As I write this, my wife is crushing her 40th week of pregnancy. The is our first pregnancy so that means one thing: everyone has advice for us.
“Just wait until…” or “have you started…” now replace the more common greetings such as “hello” or “how are you”.
In the information age, it’s easy to get lost down any number of rabbit holes. Combine that with the endless amounts of (mis)information available about “nutrition”, and it’s easy to get overloaded and end up just smashing pickles and ice cream four or five times a day. But, just like Power Athlete’s strikingly simple approach to nutrition for performance, proper nutrition while pregnant doesn’t have to be difficult. There are certain components that need some extra attention though, and this article will take you through the Talk to Me Johnnie classic “Just Tell Me What to Eat” while showing you the small tweaks to make in order to empower your pregnancy. First, let's cover the good stuff.
Eat with abandon: meat, fowl, fish, seafood, eggs, vegetables, roots, tubers, bulbs, herbs and spices as well as animal fats, olives & olive oil, avocados, and coconut (meat, oil, flour) and dairy*.
Meat (Every meal)
Aside from the numerous benefits already known about including meat in your diet, for a woman who is pregnant it is even more important. Iron and Zinc deficiencies, two nutrients plentifully found in meat, are directly linked to catastrophic events such as stillbirths and miscarriages, as well as less severe (but still unfavorable) outcomes like premature births, maternal anemia, and impaired thyroid function (1, 2). How you prepare the meat also matters. Slow-cooked meats WITH the bones provides collagen and gelatin, which both contain an important amino acid: glycine (3). During pregnancy, glycine becomes important because it is vital to your baby’s DNA synthesis and growth. Lean proteins, skinless and boneless proteins, and vegetarian protein sources are not abundant sources of glycine. You know what has glycine by the mouthful? Red meat, pork, and skin-on bone-in chicken (think wings). Stewing your own bone broth and slow cooking meats seem to be the best way to get the full benefit of this nutrient.
Fish (wild caught salmon, sardines, shrimp, roe)
The main fear of eating fish while pregnant is mercury. So first, let’s understand how mercury content rises in fish. An easy rule of thumb to remember is, the bigger the fish, the greater the likelihood of a higher mercury content. This is the “food chain” at play. Small fish and sea organisms might contain a little mercury, bigger fish eat those, and even bigger fish eat those, etc. So, the fish that have higher mercury would be towards the top of the food chain, meaning limit your tuna, shark, and other big swimmers. But what often doesn’t get discussed is selenium, a mineral abundantly found in fish that actually PREVENTS the toxic effects of mercury in humans (4). That being said, studies have linked higher IQ and communication skills in children to mothers who consumed MORE than 12 oz of seafood per week, while those who ate no seafood had less desirable outcomes (5). Fatty fish, such as sockeye salmon and roe, have high concentrations of the omega-3 DHA and vitamin D while containing a low level of mercury. If salmon and sardines aren’t your jam, other seafood options such as shrimp, scallops, and cod are a good source of iodine (a thyroid function regulator), something pregnant women need more of compared to their non-pregnant counterparts (6). As with most sources of animal proteins, wild-caught as opposed to farmed will be a safer bet, as the use of antibiotics and other unwanted chemicals may have negative effects on mother or baby (7).
Eggs (Eat two eggs a day)
For the moms to be, this still holds true. BUT there are some tweaks you may want to consider. First: Eggs. Eat eggs every day. Not egg whites, but whole eggs. Choline, a micronutrient found in the yolk, is a key component to brain and neural tube development of your baby (8). Two eggs a day will give you half your RDA of choline, which is 450mg. In addition, they are rich in vitamins A, E, D, and Omega-3s. But again, these are all found in the yolk. As with many sources, pasture-raised will have a more abundant profile of nutrients than commercially raised (9), but some is better than none! And if you’re worried about dietary cholesterol, simply stop as plenty of studies have shown the lack of correlation between dietary cholesterol and negative health outcomes (10).
Liver (~3oz once or twice a week)
Though we don’t specifically mention it, the list of benefits from consuming liver is startling, and only getting longer. Outside of eggs, liver is the only other food source that is a significant source of choline. On top of that, it contains nearly every micronutrient that research has identified. Literally. Iron, a very prevalent micronutrient in liver, decreases the risk of hypothyroidism and preeclampsia in mom, but will also help with brain and cognitive development in baby (11).
It’s also rich in folate and vitamin B12, which is preferred over a multivitamin as most Americans are unable to properly utilize the synthetic form of folic acid (Google: MTHFR genetic variant) (12). With liver having ~200x more B12 than other muscle meat, you get more bang for your buck and help to ensure proper neural development of your baby. Lastly, liver is rich in fat-soluble vitamins (A, D, E, and K2). In generations past, there was concern about toxicity of these vitamins when consuming liver, but more current research has identified little risk associated in getting these micronutrients from natural sources, because of the interplay they have with each other. It is the synthetic (read: multi-vitamin) sources that risk toxicity.
Vegetables and fats (pair them up)
So far, we’ve focused a lot of the benefits of animal protein, but don’t sleep on your veggies (leafy greens specifically) as they contain an extensive list of micronutrients. They are a great source of B6 and magnesium, which may help mom with morning sickness. Also, leafy greens are a good source of potassium, an electrolyte which may help control swelling. With vegetables, some nutrients are more easily absorbed by eating raw forms, and some are better absorbed when cooked, so you’ll want to get a mix of both. Whichever route you are going, pair them with a healthy fat to help absorb fat soluble micronutrients such as vitamin K1 (which may help prevent excessive bleeding during pregnancy) (13).
Dairy (WWJD = What Would Johnnie Do?)
For dairy, the recommendation remains the same. Limit it if you’re lactose intolerant. Eating a diet rich in whole foods, especially if you abide to the recommendations above, guarantees any nutrients contained in dairy products will also be found in other sources. If you are going to consume dairy, stick with full fat and try to keep it fermented. The one strong case for dairy is the fat-soluble vitamin K2, which is tough (but not impossible) to find in other sources. Vitamin K2 has been shown to help prevent maternal osteoporosis (14).
As you read, not much changes in terms of what's good for you when you're pregnant. Yes, maybe you have to make some tweaks if you're a big seafood eater. But otherwise, we're looking for nutrient-dense whole foods. If you stick to that as your guiding light you will properly fuel your, and baby's, fire.
- Hoffman, J. R., & Falvo, M. J. (2004). Protein–which is best?. Journal of sports science & medicine, 3(3), 118.
- Wang, H., Hu, Y. F., Hao, J. H., Chen, Y. H., Su, P. Y., Wang, Y., ... & Tao, F. B. (2015). Maternal zinc deficiency during pregnancy elevates the risks of fetal growth restriction: a population-based birth cohort study. Scientific reports,5, 11262.
- Rees, W. D., Wilson, F. A., & Maloney, C. A. (2006). Sulfur amino acid metabolism in pregnancy: the impact of methionine in the maternal diet. The Journal of nutrition, 136(6), 1701S-1705S.
- Ralston, N. V., & Raymond, L. J. (2010). Dietary selenium's protective effects against methylmercury toxicity. Toxicology, 278(1), 112-123.
- Hibbeln, J. R., Davis, J. M., Steer, C., Emmett, P., Rogers, I., Williams, C., & Golding, J. (2007). Maternal seafood consumption in pregnancy and neurodevelopmental outcomes in childhood (ALSPAC study): an observational cohort study. The Lancet,369(9561), 578-585.
- Zimmermann, M. B. (2008). Iodine deficiency in pregnancy and the effects of maternal iodine supplementation on the offspring: a review. The American journal of clinical nutrition,89(2), 668S-672S.
- Mozaffarian, D., & Rimm, E. B. (2006). Fish intake, contaminants, and human health: evaluating the risks and the benefits. Jama, 296(15), 1885-1899.
- Shaw, G. M., Carmichael, S. L., Yang, W., Selvin, S., & Schaffer, D. M. (2004). Periconceptional dietary intake of choline and betaine and neural tube defects in offspring. American journal of epidemiology, 160(2), 102-109.
- Karsten, H. D., Patterson, P. H., Stout, R., & Crews, G. (2010). Vitamins A, E and fatty acid composition of the eggs of caged hens and pastured hens. Renewable Agriculture and Food Systems, 25(1), 45-54.
- Lemos, B. S., DiMarco, D. M., Missimer, A., Murillo, A. G., Malysheva, O. V., Caudill, M. A., ... & Fernandez, M. L. (2017). Consumption of up to Three Eggs per Day Increases Dietary Cholesterol and Choline while Plasma LDL Cholesterol and Trimethylamine N-oxide Concentrations Are Not Increased in a Young, Healthy Population. The FASEB Journal, 31(1_supplement), 447-3.
- Allen, L. H. (2000). Anemia and iron deficiency: effects on pregnancy outcome. The American journal of clinical nutrition, 71(5), 1280S-1284S.
- Greenberg, J. A., & Bell, S. J. (2011). Multivitamin supplementation during pregnancy: emphasis on folic acid and l-methylfolate. Reviews in Obstetrics and Gynecology, 4(3-4), 126.
- Brown, M. J., Ferruzzi, M. G., Nguyen, M. L., Cooper, D. A., Eldridge, A. L., Schwartz, S. J., & White, W. S. (2004). Carotenoid bioavailability is higher from salads ingested with full-fat than with fat-reduced salad dressings as measured with electrochemical detection. The American journal of clinical nutrition,80(2), 396-403.
- Tsuchie, H., Miyakoshi, N., Hongo, M., Kasukawa, Y., Ishikawa, Y., & Shimada, Y. (2012). Amelioration of pregnancy-associated osteoporosis after treatment with vitamin K2: a report of four patients. Upsala journal of medical sciences, 117(3), 336-341.
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Currently, Ben is finishing his PhD while serving a clinical faculty member at the University of Louisville, molding the minds that will be the future of strength and conditioning coaches. He also helps support the Olympic Sports side of the Strength and Conditioning Department there as a sports scientist.