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Eating for a healthy pregnancy

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Women thinking about having a child can optimize the health outcomes of their offspring by maintaining good nutrition and a healthy lifestyle preconception. Good maternal health can reduce the risk of birth defects, poor growth of the unborn baby, and development of chronic health problems.

Women considering getting pregnant should begin to take a look at their lifestyle habits and consider what they could do to optimize their health. This includes getting adequate sleep, drinking enough fluids, getting regular exercise (preferably exercise that increases heart rate and exercise to strengthen muscles), eating consistently throughout the day, getting at least the baseline number of servings from the five healthy food groups, including a moderate amount of healthy fats, and limiting saturated fat/sugar/sodium.

Before pregnancy, women who are underweight may be low in nutrients as well as calories to support a healthy pregnancy. They should attempt to increase their intake of healthy foods with a goal of working toward a healthy body weight.

Maternal obesity increases the risk of neural tube defects, fetal death, and preterm delivery. Before pregnancy, overweight women should maintain at least the baseline number of servings from each food group, while limiting their intake of less healthy calorie-dense foods with a goal of gradual weight loss. They should also try to gradually increase the amount of exercise they do. Goals during a healthy pregnancy include appropriate weight gain, appropriate physical activity (30 minutes or more of moderate activity most days), eating the recommended number of servings from the five healthy food groups, vitamin and mineral supplementation as needed, avoidance of alcohol, tobacco, and other harmful substances and safe food handling.

Pregnancy and delivery outcomes can be influenced by the mother's pattern of weight gain during pregnancy. Women should strive for weight goals suggested by their health-care provider. Generally, the need for fluids, calories, and some nutrients is increased during pregnancy because of physical changes for the mother, and the growth and development needs of the fetus.

Nutrients that tend to be the most lacking in the diets of pregnant women are calcium, vitamin D, vitamin E, magnesium, potassium, iron, and fiber. Intakes of vitamins A, C, B6, and folate may also be low. On the other hand, saturated fat and sodium intake may be too high.

Health-care providers generally suggest that pregnant women (and sometimes those trying to get pregnant) take a prenatal vitamin. These contain higher amounts of some nutrients than normal multiple vitamins, because of increased needs during pregnancy. An example would be iron needs that increase to 27 mg a day. Moms who are vegans need not only supplemental iron, but also B12. Remember that taking a supplement of any kind is not meant to replace a healthy diet!

Folate goals rise from 400 mcg to 600 mcg a day. Pregnant women should be sure to get three to four good sources of calcium (with vitamin D) daily (such as 8 ounces milk, yogurt, fortified soy milk). Pregnant woman may also want to add a supplement of DHA (one of the omega 3 fatty acids) and should include some healthy fats (for essential fatty acids) in moderation (unsaturated oils, nuts, seeds, peanut butter).

Protein needs increase by another 25 gm a day. Seven grams is equal to 1 ounce of meat, poultry, fish or cheese; one egg; 8 ounces of milk, 6 ounces of yogurt, ½ cup beans, 2 tablespoons peanut butter, one-quarter cup nuts, one-quarter cup tofu or tempeh.

Fluid needs increase as well, for a number of reasons. Adequate fluid (at least 64-80 oz.a day), a diet containing 25-30 gm of fiber, and regular exercise can help to reduce the risk of constipation. Fiber is found in fruit, vegetables, whole grain bread products and cereals, whole grain pasta, beans, nuts and seeds.

Some nutrients in excess can be a problem, so "more is not better" when it comes to all nutrients. An example would be vitamin A in the form of retinol. A safer form of vitamin A is its precursor beta carotene found in orange fruits and vegetables.

Although viewed as "natural," some herbal substances should not be used during pregnancy. Pregnant women should also be very cautious with regard to food poisoning. (See link below.)

A registered dietitian and exercise professional can assist women before, during and after pregnancy. These professionals are especially important if the mother is at high risk for or has diabetes or high blood pressure.

Also check out www.mypyramid.gov/mypyramidmoms, which has information on possible food plans, food safety, supplements, and breastfeeding.

Pamela Stuppy, MS,RD,LD, is a registered, licensed dietitian with nutrition counseling offices in York, Maine, and Portsmouth. She is also the nutritionist for Phillips Exeter Academy.

This article was originally written by Pamela Stuppy for Seacoast Media Group (seacoastonline.com).