Smart, simple nutrition

Eating right when you'Â’re pregnant doesn'Â’t have to be, well, laborious. Our five-day meal plan will keep you healthy and satisfied the easy way.

If you’re like most women, one of the first things you did when you found out you were pregnant was resolve to eat everything you should — and nothing you shouldn’t. Out with the fast-food fries, in with the nutrient-packed salads, veggies and grains. After all, it’s a small sacrifice to make for the sake of your baby’s health.

But as with most resolutions, these don’t always work out. Being tired, busy or worried about weight gain can conspire against your preparing and eating plenty of the right foods, no matter how good your intentions. And then there’s the havoc morning sickness and food cravings often wreak on those intentions.

Well, don’t beat yourself up too much. “Pregnancy is a time when you just have to bend the nutrition rules a little,” says Elizabeth M. Ward, M.S., R.D., a nutritionist at Harvard Vanguard Medical Associates in Boston, author of The American Dietetic Association’s Pregnancy Nutrition: Good Health for You and Your Baby (Chronimed, 1998) and a mother of three. Not that good nutrition isn’t important during pregnancy. In fact, you need more of several nutrients than ever, including vitamins B6 and B12, copper, zinc, folic acid and calcium.

But giving in to an occasional craving for chocolate or indulging in a baked potato with sour cream to tame your churning stomach is not the end of good nutrition. In other words, you don’t have to eat textbook-perfectly at every single meal to get the nutrition you and your baby need; what counts is your intake over the longer term.

Here’s some advice on overcoming three of the biggest obstacles to eating right during pregnancy, as well as a suggested real-world (read: simple) five-day meal plan that accommodates some of the more frequently encountered pregnancy cravings, such as the hankering for sweets.

Morning sickness

Although many pregnant women’s food cravings sound unusual, to say the least, satisfying them can often prevent yet another wave of nausea and vomiting — two major obstacles to good nutrition during pregnancy. If it’s any consolation, research shows that women who experience nausea during pregnancy have a lower miscarriage rate than do those who remain nausea-free. (Of course, plenty of women who never suffer one nauseous moment during pregnancy give birth to healthy babies, too.) The bad news is, if you have nausea, even that reassuring bit of information offers little comfort. Misleadingly named, morning sickness can occur at any time of the day or night, and only those who experience it can truly understand the impact it can have.

While there are few, if any, proven ways to prevent or relieve morning sickness, eating ginger sometimes works (it’s a known motion-sickness remedy), as does avoiding strong smells or sniffing a lemon. The main concern is dehydration. According to Miriam Erick, M.S., R.D., a senior dietitian at Brigham and Women’s Hospital in Boston and author of No More Morning Sickness (Plume, 1993), women who are nauseous often don’t get enough fluids (she recommends about 10 cups a day). Sometimes satisfying a craving for a specific food can settle your stomach, allowing you to drink more. If you can’t keep any food down, at least take your prenatal vitamins religiously. Because they can be nauseating, some doctors recommend taking them at night.

Cravings and aversions

There’s no proof that food cravings mean you need more of a certain nutrient or that aversions are your body’s way of protecting the fetus from toxins. Still, food cravings, the subject of countless pickles-and-ice-cream jokes, are, as many pregnant women can tell you, really no laughing matter.

“Most women start out with wonderful intentions, but once those hormones kick in, good nutrition doesn’t always come easy,” Ward says. Food cravings often accompany morning sickness; both often are simply a side effect of pregnancy. The key is to keep cravings under control. If you must have potato chips, for example, opt for a single-serving bag.

On the flip side of the craving coin are food aversions. It’s not unusual for some nutritious foods such as broccoli, once enthusiastically consumed before pregnancy, to make your stomach turn over just thinking about them now that you are expecting. If your aversion is to something like coffee, nothing’s lost; but if vegetables now make you sick, you’ll have to make up the loss by eating more of other nutritious foods that may be better tolerated, such as fruit.

Fear of weight gain

If you’re overly worried about eating too much, you just might not be eating enough. During the first trimester, your calorie needs increase very little, but your pregnant body requires an additional 300 calories a day during the last two trimesters. That means if you required 1,800 calories a day before you were pregnant, you’ll need 2,100 calories daily once you reach your fourth month. Breastfeeding demands even more — an extra 500 calories a day over your prepregnancy needs. But the increase is not a license to pig out; it just provides a little leeway in your usually lean eating plan.

“Pregnancy is not the time to worry about weight control,” Ward says. “Instead, it’s the one time when you should really listen to your body, and if you’re hungry, you should eat.” Of course, there are limits to how much weight gain is healthy. The American College of Obstetricians and Gynecologists recommends that women who are of normal weight before they conceive gain about 25–35 pounds during pregnancy. Overweight women should gain 15–25 pounds; underweight women, 28–40 pounds; and women carrying twins, 35–45 pounds.

A meal plan you can live with

Our five-day eating plan features easy-to-prepare dishes that will provide all the nutrients you and your baby need for the whole nine months. But it was also created with variety and satisfaction in mind, to accommodate the possibility of new food cravings and aversions. Specifically, it’s relatively low in fat to allow for those all-too-common cravings for high-fat foods but offers plenty of healthy treats to satisfy the yen for sweets. The recipes included are simple and require few ingredients, but when you’re in the mood for something special, maybe even a bit exotic, you might want to try the recipes in “Three Chef-Moms and Their Favorite Pregnancy Recipes."

You don’t need to slavishly follow this plan to derive its benefits; if you don’t feel like a certain food at one meal, feel free to substitute another similar to it. Just do your best to get the nutrients you need over the course of a day or even several. As nutritionist Elizabeth Ward says, “Challenge yourself to eat better each day if you can. But if you can’t, don’t be too hard on yourself.”

The five-day nutrient-dense meal plan

The key nutrients here — calcium, folic acid, iron, zinc — are “marker nutrients,” meaning that if you get enough of them, chances are you’re getting everything else you need as well. Why? These four are mainly found in foods that are nutrient-dense. Here, the foods richest in these nutrients are marked with asterisks. This plan is designed to meet your first-trimester needs; the second- and third-trimester additions can be eaten at any time during the day.

Day 1

Breakfast

2 slices whole-wheat toast* with 2 tablespoons peanut butter*

8 ounces nonfat milk*

Snack

1/2 cup pear sorbet topped with 1/2 cup fresh blueberries*

Lunch

1 medium baked potato* topped with 1 tablespoon low-fat sour cream, 2 teaspoons low-fat margarine and 1/2 cup chopped broccoli*

Mixed salad*: 1 cup shredded romaine lettuce leaves, 1/2 sliced tomato, 1/8 sliced red bell pepper and 2 tablespoons low-calorie French dressing

8 ounces nonfat milk*

Snack

1 baked apple: Spoon 1 teaspoon reduced-fat margarine, 1 teaspoon brown sugar and 1/2 teaspoon cinnamon into a cored apple. Microwave until soft, 2–5 minutes.

Dinner

Fajitas*: 2 flour tortillas filled with 2 ounces beef strips, 1/2 cup pinto beans, 1 ounce shredded cheddar cheese, 1/2 cup chopped romaine lettuce, 1 chopped tomato and 1/8 avocado

Second- and Third-Trimester Additions

1 cup low-fat fruit yogurt* topped with 1 tablespoon granola

1 kiwi, sliced

First trimester: 2,007 calories, 24 percent fat (54 grams), 59 percent carbohydrate, 17 percent protein, 1,231 milligrams calcium, 813 micrograms folic acid, 19 milligrams iron, 2.3 milligrams vitamin B6, 13 milligrams zinc, 49 grams fiber.

Second and third trimesters: 2,316 calories, 23 percent fat (59 grams), 61 percent carbohydrate, 16 percent protein, 1,569 milligrams calcium, 839 micrograms folic acid, 20 milligrams iron, 2.4 milligrams vitamin B6, 14 milligrams zinc, 53 grams fiber.

Day 2

Breakfast

2 whole-wheat pancakes topped with 1/2 cup sliced strawberries* and 2 tablespoons syrup

8 ounces nonfat milk*

Snack

8 ounces orange juice*

1 low-fat cereal bar*

Lunch

1 whole-wheat pita* filled with 1 ounce Swiss cheese*, 1/4 cup shredded romaine lettuce, 2 slices tomato and 2 teaspoons mayonnaise

1/2 cup ice milk*

1 banana, sliced, drizzled with honey*

8 ounces nonfat milk*

Snack

8 ounces nonfat milk* with 2 tablespoons chocolate syrup

3 reduced-fat chocolate chip cookies

Dinner

1 bowl Bountiful Beta-Carotene Carrot Soup*: Place 4 cups chopped leeks (white parts only), 2 cups chopped onions and 2 tablespoons olive oil in a large saucepan. Cover and cook on low to soften. Add 2 pounds carrots, peeled and sliced; 4 quarts chicken stock or canned chicken broth; 1 teaspoon salt; and 1/2 teaspoon white pepper. Bring to boil, reduce heat and simmer until carrots are tender, about 40 minutes. Cool slightly. Purée, return to saucepan, bring to simmer and serve. Serves 16.

Mixed salad*: 1 cup shredded romaine lettuce; 1 tomato, cut into chunks; 2 chopped green onions; 1 tablespoon lemon juice; 1 tablespoon olive oil; 1 tablespoon vinegar; 1/4 cup croutons; and ground pepper, to taste

2 slices French baguette

Seltzer with lime

Second- and Third-Trimester Additions

1 whole-wheat pancake*

1 ounce baked tortilla chips with 1/4 cup bean dip*

First trimester: 2,054 calories, 22 percent fat (51 grams), 65 percent carbohydrate, 13 percent protein, 1,815 milligrams calcium, 666 micrograms folic acid, 19 milligrams iron, 2.4 milligrams vitamin B6, 10.6 milligrams zinc, 29 grams fiber.

Second and third trimesters: 2,322 calories, 22 percent fat (57 grams), 65 percent carbohydrate, 13 percent protein, 2,006 milligrams calcium, 675 micrograms folic acid, 22 milligrams iron, 2.4 milligrams vitamin B6, 11 milligrams zinc, 34 grams fiber.

Day 3

Breakfast

1 packet flavored oatmeal* topped with 2 tablespoons wheat germ, toasted*

8 ounces grapefruit juice

Snack

1 ounce whole-wheat pretzels

8 ounces lemonade

Lunch

Grilled cheese sandwich*: 2 slices whole-wheat bread with 1 slice reduced-fat cheese and 2 teaspoons reduced-fat margarine

1 orange*

1/2 cup chopped cucumber and 1/2 cup chopped tomato, drizzled with 1 tablespoon olive oil

8 ounces nonfat milk*

Snack

1/2 cup seedless grapes

2 tablespoons chopped dates

4 wheat crackers

Dinner

Pasta primavera*: Mix 1/2 cup 2 percent cottage cheese and 1 tablespoon lemon juice; set aside. Cook 2 ounces angel hair pasta. Meanwhile, heat 2 tablespoons olive oil in skillet. Add 1/8 cup chopped scallions, 1/4 cup chopped onions, 1 chopped garlic clove and 1/4 sliced bell pepper, and sauté until softened. Add 3 sliced mushrooms and 1 sliced small zucchini and stir 1 minute. Add 2 cooked sliced carrots and 1/2 cup broccoli florets and stir 5 minutes. Toss hot pasta with cottage cheese mixture and top with vegetables. Serves 2.

2 French baguette slices with 1 teaspoon reduced-fat margarine

1 cup Celestial Seasonings Red Zinger tea

Second- and Third-Trimester Additions

1 bran muffin

6 ounces cranberry juice cocktail

First trimester: 2,008 calories, 26 percent fat (58 grams), 57 percent carbohydrate, 17 percent protein, 1,179 milligrams calcium, 742 micrograms folic acid, 30 milligrams iron, 3.45 milligrams vitamin B6, 12 milligrams zinc, 30 grams fiber.

Second and third trimesters: 2,334 calories, 26 percent fat (68 grams), 59 percent carbohydrate, 15 percent protein, 1,235 milligrams calcium, 758 micrograms folic acid, 32 milligrams iron, 3.7 milligrams vitamin B6, 13 milligrams zinc, 35 grams fiber.

Day 4

Breakfast

1 ounce high-fiber cereal* with 4 ounces nonfat milk* and 1 sliced banana*

8 ounces orange juice*

Snack

1 oat-bran bagel* with 2 tablespoons cream cheese

1 cup apple-cinnamon tea

Lunch

1 whole-wheat pita* with 1/8 cup hummus and 1/4 cup soybean sprouts

1 carrot and 1 celery stalk, cut into strips, with 1/8 cup low-calorie Italian dressing

1 apple

8 ounces nonfat milk*

Snack

Banana-strawberry shake*: Blend 1 banana, 1/2 cup frozen strawberries,

1/2 teaspoon vanilla extract and 1 teaspoon honey until smooth.

Dinner

3 ounces grilled salmon topped with 1 tablespoon olive oil, 1/8 cup chopped coriander, 1/8 cup chopped parsley and 1 tablespoon lemon juice

1/2 cup mashed potatoes* with 2 teaspoons margarine

1/2 cup Savory Spinach*: Sauté 1 sliced onion in 2 tablespoons olive oil until brown. Add 2 bunches fresh, cleaned spinach and cook, stirring frequently, until wilted. Season to taste with salt and pepper. Serves 2.

1/2 cup sliced peaches in juice

Second- and Third-Trimester Additions

1 scoop chocolate ice cream* with 2 tablespoons chopped walnuts

1 apple with 1 ounce Gruyère cheese*

First trimester: 1,973 calories, 29 percent fat (64 grams), 59 percent carbohydrate, 12 percent protein, 1,044 milligrams calcium, 524 micrograms folic acid, 18 milligrams iron, 3 milligrams vitamin B6, 14 milligrams zinc, 38 grams fiber.

Second and third trimesters: 2,330 calories, 32 percent fat (83 grams), 57 percent carbohydrate, 11 percent protein, 1,414 milligrams calcium, 544 micrograms folic acid, 19 milligrams iron, 3.1 milligrams vitamin B6 , 15 milligrams zinc, 42 grams fiber.

Day 5

Breakfast

1 whole-wheat English muffin* with 2 tablespoons strawberry jam and 2 slices Canadian bacon

8 ounces nonfat milk*

Snack

1/2 cup 2 percent cottage cheese*

1/2 cup peach slices in juice

4 wheat crackers

Lunch

1 3-ounce lean ground beef patty* on a mixed-grain hamburger bun

2 ounces baked french fries with 1/4 cup ketchup*

8 ounces nonfat milk*

Snack

6 ounces mango juice

2 slices French baguette with 1 ounce brie*

Dinner

3 ounces lean grilled steak with onions*

1/2 cup steamed new potatoes with basil, parsley and olive oil

1 rye dinner roll

Grilled squash*: Heat 2 tablespoons olive oil in skillet. Add 1 sliced medium zucchini, 2 sliced small yellow squash, 1 sliced red onion, 1 sliced red bell pepper and 2 teaspoons fresh basil, and sauté until brown. Serves 4.

Second- and Third-Trimester Additions

1 oat-bran dinner roll

1 scrambled egg

2 reduced-fat vanilla creme cookies

First trimester: 1,982 calories, 37 percent fat (81 grams), 43 percent carbohydrate,

20 percent protein, 1,075 milligrams calcium, 230 micrograms folic acid, 16 milligrams iron, 1.71 milligrams vitamin B6, 13 milligrams zinc, 16 grams fiber.

Second and third trimesters: 2,253 calories, 37 percent fat (93 grams), 47 percent carbohydrate, 16 percent protein, 1,124 milligrams calcium, 260 micrograms folic acid, 18 milligrams iron, 1.8 milligrams vitamin B6, 14 milligrams zinc, 17 grams fiber.

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