Nutrition is indisputably important at all stages of life, and each stage has its own nutritional challenges. But I have believed for a while now that good nutrition is probably most crucial during pregnancy. So much so that I have chosen maternal diet and nutritional status as the focus of my dissertation. Research is beginning to show that what a woman eats during her pregnancy may have profound effects on her risk of pregnancy complications as well as her child's health at birth and throughout life. In fact, there is even some evidence to suggest that a pregnant woman can even influence her grandchildren's health through what she chooses to eat. Despite the scientific evidence-- and I might add, common sense-- that implies that a healthful diet is best in pregnancy, convention and popular belief have not quite caught up. Indeed, pregnancy has become practically synonymous with gastronomic indulgence. One reason for this is that the results of research studies aren't disseminated to the general public very effectively. As a result, many pregnant women may simply be oblivious to the effects their diets can have on their own health and that of their babies.
Aside from lack of knowledge, there are other issues unique to pregnant women that may hinder even the most educated and well-intentioned of mothers-to-be. The nausea and vomiting and food aversions that often occur in early (and sometimes middle and late!) pregnancy can make eating nutrient-packed foods like vegetables and whole grains nearly impossible. Secondly, the cravings that occur during pregnancy can be very strong and difficult to resist-- even for the most self-disciplined.
I have a new appreciation for these important issues, now that I have experienced them firsthand. Now almost 10 weeks into my first pregnancy, I can say that my diet bears little resemblance to the nutritious one I ate consistently for years. Although I don't think I'm doing a horrible job of eating healthfully, it has been a much greater challenge than I ever anticipated. In the remainder of this post, I'll explain: 1) why I refuse to simply "give in" to every craving, and 2) how I strive to find a balance between what I want and what I think my body (and my baby) needs.
I vaguely cited "research" that suggests that a mother's diet can influence the health of her baby in the long-term. Let me give some more concrete examples. Studies in animals (including this one and this one) have found that mothers who were fed high-fat diets during pregnancy had offspring with higher rates of obesity and diabetes. This study found that pregnant mice who ate a diet supplemented with antioxidants had offspring with reduced risks of obesity and glucose intolerance. Another study reported that a high-fat diet, such as the typical American diet, may reduce blood flow to the placenta and increase the risk of stillbirth. One observational study in humans found that women who frequently ate vegetables, fish, and legumes during pregnancy had children who were less likely to develop asthma or allergies.
The research I've listed here represents the tip of the iceberg. I was able to pull these from a quick search on ScienceDaily.com. Hopefully I've adequately convinced you that it might be unwise for pregnant women to subsist on a diet of ice cream, macaroni and cheese, and whatever other combinations of sugar, starch, and saturated fat might sound good. Now I'll discuss the bigger challenge: putting knowledge into practice.
When my "morning" (i.e. all-day) sickness first set in, my main concern was getting any nutrition at all. Everything sounded disgusting to me. So, I got calories wherever I could. I drank Gatorade and non-diet soda, ate Italian ice and popsicles, and popped sour candies all day in an attempt to keep the nausea at bay. In short, my diet was full of sugar and little else. Slowly, I felt a little better and started incorporating more normal foods, but many were still severely lacking in nutrients.
Then, the cravings struck. And they're still alive and well. The ones I've given into include frosted flakes cereal (daily, sometimes 2 or 3 bowls a day), macaroni and cheese, pancakes, banana bread, toaster waffles with peanut butter, peaches & cream flavored instant oatmeal, bagels with cream cheese, and baked potatoes with far too much sour cream. The cravings I've only dreamt about are worse: fast food cheeseburgers, donuts, Pop Tarts, and Hostess cupcakes (the orange ones!), among other things. Thankfully, I have had some cravings for healthful foods too: sauteed spinach with lemon, canned artichokes with red wine vinegar (at least a can a day; it's getting ridiculous), low-fat sharp cheddar cheese, and fruit, fruit, and more fruit.
I've realized that there are 3 strategies I use to keep my diet as nutritious as I can, without depriving myself of what I really want. The first is to avoid foods that are really bad and to try to eat the most healthful version of whatever food I'm craving. This means not eating anything with trans fat or an ingredient list a mile long. It also means getting "processed" foods from manufacturers that tend to use fewer and more natural ingredients, and making my own food when I can. For example, when I wanted banana bread, I baked it myself and used canola oil instead of butter and substituted applesauce for some of the oil.
The second strategy is to minimize the portion size of the unhealthful food. If I'm making pasta, I only cook one serving at a time so that I'm not tempted to eat a pound of pasta in one sitting. Unless its a fruit or vegetable, I usually have just one serving at a time. Finally, I try to maintain a balance between the less-healthful and more-healthful foods that I eat at any particular meal. Typically, this means having a fruit or vegetable with most meals.
My diet is still far from perfect, but it's better than it could be. My hope is that the strategies I've described here can offer some support to anyone who is experiencing a craving, whether it's pregnancy-related or not.
