Expecting? Here’s What You Should Eat (And Avoid)

Eating a healthy diet during your pregnancy is one of the best things you can do for yourself and your baby. At Westchester Health, we stress to all our expecting moms that the food they eat is their baby’s main source of nutrition. Good nutrition is crucial to meet the added demands on their body and the needs of their growing baby.

Dennis McGroary, MD, FACOG

If you already eat a balanced diet, you just need to add a few extra calories from healthy sources. If your diet has not been so great, pregnancy is a good time to change old habits and develop healthy new ones.

To help moms-to-be know which foods they should be eating and which they should avoid, I have found the chapter “Nutrition During Pregnancy,” published by the American College of Obstetricians and Gynecologists, to be a great resource. In this blog, I’ll summarize the information but you can read it in its entirety and download it here.

Healthy eating also includes knowing how much you should eat

Pregnant women used to be told to “eat for two.” But that has changed. Physicians now do not tell pregnant women to eat twice as much as they normally do. “Finding a balance between getting enough nutrients to fuel the baby’s growth and maintaining a healthy weight is important for your and your baby’s future health,” according to ACOG.

The guidelines now state that a pregnant woman with a body mass index (BMI) in the normal range before pregnancy needs, on average, only about 300 extra calories a day—the amount in a glass of skim milk and half a sandwich. In other words, not much. A woman carrying twins will need 600 extra calories per day.

Again, there is no “magic number” of extra calories a pregnant woman should consume. It’s specific to each individual woman, and depends on her pre-pregnancy BMI.

You can calculate your own BMI using this easy online tool from the NIH.

Balancing your diet

Nutrients are what help your body function, grow and repair. Important nutrients include proteins, carbohydrates and fats. When you’re pregnant, you not only need to meet your own body’s needs but also those of your baby. That’s why getting enough nutrients during pregnancy is so important: it safeguards your own health and fuels your baby’s development.

Protein

Protein provides the nutrients your body needs to grow. Good sources of protein include:

  • Beef, pork, and fish
  • Poultry
  • Eggs
  • Milk, cheese and other dairy foods
  • Beans and peas
  • For vegetarians: nuts, seeds, nut butters and soy products such as tempeh and tofu
Carbohydrates

Carbohydrates break down into glucose, the body’s main fuel source. There are two types of carbohydrates: simple carbohydrates and complex carbohydrates.

Simple carbohydrates provide a rapid energy boost because they are quickly digested and absorbed. However, they are typically high in calories, so it is best to limit your simple carbohydrate intake to ones that exist naturally in foods such as fruits. They can also be found in sugary drinks and foods with added sugar, but physicians recommend that pregnant women avoid these.

Complex carbohydrates include dietary fiber and starches. It takes your body longer to process these, which is why complex carbohydrates provide longer-lasting energy than simple carbohydrates. They can be found in bread, rice, pasta, some fruits and starchy vegetables such as potatoes and corn. The following foods are good sources of fiber:

  • Fruits (especially dried fruits, berries, oranges, apples, and peaches with the skin)
  • Vegetables (dried beans, peas and leafy vegetables like spinach and kale)
  • Whole-grain products (whole wheat bread or brown rice)
Fats

During pregnancy, fats provide energy as well as help sustain the placenta and many fetal organs. However, too much saturated fat and trans fat can lead to health problems, including heart disease. Fats should make up about 20–35% of your total food intake—approximately 6 tablespoons per day and should mostly be unsaturated fats, such as olive oil and peanut oil.

There are three different types of fat found in foods:

  1. Saturated fats: mainly from meat and dairy products that tend to be solid when chilled, such as butter and lard. There also are two plant-based saturated fats: palm oil and coconut oil.
  2. Unsaturated fats tend to be liquid and come mostly from plants and vegetables. Olive, canola, peanut, sunflower and fish oils are all unsaturated fats.
  3. Trans fats are unsaturated fats that have been chemically processed to be solid at room temperature so that foods last longer and have better flavor. Vegetable shortenings, margarines, crackers, cookies and snack foods like potato chips often contain trans fats. You should avoid trans fats as much as possible, which have no nutritional value.

Planning healthy meals using the 5 food groups

The U.S. Department of Agriculture has made it easy to plan nutritious meals by creating www.choosemyplate.gov. The “MyPlate” website offers dietary guidelines and nutrition advice and can be found here.

To illustrate how MyPlate works, the chart below shows the foods and amounts that a pregnant woman with a normal BMI before pregnancy should eat for each trimester of pregnancy. Food items are broken down into the five food groups: grains, vegetables, fruit, dairy and protein.

Important vitamins and minerals

Vitamins and minerals also play key roles in nutrition. During pregnancy, you need more folic acid and iron than when you’re not pregnant. Many OB/GYNs prescribe prenatal vitamins for their pregnant patients to make sure they’re getting the right amounts. The following chart details the vitamins and minerals you need for a healthy pregnancy:

How much weight should you gain during your pregnancy?

The amount of weight you should gain when carrying a baby depends on 1) your health, and 2) your BMI before pregnancy.

Most importantly, weight gain during pregnancy should be gradual. During your first 12 weeks—the first trimester—you may gain only 1–5 pounds or no weight at all. In your second and third trimesters, if you were a healthy weight before pregnancy, you should gain between ½ pound and 1 pound per week.

The key to gradual weight gain is to slowly increase the number of calories you consume throughout all three trimesters.

  • First trimester when weight gain is minimal: usually no extra calories are needed.
  • Second trimester: an extra 340 calories a day
  • Third trimester: an extra 450 calories a day
  • Keep in mind that these amounts are for women who were a normal weight before pregnancy. If you were overweight or obese to start with, you probably need fewer extra calories.

Special dietary concerns

Certain foods, diets or health conditions often cause some moms-to-be to worry about what to eat and not eat while pregnant. Here’s a brief summary but for more detailed information, click here.

Fish and shellfish

Fish and shellfish are excellent sources of omega-3 fatty acids, and there is strong scientific evidence that they play an important role in fetal nervous system development. However, some types of fish have high levels mercury, which has been linked to birth defects. To limit your exposure to mercury:

  • Choose fish that is lower in mercury, such as shrimp, salmon, catfish, canned light tuna (not albacore, which has a higher level of mercury) and sardines.
  • Do not eat shark, swordfish, king mackerel or tilefish, which have the highest levels of mercury.
  • Albacore tuna: limit the amount to 6 ounces a week.
Caffeine

Most experts believe that consuming less than 200 mg of caffeine a day (one 12-ounce cup of coffee) during pregnancy is safe. Remember, though, that caffeine is also present in teas, colas and chocolate, so make sure you count these in your total caffeine intake each day.

Vegetarians

If you’re a vegetarian, it still is possible to get all of the nutrients you and your baby need during pregnancy. It just takes some extra planning.

  • Make sure you get enough protein from foods such as soy milk, tofu and beans. Eggs, milk and cheese also are good protein sources if you eat these.
  • Eat lots of iron-rich vegetables and legumes, such as spinach, white beans, kidney beans and chickpeas.
  • To get the recommended amount of calcium if you don’t consume dairy, eat dark leafy greens, calcium-enriched tofu and other calcium-enriched products (soy milk, rice milk and orange juice).
Lactose intolerance

Women who have trouble digesting dairy products can get calcium from other foods, such as seeds, nuts and soy. Lactose-free milk, cheese and other dairy products are also now widely available. Another option is to take a calcium supplement.

Celiac disease

If you are unable to eat foods containing gluten (found in wheat, barley and rye), there are several foods that are naturally gluten-free, such as fruits, vegetables, meats, potatoes, poultry and beans. Plus, these days you can fairly easily find gluten-free varieties of many foods.

Count on us for information and advice to help you have a healthy pregnancy, labor and delivery

You’ve got questions, we’ve got answers. Whether this is your first baby or you’ve been through pregnancy before, rest assured. At Westchester Health, we have years of experience helping expecting moms make healthy nutrition choices for themselves and their baby, and we’re ready to help you too.

Helpful articles we recommend:

Questions about what to eat and not eat while pregnant? Come see us.

If you’d like more information about which foods to eat and which to avoid during your pregnancy, please call (914) 232-1919 to make an appointment with one of our Westchester Health OB/GYNs. Our #1 goal is for you to have a safe pregnancy and deliver a healthy baby. Whenever, wherever you need us, we’re here for you.

By Dennis McGroary, MD, FACOG, Department of OB/GYN, Westchester Health, member of Northwell Health Physician Partners

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