Pregnancy nutrition Q & A

Women are bombarded with conflicting information about what they can and cannot eat during their pregnancy.  Never mind your mother-in-law trying to give you that extra bit of maybe not so wanted advice. It can all get a bit overwhelming and confusing.

So we’re speaking to Sarah, a registered dietitian who has a little 9 month old girl. We’re sure that these questions have been on your mind at some stage. So here are some answers to put your mind at ease and bust those common pregnancy nutrition myths.

 

Q: Should I be “eating for two” during my pregnancy?

A: This concept of ‘eating for two’ is actually very outdated. Being pregnant doesn’t give you the license to go crazy and munch your way through the fridge! Your energy needs increase slightly in the second and third trimesters – this extra energy needed equates to one extra healthy snack during the day. During pregnancy, your body changes to accommodate your growing baby. It is so important to focus on the quality and not the quantity of your food and make healthy choices. What can be motivational is to remember that what you put into your body has a direct effect on both you and your baby’s health during and AFTER pregnancy.

 

Q: I am feeling hungry all the time and very tired in my first trimester – what can I do to help with this?

A:  Try eating 4 -5 small meals in the day.  A good approach is to “smart snack” by choosing healthy snacking options. A “smart snack” is a healthy snack made by pairing two food groups such as a lean protein with a healthy whole grain carb or fruit, or a healthy fat with a fruit. Combining food groups will help keep you feeling fuller for longer. This will improve energy levels, control your hunger as well as help manage cravings.

Some healthy snack combo’s include:

  • Nuts and fruit
  • Plain yoghurt and fruit
  • Hummus and whole wheat rice cakes or seed crackers
  • Half an avocado filled with cottage cheese
  • Boiled egg and nuts
  • Veggie sticks and hummus

 

Unhealthy snack options provide empty calories (poor nutrient options) such as cakes, sweets, pastries, sugary drinks and fast foods.  These have no benefit to you or your baby.  And on top of that snacking on these nutrient poor choices will just continue to make you feel tired.

 

Q: I have a craving for ice cream and pickles – should I give into these cravings, what do they mean and how can I deal with them?

A: Sorry ladies there’s no explanation as to why pregnant women get cravings. We do know that they exist, but it actually doesn’t mean our bodies need these nutrients. If this were true, wouldn’t we all be craving more broccoli and less chocolate? So how do we handle that late night call for chocolate. The best is to wait for this craving to pass – it’s the same as a thought, if you distract yourself you’ll forget the craving. If you’re still struggling consult your dietician to help you plan a healthy eating program that suits you and your lifestyle.

If waiting it out doesn’t do the trick try this 2 step approach:

  1. Try to find a healthier alternative. Craving something sweet? Try some fruit or make some healthy homemade date balls (https://munchwize.co.za/blog/project/healthy-date-balls-munchwize-dietitians-cape-town/)
  2. If the first approach fails – try and go for the ‘real thing’. What do I mean by this? If you are craving chocolate, rather opt for a dark, less processed chocolate and then savour and eat it slowly so you can stick to that 2 block portion size.

 

Q: Do I need to give up my morning caffeine fix now that I am pregnant?

A: Caffeine is actually a stimulant and you will feel much better if you don’t drink a lot of it. Caffeine can cross over into your baby’s system. So why is this a problem? Well, unlike us our babies are not able to get rid of caffeine as quickly and therefore they are exposed to the effects for much longer.  It is unlikely that a small amount of caffeine will affect your baby, but one large study showed a relationship between drinking more than 300mg of caffeine per day and babies that were born with low birth weights. Another reason to cut back is that caffeine can make it harder for your body to absorb that important iron needed during pregnancy. Try to limit your daily intake of caffeine to no more than 300mg per day. This is equal to about 2 cups of coffee or 6 cups of black tea. Many soft drinks also contain caffeine, but we would recommend sticking to clean, safe water as an alternative.

 

Q: I have heard that I can’t eat sushi when I am pregnant? Is this true and are there any other foods I should avoid?

A: I am sorry to say those Friday night sushi nights are a thing of the past for the next nine months. Sushi and any raw seafood are high-risk foods for pregnant women. Unfortunately it is easier for you to get food poisoning from dodgy food and the effects are unfortunately more serious. Choosing lower-risk foods from a good source and ensuring good hygienic preparation can help lower the risk.

Examples of other high-risk foods to avoid during pregnancy:

  • Raw or unpasteurized dairy products, fruit juices and ciders.
  • Unpasteurized soft cheeses
  • Blue veined cheese (e.g. Roquefort, Gorgonzola)
  • Refrigerated pate, meat spreads, smoked seafood
  • Pre-packaged raw sprouts
  • Ready to eat deli meats
  • Raw or uncooked poultry, meat, seafood and eggs. (Make sure your eggs have hard yolks).

 

Q: I take a prenatal multivitamin, should I be taking any other supplements during my pregnancy?

A: Supplements are useful as micronutrients are essential for mom and baby but remember pills can never substitute healthy balanced eating. The best would be to check with your dietician or health care practitioner to make sure you are taking a good supplement. Micronutrients that we have to give extra attention to during pregnancy are: folic acid, iron, calcium, Vitamin D and Omega-3 fatty acids.

Omega 3

Get your omega 3 fatty acids from eating fatty fish such as sardines, trout and salmon (also low in mercury) at least twice a week. If you’re not a fish lover opt for an Omega 3 fish oil supplement. (Check in with your dietitian about options)

 

Iron

Did you know that when you are pregnant your iron needs almost triple? Iron helps to build new red blood cells and carry oxygen. The iron you eat will build up your baby’s iron stores which she can use after she’s born.

It is important to include enough iron rich foods into your daily diet. Animal sources of iron (haem iron) are absorbed the best. Plant sources (non-haem iron) are not as well absorbed so you need to eat these with foods that are high in vitamin C to enhance the absorption. Citrus, tropical fruit and bell peppers are great sources of vitamin C.

To meet your iron needs throughout your pregnancy, you can include the following foods into your diet:

  • Beef
  • Chicken and fish
  • Pumpkin seeds, cashew, pine and hazel nuts*
  • Dried beans, peas and lentils*
  • Fortified whole grain cereals*
  • Dark leafy greens (e.g. spinach and Swiss chard)*

(* Eat with a high vitamin C food)

 

Recommendation
Omega 3 500-900mg of DHA and EPA combined
Iron Most multi-vitamins will contain iron, but check that yours provides at least 27mg per day.

 

Q: Why do I need to take Folate during my pregnancy?

A: Folate is especially important in your first trimester for baby’s brain and nerve development. Making sure you are getting enough folate can help reduce the risk of a birth defect that affects the brain and spinal cord (also known as neural tube defect). To benefit the most from folate supplementation, it is recommended that you initiate it once you start trying to fall pregnant.  If you haven’t started it before, it is still beneficial to take it once you find out you are pregnant.

Include these high folate foods into your daily diet:

  • Lentils and dried beans (e.g. chickpeas, black, pinto beans and edaname beans)
  • Sunflower seeds and peanuts
  • Green vegetables (eg broccoli, asparagus, okra, spinach, brussels sprouts, collards and mustard greens)
  • Fruits (eg papayas and avocados)

 

Q: I have heard that some fish is not safe to eat during my pregnancy – is there any truth to this?

A: As mentioned, fish can be an excellent source of omega 3’s for baby’s brain development and therefore it is good to include fish into your daily diet. But certain fish are high in mercury. These are not so great for you because high levels of methyl mercury exposure during pregnancy can actually harm the developing nervous system of your baby. Environmental sources of mercury (eg burning of refuse and breathing in that air) are more of a threat to you, but it is still a good idea to avoid the fish that are high in mercury. Global guidelines recommend that pregnant women avoid the following fish during pregnancy: swordfish, king mackerel. Unfortunately, you also need to limit tuna intake to 150g/month. Remember to include at least two servings of fish into your weekly diet, one of these must be a low mercury, oily fish. eg herrings, pilchards, sardines, trout and salmon.

 

Q: I have heard that pregnant women are more prone to constipation. Is this true and what can I do to prevent it?

A: Constipation is a reality in pregnancy. To help relieve this, make sure you are following a diet that is high in fibre and that you are drinking enough water. Your diet should contain an increased amount of both types of fibre (soluble and insoluble). Insoluble fibre acts like a broom pushing waste materials through the digestive system and helps keep your bowel movements regular. Soluble fibre on the other hand acts like a sponge by soaking up fluid during digestion which helps slow down digestion.

 

Insoluble fibre is found in:

  • Wholegrain breads and cereals
  • Vegetables
  • Nuts, wheat bran and rice bran

 

Soluble fibre is found in:

  • Fruits
  • Legumes
  • Nuts, seeds, psyllium husks
  • Oat bran and barley bran

 

Bran/ flaxseed powder/ Jungle Oat bran/ psyllium husks are great options to help increase the amount of fibre in your diet.

  • Start with 1 tablespoon a day
  • Increase it gradually to 3 tablespoons a day
  • This can be added to things like porridge, soup and yoghurt etc.

 

It is also important to make sure you are drinking enough water in the day. Drinking a hot cup of caffeine-free tea (such as rooibos tea) or water in the mornings and evenings can also help stimulate your bowel movements. Physical activity is another great way to stimulate bowel movements – aim for light to moderate exercise 3-5 times a week.

Sarah is a registered dietitian and new mother to a 9 month old. She is a partner at Munchwize (a private dietetic practice based in Claremont, Cape Town). Prenatal nutrition and weaning babies onto healthy foods has really become a passion of hers. She discovered how difficult it can be putting what you preach into practice through her pregnancy and while breastfeeding her baby. “Food and nutrition have always been such a big part of my life. I grew up in a family where cooking yummy meals was a real passion. I love food and the fact that healthy food can be so delicious and has the power to change people’s lives. I enjoy cooking and developing recipes that make the healthier choices easy to prepare and delicious to eat. Having my little girl Ava has been an amazing journey and it has been so much fun preparing healthy and delicious foods for her.”

 www.munchwize.co.za / dietitians@munchwize.com

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