Healthy Pregnancy

Pregnancy Nutrition

When you get pregnant, one of the first things you’re likely to hear is, “You’re eating for two now!” This may be true, but one of you is the size of a peanut.

When it comes to nutrition during your pregnancy, quality is just as—if not more—important than quantity.

Women’s experiences with food during pregnancy can differ greatly. Some women have crazy cravings for very specific things, while for other women, the idea of food in general can be nauseating—and that might change from one month to the next. While it can be challenging, building and maintaining a foundation of good nutrition is a key to keeping you and baby as healthy as possible throughout your pregnancy. Don’t be hard on yourself, you won’t eat perfectly and that’s OK.

Wherever you are in your pregnancy, it’s important to remember that you need to be taking care of yourself first. This may sound selfish, but it’s just like the safety instructions on an airplane… put your oxygen mask on first, before helping others with theirs. One of the biggest “oxygen masks” in this situation (and in your life in general) is to eat a healthy diet for pregnancy and nourish your body. These days “eating healthy” can be very difficult to figure out with all the conflicting information available at your fingertips.

Below you’ll find some easy-to-implement healthy pregnancy diet tips and guidelines that can help you eat more nutritious food throughout your pregnancy.

The Building Blocks of a Healthy Pregnancy Diet

  1. Vegetables and fruits
  2. Lean protein from animal and vegetable sources
  3. Healthful dietary fats
  4. Grains from whole food sources carbohydrates
  5. Water

Why are these healthy pregnancy foods?

Your body needs to carry an optimal amount of body fat in order to provide nourishment and the healthiest “capsule” for your developing baby.

How much should you eat?

We hear serving size recommendations all the time, but most of us are not carrying around measuring cups and a food scale, and have no real idea of what a serving looks like. An easy way to figure out approximate serving sizes that are tailored to you, is to use your hand. You hands are always with you and are proportional to your size. If you’re smaller your hand is smaller, so your serving will be smaller.

Pregnancy Fruits and Vegetables

It turns out Grandma was right when she wagged her finger at you and said, “Eat your vegetables (and fruits)!” Vegetables and fruits are packed with vitamins, minerals, and antioxidants to keep you and your baby healthy. Plus, the fiber aids in digestion and helps you feel full and satisfied.

Ideally, you’re eating 10 servings of vegetables and fruits a day. A serving is the size of your closed fist. This could be one or two handfuls of leafy spinach with your lunch as a salad or wilted into a bowl with protein and carbs; or perhaps a small or medium apple as part of a snack. You can also get several servings at a time by fixing up a big salad with a few of your favorite veggies and chopping it very fine so it doesn’t feel like you’re just munching on leaves.   And try not to let this recommendation intimidate you. If you don’t eat many vegetables or fruits right now, the goal isn’t to start eating 10 servings a day immediately. Just start with adding one serving a day for a few weeks until you’ve mastered that habit, and slowly build from there.

Lean Protein

Protein is crucial for building and maintaining muscle mass both for you and your baby. In fact, protein is a building block for all cells in the human body. Eating adequate amounts of protein will help you be strong and fit for your pregnancy and will aid in your growing baby’s development. Protein will also help you feel satiated, and will keep your energy steady by supporting stable blood sugar. A serving of protein is about the size of and thickness of the palm of your hand. Aim for one serving at each meal, and most snacks if possible. Partial proteins like nuts and nut butters are good choices for snacks as well.

Healthy Fats

You may be worried about eating fat, but healthy fats are vital to your and your baby’s good health. Fats are needed to make hormones, neural tissue and absorb certain vitamins among other things. Some types of fat are absolutely necessary for the healthy development of your baby’s eyes, brain, and nervous system.

A particular group of fats, essential fats (or essential fatty acids) are fats that your body can’t produce. They are called “essential” because you need to obtain them through the foods you eat, like nuts, seeds, fatty fish, oils.

Omega-3 fats are particularly important, and most of us don’t get enough. As adults, omega-3 fats are needed for proper brain function. Your baby will needs them for brain and eye development. This partly explains why many pregnant women experience “baby brain” and feel like they can’t remember anything. When you’re pregnant and breastfeeding and you’re not getting enough omega-3 fatty acids, much of the available omega-3s fat is going to your baby, leaving your brain without what it needs to function well.

Aim to get one thumb-sized serving of healthy fats with each meal. Some examples of healthy fats include: extra virgin olive oil, nuts and nut butters, seeds and seed butters, and avocados. Supplement with fish oil to get your omega-3 fats. We’ll touch more on that in a moment.

Nutrient Dense Carbohydrates: Whole Grains

The quality of carbohydrates you eat matters. Many people eat way more carbohydrates than they actually need for their activity level, and they usually choose processed carbs that have little to no nutrients over more nutrient-dense carbohydrate options.

According to Girls Gone Strong Advisory Board member and Registered Dietitian Dr. Cassandra Forsythe, “We are often told to eat whole grains, but for many people ‘whole grains’ often translates to ‘breads and pasta.’ In my opinion, and the opinion of other nutritionists and registered dietitians, whole grains are really those grains that you can see or feel in your hand, such as brown rice, oatmeal, oat bran, quinoa, teff, and amaranth. These foods are an excellent source of B-vitamins, which act as co-factors in energy-producing reactions in the body. They also are an excellent source of fiber that keeps our bowels functioning normally and helps us to maintain ideal blood cholesterol levels to reduce our risks of heart disease.

Dr. Cass is right. When it comes to making smart carb choices, nutrient density can help guide you. Grains like kamut, quinoa, wild rice, or oats are nutrient-dense carbohydrates. A donut, not so much. Even a bran muffin isn’t nutrient dense. This doesn’t mean you shouldn’t ever have them, but focus primarily on the more nutrient-dense carbs most of the time.

In addition to choosing carbohydrates that offer more nourishment, let your activity level determine the amount you eat. A serving of carbohydrates is approximately one cupped handful. The number of servings you should eat depends on various factors. This article by Dr. Krista Rompolski provides some useful guidelines to help you figure out the amount that is right for you.

Hydration During Pregnancy

What (and how much) you drink is just as important as what you eat. During pregnancy you need to drink more water than you might have been used to before you were pregnant. Hydration during pregnancy is necessary for the development and maintenance of a healthy placenta and amniotic fluid1 to help support your baby’s health.

Avoiding dehydration during pregnancy is not only crucial for your baby’s health, it’s important for your health as well. Being well hydrated helps you regulate your body temperature and keep you from feeling too uncomfortable, especially later in your pregnancy. Staying hydrated can also help prevent urinary tract infections2 and constipation3, and help with hemorrhoids and edema (swelling).

You’re probably so over getting up to go pee three times in an hour, that you won’t want to hear this, but we can’t stress enough how important that you drink plenty of water.

What does “plenty” mean? For most active women, around eight to 12 eight-ounce glasses of water each day is good. You can even use the color of your urine to help determine how well-hydrated you are. Read more about hydration and urine color.

When you’re exercising strenuously, working out hard enough that you’re sweating, or when you’re working out on a warm day, drink a glass or two, one to two hours before you start working out and a glass every 15 minutes.

Pregnancy Supplements: Vitamins, Minerals, and Omega-3 Fats

Prenatal vitamins

Even if you’re eating a nutritious and healthy pregnancy diet, your doctor will recommend that you take prenatal vitamins, and we agree with this recommendation. Prenatal vitamins have more iron, folic acid, and calcium than the standard adult multivitamins. There is a large body of research that supports supplementing with these three nutrients.

You need more iron since your body is making a lot more blood during pregnancy. Folic acid helps prevent serious developmental defects of the brain and spinal cord (neural tube defect). Calcium help build your baby’s bones and protects you against bone loss.

Here’s a list of prenatal vitamins and supplements for pregnancy recommended by WedMD:

  • 400 micrograms (mcg) of folic acid
  • 600 IU of vitamin D4
  • 200 to 300 milligrams (mg) of calcium
  • 70 mg of vitamin C
  • 3 mg of thiamine
  • 2 mg of riboflavin
  • 20 mg of niacin
  • 6 mcg of vitamin B12

Omega-3 Fats

As we briefly mentioned earlier, fish oil is important to the growth and development of the brain, eyes, and central nervous system, as well as heart, immune system, and inflammatory responses5. Supplementing with a high quality fish oil that contains omega-3 fats (DHA & EPA) during pregnancy (especially in the third trimester) is suggested. A commonly recommended dose is 250 mg of DHA per day during pregnancy6.

Pregnancy Exercises

Exercise and staying physically active in general during your pregnancy will make your labor and delivery easier7,8,9, and help with recovery. Exercise during pregnancy has also been found to be beneficial for baby10.

Gaining strength through exercise during pregnancy will help you adjust to pregnancy-related weight gain and the shift in weight distribution as your pregnancy progresses.

Training your core and pelvic floor can help reduce your risk of pelvic floor dysfunction, urinary incontinence, and organ prolapse11,12. The key elements of proper core and pelvic floor training are:

  • Breathing
  • Activation and relaxation of your pelvic floor and abdominal muscles

While you may only be thinking about the next few months, pregnancy is the short-term goal. The long-term goal is postpartum recovery. The following five exercises and movement patterns will be very helpful during pregnancy, labor, delivery, and postpartum recovery.

Restorative Activities

The first and often overlooked are restorative activities that help you manage stress and help you recover from more intense exercise. This is as simple as a walk, stretching, or less intense forms of yoga.

Kegels

Kegels are the second exercise, but technique is everything. Properly done kegels involve a connection between your breath and your core and pelvic floor.

Quality is the key for a good kegel. On each inhalation you relax you let your diaphragm (the muscle under your lungs) drop, your belly and pelvic floor relax and expand. When you breath out, during your exhalation you want your diaphragm to return and increase the tension in your pelvic floor and belly.

You can see a pelvic floor physiotherapist ensure that you’re doing this correctly.

Squatting

Squatting is a basic movement pattern that develops lower body strength, good alignment, and core stability, and activates your core and pelvic floor connection.

Variations of the squat from easiest to most challenging are the bodyweight squat, goblet squat, barbell back squat, dumbbell or kettlebell front squat, and barbell front squat.

Pulling

As with squatting, pulling is a basic movement pattern. Pulling primarily involves the back and also promotes proper alignment. Pulling movements help counteract rounding forward of the shoulders, which is a common side effect of daily modern life (due to computer use, driving, sitting), and which can be exacerbated postpartum when carrying your baby and breastfeeding.

Pulling variations from easiest to most challenging include band or cable rows, dumbbell bent over rows, inverted rows, assisted chin-ups and pull-ups, unassisted chin-ups and pull-ups.

Hip Hinges

Hip hinge exercises start by bending at the hip (rather than the knee). These movements are important for body awareness especially keeping neutral spine.

Hip hinge variations, from easiest to most challenging include hinge with a dowel, tall kneeling hinge, deadlifts, glute bridges, hip thrusts, Romanian deadlifts.

Stress and Pregnancy

While everyone experiences stress, and you can’t simply make it disappear, you can manage it. While it may feel like yet one more thing to add to your long to-do list, along with going to the doctor nearly every day, stress management, is very important for a healthy pregnancy. Pregnant women with high levels of perceived stress and anxiety are more likely to give birth prematurely13.

The good news is that stress management through relaxation using guided imagery is a proven way of reducing stress in pregnant women. In fact, here is an example of one such relaxation exercise14:

  • Sit comfortably and focus your attention for a few minutes on your breathing
  • Let your breath fall into its own natural rhythm—slow, easy, and comfortable.
  • Focus your attention on your breathing throughout this exercise. Slow, deep easy breathing alone can help produce a state of deep relaxation.
  • Gently turn your attention inward, notice your energy level, your mood, and where you’re feeling tense or tight. Start from your head and work down to your toes.
  • Focus on a tense or tight body part and inhale deeply, and imagine sending a white light to that area of your body.
  • In this way, you can use your breath to relax any part of your body that might still be tight or tense … continue the slow, deep, comfortable breaths.

Pregnancy Sleep

Sleep disturbances are common in pregnant women with 38 percent of women getting six hours or less of sleep15 and are linked to a lower mental and physical health-related quality of life16.

Getting more sleep during pregnancy often seems easier said than done. It helps to have a plan or nighttime routine that will help you relax and get to bed in a state in which you can fall asleep.

The first step in creating a pregnancy sleep routine is figuring out when you’re going to get up the next day. Count back seven to nine hours, at least. Getting up at 7 a.m.? To get seven hours of sleep you need to be asleep by midnight. To get nine hours you need to be asleep by 10 p.m. The key words here are “be asleep by,” not “in bed by.”

Whatever time you’ve figured out, that’s the time by which you are in bed with the lights out. One hour before that, turn off every electronic thing you own. Your TV, computer, e-reader, mobile phone—all of it. If you can’t turn it off, put it away. For the next hour, go through your pre-bed ritual. Brush your teeth, floss, put out your clothes for the next day and include one more of the following: stretch, meditate, read a physical book, write in your journal, and/or do a brain dump.

A brain dump is helpful for quieting your mind when you have a lot of things swirling around. Things you’re worried about, things you should do, anything that will keep you up at night. Simply write down everything you’re thinking about. Get it “out of your head” and onto a piece of paper. While it may seem odd to bring up all this stuff before bed, this strategy can be quite helpful. Give it a try and see if you sleep more peacefully.

Go to bed at the same time each night and get up at the same time each morning. Yes, it’s Friday night, an hour before bed, and you’re going to watch just one episode of your favorite show on Netflix, but who are we kidding here? It rarely ends up being “just one” episode, right?

If you establish a sleep ritual now, you’ll at least lay the foundation for good sleeping habits when your baby arrives, even if sleep feels impossible for a while.

Healthy Habits During Pregnancy

While all the changes happening to you may feel overwhelming, if you develop healthy habits during pregnancy, you are more likely to stick with them after pregnancy.

At Girls Gone Strong, we like to use a habit-based approach to nutritional and exercise behavior change, focusing on only one change or new habit a time. In our experience, trying to change too many things at once becomes overwhelming and you’re likely to drop everything at once. We encourage everyone to focusing on the “big rocks,” or the most important priorities (see the healthy pregnancy checklist below). The “big rocks” are things that, if done consistently, then the “small rocks” (the details) won’t matter much, if at all.

Spend at least two weeks focusing on each new habit. Evaluate how you’re doing, and as a new habit become easier to maintain, keep it going while shifting your focus to the next new habit. Repeat the process with each new habit.

Healthy Pregnancy Checklist (The “Big Rocks”)

  • Eat one fist-sized portion of vegetables at every meal.
  • Eat one palm-sized portion of lean protein at every meal.
  • Eat an adequate amount of carbohydrates each day.
  • Drink eight to 12 eight-ounce glasses of water each day.
  • Exercise 30 minutes a day for at least three days a week (up to six days a week).
  • Eat one thumb-sized portion of healthy fats at every meal.
  • Practice stress management.
  • Create sleep ritual/bedtime routine.

Additional Healthy Pregnancy Resources

  1. Patrelli TS, Gizzo S, Cosmi E, Carpano MG, Di Gangi S, Pedrazzi G, Piantelli
    G, Modena AB. Maternal hydration therapy improves the quantity of amniotic fluid
    and the pregnancy outcome in third-trimester isolated oligohydramnios: a
    controlled randomized institutional trial. J Ultrasound Med. 2012
    Feb;31(2):239-44. http://www.jultrasoundmed.org/content/31/2/239.full.pdf
  2. Beetz R. Mild dehydration: a risk factor of urinary tract infection? Eur J Clin Nutr. 2003 Dec;57 Suppl 2:S52-8. Review. http://www.nature.com/ejcn/journal/v57/n2s/full/1601902a.html
  3. García Duarte S, Ruíz Carmona M, Camacho Ávila M. Prevention of constipation
    during pregnancy with the hydration. Nutr Hosp. 2015 Dec 1;32(s02):10298. http://www.redalyc.org/pdf/3092/309243334043.pdf
  4. The American College of Obstetricians and Gynecologists FAQs for Nutrition and Pregnancy http://www.acog.org/Patients/FAQs/Nutrition-During-Pregnancy
  5. Larqué E, Gil-Sánchez A, Prieto-Sánchez MT, Koletzko B. Omega 3 fatty acids,
    gestation and pregnancy outcomes. Br J Nutr. 2012 Jun;107 Suppl 2:S77-84. doi:
    10.1017/S0007114512001481. http://www.ncbi.nlm.nih.gov/pubmed/22591905
  6. Colombo et al., Child Development, July/August 2004, Vol. 75: pp. 1254-1267
  7. Domenjoz I, Kayser B, Boulvain M. Effect of physical activity during pregnancy on mode of delivery. Am J Obstet Gynecol. 2014 Oct;211(4):401.e1-11.
  8. Poyatos-León R, García-Hermoso A, Sanabria-Martínez G, Álvarez-Bueno C, Sánchez-López M, Martínez-Vizcaíno V. Effects of exercise during pregnancy on mode of delivery: a meta-analysis. Acta Obstet Gynecol Scand. 2015 Oct;94(10):1039-47.
  9. Nascimento SL, Surita FG, Cecatti JG. Physical exercise during pregnancy: a systematic review. Curr Opin Obstet Gynecol. 2012 Dec;24(6):387-94.
  10. Melzer K, Schutz Y, Boulvain M, Kayser B. Physical activity and pregnancy: cardiovascular adaptations, recommendations and pregnancy outcomes. Sports Med. 2010 Jun 1;40(6):493-507.
  11. Pelaez M, Gonzalez-Cerron S, Montejo R, Barakat R. Pelvic floor muscle training included in a pregnancy exercise program is effective in primary prevention of urinary incontinence: a randomized controlled trial. Neurourol Urodyn. 2014 Jan;33(1):67-71.
  12. Hall B, Woodward S. Pelvic floor muscle training for urinary incontinence postpartum. Br J Nurs. 2015 Jun 11-24;24(11):576-9.
  13. Paarlberg KM, Vingerhoets AJ, Passchier J, Dekker GA, Van Geijn HP. Psychosocial factors and pregnancy outcome: a review with emphasis on methodological issues. J Psychosom Res. 1995 Jul;39(5):563-95. Review
  14. Jallo N, Bourguignon C, Taylor AG, Utz SW. Stress management during pregnancy: designing and evaluating a mind-body intervention. Fam Community Health. 2008 Jul-Sep;31(3):190-203
  15. Mindell JA, Cook RA, Nikolovski J. Sleep patterns and sleep disturbances across pregnancy. Sleep Med. 2015 Apr;16(4):483-8.
  16. Tsai SY, Lee PL, Lin JW, Lee CN. Cross-sectional and longitudinal associations between sleep and health-related quality of life in pregnant women: A prospective observational study. Int J Nurs Stud. 2016 Apr;56:45-53.
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