Healthy Beginnings Project

NUTRITION FOR YOU AND YOUR BABYPARTICIPANT HANDBOOK

date:

3

TABLE OF CONTENTS

General Guidelines ➙ Good Food Choices ➙ BMI ➙ Recommended Weight Gain

Why Eat Healthy? ➙ Key Nutrients and Their Benefits ➙ Your Food Chart

Smart Choices

Special Considerations

Buying Fruits & Vegetables ➙ How Much Can I Buy for under $10? ➙ Tips on Buying Fresh and Canned

Questions and Notes

Food Journal

Resources & Contributors

page 5

page 8

page 11

page 12

page 14

page 17

page 18

page 20

5

GENERAL GUIDELINESGOOD FOOD CHOICES

“Women who exercise during pregnancy deliver their babies about five days earlier, experience fewer complications during labor and delivery, have fewer inductions and caesarian sections, and need

fewer drugs to relieve pain than women who don’t exercise.”-Fit Pregnancy for Dummies

your body needs protein, fiber, vitamins, minerals, fluids, and calories

Good food choices are key to a healthy baby!

6

GENERAL GUIDELINESBODY MASS INDEX

12

15

15

14

14

13

1717181819

16

141415151616 121212131314

20

20

19

18

17

22

22

21

23

23

18

17

26

25

25

24

1516 1314 1415 13 1319 19 18 18 17 17 1620

21 20 20 19 18 18 17 17 16 16 15 15 14 14 14 13

15 15 14 1422 21 21 20 19 19 18 18 17 17 16 16

23 22 22 21 20 20 19 18 18 17 17 16 16 15 15 15

24 23 22 22 21 20 20 19 19 18 18 17 17 16 16 15

25 24 23 23 22 21 21 20 19 19 18 18 17 17 16 16

26 25 24 24 23 22 21 21 20 20 19 18 18 17 17 16

27 26 25 24 24 23 22 22 21 20 20 19 19 18 18 17

28 27 26 25 24 24 23 22 22 21 20 20 19 19 18 18

2329 28 27 26 25 25 24 22 22 21 21 20 19 19 18

30 29 28 27 26 25 25 24 23 22 22 21 21 20 19 19

26

26

25

25

24

23

23

22

21

21

20

20

27

27

26

25

25

24

23

23

22

21

21

20

28

27

27

26

25

25

24

23

23

22

21

21

29

28

27

27

26

25

25

24

23

23

22

2122

25

25

24

24

24

24

23

2323

23 23

26

26

26

25

25

25

25

25

25

25

25

25

27

27

27

27

27

27

27

27

26

26

26

26

29

29

29

29

29

28

28

28

28

28

28

28

28

28

30

30

30

30

30

28

28

28

28

2930

31

31

31

31

31

29

29

29

29

29

29

31

31

32

32

32

32

30

30

30

30

30

3032

32

32

32

33

33

33

30

31

31

31

3133

32

33

33

33

33

33

34

34

31

32

32

35

35

36

36

33

34

34

34

34

34

35

35

37

37

38

35

36

36

36

36

37

34

35

35

42 40

41

39

39

40

38

38

38

39

37

37

100

215

200

210

205

195

190

185

180

175

170

165

160

155

150

145

140

135

130

125

120

115

105

110

5’0” 5’1” 6’4”6’3”6’2”6’1”6’0”5’11”5’10”5’9”5’8”5’7”5’6”5’5”5’4”5’3”5’2”

wei

ght (

lbs)

height

below 18 - underweight18 to 24 - healthy weight

25 to 29 - overweight30 to 39 - obese

over 40 - extremely obese

7

GENERAL GUIDELINESRECOMMENDED WEIGHT GAIN

your pre-pregnancy BMI: _______

pre-pregnancy BMI expected weight gain

below 20

20 to 26

above 26

28 to 40 pounds

25 to 35 pounds

15 to 25 pounds

if you are having twins, you should expect to gain 35-45 pounds

you should expect to gain between 2 and 8 pounds the first 3 months, and 1 pound per week after that

8

WHY EAT HEALTHY?KEY NUTRIENTS AND THEIR BENEFITS

NUTRIENT IMPORTANCE SOURCESONE-A-DAY PRENATAL

Calcium1000 mg

Iron27 mg

Vitamin A770 mcg2565 IU

helps build strong bones and teeth

helps red blood cells deliver oxygen to your baby

forms healthy skin, helps eyesight, and helps with bone growth

milk or lactaid milk, swiss, cheddar, muenster, mon-terey cheese, yogurt, tofu, sardines, pudding, collards, broccoli, fortified instant oatmeal, kale, cornbread

lean red meat, dried beans and peas, iron-fortified cere-als, prune juice, oatmeal, soybeans, baked potatoes, shrimp, clams, oysters, bran, beef liver, beef kidney, cream of wheat, spinach, raisins, cooked kale, dried apricots, dried prunes, walnuts, cashews, brazil nuts

raw or cooked carrots, dark leafy greens, sweet pota-toes, boiled spinach, but-ternut squash, boiled kale, nonfat fortified milk, instant oatmeal, cantaloupe, raw spinach, eggs, frozen peas

300 mg

28 mg

4000 IU

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WHY EAT HEALTHY?KEY NUTRIENTS AND THEIR BENEFITS

NUTRIENT IMPORTANCE SOURCESONE-A-DAY PRENATAL

broccoli, tomatoes, straw-berries, citrus fruits such as lemon, grapefruit, lime, orange, tangelo, tangerine, clementine

sunlight exposure, vitamin D fortified milk, fatty fish such as salmon

beef, liver, pork, ham, whole-grain cereals, bananas

liver, meat, fish, poultry, milkfound only in animal products; vegetarians and vegans should take a supplement

fortified cereals, beef liver, orange juice, legumes, lentils, spinach, asparagus, northern beans, avocado, raw papaya, sweet corn, tomato juice, green peas, cooked broccoli, nuts

Vitamin C85 mg

Vitamin D200-400 IU

Vitamin B61.9 mg

Vitamin B122.6 mcg

Folate600 mcg

promotes healthy gums, teeth and bones and helps your body absorb iron

helps build your baby’s bones and teeth

helps form red blood cells and helps your body use protein, fat, and carbohy-drates

maintains nervous system and is needed to form red blood cells

needed to produce blood and protein and helps some enzymes function

60mg

400 IU

2.5 mg

8 mcg

800 mcg

10

WHY EAT HEALTHY?YOUR FOOD CHART

foods I want toeat daily

foods I want toeat weekly

foods I want toadd to my diet

dairy

fruits

grains

protein

vegetables

be sure to always take your prenatal vitamins!

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SMART CHOICES

1 slice whole-wheat bread with 1 tbsp peanut butter and

jelly

20oz regular soda (average large soda)

8oz glass of 1% milk2 Hershey’s kisses

you will need 300 extra calories per day in your first trimester and 500 in your second and third

if you are in your first trimester circle the smart choices that equal 300 calories and if you are in your second or third

trimester circle the ones that equal 500 calories with the lowest amounts of solid fats or added sugars

1 slice whole-wheat bread with 1 tbsp peanut butter and

jelly

20oz regular soda (average large soda)

8oz glass of 1% milk and a large banana

with 12 almonds

2 Hershey’s kisses and 5 twizzlers

300 options

500 options

the healthy choices from the 500 calorie option give you: ➙ protein (28 g) ➙ fiber (11 g) ➙ folate (31 mcg) ➙ calcium (300 mg) ➙ Vitamin D (300 mg) ➙ iron (2.5 mg)

the unhealthy options give you nothing but fat and added sugar!

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SPECIAL CONSIDERATIONSNAUSEANausea and/or vomiting are common in the first trimester. Don’t force yourself to eat or drink during these times. You may try: ➙ eating small means every two to three hours ➙ drinking liquids separately from solid foods ➙ eating before getting out of bed in the morning ➙ eating foods such as saltines, toast, pretzels, and dry cereal

HEARTBURNHeartburn is a common complaint of pregnancy. Try: ➙ eating small, frequent meals ➙ avoiding lying down after meals ➙ avoiding large meals at bedtime

➙ taking over-the-counter antacids like Tums

CONSTIPATIONConstipation is a common complaint of pregnancy. You may try: ➙ drinking eight to twelve eight-ounce glasses of caffeine-free fluid ➙ increasing the amount of fiber in your diet gradually ➙ exercising regularly if approved by your doctor

ARTIFICIAL SWEETENERSThe effects of artificial sweeteners on the unborn baby are not clear. Try to limit these to no more than two servings per day.

CAFFEINEPregnant women should limit caffeine-containing drinks to two five-ounce cups or 200 mg per day if approved by their doctor.

DENTALBecause pregnancy causes hormonal changes that puts you at increased risk for periodontal disease and for tender gums that bleed easily, it is especially important to follow good oral hygiene practices, including brushing with a fluoride toothpaste twice a day and flossing daily.

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SPECIAL CONSIDERATIONSFOOD-BOURNE ILLNESSESListeriosis can occur any time during pregnancy, though most commonly dur-ing the third trimester. Symptoms include mild flu-like symptoms, headaches, muscle aches, fever, nausea, and vomiting. Processed foods are at risk for contamination, so always heat meats to 160 degrees to be safe. Avoid: ➙ unpasteurized products ➙ raw sprouts and undercooked meats ➙ sushi or other raw fish ➙ soft cheeses such as feta, brie, etc., unless pasteurized

➙ deli meat and hot dogs unless heated until steaming

MERCURYAvoid foods high in mercury and limit fish to 12 ounces or less per week. ➙ shark ➙ swordfish ➙ king mackerel ➙ tilefish

ALCOHOLAlcohol intake has been linked to Fetal Alcohol Syndrome. Therefore, it should be avoided throughout the pregnancy.

ITEMS TO AVOIDWhile you are pregnant, you should also avoid tobacco, illicit drugs, and herbal remedies unless approved by your doctor.

PICAIt may be normal to crave a non-food item such as ice, dirt, ashes, and laundry starch. This is called pica. If it occurs talk with your doctor.

TOXOPLASMOSISToxoplasmosis is caused by a parasite that is found in raw meat and cat feces. It may cause spontaneous abortion or death. Babies who survive may have serious eye or brain damage. Avoid raw meat and changing cat litter.

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BUYING FRUITS & VEGETABLES

HOW MUCH CAN I BUY FOR UNDER $10?

1.471.23.98.74.49 2.452.211.961.72

2.95.89 1.18 1.48 1.77 2.07 2.36 2.66.59

.69 1.04 1.38 1.73 2.07 2.42 2.76 3.11 3.45

.79 1.19 1.58 1.98 2.37 2.77 3.16 3.56 3.95

.89 1.34 1.78 2.23 2.67 3.12 3.56 4.01 4.45

.99 1.49 1.98 2.48 2.97 3.47 3.96 4.46 4.95

1.09 1.64 2.18 2.73 3.27 3.82 4.36 4.91 5.45

1.19 1.79 2.38 2.98 3.57 4.17 4.76 5.36 5.95

1.29 1.94 2.58 3.23 3.87 4.52 5.16 5.81 6.45

1.39 2.09 2.78 3.48 4.17 4.87 5.56 6.26 6.95

6.711.49 2.24 2.98 3.73 4.47 5.22 5.96 7.45

1.59 2.39 3.18 3.98 4.77 5.57 6.36 7.16 7.95

8.95

7.61 8.45

8.51

7.16

5.92

9.45

8.06

6.76

10.45

8.96

7.56

6.27

5.07

9.95

8.36

6.97

5.67

4.48

3.38

10.95

9.41

7.96

6.62

5.37

4.23

7.32

5.97

4.73

3.59

2.54

11.45

9.867.67

6.27

4.98

3.78

2.69

1.69

11.95

10.31

8.76

8.02

6.57

5.23

3.98

2.84

1.79

12.45

10.76

9.166.87

9.96

8.37

5.48

4.18

2.99

1.89

11.21

9.567.17

8.72

5.73

4.38

3.14

1.99

6.23

4.78

3.44

2.19

7.47

5.98

4.58

3.29

2.09

3.74

2.39

4.98

3.59

2.29

2.49

$.49

$2.49

$2.39

$2.29

$2.19

$2.09

$1.99

$1.89

$1.79

$1.69

$1.59

$1.49

$1.39

$1.29

$1.19

$1.09

$.99

$.89

$.79

$.59

$.69

1lb 1.5lbs 5lbs4.5lbs4lbs3.5lbs3lbs2.5lbs2lbs

pric

e pe

r pou

nd

pounds

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BUYING FRUITS & VEGETABLES

HOW MUCH CAN I BUY FOR UNDER $10?

TOMATOES

Tomatoes are fresh and in season during the summer.

How much would 1.5 pounds cost you at $2.49 a pound?

________________

According to the FDA this is equivalent to an average of $1.28 a cup.

After purchasing tomatoes, you can make mozzarella, basil, and tomato caprese salad, you can make a pasta salad, or you can make bruschetta or homemade salsa .

WINTER SQUASH

Winter squash is fresh and in season during the fall.

How much would 2 pounds cost you at $2.29 a pound?

________________

According to the FDA this is equivalent to an average of $1.42 a cup.

After purchasing winter squash, you can make winter squash rolls or but-ternut squash soup, or you can roast the seeds for a tasty snack.

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BUYING FRUITS & VEGETABLES

TIPS ON BUYING FRESH AND CANNED

BUYING FRESHFruits like peaches, melons, and berries will have a strong scent when ripe. Not all produce will have a strong smell but it should never smell moldy or mildewed.

Fresh produce should not be shriveled or have spots or bruises.

Typically if produce feels too soft, it is too ripe. If it feels too hard, it is not ripe enough.

Buy only the amount of produce you can use. Plan menus ahead to use fresh fruits and vegetables within three to five days.

Fruits and vegetables in season taste better and are more likely to have ripened naturally.

BUYING CANNEDBe sure the cans are not leaking, swelling, or bulging at either end. Bulging or swelling indicates spoilage.

Buy foods before their expiration date. Canned foods that sit on shelves for too long may lose their flavor, color, or texture.

Always choose canned fruits packaged in their own juice or in a water-based liquid as opposed to a syrup-based liquid.

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QUESTIONS AND NOTES

EXAMPLESAm I not gaining enough weight?

Slow down and eat a healthy diet! You may need to add a few snacks in.

Am I gaining too much weight?Limit sweet intake to fewer than four times a week, limit fast food intake to fewer

than once a week, and avoid eating when you are not actually hungry.

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FOOD JOURNALMonday Tuesday Wednesday Thursday

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FOOD JOURNALThursday Friday Saturday Sunday

PRINT RESOURCES

Adapted from American College of Obstetricians and Gynecologists (2012). Nutrition during pregnancy. 409 12th Street, SW, PO Box 96902, Washington, D.C. 20090-6920

Adapted from WIC-0141 pamphlet, Chart for fresh fruits and vegetables. Virginia Department of Health

Cram, C., Drenth, R. S., (2004). Making your pregnancy a fit pregnancy. Fit Pregnancy for Dummies, NJ: Wiley Publishing Inc., (pgs 9-10).

Langley Outpatient Nutrition Clinic, (757) 764-6789, Eating for two nutrition during pregnancy and breastfeeding, (pgs. 1-13).

Swinney, B., Anderson, T., (1996-2000). All about gaining weight... and not gaining enough, managing morning sickness. Modified from Eating Expectantly: A Practical and Tasty Approach to Prenatal Nutrition, (1st-3rd ed.) NY: Meadowbrook Press/Simon & Schust.

Swinney, B. (1999). Iron up for good health. Modified from Healthy Foods for Healthy Kids, Meadowbrook Press.

WEBSITES

Adapted from fda.gov (2002). An important message for pregnant women and women of childbearing age who may become pregnant about the risk of mercury in fish. Retrieved November 13, 2012 from http://www.fda.gov/OHMRS/DOCKETS/ac/02/briefing/3872b1.htm

Adapted from usda.gov (2007). Protect your baby and yourself from listeriosis. Retrieved November 14, 2012 from http://www.fsis.usda.gov/Fact_Sheets/Protect_Your_Baby/index.asp

Lowfatdietplan.com (2012). Low fat diet plan low fat diet- weight loss for healthy living. Retrieved on November 14, 2012 from http://www.lowfatdietplan.com/bmi-chart

RESOURCES & CONTRIBUTORS

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RESOURCES & CONTRIBUTORS

SPECIAL THANKS

Danielle Dallaire, PhD

Catherine Forestell, PhD

Scott Ickes, PhD

Jessica Fielek, MPH

Marietah Kilundo, RN, BSN

Camilla Buchanan, MD, MPH

Elizabeth Rey, RN, BSN

Funded by the W.K. Kellogg Foundation

The College of William & MaryPsychology DepartmentDanielle Dallaire, Ph.D.

Catherine Forestell, Ph.D.Elizabeth Rey, BSN, RN

(855) 825-3541