The Role of Integrative Nutrition in Supporting Pregnancy

Pregnancy is a life-changing experience that brings forth a new life but is also marked by numerous mental, emotional, physical, and hormonal changes. During this process, the mother’s nutritional needs and that of her growing baby are essential to support and nurture if optimal well-being is to be achieved. 

Integrative nutrition is an emerging field that looks at the importance of health through a holistic nutrition lens. It encourages holistic nutrition by taking a whole-health approach, including the body's ability to absorb nutrients, how lifestyle factors into nutrition, the impact nutrition has on gut and hormone health, and how mental and emotional factors affect eating. With this approach, women can fully connect to their personal nutrition journey and how that can create a transformative pregnancy. 

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Why Is Integrative Nutrition During Pregnancy Important?

Integrative nutrition during pregnancy can help set the stage for both the mother and her developing baby. Looking at each pregnancy journey at an individual level with tailored nutrition in mind can enhance the mother's nutrient status and therefore provide optimal growth factors for the fetus. Integrative nutrition allows for this approach as it looks at how foods impact the ecosystem of the mother, promote overall vitality, and can support nutrient absorption by the fetus.  

What Are The Benefits of Integrative Nutrition for Pregnant Women?

Integrative nutrition entails how your body absorbs and utilizes nutrients from your diet. This can then influence your hormones, physical well-being, weight management, fetal development, and health risks associated with pregnancy. Detailed here are ways in which integrative nutrition can optimize your pregnancy. 

Enhanced Nutrient Absorption and Bioavailability

Integrative nutrition for pregnancy focuses on nutrient-dense whole foods. Eating, then assimilating and absorbing vitamins, minerals, and macronutrients from these foods, allows for the transportation of nutrients across the placenta to the growing baby. The body needs a healthy balance of nutrients, many of which can be easily depleted if you are not taking care of your body, eating a variety of foods, or consuming a low-nutrient, highly processed diet.

While some women may be consuming a balanced diet, there are individual considerations to keep in mind. Absorption and bioavailability of the nutrients consumed are dictated by genetics, the health of your gut microbiome, pre-existing health conditions, and pre-pregnancy weight. Bioavailability is also based on the interplay between macro and micronutrients, meaning that there is a relationship among these nutrients which can either promote or inhibit their accessibility for physiological processes in the body. Working with an integrative health practitioner that will approach your nutrition from an individual perspective can provide you with a tailored dietary approach that can enhance your body's ability to utilize nutrients. 

Balancing Hormones and Reducing Pregnancy Discomfort

The presence and fluctuation of specific hormones play a key role during pregnancy. There are four hormones that are the main contributors for pregnancy. The first one, which is what is picked up on an at-home pregnancy test, is the human chorionic gonadotropin hormone (hCG). This hormone is made by the placenta and is the most present hormone in the first trimester of pregnancy. Nausea and vomiting, also known as “morning sickness”, in the first trimester, have been correlated to the effects of hCG, especially in women who may have elevated levels. 

Progesterone, which is known as “the pregnancy hormone,” is important for both conception and maintaining a pregnancy. It assists with thickening the uterus lining to prime it for the implantation of an egg. Initially, progesterone is supplied by the ovaries, but at about weeks 8 through 10, the placenta takes over the production of progesterone, which maintains pregnancy. 

Estrogen is also important for the maintenance of a healthy pregnancy and the development of female sex traits. Although science has still not figured out the exact roles of estrogen in pregnancy, there is a primate study that has linked estrogen as an essential hormone in the maturation of the lungs, liver, and other tissues of a developing fetus, as well as a key player in miscarriage prevention. 

The last hormone to play an essential role in pregnancy is human placental lactogen (hPL), which is also called human chorionic somatomammotropin. HPL is released by the placenta during pregnancy. It helps regulate metabolism and insulin so nutrients can remain in the blood for transfer to your growing baby. It also plays a role in stimulating milk glands in preparation for breastfeeding. 

Supporting these hormones through nutrition can benefit both the mother and the growing fetus. Hormone balance is directly correlated to gut microbiome health. Ideally, you would want to establish a healthy gut microflora prior to pregnancy, but if gut health discomfort arises during pregnancy, you can implement dietary strategies to help. Consuming high-fiber foods, including a variety of fruits and vegetables, eating adequate protein, and healthy fats such as avocado, flaxseed, and grass-fed butter can help support gut health and therefore support hormone balance. 

Just as important as what you eat is when and how you eat. Eating small meals, incorporating snacks, avoiding trigger foods, adding soothing foods such as ginger, and not being sedentary right after eating can help with discomforts like nausea and vomiting. 

Managing Weight and Reducing the Risk of Gestational Complications

It’s important to monitor and be mindful of healthy weight fluctuations during pregnancy. This should be looked at from an individual perspective, with pre-pregnancy BMI playing an important role. A general guideline is that the lower your BMI, the more wiggle room you have for weight gain. The higher your BMI, the higher risk you are for pregnancy complications with excessive weight gain in pregnancy. 

Complications include gestational diabetes, preeclampsia, and increased risk for premature birth or cesarean section delivery. For women with a low BMI that do not gain much weight in pregnancy, there can also be a risk of premature birth or low birth weight. Working with a holistic nutritionist that can assist you in maintaining a healthy pregnancy weight through food choices, macronutrient balancing, and not over-eating can be helpful. While you don't want to be on a weight loss diet per se, it is beneficial to follow a low-inflammatory meal plan to help manage any inflammation that can contribute to gestational complications. 

The Mediterranean-style diet is beneficial in reducing gestational diabetes, reducing weight gain or obesity, and other complications that can arise in pregnancy. Eating this way will ensure you get lean protein like chicken and fish, the occasional red meat, essential fatty acids, fresh produce, and complex carbohydrates into your diet. 

Supporting Fetal Development and Reducing Birth Defects

Aside from eating adequate macronutrients, there are a number of vitamins and minerals that are essential for fetal development. The American College of Obstetricians and Gynecologists lists these as the top 10 nutrients you should obtain optimal levels of during pregnancy:  folate, vitamin A, vitamin B12, vitamin B6, vitamin D, vitamin C, calcium, choline, iodine, and iron. Each of these nutrients play an important role in the development of organs and tissues of a fetus. You can obtain most of these through eating a well-rounded, nutrient-dense variety of foods such as green leafy vegetables, milk, yogurt, poultry, fish, red meat, fruits, carrots, sweet potatoes, beef liver, and whole grains. Taking a prenatal vitamin is typically recommended to ensure you are getting these necessary nutrients on a daily basis. 

Folic acid should be taken at a minimum of 400 micrograms per day due to the complexities of getting enough through your diet alone. This vitamin is especially important because a deficiency in folate has been directly linked to neural tube birth defects. Incorporating holistic nutrition, with whole foods as the basis of your diet, can put you in the best position to consume the necessary nutrients for your pregnancy and growing baby. 

What Are The Components of An Integrative Nutrition Approach? 

Integrative nutrition is more than just the food you eat. It takes into account optimizing nutrient content, your lifestyle that is connected to eating habits, and the mental and emotional connection to food. With these concepts in mind, here is an avenue to pursue nourishment during your pregnancy. 

Balanced and Nutrient-Dense Diet for Pregnancy

Consuming a balanced diet can make a profound impact on both the fetus's and the mother’s health. Eating nutrient-dense foods that provide you will the necessary vitamins and minerals are crucial for the development of your baby and for your body to sustain a healthy pregnancy. Calorie consumption should stay about the same in your first trimester. You may hear the saying that you are eating for two, but ideally, you only need to consume around 300 extra calories in the 2nd and 3rd trimesters of pregnancy. Overeating can lead to excess weight gain, discomfort, and complications. 

The more paramount goal is to make sure you are eating a variety of fruits, vegetables, whole grains, and protein which will provide you with all the building blocks your body needs to sustain both you and the baby. While this varies based on your activity level and special circumstances, in general, you should be consuming about 60 grams of protein per day, six to nine servings of complex carbohydrates (45-64% of daily calories), and 20-35% of your calorie intake should be in the form of healthy fats. Examples of protein include chicken, lean beef, fully cooked fish, or lamb. Carbohydrates can come in the form of legumes, potatoes, fruits such as strawberries, and oatmeal. 

When thinking of fats, research shows that omega-3 fatty acids are particularly important for the brain and eye development of your baby. Essential fatty acids can also support the health of your pregnancy and decrease your risk for postpartum depression. The most nutrient-dense sources of omega-3 fatty acids are seafood and flaxseed. You can also take a purified fish oil supplement if toxins such as mercury are a concern. The ideal dosage for fetal development in pregnancy and to prevent preterm birth is 600 mg per day, mainly in the form of DHA. 

Creating a nutrition plan that works best for you can be simple yet nutritious. Consuming unprocessed whole foods is one of the best ways to achieve this. If you are struggling in this area, working with an integrative nutritionist can also help you establish this lifestyle. 

Supplementation and Herbal Support for Pregnancy

Taking a prenatal vitamin is the number one supplement recommendation during pregnancy. While prenatal vitamins may vary in their content and dosage, there are key vitamins and nutrients that evidence has shown are essential. Here is a list, including optimal daily dosages that should be in a prenatal vitamin.

• Vitamin A- 1200 mcg as retinol, 1000 mcg as mixed carotenoids
• Vitamin C- 200 mg
• Vitamin D- 2000-4000 IU
• Vitamine E- 19 mg 
• Vitamin K- 90 mcg
• Vitamin B1(Thiamine)- 6 mg
• Vitamin B2 (Riboflavin)- 2-2.5 mg
• Vitamin B3 (Niacin)- 35 mg
• Vitamin B5 (Pantothenic Acid)- 10 mg
• Vitamin B6 (Pyridoxine)- 10 mg
• Vitamin B7 (Biotin)- 100 mcg
• Vitamin B9 (Folate)- 400 mcg
• Vitamin B12- 25 mcg
• Choline- 350 mg (1st and 2nd trimester), 600 mg (3rd trimester)
• DHA- 600 mg
• Inositol- 500 mg (as Myo-inositol)

In addition to a great quality prenatal vitamin, there are a few herbal medicines that can be supportive during pregnancy. This chapter of life can be stressful to both your body and your mental and emotional well-being. Lavender, lemon balm, and chamomile have all been shown to help induce relaxation, reduce anxiety, modulate your stress response, and potentially improve your sleep. Being relaxed during pregnancy can also help you make the best lifestyle choices when it comes to nutrition and eating ideally. 

Mindful Eating and Stress Reduction for Pregnancy

Mindfulness is a practice of intentional awareness of your current life circumstances and allowing your mind and body to accept the thoughts, sensations, and emotions connected to it while also learning how to consciously react. When applying this to eating and pregnancy, it can help you eat only what is necessary and focus on the process. 

Mindful eating entails being fully present, void of distractions and on-the-go meals, which allows you to eat more slowly and be acutely aware of satiety. It also consists of you thinking through why you want certain foods, how you feel after eating specific foods, and understanding your relationship with food. This practice can increase your enjoyment of eating, reduce cravings, improve digestion, regulate eating patterns, help manage your weight, and shift your attitude toward eating. 

While eating habits can play a major role in how you feel throughout your pregnancy, there are additional ways to modulate stress that can come with pregnancy. Whether it is physical stress or mental and emotional stress incorporating exercise, yoga, meditation, and acupuncture are all great ways to reduce your body's stress response and enhance your ability to relax. 

Integrative Therapies and Practices

Complementary and integrative therapies can provide a variety of support during pregnancy. Depending on issues that may arise in your pregnancy, you could benefit from seeking integrative care. Functional medicine doctors can help you address ailments such as hyperemesis gravidarum and gestational diabetes, while physical medicine providers such as chiropractors and pelvic floor therapists can assist with musculoskeletal discomforts. 

Acupuncturists, in particular, are great for treating nausea and the mental and emotional distress that may occur during pregnancy. As a naturopathic doctor, I assist pregnant women with lifestyle modification, nutrition counseling, and stress relief. While each profession provides its own unique service, working with one or a variety of practitioners could optimize your pregnancy experience. 

Functional Medicine Labs to Support Optimal Wellness During Pregnancy

Making sure your health is in tip-top shape can lead to a vibrant pregnancy for both you and your growing baby. Here are four testing areas to consider when looking to optimize your pregnancy health.

Routine Labs

Making sure that key factors in your health are in place is foundational to a healthy pregnancy. The Obstetric Panel by Access Medical will look at your red and white blood cell function, along with blood typing, so you can make sure your labor and delivery go smoothly. 

Hormone Testing

Looking at hormones from an optimal range for the stage of pregnancy you are in is ideal if you have persistent nausea, vomiting, or concerns for fetal development. An hCG blood test can look at your precise levels. Assessing your levels of progesterone and estrogen in the form of estriol (E3) can also add information to the picture. 

Comprehensive Stool Test

Obtaining information about your gut microbiome can be beneficial for therapeutic interventions. This comprehensive stool analysis will look at microbial balance, inflammation, absorption, and digestive function.  

Micronutrient Panel

Microbiome imbalance and a less-than-optimal diet can result in nutrient deficiencies. Investigating your micronutrient status can bring insight into avenues for replenishments. Results can even help you decide whether upping a prenatal vitamin or eating more wholesome nutritious foods will be part of the game plan. 

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Summary

Integrative nutrition can play a significant role when it comes to health optimization during pregnancy. Women who are having difficulty managing conditions such as diabetes, are at risk for preeclampsia, or are struggling to manage their weight could all benefit from this holistic approach. Taking a whole-person mindset when addressing nutrition is paramount to helping you find an effective and sustainable plan that carries you through pregnancy and beyond.