Eating for two?

How many times will people ask you that while you're pregnant? Lots! Although you don't have to eat twice your usual volume of food, you do need adequate nutrition to help keep yourself and your growing baby healthy.

Some women do experience nutritional ups and downs during these nine months (morning sickness and heartburn are no fun), but overall, it's not difficult to eat well during pregnancy. To take the guesswork out of your meals and snacks, you can rely on Canada's Food Guide to Healthy Eating, to help you choose a balanced diet made up of a variety of wholesome foods.

Here are some of the most common areas of concern:

The Building Blocks of Prenatal Nutrition

	Folic acid There's been a lot of media coverage about this nutrient since researchers discovered a link between folic-acid deficiency and neural tube defects such as spina bifida. Folic acid is especially important during the first two or three months of pregnancy, and it's best to have a good folic acid intake even before you conceive.The Society of Obstetricians and Gynaecologists of Canada recommends a daily supplement of .4 to 1 mg, preferably starting in the months before conception. Foods rich in folic acid include dark green vegetables (spinach, broccoli), corn, dried peas, beans and lentils, orange juice and whole grains.
	Protein Protein helps to form the placenta, blood cells, and fetal tissue. It's important all through pregnancy, but especially in the second trimester. Most of us in developed countries don't have to worry about getting enough protein. It's available in meat, poultry, fish, eggs, dairy products, legumes, nuts and seeds. Don't use protein supplements (powders and liquids). They're unnecessary and can be harmful during pregnancy.
	Iron Some minerals are absorbed by the body better during pregnancy than at other times. Iron, for example, especially when taken at a meal with a Vitamin C-rich food, is well absorbed. Be aware that tea and coffee interfere with iron absorption, so you're better off having orange juice, or prune juice with added Vitamin C, with your iron-rich cereal at breakfast. If your health care provider suggests you take an iron supplement, dietitian Louise Lambert-Lagacé recommends you increase the fibre in your diet at the same time, to prevent constipation. She adds, "If your iron supplement upsets your stomach, you can try another formulation. Some women do well with baby iron drops." The most common dosage of iron supplements is 30 mg. Be aware that higher doses can lead to an imbalance of other minerals, especially zinc. Iron powerhouses include red meats, enriched breads and cereals, legumes, dried beans and dried fruit.
	Calcium Your baby needs calcium to form teeth and bones, and you need it to keep your own bones strong. Milk and other dairy products are the most reliable source of this mineral, but certain vegetables can boost your total calcium intake, such as collard greens, spinach, turnip greens, kale and okra. Sesame seeds and tofu are good sources too. People who can't tolerate dairy products may need a calcium supplement.
	Fibre You know fibre helps reduce cholesterol and control blood glucose, but during pregnancy, you may be more impressed with its ability to help relieve constipation! Sources include whole grain breads and cereals, fruits and vegetables and legumes. Be sure to drink plenty of water, to help the fibre do its job.
	Salt Your mother was probably told to cut down on salt during pregnancy to prevent fluid retention. Health experts now acknowledge this is unnecessary and may even be harmful. More sodium is required during pregnancy and breastfeeding than at any other time of life, because of increased blood volume, but virtually all women can meet this need with a normal intake of salt (adding some salt during cooking and occasionally sprinkling it on food, for example.)
	Supplements Should you take vitamin pills during your pregnancy? Many doctors recommend them automatically. But if you follow Canada's Food Guide to Healthy Eating, you won't necessarily need supplementation, with the exception of folic acid during the first trimester (and ideally in the months before conception). Ellen Desjardins, dietitian and co-ordinator of Healthiest Babies Possible (a City of Toronto program for high-risk mothers), says it's preferable to get your nutrition through food, although supplements can be important when a person comes into pregnancy with a poor nutritional status. "Women have to be careful not to use vitamin pills as an excuse for not eating well," she says. Lambert-Lagac, however, believes that supplements can be useful for many pregnant women. If you take supplements, it's best to buy a multi-vitamin with zinc; it can be dangerous to take large quantities of individual nutrients. An excess of one mineral, for example, can cause a deficiency in another. Discuss the issue with your health-care provider, after making an honest assessment of your diet, and do not exceed the recommended dosage.
	Special concerns for vegetarians Vegetarianism is on the rise. This mode of eating offers many health advantages, including lower blood cholesterol, a lower incidence of coronary heart disease, and lower rates of osteoporosis, cancer and gallstones. Lacto-ovo vegetarians, who eat no meat, poultry or fish, but who do consume eggs and dairy products, have little trouble meeting the dietary needs of pregnancy. Vegans, who eat no animal products of any kind, must be sure to include an adequate source of vitamin B12 in their diets. The vegan's need for calcium is actually less than that of meat eaters who consume large amounts of protein. However, the vegan may have to make an effort to consume sufficient vegetable sources of calcium. She may also have trouble getting enough iron and vitamin D. Ask your health care provider about supplementation.
	How much is enough? In her book Eating Well When You're Pregnant (Macmillan Canada, 1996), Ellen Lakusiak adapts Canada's Food Guide to Healthy Eating for women of childbearing age. She suggests that grain products make up a "healthy" portion of your diet. Nine to ten servings a day isn't so hard when you keep in mind that one serving is the equivalent of one slice of bread, a half-cup of pasta or rice, half of a bagel or half of a large muffin. If you have two slices of bread at breakfast and lunch, you've already eaten four servings. Fruits and vegetables can be spread over the day, too. Just half of a cup of cooked vegetables, a medium piece of fruit or a half-cup of juice equals one serving. Try to consume eight or nine servings a day. Versatile dairy products offer you many choices. One cup of milk is one serving, as is 3/4 cup of yogurt or 50 grams of cheese. Aim for three to four servings daily. You probably don't need as much meat as you think you do. Two to three servings each day are recommended, and that can be in the form of meat, poultry or fish (50 to 100 grams), beans or lentils (1/2 to one cup) or nut butters (just two tablespoons). And one or two eggs equal one serving. It's best to moderate your intake of cakes, cookies, doughnuts, butter and margarine, oily salad dressings, and sauces.