I’ve safely trained others (and myself!) through healthy pregnancies, helping them with safe exercise choices throughout and after their pregnancies. I even wrote a book and DVD about it! But little is really known about optimizing nutrition for the active/exercising pregnant mom or the active/exercising nursing mom.
So I was thrilled to learn that a fellow mother and friend was also a Specialist in Maternal and Child Nutrition Education at the Texas Department of State Health Services. Debbie Lehman, PhD, RD has also worked as a personal trainer, and recognizes the importance of exercise during and after pregnancy.
Below is my interview with Dr. Lehman.
1. What are the most important things for a woman to include in her diet while pregnant?
The 40 weeks of pregnancy are a magical time for a woman and her family. Maintaining a healthy lifestyle before, during and after pregnancy is key for a healthy baby and mother. Ensure a healthy pregnancy by eating balanced meals with foods from all food groups, eat small frequent meals, eat plenty of fruits and vegetables, lean meats and beans, whole grains, and low-fat dairy. Also, try to cut down on fast foods, junk foods, sweets, soda and sweetened drinks, and drink plenty of water. A good plan is to fill half of your plate with fruits and vegetables, one fourth with lean protein, and one fourth with a whole grain. Then add a small low-fat dairy food or drink.
In addition to eating foods rich in nutrients, pregnant women are encouraged to check with a health-care provider because they may need a prenatal vitamin and mineral supplement to ensure they are consuming enough iron, folic acid and other important nutrients. It is also vital to avoid alcohol, tobacco and other harmful substances during your pregnancy.
Special nutrients during pregnancy:
Folic acid reduces the risk of birth defects affecting the spinal cord. Women of childbearing age who may become pregnant should consume 400 micrograms per day, and women who are pregnant should increase their intake to 600 micrograms per day. Folic acid is found in fortified cereals and enriched grains such as rice or pasta, beans, orange juice.
Iron is needed to make sure pregnant women are not at risk for anemia. Pregnant women need at least 27 milligrams of iron each day. High-iron foods include leafy greens, beans, fortified cereals, lean meat, chicken and fish.
Calcium is needed for the healthy development of a baby’s teeth, bones, heart, nerves and muscles. When a pregnant woman does not consume enough calcium, it is taken from her bones for the baby. It is important to consume 1,000 milligrams of calcium a day before, during and after pregnancy. Good sources of calcium are milk, yogurt, cheese, tofu, and dark leafy greens.
Omega-3s are important for your baby’s brain and eye development and function. Eat 8 to 12 ounces of a variety of seafood per week while you’re pregnant, including those high in omega-3s and low in mercury like salmon and trout.
Protein provides the building blocks for our body. Our bodies break down and rebuild tissue all the time, so we need a steady supply of protein to build new tissue. Protein is found in chicken, turkey, fish, meat, eggs, beans, dairy, and tofu.
2. Are the needs much different for a post-partum mom? Any different for one that is nursing?
Postpartum women who are not breastfeeding have the same nutrient recommendations as non-pregnant women. There is no special diet for postpartum or breastfeeding moms; it is really a matter of following a healthy and balanced eating plan. For women who need to put more focus on losing weight, the best advice is to cut out extra calories by avoiding empty-calorie foods such as sodas, desserts, fried foods, and high-fat snack foods, while also getting more physically active.
As for breastfeeding, it’s a common belief that breastfeeding promotes postpartum weight loss. This seems logical since lactation requires extra energy, plus it’s one reason women increase their fat stores during pregnancy. But research results are mixed — some breastfeeding women lose weight while others don’t. Breastfeeding can burn up to 600 calories per day and reduces a mother’s risk for postpartum overweight. Be sure to drink plenty of water, especially while breastfeeding.
Now more than ever, health professionals are urging women to eat right and manage their weight before getting pregnant.
For new mothers who are trying to get back to their pre-pregnancy weight: remember weight loss during the first six weeks after delivery is determined by many things. It is not just the result of how much food you eat. Postpartum weight loss varies from woman to woman. Some of you will lose weight quickly, others will not. During the first six weeks, you need healthy foods and plenty of fluids to help you regain your strength after having a baby. This is not a good time to go on an extreme or “miracle” diet. You need enough energy to take care of your baby. Also, check with your doctor before starting any physical activity.
3. How important are supplements for the pre-and post-natal mom?
During pregnancy, requirements increase for many vitamins, including folate, vitamin A, vitamin C, and most of the B vitamins. A pregnant woman who eats enough fruits, vegetables, and fortified bread and cereal products is usually able to meet her needs for extra levels of vitamins. Also, many physicians prescribe prenatal supplements to help cover vitamin requirements.
Many doctors routinely prescribe a prenatal vitamin-mineral supplement during pregnancy. Prenatal supplements are especially helpful for meeting iron needs, since many pregnant women don’t get all the iron they need through diet alone. Likewise, a prenatal vitamin provides extra folic acid during pregnancy, as well as other nutrients. But remember, even though a daily vitamin-mineral pill can help fill in the gaps, it’s not a substitute for a healthy diet.
Prenatal vitamin-mineral supplements can be especially important in helping pregnant vegetarians meet their needs. Also, fortified foods can make important contributions to nutrient intake, especially for vegans. Here’s a brief summary of key nutrients that vegetarians need to consider: iron, vitamin B12, calcium, vitamin D, and zinc.
While regular prenatal vitamins generally provide safe levels of nutrients for pregnant women, some nutritional supplements supply megadoses of nutrients (levels in excess of 10 times the amount the body needs). Taking excessive amounts of nutrients without medical supervision is dangerous. Depending on the supplement and the dosage, the side effects can include anything from hair loss, fatigue, or gastrointestinal distress to more serious results such as kidney stones, nerve damage, and birth defects.
Following pregnancy, take a basic one-a-day multivitamin/mineral supplement to ensure you are getting enough of important nutrients. Make sure the supplement includes at least 400 micrograms of folic acid to help prevent neural tube defects during the critical development period in the first few weeks of pregnancy (many women may not know they are pregnant during this time).
4. There’s plenty of confusion on the role of calories while pregnant and nursing. You’ve heard the saying about eating for two while pregnant, I’m sure!
Most women only need about 340-450 extra calories/day during the 2nd & 3rd trimesters. This equals an extra healthy snack or two throughout the day (such as a turkey sandwich and glass of milk) but not twice as much food!
Breastfeeding can burn up to 600 calories per day. Breastfeeding is a great way to lose pregnancy weight, and it is the healthiest food for your baby.
5. How important is it to shop organic, fresh, frozen, etc? I have many clients who have been somehow misled to believe that ONLY organic foods should be consumed.
When it comes to buying fruits and vegetables, many factors play a role in which types consumers choose, including nutritional value. The Academy of Nutrition and Dietetics says no matter what form they take — fresh, frozen, canned or dried — fruits and vegetables are good-for-you foods that can be enjoyed at any time.
The growing demand for foods that are healthful, tasty and environmentally friendly are the main drivers of organic food sales. Because organic production methods emphasize the use of renewable resources and the conservation of soil and water, organic foods also appeal to environmental concerns. With demand growing for more flavorful foods, many consumers and chefs believe that organic products taste better.
Overall, organic food is neither safer nor more nutritious than conventionally produced food. Many basic organic foods such as milk, butter, ice cream and meat contain as much fat and calories as their conventional counterparts. Certain health benefits motivate shoppers to buy natural or organic foods. For instance, people allergic to foods, chemicals or preservatives can gain relief by switching to organic foods, personal care products and clothing. To reduce fat and cholesterol in their diets, consumers can replace meat with products made from organic soy, wheat or vegetables.
6. So, in the earlier question I mentioned this irrational focus on only organic, or non-genetically modified, or “clean” foods while pregnant. It’s not just pregnant moms that have this “hyper” focus on eating organic; many people do this. It’s the newest form of disordered eating, also known as Orthorexia. What is Orthorexia?
Orthorexia – an unhealthy fixation on eating only healthy or “pure” foods – was originally defined as a disordered eating behavior in the ’90s, but experts believe it has been gaining steam in recent years, fed by the profusion of foods marketed as healthy and organic, and by the media’s often conflicting dietary advice. Like anorexia nervosa, orthorexia is a disorder rooted in food restriction. Unlike anorexia, for othorexics, the quality instead of the quantity of food is severely restricted.
“Orthorexia starts out with a true intention of wanting to be healthier, but it’s taken to an extreme,” says Academy of Nutrition and Dietetics Spokesperson Marjorie Nolan, MS, RDN, CDN, ACSM-HFS, who specializes in working with eating disorder clients. ” If someone is orthorexic, they typically avoid anything processed, like white flour or sugar. A food is virtually untouchable unless it’s certified organic or a whole food. Even something like whole-grain bread – which is a very healthy, high-fiber food – is off limits because it’s been processed in some way.”
Orthorexics typically don’t fear being fat in the way that an anorexic would, but the obsessive and progressive nature of the disorder is similar. Orthorexics may eliminate entire groups of food – such as dairy or grains – from their diets, later eliminating another group of food, and another, all in the quest for a “perfect” clean, healthy diet. In severe cases, orthorexia eventually leads to malnourishment when critical nutrients are eliminated from the diet.
7. What are your thoughts on whey protein? It’s a convenient source of protein for busy moms. I recommend plain whey protein, if a client has an aversion to artificial sweeteners, but the unflavored products taste like watery chalk. I supplemented with whey protein during my nursing months (almost 1 year) with no adverse effects. I also had my doctor’s blessings.
Whey protein is considered an excellent source of protein. Research is ongoing in this area.
As a source of high nutritional quality protein, whey protein has been found to reduce short-term food intake and may aid in reducing appetite. Additional studies are required before firm conclusions can be made.
As a nutritional supplement (protein source), up to a single daily dose of 15 grams whey protein or single doses of 0.4 and 0.3 grams whey protein per kilogram of body weight may be taken.
Whey protein is likely safe for most adults when used appropriately. High doses can cause some side effects such as increased bowel movements, nausea, thirst, bloating, cramps, reduced appetite, tiredness (fatigue)and headache.
Special Precautions & Warnings:
Pregnancy and breast-feeding: Not enough is known about the use of whey protein during pregnancy and breast-feeding.
Milk Allergy: If you are allergic to cow’s milk, avoid using whey protein.
WHEY PROTEIN Interactions
Major Interaction Do not take this combination
- Levodopa interacts with WHEY PROTEIN
Whey protein might decrease how much levodopa the body absorbs. By decreasing how much levodopa the body absorbs, whey protein might decrease the effectiveness of levodopa. Do not take whey protein and levodopa at the same time.
Moderate Interaction Be cautious with this combination
- Alendronate (Fosamax) interacts with WHEY PROTEIN
Whey protein can decrease how much alendronate (Fosamax) the body absorbs. Taking whey protein and alendronate (Fosamax) at the same time can decrease the effectiveness of alendronate (Fosamax). Don’t take whey protein within two hours of taking alendronate (Fosamax).
- Antibiotics (Quinolone antibiotics) interacts with WHEY PROTEIN
Whey protein might decrease how much antibiotic the body absorbs. Taking whey protein along with some antibiotics might decrease the effectiveness of some antibiotics. To avoid this interaction take whey protein supplements at least one hour after antibiotics.
Some of these antibiotics that might interact with whey protein include ciprofloxacin (Cipro), enoxacin (Penetrex), norfloxacin (Chibroxin, Noroxin), sparfloxacin (Zagam), trovafloxacin (Trovan), and grepafloxacin (Raxar).
- Antibiotics (Tetracycline antibiotics) interacts with WHEY PROTEIN
Whey protein contains calcium. The calcium in whey protein can attach to tetracyclines in the stomach. This decreases the amount of tetracyclines that can be absorbed. Taking calcium with tetracyclines might decrease the effectiveness of tetracyclines. To avoid this interaction take whey protein two hours before or four hours after taking tetracyclines.
Some tetracyclines include demeclocycline (Declomycin), minocycline (Minocin), and tetracycline (Achromycin).
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