A Food Plan For Pregnancy

Sep 06 2007

Weight gain, of course, is only one component of good nutrition in pregnancy. What you eat is important too.

To gain the recommended amount of weight in pregnancy usually requires eating two hundred to three hundred extra calories a day in the second and third trimesters. According to the National Research Council, the average woman requires twenty-two hundred calories a day. This means that the average pregnant woman needs twenty-five hundred calories daily. This will vary, of course, according to your height and activity. The taller you are and the more active you are, the more calories you will need. For example, a nonpregnant woman who is 5′2″ tall (with 2″ heels), has a small frame, and is sedentary may only require about sixteen hundred calories a day, while an active, large-framed woman who is 5′6″ tall may require as many as twenty-five hundred calories daily.

The common phrase “eating for two” is rather misleading. Adding three hundred calories to your diet does not mean adding a lot of extra food. The following list offers four ways to add approximately three hundred calories to your diet.

3½ to 4 glasses of skim milk (eight-ounce glasses)
2 ½ to 3 glasses of skim milk and 1 medium apple
2 glasses of skim milk and 3 ounces of chicken (approximately 1 breast)
2 glasses of skim milk, 1 apple, and 1 egg

In addition to extra calories, pregnant women should eat extra protein and increase their intake of certain vitamins and minerals. Protein is especially important to promote the growth of tissue in the body and support the increased volume of circulating blood. Some researchers have suggested that protein deficiency is responsible for the development of preeclampsia or toxemia of pregnancy, but these claims have not been supported. Protein supplementation in the form of protein drinks or protein powders are not recommended, except perhaps among women who are severely protein deficient, as occurs in conditions of famine or near starvation.

About 10 to 15 grams of extra protein a day are needed in pregnancy, for a total of 60 grams of protein. Three ounces of most meat, fish, or poultry (three ounces is about an average serving) supply about 20 grams of protein. Two cups of milk provide 16 grams of protein. If you drink four cups of milk a day (eight ounces each), and eat two average servings of meat or fish or legumes (three to four ounces at each serving or, say, a chicken breast or a cup and a half of beans with rice), you will have sufficient protein.

The pregnant woman needs at least 1,200 milligrams of calcium a day. Calcium is needed for formation and growth of the bones and teeth. Calcium is needed most in the third trimester. A quart-or four eight-ounce glasses-of milk provides the daily required amount of calcium. One and a half ounces of hard cheese, 1½ cups of soft cheese, or 1 cup of plain yogurt is equal to about an eight-ounce glass of milk in calcium content .

Legumes, nuts, dried fruit, and some green vegetables have calcium. Among the green vegetables, the calcium in spinach, chard, and beet greens is not available to the body because these vegetables also contain oxalic acid, which binds the calcium.

Most people prefer to think in terms of food groups rather than grams of nutrients. Following the daily plan shown in the table below will ensure that you have adequate calories, protein, calcium, and other vitamins and minerals.

If you have questions about the adequacy of your diet, write down everything you eat over a one-to-three-day period, and the amount in each serving, and then compare your list with general recommendations such as those above, or the much more detailed recommendations in books specifically on nutrition in pregnancy.

Here is an example of how one pregnant woman filled out a chart to help her see how well she was eating. This one-day food diary reflects good eating. This woman drank only one cup of coffee, with milk. She had few sweets, which supply empty calories and sometimes lots of fat. She lacked one serving of meat, but with the extra serving of milk, she has had far more than 60 grams of protein. She could have added one egg to her breakfast for protein and iron. Her diet was a bit heavy in the breads/cereals/grains family, but most were whole grains. It might be heavy on fats, depending on what type and how much salad dressing was used, and how the mashed potatoes were cooked. The food diary could have indicated how the food was prepared and whether butter or fats were used in cooking. The type of milk used was not specified. Skim (nonfat) or 1 percent milk is preferable to whole milk or 2 percent milk.

If this daily food pattern is representative of this woman’s regular eating, she is doing well, although depending on her height, activity level, and prep regnant weight, she might gain a bit too much. Based on her weight at her prenatal visits, she might want to adjust her intake from the breads/cereals/grains group and the fat group, and make sure that her milk is skim or low fat. If she is very tall or very active, however, she might not gain enough on this diet and might have to add to the breads/ cereals/ grains group, preferably with whole grains.

When you write your food diary, choose days that represent your usual eating habits. Don’t chart a day you go to your friend’s wedding, for instance, or have twenty people at your house for dinner. Add up and then analyze your food group intake. Use your weight gain and food diary to make adjustments as necessary.

Your physician or midwife can help you assess your eating patterns. Some prenatal practices or clinics routinely refer all pregnant women for at least one visit with a dietitian or nutritionist who can be of even greater assistance.