Healthy Eating for a Healthy Pregnancy

There’s nothing else quite like pregnancy to sharpen your focus on your health and well-being. The journey of carrying and nurturing new life within your body is an exceptionally special time, and moms-to-be are deeply invested in doing it as well as they can. Advice will inevitably come from all quarters, and it is important to tap into expert sources that will give you peace of mind that you are on the right track.

The aim of Pregnancy Awareness Week this month is to help moms access the information they need to support a healthy pregnancy and safe motherhood. The Department of Health urges pregnant South African women to access antenatal care as early as possible in their pregnancies. This provides the opportunity to understand and manage any health issues, as well as get information on important factors such as self-care and nutrition. Once the pregnancy is confirmed by a nurse at a health facility, the mother can register for MomConnect, a free cell phone-based resource for accessing pregnancy-related health information.

Nazeeia Sayed, a registered dietitian and spokesperson for ADSA (Association for Dietetics in South Africa), points out that good nutrition is vital as it supports a healthier pregnancy and a healthier baby. “Pregnancy is a great opportunity to get yourself and the family into the habit of healthy eating before the new baby arrives,” she says. “You don’t need special or expensive foods. A healthy diet during pregnancy is made up of foods that we commonly encounter when grocery shopping. A variety of fruit and veg, whole grains, legumes and lentils, dairy, plant fats and lean meats, fish and eggs can all be enjoyed while you are pregnant and will provide the nutrients you need.”

What nutrients should moms-to-be focus on?

Following a balanced diet according to the accepted healthy eating guidelines is the optimum nutritional route to support a healthy pregnancy. Pregnancy is definitely not the time for weight loss or fad diets that focus on particular nutrients at the expense of others. Registered dietitian and ADSA spokesperson, Cath Day says, “Energy (kilojoule) restriction during pregnancy is not recommended! High protein diets which increase ketone production are also not recommended as the foetus has a limited ability to metabolize ketones. It is much healthier for you to adopt a balanced diet with a good variety.”

Nutrients such as folic acid, calcium, iron and protein are all important to the developing baby; however a balanced diet will, in most cases, meet these needs. Women enrolled in the government’s antenatal care programme will receive supplements of the essential micro-nutrients; and many women choose to supplement with folic acid to prevent the risks of Spina Bifida and cleft palate.

Day points out that meeting protein requirements during pregnancy is as simple as ensuring that you eat roughly six servings or between 180 g- 210 g of protein each day (size of two palms or two decks of cards). One serving equates to 30 g lean meat or fish, 1/2 cup of legumes, 15 g nuts or one egg. “These are also the best sources of iron which is needed to prevent anaemia,” she says. “By eating fruit and vegetables high in vitamin C at the same time as eggs, nuts and pulses, you can enhance iron absorption from these foods.”

Focusing on a variety of healthy foods for each meal or snack, rather than the particular nutrients, is what helps to ensure you and baby get what you need. Sayed says, “Some examples of this are choosing nutrient-dense meals or snacks like an omelette with veg, a fruit and yoghurt smoothie, a salad with raw veg, nuts or lean meat; or a cooked lentil dish with green leafy veg and rice.”

What should moms-to-be avoid?

Smoking tops the list of what shouldn’t be going into a pregnant body. While there’s debate about whether drinking one glass of wine is safe for a growing baby, many experts and governments around the world advise a complete avoidance of alcohol during pregnancy. Pregnant women should avoid foods with a greater risk for contamination with Listeria or other bacteria or parasites, including under-cooked meat and eggs, raw fish, processed meats and unpasteurised dairy and soft cheeses. Dietitians also advise avoiding fish that may contain high levels of mercury such as swordfish, shark, tuna steaks and canned fish brands that are not tested. Caffeine intake should be limited, and rather swopped out for decaf options, with water as your best beverage of choice. Foods that are high in salt, sugar and other refined carbohydrates should be limited as they crowd out the opportunity for you to eat healthy foods which provide for your vitamin, mineral and fibre needs. They can also lead to excessive weight gain which increases your risks of developing high blood pressure issues and gestational diabetes.

Reach out and get help when you need it

Healthy eating during pregnancy does not have to be complicated or a minefield. It might be more challenging for moms-to-be who need to make big changes; or who are overweight or managing other health conditions. A registered dietitian can be an important ally to come up with a healthy eating plan that suits your food preferences, your budget and your lifestyle. “The big advantage of using your pregnancy as the inspiration to eat well is that you can go on to become a healthy eating role model for your precious child, instilling healthy eating habits that can last them a lifetime,” Sayed concludes.

To find a registered dietitian in your area visit www.adsa.org.za.


Pregnancy and Nutrition

This Pregnancy Week a reminder that good nutrition before and during pregnancy may influence the pregnancy, the delivery and the health of mother and child later on. What you eat now will help your baby to grow healthily and give them the best start in life and help you to feel your best. We asked registered dietitians and ADSA (Association for Dietetics in South Africa) spokespeople to provide their top tips for healthy eating during pregnancy.

Does eating for two mean doubling up your portions?

“Additional energy is needed during pregnancy to support the growth demands of your baby, however the saying ‘eating for two’ has been taken out of context,” says Cath Day, Registered Dietitian. “During the first trimester, you don’t need any additional energy. This means that if you were maintaining a healthy weight before you became pregnant, you can continue eating the same amount. It is only in your second and third trimester that you need to eat a little more.”

But, how much more?

The professional advice from a dietitian is that an expectant mom who is at a healthy weight should take in an extra 350 kCal / 1470 kJ per day in her second trimester. This would be the equivalent to eating an extra half a cup of fruit or one tennis ball-sized fruit, a 175 ml of plain low fat yoghurt, two wholewheat crackers, two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese.

In the third trimester, the recommended additional intake rises to just 460 kCal / 1930 kJ per day, and that would be equivalent to eating an extra one cup of fruit or two tennis ball-sized fruits, 175 ml plain low fat yoghurt, four wholewheat crackers with the same two teaspoons peanut butter without added sugar and salt, and a 30 gram portion of a medium fat cheese.

What should you do if you are overweight and pregnant?

Overweight and obesity can present health challenges during pregnancy, so health professionals do advise that women should get to a healthy weight before they fall pregnant. However, in South Africa where women’s rates of overweight and obesity are high, less than ideal conditions for pregnancy need to be managed.

“Pregnancy is not the time to think about dieting and weight loss,” says ADSA spokesperson and Registered Dietitian, Nazeeia Sayed, “An overweight pregnant woman should focus on the healthy eating of a variety of nutritious foods, and her weight gain needs to be monitored at her ante-natal check-ups. She should also focus on light exercise such as walking.”

Day also points out that: “Overweight and obese pregnant women would benefit from seeing a registered dietitian who can assist them with an eating plan which will support baby’s growth and ensure that they gain weight within healthy parameters.”

How can you eat healthily on a budget?

Day has some sensible tips:

  • Eat fruits and vegetables which are in season and more affordable
  • Get your family members and neighbours to shop with you for bulk fruits and vegetables that are more cost-effective
  • Start a vegetable garden using water-saving ideas at home or in your community. NGOs such as Soil for Life and many more help households and communities to sustainably increase their access to fruits and vegetables
  • Spend less money on fizzy cold drinks, junk food and take-aways, and use what you save to buy seasonal fruits and vegetables instead
  • You can save money by reducing your meat intake by half and instead use beans, split peas and lentils to bulk up your favourite meat dishes. These legumes are a more affordable, healthy vegetable protein source that also include the B-vitamins and folic acid
  • Buy frozen vegetables when they are on promotion – they contain as much or even more nutrients than vegetables which have been on the shelf for an extended period of time

What can pregnant women who can’t afford supplements eat to get the micro-nutrients important to pregnancy?

Pregnant women and those planning on falling pregnant should take a supplement of iron and folic acid, as these are essential nutrients needed for a healthy pregnancy.

Sayed points out that it is important for all pregnant women to know that they have access to the State ante-natal services because supplements such as folic acid, iron and calcium are included in their free healthcare.

Day also adds that there are many affordable food sources that provide these nutrients that are vital to a baby’s healthy development. “For instance,” she says “Green leafy vegetables such as spinach, morogo and legumes such as beans, split peas and lentils are good sources of folic acid and iron. You can also find staples such as maize meal and brown bread that are fortified with folic acid and iron. Amasi and milk provide calcium. Tinned sardines and pilchards provide calcium and iron, and chicken livers are another good source of iron.”

How can you use your pregnancy to develop healthier habits?

Pregnancy is a time when your health and the health of your developing baby is an absolute priority.   Day says that it is not only what you consume but also what you do not consume that counts. “Don’t drink alcohol when you are pregnant. All forms of alcohol could be harmful to your baby and the safest choice for your unborn baby is not to drink any alcohol at all when you are pregnant.”

Sayed concludes: “Pregnancy is not a state of ill health but a time to be enjoyed, and it can help you to develop life-long healthy eating patterns that you sustain as you become a role model for the new addition to your family!”


Healthy Nutrition during Pregnancy

We are sharing success stories to find out why people decide to see a dietitian, what happens on the journey, what the hardest part of that journey is and what results are achieved. This week we chat to Bonnie Classen, who started seeing Registered Dietitian Alex Royal when she fell pregnant:

Tell us about your journey with the dietician? 

Over the past few years I have strived to lead a healthy lifestyle, with my food choices being based around eating as many real foods as possible, and minimal processed and refined foods. Despite my diet being healthy for the most part, I still  found that I still struggled in a few areas – such as afternoon slumps, sugar cravings, and low energy during certain times of the day.

After falling pregnant, I felt it would be a good idea to visit Alex Royal for a dietetics consultation, to help guide me on the optimum food choices during my pregnancy. As the majority of my food choices were already healthy, I was very curious to see the assessment of my current diet, as I couldn’t imagine what possible improvements could be made.

Wow did I have a lot to learn !!

 While on the whole my food choices had been good, Alex highlighted so many interesting points regarding my current diet. From the excessive amount of fat I was eating each morning (I was shocked to hear how much fat I was consuming with my breakfast each morning, I had no idea), my very low calcium intake, and so much more.

Using my existing food choices and lifestyle – Alex helped adjust my current eating regime. Adjustments were made to my meals. From distributing my fat intake more evenly throughout the day, increasing of calcium, including protein & vegetables during certain times and so much more.

 As Alex worked with my current eating style and diet when making these adjustments, these changes weren’t very challenging to implement into my daily routine, which made them far more manageable to achieve.

What a difference these seemingly simple changes made to my life !

She also helped highlight some really important information to me regarding my dietary needs during pregnancy, such as the importance of calcium intake during pregnancy and the daily recommended dosage, as well as information on all the other essential nutrients required during pregnancy.

During our second consultation Alex also suggested I bring in all my vitamins, and assessed my vitamins dosages, giving fantastic suggestions on inclusions and improvements here too.

 Tell us about your results? 

The results I achieved after implementing the dietary changes were nothing short of fantastic! My afternoon slumps diminished, and I realized that my previous afternoon ‘sugar’ cravings was simply hunger – I was eating lunch far too early in the day and then only eating dinner after 7pm. So without an afternoon snack, was starving by 5pm!

By adjusting my food quantities, including protein into my breakfast each morning, and spreading out my fat intake –  I also felt far more sustained throughout the day.

Alex also gave me tips on how to ‘give in’ to my pregnancy craving, but ensuring that this was done with the right food choices, so that the extra calories I was consuming weren’t empty calories. She took my pregnancy experiences into consideration when creating my customized eating plan. Despite being starving, I was also struggling with severe nausea (a combination I didn’t know was possible prior to pregnancy!) After most meals, I then also suffered from heartburn and indigestion, making eating full-size meals very unpleasant.

One of Alex suggestions was to eat a healthy snack a few hours after dinner, which ensured I still got my extra calories required despite eating a small dinner. By also eating this healthy snack before the hunger & cravings hit, I felt satisfied and managed to avoid the late night “pregnancy” sugar binges I found myself giving into prior to my consultations.

During my consultations Alex tracked my pregnancy weight gain, ensuring this was on track, while still increasing my muscle mass. I have now managed to maintain an extremely healthy weight gain throughout my pregnancy. I have not only loved my pregnancy body, but also feel such a great sense of confidence that I have given my baby the best head start in life, by ensuring she has had the optimal nutrition needed 🙂

 What was the hardest part of the journey? 

The hardest part was to be more disciplined in preparing lunches and snacks for my work day. While packing lunch was easy (as we generally made a generous healthy dinner the night before – and took leftovers to work), I never prepared any snacks for work.

So it took some time to adjust to having to be slightly more disciplined in my preparation each morning, but the results were worth it! By simply taking those 15 minutes each morning to pack for the day, I now am completely able to avoid the 5pm ‘binge’ I found myself falling into each afternoon.  

What are the top 3 tips you can share? 

  • From the 2nd trimester you should increase your daily calorie, but the extra food you eat shouldn’t just be empty calories, as it should provide the nutrients for your growing baby needs. It is also easier than you think to get these extra calories!
  • You can get creative with your eating schedule during pregnancy. As mentioned, I suffered from extreme nausea, heartburn and indigestion when eating full-size meals, often making meals unpleasant. By splitting up your meals and eating smaller meals and snacks at different times within the day, it helped ensure I still consumed the calories and nutritional intake during pregnancy, while avoiding the excessive pregnancy heartburn & indigestion i experienced with larger meals.
  • Be prepared !! When you have a busy work schedule, it is very easy to get caught up in your day and go for long stretches without food, then give in to the ‘convenient’ foods that are in reach (these usually being unprocessed, sugar filled snacks) By simply making time to prepare your lunches & snacks for your day ahead, you can maintain your healthy diet habits and continue to feel sustained throughout the day.

Feedback from the Alex Royal

It was an absolute pleasure to help Bonnie along this path. She made excellent dietary and lifestyle changes which benefited both her and her little one. Her body composition improved during her pregnancy with her body fat decreasing while her muscle mass improved. She managed her cravings and followed the meal plan to the letter, including the nutrients that we needed to focus on to help her baby develop and grow well.  Her motivation and commitment to her health and to her baby’s well being was inspiring.


“I made a complete lifestyle change” – Glenise’s Story

We are sharing success stories to find out why people decide to see a dietitian, what happens on the journey, what the hardest part of that journey is and what results are achieved. This week we chat to Glenise Valentyn, who started seeing Registered Dietitian Retha Mostert after she struggled to fall pregnant and was diagnosed with insulin resistance. Here is her story ….

Why did you decide to see a dietitian? (the before story)

When I visited a gynaecologist, because I was struggling to fall pregnant, he did some tests and I was diagnosed with insulin resistance. He explained the dangers involved for the baby and me, should I fall pregnant and advised me to immediately start with a healthy lifestyle. I decided to see a dietitian.

Tell us about your journey with the dietitian?

I made my first appointment with Registered Dietitian Retha Mostert soon after I saw the gynaecologist. She worked out very easy meal plans (not diet plans) for me. All the ingredients were readily available at our supermarket. I could prepare food that my whole family enjoyed. She taught me how to make the right choices when making decisions on what to eat. I was very comfortable with her. A little bit later I found out that I was pregnant. I visited Retha throughout my whole pregnancy, looking forward to my bi-monthly visits with her.

Tell us about your results / successes?

I could feel a difference in myself right after I started to see Retha. I had much more energy. I only gained a total of 5kg throughout my whole pregnancy. Most of it was only in the last weeks. The gynaecologist was very worried at first that I wasn’t gaining weight, but she checked the baby’s progress and growth and was happy. I was tested for insulin resistance during my pregnancy and there was no sign of it. I gave birth to a normal baby daughter of 2.89kg. My weight after the birth of my baby was less than before I fell pregnant. Seeing Retha helped me make a complete lifestyle change.

What was the hardest part of the journey?

The hardest part was to resist pregnancy cravings. I always had to remind myself of the consequences of eating the wrong foods.

What are the top three tips you can share?

  1. Believe in yourself
  2. Trust your dietitian
  3. Always plan ahead and put your plans in writing

What the dietitian says (a few words from Retha Mostert)

Throughout her pregnancy Glenise was so motivated. Her sugar levels were showing warning signs before the pregnancy and by making smart food choices she kept them under control throughout her pregnancy. She proved that its not necessary to ‘eat for two’ when you are pregnant. Even when she went for her regular check-ups with her gynaecologist, he couldn’t believe that she herself was not gaining a lot of weight, but sonars confirmed that her baby was growing the way she should. At 38 weeks Glenise had a healthy baby girl! What better reward can there be?

To find a Registered Dietitian in your area, please visit: www.adsa.org.za