What Are Pregnancy Superfoods (Power Foods)?
Superfoods or power foods are foods that have extra benefits beyond their nutritional content. Examples of power foods are:
- Pumpkin seeds
- Blackstrap molasses
- Almond butter
Women who are planning in advance to become pregnant have a great opportunity to focus on a healthy diet and get into optimum health before conceiving. Many women are encouraged to consider the 3 months before conception as a "pre-mester" or a trimester of pregnancy before conception. Not only does following healthy pregnancy diet plan guideline help a woman get into optimal health, it may help her conceive more easily. The father-to-be also is encouraged to follow a pre-pregnancy diet because it may help the mother-to-be stick to a healthy pregnancy eating plan.
Myths of pregnancy such as 'you need to eat twice as much because you're eating for two' or that indulging your cravings will give your baby birthmarks are outdated and inaccurate. From a scientific perspective, there are increased nutrient demands during pregnancy, but the wisdom of the body also tells us pregnancy is a time to focus on nourishment. It is a time for the mother-to-be to focus on being as healthy as she can because that care will translate to her baby in utero. Also, establishing healthy habits now will set a positive example that will benefit the child over his or her lifetime.
A well-balanced, micronutrient dense diet is the key to a healthy pregnancy. Ideally, women should start eating this way before conception, but making healthier choices at any time will always help.
A well-balanced diet should contain:
Pregnant women need more iron, folic acid, calcium, zinc, iodine, and vitamin D, and higher amounts of most other nutrients, than nonpregnant women. The US Recommended Daily Allowance2 sets the level of nutrient intake that is estimated to meet the nutritional needs of 97.5% of pregnant women. Malnutrition increases the risk of having a low birth weight baby or going into preterm labor. Pregnant women need the following daily:
In general, women will get high levels of these nutrients by choosing a diverse, colorful diet that focuses primarily (but not entirely) on plant-based foods.
Superfoods or power foods are foods that have extra benefits beyond their nutritional content. Examples of power foods are:
Pregnant women only need about 300 extra calories per day. While every woman is going to be different, research shows that for a normal weight woman (BMI 18.5 – 25), the optimal pregnancy total weight gain is about 25-35 pounds7. Larger women will gain less and smaller women gain more. All women should decrease their focus on weight and focus on the quality of their diet, ensuring good nutrition.
During the first and second trimesters, weight gain manifests as an increase in maternal fat stores, plus a 60% increase in blood volume. Later in pregnancy, more of the weight gain is due to the fetal growth, amniotic fluid, breast development, and placenta. Overweight women sometimes even experience weight loss during the first trimester and slowly gain a small amount over the second and third trimesters. There is no minimum amount of weight an overweight woman needs to gain as long as she is eating micronutrient dense foods and fetal growth is on track.
Regardless of the weight of the woman when she becomes pregnant, it isn't a good idea to diet during pregnancy. Research from famines during World War II in Europe have taught us about the epigenetic implications of restriction during pregnancy. Epigenetics describes the impact of the prenatal environment on the genetic programming of the child that stays with them for life. In fact, the prenatal environment has an impact on the developing ovaries and eggs in the female fetus, having an impact on the next generation too! A mother's nutritional choices during pregnancy can affect her grandchildren!
During the famines in World War II, pregnant Dutch women lived on less than 900 calories a day for a winter and their metabolism became very efficient at storing energy. When the war ended and food supplies returned to normal, and the babies were born, the women and their babies had normal calorie intake. However, those babies were far more likely to go on to become obese or develop diabetes because their genes were influenced during the time of scarcity. In the same way, dieting during pregnancy can have unintentionally metabolic consequences on the genetic programming of the infant that will stay with them for life.
While dieting (restricting calories) during pregnancy is discouraged, eating a healthier diet by removing extra sugar and processed foods is an excellent idea. This is the type of "diet" I put all my patients on. The focus should be on high quality nutrition, optimizing micronutrient intake, and minimizing empty calories.
Low carbohydrate diets can be healthy during pregnancy, as they are for any life phase, but the devil is in the details, as they say. More precise than simply a low carb diet, glycemic load diet is beneficial during pregnancy (and throughout life). Glycemic load is a term that measures how quickly a carbohydrate is digested and turned into blood sugar. Carbohydrates with lots of fiber, or combined with fat or protein have lower glycemic loads and raise blood sugar slowly, providing steady energy and preventing a spike in blood sugar and the subsequent low blood sugar drop. How do you follow a low glycemic load diet?
Choose carbohydrates in their unrefined (less processed) form:
An easy way to do this is to stay away from "white" foods:
White foods are also low in micronutrients. Stay away from processed carbs such as:
Dr. Brewer Pregnancy Diet is a diet plan that was popular in the 1980s. While it is a little outdated, the basics are still relevant and credible. Dr. Brewer calls for frequent snacks and pays close attention to salt, calories, and protein. The recommendations include getting daily servings from major groups of healthy foods, like calcium or iron containing foods.
Healthy breakfast options may include:
Healthy lunch options may include:
Dinners should have half the plate filled with
Healthy snacks may include:
Other important micronutrients during pregnancy are omega-3 fatty acids, DHA specifically, and probiotics. DHA is necessary for healthy development of brain and nervous system and may have beneficial effects on the cognitive development of the child.
Pregnancy superfoods may be included in a holistic pregnancy diet to ensure that optimal amounts of nutrients are enjoyed from food.
Pregnant women can absolutely follow vegan or vegetarian diets during pregnancy. In fact, doing so may help them avoid some of the added hormones that are common in non-organic animal products. However, there are some nutrients that are commonly deficient in vegetarian diets. Pregnant women who are vegan or vegetarian should be extra careful to ensure they are getting enough calcium, iron, and B-12. Protein intake needs to be monitored too.
Vegetarian protein sources include:
These last three are not part of a vegan pregnancy diet, but are appropriate for a lacto-ovo-vegetarian diet.
B-12 is needed for proper DNA expression in the growing embryo and fetus. Deficiencies cause anemia and are associated with low birth weight, pre-term delivery, preeclampsia, and neural tube defects8. Pregnant women need 30mcg a day according to the Recommended Daily Allowance, and the sources are all animal-based. Vegan women may want to ensure they get enough by taking a methylcobalamin supplement. Other B vitamins, specifically folate and B6, are important in pregnancy. A good-quality prenatal multi or B complex will provide these nutrients.
Protein requirements in pregnancy are increased by 50%. On average, a pregnant woman needs about 70 grams of protein per day. Protein will not only ensure good growth of the baby, it will help keep the mother's blood sugar stable and may help reduce morning sickness. Research studies have shown better birth outcomes (fewer underweight or early babies) when a mother's daily diet is at least 25% protein. Most people think of meat when they think about protein, but there are many excellent vegetarian sources. A vegan or vegetarian pregnancy diet can easily get enough protein from bean, nut, and grain sources. Additionally, relying only meat sources can increase your intake of saturated fat and other components of meat that are wise to limit in the diet. Here are some examples of good sources of healthy proteins.
Iron is a common deficiency during pregnancy. Iron is an essential mineral needed to transport oxygen to tissues. It is also necessary for DNA repair and mitochondrial energy production. Insufficient iron can cause anemia and symptoms of:
Anemia has been linked to pre-term births, low birth weight, and even autism and increased maternal mortality10. Thus, it's really important to get enough iron during pregnancy. The RDA for iron is 27mg during pregnancy; your obstetrician or midwife may recommend 40mg per day to correct a deficiency. Cooking in cast-iron skillets can also increase iron intake – you can add 5mg of additional iron for each per saucy, vitamin C-rich dish you cook in cast iron.
These are some good food sources of iron:
Folate occurs naturally in vegetables and whole grains but it is lost in the processing of refined grains. Folate deficiency increases the risk of congenital anomalies, most notably neural tube defects such as spina bifida. For this reason, it's one of the most serious nutritional deficiencies in pregnancy. Unfortunately, the critical time for neural tube development occurs in the first few weeks of pregnancy, often before a woman knows she's pregnant and thus when she is less likely to be taking a prenatal vitamin with folic acid or getting enough in the diet. Because of this, fortification of grain products (adding back in what was lost in processing) was mandated in 1998, and the prevalence of neural tube defects has dropped dramatically. Unfortunately, these foods are fortified with synthetic folic acid, not folate, and a very common genetic variant of the MTHFR gene (that codes for an enzyme important in processing of amino acids), makes it difficult for people to convert folic acid to useable folate and pregnant women with this variant are at particular risk. Researchers have suggested it would be much better to supplement pregnant women, and enrich food, with the active form methyltetrahydrofolate, rather than folic acid11. Fortunately, pregnant women can get the necessary 600mcg of active, natural form folate from these dietary sources:
Calcium is critical for developing bones. It also reduces the risk of pre-eclampsia and hypertension. Women who get enough calcium during pregnancy have a 35% lower risk of high blood pressure and a 55% lower risk of preeclampsia. If the mother isn't getting enough additional calcium in the diet, the fetus will still get enough, but it will come from the reserves in the mother's bones. The mother's ability to absorb calcium is greatly increased during pregnancy. This is why the RDA for calcium doesn't increase during pregnancy. However, most adult women don't get enough calcium in the first place.
When we think about calcium, most people think about milk, but there are numerous non-dairy sources of calcium. Women who are lactose intolerant can choose non-dairy sources. Pregnant women need 1000mg of calcium per day9. This can be reached with a few servings per day from the food list below. The minerals in vegetables sources, like spinach, can be made more available by cooking them with an acid such as vinegar or lemon juice. Try sautéing kale with apple cider vinegar and walnuts.
Iodine needs increase by almost 50% during pregnancy. Iodine is used for thyroid hormone function and for the developing nervous system of the fetus. Women who have iodine deficiency, or are hypothyroid for other reasons, are at risk of slowing the brain development of their baby. Pregnant women need 220mcg of iodine and the American Thyroid Association suggests pregnant women supplement with 150mcg of iodine daily12. Seaweed and seafood are the major source of iodine, but because of the need to limit mercury exposure in pregnancy, relying on seafood may not be wise.
Research suggests that 82% of pregnant women are deficient in zinc, which makes it one of the most important nutrients to pay attention to during pregnancy12. In addition to the negative outcomes of low birth weight, early delivery, and preeclampsia that result from deficiency, zinc is important for the immune system of the mother and baby. Iron competes with zinc for absorption, so women who are supplementing with extra iron also need to make sure they are getting extra zinc. Some food sources are:
Pregnant women need 600 IU of vitamin D according to the USDA RDA guidelines; however, many experts believe this estimate is far too low. Humans synthesize vitamin D from sun exposure and there are very few food sources. Additionally, factors such as skin pigmentation, obesity, and sunscreen usage impact the ability to make vitamin D from sunlight. In clinical practice, I measure patients' blood levels of vitamin D and find that many are deficient even if they are taking a 2000mcg vitamin D3 supplement every day. Pregnant women who are concerned about vitamin D can consult a midwife, naturopathic midwife, or obstetrician who is willing to test their vitamin D levels so they know how much they need. Here are a few food sources:
Pregnant women should stay away from several categories of unsafe foods:
Common bacteria pose a greater risk to pregnant women and their fetus, so extra precautions should be followed.
Some of the man-made food additives are known to cause problems and should be avoided. For example, trans fats cross the maternal/fetal barrier, and are absorbed by fetus and may cause adverse effects on cellular membrane structure.6 Although limited research is available to quantify the risks of artificial sweeteners in pregnancy, they are able to cross the placenta into the fetal circulation and are typically found in nutrient-poor, processed foods that should be limited regardless.
Illicit drugs, some over-the-counter (OTC), and many prescription drugs should also be avoided. If you are having trouble stopping taking illicit drugs or alcohol during pregnancy, talk to your midwife or obstetrician to get help specifically for pregnant women right away. There is help.
Medications, either OTC or prescription, can be harmful to the fetus; double check with your health-care professional or look up the "Pregnancy Class" of the medication before taking it.
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Artal R, O'Toole M. "Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period." Br J Sports Med. 2003 Feb;37(1):6-12; discussion 12.
2. OSU Linus Pauling Institute. Micronutrient Needs During Pregnancy and Lactation.
3. Dotterud, CK. et al. Probiotics in pregnant women to prevent allergic disease: a randomized, double-blind trial. Br J Dermatol. 2010 Sep;163(3):616-23. doi: 10.1111/j.1365-2133.2010.09889.x. Epub 2010 Jun 9.
4. Lassi, ZS, et al. Preconception care: caffeine, smoking, alcohol, drugs and other environmental chemical/radiation exposure. Reprod Health. 2014 Sep 26;11 Suppl 3:S6. doi: 10.1186/1742-4755-11-S3-S6. Epub 2014 Sep 26.
5. Natural Resources Defense Council. Sustainable Seafood Guide.
6. Atheroscler Suppl. 2006;7(2):17
7. Cogswell, M.E., et al. (February 1995). Gestational Weight Gain Among Average-Weight and Overweight Women - What Is Excessive? American Journal of Obstetrics and Gynecology. 172(2 Pt. 1): 705–12.
8. Molloy, AM. et al. Maternal vitamin B12 status and risk of neural tube defects in a population with high neural tube defect prevalence and no folic acid fortification. Pediatrics. 2009;123(3):917-923
9. Hofmeyr, GJ. et al. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database Syst Rev. 2011;(8):CD001059
10. Am J Clin Nutr May 2000 vol. 71 no. 5 1280s-1284s
11. Wilcken, B. et al. Geographical and ethnic variation of the 677C>T allele of 5,10 methylenetetrahydrofolate reductase (MTHFR): findings from over 7000 newborns from 16 areas world wide. J Med Genet. 2003;40(8):619-625.
12. Am J Clin Nutr. 2008 Mar;87(3):517-33.
13. Becker, DV. et al. Iodine supplementation for pregnancy and lactation-United States and Canada: recommendations of the American Thyroid Association. Thyroid. 2006;16(10):949-951
14. Caulfield, LE. et al. Potential contribution of maternal zinc supplementation during pregnancy to maternal and child survival. Am J Clin Nutr. 1998;68(2 Suppl):499S-508S
15. Wibowo, N. et al. Vitamin B6 supplementation in pregnant women with nausea and vomiting. Int J Gynaecol Obstet. 2012 Mar;116(3):206-10. doi: 10.1016/j.ijgo.2011.09.030
16. Matthews, A. et al. Interventions for nausea and vomiting in early pregnancy. Cochrane Database Syst Rev. 2014 Mar 21;3:CD007575. doi: 10.1002/14651858.CD007575.pub3. Review.
17. Fejzo, MS. et al. Antihistamines and other prognostic factors for adverse outcome in hyperemesis gravidarum. Eur J Obstet Gynecol Reprod Biol. 2013 Sep;170(1):71-6. doi: 10.1016/j.ejogrb.2013.04.017. Epub 2013 Jun 7.
18. Makrides, M. et al. Magnesium supplementation in pregnancy. Cochrane Database Syst Rev. 2014 Apr 3;4:CD000937. doi: 10.1002/14651858.CD000937.pub2. Review.
Please share your experience with eating a healthy diet during pregnancy, for example, how did you overcome challenges, what foods soothed and what foods aggravated your stomach, etc.Post
Did you, or do you plan to start eating a healthy pregnancy diet before you conceive?Post
How much weight did you gain during your pregnancy, and how did you lose it?Post
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Later symptoms and signs that labor that labor is are the woman’s water breaking, and when contractions begin.
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