guide to Eating Right (cont.)
Erica Oberg, ND, MPH
Dr. Erica Oberg, ND, MPH, received a BA in anthropology from the University of Colorado, her doctorate of naturopathic medicine (ND) from Bastyr University, and a masters of public health (MPH) in health services research from the University of Washington. She completed her residency at the Bastyr Center for Natural Health in ambulatory primary care and fellowship training at the Health Promotion Research Center at the University of Washington.
Melissa Conrad Stöppler, MD
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
In this Article
- Goal setting for eating healthy during pregnancy
- Foods that comprise a healthy diet during pregnancy
- Foods to avoid during pregnancy
- Weight gain during pregnancy
- Dieting during pregnancy
- Vegan and vegetarian diets
- Low carb diets
- Getting enough protein
- Getting enough calcium, even if you are lactose intolerant
- Getting enough iron, even if you don’t eat meat
- Getting enough folate
- Getting enough Iodine
- Getting enough zinc
- Getting enough vitamin D
- Supplements, herbs, and over-the-counter (OTC) medications
- Foods that may help when not feeling well during pregnancy (morning sickness, heartburn)
- Find a local Obstetrician-Gynecologist in your town
Weight gain during pregnancy
As mentioned before, pregnant women only need about 300 extra calories per day. While every woman is going to be different, research shows that for a normal weight woman (BMI 18.5 – 25), the optimal pregnancy total weight gain is about 25-35 pounds7. Larger women will gain less and smaller women gain more. All women should decrease their focus on weight and focus on the quality of their diet, ensuring good nutrition.
- BMI <18.5 kg/m2 (underweight) - typically gain 28 to 40 lbs.
- BMI 18.5 to 24.9 kg/m2 (optimal weight) - typically gain 25 to 35 lbs.
- BMI 25.0 to 29.9 kg/m2 (overweight) - typically gain 15 to 25 lbs.
- BMI ≥30.0 kg/m2 (obese) - typically gain 11 to 20 lbs.
During the first and second trimesters, weight gain manifests as an increase in maternal fat stores, plus a 60% increase in blood volume. Later in pregnancy, more of the weight gain is due to the fetal growth, amniotic fluid, breast development, and placenta. Overweight women sometimes even experience weight loss during the first trimester and slowly gain a small amount over the second and third trimesters. There are no minimums on the amount of weight an overweight woman needs to gain as long as she is eating micronutrient dense foods and fetal growth is on track.
Dieting during pregnancy
Regardless of the weight a woman is at when she becomes pregnant, it isn't a good idea to diet during pregnancy. Research from famines during world war II in Europe have taught us about the epigenetic implications of restriction during pregnancy. Epigenetics describes the impact of the prenatal environment on the genetic programming of the child that stays with them for life. In fact, the prenatal environment has an impact on the developing ovaries and eggs in the female fetus, having an impact on the next generation too! A mother's nutritional choices during pregnancy can affect her grandchildren!
Because of famines in World War II, pregnant Dutch women lived on less than 900 calories a day for a winter and their metabolism became very efficient at storing energy. When the war ended and food supplies were normal, and the babies were born, the women and their babies had normal intake. However, those babies were far more likely to go on to become obese or develop diabetes because their genes were influenced in the time of scarcity. In the same way, dieting during pregnancy can have unintentionally metabolic consequences on the genetic programming of the infant that will stay with them for life.
While dieting (restricting calories) during pregnancy is discouraged, eating a healthier diet by removing extra sugar and processed foods is an excellent idea. This is the type of "diet" I put all my patients on. The focus should be on high quality nutrition, optimizing micronutrient intake, and minimizing empty calories.
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