Wednesday, April 16, 2014

Healthy Eating While Pregnant

Diet.  Even as a dietitian this can be a serious struggle for me.  While I do know (what feels like) everything under the sun about nutrition &vfood and can encourage and spur my clients along all day, I still come up with an empty brain on occasion when it comes to my own health and well-being.

When I found out I was pregnant with twins, taking care of myself shot to the top of my list of things to do.  That meant eating well, eating often, and eating enough to fuel my body to grow a couple babies.  The daily recommended caloric intake for normal-BMI women carrying twins is 40-45 kcal/kg (that's dietitian talk), which meant I needed anywhere between 2,200-2,500 calories/day.  You may need more or less depending on your frame and pre-pregnancy body weight.  For the most part I was able to hit this goal every day.  In the beginning of my pregnancy this was much easier to do.  I didn't have two full sized babies taking up all my stomach space and I would focus on small meals often throughout the day.

A typical day during my first and early part of my second trimester

BREAKFAST 7am: (home) 8oz decaf coffee with creamer, 6oz Greek yogurt with 1/2 cup pumpkin flaxseed granola mixed with 2 tablespoons wheat germ (for a good source of folic acid).
SNACK 10am: (work) 1 apple with 2 tablespoons peanut butter or 2 (2%) string cheese sticks.
LUNCH 12p-1p: (work) Leftovers from dinner or 2 cups mixed steamed veggies with 5 ounces natural deli turkey or ham (I like Boar’s Head) and some kind of fruit with more plain Greek yogurt.
SNACK 3:30pm: (home) 2 slices of whole wheat toast with peanut butter and 1 small banana, graham crackers and peanut butter, or a bowl of Cheerios with skim milk.
DINNER 6pm-7pm: varied, but most often it was a grilled or baked meat, veggies and a carb (potatoes, whole wheat pasta, brown rice).
SNACK 9pm-10pm: dry cereal (Life Original or Multi Grain Cheerios) 

I had a weird issue with chicken and craved seafood!  Oftentimes my protein in the evening was plant-based or shrimp, tilapia or some kind of beef.  We usually eat meatless a couple times/week anyway- so a homemade bean burger or something like that was regular.  I love, love, love to cook and was thankful to still have some energy to cook a dinner meal.  About the middle of my 2nd trimester I found that I couldn't eat much at all before I felt miserably full.  I started having to limit my intake of fluid during meals or else I couldn’t finish the already small portion of food I was consuming. Outside of meal times I notoriously carried a tumbler of water.  I drank 2 gallons of water a day (water coupled with crunchy ice!) and I can wholly attribute this water intake to my lack of swelling during the entire pregnancy.  Not only does water ward off swelling, it can also help to retain pregnancy.  Dehydration can cause premature contractions and labor, so staying hydrated is extra important.  Carrying twins, the recommendation is 16 (8-ounce) glasses of water a day in addition to other fluids you consume through beverages and food (mainly fruit and vegetables).  

The biggest concern during this time of growth and development was making sure I got enough protein and nutrients to maintain my own needs and the needs of the babies. Women carrying more than one baby are at a higher risk for iron-deficiency anemia during pregnancy. I took, in addition to my prescribed prenatal vitamin, an additional iron supplement, 1,000mg Vitamin D, as well as 1200 mg Calcium from 24 weeks until the day I went in to deliver.  This was a direction from my doctor and your OB may have other recommendations, but with those two taking everything out of me physically to grow, it helped to have the extra nutrients left over for mama bear. There is a high incidence in women who develop early onset  osteoporosis after pregnancy, so the additional supplements were taken in hopes to offset this issue.  

Protein is the building block of development and tissue production, so I wanted to make sure I was getting enough to feed these girls! During the second trimester of a twin pregnancy your needs increase to 175-200 grams of protein/day.  At that point there was no way I was getting that on a daily basis.  I couldn't eat enough food to meet that goal - space was limited!  Although protein from food sources is the very best, I had to do something extra to get all I needed to meet that lofty goal.  This is when I purchased Isopure Zero Carb (Vanilla) protein powder and mixed it into plain Greek yogurt. One plain Greek yogurt  is about 15g of protein and one scoop of the Isopure is 25g of protein.  I would do this 2-3 times/day. At the end of my pregnancy I was living on it practically but getting plenty of protein. I like this particular powder because it doesn't have any saturated fat or artificial sweeteners. I recommend it to my nutrition clients all the time, so I figured I would take my own advice and use it for myself.

Once I went on bed rest (modified at 24 weeks and full bed rest at 26 weeks) I wasn't nearly as active as I had been and I found that I was hardly hungry at all.  I learned to make every bite count.  Meals became anything that sounded good at the moment.  I got to a point that nothing sounded good at all and would go all day without eating anything really.  Not good for me and not healthy for my babies.  I began to make a serious effort in planning out my meals and snacks.  I could no longer eat foods that were too filling and didn't provide enough calories (I was stuffed after about three bites of pasta). I had terrible insomnia and was up every night around 3:30 am until about 7 am then back to sleep until 9 am or 10 am in the morning- so I would always eat something small during the window I was awake. 

A typical day during my second and third trimester

SNACK 5 am: 6oz plain Greek yogurt
BREAKFAST 9 am: 8oz decaf coffee with regular creamer 2 pieces sprouted grain toast with peanut butter and sliced banana
SNACK 10 am: 1 cup cottage cheese with 1/2 cup mandarin oranges or pineapple
LUNCH 12-1 pm: 6 ounces natural deli turkey or ham on whole wheat pita bread with flax and about a tablespoon of basil pesto and olive oil mayo, lettuce, tomato, and onion, and veggie chips or  some kind of fruit.
Protein Fruit Bowl: 1 chopped apple, 1 sliced banana, 1 chopped plum or 15 grapes, 5 chopped strawberries, mixed with 6 ox plain Greek yogurt and 1.5 scoops protein powder
SNACK 3:30 pm:  Bowl of Cheerios with skim milk
DINNER 6-7 pm: varied, but most often it was something super simple.  The hubby was forced to take over cooking and so it was always some kind of grilled meat and a veggie for me. Carbohydrates were too filling, so I usually skipped those at dinner.
SNACK 9-10 pm: 6 oz Greek yogurt with 1 scoop protein powder and dry cereal
SNACK 3-4 am: dry cereal or saltines, honey wheat pretzel sticks and string cheese

I couldn't eat a whole lot of carbohydrates or I wouldn't be able to get in the protein like I needed to.  I found that my peanut butter and banana toast would fill me up all day and into the evening if I wasn't careful! Often times I would eat the protein fruit bowl (again) for dinner, but with 2 scoops of protein powder instead of just 1.5 scoops.  The protein powder and yogurt before bed was a treat for me.  Almost like eating ice cream, but a healthier version with a surplus of protein. 

Eating Right for Pregnancy– A few things to remember when seeking nutritional balance:
Women in general should enjoy a variety of foods, such as whole grains, fruits, vegetables, healthy fats, low-fat dairy and lean protein. Nutrient-rich foods provide energy for both pregnant and non-pregnant women, so taking care of yourself should be at the top of your priority list.  
Foods to Limit During Pregnancy

To keep weight gain in check and proper growth and development of your babies, women should avoid excess calories from added sugars, fat, and alcohol should be avoided.
  • Limit regular soft drinks, sugar-sweetened beverages, candy, baked goods and fried foods.
  • Opt for low-fat dairy and meat products instead of their full-fat counterparts.
With all that said above, it is still 100% OK to have these items on occasion, but making it a regular thing can cause weight gain that could be difficult to work off after the babies are born (and when you are exhausted, mind you).
Keeping to the recommendations of your doctor and/or dietitian can help maintain a healthy weight during pregnancy, proper protein and nutrient intake, as well as appropriate growth in your babies.
These recommendations, of course, are from my personal and professional experience, but are by no means the only way to maintain a twin pregnancy.   If you have any questions please feel free to email

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  1. This is so great... I wish I could have eaten that way (I survived on french fries for all 37 weeks LOL)

  2. I noticed your deli meats... What is your advice on all the warnings on avoiding deli meat, especially turkey?


    Dr. Maureen Muoneke MD

  4. Do you know if the isopure drink is a good source of protien if I am not eating enough protien while pregnant? Or is the powder the best option? I am not a shake or much of a yogurt person. So glad I found this post!