Cravings VS nutrition during pregnancy.

Nutrition in Pregnancy - From the Point of View of a (Pregnant) Sports Dietitian

As a clinical and sports dietitian, as I prepared for my pregnancy I felt it was my duty to research, in depth, the subject of nutrition.

Usually, advice to pregnant women begins with what we can’t have. From there, we’re advised on what is recommended and finally what is really important for us to eat. The Ministry of Health website features lots of up-to-date information about dietary recommendations and food safety during pregnancy, and even Google has an answer to almost any "is .... allowed in pregnancy?" search you could think of – you just need to make sure that the source is reliable...

Just as I was feeling satisfied with the research I‘d done and the information I’d gathered, happy and confident as I was that I had a pregnancy nutrition plan – bang! I was hit by nausea and extreme fatigue. After I got over the shock pf these pregnancy side effects, I realized it was time to move on to Plan B: making the best of the situation by doing the best I can, at any given moment.

And yes, there are situations where my ‘best’ would be pizza or a hamburger 😊 – and when that is the case, I let myself enjoy it, without an ounce of guilt! After all, in my professional life as a dietitian, I advocate the philosophy that the majority of what we eat should be ‘good’ – which is totally compatible with my pregnancy Plan B.

Here are some tips that have helped me – and which I hope will also help you – to make better choices, based on how I’m feeling, giving me the sense that I am doing the best I can for our unborn child and for my health and body 😊

•                      I crave carbs all the time!  Pregnant or not, carbs aren’t all bad. If this sounds like you though, do try to choose fruits and whole grains, and prepare the dishes yourself whenever possible instead of opting for processed foods. For example, if I want something sweet – instead of running to the nearest bakery (let’s be honest... instead of my husband running...), I know that a slice of whole wheat bread with white cheese, or natural peanut butter and a little jam (one of my cravings in this pregnancy!) is preferable to pastry/ cookies/ an energy snack etc.... And if I do fancy some cake, I make it at home, taking care to use quality ingredients (or I take leftovers from a family meal - who would refuse a pregnant woman?!)

Ugh! It's hard for me to eat protein! It’s still a wonder to me that I, as someone who advocates the importance of protein and emphasizes it in nutritional counseling - especially for athletes - am not getting enough protein myself! Absurd, but true... Given my unexpected new aversions to certain foods, I’ve been seeking out alternative protein sources to the norm. I’ve found that yogurts with a higher protein content are a relatively easy and convenient solution. Most of them also contain a fair amount of calcium, which is important in pregnancy too. Nutritionally speaking, yogurt with a natural flavor and no added sugar is preferable. If you are looking for something sweet, you can mix in some fruit/ homemade granola and/ or a little honey or date honey.

Another solution is to make crustless pies. I’ve been finding it easier to eat cooked, hot food, and it’s simple to combine protein with carbohydrates and vegetables in a balanced, varied and easy-to-prepare meal - for example, cheese and vegetable pie. you can also upgrade the carbohydrate component of the dish with a range of legumes (e.g. rice with lentils/ beans) to give you a healthy dose of protein, dietary fiber, vitamins and minerals all in one shot. Bulgur wheat with lentils has become one of my new favorites in pregnancy.

•                      Enjoy nutritious and good meals at whatever time of day you most feel like eating. For me, my appetite is strongest in the morning, with the peak of my nausea being in the evening. As someone who used to consistently include a salad with my dinner, even now, well into my second trimester, as the day progresses it becomes harder for me to face vegetables. So, I start the morning with fresh vegetable salad, protein and carbs, and then I already know I’ve had one good meal. When you start the day well, it's easier to keep going well 😊.
•                      Iron - At 27 mg, the daily recommended intake of iron during pregnancy is higher than before pregnancy (18 mg for women aged 19-50). There are two types of iron in food: one that is most commonly found in animal sources and is more easily absorbed by the body; the second found mainly in plant foods, which is less well absorbed - though combining it with foods rich in vitamin C can help. According to Ministry of Health guidelines, it is recommended to follow an iron-rich diet during pregnancy, and from the end of the third month of pregnancy, most women are recommended to take an iron supplement containing 30 mg of iron every day. Which leads me to my next point -
•                      Dietary supplements - In pregnancy perhaps more than at any other time in your life, nutritional supplements become part of your daily routine. It starts with taking folic acid before and during pregnancy, then iron, which we’ve already spoken about, and there are those who take prenatal, omega 3 etc. as necessary, in accordance with doctor’s recommendations. What I want to emphasize here is the importance of matching supplements to your specific needs. There are many recommendations, opinions and supplements on the market that are aimed at pregnancy, but it’s best to rely on a qualified professional, such as a doctor or clinical dietitian, who understands the field and will assess your specific data, along with your blood test results and dietary habits, before recommending what you personally should take, and in what doses. It is therefore very important to consult a professional, and not decide based on your own opinion, or on what your friends have done.
•                      Coffee and caffeine – Coffee is the love of my life! Before pregnancy, I used to have 2-3 cups of homemade Nescafe every day. One of my biggest concerns was how the hell would I be able to reduce the dose after so many years...? If there’s one good thing that came out of the nausea, it was that I couldn’t even look at coffee. So, the detox process was much simpler than I could have imagined... Now that the nausea has passed, I’m playing it safe with just one cup of coffee a day.

The most recent recommendation I have seen for caffeine intake for pregnant women is up to 200 mg a day (some advice also talks about the consequences of consuming over 150 mg of caffeine a day). Considering that a cup of Nescafe contains about 65 mg of caffeine, it would probably be ok for me to indulge in two cups a day, but I’d rather err on the side of caution; and since I already detoxed – I’m sticking to just the one cup!

Bear in mind that caffeine is found not only in coffee but in other foods and beverages such as chocolate, cola, tea, etc ... and in varying doses. So, do check how much you’re having overall, according to everything you eat and drink.

•                      Drinking water - I am constantly thirsty. I drink a lot, and then need to go to the bathroom - it’s a never-ending cycle. But the pregnant body does need more fluids, and it’s important not to skimp in this regard. On the other hand, you should avoid diet drinks (and foods) during pregnancy, because of the artificial sweeteners usually found in these products.

There is no doubt that pregnancy is a challenging period in terms of nutrition. My advice is to strive for a nutritious diet overall, while at the same time dealing with cravings, nausea and an emotional state that can change without warning. It is important to remember that in nutrition as in life, nothing is perfect. It's not black and white; one less ‘successful’ choice will usually not undo all those good choices you’ve made. Just do the best you can at any given moment. Planning can help, but it’s also important to learn to adapt and make adjustments in real time - what's more it’s good practice for real life, especially when you have a baby on the way 😊

Yael Yellin Sedbon, Clinical Dietitian and Sports M.Sc

Fitness trainer

Israeli champion and former player on the Israel national beach volleyball team

Written in the second trimester of pregnancy

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