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Essential Nutrients for Pregnancy: A deep dive into macronutrients for a healthy and balanced diet




Nutrition and Pregnancy

Today’s post will focus on calorie and macronutrient needs during pregnancy. To best tailor the recommendations to fit you, consider your personal situation and goals. If you ever have any specific questions about your nutrition needs, then speak with your midwife, OBGYN, or a nutritionist.

 

Caloric Needs During Pregnancy

Many factors influence caloric needs during pregnancy:

 

·      your pre-pregnancy and current weight

·      body composition (muscle vs fat)

·      level of activity before and during pregnancy

·      multiples [twins = 600 extra calories/day and triplets = 900 extra calories/day (ACOG)]

 

In the first trimester, caloric needs are the same as if you were not pregnant, unless you are:

  • physically hungry

  • underweight (BMI less than 18.5) at the beginning of pregnancy or have a thyroid condition making weight gain difficult (Kane and Prelack).

  • exercising regularly or have a physically demanding job


For adequate weight gain, add 300-400 calories to your pre-pregnancy needs (see table below). Monitor your weight gain and adjust your caloric intake as needed.


Pre-Pregnancy Calories

(ages 14-50)

Pregnancy Calories

(2nd and 3rd trimesters)

Sedentary

1800-2000

2100-2400

Moderately Active

2000-2200

2300-2600

Very Active

2200-2400

2500-2900

***This table includes estimates and is a simplification of the tables found in the Dietary Guidelines 2020-2025. See pages 140-141 for more details: DietaryGuidelines.gov

 

Macronutrients

 

Macronutrients or “macros” consist of carbohydrates, protein, and fat. During pregnancy, you’ll want to consider how macros make up your overall diet for nutrients and adequate weight gain (Kominiarek). Consider trying a short-term experiment on yourself and log your foods for a few days to see what percentages of carbs, fat, and protein you currently eat and/or will work best for you!

 

Carbohydrates

 

Carbohydrates include:

  • grains (rice, pasta, bread, oatmeal, grits)

  • vegetables

    • starchy (potatoes, sweet potatoes, corn)

    • non-starchy (leafy greens, tomato, broccoli, bell peppers)

  • legumes (beans, lentils, peas)

  • fruits

  • dairy milk and yogurt (contain milk sugar)

 

The Academy of Nutrition & Dietetics (Procter and Campbell) suggest 175 g/day or 45-65% of calories from carbs (Proctor and Campbell, Kominarek). However, studies show women benefit from about half of that (25-35% or 90-150 grams/day) with a focus on non-starcy vegetables and fruit for added nutrients (Nichols).


Protein


Protein is made up of amino acids which are required to make all body cells. Most dietary protein comes from animal foods/products (broths, meats, and dairy) while non-animal sources include nuts/seeds, nut butters, soy products, and legumes (beans, peas, lentils). If you can, try your best to aim for variety since each source of protein provides different amino acids and nutrients.

 

Some sources recommend merely 1.1 grams/kg/day for pregnant women (Kominarek, Kane and Prelack) while other sources recommend 1.22 grams/kg in early pregnancy (less than 20 weeks) and 1.52 grams/kg in late pregnancy (20 weeks to birth) (Nichols, ACOG). Increasing protein intake ensures mom and baby get adequate amino acids (building blocks for life) and vitamins/minerals commonly found in protein rich foods (like iron, zinc, iodine, and choline). Most women can aim for about 80-100 g protein/day.


Fat

 

Fat can be found in animal foods, dairy (butter, ghee, sour cream, yogurt, cheese, milk), and plants (olives, coconut, avocados, nuts/seeds). A recommended range would be about 20-35% of calories from fat (Kane and Prelack, Kominarek, Nichols). You can aim for higher if you wish. The amount or percentage of fat that’s right for you should be based on your hunger levels and intake of protein and carbs.


Regardless of the macro distribution you decide on, always balance your meals and snacks (carbs, fat, and protein). Examples:

  • Greek yogurt + berries + almond slithers

  • 2 pieces of baked chicken, collard greens + small sweet potato (with butter or your choice of fat)

  • Small salad + side of broccoli (with butter or your choice of fat) + pasta with meat sauce

 

Pregnancy is work and work requires energy. Never forget that you are fueling both you and baby during this beautiful journey. Find the calorie and macronutrient balance that works best for you. Use a food tracking app or dietitian if you need extra help.

 

References:

1.    Kominiarek MA, Rajan P. Nutrition Recommendations in Pregnancy and Lactation. Med Clin North Am, 2016. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5104202/

2.    American College of Obstetrics and Gynceologists. “Nutrition During Pregnancy”. https://www.acog.org/womens-health/faqs/nutrition-during-pregnancy#:~:text=If%20you%20are%20carrying%20twins,900%20extra%20calories%20a%20day.

3.    Nelson JB. Mindful Eating: The Art of Presence While You Eat. Diabetes Spectr, 2017. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5556586/

4.    U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov.

5.    Kane K, Prelack K. Advanced Medical Nutrition Therapy. 2018. Jones & Bartlett Learning: Burlington, MA.

6.    Nichols L. Real Food for Pregnancy. 2018

7.    Procter SB, Campbell CG. Position of the Academy of Nutrition and Dietetics: nutrition and lifestyle for a healthy pregnancy outcome. J Acad Nutr Diet, 2014.

8.    Manzella D. “What is Glycemic Index?” Available at: https://www.verywellhealth.com/glycemic-index-chart-for-common-foods-1087476

 

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