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In Part 2 of Nutrition Tips for Pregnancy, Coach Sinead discusses food aversion and nausea, foods to eat in moderation or completely avoid, and some supplements that you might consider during pregancny.
The other week in Nutrition Trips for Pregnancy - Part 1 I discussed additional calories needed, expected weight gain during pregnancy, and the fundamentals of nutrition. This week, in Part 2, I will cover food aversions and nausea, foods that you should eat in moderation or completely avoid during pregnancy and some particular nutrients and/or supplements that you might consider.
Like with anything, these recommendations are general recommendations for the average, healthy pregnant women who do not have any underlying health conditions or contraindications. Always consult with your own health care provider when considering supplements or dietary changes.
Food aversions are common during pregnancy; where once you loved the sight of freshly stir-fried vegetables, now they make you want to heave. It can be different for different people, so continue to listen to your body each day and be flexible with your food choices, meal times, etc. Eat what you can eat, when you can eat it.
There are different theories on why food aversions occur; one is hormone fluctuations, particularly, chorionic gonadotropin (hCG) and another is association of eating food and being nauseous during your pregnancy (Moms Gone Strong, 2018). Morning sickness is also very common during the first trimester, so if you are only managing to eat ‘beige foods’ don’t worry too much about this, just eat what you can when you can. 2nd and 3rd trimesters tend to be better with regards to nausea so focus on building up the foundations of good nutrition during this time. Naturopathic doctor and Moms Gone Strong advisor Dr. Brooke Kalanick, N.D., recommends to her clients to eat small meals/snacks before they get hungry as the nausea may be linked to dips in blood sugar levels. Take any prenatal supplements on a full stomach rather than an empty one and speak to you your HCP if the nausea is particularly debilitating or long.
Caffeine is a surprising stimulant that exists in a load more beverages and foods than we realise; 4.5 oz of dark chocolate contains 30mg of caffeine, 8oz black tea contains 48mg and an 8oz drip coffee contains 137mg (remember - Starbucks ‘tall’ coffee = 12 oz) (ACOG, 2010).
There are mixed results on whether or not a high-amount of coffee consumption can result in miscarriage, preterm birth and intrauterine growth restriction, however the American Congress of Obstetricians and Gynecologists state that “Moderate caffeine consumption (less than 200 mg per day) does not appear to be a major contributing factor in miscarriage or preterm birth.”(ACOG, 2010). Please note that the “relationship of caffeine to IUGR remains undetermined” (ACOG, 2010). I would say that you are better off safe than sorry and err on the side of caution.
Sugary drinks and foods, like energy drinks, soft drinks, and candy bars are loaded with simple sugars and offer little to no fibre and nutritional value. This can send your blood sugar see-saw and won't help with any energy issues that you may be having. Similarly, consuming these foods can make you more susceptible to gestational diabetes. The HSE Guidelines on Pre-gestational and Gestational Diabetes Mellitus recommends a diet of “carbohydrates from fruit, vegetables, whole grain, legumes* and low fat milk” for good health (HSE, 2010).
Highly-processed foods can also have a high-glycamic load that can impact your blood sugar levels as well as being full of additives and saturated and/or trans fats. I mentioned in Part 1, that the standard western diet tends to be very high in Omega-6 in comparison to Omega-3 due to the over-consumption of vegetable oils used in processed and fried foods.
Image Source: A.Ponce, Pixaby
According to the HSE and ACOG, there is no amount of alcohol that is safe during pregnancy. There are a lot of bars and restaurants that offer non-alcoholic drinks (just make sure it is 0% not low alcohol), so you do have more interesting options than sparkling water with lemon on a night out. Check out The Virgin Mary Bar on Capel Street if you are craving a date-night or night out with friends (I have been there myself so can vouch for it!)
Raw or undercooked meats/fish/milk/eggs
Mould-based or soft cheeses (think brie, feta, cashel blue), unpasteurised milk, undercooked/runny eggs and sushi using raw fish are all types of food that you should avoid during pregnancy. These foods contain a risk of listeriosis, salmonella or food poisoning. Toxoplasmosis is an infection caused by a parasite that, if caught during pregnancy, can cause serious health risks to your baby. It is rare to catch but can be caught through cat pee, unpasteurised sheep's milk, raw/undercooked meat, cold cured meats, soil and untreated water (NHS) so avoid unwashed vegetables and any other high-risk foods mentioned above.
Listeriosis is caused by foods contaminated with the bacteria Listeria monocytogenes and is a serious infection that can result in miscarriage and stillbirth. It can be found in processed meats, like hot dogs, pate, including vegetable pates, and some seafoods.
Avoid foods like pate, sausage, haggis, and liver as they are high in vitamin A which can cause damage to your baby if consumed in high amounts.
Lead and mercury can affect your baby’s developing neurological system and can cause neurological development disorders and delays in your baby if you consume it. It is recommended that older and larger fish should be avoided, such as shark, marlin, king mackerel, or swordfish. Tuna too should be restricted as it can contain mercury. The NHS recommends no more than 2 tuna steaks or 4 medium-sized cans of tuna per week. Make sure that your water bottle is lead-free as well as BPA, which can mimic female hormones and cause poor health outcomes in your baby.
Oily fish should also be restricted to 2 portions a week as they can contain pollutants like dioxins and polychlorinated biphenyls (PCBs), but they can be eaten in addition to the tuna portions mentioned above.
Make sure when you are selecting supplements (see below) that you choose supplements that are traceable and suitable for pregnancy.
Precision Nutrition - What to eat during Pregnancy
You should be looking to get the majority of your macro and micronutrients from eating a variety of whole-foods. However, during pregnancy, there are a few nutrients that we might need to get a bit of a boost from supplements, such as folic acid and vitamin D if you are living in the sun-starved Emerald Isle.
Like with anything, these recommendations are general recommendations for the average, healthy pregnant women who do not have any underlying health conditions or contraindications. Always consult with your own health care provider when considering supplements or dietary changes.
Image Source: E.Damilian, Pixaby
Folic acid plays an important role in the development of your baby’s spine and brain, helping to prevent neural tube diseases in developing foetuses.
The HSE recommends that pregnant women consume 400mcg of Folic Acid for 3 months prior to the start of your pregnancy, as well as the first 12 weeks of your pregnancy. In fact, as my colleague Aoife spoke about in her blog post last week, it is recommended that women of childbearing age consume folic acid daily to ensure that any pregnancies, planned or unplanned, have a sufficient level of folic acid at the time of conception (Cawley et al., 2015). So if you are considering having a baby or at a stage in your life that you may conceive then it is recommended to start taking 400mg of folic acid now to allow for sufficient levels to be present at the time of conception.
As your blood volume increases throughout your pregnancy you may find yourself getting fatigued. The HSE recommends that you eat two sources of iron per day and aim to get a mix of haem and non-haem sources of iron, as non-haem iron is not as easily absorbed by the body as haem iron.
Haem iron can be found in red meats, like beef, pork, and lamb. Non-haem iron can be found in foods like eggs, spinach and other green leafy vegetables, and pulses.
Keep in mind that Vitamin C helps in the absorption of iron so it is a good idea to consume Vitamin C with your non-haem iron to help absorption. You can find it in berries, kiwis, and oranges. Moms Gone Strong recommend you get 75mg of Vitamin C.
The HSE recommends getting 3 sources of milk, cheese, or dairy a day as they are a good source of calcium. If you don’t consume dairy or animal-produce, then focus on getting your calcium from dark green leafy vegetables, nuts, seeds, and fortified milk-alternatives.
According to Moms Gone Strong, you are looking to get 200-300mg of calcium in your prenatal vitamin.
Vitamin D plays an important role in regulating the amount of calcium and phosphate in the body and therefore is necessary for healthy bones and teeth.
Our bodies naturally produce it when the skin is exposed to sunlight but in Ireland, we are at the mercy of our weather so we are often deficient in Vitamin D. You can get Vitamin D from food sources like oily fish (think salmon), a bit from eggs and fortified milk and cereals.
If you are not getting enough, then consider taking a supplement. PN recommends getting 1,000 IU of Vitamin D a day but speak to your HCP to find out what you need.
As discussed in Prenatal Nutrition Part 1, Omega 3 fatty acids are beneficial for your cardiovascular and nuerological health and can only be obtained from the diet . According to FIGO, fats should make up 15-30% of your daily nutrition during pregnancy, which is the same amount as pre-pregnancy, with a focus on polyunsaturated fats like Omega 3. Omega 3 DHA and EPA fatty acids, as well as Omega 6 AA fatty acids are important to fetal CNS development. As Omega-6 is in ready supply in the typical western diet via vegetable oil and because pregnant women are restricted to eating 2 pieces of low-mercury fish a week, consumption of flaxseed, chia seed, and canola and/or supplementation with a low-mercury Omega 3 supplement will be necessary during pregnancy.
I hope you found this information useful. In a few weeks time, I will be discussing food aversions and nausea, foods that you should eat in moderation or completely avoid during pregnancy and some particular nutrients and/or supplements that you might consider. If you’d like any additional information on any of the above feel free to contact me ( sinead@ffs.ie).
If you are interested in 1:1 Personal Training or Small Group Personal Training suited to pregnancy then email sinead@ffs.ie for more information or get her on Instagram @sineadbrophy.
Sinead's Prenatal Training is based in FFS Gyms Ivy Exchange. If this location does not suit, Coach Aoife also offers SGPT for Pregnancy on Leeson Street.
Email Sinead at sinead@ffs.ie
Find Sinead on Instagram at @sineadbrophy