Food First Nutrition with Ryan Kipping

(Derived from Ep. 148 of The Birth Lounge Podcast)

Today Ryann Kipping, a Registered Dietitian Nutritionist, Certified Lactation Educator, and Author of The Feel-Good Pregnancy Cookbook is here to break down how to get the majority of your crucial vitamins and minerals from food first! So many foods can be solutions to problems that pop up in pregnancy--constipation, nausea, heartburn. Ryann is sharing how to find the perfect prenatal, how to spot 3rd party testing, and how to identify trustworthy brands!

Diet culture is crazy right now. It's hard enough to eat when you aren't pregnant to figure out what to eat when you aren't pregnant. Then when you throw a pregnancy in the mix there's like so much confusion. There's so many do's and don'ts floating around. One source says something and another source says something completely different. That is why I'm here- to clear that confusion and make you feel confident. Not only that, but just so you have informed decisions, because like I always say, I'm not trying to steer you one way or the other. I'm just trying to give you the science and give you the information. So you can make the best choice for you and your pregnancy, because with all these diets floating around out there, ultimately nutrition should be individualized. You shouldn't be following the exact same diet as your neighbor, right? We are all so unique and we all have different health backgrounds and nutrition concerns.

So at the end of the day, it's definitely going to be individualized to you. With that being said, of course, during pregnancy, there are nutrients that are super important and things we do want to focus on. So to start us off, I think that one nutrient that most people immediately think of when they think of pregnancy is folate or folic acid, which are commonly used interchangeably. We're talking about the same nutrient. They're just different forms of that nutrient.

Folate vs. Folic Acid

So folate is the kind that's naturally found in food and folic acid is the synthetic form. So folic acid is generally the more common type found in supplements. It's also the kind that food is fortified with. So whenever you see these like flour/grain based products that are fortified - it is with folic acid. So that means it wasn't naturally there. They companies and organizations actually took folic acid and put it in that food.

I like to give a little background here, because the reason they did that was that there was a lot of neural babies being born with neural tube defects. Folate is the nutrient that helps close the neural tube. So it's super important for baby's brain and spinal cord development. So they companies decided to fortify the foods that people eat the most with folic acid and we'll fix this issue- and they did. So we saw a major decline in neural tube defects, which was great. But to me, I'm thinking, is it smart to be promoting the increased intake of processed refined grains essentially? And I'm not saying we can not eat those things. Just to pull back a little bit. I'm not saying we can't include those. We just want to include them within moderation. So all that being said, my focus and my recommendation is to put the majority of our focus on natural sources of foliage.

So that's the folate that's naturally there in dark leafy, green vegetables, avocados, asparagus, citrus, fruits, nuts, seeds, eggs. There's a lot of ways you can get natural folate. So that's the kind I say, we spend the majority of our time focusing on and that's also the kind we should look for in supplements too. We want to pick a supplement that has folate versus folic acid because that's what the body prefers and it's absorbed better in the body.

Choline

So another nutrient we want to talk about is choline. Choline has been compared to folate and it's important, although it is a new, relatively new nutrient in the science world. So not many people talk about it and not many providers even know that it's so important. They haven't seen the research out there, especially, doctors that went to school in like the sixties before it was like even discovered, right?

So choline has been compared in pregnancy to folate. It's important in brain and spinal cord development. It's mostly found in eggs, specifically in the yolks. So I always like to say, make sure you eat the yolk whenever you're eating eggs, because a majority of the nutrients are in the yolk.

Iron

Iron is obviously super important too. I think iron is the second nutrient people think of when we think of what nutrients are important for pregnancy, because your risk of iron deficiency is extremely likely because your blood volume is continuing to increase as you get bigger and bigger. As baby grows bigger and bigger- iron is super important for overall development of baby. Also, just for you to have energy, because pregnancy is so hard and you experience fatigue a lot in the first trimester. And I mean, throughout the whole pregnancy, but iron is a nutrient that's super important to make sure you're maintaining your energy levels. Super important, if you are feeling super fatigued to get your iron levels tested. Cause that's definitely a red flag.

Testing is so important because not everyone needs iron supplements, sometimes providers will just put blanket recommendation out there. They'll just like list off nutrients. When in reality it should be individualized to you. And if you don't need to supplement with iron, you shouldn't. It can cause stomach issues and constipation and things like that. So if you don't need to supplement with iron, if your levels are looking good, then we don't need to put you through that. So test, if you can. If your iron levels are looking good then I would honestly recommend finding a prenatal without iron because for lot of people, it does cause constipation and things like that.

There's different forms of iron, too. So if you are someone who does need iron try different forms of iron. Try food first, I'm totally a food first dietician. So the best way to increase your iron levels is by through food. So definitely work on increasing high iron foods. There's heme iron and there's non-heme iron. Heme iron is the kind that's better absorbed by our bodies and that's the kind that's found in animal products. So that's kind of where we want to put our majority focus is getting iron from animal products. Ideally from red meat, chicken, those kinds of things. You can include plant sources too, those aren't going to be like the best to increase your levels. Spinach is one of the best sources of iron from plants. Pumpkin seeds are great too. My final tip is to pair them with some source of vitamin C, especially with the non-heme sources because vitamin C will enhance iron absorption.

How much should we be eating to know we're getting enough from food?

So I say food first because ideally we want to strive to meet our nutrient needs through food. Then use supplements as an insurance policy that we're getting everything that we need. So a prenatal vitamin is not going to provide everything you need. It just doesn't. And it won't. So you have to think about your food. There are certain times in life that I think it's necessary to supplement and pregnancy is one of those times because your needs are heightened.?Your needs are higher for nutrients than they will likely ever be in your life during pregnancy and breastfeeding. Your needs are so high, so it can be challenging to meet those nutrient needs, especially if you're like a smaller person and you don't eat that many calories.

So if you are eating around 1600 calories, you won't be able to meet your nutrient needs because you're just simply not eating enough food. So in that case you definitely need to be taking a well-rounded prenatal vitamin. I have worked with people that don't want to take anything that they don't want to supplement with anything. I say maybe we can just take a few like individual nutrients to make sure you're good to go, but yeah, if you don't want to supplement- you're going to have to be really on top of your planning.

You're just going to have to be able to run through the nutrients in your head and look at your days and plan them out. You can't just like wing it and go by the fly. I think we should all do a little bit of planning, even if we are taking a prenatal vitamin, but pregnancy is hard too, right? There's so many ups and downs. There's morning sickness, heartburn, fatigue. There's so many things that you're going to go through that make it challenging to stay on top of your nutrition. We just want to make sure we're doing the best we can.

How Do we Know What Prenatal to Pick?

So I always say, I wish that people spent the amount of time and money on their nutrition and food and planning versus the time they spend on finding supplements and spending money on supplements, because truly the food you eat is way more important.

So just to preface it with that, however, we do want to find a supplement that is quality and that is going to work. The number one thing to look for is if the brand is third-party tested. So essentially that means they've paid a third party to take their supplement, run it through tests, to make sure that it is free of certain harmful things. That what they're saying is in there, if they're saying so much of a certain vitamin in there, that that is actually true.

It's pretty apparent if this is something that they have done. They usually have stickers that will say, 'third-party tested' on the bottle. If you're doing online research, usually it's clear on their website. That's definitely a good way to know if they're a quality supplement brand.

You definitely want to do your due diligence. People are always asking, which one do you recommend? Which one do you recommend? And I never bulk recommend one, because that really doesn't make any sense. It should be individualized. There's so many factors that come into play, but of course always third-party testing.

Nausea and Prenatals

If you think it's your prenatal vitamin that's causing the nausea, I would definitely say changing your prenatal vitamin and trying another. You can also try taking it with food, because that can absolutely help. There are also gummy or powdered versions of prenatal vitamins. If you have one that's a large pill, you can absolutely cut it and break it up to see if that helps too.

So there's just a lot of options when it comes to that. Again, considering what is in your prenatal- iron could be causing some nausea too. So do you need iron? We can look at that. And then nutrients that specifically help with nausea. Magnesium and vitamin B6 can definitely help. I'm going to bring up the point that we do want to try food first. We want to try more natural options. So we want to try increasing our food intake of high magnesium foods, high B6 foods. We want to try ginger, ginger tea or anything like that smells like lemon, eucalyptus, or lavender. If none of those things are working, we can talk about supplements. Your doctor might also want to talk about medications like Zofran and things like that for nausea.

There are so many options out there to help you manage morning sickness and nausea. So try everything. And you never know what might work. A lot of times too, women will say the only thing they can tolerate is carbs. You want to be able to eat something. Some calories is better than nothing at all. But I usually say is try to follow them up after with some source of protein. So, if you can eat a piece of plain toast and then maybe 30 minutes later, have some nuts, a piece of chicken, or have a piece of cheese. Something that has protein and fats in it. So you're getting some other nutrients that will be better to manage your blood sugar, all of those types of things.

Constipation in Pregnancy

As far as constipation goes, the two things we want to focus on are fiber and fluid. So increasing fiber foods, like cooked vegetables. Vegetables in general, but cooked is usually more advantageous because women often experience bloating and gas in pregnancy. So cooking vegetables can help with that. Fruits and vegetables are really high in fiber. Apples, brussel sprouts, lentils, chia seeds. Chia seeds are unique in that they can actually help with diarrhea and with constipation. You do want to make sure anytime you're increasing your fiber, you also increase fluids because it could make you more constipated.

What about Heartburn in Pregnancy?

One of the best things I say is walking after a meal, I know that's not super food related, but walking gets your digestion going. So the worst thing you can do after a meal is lie down. So don't lay down on the couch after a meal, because you're only like helping gravity pull that acid back up your esophagus. So at the least you want to sit up straight on the couch and work on your posture to make sure digestion is moving. But best case scenario, you go for like a 10 to 20 minute walk after you eat.

So you can eat small frequent meals throughout the day can really help your body is having a hard time, digesting it all. Trigger foods is another and super important tip. A lot of people have that one or two food, food groups, or specific foods that will trigger it. A lot of times it's tomatoes because they're super acidic. So it's important to find what your trigger food is. Sometimes dairy will help, but some people say that dairy makes their heartburn worse. So again, it's individualized and you just kind of have to figure out what helps your heartburn and what are your triggers. That way you can avoid that food or minimize it.

Healthy Fats

Fats are super important and fats do not correlate to the fat on your body. So I think that that's definitely something we want to bust as a myth. Your baby's brain is like 60% fat and it's being made from scratch. So you definitely need healthy fats. And then to that point as well, your need for fat soluble vitamins increases during pregnancy. So you have to eat fat for your body to absorb those vitamins. So it's super important that you have healthy fats in your diet.

So very specifically in oils like cooking oils, we want to do our best to avoid processed vegetable oils. Instead use like avocado oil, extra virgin olive oil, real butter, coconut oil is fine. Also nuts and seeds, avocados, olives, the fats that are naturally found in meats, fatty types of fish. Definitely lots of healthy fat options. We also don't need to limit our fat in dairy. I actually recommend full fat dairy during pregnancy.

If you're lactose intolerant and you can't eat dairy at all, that's okay. Dairy is a huge source of calcium, but there's plenty other foods that have calcium. You just have to kind of be a little more cognizant of like where your calcium is coming from.

Most milk alternatives can all generally fit in your prenatal diet. You just want to be aware of what nutrients you're missing and where you're getting those nutrients. Because most of those milks don't have protein like cow's milk does. So those aren't going to be a source of protein for you. They aren't going to be a source of B vitamins like cows milk is they aren't going to be a source of B12. So if you are choosing like a plant-based milk, we do want to try to pick one that is fortified with some nutrients. Dairy can be a source of vitamin D one of the only sources of vitamin D, because vitamin D is so hard to get from food. So that's another nutrient to think about. Dairy as a major source of iodine. So there are definitely nutrients you want to kind of think about if you are not including dairy in your diet at all.

Looking for more? You can find Ryan at https://www.theprenatalnutritionist.com/.  She has also created The Prenatal Nutrition Library, which gives you clear answers to guide you through a healthy, feel-good pregnancy using food first.  She has also shared her Recommended Grocery List! You definitely want to check out Ryann's resources if you are trying to conceive, pregnant, or even postpartum as you try to balance your nutritional needs!