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 Nutritional Medicine: Nutritional Programs for Pregnancy 

Exercise is also very important during pregnancy, as always. Keeping the body limber, loose, and toned is necessary to a healthy pregnancy. Do exercise; don’t get lazy. It is important for good circulation, and can help prevent constipation, varicose veins, and a flabby tummy. Regular stretching, movement classes, and even aerobic-type activities, such as indoor and outdoor bicycling, swimming, and hiking, will help maintain vitality. If you have not been exercising much prior to becoming pregnant, begin slowly with stretching and light activities. Also, avoid impact aerobics, jumping rope, and horseback riding—but keep moving. Regular, quiet internal "exercises," such as meditation and visualizations, are important to prepare for all the body changes, emotional shifts, and a smooth labor and healthy baby.

It is particularly important during pregnancy to avoid drugs of all kinds. Caffeine and alcohol should be minimized to occasional use only and are better avoided completely. Nicotine use is best eliminated, as it is associated with many problems in the pregnancy, birth, and health of the infant as well as the mother. It is also wise to avoid chemicals of all kinds—in foods, at work, and in the home. Many chemicals will pass through the placenta to the baby. Though the placenta protects the baby from many harmful substances, there are very few that it blocks completely. Pesticides or metals can be concentrated in the fetus. Sugar substitutes such as saccharin, artificial flavors, food dyes, and nitrites should be eliminated from the diet. Nitrosamines formed from nitrates and nitrites (found in hot dogs, bacon, and other lunch meats) have been shown in animal studies to produce cancer in the offspring. Good levels of vitamin C in the body can block nitrosamine formation.

Any pharmaceutical drug use should be carefully monitored by the doctor or midwife. All drugs would be best avoided if possible. Many drugs may interact with body nutrients and increase the risk of deficiency. Pregnant women need to be very careful to avoid drug and chemical exposure, because it is very hard to do any detoxification during pregnancy. The body is in a building up, gathering state and will utilize most everything that comes into it or store it away for later use.

Nutritional changes and support may help remedy some of the common problems of pregnancy. Morning sickness with nausea and vomiting is especially common during the first few months. This problem is likely a result of biliary or liver activity. During the night, the liver works to eliminate toxins, which are thus in the system on awakening. A good diet and avoidance of fatty foods, alcohol, and other liver-irritating drugs before pregnancy is helpful in minimizing morning sickness. Vitamin B6 aids liver metabolism. The active metabolic form is the pyridoxine precursor, pyridoxal-5-phosphate (P5P), because it enters directly into the functioning metabolic cycle. Usually, supplementing 25–50 mg. of B6 three times daily will help reduce the symptoms of morning sickness. Occasionally, higher amounts are needed. If these higher levels are used, it is wise to continue smaller amounts for a while to prevent pyridoxine withdrawal in mother or baby; higher dosages, however, are usually not required all the way up to delivery time, because intestinal symptoms decrease after the first few months. Other supplements helpful in morning sickness include vitamins B12, C, and E and extra magnesium and potassium. Herbs are often helpful as well. Raspberry leaf, peppermint, or ginger root teas have been effective for some women.

Dietary changes are the best way to handle morning sickness. A reduction of fatty food intake and an increase in carbohydrates may be helpful. A higher fiber intake keeps intestines moving, which helps elimination and detoxification. Acidic foods, such as citrus fruits or juice, and iron supplements or milk may increase nausea and vomiting. Small, frequent meals and snacks of carbohydrate or protein can be best tolerated. Munching on a few soda crackers or dry toast upon awakening may help alleviate early morning nausea. Don’t worry, this too shall pass; and breathing and relaxing also help.

Pregnant women and their husbands and families need to be understanding and adaptable, especially in regard to diet. Food cravings can be wild, food consumption goes up, and sometimes a woman’s whole life becomes centered around food. And these can be obstacles. The digestive tract is more sensitive, and as the pregnancy progresses, the size of the stomach shrinks due to the growing womb. Often food intolerances or many new likes and dislikes develop. To adapt, the diet may shift to frequent small and simple, but nourishing meals. Nutritious liquid meals are a good choice. From protein powders to fruit or vegetable smoothies, these drinks can be packed with nutrients. One possibility for building and nourishing mother and baby is the "Baby Shake," an adaptation of the "Pregnancy Cocktail" described by Fred Rohe in The Complete Book of Natural Foods.

The Baby Shake

Blend Together:
½–1 cup apple juice1–2 teaspoons blackstrap molasses
1 banana1–2 teaspoons nutritional yeast
½–1 cup yogurt1 Tablespoon wheat germ
1 raw egg1-2 Tablespoons honey or pure maple syrup
½–1 cup low-fat milk1/3 teaspoon kelp

This can be adapted to your special desires and the flavors you can tolerate. If something in the drink doesn’t appeal to you, avoid it and try something else. Other fruits or juices can be used, or no juice and just milk, a banana, or another fruit as a base. Adding water will make it more dilute, which some women will tolerate better. Flavorings such as vanilla or almond or a handful of raw almonds, coconut, or sunflower seeds can be added and blended. In regard to food-combining, when different foods are blended together as a drink, they seem to be better tolerated. However, if you do not handle this mixture well, simplify the drink and just use a banana, yogurt, and milk or water, along with some yeast or wheat germ and a little sweetener. Overall, your Baby Shake can be very tasty and nourishing.

Later in pregnancy, when labor is just beginning, take some extra calcium-magnesium to help reduce the pain of contractions and muscle aches and spasm. About 1,500–2,000 mg. of each has been helpful to some women. This can be repeated later if labor is extended. If a caesarean section is going to be done, it is wise to take extra tissue-healing nutrients (vitamins A and C, and zinc) prior to and after the procedure, for several days to several weeks if possible. (See the Nutrient Program for Pre- and Post Surgery.)

As for regular supplements during pregnancy, usually a high-potency multiple or special prenatal formula with plenty of iron should be taken. If nausea occurs with the supplement, try to take it later in the day with meals. The nutrient plan shown in the table gives the ranges from the MDR (minimum daily requirement) for pregnancy to what I feel is the optimum insurance level.

For special problems, such as anemia, more iron may be needed. Consult your doctor or midwife. Of course, not all of these nutrients will be used as supplements. Many of them, such as sodium, chloride, fluoride, and potassium are obtained from the diet. However, depending on the dietary intake of various nutrients, such as calcium, zinc, or B vitamins, or individual blood measurements, any specific nutrient can be further increased by supplement use to give the necessary intake.

(Also note: in the next program, Lactation, more specifics of the pregnancy diet are discussed.)

Nutrient Program for Pregnancy
(Range — RDA to Optimum)

Calories* 2,300–3,200
Fiber 10–15 g.
Protein* 75–90 g.
Vitamin A*6,000–10,000 IUs Calcium*1,200–1,600 mg.
Beta-carotene10,000–15,000 IUs Chloride+2–4 g.
Vitamin D400–600 IUs Chromium200–400 mcg.
Vitamin E*50–400 IUs Copper2–3 mg.
Vitamin K100–400 mcg. Fluoride+1.5–3.5 mg.
Thiamine (B1)1.5–50 mg. Iodine*+175–350 mcg.
Riboflavin (B2)1.5–30 mg. Iron*#40–80 mg.
Niacin (B3)16–100 mg. Magnesium*450–1,000 mg.
Pantothenic acid (B5)7–250 mg. Manganese2.5–15 mg.
Pyridoxine (B6)2.6–100 mg. Molybdenum150–500 mcg.
Cobalamin (B12)4–200 mcg. Phosphorus*+1,200–1,600 mg.
Folic acid*800–1,200 mcg. Potassium+2–5 g.
Biotin200–500 mcg. Selenium150–300 mcg.
Choline50–250 mg. Sodium*+2.5–4.0 g.
Inositol50–250 mg. Zinc*20–40 mg.
PABA10–50 mg. Essential fatty acids**2–3 teaspoons
Vitamin C*++80–1,000 mg.
Bioflavonoids100–250 mg.
(Excerpted from Staying Healthy with Nutrition ISBN: 1587611791)
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 About The Author
Elson Haas MDElson M. Haas, MD is founder & Director of the Preventive Medical Center of Marin (since 1984), an Integrated Health Care Facility in San Rafael, CA and author of many books on Health and Nutrition, including ...more
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