Changing for the better, one bite and (deep) breath at a time.

Wednesday, October 24, 2012

Food Diary of a Pregnant Dietitian

A lot of people have asked me if my eating habits have changed since becoming pregnant.  In general, I'd say they're relatively the same, but I'm certainly hungrier for more food than I used to be!

The whole "eating for two" statement is really a fallacy.  Starting in the second trimester and in addition to greater vitamin/mineral requirements, pregnant women need only 300 extra calories per day to support a growing fetus.  That equates to half a sandwich, an apple with 2 T peanut butter, or a large cookie.  Some of these extra calories should contain protein, since protein needs are also increased.

Does this mean I count out 300 calories and make sure to scarf them down?  Nope.  I don't count calories at all, just like before I was pregnant.  I just listen to my body and monitor my weight gain with my doc to make sure I'm getting enough.  My activity levels have decreased a bit since pre-pregnancy and some days the baby seems to be growing more rapidly than others, so it's really hard - and not necessary - to focus on numbers while eating.  I am aware of my hunger and fullness and make sure to have plenty of snacks nearby for when hunger strikes.  Some days I'm ravenous, while other days it seems like there's just not quite enough room in my abdomen to fit much food (which may be true).

By the way, recommended pregnancy weight gain ranges from 25-35 lb.  I will likely gain around 30ish pounds if I gain at the same rate I'm going, but I absolutely don't obsess about it.  Pre-pregnancy I rarely weighed myself, but now I hop on once a week to make sure I'm gaining enough and to check that I haven't gained a really big amount - such as 5 pounds in a week - because that can indicate that the body is retaining too much fluid and preeclampsia may be setting in.

Generally, physicians want pregnant women want to gain 2-5 pounds in the first trimester and about a pound a week thereafter. That doesn't mean that every person will follow this pattern.  I gained 6 pounds in the first trimester and then stayed there for about 4 weeks despite having an increased appetite.  After that, my weight gain pretty much increased by 0.5 - 1.5 lb per week.

What if you gain more in pregnancy?  While there are some potential risks to you and your baby if you gain a significant amount of weight, what I usually advise clients to do is listen to their bodies and not just eat "because they can."  In fact, if you have an intuitive eating mindset, you always "can" eat anything; pregnancy is no different.  Nutrition is perhaps the most critical during this imperative developmental stage, so focusing on nutrient dense foods and hunger/fullness - not necessarily weight gain - is the most important thing.  Some women will just naturally gain more or less weight than is recommended, and as long as your doctor is OK with it then don't stress.

I wanted to share three days of eating with you all so you could check out what it's really like to be a dietitian while pregnant.  I absolutely like sweets and comfort foods just like the rest of us, and I honor my cravings and only eat foods I really like.  As you will see, I still eat a lot of veggies and fruits while making sure to get protein, fat, and fiber in the form of whole grains and beans.  For more info on the supplements I'm taking, check out this post on first trimester nutrition or this post about pre-conception nutrition.  The prenatal vitamin I'm taking is divided into 3 doses per day to spread out the nutrients and not provide so much iron to the system at one time.  I take one with each meal.

For the record, my major pregnancy cravings have been the following:
- Chocolate - any kind, must have some daily
- Salads
- Turkey burgers from Red Robin
- Asian food
- Avocados
- Beans (any kind)
- Any sort of egg (although I make sure they're fully cooked)

Aversions (mainly during first trimester):
- Mushrooms
- Onions
- Peanut sauce on Picazzo's baked chicken wings (my sister and I used to get these all the time, but no more)
- Frozen yogurt (bad experience)

Note: I drink 2-3 cups of herbal ginger tea and 10-12 cups of water each day.  I don't necessarily eat everything on my plate; it just depends on how hungry I am.  When my body says it is full, I stop.

Day 1:

I was really hungry today!  Thank goodness I brought plenty of snacks to work. 

6 am - 45 minute walk with dogs

7 am - Breakfast
Ezekiel English muffin with almond butter topped with sliced banana
Prenatal vitamin, fish oil, probiotic, B complex, and Dr. Ben Kim's Greens

10 am - Snack
Tangerine chickpea and kale salad and an orange
2 calcium/magnesium/zinc + vitamin D (500 mg calcium total)

12 pm - Lunch
Romaine salad with tomatoes and avocado
Figg brand split pea soup topped with crumbled feta
Piece of dark chocolate
Prenatal vitamin

2:15 pm - Snack
Lara bar
2 calcium/magnesium/zinc + vitamin D

4:00 pm - Snack
Brussel sprout and beet salad

5:45 pm - few bites of chicken

6:00 pm - Karve class

7:15 pm - Dinner
Pomegranate chicken on top of quinoa
Salad made with romaine, apples, avocado, feta and homemade vinaigrette
1/2 piece of homemade GF bread with pasture butter
2 Hail Merry macaroons
1 Prenatal vitamin

Day 2:

Officially 27 weeks today!

6 am - 45 minute walk with dogs
7 am - Breakfast
Ezekiel English muffin topped with avocado, sliced tomato and 2 organic eggs cooked in pasture butter
Prenatal vitamin, fish oil, probiotic, B complex, and Dr. Ben Kim's Greens

10 am - Snack
Organic string cheese stick and a pear

12 pm - Lunch
Picazzo's Organic Italian Kitchen! Gluten-free slice of the day (pesto with ricotta and organic Italian sausage dipped in marinara sauce) and Berry Licious Salad (spinach, strawberries, feta cheese, walnuts, orange segments)
1 Dove dark chocolate Promise
Prenatal vitamin

2:30 pm - Snack
Lara bar

4:00 pm - Snack
Baby carrots dipped in garlic hummus

7:00 pm - Dinner
Cheesecake Factory!  Greg and I ordered off the "Skinny" menu because he's going for lighter fare these days
1/2 piece of "brown" bread with butter
1 Vietnamese Shrimp Summer Roll dipped in sauce (cold, wrapped in rice paper)
1 Mexican Chicken Lettuce Wrap
1/4 Skinny Turkey Burger and a few bites of side salad (ordered with regular vinaigrette instead of "Skinny")
Prenatal vitamin

Day 3:

OB appointment today with the lovely glucose drink (test for gestational diabetes):
6:00 am - 40 minute walk with dogs

7:00 am - Breakfast - had to be low-carb prior to test!
3 pasture eggs cooked in 1 tsp. pasture butter
1/4 avocado, sliced
4 slices tomato
Sprinkles of feta cheese 
Prenatal vitamin, fish oil, probiotic, B complex

7:20 am - Yummy (terrible) "Fruit Punch" glucose drink

9:00 am - Decaf latte from Starbucks (2% milk, added stevia and cinnamon)

11:30 am - Lunch
Salad with romaine, cucumber, avocado and hummus
Leftover chicken and a little quinoa
Piece of dark chocolate
Prenatal vitamin

2:30 pm - Snack
Lara bar
2 calcium/mag/zinc + vitamin D supplements

4:00 pm - Snack
Carrots and hummus
Organic string cheese

6:00 pm - Karve class

7:15 pm - Dinner
AJ's salmon, veggies and a few bites of mac & cheese (so heavy it hurt my tummy!)
Piece of healthy fudge 
Prenatal vitamin

So there you have it!  Each day I am for variety as much as possible, and I only eat foods I really love while getting in as much produce as possible.  I have been cooking less lately due to a very busy schedule, so there is less homemade food here than normal.  Sometimes I finish my plate, but most of the time my fullness tells me to stop.  That's the wonderful thing about our bodies - even when pregnant, we can listen to the signals our bodies give us to know when we have had enough.  And you know what?  If we really, really want something but we are full, we can save it for the next meal (or snack!).


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