The nutrient list Big 4

When you announce to the world that you’re pregnant, the warnings begin. Don’t drink coffee! Don’t eat fish! Don’t gain too much weight! You’re a vegetarian? Where will your baby get all the protein she needs?

When you go online searching for “the truth,” you’ll be bombarded by a plethora of conflicting websites. One website tells you coffee is fine in moderation. Another claims that more than one cup a day doubles your risk of miscarriage. One website says you need fish for healthy fetal brain development. Another says the mercury in fish inhibits the development of the baby’s nervous system. There was even a study concluding that an occasional glass of wine was good for you during pregnancy. It went on to say that the children of women who drank occasionally during pregnancy did better on balance tests. Go figure.

Once your head stops spinning, it’s probably best to consult your health-care provider or a nutritionist, someone who has sifted through the major studies, as well as the myths. What you’ll hear is a short list of absolute do’s and don’ts – along with suggestions about moderation and supplementation – to ensure a healthy pregnancy.

Like most nutritionists, Chelsea Fyrberg, of Women’s Wellness Comprehensive Care in Portland, advises women to give up coffee (as well as soda) because caffeine is a stimulant that has been associated with an increased risk of miscarriage. Not only that, but caffeine – also found in soda and chocolate – is a diuretic that can rob the bones of calcium and lead to dehydration. Fyrberg also doesn’t see any upside to drinking alcohol, which lowers the body’s resistance to colds and other viruses.

Fyrberg says most of her clients have very little trouble giving up alcohol and at least limiting caffeine to one cup of coffee a day.

“It’s harder (for clients) to incorporate the nutrients they need than it is to give things up,” she says.

Fyrberg says there are four very important nutrients women need to incorporate into their diets during pregnancy: folic acid, DHA, iron and calcium. Folic acid, also called folate, is a B vitamin that plays an important role in the production of red blood cells and in the development of the baby’s brain and spinal cord. Webmd.com recommends 400 micrograms a day as a supplement along with a bowl of fortified cereal, but Fyrberg counsels her clients to take 800 micrograms, and to begin taking a prenatal supplement as soon as they start thinking about getting pregnant.

Another nutrient pregnant women should be concerned about is DHA, which helps the baby’s brain and eyes develop. Fyrberg advises pregnant women to supplement with a purified, high-grade fish oil, containing 200 mgs, especially if they are feeling an aversion to seafood (or are worried about the mercury in some fish).

As for seafood, Fyrberg says pregnant women should avoid sushi entirely because of the possibility it might contain bacteria. (Bacteria, she notes, can also be present in brie, pate, and other soft or raw cheeses, which should be avoided.) Only certain types of seafood are high in mercury and should be avoided altogether. They are swordfish, shark and mackerel. Other types of fish – salmon, catfish, cod and tilapia – can be eaten up to twice a week.

Pregnant women also need more iron – 27 mgs a day – to make the extra red blood cells for the 50 percent increase in their blood supply during pregnancy. Iron-rich foods include red meats, sweet potatoes, legumes and fortified pasta. Vitamin C helps the body absorb the iron in foods and supplements, while caffeine inhibits iron’s effects.

Calcium is the fourth important nutrient for pregnant women. Calcium helps develop bones and teeth and prevents the developing baby from stealing calcium from the mother’s bones. The best source of calcium is found in yogurt (488 mgs in one cup), but servings of milk, cheese, almonds, spinach, collard greens and/or salmon also will help supply the 1,000 milligrams a day that most doctors recommend. Fyrberg points out that choosing skim milk or nonfat yogurt will help a woman stay within the daily calorie guidelines to minimize weight gain.

“You only need 250-300 more calories a day,” says Fyrberg, dispelling the myth that pregnant women can eat with abandon. “That equates to one extra snack a day.”

Fyrberg says being conscientious about weight gain is important, especially later in the pregnancy to ward off such complications as gestational diabetes, high blood pressure, and premature birth. Eating smaller meals throughout the day helps women stay within the guidelines and can also help keep morning sickness at bay.

Speaking of nausea, Fyrberg says it is usually caused in early pregnancy by a need for more protein in the diet. While pregnant women often crave carbohydrates, it is protein – 75-100 grams of it per day – that will help ease those symptoms and help the mom’s placenta – and the baby – grow. Lean meats are a good source, but vegetarians can get plenty of protein from legumes, peanut butter and nuts.

“Soy can be a great option,” says Fyrberg, “But make sure to choose a non-GMO (genetically modified) source.”

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