Pregnancy Nutrition

What foods are best to eat while I’m pregnant? I've had this question come up a few times recently with patients. So let's get into it.

Eat as much nutrient rich, whole foods as possible. Eat a wide variety of foods. Make sure you are choosing foods from all food groups: fruit, vegetables, grains, meats, beans, dairy, and healthy fats and oils. A growing baby will need food from all of these food groups. One thing is for certain, even though you are eating for 2, you don't need to double your calories. In fact, through the first trimester you don't need to eat any more than what you are currently used to. In the second and third trimesters, you can increase calories by about 300 and 450 calories respectively. But, what to eat. Let's break it down for you.

Nutrients in Food

Protein - In the 1st trimester eat 5 1/2 ounces per day and in the 2nd & 3rd trimesters 6 ½ ounces per day. Here are examples of 1 ounce of protein.

• 1 egg
• 1 tbsp peanut butter
• ½ ounce nuts
• ½ cup cooked beans
• 1 oz. fish, meat or poultry

Good sources of protein include lean meat (chicken, turkey, fish), low-fat dairy products (eggs, cheese, milk, yogurt), beans, nuts, nut butters.

Eat about 12 ounces of fish per week. Choose types of fish that are low in mercury content (tuna or salmon). Avoid fish high in mercury (swordfish, shark, king mackerel, albacore tuna). To learn more about what fish are safest to eat, visit www.doh.wa.gov/communityandenvironment/food/fish/healthyfishguide.aspx.

If fish is not appealing to you choose other dietary sources of DHA like: walnuts, wheat germ or omega-3 enriched eggs.

Fat
YOUR BABY NEEDS FAT. Eating low or no fat during pregnancy is not recommended. Choosing healthy fats is important for your overall health and for your baby. Choose fats like: olive oil, fatty fish (salmon), avocados, seeds, nuts, nut butters.

Read food labels and avoid anything with ‘hydrogenated or partially hydrogenated fat’. These contain trans fat.

Dairy is another great source of fat.  Aim for 3 cups of dairy per day.  A 1 cup serving equals: 

• 1 cup milk or yogurt
• 1 ½ ounces hard cheese

Carbohydrates

Fruits and Vegetables
Fruit and vegetables are GREAT and very healthy sources of carbohydrate. Choose dark and brightly colored fruits and vegetables – they are great sources of vitamins and minerals. Eat whole fruit instead of drinking fruit juice.
Aim for 2 1/2 cups vegetables per day and 2 cups of fruit. Eating a wide variety, and lots of different colors is best!

Grains
Choose whole grains like whole wheat bread, brown rice, whole grain pasta, oatmeal, barley, quinoa, bulgar, millet, and kasha. Limit refined carbohydrates like: sweets, cookies, sodas, instant oatmeal, and instant rice.

Aim for 6 ounces in your first trimester and 8 ounces in your 2nd and 3rd trimesters. 
1 ounce =

• 1 slice of bread
• ½ cup oatmeal
• ½ cup cooked rice, pasta
• 1 6-inch tortilla

Fluids
Drink enough water so that you never feel thirsty and so that your urine is light in color. Many pregnant women carry a water bottle with them to make sure they are drinking enough water.

Limit intake of juice and other sweetened beverages.

Do not drink any alcohol.

Limit intake of caffeine to 200 milligrams (about 1 cup of coffee) per day. If you are currently drinking more than that, cut back slowly.

Food Safety Considerations
During pregnancy, you have a higher chance of getting infections and illnesses from certain foods. Some basic food safety practices can greatly reduce your chance of becoming ill. Remember to:

• Wash hands before, during and after you prepare food.
• Keep the area where you prepare and eat food clean.
• Wash fruits and vegetables before you cook or eat them.
• Keep meat, fish and poultry separate from all other foods. Use a different cutting board for them.
• Avoid eating from salad bars, deli counters, buffets, sidewalk vendors and food carts.
• Avoid unpasteurized cheese, milk and juice. Soft cheeses like feta, Brie, Gorgonzola, Camembert, and queso fresco are often unpasteurized. Read labels carefully.
• Avoid foods made with raw or undercooked eggs (cookie dough, Caeser salad dressing, homemade ice cream).
• Put food in the fridge right after cooking and serving. Do not eat cooked food and food that needs to be stored in the fridge if it has been out of the fridge for more than 2 hours.
• Fully cook eggs and meats. Avoid eating raw or undercooked meat, fish and poultry. Be sure to heat to the following internal temperatures:

~Fish and beef roasts to 145° F
~Eggs and meat (including pork) to 160° F
~Poultry breast to 170° F
~Whole poultry to 180° F
For more regarding food safety while you are pregnant, visit:
www.foodsafety.gov/poisoning/risk/pregnant/chklist_pregnancy.html

Other Considerations
Nausea and Vomiting
Pregnancy is not the time to lose weight. Talk with your pregnancy care provider if you are: vomiting, lose your appetite, lose weight.
If you do lose your appetite, do NOT stop eating. Try these tips:

• Eat small snacks or meals every 2 hours, so your stomach is never empty.
• Eat a few crackers before getting out of bed in the morning.
• Eat a snack of protein, like cheese, eggs, meat, or nuts at bedtime.
• Try different textures like: smooth pudding or crunchy cereal.
• Try eating crystallized ginger or drinking ginger tea or ginger lemonade.

Cravings and Food Aversions
Changes in hormones during pregnancy can cause food aversions (a strong dislike for a certain food) and cravings. If food aversions are keeping you from being able to eat the food you need, try:

• Mild flavors and vegetables
• Smoothies with protein power added
• Non-meat sources of protein like cheese, beans, or eggs

It is okay to indulge in your food cravings once in a while. Be aware of your serving sizes of high-calorie foods like ice cream. Try to eat an overall healthy and balanced diet.
Some women have cravings for nonfood items like clay, dirt, paper, laundry starch or ice. This is called pica. Tell your pregnancy care provider if you are craving these non-food items.
 
Premature Fullness
As your baby grows, you will feel full from less food, when you need more calories. To avoid discomfort, try to eat smaller meals more often.
 
Activity and Exercise
Exercise is good for you and your baby. It can help ease stress, aches and pains, improve circulation, and prepare you for a healthy delivery.
Try to get 30 minutes of activity every day, even if it is just walking to a nearby park.
It is usually safe to keep doing your normal exercise early in pregnancy. Drink plenty of water and if you are questioning if something is safe check in with your pregnancy care provider.
It may be harder to exercise later in pregnancy due to discomfort. Do what is comfortable without excess strain.
It is safe to continue sexual activity.
Avoid hot tubs and saunas.
When having a massage or pedicure tell the professional working with you that you are pregnant there are some pressure points that can induce labor for them to avoid.
Consider stress relieving activities like yoga and stretching with breathing exercises, this will help with increased circulation.
 
 
Meal Ideas
Coffee and tea are okay to drink during pregnancy, but limit to 1 cup per day.
Try to include carbohydrates, protein and fat at all of your meals, here are some examples.
Breakfast
Well-cooked egg or peanut butter with whole grain toast and a piece of fruit.
Granola or whole grain cereal with milk or plain yogurt, added berries or banana.
Whole grain pancakes with cottage cheese and fruit.
Mid-morning Snack
Plain yogurt with fruit.
Hummus and carrots.
Apple with nut butter.
Lunch
Sandwich on whole grain bread with grilled chicken breast and vegetables.
Rice and beans with cheese and tomatoes; an apple; small green salad.
Turkey sandwich with lettuce and tomatoe on whole grain bread; milk; an apple.
Mid-afternoon Snack
Cheese or hard boiled egg; whole grain crackers.
Small handful of trail mix.
Peanut butter on whole grain toast.
Dinner
Tortilla with rice, beans, cheese, bell pepper and onion; melon cubes.
Lean beef cubes over noodles with cooked green beans; ½ an orange.
Chicken and potato casserole with broccoli and onions; raw carrot and cabbage slaw.
Fish with sweet potato; cooked cauliflower and green salad.
Stir fry vegetables with brown rice; glass of milk
Evening Snack
Cheese and fruit.
Small bowl of low sugar cereal and milk.
An egg, carrot sticks.