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Pregnancy - Nutrition for a Healthy Pregnancy

By Charlotte Watts Dip.ION BANT – Nutritional Therapist – www.totalbeing.com

During pregnancy Optimum Nutrition becomes even more paramount, but it is also important that any changes should be gradual so that your body is not shocked or you will begin to detoxify too quickly. If you have not been as diligent about the food you eat as you intend to during pregnancy, just take it easy and build up to the programme. In this case this diet can be introduced in stages, alongside current choices and phase in.

Optimum Nutrition during pregnancy leads to healthier mothers and therefore healthier babies, in development in the womb and then as growing children. This start will support their immune systems, digestion and ability to reduce illness and the need for medications. For the pregnant mother calorie requirements only increase in the last trimester and by only 10%. All through the term, the need for micronutrient – vitamins, minerals, amino acids and essential fats – can increase between 30-100%, as they are needed to develop organs and body structures and the grow a whole baby. This demands the rapid dividing of cells for which you will need more protein, calcium, magnesium and phosphorus. The expanding blood supply to the baby demands more iron and B vitamins and very importantly, to develop the baby’s central nervous system, you need double the amount of folic acid. These increasing demands mean that considering what you eat and supplying nutritionally dense foods rather than the ‘empty calories’ found in modern convenience foods.

A healthy diet in pregnancy aims to:

• Support the development of the growing child.
• Support the health of the mother – a strong nutritional status helps a smoother pregnancy and childbirth and also a supply of necessary nutrients to the baby.
• Relieve any adverse symptoms of pregnancy.
• Can be carried into breastfeeding for all of the above reasons and to help avoid eczema, colic and the need for antibiotics for mother and child. This will give the child’s immune system the best start in life and help to avoid post-natal depression and other health concerns for the mother.

Foods to Prioritise During Pregnancy:

• Sources of essential fats - These are labelled as omega 3 oils found in oily fish such as salmon, trout, sardines, anchovies, herrings and pilchards. These are the choices with the least mercury contamination, a very important consideration as this toxic metal can cross the placenta wall. Women shouldn't be worried if they've had the odd meal of fish with high levels of mercury. It is only a potential problem when that type of fish is eaten regularly, which causes a build-up of mercury in the mother's blood. Omega 6 oils are found in raw nuts and seeds and their oils, specifically sesame, sunflower, walnut, almond, brazil, pumpkin and hemp oils. You should eat a tablespoon of mixed seeds daily (pumpkin, sesame, sunflower and linseed). Essential fats are crucial for brain development – our brains are made of a large proportion of DHA and EPA, the omega 3 fatty acids found in oily fish and both omega 3 and 6 oils are crucial for brain and nervous system development, immune function to protect the foetus from damage and skin and tissue growth.
• Increase protein intake – in particular, vegetarian sources of protein such as pulses, soya, rice and seeds as well as organic poultry and fish and some well-cooked eggs. Include protein with each snack or meal to balance blood sugar, helping energy levels and relief of morning sickness. Protein is needed to form hormones, enzymes, neurotransmitters, antibodies and structures in the body such as tissue and muscle. This formation is happening every second for both you and the baby and a lack of protein in pregnancy has been linked to birth defects.
• Complex carbohydrates – choose brown rice, wholemeal bread and whole-wheat pasta over the white, refined carbohydrate. When we think of carbohydrates, we usually imagine bread, pasta, potatoes and rice. These are starchy carbohydrate foods, but many people don’t realise that vegetables and fruit also contain carbohydrates, but of the fibrous variety. Carbohydrates are anything that eventually breaks down to a single glucose molecule. The sugar we are familiar with is actually sucrose, which is two joined molecules of glucose; in this state it can be very damaging to cells and foetal development. It is important to avoid too much sugar in the blood by choosing complex carbohydrates and reducing those refined. Balancing blood sugar in this way can also help to relieve morning sickness. Our weekly meal plan easily avoids these as simply preparing food from scratch removes the processed element.
• Eat plenty of fruits and vegetables - Ideally 3–5 portions of fruit and 3–5 of vegetables each day provides ideal complex carbohydrates, and also fibre to avoid the constipation often seen in pregnancy. Vary your intake and eat as many different colours as possible for the full complement of nutrients and the beneficial plant chemicals (bioflavonoids) that ensure good circulation, immune support and protection from damage to cells and tissues.
• Increase your pulse and bean intake – aim for a portion daily (add to soups and stews, humous, lentil salads) to provide an ideal form of the fibre which can help relieve constipation during pregnancy and at the same time carry toxins out of the body and away from the baby.
• Include papaya (which contains papain), fresh pineapple (containing bromelain), sprouted beans and alfalfa - good sources of dietary beneficial digestive enzymes. Good digestion always equals optimal health and prevents a build-up of toxins that can be harmful to the growing foetus.

Specific Nutrients for Pregnancy

We need very particular nutrients to support the health of an average functioning human being, let alone one that is actually growing a new human being inside her too! Nutrients all work together, but some are particularly important to support the cell development and growth.

• Folic acid This is the nutrient that most pregnant women are aware of and take in supplement form; this is because a folic acid deficiency has been linked with neural tube defects such as spina bifida. Studies have shown that women who have healthy levels of folic acid (or folate) through pregnancy have babies with good birth weights and APGAR scores – a score system used to assess babies’ physical condition. Folic acid is a B vitamin and as with all of this complex, they work together and none should be eaten or supplemented in isolation, as this can lead to an imbalance. The name folic acid or folate comes from the word foliage, as the vitamin is found in abundant levels in green leafy vegetables, which should make up a good part of your diet and provide many nutrients and energy. Good food sources; pinto beans, navy beans, asparagus, spinach, broccoli, okra, brussels sprouts, any green leafy veg.
• Vitamin B6 A particularly important B vitamin during pregnancy, it helps to utilise iron and prevent morning sickness. Also needed for all female hormone balance and fluid balance, so helps to address oedema or bloating and swollen ankles commonly seen in pregnancy. It works closely with zinc and magnesium, so a good mix of these is vital and nature helpfully provides them in packages in natural foods – no mere coincidence, this is how we evolved. Good food sources; cauliflower, watercress, carrots, chicken, eggs, fish, meat, peas, spinach, sunflower seeds, walnuts, wheat germ, avocados, bananas, beans, broccoli, brown rice, whole grains, cabbage, corn and potatoes.
• Vitamin E A powerful antioxidant, which protects the fatty tissues (skin, brain, liver and heart) of you and your baby against damage and helps get oxygen to cells to help them grow and develop fully. Vitamin E is called tocopheral, which comes from the Greek for ‘fertility’, discovered because deficiencies of the vitamin where seen in cases of infertility. It is also good for stretch marks and healing scars and as it is an oil, can be rubbed directly into skin. Good food sources; cold pressed vegetable oils, dark green leafy vegetables, legumes, nuts, seeds, brown rice, cornmeal, eggs, kelp, oatmeal, soybeans, wheat and wheat germ.
• Vitamin C Needed for all collagen production and therefore formation of new body tissues. This means that Vitamin C improves skin elasticity and helps to prevent haemorrhoids, varicose veins and arterial problems. Nosebleeds can be common during pregnancy due to the increased blood volume, causing ruptures in the capillaries of the nose, which Vitamin C is needed to heal. Low levels of Vitamin C are also implicated in pre-eclampsia, so it is may also be important to supplement this from early pregnancy onwards. Large amounts eaten before childbirth may even help to reduce labour pain and will certainly help to heal tissues afterwards. This cannot be stored by the body is it is important to consume on a daily basis. Good food sources; berries, cherries, citrus fruit, apples, kiwi, peaches, mangoes, papayas, pineapple, figs, potatoes, green peppers, broccoli, beetroot, sprouted vegetables and alfalfa.
• Vitamin A Lots of scares have caused much confusion about safe vitamin intake and it has become a problem that many pregnant women avoid it completely. Levels of vitamin A above 10,000ius (total for food and supplements) have been linked been linked to birth defects and so high levels of white fish and any liver should be avoided. There is a simple solution to this problem – beta-carotene, the substance that gives carrots their orange colour can be converted into Vitamin A and the beauty is that the body will only convert what it needs, avoiding any toxic levels. Vitamin A is important for tissue growth and healing, partly through helping you to use the protein that you eat. It also importantly protective for the growing baby against any environmental toxins that may enter your body – along with Vitamins C and E and the minerals zinc and selenium, Vitamin A is an antioxidant nutrient. Good food sources; orange, dark green and yellow vegetables, especially apricots, alfalfa, asparagus, broccoli, beet greens, melon, carrots, kale, mustard greens, papayas, peaches, pumpkin, red peppers, spinach, sweet potatoes, yellow squash and watercress – all of these are rich beta-carotene, so safe to eat in large quantities.
• Zinc Needed for the replication of all cells, this amazing mineral is involved in all DNA action, which makes our proteins and therefore all our tissues and structures. We obtain it from sources of food that also grow. Without zinc we can’t even heal our own tissues, let alone grow a new body and women’s needs can double during pregnancy; stretch marks indicate a need for zinc to renew skin tissues. Zinc also regulates appetite, taste and smell and as you are using up so much to grow new tissue, your relationship with food can change. It is important that you replenish these stores so that ironically you can eat enough food to provide all the nutrients you need. Good food sources; leafy and root vegetables, meat, poultry, lamb, seafood, seeds and whole grains.
• Iron Deficiency of iron is very common during pregnancy and can lead to anaemia, which shows up as lethargy, pale skin and palpitations. Deficiencies of vitamins B12 and B6 can cause similar symptoms and a varied, natural diet ensures all of these nutrients are included so that they can work together. Iron is found in largest amounts in the blood and is needed to carry oxygen to cells and therefore for all growth and energy production. It is much easier for us to assimilate iron from animal sources than plants and vegetarians need to be very careful that have enough Vitamin C that helps iron absorption. Wine, tea and coffee should be avoided anyway, but they also contain tannins that block iron absorption. Good food sources; eggs, fish, meat, poultry, green leafy vegetables, wholegrains, cereals, almonds, avocadoes, beets, molasses, pulses, peaches, pears, prunes, pumpkins, raisins, sesame seeds and watercress.
• Calcium Important for building the baby’s bones and teeth and promotes a healthy heart and nervous system. If you don’t receive enough through your diet, the calcium in your bones can be used to make your baby's! Better that you both have healthy bones. Good food sources; fish with bones, pulses, spring beans and all dark green vegetables, sesame seeds, tofu, yoghurt, calcium-enriched soy or rice milk, goat’s cheese. NB: eating loads of green leafy veg, nuts and seeds to get folic acid and magnesium too is a good choice and can be a good alternative for excessively inflammatory milk and dairy, which, as it can lead to the leaching of calcium from bone, is not the best form of calcium.
• Magnesium Helps with muscle cramps, sleep problems, relaxation, easy fatigue, and anxiety/nervousness. It is required for the absorption of calcium and is the primary mineral required by the adrenal glands to help the body cope with stress, a major factor in problems during pregnancy. Good food sources; leafy and root vegetables, meat, poultry, lamb, seafood, seeds and whole grains.

A Note on Supplements

Because of your increasing needs and the decreasing supply of nutrients in our food supply, safe supplementation during pregnancy has become a matter of necessity. There are some good prenatal multivitamins and minerals on the market and you certainly get what you pay for, so prioritise a good brand from an established supplement company. Nutrition is highly individual though and the ‘one size fits all approach’ is very limited. It is a good idea to seek the advice of a BANT (British Association of Nutritional Therapists) certified nutritionist to identify if you have more specific extra needs and they can advise the correct dosages to take.

See totalbeing.com for more advice on supplements or to arrange a telephone consultation.

Pregnancy “Superfoods”

We have included loads of these nutrient-packed foods which are all the ‘bundles of joy’ in themselves. Fresh, growing food needs the same nutrients that your baby does to reproduce and grow new cells. It is so easy to form easy meals from the foods below and we have done it for you!

• Eggs are a great protein source for mothers-to-be as they contain all the essential amino acids your body needs – the building blocks of protein and eggs have the highest quality possible. Eggs are designed to provide all the nutrients for the growth and development of new life and so are a very neat package of iron, zinc, vitamin A, the B vitamins and omega-3 fats – cook thoroughly to avoid any risk of contamination and food poisoning.
• Oily fish such as salmon, trout, mackerel and sardines contain EPA and DHA, the fats which make up a large part of our brains and so you need to grow your baby’s whole brain and nervous system.
• Brown rice retains the hull in which it grew, which is a little vessel of fibre, B vitamins, zinc and magnesium. The fibre clears out the body of toxins, supporting the liver and blood sugar balance that also support good female hormone balance.
• Dried apricots and prunes – prunes have the highest ORAC score (Oxygen Radical Absorbance Capacity) a scale used to measure the antioxidant action of foods. This means that they are the best possible protection for you and your baby against damage from free radicals, which constantly surround us in the environment. Apricots aren’t far behind and the two are fantastic antidotes to constipation.
• Oranges – citrus fruits contain vital vitamin C, folic acid and fibre, but also their high water content can also help your meet daily fluid needs, which should come from food as well as drinks and are more important now than ever before.
• Spinach – when cooked, spinach is a veritable fountain of folic acid and iron, two nutrients vital for foetal development. The darker the greens, the greater the nutritional value, so replace lettuce in salads and sandwiches with raw spinach.
• Bananas – being naturally easy-to-digest, bananas are the perfect food for combating morning sickness and giving your body a quick burst of energy, as well as much needed potassium, a mineral needed for fluid balance that can help with swollen ankles.
• Broccoli – not only packed with loads of antioxidants, vitamin C, calcium and folic, broccoli also contains sulphur compounds that increase circulation and the clearance of toxins from cells and the liver. They can also help balance female hormones to support a healthy pregnancy.
• Avocados are actually a fruit and have always had a reputation as an aphrodisiac and seen as a symbol of fertility. The name avocado comes from the Aztec word ahuacatl, or “testicle tree” and are absolutely packed with vitamin A and folic acid, and provide iron, zinc, healthy fat, vitamin C and B vitamins!
• Nuts and seeds – consider that these are the pods from which plants grow and to do that they are full of iron, zinc, calcium, B vitamins, protein and healthy fats – the perfect snack food.
• Pulses and lentils – we have hailed the wondrous qualities of beans already and aim to show you how easy they are to prepare and how tasty they can be. Remember that relieving constipation with this excellent form of fibre can also help you to avoid haemorrhoids!

Foods to Decrease or Avoid During Pregnancy

As well as Optimum Nutrition during pregnancy, it is also important to reduce your intake of anti-nutrients – for example sugar, caffeine and alcohol serve no nutritional role in the body, deplete the body of vital nutrients and even over-stimulate, increasing the risk of miscarriage. The tannins in tea can also have a negative effect as they interfere with iron uptake from foods by up to 70%. There are other factors in our diets that usually seem less harmful, but it becomes more important to be aware of them during pregnancy.

• Phytates in wheat bran can also limit the uptake of minerals (such as calcium, iron, and zinc), so it is best to concentrate on eating other grains such as porridge oats, millet, amaranth, rye and buckwheat.
• Leafy green vegetables are healthy to include in your pregnancy diet, but oxalates found in spinach and kale can limit mineral absorption from meals, so vary intake.
• Soft or blue cheeses (camembert, brie, stilton) and raw meats, cooking poultry thoroughly and avoiding raw eggs.
• Unpasteurised milk, shellfish, raw fish, liver and peanuts should also be avoided.
• Avoid eating ready-prepared salad bags due to possible listeria contamination.
• Foods in the nightshade family (tomatoes, peppers, aubergines and potatoes) contain solanine that inhibits calcium, so do not include excessive amounts and balance out with calcium sources.
• Limit tyramine containing foods that cause stimulation - caffeine, alcohol, sugar, tobacco, cheese, chocolate, sauerkraut, wine, bacon, ham, sausage, aubergine, potatoes, spinach and tomatoes.
• Avoid hydrogenated vegetable oils found in margarines and processed food and trans-fat found in fried food.
• Reduce saturated fats (found in red meat and dairy), which may interfere with the body’s utilisation of essential fats, although some good organic red meat is a good source of iron.
• Tuna, swordfish and sea bass as these fish can be contaminated with mercury.
• Alcohol should always be avoided during pregnancy; it depletes B vitamins, vitamin C, over-stimulates and dehydrates. It is important to remember that whatever you eat or drink while pregnant goes directly through your bloodstream into the placenta. This includes alcohol, which actually interferes with the baby’s ability to get enough oxygen and nourishment for normal cell development in the brain and other body organs.

To Help Relieve the Unpleasant Side-effects of Pregnancy

• Celery is a safe remedy for high blood pressure sometimes seen in pregnancy – four sticks a day can have a therapeutic effect.
• Grapefruit can increase appetite lost during pregnancy.
• Vitamin B6 foods (see above) for morning sickness; this is linked to poor iron utilisation and you can increase iron, but without vitamin B6 you just won’t use it properly.

Specifically for morning sickness, the following changes to diet and the way you eat can help enormously and allow you to continue to eat the foods that support your pregnancy:

• Slow down when you eat or drink and eat ‘little and often’ – smaller meals every 2-3 hours can help. Morning sickness is one of the few types of nausea that can be relieved by having food in the stomach.
• Before you get up have something to eat in bed, just as small as a cracker or oatcake and then get up slowly.
• Drink lemon juice in hot water 20 minutes before eating breakfast. Sucking on a lemon can also help relieve nausea for some women.
• Aid digestion by not drinking with meals (leave an hour either side). Also avoid overly fatty or spicy foods. Fatty foods stay in the stomach longer and increase the chance of vomiting. Garlic, onion, acidic fruits and vegetables (such as tomatoes and citrus fruits) and/or spicy foods are all common causes of morning sickness.
• If feeling nauseous, sip ginger tea (slices of ginger in hot water) or carbonated water.
• Avoid caffeine in tea, coffee, colas and chocolate; it can irritate the gut.
• Dehydration can cause nausea and is dangerous during pregnancy, so achieve your 2 litres of water a day. If you are not used to this then build up slowly over a couple of weeks and try half apple juice, half water to help get water into cells – when you start hydrating it can be like watering a dried out pot plant, the water just runs straight through!
• It may be better if someone else prepares your food when possible. If cooking, ventilate the kitchen thoroughly as it is often the smell of food that triggers nausea.
• Do not lie down for at least 2 hours after eating a meal - if you need to lie down after eating, lie on your right side as the stomach empties from left to right.
• Avoid cigarette smoke, stress and practise safe handling of food.
• Avoid vigorous activities and don’t wear tight clothing.

The Dirty Dozen

The US organisation Environmental Working Group www.ewg.org has produced a Top 12 of the most toxic fruit and vegetables. That is if they are bought non-organically and so contain the most pesticide residues seen of all fresh produce.

It is possible to lower your toxic burden by up to 90% by simply avoiding the most contaminated fruit and veg as listed below. You do not have to avoid them, indeed they all have many health benefits, but these are the ones that you should prioritise buying organically:

• Apples
• Peppers
• Celery
• Cherries
• Imported grapes
• Nectarines
• Peaches
• Pears
• Potatoes
• Raspberries
• Spinach
• Strawberries

NB: Also avoid farmed salmon as it is the number one source of PCBs (polychlorinated biphenlys), which have been shown to alter major systems in the body (immune, hormone, nervous, and enzyme systems); therefore, PCBs affect a wide variety of body organs and functions.

See www.totalbeing.com for a Nutritional Assessment to choose the right diet and supplements to help you get in control of your health!

See www.healthyconvenience.com for help remembering how to get healthy – for posters, shopping guides and recipes.