Prenatal Nutrition and Autoimmunity
There can be a lot of confusion when it comes to the world of prenatal nutrition and supplementation, especially if you’re also dealing with an autoimmune disease.
Here I’m going to break down the basics and outline the specific nutrient requirements for pregnancy and the foods and supplements that will help you to achieve the recommended amounts. These suggestions are also great for reducing inflammation, a key component of any autoimmune nutrition protocol!
Nutrition + Supplementation Requirements
Pregnancy is a time of increased energy demands and nutrient changes to support your growing baby and changes to your body. You need approximately 300-400 extra calories per day throughout pregnancy and 500-700 extra calories per day during breastfeeding.
Personally, I don’t focus on counting calories. Instead, I listen to my body’s intuition and increase my nutrient intake when I feel extra hungry or fatigued. I’ve found that eating small, frequent, nutrient-dense meals throughout the day helps to stabilize blood sugar and adjust to the body’s slower digestion rates.
My digestion has definitely slowed down considerably in the second trimester. I’ll be sharing my tips for common pregnancy symptoms in a blog post coming soon!
Specific Nutrients to Increase
There are certain nutrients that are most beneficial during pregnancy. Read below for the recommended amounts, along with quality food and supplement options to choose from:
- Recommended amount: aim for 75-85 g/day, or about 1.1 g/kg of body weight
- Food sources: choose high quality organic sources of plant and animal protein, including legumes, whole grains, raw nuts/seeds, cold-water fish, organic tofu, and free-range/grass-fed/organic meat
- Supplements: I don’t advocate for protein supplements, but blue-green algae powders, such as spirulina can be beneficial during this time as a source of protein and iron. However, if you are taking medication for autoimmune disease, check with your doctor before taking because it can impact the immune system.
- Recommended amount: 1200 mg/day
- During pregnancy, the body requires up to 50% more calcium, especially during the third trimester
- Food sources: focus on organic dark leafy greens, broccoli, bok choy, organic tofu, nuts/seeds
- Supplements: Most prenatal supplements will include extra calcium. Magnesium should be included in a calcium supplement to optimize absorption. Take separately from iron.
- Iron deficiency is very common during pregnancy. To avoid this, have your levels checked pre-pregnancy (usually through a blood test for ferritin), and every few months throughout.
- Recommended dose: 30-50 mg of iron/day, you may need more if iron deficient (determine this in consultation with your healthcare practitioner)
- Food sources: blackstrap molasses, nettle, nuts/seeds/legumes, seaweed, millet, mushrooms, chard, parsley, spinach, spirulina (check with healthcare provider if currently on medication), red meat, organ meat, eggs, and salmon
- Supplements: when choosing an iron supplement, consider the form of the iron. Iron typically comes in either plant-based (non-heme) or animal-based (heme) forms. Heme iron is generally easier to absorb, but tends to be much more expensive. To avoid the dreaded side-effect of constipation, look for iron in the form of bisglycinate. Avoid taking iron with calcium/magnesium and take away from caffeine. I usually take my iron supplement in-between breakfast and lunch. Take with vitamin c-rich foods to increase absorption.
- Recommended dose: 1000 mcg/day is required, especially during the first trimester, so it’s best to begin this before pregnancy
- Food sources: green leafy vegetables, whole grains, fish, and organ meats
- Supplements: folic acid is an important prenatal vitamin (B9) found in most formulas. However, around 50-60% of the population is thought to have the MTHFR mutation. This prevents the body from converting folic acid to its usable (or methylated) form. If you have this mutation (discuss with your healthcare professional for testing), then it’s important to include the active form of folic acid (methylated folate) for optimal absorption. Look for supplements that contain L-Methylfolate.
- Absorption of B12 decreases during pregnancy, so you need to obtain it through food and/or supplements.
- Recommended dose: 50mg
- Food sources: liver, clams, salmon, lamb, beef, and algae.
- Supplements: look for the more active form of methylcobalamin (as opposed to cyanocobalamin) when searching for supplements. You can often find B9 (folate), B12, B6, and other B vitamins together in a B-complex
- A deficiency in B6 is thought to be associated with nausea, vomiting, and pre-eclampsia during pregnancy.
- Recommended dose: 50mg
- Food sources: include whole grains, bran, pork, avocado, and egg yolks
- Supplements: you can find this in most pre-natal or B-complex supplements. B6 works best with zinc and other minerals
- Vitamin D
- This is useful for increasing calcium absorption and increasing immune function. It’s also important for regulating cell growth and insulin release.
- Recommended dose: 60mcg
- Food sources: herring, mackerel, salmon, eggs, sun-dried mushrooms, fortified tofu
- Supplements: should be included in most pre-natal vitamins but, if not, you can choose a separate supplement. Vitamin D2 is the synthetic and often plant-based form, while vitamin D3 is more easily absorbed and an animal-derived form. Look for a quality oil-based supplement since vitamin D requires fat in order to be absorbed.
- Vitamin D
- Helps with the development of the immune system during pregnancy and can offset constipation and reduce muscle cramping.
- Recommended dose: 200-400 mg/day depending on your symptoms
- Food sources: whole grains, dark leafy greens, nuts, beans, garlic, green peas, and bananas
- Supplements: best taken in combination with calcium in a ratio of two parts calcium to one part magnesium to increase absorption and promote balance. It is more easily absorbed in a chelate or citrate form and can be found in most mineral formulas.
- Omega 3s
- Healthy fats are important for supporting brain, nervous system, vision development, and the health of the placenta.
- Recommended amount: 1000-2000 mg EPA/DHA either in supplement or oil form
- Food sources: cold-water fish, flax/chia/sunflower/pumpkin seeds, walnuts, and dark leafy greens
- Supplements: You can look for a quality supplement that contains about a 1000-2000mg of EPA/DHA or combine omega 3/6 cold-pressed organic oils. For example, 1 tbsp that consists of 2 parts flax oil to 1 part each sunflower and olive oil will provide the correct omega 3/6 ratio. Keep all open oil in fridge and buy small bottles to reduce the chance of spoiling. Flax seed oil is especially prone to rancidity.
- Omega 3s
- Important for cell division and repair. Also helps to support the immune system throughout pregnancy.
- Recommended dose: 10-20 mg/day
- Food sources: beets, broccoli, pumpkin seeds, ginger root, nuts, green peas, turnip, egg yolk, and fish
- Supplements: should be included in most pre-natal formulas. If you need extra, consider an amino acid chelate or citrate to increase absorption. Take with antioxidants.
- We don’t often think about fluid intake as an essential part of our nutrition plan.
- Aim for approximately 3 litres of water/day to meet increasing demands and to reduce constipation, headaches, and muscle cramping.
- Reduce caffeine (green tea, black tea, white tea, coffee, chocolate) to avoid loosing more water. In the first trimester, caffeine has been linked to an increased risk of miscarriage and may decrease fertility (Gaskins et al., 2018; Li et al., 2015; Lyngsø et al., 2017).
Putting It All Together
Meeting your daily nutrient requirements doesn’t need to take a lot of work. Focus on quality, whole foods and supplements that include many of the above nutrients and follow your body’s intuition. Eating a varied diet will help to ensure that you consume many of the above nutrients.
Supplement quality should also be considered during pregnancy. Supplements should be chosen in consultation with a nutritionist or other holistic healthcare provider, especially if you are living with an autoimmune disease.
Overall, strive to:
- Eat nutrient dense foods
- Choose organic and local whole foods
- Eat a variety of fruits and vegetables
- Include fermented foods with meals
- Choose high quality protein sources
- Increase fibre to feed good gut bacteria and keep food moving
If you’re interested in how nutrition can increase fertility, check out my blog post here.