Eating for two is old school idea

27 Jul

July 24, 2007

Personal Health

Dispelling Pregnancy Myths: Eating for 1.5

Ivy had been eating tuna sushi almost every day. But before becoming pregnant, she wisely had a checkup, which revealed high levels of mercury in her blood that could damage a fetus. Shocked, she stopped eating tuna and postponed pregnancy until the mercury had cleared her system. Last month she gave birth to a full-term healthy boy.

Mercury from eating certain kinds of seafood is just one of many nutrition-related hazards that can confront a pregnant woman or one who wishes to become pregnant. At the same time, some pregnant women worry needlessly about nonexistent nutritional risks.

The March of Dimes, which strives to make every pregnancy as well-planned and successful as Ivy’s, is making a new push to dispel nutritional misinformation and replace it with advice based on solid scientific evidence. Some of the advice may come as a distressing surprise to women, who may be fond of foods or drinks that could endanger their pregnancy.

For example, pregnant women are advised to steer clear of deli meats, including sliced turkey, unless they are fully cooked again before being eaten. But the March of Dimes, among other experts, suggests that it is safe to drink one or two cups of caffeinated coffee a day during pregnancy, whereas consuming too much herbal tea (and three or more cups of coffee a day) can be risky and may result in a miscarriage.

A Healthy Diet

The organization is also concerned about the current notion among some women that it is O.K. to gain 40 or more pounds when pregnant with one baby. Excessive weight gain in pregnancy not only makes it harder to shed the extra pounds after childbirth. It also increases the risk to the mother of gestational diabetes, dangerous rises in blood pressure (pre-eclampsia), the need for a Caesarean delivery and postpartum infection. For the baby, a mother’s excessive weight gain raises the risk of neural tube defects, birth trauma and fetal death near term.

Studies of tens of thousands of pregnancies showed that how much a pregnant woman should gain for the best chance of a healthy outcome for both mother and baby depends on how much she weighed before becoming pregnant.

Accordingly, the March of Dimes suggests that normal-weight women should gain 25 to 35 pounds; overweight women 15 to 25 pounds, and underweight women 28 to 40 pounds. But a woman having a multiple birth should gain more, depending on how many babies she is carrying.

When a woman is eating for two, or better yet, when she is contemplating getting pregnant, is an ideal time to learn the principles of good nutrition and put them into practice. The basics of a healthy diet during pregnancy are the same as what everyone should eat at any time of life:

¶Whole grains, like brown rice, whole wheat bread or whole oat cereal: 6 to 11 servings a day

¶Dairy products, like low-fat or nonfat milk, yogurt or hard cheese: 3 to 4 servings a day

¶Protein, like meat, poultry, fish, beans, nuts or eggs: 3 to 4 servings a day

¶Vegetables, like broccoli, carrots, green beans, tomatoes or beets: 3 to 5 servings a day

¶Fruits, like oranges, bananas or apples: 2 to 4 servings a day

The trick is to know what a portion means because “eating for two” does not mean a woman should double her caloric intake. Only 300 additional calories a day are needed to sustain a healthy pregnancy, provided those calories come from nutritious foods.

Here are some examples of a single serving: one slice of bread, a half-cup of rice or pasta, one cup cold cereal; one cup milk or yogurt, two one-inch cubes of cheese; two ounces of cooked meat, poultry or fish, a half-cup of cooked dried beans, two tablespoons peanut butter; a half-cup of cooked or cut-up vegetables, one cup salad greens, three-quarters cup of vegetable juice; one apple, banana or orange, a half-cup of cut-up fruit, three-quarters cup of fruit juice.

Be sure, too, to drink plenty of water — up to 64 ounces a day — and get regular exercise. Pregnant women can walk, dance, swim and do yoga, but should avoid high-risk activities like scuba diving and skiing.

Foods to Avoid

Many popular foods are potentially dangerous during pregnancy. Pregnant women should refrain from the following:

Raw fish and shellfish, a possible source of the parasite Toxoplasma that can cause fetal blindness and brain damage.

Large predatory fish like swordfish, shark, king mackerel and albacore tuna (fresh or canned), which can contain risky levels of mercury. The Food and Drug Administration says to limit albacore tuna to 6 ounces a week, but it is acceptable to eat up to 12 ounces a week of chunk light tuna, shrimp, salmon, pollock and catfish.

Undercooked or raw meat, poultry and seafood. Use a meat thermometer and cook pork and ground beef to 160 degrees; beef, veal and lamb to 145 degrees; whole poultry to 180 degrees; and chicken breasts to 170 degrees.

Unpasteurized milk and soft cheeses — feta, Brie, Camembert, Roquefort, queso blanco, queso fresco and Panela, unless the label says “made with pasteurized milk.” They may contain the food-poisoning bacteria Listeria that can cause miscarriage, premature birth, stillbirth or fatal newborn illness.

Hot dogs and deli meats, unless cooked until steaming hot. These can become contaminated with Listeria after processing.

Refrigerated pâtés, meat spreads and smoked seafood (unless it is cooked before you eat it). Canned versions are safe.

Soft-scrambled eggs and foods like homemade salad dressing and eggnog made with raw or lightly cooked eggs. Cook eggs until the white and yolk are firm to avoid salmonella poisoning.

Raw sprouts, including alfalfa, clover, radish and mung bean.

Herbal teas and supplements. Their safety in pregnancy is unstudied. Some, like black cohosh or large amounts of chamomile tea, can raise the risk of miscarriage or premature birth.

Alcohol, which can cause fetal damage, including mental retardation and abnormal behavior. Although an occasional drink may be all right, no safe amount has been established.

Extra Vitamins Needed

Pregnant women and those contemplating pregnancy are advised to take a daily prenatal vitamin that contains 400 micrograms to 600 micrograms of folic acid to help prevent neural tube defects, as well as 18 milligrams to 27 milligrams of iron to prevent iron-deficiency anemia, linked to premature birth and low birth weight babies.

But prenatal supplements do not contain enough calcium; 1,000 milligrams a day are needed to protect a pregnant woman’s bones and build strong bones and teeth in her baby. Be sure to eat enough calcium-rich foods, like milk, cheese and leafy greens, or take a calcium supplement daily.

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