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Nutrition for a healthy pregnancy Print

By Andrea Holwegner, Health Stand Nutrition Consulting Inc. – For CBC.ca

Pregnancy is one of the most intense periods of growth and development for both a woman and her baby. Choosing nutritious foods and managing a healthy lifestyle before, during and after you are pregnant is critical for the healthiest outcomes for both you and your baby.

Pre-pregnancy planning

If you are thinking about getting pregnant one of the most important things you need to do is connect with your doctor about your plans and have a full health checkup. You will of course want to refrain from smoking or using alcohol and be sure to talk to your doctor about medications, herbs and supplements to find out what is safe to consume.

Talk to your doctor about your current weight and lifestyle habits, and if you are overweight, underweight, have an eating disorder or have a medical concern such as diabetes or high blood pressure, work with a registered dietitian to create a healthy nutrition plan that will give your body the best chance to get pregnant as well as manage a healthy pregnancy.

It is also an important time to educate yourself about which foods and beverages are safe while pregnant and how much physical activity is safe and beneficial. Each day, be vigilant about taking a prenatal supplement that has 0.4 mg of folic acid and 18 mg of iron, since these vitamin and minerals are in high demand during pregnancy.

Make sure you aren’t taking a supplement that has more than 10,000 IU (3.33 RE) of vitamin A, since an overdose of this vitamin can cause birth defects. Consume a diet that is rich in whole grains, vegetables, fruits, calcium-rich foods such as dairy or fortified beverages, healthy fats and protein rich foods such as meat, poultry, seafood, legumes, eggs and nuts. Make sure you are not skipping meals, following a low-calorie diet or a fad diet that limits many different foods. Choose to eat regular meals every 3-5 hours and drink plenty of fluids.

Weight gain during pregnancy

The amount of weight that is healthy to gain during pregnancy depends on how much you weighed before you were pregnant. The following recommendations are based on your Body Mass Index (BMI) before you were pregnant. BMI is a number based on a comparison of your weight to your height (BMI = weight in kg/height in metres squared).

Pre-pregnancy Body Mass Index (BMI) Recommended Total Weight Gain During Pregnancy
Underweight: BMI Below 18.5 Between 12.5 and 18 kg (28 and 40 pounds)
Healthy weight: BMI Between 18.5 and 24.9 Between 11.5 and 16 kg (25 and 35 pounds)
Overweight: BMI Between 25.0 and 29.9 Between 7 and 11.5 kg (15 and 25 pounds)
Obese BMI Over 30 Between 5 and 9 kg (11 and 20 pounds)

To determine your pre-pregnancy BMI, use Health Canada’s BMI calculator.

If you are a healthy weight, you will likely gain a couple of kilograms in the first trimester, and then, on average, a good target is to aim for weight gain of approximately 0.5 kg (1 pound) per week in the second and third trimesters. If you are underweight, overweight, or obese talk to your doctor about weekly weight gain goals that are specific for you.

If you are pregnant with twins or multiple babies you need to gain more weight than the above table. Your doctor will help you determine a healthy goal based on your own unique needs.

Nutrients of special concern during pregnancy

Folic acid

This vitamin is especially important in helping to prevent neural tube defects in the developing spine of your baby. All prenatal supplements contain enough folic acid to make sure you have enough before and during your pregnancy. Foods rich in folic acid include orange juice, fortified breakfast cereals and other grains as well as legumes and leafy green vegetables.

Vitamin D

Vitamin D is very important in helping you absorb more calcium and helps to keep your bones strong. Although the sun helps us produce vitamin D in the skin it is an unreliable source and it is best to get our vitamin D through foods and supplements. Prenatal supplements have enough vitamin D for health during pregnancy. Foods rich in vitamin D include milk, fortified soy/rice beverages, fatty fish and egg yolks.

Omega-3 fats

Omega-3 fats are important to help with the development of your baby’s brain, eyes and nervous system. The best sources of omega-3 fats are found in fish and other sources include canola oil, walnuts and ground flax seeds. Health Canada recommends consuming two servings of fish per week. One serving of fish is 2.5 ounces (75g). Health Canada also provides recommendations for limiting exposure of certain types of fish for pregnancy due to mercury content.

Fibre

Many women experience constipation during pregnancy since pregnancy hormones can slow down digestion and your growing baby puts pressure on your intestines making it difficult to have bowel movements. Getting enough fibre can also help prevent hemorrhoids which are common in pregnancy. For this reason be sure to increase your consumption of high-fibre foods such as wheat bran cereals, bran muffins, fruits, vegetables, legumes, nuts and seeds.

Fluids

Getting enough fluids during pregnancy is important to prevent constipation, build blood volume for your baby, supply nutrients to your baby and rid waste products away from your baby. You need three litres (12 cups) of fluid per day during pregnancy. You can count fluid from water, all beverages, soups and the water that is found abundantly in fruits and vegetables.

Extra calories during pregnancy

While you may be eating for two, it doesn’t mean that you need to double your intake. For a woman with a healthy BMI, during the first trimester no extra calories are typically required compared to your typical intake. During the second trimester on average you need an extra 350 calories per day and in the third trimester about 450 extra calories are required.

Breastfeeding women also have higher calorie needs than non-pregnant women and typically require 350-400 extra calories per day for the first year depending on how much milk they produce and how quickly they lose their pregnancy weight. Most women find it easier to consume small meals and snacks throughout the day rather than large meals to keep their energy up, manage nausea and to avoid feeling too full at once.

Here are some examples of what 350-450 extra healthy calories looks like in food portions:

  • 1 cup (250ml of milk or fortified soy beverage) with a banana and 2 slices of toast.
  • 3/4 cup (175 g) of yogurt with 1/2 cup bran cereal and 1 cup of fresh or frozen berries.
  • 1/2 cup of rice/potato or pasta, 2 ounces (60 g) of meat/chicken/fish and 1/2 cup steamed veggies.
  • 1 hard-cooked egg and small bran muffin.
  • 1 apple, 1.5 ounces (50 g) of cheese and a handful of crackers.
  • 1/4 cup nuts and 1 cup raw veggies with 2 tbsp. reduced-fat dip.

Food safety, discomforts, medical complications

For more information about nutrition for a healthy pregnancy, as well as foods that you want to avoid during pregnancy, along with coping with common discomforts such as nausea, vomiting, cravings, constipation, heartburn and medical concerns, visit the Public Health Agency of Canada: Healthy Pregnancyand Health Canada: Healthy Pregnancy’s websites — and talk to your health care provider:

Andrea Holwegner, the Chocoholic Dietitian, is founder and president of Health Stand Nutrition Consulting Inc., a member of the Canadian Association of Professional Speakers and a media expert for the Dietitians of Canada. She’s the author of theJuiced Up Journal: 365 Day Nutrition & Wellness Journal.

Success stories

"I am a psychologist in private practice and it is very important to me that my clients have the best care with other health care professionals. For that reason Health Stand Nutrition is my only source for exceptional Dietitians. Andrea and her team provide highly knowledgeable, compassionate, and real world support to my clients who require assistance with food lifestyle. I trust my clients to them and you would be in excellent hands making them part of your health care team."
Adele Fox, Psychologist
“This is the first time I feel satisfied; my cravings have diminished dramatically and I have a whole new relationship with food. I am eating guilt-free for the first time in my life. My energy has also dramatically increased and I feel great!
Rhonda Jenkins, Nutrition Counseling Client
“The Dieticians at Health Stand Nutrition help you to take action on the science behind eating well by making it practical, understandable, and fun. Their office is cozy and not at all clinical or intimidating. I felt like I was sitting down with a really smart, caring friend who wanted to help me make the best choices for my lifestyle and food preferences. Andrea and her team really are the best in the business.”
Marty Avery, Nutrition Counseling Client
“I have come to think of the program as a one stop shopping excursion for everything one needs to know about creating a joyous relationship with food and our bodies. In a single word, the course has gifted me with freedom from the punishing rigidity of disordered eating, old stories that never were true, and body dysmorphia that did nothing but make me lose sight of a body that has done everything I've asked, despite my careless dismissal of her needs. Now when I look in the mirror I find myself shifting from harsh criticism to gentle gratitude.”
Lynn Haley, Pursuit of Healthiness Online Course Participant
“I spent 3 hours when first diagnosed with type 2 diabetes. I learned more from my Dietitian about food in those 3 hours than I had learned in all the years of my life. I also love the newsletter, there is always something to learn.”
Peter Whitehead, Nutrition Counseling Client
“I didn’t realize how strong my “diet mentality” was, and all the rules I had in my head about food. I was in a cycle of reward/punish/binge/cringe. I booked with your business very reluctantly, on the repeated advice of my doctor, to get my slowly rising cholesterol levels in check. I thought I knew everything about food, and my behaviour with food, but I was definitely re-schooled. My weight is creeping down, I feel good about my diet, exercise, body image, and lifestyle.”
Amy Floyd, Nutrition Counseling Client
“Thanks Andrea for an amazing presentation, I have heard all positive remarks from attendees and the evaluations show the same sentiment. It is really gratifying when a speaker does their “homework” and weaves in our profession’s day to day challenges within their content, you did an awesome job of this! You truly took the “die” out of Dietician! Your information on healthy eating and simplifying how we can work towards this as we are all so busy really hit the mark. Andrea connects very well with her audience; she is energetic, funny, and very approachable.”
Carole Ann LaGrange, Transfusion Medicine Safety Officer

Event Planner for Laboratory Diagnostic Imaging Annual Event

I am a family physician who sees patients with a myriad of eating concerns – from wanting to know how to plan healthy meals for active families, to weight loss, to eating disorders, and so on. I cannot recommend the Health Stand team highly enough. I have worked with (and been to!) other Dieticians in the past and too often find that they just ask for food logs and make suggestions that are easily obtained online or in books. The Dieticians at Health Stand offer much more than just telling clients what they “should be eating.” In contrast, the team really does more of a counselling practice, and they work hard to help their clients learn more about why their eating habits may be off track and not optimal for them, as well as helping people to effect change at a deep level that, most importantly, is sustainable for lifetime health.”
Dr. Deb Putnam, Family Physician

Nutrition Counseling Client & Referring Physician

“I am a busy mom, with kids in high level sports, working full-time downtown, and running our home acreage outside the City. I now have the knowledge and tools I need to plan for and manage the chaos of meal planning.”
Gillian Gray, Pursuit of Healthiness Online Course Participant
“As a construction company, we select speakers who can relate to our industry and its employees. Andrea’s message was delivered with humor and empathy. She makes people feel as though they can make changes without leaving behind every favorite food. Andrea focused her presentation on healthy eating as a way to keep energy high throughout the day. This message and the way it was delivered resonated with our predominantly male, blue collar culture. I would highly recommend Andrea as a speaker for groups such as ours. She will get your message across without alienating anyone in your audience – which is a huge hurdle when trying to introduce a wellness program in the workplace!”
Stephanie Wood, HR and Safety Manager

Fisher Construction Group, Burlington, WA

I found my Dietitian warm, funny, and skilled at teaching nutrition concepts without the overwhelm. The general approach of each session was to mix science with emotion, which was exceedingly effective in helping me shift my perspective on food from one of anxiety to one of joy and curiosity.”
Erin Kronstedt, Nutrition Counseling Client
“Excellent presentation! What a refreshing change to have a speaker inspire rather than “lecture” about nutrition. Your captivating stories, tips and overall approach to healthy eating uplifts and puts people at ease. It was great to hear we don’t need to strive to be perfect eaters, and that small changes really can make a difference in how we feel and in our health. Thanks to Andrea, we have solutions to our everyday nutrition challenges that can actually work in real life!”
Tina Tamagi, Human Resources

ARC Resources Ltd.

“Had I not joined this course I would have struggled with no focus, low energy, and mindless eating. Andrea is an excellent teacher and motivator. This is not just a course, it is a nutrition club with mentorship, support, and connections with other people with similar situations.”
Lorri Lawrence, Pursuit of Healthiness online course participant

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