Nutrition Requirements during Pregnancy Pregnancy is one of the most nutritionally demanding periods of a woman's life. Gestation involves rapid cell division and organ development. An adequate supply of nutrients is essential to support this tremendous fetal growth. While caloric needs increase only 15 percent (300 cal/day) the requirements for some nutrients doubles during pregnancy. Pregnant women need to choose nutrient dense foods to assure adequate nutritional intake. For many women this requires some improvement in current eating habits. The following information will give you the knowledge you need to begin to make wise food choices that enhances the health of you and your baby. The Center for Women's Health has created this handout based on the latest research from the National Academy of Science on dietary intake and nutritional supplements during pregnancy. Please contact us with any questions or concerns. General Guidelines: Eat a wide variety of foods Drink 10-12 glasses of water daily Fruit 3-5 serving/day Vegetables 2-3 serving/day Whole grains 6-9 serving/day Protein 6-8 serving/daily (you can include your dairy serving as a protein too!) Dairy 3-5 servings/day Flaxseeds 1-2 tablespoons daily Folate 800mcg daily (this is in your prenatal vitamin) Flaxseeds and/or Fish: Are sources of omega 3 fatty acids and are essential for normal retinal and brain development of the fetus. Try to put these in your diet weekly. Complex Carbohydrates: A pregnant woman's calories should come from all three energy sources: proteins, fats, and complex carbohydrates. If you restrict your carbohydrate intake during pregnancy you can put the fetus at risk. Without carbohydrates your body will burn proteins and fat for fuel. Two things happen physiologically with this: 1. There may not be enough protein available for the developing brain and nervous system of your baby, and 2. Burning fats can release ketones (an acid by product of fat metabolism) that can be destructive to fetal brain cells and the delicate acid-base balance of the fetal system. Low carbohydrate diets can be dangerous in pregnancy. Complex Carbohydrates Function Requirements Source of fuel for the mother High in B vitamins which promotes fetal cell division, aids in the digestion of nutrients and prevents anemia high in trace minerals such as zinc, selenium, chromium, magnesium 6-9 servings daily Complex Carbohydrate Choices (do not count unenriched breads, cereals) Amount per serving Brown Rice ½ cup Wild rice ½ cup Bulgar, millet, kasha ½ cup Wheat bagel ½ Whole wheat English muffin ½ Rice Wheat crackers 2 Enriched pasta ½ cup Whole grain cereals (Nutragrain, grapenut, Etc.) 1 ounce Wheat germ 2 Tlb. Whole Wheat, Rye, Pumpernickel bread 1 slice Protein: Adequate protein is vital to the developing fetus. Proteins are made up of amino acids (20 amino acids) and our bodies can manufacture all but eight. These eight are called essential amino acids and must be supplied by the food we eat. Animal products have all eight and are considered complete proteins. Vegetarian sources are lacking in one or more of the essential amino acids and are considered incomplete proteins unless they are combined properly. Function of Protein Building block of all materials in the growing fetus (from hair to toe nails. Vital to the development of brain cells Requirement 60-80 grams daily (6-8 servings) You count your dairy as a serving and make up the difference with meat, fish, poultry or vegetarian combinations. Protein servings in grams Dairy 1 cup Grams Fish (4oz) Grams Meat (4oz) Grams Nuts (1cup) Grams Beans(1cup) Grams Milk ,(lowfat, regular) 9 Canned tuna 28 chicken 20 almonds 21 Black beans 22 Yogurt 8 Salmon 22 turkey 20 cashews 19 Chickpeas 13 Soy milk 8 Flounder 22 beef 22 peanuts 30 Lentils 16 Tofu 3 oz 8 Snapper 22 lamb 20 Pignoli pine nuts 35 Navy 15 Cheese 1oz Cod 22 veal 23 Sesame seeds 15 Pinto 22 Cheddar 9 Swordfish 22 liver 20 walnuts 17 Peas 16 Swiss 9 Trout 22 ham 16 Sunflower seeds 26 Soybeans 35 Parmesan 9 Lobster 20 Bacon 1slice 7 Peanut butter 1/3c 13 Lima 8 Cottage 33 Shrimp 4 20 Egg 1 6 Special Notes: Avoid unpasturized cheeses they can carry bacteria called Lysteria that may be harmful to the baby. Avoid raw fish. If you are a vegetarian you can combine a serving form the bean column with complex carbohydrates and nuts or dairy and you will have be eating a "complete" protein meal. Calcium: Adequate calcium is important for both you and your baby during pregnancy. When your diet is low in calcium during the pregnancy the baby will draw off your maternal stores to get the calcium it needs to develop. This can but you at increased risk for osteoporosis and dental problems. A low calcium diet can also cause you to experience insomnia, irritability and leg cramps. Function of Calcium Requirements 1. Necessary for the development of fetal bone structure and teeth 1200-1500mg daily (3-5 servings) 2. Prevent maternal bone loss. Calcium Rich Foods (300mg/serving) Serving Size Soy milk, regular milk, lowfat milk 1 cup Tofu 6 ounces Yogurt 1 cup Provolone, Cheddar, Swiss 1 ounce Mozzarella 2 ounces Cottage cheese 1 cup Ice cream or frozen yogurt 1 cup Canned sardines or salmon with the bones 4 ounces Almonds 1 cup Kale (cooked) 1 cup Broccoli (cooked) 1 ¾ cup Sesame seeds 1 ounce Naturally carbonated mineral water 1 liter Special Note: Oxalic acid in spinach, beet greens, and chocolate decrease the absorption of calcium. Phosphorus in soda decreases absorption of calcium. If you are not getting enough calcium in your diet let us know and we will recommend a supplement (most prenatal vitamins have 200-250mg of calcium). Iron: When you are pregnant you need more iron than usual because your body is manufacturing more blood (your blood volume increases by 60%). This increase is necessary for the transport of oxygen and nutrients to your baby. It is very important to keeping your iron reserve up. In the third trimester the baby will begin creating its own iron reserve for its first six months of life when it will be primarily living on milk which is low in iron. The best way to get the iron you and your baby need is through foods. Please consult us before taking any iron supplements. Function of iron Supplies oxygen & nutrients to fetus Supports placental function Manufacture red blood cells Acts as buffer against blood loss during delivery Assist fetus in storing iron for the first 6 months of life Iron rich foods Dried apricots, raisins, dates, prunes Spinach Avocados Chicken, beef, turkey, liver,eggs Kidney beans, chick peas Black strap molasses Special Note: Iron from meat is better absorbed than from plants. Iron from plants is absorbed better if taken with vitamin C. Coffee, tea, bran, and calcium decrease absorption.