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Eating (Well) for Two

Eating (Well) For Two
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Eat Twice as Well, Not Twice as Much continued...

For women who are already used to eating a balanced diet with plenty of breads and grain, fresh fruits and vegetables, dairy products, and some meat or protein, the change won't be dramatic. Fats should remain at about 30% or less of total calories, although fat restriction shouldn't be a major concern during pregnancy. Vegetarians should be able to get the nutrients they need from careful food choices, although those who don't eat animal products may need an iron supplement.

But since so many of us don't always get the recommended servings when we're not pregnant, eating right during pregnancy may require a little more conscientious planning. "It takes effort," says Ward, a registered dietician in Boston. "For instance, you need 1,000 milligrams of calcium, and you can't get enough of that in your prenatal vitamin or supplement, but if you have cereal, milk and a glass of calcium-fortified orange juice for breakfast, right there you're up to about 600 milligrams." You might even use that Starbucks fix to your benefit since a 12-ounce decaf latte has about 400 milligrams of milk, she says.

Snacks can be helpful in squeezing in all the required foods, not to mention beneficial in curbing morning sickness. "Be a nibbler, a grazer," says Anne Dubner, a registered dietician and nutrition consultant in Houston. "If you nibble throughout the day you're more likely to get all the nutrients you need, rather than trying to cram it all into each meal." Yogurt or cheese will boost calcium intake, for instance; an orange will provide extra vitamin C and folic acid.

It may be difficult to get everything you need from your diet, especially essential nutrients such as folic acid and iron, so most providers recommend a prenatal vitamin "as an insurance policy," says Dr. Richard Schwarz, chairman of obstetrics and gynecology at New York Methodist Hospital. Your iron needs to double to 30 milligrams to accommodate increased blood volume during pregnancy; a lack of iron can cause anemia. Women should already be taking a prenatal vitamin with 400 micrograms, or 0.4 milligrams, of folate three months before conception to help prevent neural-tube defects. Your doctor or midwife may recommend supplements if necessary.

You should also be drinking at least eight 8-ounce glasses of fluid a day, mostly water if possible, since dehydration can bring on premature labor. Fluids also will help reduce muscle cramps, swelling and urinary tract infections. "I tell patients to drink, drink, drink. Their urine should be so pale they can't see it in the toilet," says certified nurse-midwife Katherine Puls. If drinking with food exacerbates morning sickness, try filling your quota between meals rather than with them.

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