Eating Right Through Pregnancy - Ask a Nutritionist

September 14, 2023

Pregnancy places a huge demand on a woman's body in almost every way you can think of. This also includes nutritionally. It's super important for the health of both mom and child for their bodies to have access to the right nutrients. Tune into this week's episode with Leah to learn all about what you should eat if you're expecting.

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Welcome to the “Ask a Nutritionist” podcast, brought to you by Nutritional Weight and Wellness. We are thrilled to have you join us today as we discuss the connection between what you eat and how you feel, and share practical real life solutions for healthier living through balanced nutrition. Now let's get started.

LEAH: Hello and welcome to Dishing Up Nutrition's midweek segment called “Ask a Nutritionist”. My name is Leah Kleinschrodt. I'm a Registered and Licensed Dietitian with Nutritional Weight and Wellness. And on today's show, I will be answering one particular question that we received from our Dishing Up Nutrition listeners. So this listener asks, “Could you share knowledge and or your experience through pregnancy about eating the right nutrients to restore mental focus and combat fatigue while also keeping both the little one and mom healthy?”

So this is a great question. I'm actually excited to answer this one. And just for a little bit of background, this particular person who asked this question, she is currently pregnant and said that even after a good night's sleep, she still struggles with that clarity and focus and, and just that mental acuity. So again, this is a great question and hopefully hopefully still timely for this person.

I picked this question in particular 'cause I know personally for me, I can identify with these struggles. I've had two pregnancies myself. I've worked with some pregnant mamas over the years, and I'm sure there are many other mamas out there, maybe both currently pregnant or in those early couple of years of postpartum who can also relate to this. I distinctly remember about halfway through my first pregnancy that it almost seemed like the light switch was flipped or something happened where my brain just did not function the way it had previously done.

So for me, again, it was about that 20 week mark or so I started to notice, like I would have to reread things several times for it to really kind of make sense or to sink in. I would quickly forget what I just read or what I just heard, and I would, again, have to go back and maybe re-listen or, or reread. And the other thing I really noticed is that my would, my brain just had trouble kind of tracking conversations the whole way through. So a, a very standard line for me became, I forget where I was going with that. Like I might start saying something, have a couple of things that I wanted to hit in that, in that sentence or in that conversation, and maybe I get to one or two, but then by three or four it's like, I don't remember where I was going with that. And then for the fatigue part too I, I, and I will preface some of this in saying too that everyone's pregnancy experience is different, but like, but even between mamas and even if a mama has multiple pregnancies, these pregnancies can be very different.

For me, the fatigue piece, I definitely had a lot of fatigue in both of my first trimesters. I was really hit with the morning sickness and just tons of fatigue in that first trimester. By the second trimester, starting to feel better, have a little bit more energy. My first pregnancy, I actually felt pretty good up until those last couple of weeks. I had a summer pregnancy, so like the heat and then just having a big belly at some point just got to be a lot. And in my second pregnancy, I do remember just kind of feeling in general, a little bit more worn out, a little bit more fatigued and things like that.

So again, I can really relate to some of these things. And that's naturally then we start to say, okay, what can we do nutrition-wise or what, what is it that I can control? What is it that I can do to support my changing body, make sure that baby inside of me is still getting what they need and just kind of help myself along so I can still function and get through my days with this pregnancy?

Eat in balance with real, whole foods

So I do have some thoughts I want to share. I, I can't guarantee that it's going to completely alleviate these symptoms, but I hope it gives this particular person and, and again, other mamas out there, I hope it gives you some food for thought should we say, or just some things to try, some things, some avenues to pursue. And the nice thing is, is that this will still be through the lens of real food and eating in balance, which we talk about all the time. And when we do that, you know, you can't go real wrong with that. And especially when we're eating real whole foods, most of the time we are getting a lot of the nutrients that both your body needs and that baby needs.

I do have a couple of things that I just want to impart during this, during this conversation. First and foremost, I do just want to hold some space and really acknowledge that pregnancy places a huge demand on a woman's body in almost every way you can think of. But this includes from a nutritional aspect. It takes a lot of nutrients and a lot of internal work to build and grow a tiny human inside of you. And sometimes that work is just plain and simple, it's exhausting.

What changes happen to the brain when a woman is pregnant?

Also, in preparing for the show, I was doing some reading just on what kind of changes happen to the brain when a woman is pregnant. And there, there were a couple of tidbits I just wanted to share from this little bit of digging that I was doing. What I found that it is not uncommon for certain parts of the brain, like the gray matter in the brain; which we'll talk about that in a second; that there, it's not uncommon to have reductions in certain areas of gray matter in the brain during pregnancy. So gray matter in the brain does a lot of things for us, but it includes being able to execute tasks, so things like listening and processing emotions, processing memories, and making decisions.

So when we think about maybe some of these parts of the brain starting to shrink, it makes a lot of sense that okay, maybe there's an explanation. There are physical changes that happen in the brain just as a result of the pregnancy and the hormone shifts that happen. So this could be why we do start to notice a change from our baseline or from pre-pregnancy with our brain function then when we become pregnant. And some of this can last into postpartum as well. And one thing that I found really kind of interesting was this, and is that the research describes this reduction or kind of some of the shrinkage in gray matter, they describe it actually more of a pruning type of process. So the body and the brain are just kind of getting rid of, we'll say extra or underused brain circuitry. It keeps the most important brain circuits and wiring alive and well.

But really they think that it, this is making room for things that are to come in these coming months or coming weeks after pregnancy that will be important, such as bonding with your baby or like things that you have to do to be able to care for and really respond to your baby. So you're going to be growing these new brain circuits or developing these new pathways. And so they think that some of this shrinkage or just some of this pruning, is it part of that process to prep your body and prep your brain, especially to be able to care for your baby when baby is here. And not to be the bearer of real bad news, but the researchers found that some of these reductions in the gray matter can last two and even six years postpartum. And what tends to happen is like in those couple of months after pregnancy, there is a rebound.

So some of that gray matter does come back. I, my guess is that there it is that new, those new brain circuits that are being created but they don't necessarily return to your pre-pregnancy levels. So again, that's why even postpartum, you might still have some, some of these symptoms that you're experiencing, maybe not necessarily the fatigue, although there, there might be some of that if sleep is a little wonky, but how, like you just might have some different focuses or you're, you might still have some of that mom brain of having trouble focusing on certain things, making decisions and, and the such. So I just thought some of that was kind of interesting that there are actually physical changes that happen in the brain and some of them still do even persist postpartum, maybe not to the level that they were during pregnancy, but that, that some of these things persist and why, you know, why there is a thing out there called mom brain.

Eat to balance the blood sugar & provide nourishment

So I want to bring us back into, into the topic at hand is, okay, what do we have control over and what can we do to feed our cells the best that we can nourish our bodies, the best that we can during pregnancy? And when we nourish our bodies as mamas, we help to nourish babies’ growing brains and growing bodies as well. So the first thing I want to just suggest and put out there is to maybe do some evaluating with your current diet and your current patterns just to see if you're eating enough real whole foods

On top of that, we are just like we talk about all the time at Nutritional Weight and Wellness, are you doing well in trying to keep your blood sugar balanced throughout the day? So we've got the, okay, are we eating enough and then are we eating in a way that keeps our blood sugars balanced? If you were a client sitting in front of me, these were, these would be things that I would be looking at.

We actually did a really nice podcast that covered a lot of this back in November of 2019. So it was a Dishing Up Nutrition show called Foods for Pregnancy. We had Kara and Britni on, so I'm not going to spend a ton of time right here right now talking about, okay, what specific foods do we want to be eating in pregnancy? And specifically about, you know, about balancing, how do we balance blood sugars and things like that. I just want to refer you to that particular show. I do also want to refer you to one of my favorite pregnancy related nutrition resources that I used for myself with both of my pregnancies and I use for my clients when I'm working with pregnant and postpartum mamas.

It is a book called Real Foods for Pregnancy. It was written by a registered dietitian named Lily Nichols. She's a great resource. She has a couple of books, has a great blog and a website, puts out some great content on social media as well. So she is one of my favorites, has lots of great knowledge out there.

Eat enough real food in balance

But I do want to take just a moment to circle back into the eating enough because there's, there's a lot of things that can be stacked against us when it comes to eating enough during pregnancy and sometimes we unintentionally undereat or we're a little undernourished not even realizing it. In pregnancy in general, especially as you go along in pregnancy, your energy needs and your nutrient needs just across the board go up. You are growing another human being, you are requiring a lot more nutrients. It's not quite the eating for two, so you're not like eating double the amount of calories that you were before.

You're not having to eat for two full people as a misconception kind of is out there, but you are having to eat a little bit more. Some people do end up needing to eat more than others and it just, there's a lot of factors that go into that. Some people may only need a hundred to 200 extra calories throughout the whole pregnancy every day, and that works. There are some people that need even 500 extra calories, especially by that third trimester. So there's a, there's a broad range of where we could be at there, which could just mean putting in an extra snack, having a couple, you know, just increasing your serving sizes a little bit at your main meals; a couple different ways you can go about that. But again, I, I kind of refer back to that previous podcast that we, that we did with Kara and Britni.

There are a lot of things too that kind of stack up with some challenges during pregnancy. I mentioned before, for me, early in both of my pregnancies that first trimester, like the first 12 to 14 weeks, I dealt with a lot of morning sickness and a lot of fatigue. And some days it was all I could do even to just get my prenatal in. For me personally, I have no doubts that both of my first trimesters just kind of left me a little depleted, especially going into those second and third trimesters. Some women struggle with nausea and even vomiting longer than that first trimester. Some women have it all pregnancy long, so that can make eating food in general just very unappealing. Some women struggle with a lot of heartburn. Some women struggle with feeling full all the time or getting really full after just a couple of bites.

And that especially usually can be true further on in the pregnancy as your belly gets a bit bigger. And then some women also struggle with a wide variety of like food aversions, strange cravings, things like that. So there could be a lot of challenges to getting in even enough food and nutrients during pregnancy. And then on top of it, if, if you're not feeling well or having some kind of wonky cravings, it's easy to turn to some of the more processed and refined foods. So think again, like the breads, the cereals; crackers is a big one; pastas, ice cream, things like that. And while it's not bad to have, you know, these foods here and there during pregnancy, they don't have a lot of nutrients in them and they tend to put you on a bit more of a blood sugar roller coaster where you get big spikes and big dips in your blood sugar.

So if you're not kind of getting a lot of nutrients, getting the most bang for your buck through real whole foods and you're on this blood sugar roller coaster up and down, that absolutely will impact your energy levels throughout the day. It'll impact how your brain functions throughout the day. If you think that is you, if you're struggling a lot with, with some of those things I mentioned or if you're kind of on that blood sugar rollercoaster or if you're not sure, maybe this would be a great opportunity to make an appointment with one of us registered dietitians or nutritionists at Nutritional Weight and Wellness.

Schedule Nutrition Counseling

There's a lot of us that have kids, some of us a little bit more recently than others, but a lot of us kind of understand where you're coming from with that and we can be a great resource and just give some suggestions on, on how can we even out that blood sugar, you know, what might we want to include to make as most of a nutrient dense diet as we can during pregnancy.

Incorporate omega-3 fatty acids

One area I do want to highlight very quickly here; this is also courtesy of Lily Nichols. What she referred to in some research that she did is that it may be helpful during pregnancy and postpartum to make sure that you're getting a relatively high dose of one of the omega three fatty acids called DHA. So DHA is a critical component of every single brain cell that you have. It's part of that cell membrane. And research has shown that pregnancy decreases the amount of DHA that you have in your brain and in your blood.

So one thing that I'm sure I did and or that I recommend for pregnant women that I'm working with is making sure that you are getting some kind of source of omega threes consistently throughout your pregnancy. This is your typical fatty fish. So think salmon, sardines, mackerel, herring, things like that, anchovies. This could be grass fed meats, this could be some nice pasture raised eggs and, and eggs especially, not only do they have some DHA in them, they have B12 and choline and a couple other really nice brain boosting nutrients.

Eating those foods consistently is very helpful and/or supplementing with a good quality omega three supplement, or maybe even specifically a DHA supplement. What I would aim for is at least 300 milligrams of DHA per day. And we, we have a specific DHA supplement. It's our Nutrikey brand: DHA 200 or make sure you have a good quality omega three or fish oil supplement. And what you're looking for is making sure when you're looking at the label and looking at the serving sizes, just again making sure that you're getting in at least that 300 milligrams of DHA every single day.

Incorporate a good quality prenatal multivitamin

And lastly, I think this was my other kind of big thought or suggestion is just taking a look and making sure that you have a good quality prenatal multivitamin. How do we know if we're getting a good quality prenatal multivitamin? So there's a a, a couple of things that I look for with this that I want to share. One thing I look for, and this is prenatals, but this could be any kind of multivitamin out there as well.

So a couple things I'm looking for. I'm looking at what forms of some of the B vitamins that they're using in these prenatals. So specifically I'm looking at folate. Does the prenatal use folic acid? Which is a synthetic form of folate, which is B9. Some people do just fine on folic acid and other people don't. And a lot of times we don't know who is who and what is what. So I do always make sure that a prenatal or a multivitamin is using either folate or that they're using methylfolate.

You might see something like 5-methyl folate on the label or 5-tetrahydrofolate, something along those lines. So we want that form of folate in a multivitamin or a prenatal versus folic acid just to cover our bases. And I also look at B12. What we're looking for is methyl as opposed to cyanocobalamin, again, like the methyl part of this just means that these B vitamins are more activated and our bodies use them a lot easier. They're more bioavailable to our bodies.

I'm also looking at what forms of minerals are used in this prenatal. So I'm looking to see do they use calcium carbonate in this multi in this multivitamin, which is not a really well absorbed form of calcium, or are they using something like MCHC or calcium citrate, which are better, more highly absorbed forms of calcium, you know, if they're using magnesium, are they using magnesium oxide which is cheap and not well absorbed, or are they using magnesium glycinate or magnesium malate or magnesium bisglycinate? Something along those lines.

Another one that I'm looking at as well is iron. Iron is a big deal in a prenatal. So you, your iron levels or your iron requirements in pregnancy go up a lot, but iron can contribute, it can either cause or exacerbate some of that nausea and some of the, like that tendency to want to vomit. So I do recommend a prenatal that uses a chelated iron. So just like the magnesium, I'm looking for something like ferrous bisglycinate. That's a much better absorbed form of iron and then tends also to not lead to some of that nausea.

So that is another thought that I did just have too, is what can happen. I mean, in pregnancy, again, your iron needs go up depending on what you're eating and the form of iron that might be in your prenatal, you may want to get your iron levels checked as part of pregnancy and it is usually standard to run that in the first trimester and they might not check it or run it at any other time during, during the pregnancy.

And so that doesn't necessarily mean that you're good to go after the first trimester. So you might want to have them check your hemoglobin and also look at your ferritin levels and see just where do you stand, you know, and you might even want to do that once a trimester. Some of the symptoms of iron deficiency is low energy and you can kind of have some of that brain fog or, or just, or kind of like that lack of mental focus and clarity. So that would be something else to maybe just check on.

Then back into the prenatals. So prenatals have that DHA in it, which is actually, it's a nice bonus. So that would be a great thing to have as part of your prenatal package there. I personally made sure that my prenatal had some choline in it. Again, choline, which I mentioned earlier, it's great for healthy brains and healthy nervous systems. It's just part of those building blocks of a good brain. The other thing I will note is what tends to happen when we have, when we're looking at some of these higher quality and more absorbable forms of nutrients in a prenatal, what tends to happen is that now you have to take a couple of capsules or a couple of tablets to get to the serving size or get like all those nutrients in that are on the label.

So unfortunately a good quality prenatal probably isn't going to be a one a day type of thing or just like a one and done type of supplement. When we start talking about these more bioavailable nutrients, they just tend to be bigger and take up more space. So it's not, I, it's definitely not uncommon to need three capsules or three tablets and even upwards of six tablets or capsules just to get all of these nutrients in so that your body can absorb them really well. Again, tricky, it can be real tricky when you already don't feel good or when you are dealing with an upset stomach a lot. And so that's another example of like in pregnancy sometimes we are just doing the best we can to get through day to day

And I believe Britni and Kara talk through some strategies if you are struggling with more of that nausea to how do you get in those prenatals when you're, when you're struggling, how do we get in some of these foods when you are dealing with some of these symptoms? So again, go back and and listen to that particular episode. So those are my thoughts. I hope that is helpful. Pregnancy, man, pregnancy is definitely is a season where sometimes I would even say a lot of times you are just doing the best you can. Even though it feels like it sometimes pregnancy is not forever.

So you do what you can now you do some of the, maybe you're able to implement some of the things I mentioned, but you may see some great improvements on your own or just some shifts in some of these symptoms after baby gets here. You might not have to do, have to do anything really intentionally. Some of these hormone shifts, we don't understand everything that happens around those though. Some of this stuff may get better even a after you have baby. But hopefully some of these things just gave you some avenues to look at or just some things to think about depending on how long you have left in your pregnancy.

So I wish you the best of luck and health in the rest of your pregnancy and those early weeks and early months in motherhood. And one thing that I always found helpful as a reminder when people would remind me of this is that your baby is lucky to have you and you got this. And lean into your community and lean into your support as much as you need to, especially in those those early months, those early years of motherhood.

So thank you for listening to Dishing Up Nutrition’s “Ask a Nutritionist”, and if you have a nutrition question you would like us to answer, we invite you to join our Dishing Up Nutrition Facebook community by searching Dishing Up Nutrition on Facebook.

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