Be Smart about Nutrition Even Before you Conceive

If you're planning on starting a family, you need to take action early to ensure a happy, healthy pregnancy and delivery. Following some commonsense guidelines helps assure both mom and baby are at their best.

Make an appointment
Don't wait until you're pregnant to schedule a visit with your healthcare provider. Making an appointment before you conceive can be one of the most important things you do. Your physician needs to identify any possible risk factors and learn about your medical history, diet and lifestyle, past pregnancies, and family history.

Medical conditions including diabetes, high blood pressure, and cardiovascular problems need special attention during pregnancy. It's important to have such conditions under control before you conceive. Also tell your doctor if you're taking any prescription or over-the-counter medications. When your immunizations are not up to date, get vaccinations at least three months before you try to conceive. If weight is an issue, it's wise to get it under control before you conceive or after you've weaned your baby.

About supplements
Since about half of all pregnancies are unplanned and because most women don't receive enough folate from their diets, many doctors recommend supplementing with folic acid before and during pregnancy. Often included in a prenatal supplement, folic acid taken before pregnancy can reduce by 60 to 72 percent neural tube defects, including spina bifida, which occurs very early in pregnancy. Your healthcare provider may also recommend supplements to provide extra calcium, vitamin D, and iron.

Start eating better
Because the foods you eat support your own health as well as that of your growing baby, good nutrition is crucial during pregnancy. Rather than simply eating more, make the commitment to eat better. Choose whole or minimally processed foods and avoid snacking on empty calories. Cookies, candy, and potato chips often contain high amounts of sugar, salt, and/or fat but little, if any, nutritional value.

Your daily diet should include plenty of fresh fruits and vegetables; whole-grain cereals, breads, and crackers; lean meat and poultry; and low-fat dairy products. Eating a variety of healthy foods as small meals and snacks helps you get the extra nutrients and calories you need. You may find eating smaller amounts more frequently is more comfortable than eating three large meals a day, and doing so may also relieve nausea.

An ideal weight?
Consuming about 2,200 calories a day is the norm for an average woman. But during pregnancy, most women need an additional 300 calories daily to provide extra nutrients to the growing fetus, finds the American College of Obstetricians and Gynecologists. Your body will be supporting a developing fetus and making extra blood and other fluids, so gaining from 25 to 35 pounds is considered healthy for women of average weight. Heavier women also need to gain some weight, preferably between 15 and 25 pounds.

Get the right balance
Be sure you're getting the right amount of protein, carbohydrates, and fats every day. About 60 percent of your total daily calories should come from complex carbohydrates, which can provide the recommended daily minimum of 25 grams of fiber. Constipation may be a problem during pregnancy, and eating plenty of fiber and increasing your fluid intake can keep you feeling your best. Consume adequate protein by eating plenty of beans, cheese, meat, milk, tofu, and yogurt. The Recommended Dietary Allowance for protein intake during pregnancy is 71 grams daily.

Your body needs fat to function normally and to build your baby's brain and nervous system. Beneficial omega-3 fats are found in fish, flaxseed and flax oil, and fish oil supplements. Research shows that children of mothers who had taken fish oil during pregnancy scored higher on intelligence tests at age four. In another study, older children with higher levels of DHA (the polyunsaturated fat that's critical for brain development and function) exhibited fewer behavioral problems than their peers with lower levels-and were less likely to have ADHD.

Fats should make up less than 30 percent of the total calories in your daily diet. Based on a 2,000-calorie-a-day diet, fat intake should be less than 60 grams.

Healthy Food Choices

Nutrient Why Your Baby Needs It Best Sources
Protein Main building block for your baby's cells Meat, poultry, fish, eggs, beans
Carbohydrates Provide energy for you and your baby Whole-grain breads, cereals, pasta; rice, potatoes
Fat Provides long-term energy for growth Meat, cold-water fish, dairy products, nuts, nut butter, vegetable and olive oils
Calcium Helps build strong bones and teeth Milk, cheese, yogurt, sardines, spinach, fortified orange juice
Iron Helps create red blood cells to deliver oxygen Lean red meat, spinach, whole-grain breads and cereals
Vitamin A Supports eyesight, bone growth, and healthy skin Carrots; dark, leafy greens
Vitamin C Promotes healthy gums, teeth, bones Citrus fruit, broccoli, tomatoes
Vitamin B6 Helps form red blood cells; helps the body use protein, fat, and carbohydrates Beef liver, pork, ham, whole grains, bananas
Vitamin B12 Maintains nervous system; needed to form red blood cells Liver, meat, fish, poultry, milk (found only in animal foods; vegetarians may need to take a supplement)
Folic acid Needed to produce blood and protein; helps some enzymes function Green, leafy vegetables; dark yellow fruits and vegetables; liver; legumes; nuts

Selected sources American College of Obstetricians and Gynecologists, www.acog.org; American Dietetic Association, www.eatright.org; Better Food for Pregnancy by Daina Kalnins, MSc, RD, and Joanne Saab, RD ($19.95, Robert Rose, 2006); The New Harvard Guide to Women's Health by Karen J. Carlson, MD, et al. ($24.95, Harvard University Press, 2004); Prescription for Nutritional Healing by Phyllis A. Balch, CNC, and James F. Balch, MD ($23.95, Penguin Group/Avery, 2000)

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