As part of an initial prenatal visit, all women should be encouraged to eat a balanced and varied diet that includes meat, dairy products, fruits, vegetables and grains. It is important that women and their doctors understand that the caloric reference requirements do not increase until the second and third trimesters of pregnancy, and then only 340 to 450 calories per day. Whether pregnant or not, a person’s caloric needs depend on body size and physical activity. In general, sedentary people will remain at a stable weight if they consume 13 calories per pound of body weight each day. Exercise (depending on intensity) raises that maintenance requirement to 16-18 calories per pound of body weight per day.1
This means that a moderately active 125-pound woman will need approximately 2,000 calories a day to maintain her weight if she is not pregnant. During pregnancy, you will need the same 2,000 calories per day until your second trimester of pregnancy, when you will require between 2300-2500 calories per day. Most guidelines recommend that women with a normal BMI increase between 25 and 35 pounds during pregnancy. Increased or decreased weight gain has been associated with increased risks for mothers and babies. Understanding these basic guidelines that surround the daily caloric requirements of pregnant and non-pregnant patients is the cornerstone to help all patients maintain a healthy weight throughout the course and the changing circumstances of their lives.
In addition to routine advice on alcohol, cigarette consumption and drug use, pregnant women should also receive advice on the use of nutritional supplements in pregnancy. Many patients are already taking Nutrition Counseling in Minneapolis. For example, vitamin A intake should be limited to less than 5,000 units per day since higher levels have been linked to fetal defects. Patients who have been tested and who are anaemic may require iron supplements. Patients whose diets are deficient in calcium may require supplements to meet the calcium requirement during pregnancy of 1000 mg-1300 mg per day. Women who live in areas with low sunlight may need vitamin D supplements, but not more than 200 IU per day, as higher levels may be toxic to the fetus.2
Part of the initial visit to pregnancy should include a history of the patient’s diet. This can help the doctor adapt his recommendations regarding diet. There are many common dietary practices that may require education and/or modification. For example, women who consume artificially sweetened foods and drinks should be informed about the unknown effects of these sweeteners, especially saccharin, which is known to cross the placenta and can remain in fetal tissue. Caffeine can probably be consumed in moderation but should be limited to 150-300 mg/day (approximately 1½ cups of coffee).
Soft cheeses, cold meats and pasta can also contain Listeria, and pregnant women should receive advice on this risk. Everyone should avoid raw eggs, but pregnant women should be specifically counselled about the risk of salmonella leading to intrauterine sepsis. Finally, pregnant women should wash all fruits and vegetables before eating and should be careful with cut food on a cutting board that may not have been washed properly between uses.
Herbal preparations should be used with caution, as many of them have never been tested to ensure their safety. Teas that contain ginger, citrus zest, lemon balm and rose hips are probably safe.