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Prenatal Nutrition from Preconception to Gestational Diabetes · Fit As A Fiddle

0:00
SPEAKER_01: If you ever compare two different prenatal vitamins, they are totally different.
0:04
SPEAKER_01: So telling someone just take a prenatal vitamin, well, that's not necessarily helpful advice because you don't know what they're taking.
0:12
SPEAKER_01: Um, and it also totally depends on the person.
0:14
SPEAKER_01: What are those preconception nutrient stores?
0:16
SPEAKER_01: Because if they were deficient in a certain nutrient, they might need additional supplements on top of that prenatal vitamin.
0:23
SPEAKER_02: Hello, everyone.
0:25
SPEAKER_02: I'm your host, Dr.
0:26
SPEAKER_02: Sneha Ghazi, a physical therapist, course creator, and mom.
0:30
SPEAKER_02: I own Sneha Physical Therapy, a private practice in New York City, and created the course Master Your Pelvic Floor to help you transform the way you think about and move your body.
0:41
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0:47
SPEAKER_02: At the link in all show notes.
0:49
SPEAKER_02: Each episode brings phenomenal guests in the health and wellness space who share inspiring tips and tangible advice.
0:56
SPEAKER_02: All things health and wellness starts right here.
1:00
SPEAKER_02: Welcome to this week's episode on Fit as a Fiddle.
1:04
SPEAKER_02: Our guest today is Mel Spinella.
1:07
SPEAKER_02: She is a prenatal nutritionist and she's the founder of Well by Mal Nutrition.
1:12
SPEAKER_02: And today we're gonna be talking all things nutrition, which is more than just food that you eat in terms of like breakfast, lunch, and dinner.
1:21
SPEAKER_02: And she's gonna really talk to us so much about what is good nutrition supposed to mean for because there's a lot of misunderstanding, and there's been, you know, and it's an evolving field because it hasn't been studied so well, historically speaking.
1:37
SPEAKER_02: So we have really good information now, and Mel specializes in helping people optimize their nutrition through preconception into pregnancy and into postpartum.
1:48
SPEAKER_02: So without further ado, welcome to the show.
1:50
SPEAKER_02: Mel, thank you so much for being here.
1:52
SPEAKER_02: Thank you, Sna.
1:53
SPEAKER_02: I'm so excited to be here today.
1:55
SPEAKER_02: Yeah, absolutely.
1:56
SPEAKER_02: I would love if you could tell our listeners a little bit more about yourself, what brought you into this space, and what you do on a day-to-day basis.
2:05
SPEAKER_01: Yeah.
2:06
SPEAKER_01: So as you mentioned, my name is Mel, and I am a registered dietitian who specializes in pregnancy.
2:13
SPEAKER_01: So I see women for a whole host of reasons, um, for you know, preconception, if they want to put their body in the best position possible to conceive and have a healthy pregnancy.
2:24
SPEAKER_01: Um, and the majority of the people I see are pregnant.
2:27
SPEAKER_01: So it could be anything from certain conditions like gestational diabetes to wanting to nourish themselves with the right foods or review their supplements to make sure they're on track, or experiencing symptoms like morning sickness or reflapse, which are super common during pregnancy, but there are so many things that we can do to help alleviate and even prevent those symptoms.
2:49
SPEAKER_01: So, overall, helping mamas to be properly nourish themselves during pregnancy in a feel-good way.
2:55
SPEAKER_01: So, this is actually my second career uh before becoming a dietitian.
2:59
SPEAKER_01: I was an engineer for about a day, about a decade working in supply chain and manufacturing and kind of got interested in nutrition like after college during that time, and you know, found that I was spending a lot of time getting like inundated with nutrition information.
3:15
SPEAKER_01: I was listening to a podcast, I was reading the books, I was, you know, reading articles online and I was getting really frustrated because I found that there was so much conflicting information.
3:24
SPEAKER_01: I just I didn't know where to get my nutrition information from.
3:28
SPEAKER_01: So I decided, okay, like I want to get a formal education, um, went and got my master's at Columbia.
3:34
SPEAKER_01: And in the beginning of the program, one of the first classes we take is human development.
3:40
SPEAKER_01: And, you know, prenatal nutrition had never really crossed my mind until that moment.
3:44
SPEAKER_01: And that's really where I, you know, fell in love with it and thought it was so cool how what mom was eating, those nutrients played a key role in baby's broken development and also how mom felt.
3:55
SPEAKER_02: I love that.
3:56
SPEAKER_02: I um always think back to this.
3:59
SPEAKER_02: I studied psychology in at school and in undergrad.
4:03
SPEAKER_02: And I remember there was this one study that our professor told me about how they studied like mothers who in um had some ingested some various amounts or a none of lemon concentrate or like some kind of acidic concentrate.
4:18
SPEAKER_02: And then they did like a swap test.
4:20
SPEAKER_02: And as soon as the babies were born, they put a little bit of the lemon concentrate on their tongues.
4:24
SPEAKER_02: And then the ones that whose moms had a quite a large bit of the lemon concentrate, just like you know, did them.
4:33
SPEAKER_02: And then the ones that didn't have that exposure were like, like, like get away from me.
4:38
SPEAKER_02: And it was just to, and I, and that was the first time, like you said to your point, that was the first time I was like, oh, what moms eat makes a difference in what babies, for example, preferences are in that situation.
4:51
SPEAKER_02: But I'm pretty sure it's so much more than that.
4:53
SPEAKER_02: So I'm excited to talk to you and learn because I am not well versed in this field, and I'm sure that listeners are coming here to optimize their health and are thinking about pregnancy or are already pregnant, um, or just want to educate themselves on a nutrition period.
5:10
SPEAKER_02: So um let's dive into some of the details here.
5:14
SPEAKER_02: So, what firstly, can you define what the period of preconception would look like?
5:19
SPEAKER_02: I'm not sure if there's like a specific time frame in your world that that could be.
5:23
SPEAKER_02: Um, but what about pre-nate uh preconception nutrition sets up a healthy pregnancy in the first place?
5:32
SPEAKER_02: What are those the things that we need to be thinking about then?
5:35
SPEAKER_01: Yeah, that's a good question.
5:37
SPEAKER_01: So the preconception time, when I'm thinking about it, I'm thinking at least three months before pregnancy.
5:44
SPEAKER_01: So this period is really important to start building up your nutrient stores because nutrients play a really important role in your fertility as well as having a healthy pregnancy.
5:56
SPEAKER_01: And during pregnancy, everyone knows like calories increase somewhat, you know, in the second and third trimesters.
6:03
SPEAKER_01: But something a lot of people don't realize is what it can increase quite a bit is your needs for certain vitamins and minerals.
6:10
SPEAKER_01: For example, iron during pregnancy needs increase from 50% from the preconception time, which is pretty significant.
6:17
SPEAKER_01: Um, so it's really important pre-conception to start building those nutrient stores.
6:22
SPEAKER_01: Um, it's actually recommended to start taking a prenatal vitamin at least three months before becoming pregnant, even longer if you have any kind of nutritional deficiencies.
6:32
SPEAKER_01: So this will be a good time to get some baseline lab work done to see if you have any nutritional deficiencies, like for example, vitamin D, which a lot of people in these colder climates uh tend to be deficient in the winter months.
6:43
SPEAKER_01: Umate, vitamin B12, iron panel, and then other lab work, things like getting your blood sugar checked, um, getting your thyroid checked.
6:51
SPEAKER_01: Those will be good things um to know if anything is out to correct prior to becoming pregnant, because they can impact a healthy pregnancy.
7:00
SPEAKER_02: I have a stupid question.
7:01
SPEAKER_02: Sorry.
7:02
SPEAKER_02: Yeah, I have a really stupid question.
7:04
SPEAKER_02: I don't know the answer for this question.
7:06
SPEAKER_02: So how what does what kind of nutritional changes affect your thyroid?
7:12
SPEAKER_02: I just I don't know.
7:13
SPEAKER_02: I genuinely don't know.
7:14
SPEAKER_02: Is there something you can do nutritionally, or is it just like the medications that you have to be on?
7:20
SPEAKER_01: Yeah, so there's a variety of different reasons, depending on the person, um, and depending on, you know, their medical history and whatnot.
7:27
SPEAKER_01: But, you know, there's medications which can help improve your thyroid.
7:31
SPEAKER_01: Um, also certain nutrients like iodine are really supportive of your thyroid and then lifestyle, things like stress and sleep and whatnot um can all play a role.
7:40
SPEAKER_02: Okay, good to know.
7:41
SPEAKER_02: Sorry, please continue.
7:43
SPEAKER_02: I will ask a bunch of second questions because I genuinely have a lot of questions on nutrition because I never studied this.
7:49
SPEAKER_01: No, that's a great question.
7:51
SPEAKER_01: And speaking of iodine, that's an important nutrient, especially in those early weeks of pregnancy, because baby's thyroid isn't developed yet.
7:59
SPEAKER_01: So baby is completely reliant on mom's thyroid hormones.
8:04
SPEAKER_01: So that's why it's really important to have a good amount of iodine to support that.
8:08
SPEAKER_01: Um, another nutrient is folate, which I feel like this is the one nutrient like everyone hears about folate or folic acid for pregnancy.
8:16
SPEAKER_01: So that nutrient is so important because it helps prevent a certain birth defect, which is called the neural tube defect.
8:22
SPEAKER_01: And the neural tube actually closes in the early weeks of pregnancy before some people even know that they're pregnant.
8:28
SPEAKER_01: So that's why it's really important to be building up those nutrient stores, um, because certain nutrients, vitamin D is another one, are really important in those early weeks of pregnancy.
8:38
SPEAKER_02: I love that.
8:40
SPEAKER_02: Um, okay, so we want to focus on taking those prenatals.
8:46
SPEAKER_02: Are we like, I know you probably can't like support certain brands or not on the show, or maybe you can, I don't know.
8:53
SPEAKER_02: But are there what are we looking for in terms of the um ratios or percentages or like the measurements and MM something, something or the, you know, oh, there's like various different types of measurements for these things.
9:07
SPEAKER_02: Like when it comes to like vitamin D or like the big ones, like the three or four big ones, like how much should we be having preconception and looking at those labels?
9:15
SPEAKER_02: Because I think people tend to just like, whatever.
9:17
SPEAKER_02: And then I've been told, and you can correct me, sometimes it was not enough.
9:21
SPEAKER_02: And so you have to take this like extra thing.
9:25
SPEAKER_01: So totally hell, so there is so much variability here.
9:29
SPEAKER_01: So just to start with the prenatal vitamin, if you ever compare two different prenatal vitamins, they are totally different.
9:36
SPEAKER_01: So telling someone just take a prenatal vitamin, well, that's not necessarily helpful advice because you don't know what they're taking.
9:44
SPEAKER_01: Um, and it also totally depends on the person.
9:46
SPEAKER_01: What are those preconception nutrient stores?
9:48
SPEAKER_01: Because if they were deficient in a certain nutrient, they might need additional supplements on top of that prenatal vitamin.
9:55
SPEAKER_01: Plus, it depends on the person.
9:57
SPEAKER_01: Like, are they following a vegetarian or vegan diet, for example?
10:01
SPEAKER_01: And, you know, not eating fish is a big one for pregnancy.
10:05
SPEAKER_01: Then, like, if they're not eating fish, they might need a DHA supplement or a fish oil, for example.
10:10
SPEAKER_01: So it does come down to the person, but things that I think are important to be aware of.
10:17
SPEAKER_01: Um, one is choline.
10:19
SPEAKER_01: That is a new nutrient that like a not a new nutrient, but one that's being talked about more.
10:23
SPEAKER_01: Um, and that's a really important nutrient because it is plays a key role in baby's brain development.
10:29
SPEAKER_01: And it's not in every prenatal vitamin.
10:32
SPEAKER_01: So, or some prenatal vitamins have like 55 milligrams, which is a pretty small amount.
10:38
SPEAKER_01: The recommendation is 450 milligrams per day in pregnancy.
10:42
SPEAKER_01: So some companies will have a small amount and say that they have the nutrient, but a lot of people don't realize it's nowhere near the amount that you need in pregnancy.
10:51
SPEAKER_01: So eggs are one of the best food sources of choline.
10:55
SPEAKER_01: Um, sticking to choline for now.
10:57
SPEAKER_01: So if you're eating about two to three eggs per day, you'll meet your choline needs.
11:01
SPEAKER_01: It meets over half your choline needs, so you'll be pretty close.
11:04
SPEAKER_01: Um, or making sure that you have a prenatal vitamin with choline to be getting that amount.
11:10
SPEAKER_01: Now, something like vitamin D, that can be pretty variable, the amount in a prenatal vitamin.
11:15
SPEAKER_01: It can have as little as 600 IUs I've seen, all the way up to 4,000 I've seen.
11:20
SPEAKER_01: And that's something that would be really helpful to get checked, um, just because people's levels are so variable and the time of year also makes a really big impact on your vitamin D.
11:31
SPEAKER_01: So some people may need additional supplementation beyond their prenatal vitamin.
11:35
SPEAKER_01: Um, it really depends on the person.
11:37
SPEAKER_01: Um, other things, I recommend a prenatal vitamin that contains either iron or calcium, but not both, because calcium and iron, they actually compete for absorption.
11:48
SPEAKER_02: So in sorry, what did you say?
11:51
SPEAKER_02: Iron and calcium.
11:53
SPEAKER_02: This is a free suction, folks.
11:57
SPEAKER_01: Yeah, so they compete for absorption.
12:00
SPEAKER_01: So if you, you know, need both of the, you do need both of these nutrients, but ideally you want to consume them at separate times just to optimize your absorption of them.
12:09
SPEAKER_01: So, like, let's say, kind of jumping ahead here, but let's say you are anemic, which is pretty common, you know, in the third trimester later in pregnancy, because there's an increase in blood volume and fluid volume.
12:20
SPEAKER_01: Um, so pregnant women are more susceptible to anemia later in pregnancy.
12:25
SPEAKER_01: Um, so if you're adding an iron supplement, but you know, having it at the same time as you're you're having your morning coffee with some milk or, you know, big ball of Greek yogurt or with a calcium supplement, um, it's not gonna be absorbed as optimally as if you had it separately.
12:40
SPEAKER_02: Good to know, everybody.
12:43
SPEAKER_02: Please take notes.
12:44
SPEAKER_02: You will forget otherwise.
12:46
SPEAKER_02: Okay, let's jump into prenatal nutrition.
12:50
SPEAKER_02: So we want to obviously keep all of these reserves.
12:52
SPEAKER_02: I'm sure like so much of what you just said holds up for in terms of supplementation throughout the pregnancy.
12:58
SPEAKER_02: Like we want to make sure our vitamin D reserves are up.
13:00
SPEAKER_02: We want to continue the choline, we want to continue the um, what's that thing for what's the other one that you said?
13:06
SPEAKER_02: Folate, folic acid?
13:08
SPEAKER_02: Yep.
13:09
SPEAKER_02: So we maintain those supplementations.
13:11
SPEAKER_02: Do we need to change it during trimesters or do we just keep it kind of going similarly?
13:18
SPEAKER_01: That's a good question.
13:19
SPEAKER_01: So throughout pregnancy, your OB typically is monitoring your iron levels.
13:24
SPEAKER_01: Um, because again, um, there's a higher risk of becoming anemic or having lower iron later in pregnancy.
13:30
SPEAKER_01: Um, so that's something some people may need to add additional iron as they progress through pregnancy, um, because it becomes more important.
13:39
SPEAKER_01: But what I like to recommend, or what I typically recommend, is focusing on certain nutrients that become especially important later in pregnancy.
13:48
SPEAKER_01: So, on top of the prenatal vitamin, um, three nutrients I'm thinking of iron, like I mentioned, also calcium and magnesium, those are ones that I find become especially important later in pregnancy.
13:59
SPEAKER_01: So calcium and iron absorption to baby is the greatest um in that third trimester.
14:05
SPEAKER_01: And you want to make sure that you are consuming enough, not only for baby's health, but also for mom's health.
14:10
SPEAKER_01: Because during pregnancy, baby eats first.
14:13
SPEAKER_01: So whatever you're consuming, those nutrients are preferentially going to baby to make sure that they have what they need to grow and develop.
14:19
SPEAKER_01: But if mom's not consuming enough, in the case of calcium, actually take calcium from mom's bones, which can impact her bone health.
14:28
SPEAKER_01: So you want to make sure that you're consuming enough, not just for baby, but also for mom.
14:32
SPEAKER_01: Uh, so prioritizing those calcium-rich foods later on in pregnancy.
14:37
SPEAKER_01: So, of course, dairy is a great source of calcium, almonds are a good source of calcium, things like leak beet greens, chia seeds have some calcium, salmon with the bones, those are all good foods to be incorporating.
14:48
SPEAKER_01: Um, and salmon I didn't mention it's just like a good food throughout pregnancy because it has DHA, which is important for baby's brain development.
14:55
SPEAKER_01: And that's one that's in some prenatal vitamins, but not all of them.
14:59
SPEAKER_01: Um, I digressed a little.
15:01
SPEAKER_02: Wait, I have a question.
15:02
SPEAKER_01: What do vegetarians do who don't eat fish?
15:06
SPEAKER_01: Yeah, so you can get um DHA algae-based supplements, those exist.
15:12
SPEAKER_02: And this this is DHA, which is the same as what you were discussing before, as like something that you can add into your prenatal, like it can be like an optional addition into your prenatals, but not that all prenatals have it.
15:26
SPEAKER_01: Yeah, some prenatals have it.
15:28
SPEAKER_01: Um, some don't.
15:29
SPEAKER_01: So if you're eating fatty fish, the low mercury ones like salmon, sardines, um, the low mercury tuna, if you're eating that a couple times a week, you'll likely meet your DHA needs.
15:39
SPEAKER_01: If not, that's when you might want to consider a DHA supplement, just to also know those needs.
15:44
SPEAKER_01: You said fish oil.
15:46
SPEAKER_01: You can have is that have DHA in it?
15:49
SPEAKER_01: Well, it would depend on the supplement.
15:51
SPEAKER_01: Um, but yeah, I would look for a supplement that specifically has DHA in it.
15:55
SPEAKER_01: Okay.
15:56
SPEAKER_01: Cool.
15:57
SPEAKER_01: And not just so DHA is an omega-3.
15:59
SPEAKER_01: A lot of people I find are taking omega-3 supplements, but the omega-3 DHA is that one that's specifically important for brain development.
16:07
SPEAKER_01: Got it.
16:08
SPEAKER_01: Is this different?
16:09
SPEAKER_01: How is this different from the choline?
16:12
SPEAKER_01: That's a good question.
16:13
SPEAKER_01: So the DHA is an omega-3 fatty acid, whereas the choline is similar to a vitamin, it's like a cousin to the B vitamin, but not exactly.
16:23
SPEAKER_01: Um, and they just play different roles in the body.
16:25
SPEAKER_01: So the DHA also supplies, um, sorry, supports eye development as well.
16:30
SPEAKER_01: And the choline is also important in in this process called one-carbon metabolism, which is also important for cell proliferation and whatnot, which is really important during a time like pregnancy.
16:42
SPEAKER_02: Okay, I have to come back to a previous point.
16:45
SPEAKER_02: This is turning into a full, I always tell people like, oh, it's a conversation.
16:49
SPEAKER_02: It's not a question and answer.
16:51
SPEAKER_02: This is a question and answer Mel at all.
16:54
SPEAKER_02: Okay.
16:55
SPEAKER_02: My question is this whole magnesium business, you know?
17:00
SPEAKER_02: I've been hearing about it.
17:01
SPEAKER_02: I've listened to a couple podcasts on it.
17:03
SPEAKER_02: I have heard my patients ask me questions on it.
17:05
SPEAKER_02: I am not licensed to provide like a significant amount of information.
17:09
SPEAKER_02: But what I what I'll have heard, which you can tell me, is like it's best absorbed through the skin.
17:15
SPEAKER_02: So to get like the lotions or like the bats with the salt, like the magnesium salt.
17:20
SPEAKER_02: Um, what do you recommend for specifically for this pregnant population with magnesium?
17:28
SPEAKER_01: Yeah.
17:28
SPEAKER_01: So it depends on what symptoms they're having.
17:32
SPEAKER_01: So there's different forms of magnesium and they serve different purposes.
17:36
SPEAKER_01: For example, magnesium citrate can be really helpful for digestion, which a lot of people struggle with during different times of pregnancy with those hormonal changes, um, constipation.
17:47
SPEAKER_01: So that's something that could be helpful.
17:50
SPEAKER_01: Or um later on in pregnancy, especially, you know, during the warmer months, those muscle cramps.
17:55
SPEAKER_01: Like some people wake up in the middle of the night with muscle cramps, um, electrolytes with magnesium can be helpful.
18:01
SPEAKER_01: And then last, if you have any kind of pregnancy insomnia, um, which is common, I know I've had it, um, it can be pretty miserable.
18:09
SPEAKER_01: Um, magnesium glycinate can be really helpful to just promote that nice restful sleep.
18:15
SPEAKER_02: Glycinate.
18:17
SPEAKER_02: Yeah, my patients ask me about this a lot.
18:19
SPEAKER_02: The pregnancy and not insomnia can be so tricky because I'm like, ah, I know it's so hard.
18:24
SPEAKER_02: I've had it on and off before in my first pregnancy.
18:28
SPEAKER_02: And I remember telling my patients, like, if whatever we can do positionally, like get the pillows, get the cushions, if that's the issue, like try your best to provide like a really good sleep environment so you can fall asleep and stay asleep.
18:41
SPEAKER_02: Um, but sometimes, yeah, they still really struggle with it.
18:43
SPEAKER_02: It's either the cramping or like, you know, the anxious thoughts.
18:46
SPEAKER_02: And I, of course, I refer them to um uh a mental health therapist that specializes in perennial care.
18:52
SPEAKER_02: But it can be so, so frustrating for people because they're like, I know I'm not gonna sleep once the baby comes.
18:58
SPEAKER_02: I know we're gonna be up all night, but I'm up all night right now.
19:01
SPEAKER_02: And it's so tricky.
19:03
SPEAKER_02: So there we go.
19:04
SPEAKER_02: We got a good tip here.
19:05
SPEAKER_02: You gotta try all the things to get that rest so that you can prepare for baby, right?
19:11
SPEAKER_02: Totally.
19:12
SPEAKER_02: Awesome.
19:13
SPEAKER_02: Okay, sorry.
19:14
SPEAKER_02: You go ahead and continue with the train of thought that I probably have interrupted 25 times now.
19:20
SPEAKER_01: Where were we?
19:21
SPEAKER_01: I think, yeah, I think we were talking about nutrients as you progress through pregnancy.
19:26
SPEAKER_01: And I think we covered the calcium, the iron, and magnesium.
19:28
SPEAKER_01: I don't think I had anything else to add there.
19:30
SPEAKER_02: Okay, perfect.
19:32
SPEAKER_02: Um, okay, so let's talk about like the foods themselves.
19:36
SPEAKER_02: I know you mentioned the salmon is good and a couple of the other things.
19:41
SPEAKER_02: What are things that people like should really consider avoiding?
19:46
SPEAKER_02: I know that there's like a lot of talk around like, is it really that bad?
19:50
SPEAKER_02: Is it not that bad?
19:51
SPEAKER_02: Kind of a thing.
19:52
SPEAKER_02: So what's the kind of latest conversation around this?
19:55
SPEAKER_02: Yeah, so this is a bit of a gray area.
19:58
SPEAKER_01: So I gotta kind of start with the ones that are easier to answer.
20:02
SPEAKER_01: So things should be kind of avoided or limited during pregnancy.
20:06
SPEAKER_01: So, first, no amount of alcohol is considered safe for pregnancy.
20:10
SPEAKER_01: Second, is caffeine should be limited.
20:12
SPEAKER_01: It's no more than 200 milligrams per day, which is roughly one cup of coffee, depending on how strongly it's brewed.
20:18
SPEAKER_01: Third, high mercury fish.
20:20
SPEAKER_01: So different fish contain different amounts of mercury, and it's okay to eat fish, like I said, like those low mercury fatty fish like salmon, sardines, um the low mercury tuna, which is skitjack or canned light, those are fine options for pregnancy and contain key prenatal nutrients.
20:38
SPEAKER_01: So we don't want to totally avoid fish.
20:39
SPEAKER_01: We just want to avoid the ones that are higher in mercury.
20:42
SPEAKER_01: And the FBA actually has like this really handy chart.
20:45
SPEAKER_01: Um, I recommend like screenshotting it.
20:47
SPEAKER_01: So if you're at the store or like at a restaurant, you can just refer to it.
20:51
SPEAKER_01: But it tells you which fish are low mercury, which are medium mercury, and which are high, and what the safe serving sizes are to consume, if any, during pregnancy, as well as breastfeeding, if you choose to do that.
21:02
SPEAKER_01: Um and then last, um, kind of in this category is like herbal blends.
21:09
SPEAKER_01: Um, so more so like if you are taking a supplement or certain herbal teas are recommended to be avoided during pregnancy because we simply don't have the research on whether or not they're safe to consume.
21:22
SPEAKER_01: So things like if you're having a pure ginger tea or a pure peppermint tea, or like the caffeinated teas, like the green tea or the black tea, um, of course, you'd need to consider that into your caffeine allotment for the day.
21:33
SPEAKER_01: Um, but those are generally considered safe to consume during pregnancy.
21:37
SPEAKER_01: One thing I would recommend though is when you're having tea, is looking at the ingredients list because certain brands, um, for example, yogi tea, which is a popular brand, some of their teas contain licorice root in them, which is not safe to consume during pregnancy.
21:53
SPEAKER_01: So it's always important just to check the ingredients list just to make sure it's just the one herb that you think you're consuming.
22:00
SPEAKER_01: Hmm, liquor is root.
22:01
SPEAKER_02: Interesting.
22:02
SPEAKER_02: Um, I what about the what are those things?
22:07
SPEAKER_02: Those uh like white, grassy looking things.
22:10
SPEAKER_02: What are those things called?
22:12
SPEAKER_02: That are like often in like a pad tie on top of a pad thyme.
22:16
SPEAKER_02: Oh, sprouts.
22:17
SPEAKER_02: That um there's like a lot of questions and conversations around that one.
22:22
SPEAKER_02: I remember my cousin like swatted my hand before I put a bite of Thai food in my mouth.
22:27
SPEAKER_02: Like, relax.
22:30
SPEAKER_01: Yeah, so that's kind of the next category of foods to avoid is food safety concerns.
22:36
SPEAKER_01: Oh, what I find is a lot of people are given a long list of foods to avoid during pregnancy, but they're not necessarily sure why they need to avoid them, which can create a lot of fear, right?
22:46
SPEAKER_01: Like you're told, oh, avoid sprouts, for example.
22:48
SPEAKER_01: And then all of a sudden you're out to dinner and eating, you know, a salad or whatever the case may be.
22:54
SPEAKER_01: And then people find themselves googling, oh, well, can I eat this?
22:57
SPEAKER_01: If I can't eat that, can I eat this?
22:58
SPEAKER_01: And then it turns into kind of this constant questioning of everything that you're eating.
23:02
SPEAKER_01: So I'd like to explain the background here.
23:05
SPEAKER_01: Um, so basically, during pregnancy, mom is um has a depressed immune system.
23:11
SPEAKER_01: So she is more vulnerable to getting foodborne illness.
23:15
SPEAKER_01: So we recommend avoiding higher risk foods to reduce the likelihood of getting foodborne illness because you know that could be harmful to baby, of course.
23:26
SPEAKER_01: So higher risk foods um are often told things like undercooked eggs, undercooked meat, undercooked fish, those sorts of things.
23:34
SPEAKER_01: Um I like to say like that's kind of up to the person and their comfort level in terms of consuming, because of course, something that is fully cooked is going to be lower risk than something that is a little bit less cooked.
23:49
SPEAKER_01: Um, so it kind of ends it it's up to the the pregnant person's comfort level to decide what they feel comfortable eating.
23:56
SPEAKER_01: But then a lot of people don't realize um that certain foods like pre-cut fruits and vegetables are actually higher, one of the higher risk foods um in terms of food safety.
24:06
SPEAKER_01: So that is something that I do recommend avoiding.
24:09
SPEAKER_01: And not saying don't eat fruits and vegetables.
24:11
SPEAKER_01: Of course, we want to be eating fruits and vegetables during pregnancy, but taking those extra safety steps of buying the whole fruit or vegetable, washing it yourself and cutting it yourself just to reduce that risk of foodborne illness.
24:22
SPEAKER_01: The other time I'd say, like you could get pre-cut is if you're gonna heat it.
24:25
SPEAKER_01: Like if you get a bag of broccoli and you're gonna put it in the air fryer or in the oven and bake it, then that heat would significantly reduce that risk.
24:33
SPEAKER_01: Um, in terms of cheese, pasteurized cheese, I recommend, um, it's just gonna be lower risk of foodborne illness than raw cheese.
24:41
SPEAKER_01: Now, most cheese in the US is pasteurized, but I always still recommend checking the ingredients list.
24:45
SPEAKER_01: Like I've seen one at Trader Joe's that's raw.
24:48
SPEAKER_01: Um, if you're going to like a fancy cheese shop, then you might see some raw cheeses.
24:51
SPEAKER_01: So always confirm by checking that ingredients list.
24:54
SPEAKER_02: I love that.
24:55
SPEAKER_02: It's more of like a precaution and like avoid if possible, but like if it just happens to be that it it's like a small quantity and it's kind of floating around in something, like it's not the end of the world and not to be so anxious, which is I think what sometimes people get caught up on the absolute no's and then the please avoid if possible, when possible, kind of things.
25:18
SPEAKER_02: So I like how you distinguish those things.
25:21
SPEAKER_01: Um yeah, and sorry, just to add one thing there, sorry.
25:25
SPEAKER_01: Um, yeah, and a lot of people get scared if they accidentally eat one of those foods.
25:29
SPEAKER_01: And it's not that, and I'm talking about the food safety, um, the ones that that are a food safety concern, and it's not that anything, you know, it's guaranteed that you're going to get sick, it's just a higher risk.
25:41
SPEAKER_01: So just to make the best decisions possible to support a healthy pregnancy.
25:47
SPEAKER_01: And if you find that you're scared to eat so many foods because, you know, you want to be avoiding all the risks and it's, you know, compromising your nutrient variety or intake, it's creating another problem.
25:58
SPEAKER_01: So we want to make sure that we're going about it in a way that we're still we're making healthy choices to support us and our baby during pregnancy and as well as our mental health.
26:09
SPEAKER_01: I think that's another component.
26:11
SPEAKER_01: Um, you know, some people just kind of going back to like things that, you know, runny eggs, for example, versus fully cooked.
26:19
SPEAKER_01: You know, some people are like, oh, I know, like I I was told I can eat it versus like other people are telling me I absolutely can't.
26:27
SPEAKER_01: And we talk about the risks.
26:28
SPEAKER_01: And then I say, if you are someone that is going to stress about this and think about this after you eat this, not worth it.
26:36
SPEAKER_01: Yeah.
26:37
SPEAKER_01: Like just have the fully cooked one and move on because you also like need to protect your mental health during pregnancy.
26:43
SPEAKER_01: And food should not be a stressor.
26:45
SPEAKER_02: Yes.
26:46
SPEAKER_02: I love the way that you phrase that.
26:48
SPEAKER_02: Um, I just remember when very early in my pregnancy, I think it was probably like one or two weeks after I found out that I was pregnant.
26:56
SPEAKER_02: I had a like a really bad cold.
26:58
SPEAKER_02: And so I took mucinex.
27:00
SPEAKER_02: I forgot that I was pregnant.
27:01
SPEAKER_02: And then I completely, because it was like only like one or two weeks old news for me.
27:05
SPEAKER_02: I totally forgot.
27:06
SPEAKER_02: I took mucin X.
27:07
SPEAKER_02: And then I was like, hold on, I'm supposed to be wary of labels now, which I've never had to in the past, right?
27:13
SPEAKER_02: So I go like read the labels and I like Google the thing, and then it was like, do not take this medication.
27:19
SPEAKER_02: It's the worst for like blah blah blah blah blah blah.
27:21
SPEAKER_02: And I like called the um, I don't know who I called, crying, some healthcare professional, just sobbing on the phone, like, I'd have murdered my baby.
27:30
SPEAKER_02: What do I do?
27:31
SPEAKER_02: My husband like flies me on the floor, just like I'm laughing now because it was just so dramatic.
27:38
SPEAKER_02: Like, one dose of one thing is not the end of the world.
27:42
SPEAKER_02: Like, obviously, avoid the thing that's going to hurt the pregnancy and hurt the baby.
27:46
SPEAKER_02: But like mental health is very important.
27:49
SPEAKER_02: And accidental single ingestions are not going to harm your baby in the way that you think that it's going to, at least.
27:57
SPEAKER_02: So just further propagating what you just mentioned.
28:01
SPEAKER_01: Now, there's a lot of stressors during pregnancy.
28:04
SPEAKER_01: So I hope to make food not be one of those.
28:08
SPEAKER_01: Yes.
28:09
SPEAKER_02: Okay, let's dive into the lovely conversation of morning sickness.
28:13
SPEAKER_02: Um, can we do anything about that nutritionally?
28:18
SPEAKER_02: I know that there's obviously a very, very big range of what people experience.
28:24
SPEAKER_02: It changes from pregnancy to pregnancy often for people.
28:28
SPEAKER_02: And some severe cases, you have to be like highly, highly, you know, medical intervention, hospitalized, IV, things like that.
28:35
SPEAKER_02: Um, but for the very general, just feeling sick in the morning, couple vomits at most, not debilitating, we move right along.
28:43
SPEAKER_02: What can we do for that?
28:46
SPEAKER_01: Yeah, so morning sickness or all day sickness, uh, pretty common in the first trimester.
28:53
SPEAKER_01: And for a lot of people, it does clear up starting in the second trimester, but those two, three months is still quite a bit of time.
29:01
SPEAKER_01: So, vitamin B6 is something that can be really helpful for reducing the nausea.
29:08
SPEAKER_01: It's not included in every prenatal vitamin.
29:10
SPEAKER_01: Um, so that is an important nutrient to look for, especially if you're not feeling well.
29:14
SPEAKER_01: Or if it is included in your prenatal vitamin, you might have some wiggle room to add more.
29:19
SPEAKER_01: So that would be a good conversation to have with your doctor or with a dietitian.
29:24
SPEAKER_01: Additionally, blood sugar balance can be really helpful for nausea.
29:29
SPEAKER_01: So a lot of the times when we have morning sickness, the food aversions may go with it.
29:34
SPEAKER_01: And a lot of people are resorting to plain carbs like crackers and bread and you know, chips, whatever the case may be.
29:41
SPEAKER_01: But if we can pair those with a little bit of protein, fat, or fiber, that's gonna help balance your blood sugar, which can actually help prevent the morning sickness because those blood sugar swings can make even more nauseous.
29:54
SPEAKER_01: Like if you're having toast, can we add some peanut butter on it?
29:57
SPEAKER_01: Or like if you're having chips, can we dip it in guacamole?
29:59
SPEAKER_01: Can we have it with some cheese?
30:01
SPEAKER_01: Can we find ways to pair it with a little bit of protein and fat and some fiber where we can make it more balanced?
30:09
SPEAKER_01: And eating consistently is another one that can go a really long way.
30:13
SPEAKER_01: So starting out in the morning, even if eating food sounds absolutely disgusting, getting a little something in your stomach within an hour of waking up just helps with the day for a better day from a nutrition and nausea standpoint.
30:27
SPEAKER_01: And then continuing to eat a little bit every like two-ish hours, even if you're not hungry.
30:33
SPEAKER_01: Because if you wait until you're hungry, you may have waited too long.
30:36
SPEAKER_01: And then that like empty stomach feeling can trigger the nausea.
30:40
SPEAKER_01: So being prepared, having like good balanced snacks, ready to go, and having them about every two-ish hours to just, you know, prevent that empty stomach feeling can be really helpful.
30:51
SPEAKER_02: I love that.
30:52
SPEAKER_02: And yeah, I know it can be so tough sometimes with the, you know, food aversion to be like eating something is actually going to help.
31:01
SPEAKER_02: But that's why it's really good to find your food preferences too, and just stick to some of those when possible to at least get something down.
31:09
SPEAKER_02: And then maybe you add the, you know, protein fats like a few minutes later once you just like feel a little bit more settled.
31:16
SPEAKER_02: Um, so that you can just have a better day.
31:19
SPEAKER_02: Um, I know that there's been there's such big um variances, and people will be like, I would be brushing my teeth and then vomit in the sink.
31:27
SPEAKER_02: Just I wasn't even hard eating.
31:29
SPEAKER_02: I was just brushing my teeth, but just something just keeps like triggering, uh, can be a trigger and uh really um annoying and frustrating.
31:38
SPEAKER_02: But you're not alone and it literally will go away.
31:41
SPEAKER_02: Um, it will go away and then it'll be done.
31:44
SPEAKER_02: That's the it has a finite end.
31:46
SPEAKER_02: We don't know exactly when, but it will it will be gone.
31:49
SPEAKER_02: Um, that's the good news.
31:51
SPEAKER_02: Um, all right.
31:52
SPEAKER_02: Shall we toggle over to gestational diabetes and have a little conversation about that and what that means and what people should be thinking about?
32:00
SPEAKER_01: Yeah, let's do it.
32:02
SPEAKER_01: So actually, coming off of our conversation on morning sickness and eating mostly carbs, that will not cause gestational diabetes.
32:11
SPEAKER_01: I know that's a common fear, like, oh, I'm so sick, I can only eat bread or carbs, or I ate more sweets in my first trimester.
32:18
SPEAKER_01: Nothing you do or eat causes gestational diabetes.
32:21
SPEAKER_01: So gestational diabetes is largely driven by those placental hormones.
32:26
SPEAKER_01: And in some pregnancies, they result in gestational diabetes.
32:30
SPEAKER_01: They block insulin, lead to insulin resistance, which is where you get these high blood sugars and gestational diabetes diagnosis.
32:36
SPEAKER_01: And this can vary from pregnancy to pregnancy.
32:39
SPEAKER_01: So some people get it one pregnancy, but not another.
32:41
SPEAKER_01: It's really what that placenta and what those placental hormones are doing during that pregnancy.
32:46
SPEAKER_01: So if you get this diagnosis, it is not your fault.
32:49
SPEAKER_01: Um, and there are, you know, nutrition plays a really big uh role in managing your blood sugar.
32:56
SPEAKER_01: So it's kind of what I mentioned before, um, balanced meals.
32:59
SPEAKER_01: So balancing your carbs with protein, fat, and fiber is really important, as well as meal timing and not going too long without eating because our blood sugar really likes that consistency.
33:09
SPEAKER_01: Um and you still eat carbs.
33:12
SPEAKER_01: You need to eat carbs.
33:13
SPEAKER_01: Um, a lot of people, you know, I'll see and they've been doogling and they're like, I've cut out all carbs.
33:17
SPEAKER_01: No, no, no, like you're pregnant, you still need you need to eat carbs.
33:20
SPEAKER_01: I want you to eat carbs.
33:21
SPEAKER_01: They have important nutrients.
33:22
SPEAKER_01: We just need to balance them.
33:25
SPEAKER_01: Um, and also if you get this diagnosis, um, you know, a lot of people are afraid, like, oh, I'm gonna be eating like grilled chicken and broccoli, I'm gonna be eating like these boring meals for the rest of my pregnancy, but you can still include the meals you love.
33:38
SPEAKER_01: Just want to be a little bit more strategic about how you eat those meals or foods to support better blood sugars.
33:45
SPEAKER_01: So food pairing, meal timing and spacing, as well as exercise are all tools to keep your blood sugar in range.
33:54
SPEAKER_02: I love that.
33:55
SPEAKER_02: I love the exercise piece at least.
33:57
SPEAKER_02: Um, what I know you mentioned like every two hours is a pretty good uh, you know, time frame to like try to eat something small, but are there like specific kind of like breakfast, lunch, dinner timings that support not only the blood sugar, but I know how like, you know, in general they say try to eat several hours before bedtime to improve your sleep quality and all those things.
34:24
SPEAKER_02: So thinking about pregnancy-induced insomnia, thinking about blood sugar regulation, are there certain times that people should try to have their big proper meals?
34:34
SPEAKER_02: What do you think?
34:35
SPEAKER_01: Yeah.
34:36
SPEAKER_01: So I would say the smaller meals, um, like eating a little something every two hours, more relevant for the nausea or gestational diabetes.
34:44
SPEAKER_01: Still want to have like three meals, but snacks in between.
34:47
SPEAKER_01: So you're not going longer than like three-ish hours without eating.
34:50
SPEAKER_01: Um, and actually, I recommend typically a bedtime snack for gestational diabetes.
34:57
SPEAKER_01: And that's to prevent fasting for too long.
35:00
SPEAKER_01: Because if you're fasting for too long, that can impact your overnight or your fasting blood sugar.
35:05
SPEAKER_01: So it is person dependent, but oftentimes I find myself recommending a bedtime snack within like an hour before going to bed.
35:12
SPEAKER_01: Um, you know, not a full meal.
35:14
SPEAKER_01: It could be something like a Greek yogurt with some berries and chia seeds, or um, you know, an apple and peanut butter, any kind of snack with some protein and carb and fiber combination.
35:24
SPEAKER_01: Um, but that can be really helpful just to break up that fast and avoid fasting for too long.
35:29
SPEAKER_02: That is helpful because I think a lot of times people are like, oh, I maybe shouldn't be eating before bed for whatever all the reasons of that people have kind of heard in the past of like making sure you eat um earlier.
35:41
SPEAKER_02: But think this is different when it comes to pregnancy because your body really needs that fuel.
35:45
SPEAKER_02: And sometimes, like you mentioned, having that snack can actually regulate your sleep and your blood sugar much better.
35:52
SPEAKER_02: And, you know, just to be thinking about that.
35:54
SPEAKER_02: Um, and not having obviously I'm assuming it's not like a cupcake or like very refined high sugar that shouldn't be your snack, but something balanced that will hold you down and prevent the nighttime wakings.
36:06
SPEAKER_02: Because sometimes my patients will even say, like, I'm I sometimes wake up because I'm hungry at night.
36:10
SPEAKER_01: Yeah.
36:11
SPEAKER_02: And then when they're hungry, they go eat and then they're peeing.
36:13
SPEAKER_02: So then now they have this like nocturia, this like nighttime peeing problem, nighttime eating problem, insomnia, waking up, anxious thoughts, it like feeds into itself and becomes a cycle.
36:25
SPEAKER_02: So that's a great tip, Mel.
36:28
SPEAKER_02: Wow, we covered so much.
36:30
SPEAKER_02: I want to keep talking.
36:31
SPEAKER_02: I have so many more questions for you.
36:33
SPEAKER_02: Uh, thank you for the personal session.
36:37
SPEAKER_02: Of course, anytime.
36:38
SPEAKER_02: I love it.
36:39
SPEAKER_02: Um, is there anything else, Mel, that you want to add to our conversation today, along the work that you do and the people that you treat?
36:47
SPEAKER_01: Uh no, I think we pretty much covered it.
36:50
SPEAKER_01: Uh yeah, like I said, I treat everyone from, you know, someone that's trying to navigate pregnancy foods to avoid um the right supplements, nourishing themselves with the right foods, to high-risk pregnancy conditions like the gestational diabetes, preoclampsia, twin pregnancies.
37:06
SPEAKER_02: I love that.
37:07
SPEAKER_02: It's very important if you're listening and you're thinking about being pregnant or you're pregnant already.
37:12
SPEAKER_02: Um, what we put in our bodies is just so important.
37:14
SPEAKER_02: I think we don't think about that enough.
37:16
SPEAKER_02: We what we do with our physical bodies, what we put into our bodies and our thoughts and our emotions, they really all do affect the pregnancy.
37:26
SPEAKER_02: And while we can't control every piece all the time, whatever we can control, we should try to.
37:32
SPEAKER_02: And we should try to optimize.
37:34
SPEAKER_02: And I know that for some people listening, this is the first time that they're thinking about their nutrition, right?
37:39
SPEAKER_02: Like it takes being pregnant and having a baby to care for another human being and understand the weight of that responsibility to actually take care of themselves for the first time.
37:49
SPEAKER_02: And they never felt like they needed to before.
37:52
SPEAKER_02: Like I said, I never like really read let read labels and like spent time to like care about it before I was pregnant.
37:59
SPEAKER_02: I did to a certain extent, but like nothing compared to when I was pregnant.
38:03
SPEAKER_02: And sometimes, you know, especially as moms, we end up kind of doing so much for the benefit of our child.
38:08
SPEAKER_02: But taking care of nutrition and then thinking about it for long-term health is just so important for you.
38:15
SPEAKER_02: And sometimes I have to tell people this, they're like, oh yeah, I know, like eat well.
38:18
SPEAKER_02: And then, you know, they're postpartum and like junking and kind of just having these crashes and everything.
38:23
SPEAKER_02: I'm like, hey, listen, especially when it comes to exercise and physical health, like all the stuff that we did pregnant during pregnancy to prepare for a great birth.
38:31
SPEAKER_02: And in your line of work, all the pre-uh prenatal nutrition that you're doing to keep your reserves going for birth and postpartum, you kind of have to continue, you're not kind of, you have to continue that afterwards as well.
38:44
SPEAKER_02: Because even though you're not carrying your child in your body, you are caring for your child outside of your body.
38:51
SPEAKER_02: And so you have to understand that if you don't show up and you don't put your oxygen mask on first, you don't get the exercise that you need, and you don't get the nutrition that you need, and you're not managing your thoughts the way that you need, and you're not sleeping the way that you need, you're not showing up for your baby in the best way that you can.
39:08
SPEAKER_02: And that does impact them too.
39:10
SPEAKER_02: So if you're doing it just for the kid, keep that in your mind.
39:14
SPEAKER_02: But I hope people also think about it for themselves.
39:17
SPEAKER_02: Like, do this for yourself too.
39:18
SPEAKER_02: Do it because it's important for you to stay healthy and to be independent for as long as you live and not have to become little old ladies who have like severe health conditions that could have been mostly prevented with help, exercise, and mental well-being.
39:35
SPEAKER_02: So um, I'd love to hear if you have any thoughts on that, Mel, and also how people can find you so they can touch base with you and ask questions and work with you if they'd like to.
39:45
SPEAKER_01: Yeah, of course.
39:46
SPEAKER_01: So just to add on the postpartum piece, totally agree.
39:50
SPEAKER_01: Nutrition is really important to support your postpartum recovery.
39:53
SPEAKER_01: Your body just went through a lot giving birth.
39:56
SPEAKER_01: And then, of course, there's a lot of changes after giving birth.
39:58
SPEAKER_01: You know, your tissues are remodeling, your uterus is shrinking, milk is coming in.
40:02
SPEAKER_01: So, nutrition is really important, you know, to help support your body during this time.
40:07
SPEAKER_01: And also, you know, postpartum is an amazing, but also, you know, crazy and time of not a lot of sleep and maybe some more stress as well.
40:16
SPEAKER_01: So good nutritional habits can just help get you feeling more like you again.
40:22
SPEAKER_01: And then in terms of finding me, so um, you can find me on Instagram and TikTok.
40:27
SPEAKER_01: I'm well or I'm sorry, I just switched it.
40:29
SPEAKER_01: I am uh at Pregnancy Nutritionist underscore.
40:32
SPEAKER_01: Uh and my website is well by Mel Nutrition, and I offer uh personalized virtual nutrition coaching on those on that um there.
40:41
SPEAKER_02: I love that.
40:42
SPEAKER_02: I will link that into the show notes so listeners can get in touch with you.
40:47
SPEAKER_02: Thank you so much, Mel.
40:48
SPEAKER_02: I really think the work that you do is very important.
40:51
SPEAKER_02: I'm so glad that there's more research around it and wonderful people like yourself who are propagating this research and synthesizing it and presenting it to really help people because truly I think it's one of the most wonderful things to be supporting pregnant clients and postpartum clients because they're literally the reason why we have human life.
41:09
SPEAKER_02: So thank you for doing that.
41:10
SPEAKER_01: Yeah, thanks so much for having me.
41:12
SPEAKER_02: This was so much fun.
41:13
SPEAKER_02: Thank you all for tuning in and investing in yourself and your well-being.
41:18
SPEAKER_02: If you listened to the show today and gained anything out of it, share it far and wide.
41:23
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41:26
SPEAKER_02: Don't forget to use your exclusive 20% discount code FIT20 when you sign up for our signature course Master Your Public Floor, linked in the show notes.
41:37
SPEAKER_02: See you again next week with an exciting new guest and topic.