Pregnant? Diet Changes to Make Right Now

You're pregnant. Congratulations…and don't panic! If healthy eating hasn't been a habit, don't worry. Now is the perfect time to make a change you (and your family) will benefit from for decades.

And because the first trimester is one of the most important periods of your baby's development, now really means now.

But it doesn't have to be hard or overwhelming. Here are some simple diet changes that will help make pregnancy a happy and healthy time for both of you!

"The earlier you get on a prenatal vitamin, the better,"says Frances Largeman-Roth, RD, author of Feed the Belly: The Pregnant Mom's Healthy Eating Guide, "because the nutrients in it are essential to the development of your baby's spinal cord and nerves."

In fact, doctors recommend starting a prenatal vitamin as soon as you begin trying to conceive, if possible. But if you haven't yet, get to the pharmacy now. While prenatal vitamins are available by prescription, there are also many inexpensive options over the counter.

Just check the label to make sure that it has 30 milligrams of iron and 600 to 800 micrograms of folic acid, advises Roth.

Folic acid is a powerhouse nutrient in pregnancy that has been proven to dramatically reduce the risk of serious birth defects and helps with the normal development of all the cells in the body.

Women who are at greater risk for birth defects, for instance those taking anti-seizure medications, will need a prescription for a prenatal with a higher amount of folic acid, says Carl P. Weiner, MD, professor and chair of obstetrics and gynecology at the University of Kansas School of Medicine in Kansas City and coauthor of The Complete Guide to Medications During Pregnancy and Breast-feeding.

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Although nausea during pregnancy feels awful, it won't hurt your baby if you can manage to keep some food and water down. If morning sickness makes it tough to keep your prenatal down, Dr. Weiner recommends taking it at night.

And if your nausea is so severe that you cannot keep your prenatal (or much food) down, Dr. Weiner advises talking with your doctor about anti-nausea medication. You should also tell your doctor about any other vitamin supplements you are taking to avoid taking more than the recommended amount of any one nutrient in pregnancy.

The same folic acid that prenatal vitamins are filled with also comes in foods rich in folate. The B vitamin occurs naturally in many foods including lentils, pinto and black beans, edamame, spinach, asparagus, citrus fruits and juices.

Other foods are fortified with folate to increase the levels women eat and reduce their chance of having a baby with a birth defect. Enriched choices include cereals (Largeman-Roth likes Total, which comes with 400 micrograms per serving), bread, pasta, and flour (look for the word “enriched” or “fortified” on the label).

If you eat meat, it's easy. There are 3.5 milligrams in 6 ounces of sirloin steak and 2 milligrams in a 6-ounce chicken breast. Eggs are another terrific source for meat eaters and vegetarians. But there are also plenty of vegetables filled with iron such as spinach, Swiss chard, beans, lentils, and apricots. The only catch for vegetarians and vegans is that the body does not absorb the iron from vegetables and fruits (called non-heme iron) as easily as that from animal products, so you need to help your body make the most of it.

Eating an iron-rich piece of produce along with a good source of vitamin C will help you absorb more iron. Squeeze a little lemon juice on your steamed spinach or into your lentil soup or add some sliced red peppers to a spinach salad. Finally, fortified cereal, which is also rich in iron, is a good shortcut to getting your daily fill.

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The amount of blood coursing through your body increases by 40% during pregnancy, and you need more iron to produce it. But half of pregnant women are not getting enough, says Largeman-Roth, which can lead to anemia. “Severe anemia can cause preterm birth and low birthweight,” she says. Symptoms of anemia include pale skin, an irregular heart rate, cold hands and feet, and dizziness. Plus, it will make you tired. And, let’s face it, there’s not a pregnant woman on the planet who needs to feel any more tired than she already does. Make sure your prenatal vitamin contains at least 30 milligrams of iron, and then shoot for another 12 or so in your diet.

If remembering what foods will provide which nutrients gets complicated for you, follow Largeman-Roth's list of pregnancy power foods and work them into your diet as often as you can.

• Lentils (protein, fiber, and folic acid)
• Eggs (protein, omega-3s, iron, and choline)
• Asparagus (folic acid)
• Citrus fruits (folic acid and vitamin C)
• Greek yogurt (protein and calcium)
• Lean meats (iron and protein)
• Salmon (protein, calcium, and omega-3 fatty acids)
• Mango (beta-carotene, an antioxidant vital for skin and eye cell growth and immune function)
• Fortified milk (calcium and vitamin D, which helps absorb it)

Here's a sobering fact to help: "Alcohol is a recognized cause of birth defects and one of the most common causes of mental retardation," Dr. Weiner says. "Though low consumption, for instance a 6-ounce glass of wine every other day, is safe for most women, in some it is enough to injure the fetus."

That's because there are genetic and other factors that can influence how much damage alcohol can do to a developing fetus. Which is why, says Dr. Weiner, "the safest approach is to avoid alcohol completely during pregnancy," which is the official recommendation of American Congress of Obstetricians and Gynecologists (ACOG).

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The good news for coffee lovers is that coffee is no longer the big no-no it used to be during pregnancy. "Caffeine has been intensively studied," says Dr. Weiner, "and although there has been harm discovered with extreme consumption, moderate amounts are fine. A cup of coffee or a cola product every 6 to 8 hours is probably safe."

Dr. Weiner says that caffeine can, in rare instances, cause an irregular fetal heart rate, but your consumption would need to be very high, and the problem is not life-threatening and can be treated by stopping the caffeine intake.

ACOG concluded that less than 200 milligrams daily (one to two cups of coffee or three caffeinated sodas) does not raise health risks in pregnancy.

Unfortunately, the old adage "you're eating for two," isn't really right. While it would be nice if these nine months gave you a free pass on almond croissants and milkshakes, "the biggest mistake a pregnant woman can make in her diet," says Dr. Weiner, "is to assume she is eating for two or use her pregnancy as an excuse for a binge."

That's because gaining too much weight in pregnancy can have an adverse effect on a baby by increasing his or her lifelong risk of obesity,

heart disease, and diabetes. In fact pregnant women only need 300 extra calories daily (a cup of milk and a half sandwich).

"That really is a challenge for pregnant women," says Largeman-Roth, "because you need a lot of extra nutrients and you can't get them all into that extra 300 calories. So, you need to be smart about your food choices all day."

"Pregnant women should be getting extra antioxidants, because we are always under free radical assault," says Largeman-Roth. Antioxidants (nutrients found in many fruits and vegetables, particularly those with bright colors) help to undo the damage that free radicals can cause, which is a boon to pregnant moms and their developing babies.

So work to add as many

colors as you can to your diet each day. Your goal should be 5 to 9 daily servings.

"A salad at lunch will knock a lot of those out," says Largeman-Roth. And don't limit yourself to fresh. Dried and frozen fruits and vegetables are also full of antioxidants. "Sprinkle dried fruit into cereal in the morning or toss it in your yogurt for a mid-afternoon snack," she suggests. Add two frozen veggies to dinner and you've done a great job that day.

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More and more research is finding that eating fish in pregnancy is great for a developing baby. Unfortunately, because of concerns about mercury (a heavy metal found in some seafood, which can be toxic to developing brains), some women play it safe by avoiding seafood altogether. However, the United States Department of Agriculture recommends that pregnant women eat 8 to 12 ounces of omega-rich seafood weekly.

Great sources include salmon, canned light tuna (not albacore, which is high in mercury), catfish, anchovies, sardines, herring, trout, Pollock, cod and shrimp. Stay away from sushi (which can carry harmful bacteria) and swordfish, tilefish, king mackerel and shark (which are highest in mercury).

Those brain and heart-healthy fatty acids you can get from salmon are also found in enriched eggs (look for "Omega-3" on the carton), and a similar healthy fat is abundant in walnuts, and flaxseeds.

For a power breakfast, grab a hardboiled egg and a slice of fortified whole-wheat toast. Or try sprinkling walnuts or flax seeds on your morning oatmeal or adding flaxseed oil to a citrus-fruit smoothie.

Calcium is an important nutrient for women throughout their lives, but during pregnancy their babies (who depend on calcium to develop a strong skeleton and healthy teeth buds) take what they need from you. So make sure you are getting 1,000 milligrams daily.

Great choices include skim milk (300 mg per cup), plain yogurt (400mg per cup), cheese (200mg per ounce), fortified orange juice (350 mg per cup), and tofu (200 to 420 mg in 4 ounces).

Try one of these

calcium-rich recipes.

You may have never heard of it, but choline is one of the new baby superfoods. (You will see it mentioned on those squeeze packs of baby food that will be so helpful to you in a few months.) The nutrient is important for your baby's brain health and helps develop the hippocampus, which is essential for memory.

You need 450 milligrams daily and can find it in eggs (250 mg per egg), soy-based foods (a half cup of roasted soybeans offers 107 mg), pork chops (97 mg in a 4-ounce chop), cauliflower (60 mg per cup), wheat germ (sprinkle it over your cereal!), and liver.

This diet change is admittedly annoying, because it takes away some folks' favorite food choices—from soft cheeses to hot dogs. But, here's the problem: Unpasteurized foods, soft cheeses, processed meats, and even some fruits and vegetables (if they are not properly washed) can carry a type of bacteria called listeria. In a non-pregnant, healthy individual, the bacteria don't usually do that much damage.

But in pregnancy the illness they cause—listeriosis—can lead to miscarriage, preterm delivery, low birthweight, and even stillbirth. If you simply must have that turkey sandwich, heat the deli meat until steaming, which will kill off the bacteria. And it's important to thoroughly wash all fruits and vegetables before eating them raw.

Eating undercooked meat and eggs puts pregnant women at risk for a number of illnesses, among them listeriosis, salmonella, and toxoplasmosis (which can cause vision problems, seizures, and other problems in children exposed to it in the womb).

"If you've never been a person who's actually checked the internal temperature of meat when you cook it, now is the time to start," advises Largeman-Roth. "Make sure you are cooking everything to its proper temperature."

Avoid raw fish and raw eggs and raw egg products (no licking the mixers when you make cookies!) and order burgers and steaks well done when you go out.

Constipation is a fact of pregnancy. Your whole system slows down when you're pregnant, so it can suck every possible nutrient out of the foods you are eating to share them with your babe. Helping your body keep the traffic flowing will make you more comfortable.

Largeman-Roth advises aiming for 28 to 30 grams of fiber daily, which is easier to get than it sounds. Two ounces of almonds has 6 grams, while a cup of black beans (already offering you iron and folate), packs 15. Largeman-Roth likes Kashi Go Lean cereal, which will start your day with a third of your fiber needs met.

"Staying hydrated is huge," says Largeman-Roth. "It prevents constipation and it can prevent preterm contractions."

The Institute of Medicine recommends that pregnant women drink 10 cups (2.4 liters) of water daily, which Largeman-Roth admits can be a struggle. She recommends buying a pretty glass to keep at your desk, or, if you're driving around all day, a water bottle you really like. And make sure it is easy to clean.

"And if you find you're getting really bored with just water, add lemon, cucumber, or herbs such as mint or basil to make it more appetizing. Teas, juices, and even fruits and vegetables can also help you get to your goal.