healthyeating - food · pdf file2 healthy eating during pregnancy ... other sources of...

With so much information on how food can affectyour health, it may seem confusing at times to knowwhat to eat.

Still, the relationship between diet and health isvery important. It is even more important during pregnancy since good nutritionand safe food handling play a key role in the health of both the mother and baby.

As the title implies, this brochure provides information on healthful eatingduring pregnancy. It will cover how to eat a balanced diet, eating a variety offoods, healthy weight gain during pregnancy, and food safety concerns specificto pregnant women.

A BALANCED DIET—What a Mother-to-Be NeedsPregnant women have special dietaryneeds. Eating a balanced diet before, dur-ing, and after pregnancy is one part ofgood health. This section of the brochuredescribes key nutrients pregnant womenneed, how much they need, and sources ofthose nutrients. Certain foods should beavoided during pregnancy because theypose a food safety risk. These are discussedlater in this brochure.

CALORIESDuring pregnancy, a woman’s calorie needsincrease by about 15 percent. Some womenare surprised to learn that “eating for two”really only means eating an additional 300calories per day. Three hundred caloriesequals about 3 cups of non-fat milk or anEnglish muffin with one tablespoon ofpeanut butter and a small banana.

Pregnant women should choose foodsand beverages that are “nutrient-dense,”or rich in nutrients. Nutrient-dense foodsare packed with vitamins, minerals andother nutrients, and have relatively fewcalories. Choosing a variety of foods fromall five food groups (grains, vegetables,fruits, dairy, and meat and beans) will helpto ensure that a woman gets the nutritionshe and her growing babyneed. However, there are afew nutrient-dense foodsthat pregnant womenshould avoid due to foodsafety concerns.

MyPyramid.gov is anexcellent resource forspecifics regarding theamount of calories individ-ual moms-to-be and newmoms should consume.

INTRODUCTION:

HealthyEATINGDURING PREGNANCY

A Messagef rom the

American Academyof Physician

Assistants (AAPA)Physician assistants are

licensed healthprofessionals, and valuedmembers of a healthcare team that includesa supervising physician.PAs deliver a broad rangeof medical and surgicalservices to diverse

populations. PAs candiagnose and treatillnesses, order andinterpret tests, and

prescribe in all 50 states,District of Columbia, andGuam. PAs also counselon preventive health careand assist in surgery.

AAPA is the only nationalorganization to represent

the nation’s nearly80,000 physician

assistants in all clinicalspecialties. Founded in1968, the Academyworks to promote

quality, cost-effectivehealth care, and theprofessional and

personal growth of PAs.

For more informationabout the Academy andthe PA profession, visit

AAPA’s Web site,www.aapa.org.

August 2009

See page 10 for new, important food safety information.

INTERNATIONAL FOOD INFORMATION COUNCIL (IFIC) FOUNDATION2 Healthy EATING DURING PREGNANCY

KEY NUTRIENTSPROTEINProtein is found in many foods. It helps main-tain muscle and body tissue, helping thebody to produce some hormones and anti-bodies. Pregnant women should take in 60grams of protein every day. This is only 10grams more than non-pregnant women. Leanmeats, poultry, fish, dairy products, andlegumes (beans) are good sources of pro-tein. These foods also supply other key nu-trients, such as iron, B vitamins, and othervery important minerals. Dried beans,lentils, nuts, soybeans, eggs, and cheesesare other sources of protein.

Most Americans consume more proteinthan they need. Therefore, most womenshould not need to increase the amount ofprotein they eat during pregnancy. Usuallythere is no need to consume high-proteinbeverages, supplements, or powders.

Vegetarians can meet their protein needsby eating select milk and egg foods, but preg-nant vegans who eat only plant foods shouldtalk to a registered dietitian about how tomake sure their diet has adequate protein andother essential vitamins and minerals. Soyprotein is the only complete protein sourcefor vegans and so it is an important part of amother-to-be’s diet. Soy protein is found insoy milk, soy cheese, soy yogurt, and tofu.Examples of other protein-rich vegan foodsare nuts, hummus, and beans (red kidneybeans, chickpeas, navy beans, etc.).

CARBOHYDRATESMany foods contain carbohydrates. Fruits,vegetables, grains, and several dairy prod-ucts contain carbohydrates and bring avariety of other important nutrients to thediet, like vitamins, minerals, antioxidants,and fiber. Additionally, sugars are the sim-plest form of carbohydrates and can addsweetness to a nutritious diet. Breakfast is atime to fit healthful carbohydrates into the

diet. Whole grain and enriched Englishmuffins, cereals, and breads, as well asfruit are just some examples of good break-fast choices containing carbohydrates.Carbohydrates enriched with folic acidreduce the rate of birth defects. Of course,carbohydrates can be eaten at any time ofthe day too.

The Institute of Medicine (IOM) DietaryReference Intakes (DRI) Report recom-mends that Americans get the majority oftheir daily calories from carbohydrates—about 45 to 65 percent of daily calorie in-take. Children and adults need a minimumof 130 grams of carbohydrates per day.However, pregnant women require an addi-tional 45 grams of carbohydrates per day.

FATSThe fat in food is needed for good nutritionand good health. Like carbohydrates andprotein, dietary fat is an important sourceof energy for the body. Certain foods thatcontain fat supply the body with essentialfatty acids—essential fatty acids are fatsthat are not produced by the body, so theymust be obtained through food. Most im-portantly, these fats are needed for proper

development of the baby.The 2005 Dietary Guidelines for Americans

recommend keeping total fat intake be-tween 20 and 35 percent of total calories,with most fats coming from unsaturatedsources. Sources of unsaturated fat includefish, vegetable oils (canola, olive, peanut,safflower, and sunflower oils), nuts, and

Like carbohydrates and protein,dietary fat is an important source

of energy for the body.

AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA)

flaxseeds. All women, including thosewho are pregnant or breastfeedingshould follow these recommendations.

DHA is an omega-3 fatty acid that isimportant for babies’ brain and eyedevelopment. Some experts now rec-ommend that pregnant women get anaverage dietary intake of 200 miligrams (mg) DHA per day. DHA isfound in oily fish such as salmon, and in supplements that may berecommended by your healthcare provider. (For more informationon eating fish during pregnancy, see the Food Safety section ofthis brochure.)

CALCIUMCalcium is needed for the growth of strong bones and teeth. Cal-cium intake is very important for all women, particularly pregnantwomen younger than 25 years old whose bones are still growing.

The calcium recommendation for pregnant women 19 to 50years old is 1,000 mg per day. Many women who don’t consumedairy products or don’t get enough calcium in their diet are ad-vised to take a calcium supplement of 600 mg calcium per day.

Milk, yogurt, and cheese are good sources of calcium. If yourhealthcare provider is concerned about you gaining too muchweight, non-fat (skim) and low-fat (1%) dairy products supplyequal amounts of calcium with fewer calories than their higher-fat(2% and whole) counterparts.

Other sources of calcium include dark green leafy vegetablessuch as spinach, dried beans and peas, nuts and seeds, tofuthat has been supplemented with calcium and sardines. Calcium-fortified foods, such as some orange juices, soymilk, and breakfastcereals, are also good sources of calcium in the diet.

Women with lactose intolerance or a milk allergy may needguidance from their allergist or healthcare provider on how to in-clude sources of calcium into their diet.

Vitamin D is important for the absorption and use of calcium;therefore, Vitamin D intake is also very important. Sunlight is onesource of Vitamin D. About five to ten minutes of sunlight to ex-posed arms and/or the face can supply a day’s worth of Vitamin D,depending on the season of year, latitude, and pigment of skin.Dietary sources of Vitamin D are limited, but can include milk withadded Vitamin D, oily fish (salmon, sardines, whitefish), some forti-fied cereals, and supplements. Five micrograms (mcg) of Vitamin Dare recommended per day.

Healthy EATING DURING PREGNANCY 3

Recommended Weight GainFOR PREGNANT WOMEN

BY PRE-PREGNANCY BODY MASS INDEX (BMI)*

Pounds

Underweight 28–40(BMI < 19.8)

Normal weight 25–35(BMI 19.8 to 25)

Overweight 15–25(BMI 26 to 29)

Obese 11-20(BMI > 29)

Twin Gestation 35–45(any BMI)

Triplet Gestation 50(any BMI)

Women who are at greater risk for deliveringlow birthweight babies, including adolescents,African-American women, and others shouldbe monitored for optimal weight gain anddietary quality throughout pregnancy.

*Body mass index, or BMI, is an indicator ofbody fat based on two common measurements,height and weight. Because it reflects bodycomposition such as body fat and lean bodymass, BMI is considered a more accurateindicator than height/weight tables.

Calculate your BMI athttp://www.NHLBISupport.com/BMI/.

Breakfast is a time tofit healthful carbohydrates

into the diet.

SOURCES:

Institute of Medicine. Weight Gain During Pregnancy:Reexamining the Guidelines. Washington, DC: NationalAcademy Press, May 2009.

Brown, JE, Carlson, M. Nutrition and multifetal pregnancy.J Am Diet Assoc, 2000; 00:343-348.

WEIGHT-FOR-HEIGHT RECOMMENDEDCATEGORY TOTALWEIGHT

GAIN

IRONIron carries oxygen through the blood anddelivers it throughout the body. It also aidsin immunity, brain development, body tem-perature regulation, metabolism, and physi-cal performance. About 90 percent of theiron in the human body is conserved andreused every day. The developing baby alsostores enough iron to last through the firstfew months of life.

Because pregnant women have an in-creased amount of blood in their bodies,they need more iron than non-pregnantwomen. Therefore, pregnant women shouldconsume 27 mg of iron per day. Most prena-tal vitamins supply this amount.

A healthful eating plan provides womenwith up to 12 to 14 mg of iron per day. Redmeat is rich in iron. Fish and poultry are alsogood sources. Other options include en-riched and whole grain breads and cereals,green leafy vegetables, beans and nuts, eggs,and dried fruits.

The body does not absorb the iron in eggsand plant sources as well as the iron in meat,fish, and poultry. However, iron absorptionfrom eggs and plant foods can be increasedwhen eaten with foods high in vitamin C,such as orange juice or red bell peppers.

Iron stores are often used up by thewoman’s body. Since many women enterpregnancy with low iron reserves to beginwith, they risk developing anemia, a redblood cell deficiency that can make awoman feel tired and result in many otherhealth problems. Routine supplements oflow-dose iron starting at the first prenatalvisit are recommended. Some women mayalso need to be screened on an ongoingbasis. A registered dietitian can recommendiron-rich foods and foods that can help withiron absorption.

Iron supplements are absorbed best whentaken between meals, with water or juice,and not with other supplements. Substancesin coffee, tea, and milk can inhibit iron ab-sorption. Taking iron supplements at bed-time may help reduce upset stomachand/or heartburn.

FOLIC ACID/FOLATEFolic acid, a B vitamin, should be taken be-fore and during early pregnancy to reducethe risk of spina bifida and other neural tubedefects (NTDs), or birth defects of the brainand spinal cord in infants.

All women of childbearing age need anadequate intake of folate or folic acidbecause it plays an important role in thebaby’s development. “Folate” is the termfor the different forms of the nutrientfound naturally in foods; “folic acid” is thesynthetic form used in supplements and infortified grain products.

The U.S. Public Health Service and theMarch of Dimes recommend that any womanof childbearing age planning or capable ofbecoming pregnant should consume 400mcg of folic acid daily to help prevent birthdefects. Most women of childbearing age donot consume enough folate, which unfortu-nately is the time when folate intake is themost critical. To make up for this, all womenwho can become pregnant should consumea multivitamin containing 400 mcg of folicacid daily, in addition to eating foods thatcontain folate such as grain products thathave been fortified with folic acid, leafydark-green vegetables, legumes (such aspeanuts), citrus fruits and juices. Womenwho have had a baby with NTD in the pastare advised to take a higher dose of folicacid — 4 mg per day — before gettingpregnant again.


All women of childbearingage need an adequate intakeof folate or folic acid becauseit plays an important role in

the baby’s development.

All pregnant women should considertaking prenatal vitamins, regardless ofhow healthfully they think they eat.

Healthy EATING DURING PREGNANCY 5AMERICAN ACADEMY OF PHYSICIAN ASSISTANTS (AAPA)

OTHER FOOD INGREDIENTSCAFFEINEMany pregnant and breastfeeding women are con-cerned about consuming too much caffeine. Caffeine isfound in coffee, tea, some soft drinks, chocolate, andsome over-the-counter medications. Most researchfinds that it is safe for both pregnant and breastfeedingwomen to consume moderate amounts of caffeine.Moderate caffeine intake is considered to be about 300mg/day. This is typically about the same amount that isfound in two to three 8-ounce cups of coffee, dependingon the type and strength of the coffee, or six cups oftea. Pregnant and breastfeeding women don’t have togive up their morning cup of coffee, tea, or soft drink.However, if their usual coffee consumption is morethan two to three cups per day, it would be wise to cutback until they are no longer pregnant or breastfeeding.

With that in mind, women who are planning to con-ceive may want to limit caffeine consumption to lessthan 300 mg/day. This includes caffeine from all sources.

Moderate caffeine consumption of up to 300 mg/daythroughout the entire pregnancy has not been shownto increase the risk of birth defects. Although the topicremains controversial, scientific research organiza-tions like the Organization of Teratology InformationSpecialists (OTIS) conclude that moderate caffeineconsumption during pregnancy does not increase therisk of miscarriage. The March of Dimes takes a more

conservative approach,recommending pregnantwomen limit caffeineconsumption to less than200 mg/day.

Caffeine from foods andbeverages becomes partof the mother’s breastmilk, but nursing motherscan consume smallamounts of caffeine without harming the baby. Over300 mg/day of caffeine could make it hard for the babyto fall asleep and/or lead to trouble feeding the baby.Limiting caffeine intake to no more than 300 mg/day isrecommended for breastfeeding mothers.

LOW-CALORIE SWEETENERSAccording to the Food and Drug Administration (FDA),consumption of low-calorie sweeteners is safe for thegeneral public, including pregnant women. In theUnited States, there are five low-calorie sweeteners(also sometimes referred to as artificial sweeteners orsugar substitutes) approved for use in foods and astabletop sweeteners. They are: acesulfame potassium(Ace-K), aspartame, neotame, saccharin, and sucralose.Studies show that they are all safe to consume dur-ing pregnancy.

However, anyone – pregnant or not – with phenylke-tonuria (PKU) an inherited disease, must restrict theirintake of phenylalanine from all sources, including as-partame. Studies show that pregnant women who havethe PKU gene but not PKU disease can digest aspar-tame well enough to protect the baby.

Although saccharin can cross the placenta, there isno evidence that it is harmful to the developing baby.Both the American Dietetic Association and the Ameri-can Diabetes Association state that saccharin can beconsumed in moderation during pregnancy.

SODIUMSodium is a very important, natural part of fluids inthe human body, and is found in blood and sweat.Working with other minerals, such as potassium,

Most research findsthat it is safe for both

pregnant andbreastfeeding women to

consume moderateamounts of caffeine.

magnesium, and chloride, sodium’s main role is tokeep water balance in the body and the acid-basebalance of body fluids.

Sodium requirements for pregnantor breastfeeding women are not dif-ferent from those of other women.The IOM recommends no morethan 1,500 mg of sodium per day

(3,800 mg of salt). It is estimatedthat individuals in the United States

consume almost twice the recommendedamount daily (3,200 mg).

At one time, salt was restricted during pregnancy toreduce the incidence of toxemia (a condition with symp-toms including high blood pressure, fluid retention andprotein in the urine). However, there is no scientific evi-dence that restricting sodium will prevent toxemia.

Women who have been advised by their healthcareprovider to limit their sodium intake before becomingpregnant should continue to do so.

ALCOHOLThere is no data to support how much alcohol is safeto drink during pregnancy. Therefore, most healthcare providers recommend drinking no alcohol duringpregnancy. Alcohol consumption during pregnancycan cause a number of birth defects, ranging frommild to severe. Babies born to mothers who con-sumed alcohol during pregnancy may suffer frommental retardation; learning, emotional, and behav-ioral problems; and defects involving the heart, face,and other organs. Also, women who may be pregnantor are trying to get pregnant should not drink alcohol.

Some women are concerned about having consumedmoderate amounts of alcohol soon after conception,before becoming aware of their pregnancy. Generally,women should not worry if they consumed smallamounts of alcohol during this time. However, theyshould stop drinking alcohol as soon as they find outthey are pregnant.

OTHER NUTRITION SOURCESVITAMIN/MINERAL SUPPLEMENTSMost nutritional needs can be met through a balanceddiet, but many experts recommend that pregnantwomen take a daily vitamin/mineral supplement aswell. Vegans, women under age 25, and those whodon’t consume dairy products (such as those individu-als with lactose intolerance or milk allergy) shouldalso take a calcium supplement (600 mg per day) plusVitamin D.

Vitamin/mineral supplements areespecially recommended forpregnant women who may be atnutritional risk. This includeswomen who are strict vegetariansand consume no animal products,those who are breastfeeding, followingrestrictive diets, are heavy cigarette smokers,consume high amounts of alcohol (multiple drinks perday), or who are carrying twins or triplets. For strictvegetarians who consume no animal products, vitaminB12 supplements (and perhaps vitamin D and zinc) arealso recommended.

Vitamin A supplements are not recommended duringpregnancy, except at low levels, because excessive lev-els of Vitamin A could be toxic to the developing baby.Adequate levels are available through a healthful diet.

There is no evidence that taking Vitamin B6 is aneffective treatment for morning sickness, nor is therescientific evidence to support benefits from herbalproducts. In fact, some herbal products may have seri-ous side effects.



Weight GainDURING PREGNANCYGaining the right amount of weight during pregnancyhelps to make sure the pregnancy outcome for bothmother and baby is healthy. Women who gain too littleweight are at risk of having a small baby (less than 51/2 pounds). On the other hand, women who gain toomuch weight have a greater risk of having an earlybaby or a large baby. Additionally, gaining too muchweight during pregnancy may be associated withhealth problems such as gestational diabetes, highblood pressure (preeclampsia), and varicose veins inthe mother.

In addition to weight gain associated with thegrowth of the baby during pregnancy, pregnantwomen store fat to prepare for breastfeeding. Womenbelow optimal weight need careful monitoring andmeal planning advice in preparation for breastfeeding.

The chart, “Where Does Weight Gain Go?” highlightsthe typical distribution of weight during pregnancy.

GOALS FOR WEIGHT GAINGoals for weight gain should be based on pre-pregnancyweight, height, age, and usual eating patterns. In 1990,the IOM issued guidelines for weight gain during preg-nancy, which are still used today. Because every womanand every pregnancy is unique, pregnant women shouldtalk to their healthcare provider to ensure properweight gain throughout their pregnancy.

A weight gain of 25 to 35 pounds is considered nor-mal for healthy women of normal weight (with a BMI of18.6 to 24.9). BMI is one way to determine if individualsare at an appropriate weight. This tool can also be

Baby 71⁄2Placenta 11⁄2Amniotic fluid 2MotherBreasts 2Uterus 2Body fluids 4— Blood 4—Maternal stores of fat,protein, & other nutrients 7

TOTAL 30 lbs.

SOURCE: Planning Your Pregnancy and Birth, Third Edition,American College of Obstetricians and Gynecologists (ACOG).

Approximate Weight Gain, in pounds

WHEREDOESTHEWEIGHTGO?

Women should listen to theirbodies’ signals and stop eating when

they feel full, instead of overeatingbecause “you’re eating for two.”

used to determine how much weight a woman shouldgain during pregnancy. See chart on page 3.

Obese women (BMI > 30) can have successful preg-nancies and healthy babies if they watch their weightgain. Obese women should gain no more than 15pounds, but cutting calories below required levels dur-ing pregnancy has been associated with reduced birthweight and is not recommended. It is also suggestedthat obese women receive nutrition counseling to en-sure they get enough nutrients and regular physical ac-tivity, and to discourage weight loss during pregnancy.

Carrying multiple babies presents unique chal-lenges. Regardless of their pre-pregnancy weight andheight, women carrying twins should gain 35 to 45pounds, and women carrying triplets, 50 pounds.

PATTERN OF WEIGHT GAINPatterns of weight gain are as important as total weightgain. While setting goals for total weight gain is impor-tant, weight gain progress needs to be carefully moni-tored. These records of weight gain will begin withtaking accurate measurements from the first prenatalvisit with regular weigh-ins recorded at each visit.

Weight maintenance or slight weight losses are normalduring the first trimester, or first 13 weeks of pregnancy.However, women should aim to gain a total of fourpounds during this time. Weight gain should comefrom the nutrient-dense foods described earlier inthis brochure. Women should listen to their bodies’signals and stop eating when they feel full, instead ofovereating because “you’re eating for two.”

Women with healthy pre-pregnancy weights shouldgain an average of one pound a week during the sec-ond and third trimesters. Women who are under-weight before conception should gain slightly morethan one pound per week. Those who were initiallyoverweight should gain at a slower rate (slightlymore than a half a pound per week).

FOOD CRAVINGS AND AVERSIONSFood cravings and dislikes of certain foods are com-mon during pregnancy. There is no evidence that foodcravings result from nutritional deficiencies, and theircause remains a mystery. It is acceptable to satisfyfood cravings within reason, especially when theysupply nutrients to the diet.

In rare cases, some pregnant women crave nonfoodsubstances, such as laundry detergent or clay. This iscalled pica. The consumption of nonfood items canbe dangerous for both mother and baby. In somecases pica involves eating large amounts of nonfooditems that displace foods and interfere with gettingenough nutrients. Examples of these nonfood itemsinclude clay, starch, ice, coffee grounds, or bakingsoda. If a woman experiences nonfood cravings, sheshould talk to her healthcare provider right away.

PHYSICAL ACTIVITYPhysical activity is another critical part of goodhealth. Pregnant women are encouraged to include30 minutes or more of moderate physical activity onmost, if not all, days of the week. Activities may in-clude walking or swimming, but should not includethose associated with a high risk of falling or injury.If being physically active for 30 minutes at one timeis not possible in your schedule, you can split up thetime into three 10-minute intervals throughout theday. Women with special circumstances should con-sult with their healthcare provider about how muchexercise and at what intensity is right for them.



MyPyramid (http://www.mypyramid.gov),developed by the U.S. Department ofAgriculture (USDA), offers personalizedeating plans, interactive tools to help planand judge food choices, advice on smartfood choices from every food group, andtips for how to get the most nutritionwhile staying within calorie needs.The MyPyramid for Pregnancy andBreastfeeding guidelines help women planhealthful meals and snacks before, during,and after pregnancy. Variety within themeat and beans and dairy groups offerschoices for vegetarian women as well.

Pregnant women should consume eightto 12 cups of fluid per day. Milk, juice,water, soup, and other beverages,including soft drinks and coffee, allcontribute to fluid intake (see section oncaffeine for information aboutconsumption during pregnancy).

MYPYRAMID forPregnancy and BreastfeedingBreastfeeding

Research has shown that there is no better food than breast milkfor a baby’s first year of life. Breast milk provides good nutrition,immunity boosters, and nutrients aimed at brain development fornewborns and infants. Also, current scientific evidence showsthat breastfeeding may help prevent childhood obesity.

Some components of breast milk enhance the baby’s naturaldefenses and promote development of the immune system. Infact, research suggests that breastfeeding may be associated witha reduction in risk of food allergy in high-risk infants (those witha parent or sibling with food allergies). That said, there is stillsome debate surrounding the degree to which breastfeeding pre-vents, reduces, or delays the development of allergy. Researchhas also shown that children who are breastfed may have a lowerrisk of developing asthma.

The World Health Organization (WHO)/UNICEF infant feedingguidelines support exclusive breastfeeding for the first sixmonths of life and the continuation of breastfeeding, togetherwith age-appropriate solid foods, up to two years of age orbeyond. While breastfeeding is highly encouraged, iron-fortifiedand water-based soy formulas can also be given to infants, ifbreastfeeding is not possible.

HTTP://WWW.MYPYRAMID.GOV

Breast milk provides good nutrition,immunity boosters, and nutrients aimed at

brain development for newborns and infants.

LISTERIOSISListeria monocytogenes is a type of bacteria oftenfound in soil, ground water, and on plants. These bac-teria can also be found in refrigerated, ready-to-eatfoods such as meat, poultry, seafood, dairy, unpas-teurized milk, and milk products or foods made withunpasteurized milk. When eaten, Listeria can cause anillness called listeriosis, which can be dangerous forpregnant women and their unborn babies. Listeriosiscan result in premature delivery, miscarriage, fetaldeath, and severe illness or death of the newborn.

Symptoms of listeriosis can take a few days or evenweeks to appear and can be mild. You may not evenknow you have listeriosis, which makes practicingproper food safety even more critical. Listeriosis canproduce flu-like symptoms initially, including suddenonset of fever, chills, muscle aches, diarrhea, and/orupset stomach. If the infection spreads to the nervoussystem, additional symptoms could include headache,stiff neck, confusion, loss of balance, or convulsions.

Certain foods are associated with a higher risk ofzzlisterosis and should be avoided during pregnancy.

Pregnant women should not eat:

• Hot dogs, luncheon or deli meats, unless they arereheated until steaming hot.

• Soft cheeses such as feta, Brie, Camembert, blue-veined cheeses, and certain Mexican-style cheeses(“queso blanco fresco”) unless they are labeled asmade with pasteurized milk.

• Refrigerated meat-based pâté or spreads.

• Refrigerated smoked seafood, unless it is an ingre-dient in a cooked dish such as a casserole.

• Raw (unpasteurized) milk or foods that containunpasteurized milk.

Toxoplasmosis is another illness that can be causedby food. If a pregnant woman becomes infected, seri-ous health problems, including mental retardation andblindness, can occur in the unborn child. People canget the parasite by eating meat (especially pork andlamb) that is infected or by eating food contaminatedby soil that contains the parasite. It is important tocook food thoroughly to the recommended tempera-ture, and peel or thoroughly wash vegetables andfruits before eating.


Tips for Prevention of Foodborne IllnessBEING SMART ABOUT FOOD SAFETY –

Food safety is important for everyone, but there are certain foods that posean additional risk to pregnant women and their unborn babies. In particular,

pregnant women should be aware of their increased risk of listeriosis.

HTTP://WWW.FIGHTBAC.ORG/


MERCURY IN FISHPregnant women should eat up to 12 ounces a week of seafood thatis low in mercury for daily nutrient goals. Examples of fish low inmercury include shrimp, canned light tuna, salmon, pollock, andcatfish as these do not pose an increased health risk. In fact, fishcontains high-quality protein and other essential nutrients, is lowin saturated fat, and some types contain healthful fats such asomega-3 fatty acids, which contribute to heart health, brain devel-opment and children’s proper growth and development.

While fish provides important nutri-ents, certain types of fish may containchemicals that can cause health risksfor pregnant women. Specifically, fishthat have high levels of mercury canharm the developing nervous systemof an unborn child or young baby.FDA, Environmental ProtectionAgency (EPA), and USDA recommendthat pregnant women avoid sword-fish, shark, king mackerel and tilefishduring pregnancy because theselarger fish tend to have higher levelsof mercury than other fish. However,these fish are very uncommon inmost women’s diets.

CONCLUSION:

Pregnant women should eat up to12 ounces a week of seafood that is

low in mercury for daily nutrient goals.

Food plays a significant role in maintainingthe health of pregnant women and theirbabies. Good nutrition and food safetyhabits adopted during pregnancy, whencontinued after giving birth, can have

lifelong benefits for the mother and child.Knowing that whole grains, fruits,

vegetables, low-fat dairy, lean meats, andbeans provide essential nutrients, as wellas knowing foods that may pose healthrisks to the mother and unborn baby,is critical for a healthy pregnancy.

Choosing foods based on the principles ofbalance, variety and moderation is a goodapproach to enjoying a healthful eatingplan during pregnancy and for a lifetime!

International Food InformationCouncil Foundation1100 Connecticut Avenue, NW, Suite 430Washington, DC 20036

http://ific.org

[email protected]

INTERNATIONAL FOOD INFORMATION COUNCIL (IFIC) FOUNDATIONHealthy EATING DURING PREGNANCY

8/09

CONTACT US:

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NOTES:

American Academyof Physician Assistants950 North Washington StreetAlexandria, VA 22314

Phone: 703-836-2272

www.aapa.org

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