Superfoods & Dietary Guidelines for a Healthy Pregnancy

by Florence Lim, L.Ac., DAOM


Benefits of Eating Well During Pregnancy

Numerous studies have shown that eating a wide variety of nutrient rich foods during pregnancy can have beneficial long-term effects for both you and your baby, such as:

  • Alleviating nausea

  • Boosting energy

  • Support healthy fetal development

  • Improving your child’s language and communication skills

  • Decreasing your child’s risk for future health issues like eczema & asthma

  • Supporting healthy skin and minimizing acne

  • Preventing pre-eclampsia, or pregnancy induced hypertension

  • Preventing or minimizing postpartum depression

For instance, multiple studies throughout the years have found that pregnant or breastfeeding moms who ate 2-4 servings of fish per week versus 1 serving had a 37 % lower risk of developing eczema and asthma, and also had better language and communication skills! Women who consume more vitamin D during pregnancy also help reduce the risk of asthma in their children.


The Do’s and Don’ts of Pregnancy

Do eat:

  • Whole grains

  • Fresh, preferably organic fruits & vegetables

  • Low-fat protein

  • Good fats (plant oils, fish)

  • Also make sure to thoroughly wash all raw fruits and veggies. Preferably, eat more warm, cooked veggies. From a TCM perspective, this is better for overall Spleen Qi and digestive function.

Avoid the following:

Alcohol, cigarette smoke, drugs like cocaine and methadone, lithium, pesticides, retinol products, certain antibiotics like tetracycline and penicillin, Valium, warfarin and many other substances are considered teratogens (cause problems in baby’s development)


Don't Eat:

  • Raw or undercooked meat or fish, soft cheeses, raw sprouts, unwashed produce, high mercury fish, raw eggs (may contain Salmonella bacteria), and deli meats. Note that raw eggs are also found in mayonnaise and Caesar salad dressing!!

  • Organ meats due to vitamin A toxicity. Limit to a few ounces per week

  • Unpasteurized milk, cheese, and fruit juice

  • Caffeine: Caffeine easily passes through the placenta. Babies and placentas don’t produce the enzyme necessary to metabolize caffeine, so it can accumulate in the womb. A study published in the American Journal of Obstetrics and Gynecology (2008) found that pregnant mothers who consumed more than 200 mg of caffeine daily (about 10 ounces of coffee or 25 ounces of tea) doubled their risk of miscarriage and had increased risk for restricted fetal growth and low birth weight. Coffee, black tea, green tea, white tea, chocolate, soft drinks all contains caffeine.

  • Alcohol: Drinking alcohol during pregnancy can lead to fetal alcohol syndrome, which can results in facial deformities, heart defects, and intellectual disability in the newborn.

  • Processed junk food


Key Nutrients Needed Throughout the Pregnancy

1) Folate (Folic Acid, Vitamin B9)

• Involved in growth and division of cells

• Deficiency is linked to increased incident of neural-tube defects and lower birth weights

• Involved in formation of red blood cells and proteins

• Supplement: 800 mcg to 1 mg/day

• Folate-Rich Foods Include: Breakfast cereals fortified with folic acid, beef liver, beets, spinach, beans and lentils, asparagus, green peas, brussels sprouts, broccoli, avocado, peanuts, romaine lettuce, wheat germ, oranges, eggs, and papaya


2) Iron

• Iron is a part of your red blood cells, which help carry oxygen throughout the body

• Supports increased blood volume and development of baby’s blood cells. A pregnant woman's blood volume almost doubles during pregnancy, and therefore, her iron needs are quite significant during this time!

• Anemia is very common during pregnancy and can cause fatigue and shortness of breath

• Vitamin C enhances absorption of iron, so be sure to eat foods rich in vitamin C while eating foods rich in iron

• Iron-Rich Foods Include: Spinach and other dark leafy greens, dark meat, dried fruit (apricots, prunes, raisins, figs), beets, wheat germ, legumes, egg yolk, blackstrap molasses, clams or oysters, tofu, fortified cereals and grains, oatmeal, baked potato with skin, liver (no more than once per week)

• Cooking with a cast iron pan is another great way to ensure you are getting enough iron in your diet!


3) Calcium and Vitamin D

• Important for healthy bone development

• Decreases risk of preeclampsia (high blood pressure and protein in urine during pregnancy). Research has shown that supplementation with calcium (>1000 mg/day) can 1) reduce risk of developing preeclampsia during pregnancy in women with low calcium intake and 2) prevent preterm labor. It is recommended that you get enough calcium in your diet even before becoming pregnant, during early pregnancy, and also postpartum to prevent preeclampsia.

• May help with leg cramps (together with magnesium) and is important during delivery because calcium is needed for the muscles and uterus to contract during delivery

• Note: Avoid eating iron-rich foods and calcium-rich foods at the same time! Calcium interferes with iron absorption.

• Recommended: 1,000 mg/day of Calcium; 400 IU/day of Vitamin D

• Calcium-Rich Foods Include: yogurt, milk, cheese, tofu, fortified beverages, canned salmon or sardines with bones, soybeans, collard greens, soy nuts, bok choy, turnip greens, chia seeds, sesame seeds or tahini, figs (dried>fresh), almonds, hazelnuts, broccoli, brussels sprouts, beans (navy, pinto)

• Vitamin D-Rich Foods Include: Eggs, milk, salmon, herring, sardines, cod liver oil, canned light tuna (which less mercury than white or albacore tuna), egg yolks, mushrooms, fortified orange juice or cereals, soy milk


4) Vitamin B6 (Pyridoxine)

• Keeps energy levels up

• 25 mg to 75 mg of vitamin B6 can quell nausea and vomiting during pregnancy

• Recommended foods: salmon, chicken, fortified tofu, pork chops, meat, sweet potatoes, bananas, potatoes, avocadoes, pistachio nuts

• If you are suffering from morning sickness, below are some over-the-counter remedies that you can try along with acupuncture before resorting to Western medication (Western medicine doctors often prescribe Diclegis to treat morning sickness, but it is actually just a combination of vitamin B6 and doxylamine (aka Unisom), which can both be purchased inexpensively at your local drugstore):

  1. Ginger capsules, 250mg orally four times a day; or 8 ounces of ginger tea four times a day.

  2. For mild nausea without vomiting: Vitamin B6, 25mg with food, three times a day.

  3. For moderate nausea with mild vomiting (≤ 2 times a day) or if no relief from Vitamin B6 alone, ADD Unisom (doxylamine) 12.5mg (1/2 tablet) at bedtime and continue Vitamin B6 (pyridoxine) 25mg three times a day.

  4. If no relief after 4-5 days, try Unisom (doxylamine) 25mg at bedtime and 12.5mg (1/2 tablet) in the morning and midafternoon, PLUS Vitamin B6 (pyridoxine) 25mg three times a day. May also increase Vitamin B6 to 50mg at bedtime with 25mg in morning and midafternoon if needed.

  5. Unisom can cause drowsiness. Start with bedtime dose for 4-5 days first to decrease drowsiness, then add as needed and as tolerated in morning and afternoon.

  6. NOTE: Bedtime dose helps with morning nausea, morning dose helps with afternoon nausea, and afternoon dose helps with evening nausea, so adjust times for your particular needs.


5) DHA

• DHA is an essential fat primarily found in fish. Although seeds such as chia seeds and flax seeds contain a type of fatty acid called alpha linolenic acid (ALA) that converts to EPA and DHA, it is a very inefficient process, and the fetal liver is not mature enough to metabolize plant based ALA (alpha-linolenic acids) into EPA and DHA until 16 weeks after birth. Thus, fish is still the best way for pregnant mothers to get adequate amounts of EPA and DHA, particularly during the first 16 weeks of pregnancy.

• Research has shown that babies whose moms consumed 2-4 servings of higher-fat fish like mackerel, sardines, anchovies, salmon, and tuna during their pregnancy had higher IQs, better sleep, better vision, and better language and communications skills. They also had reduced risk for preterm delivery and low birth weight. Eating fish regularly, particularly during the last trimester, can lower rates of restricted fetal growth (Journal of Epidimiology and Community Health Report 2004, in a study that looked at 11,580 women) and prevent the development of asthma or eczema in children.

• Researchers in Denmark studied 8,729 whose seafood intake in early pregnancy was assessed by questionnaire. They found that 1.9% of women who ate fish at least once per week had premature birth, whereas this increased to 7.1% of women who never ate fish.

• Besides the benefits for the baby during the pregnancy, getting adequate DHA also reduces the mother's risk for developing postpartum depression.

• Wild fish is preferable to farmed raised fish

• Fish oil supplements should contain at least 300 mg DHA/day

• Omega-3 foods which contain both DHA and EPA include: organic free range eggs, sardines, wild salmon. Avoid cod liver oil fish oil supplements, as they contain high amounts of vitamin A that are potentially toxic during pregnancy. Omega-3 supplements derived from algae are excellent options for vegetarians.

First Trimester (Weeks 1-12)

First Trimester Characteristics

• During the first weeks of pregnancy, the sperm and egg unite, and cell division occurs. All this takes a lot of energy, which is why first trimester moms oftentimes feel exhausted and want to sleep all the time!!

• Spine, limbs, organs (heart, circulatory system) have started to form

• Body changes: blood volume almost doubles, heart rate increases, breasts enlarge, increased hormone production, mood swings, nausea and/or cravings

• Eating high quality, nutrient dense foods is more important than significantly increasing the quantity of foods you put at the table: aim for about 300 extra calories per day

• Morning sickness tip: sniff a lemon or orange. Sour or sour/sweet foods such as lemonade, applesauce, and ginger can often be helpful for pregnant moms with morning sickness


Key Nutrients Needed During First Trimester

Protein: Protein is necessary for hormone production and is an important raw material of enzymes, which are needed to instruct cells to divide, grow, and metabolize

Vitamin A: an important antioxidant that prevents DNA damage to the cells as they divide. The best and safest way to get vitamin A is through beta-carotene, which is the plant based form of vitamin A and found in a variety of orange colored fruits and vegetables such as butternut squash, carrots, sweet potatoes, apricots, and dark green leafy veggies. Because vitamin A, vitamin D, and vitamin E are fat-soluble nutrients, it helps to eat them together with some sort of fat or oil-containing food to aid in absorption.

Vitamin E: another antioxidant that also benefits fetal growth, possibly due to improved blood flow and nutrient supply to the fetus

Folate (folic acid)

Iron: eat together with foods rich in vitamin C to enhance its absorption.

Superfoods for First Trimester

These foods are chosen because they are easier to digest and may be more palatable for women experiencing morning sickness. It is common for women to crave simple carbs like bread during the first trimester, but try to select healthier choices such as brown rice crackers with peanut butter, oatmeal, or popcorn rather than grabbing that bag of potato chips!

Fruits: Bananas, Watermelon, Applesauce, Lemons, kiwis

Vegetables/Herbs: Sweet Potatoes, leeks, chives

Spices: Ginger

Nuts/Seeds: Almonds, Sesame Tahini

Fish: Anchovies

Meat: Dark meat, Bone broth

Whole Grains: Brown Rice, Multigrain Cereal, Oatmeal, Popcorn

Legumes: Beans, Peanut Butter (peanuts are considered legumes, not nuts!)

Dairy: Yogurt, Cheese

Beverages: Ice chips and water, mint tea (or other herbal teas such as ginger, chamomile, lemon balm, citrus peel, and rose hips), bone or vegetable broth


Almonds:

· great source of folate

· aim for 20 to 25 almonds per day;

· low glycemic index;

· Eat with the skin, which contains most of the antioxidant activity

·

Anchovies

· Can be good for those who crave something salty during the first trimester

· Good source of protein and omega-3 fatty acids; 3 ounce serving has 450 mg EPA and 775 mg DHA

· Contains calcium, iron, and vitamin D

· Also contains choline , which researchers have found that in addition to folate, helps to lower risk of neural tube defects in babies. Eggs are also an abundant source of choline.

Apple Sauce/Apples

· Sour, great for morning sickness and easy to digest

· Make sure to buy organic due to pesticides

· Very high in flavonoids such as quercetin. Quercetin helps to prevent free radical damage to your cells and the baby’s developing cells.

o Eating foods packed with antioxidants helps give your body the energy it needs to repair cellular damage caused by free radicals


Whole grains

· Good source of chromium, which is important for protein synthesis in growing baby’s tissues, and also it regulates blood sugar levels.


Sweet Potatoes: Rich in vitamin A (beta-carotene, fiber, and B6)


Beans

· Packed with fiber, protein, and minerals like copper, selenium iron, phosphorus, and manganese

· Copper is important for formation of red blood cells

· Phosphorus and calcium work together to help with bone growth

· Baby’s teeth already begin to form during the first trimester, so it's important to eat phosphorus and calcium rich foods


Nuts, seeds, and legumes are good protein options for patients who have meat aversion during the first trimester.



Second Trimester: 4-6 months or 13-27 weeks

• Baby’s major organs have formed by the 15th week of pregnancy, but some organs such as lungs, kidney, and heart continue to develop during the 2nd trimester.

• At week 17, baby starts to accumulate fat underneath the skin, which will provide energy and keep the baby warm after birth. Intake of healthy fats is also important for absorption of fat soluble nutrients like vitamins A, E, D, and K. Foods like avocados are an excellent source of healthy fat during the second and third trimesters.

• Baby will be about 11 to 14 inches and 2-2.5 pounds by the end of the 2nd trimester, and the mother's belly will start to show.

• Although the morning sickness will typically go away during the second trimester, other symptoms such as acne, heartburn, constipation, leg cramps, low energy, backaches, nosebleeds, bleeding gums, and dizziness may occur. Dizziness is caused by the increased blood volume, which causes blood vessels to dilate.

• Eat smaller, more frequent meals, which will help minimize the heartburn. Tums can be helpful for women experiencing heartburn during pregnancy, and it contains calcium, which pregnant women need more of.

• Avoid spicy, overly greasy, or fatty foods

• Eat more high fiber foods and hydrate regularly to minimize constipation and prevent urinary tract infection (UTI), which is more common during pregnancy.



Third Trimester: 28 weeks until labor

• Baby’s brain is 60% fat by weight - mostly made up of DHA - and developing very quickly

• Common symptoms: Increased digestive discomfort, heartburn, increased urination, back pain, feet and ankle swelling.

• Staying hydrated (8 to 12 8-oz glasses/day), decreasing sodium intake, and eating potassium-rich foods will help the body maintain normal fluid balance, which will help with swelling.

• Eating fish regularly during the last trimester can lower rates of restricted fetal growth (Journal of Epidimiology and Commu