Eating for One
When it comes to prenatal nutrition, the experts say that expectant moms should
focus on proper eating for themselves and their babies will also reap the benefits.
So a healthy diet—starting before conception—begets a healthier child.
It’s incredible, if you think about it: In 40 weeks a single fertilized egg blossoms into a multibillion-celled human being fully equipped for life outside the womb. But such exquisite biochemical choreography depends on high-quality nourishment, so the same sedentary, fast-food habits that often impair the health of both adults and children are just as harmful to developing babies.
For women, pregnancy can alter those bad habits. “It is a great time—women will make lifestyle changes to help their babies that they wouldn’t do for themselves,” says Dr. Jane Higdon of the Linus Pauling Institute at Oregon State University. “But a vital part of prenatal care is getting people to realize the importance of nutrition before they get pregnant.”
A look at a standard pregnancy timeline helps explain why. Days 7 to 56 of a pregnancy not only “correspond to the time the organs are being formed in the fetus,” according to Higdon, but they also cover the two or three weeks before a missed period alerts a woman to a possible pregnancy. By the time proud poppa is making excited phone calls, the fetus is far along the developmental path. That means you need to start eating right when Junior is just a twinkle in his eye.
It’s time to ditch a dietary cliché often foisted on expectant moms. “Try to keep in mind that you are not eating for two, you are carefully eating for one,” write Catherine Jones and prenatal nutrition expert Rose Ann Hudson in Eating for Pregnancy (Marlowe & Company), who add that pregnancy “is not a time to skip meals, eat junk food or load up on empty calories for quick energy.” The idea is to eat a nutritious diet that allows you to gain weight gradually as your baby grows.
It helps to be at a healthy weight when starting a family. Being overweight makes conception more difficult, and at least one study has found a link between excess maternal weight and the risk of a birth defect called cleft palate (in which the roof of the mouth is split from behind the teeth to the nasal cavity). However, dieting during pregnancy may actually program a child for obesity by rewiring the developing brain, so try to lose weight before you try to conceive.
How much should you expect to gain over the course of nine months? A lot depends on your unique circumstances and the advice of your health care provider, but in general you can anticipate adding from two to five pounds a month for the first 14 weeks and roughly a pound a week thereafter until your due date—between 25 and 35 pounds in total. That translates into roughly an extra 300 calories a day; Jones and Hudson say that more nourishment may be necessary if you are breastfeeding, extremely active or carrying more than one child. Since stress and anxiety often lead to out-of-control eating (and gaining), be sure to tend to your own emotional needs during what can be a very exhilarating, yet sometimes overwhelming, time of life.
For maximum nutrition try to eat a variety of foods while avoiding anything that provokes morning sickness. Whole grains provide both steady energy (unlike sugar-fueled spikes and crashes) and B vitamins to boot. Do not scrimp on fat—your baby’s developing nervous system depends on it—but “don’t use your pregnancy as an excuse to pig out, either,” warn Jones and Hudson. Stick with such unsaturated fats as olive oil along with rich sources of omega-3 fatty acids like flax seed oil.
You definitely want to indulge in those omega-3s, which appear to boost infant intellectual development. Fish is a fine source of both omega-3 and the high-quality protein needed to build your baby’s tissues, but beware: Some species, such as fresh tuna, swordfish, tilefish and king mackerel, can be contaminated with mercury. Your best low-mercury bets are catfish, pollock, salmon and shrimp. (Other good protein sources include chicken, cottage cheese, lean red meat, yogurt and milk, all organically sourced whenever possible.)
Supplemental fish oil is another omega-3 possibility because “mercury is found in the muscle of fish and not in the oil,” according to OSU’s Jane Higdon, who suggests consulting your health care practitioner for advice. “If I was going to take a fish oil supplement, I’d look for one that the manufacturer is testing for PCBs [an industrial pollutant],” such as products that meet California’s Proposition 65 standards.
Don’t forget to stock the fridge with fresh produce. Fruits and veggies are richly endowed with vitamins and minerals; for example, making like Popeye and downing your spinach helps ensure you get plenty of folic acid and iron.
These superfoods also supply phytonutrients, substances that may actually help protect your baby against cancer even as they enhance your own well-being. Studies on the link between maternal diet and childhood cancer protection are in the early stages according to Dr. David Williams, a researcher at the Linus Pauling Institute, but he says that shouldn’t stop you from loading up on cancer-fighting green stuff. “Certainly among the vegetables the cruciferous ones [the broccoli family] are particularly valuable in protecting against cancer,” he says. “These vegetables are also a good source of fiber and vitamin C.”
All authorities agree that taking prenatal vitamins is a smart idea. Especially important nutrients include:
• Folic Acid. This B vitamin helps prevent neural tube birth defects such as spina bifida, in which a malformed spinal cord can cause everything from fluid on the brain to paralysis. “The great news is that supplemental folic acid decreases the risk of neural tube defects pretty significantly,” says Higdon. “It’s recommended that women who are planning to become pregnant take a supplement that supplies 400 mcg.” Low folate is also associated with high levels of a metabolic byproduct called homocysteine; it’s not clear whether high homocysteine is a symptom of folate deficiency or a cause of birth defects. To help folate control homocysteine, add vitamins B-6 and B-12 to your regimen, especially if you are a vegan.
• Iron. Iron deficiency is the most common micronutrient deficiency in the US, especially among women of childbearing age, and “has been associated with poor child development after birth along with increased risk of miscarriage and premature delivery,” according to Higdon. “Also, if you’re deficient you’ll get really tired—you get less oxygen delivered to your tissues and the baby’s.” A supplement should supply 30 mg; vegetarians have to pay particular attention to their iron levels. Eating foods rich in vitamin C can make it easier to absorb iron, as can eating such fermented soy goodies as tempeh and miso.
• Calcium. Building baby’s bones requires plenty of calcium; Jones and Hudson recommend getting 1200 mg a day. If you are lactose intolerant—that is, you can’t properly digest milk products—they suggest you “try yogurt made with live or active cultures, whose bacteria releases lactose-digesting enzymes.” Supplemental calcium is another option, preferably in gluconate or chelate form for better absorption. (Calcium can also help cut the leg cramps caused by the pressure of a growing baby.)
• Vitamin D. It doesn’t matter how much calcium you take if you’re not getting enough of the vitamin D that lets your body utilize calcium properly. “Vitamin D deficiency is increasingly common,” says Higdon, “and the RDIs [Reference Daily Intakes] might not be high enough for people who don’t get sun exposure.” Spending 15 minutes a day in the sun can restore your body’s supplies, but “the farther north you live, the longer that period in the winter you can’t make vitamin D, and it’s actually not in too many foods.” Taking 400 IU daily can make up the shortfall.
Believe it or not, iodine deficiency is a growing concern in the US as people cut back on salt, which is commonly fortified with iodine. Higdon says that most prenatal vitamins contain 150 mcg.
Mother’s Little Cupboard Helpers
It’s oft-said but still true—breakfast really is the most important meal of the day, especially when you’re expecting. To make morning eating easier while trying to do eight things at once, Jones and Hudson recommend keeping your kitchen well supplied with whole-grain versions of cereal, bread, English muffins and cereal bars (along with that old healthy-breakfast standby, oatmeal). And stocking up on yogurt, fresh fruit and soy- or whey-based protein powder lets you whip up breakfast smoothies in a jif.
While you’re at it, have plenty of good-stuff snacks on hand, including raisins and other dried fruits, nuts and nut butters, fruit sauces, oatmeal cookies, whole-grain pita bread with hummus, low-fat cottage cheese and hard-boiled eggs.
Minor miseries like heartburn and constipation can set in as your uterus starts elbowing other internal organs out of the way. You can head off heartburn by eating several small meals throughout the day and by taking the time to eat more slowly. Don’t lie down right after eating and when you do go to bed, keep your head elevated. The fiber in all those whole grains and produce should help keep things moving along smartly in your intestines, especially if you remember to stay well hydrated; if it isn’t enough, try adding some supplemental fiber to your daily routine.
Another way to ease constipation is to get adequate exercise. At one time, “it was believed that an active pregnant woman would divert blood away from her growing fetus and toward her exercising muscles, resulting in a smaller baby,” say Karen Nordahl, Carl Petersen and Renée Jeffreys, authors of Fit to Deliver (Hartley & Marks). Ain’t so; exercise actually helps reduce the risk of pregnancy-induced diabetes and high blood pressure while giving you more energy and helping you rebound to your pre-pregnancy weight after delivery (just check with your health practitioner first). They recommend a program that emphasizes aerobics and exercises designed to improve your balance and strengthen your body’s core muscles, the ones that stabilize and support your back and abdomen.
Exercise is just one component of an overall healthy lifestyle. That includes the negative stuff—you know, not smoking or drinking—and the positive stuff, like yoga and breathwork to help you feel integrated and whole. If you’re new to yoga, try taking a class with a qualified instructor, preferably someone with experience in teaching pregnant women.
One last thing: Enjoy this special time in your life as you await the great adventure known as motherhood.