Macros for Momma

Macros. No, not counting them. We’re talking about what macronutrients are and how your needs might change during pregnancy. Remember, while you might like to think of it as “eating for two”, the reality is that your actual calorie needs increase very little throughout pregnancy, just by about 200-300 calories per day in the 2nd and 3rd trimesters, respectively. And where do calories come from? Macronutrients!

What are Macronutrients?

Your macronutrients are the things you eat that contribute calories. There are 3 – fat, protein, and carbohydrates. Each one offers different types of essential building blocks for the body and a variety of vitamins and minerals. All three are important for health and to grow a nourished, happy baby. But, as is often the case, the real food approach to macronutrients and pregnancy tends to be a bit different than the conventional one.

To give you a better sense of how different these two approaches are, let’s take a look at macronutrients by the numbers. The standard, conventional recommendations suggest about 45-65% of your calories be from carbohydrates with a minimum of 175g of carbs per day. To put this in perspective, that’s like 12 servings of fruit, or 12 pieces of bread, 4 bagels, 4 cups of cooked rice, or almost SIX bags of Skittles! In reality, there is no real minimum. In fact, the amount of carbs per day that is compatible with life is...zero. Zilch. Seriously. There are some tribes that eat little to no carbs as part of their diet, and yet, they still exist and reproduce. Without going too biochem-crazy on you, suffice to say that your body is so so smart. It prefers glucose for energy (which you can get from carbs), and prefers it so much so (as does the fetus during pregnancy), that it can make it from basically any macronutrient. So while carbohydrates will allow for a “direct” glucose supply, your body can also make glucose through other means from protein and fat. And, carbohydrates are the only macronutrient that are going to raise your blood sugar when you eat them, thereby raising your insulin levels. Which means if you can keep your carbs and blood sugars in balance, your risk of gestational diabetes (and type 2 diabetes!) is significantly lower!

Conventional recommendations also suggest only about 20-35% of calories come from fat, and to limit saturated fat. For some perspective, if you were on about a 2,000 calorie diet (and I don’t recommend calorie counting, just using this as an example!), 35% would be about 78 grams of fat per day. Again, to give you some sense of what that means in food, ½ an avocado is about 15 grams of fat, two eggs have 10 grams of fat (if cooked without oil/butter!), 3 oz of salmon has about 5 grams, ¼ cup of walnuts has around 20 grams, and one tablespoon of PB has nearly 8 grams. This would be a nice variety of healthy fats for a day and adds up to just 58 grams of fat. In other words, you still have a lot of room for more healthy fats! And you want to eat them. Fat is essential for hormone synthesis, growing baby’s brain, and part of every single cell membrane in the body (and the baby’s!). However, conventional recommendations also focus on more processed (and less healthy!) fats, like vegetable oils, rather than real food fat from whole sources like eggs, meat, fish, etc.

And last, but certainly not least, especially for pregnancy, protein. The recommendation, conventionally, is 10-35% of calories, or 100-175g of protein for a 2,000 calorie diet. Here’s the thing; very few women are getting this, especially during pregnancy. And recent studies suggest protein needs are quite a bit higher than originally thought in pregnancy. Most docs might suggest 0.8 grams of protein per kg of your body weight (if they can suggest anything at all, since nutrition really isn’t their area of expertise!). For a pre-pregnancy weight of 135 lbs (61 kg), this would only be about 50 grams of protein. How can the percent of your calories for protein (10-35%) be so far off the “recommended” grams per kg? It’s just one of the fun inconsistencies of conventional nutrition! In any case, we know that protein needs are much higher during pregnancy, with a minimum of 80 grams being recommended in the first trimester and 100+ in the 2nd and 3rd, more if you’re active (and you should be! It’s good for you and baby!!). Conventional guidelines also push a lot of plant-based protein, which is problematic for several reasons we’ll dive into in a moment.

REAL FOOD RECS

As a reminder, Real Food is as unprocessed as you can get it. It’s food you could a) hunt, or b) gather. So, “real” food carbs are fruits, veggies, maybe some whole grains, and legumes (dairy has some too!). Not only do these foods have WAY more nutrients than a bagel or candy, they also have a lot more fiber, which helps stabilize blood sugar levels and improves microbiome health. In general, I recommend focusing on veggies, then fruits, then whole grains/legumes for your carb sources each day. High carb diets (essentially the high end of the conventional recommendations!) are linked to increased risk of gestational diabetes, pre-eclampsia, excess weight gain, and obesity in the child later in life. Remember, while the conventional recommendations encourage 45-65% of your calories to come from carbs each day, modern hunter-gatherer communities average just 16-22% of their calories from carbs (and have much lower rates of chronic disease!)!

Speaking of hunter-gatherers...when we look at what sorts of foods are traditionally eaten to support fertility, we find that there’s a huge emphasis on animal products. In some cultures, a newly married couple is given all sorts of eggs, fish, and organ meats, foods rich in not only saturated fat, but vitamins and minerals. These are provided to support and encourage fertility and then a healthy pregnancy. Yet, our culture has replaced fat with low-fat, high-carb...everything! The fear of fat is going down a bit, but there’s still a huge emphasis on high refined oils like corn and soy, with a warning against traditional fats like butter and lard. Unfortunately, this separating out of fat from its natural food sources (think PB “powder” and skim milk) has some pretty big consequences. First, the nutrient density goes way, way down. Fat typically comes with protein...unless it’s processed! And there are a number of vitamins that are fat soluble (meaning they require fat to be properly absorbed), so removing the fat also removes these important nutrients! Baby’s brain is 60% fat! Growing a new little person, their brain, all those new cells, and the extra hormones on board all require fat to properly form. Fat is good; don’t fear it! Some of the key nutrients for brain health and growth come from fat-rich foods (choline, preformed vitamin A, DHA...). Besides, when’s the last time you associated “corn” or “soybeans” with fat? Does it make any sense to get our fat from sources that are quite literally an entirely different macronutrient than the one we’re trying to consume?

And finally, protein. Protein is a building block for every...single...cell in the body. During pregnancy, we need protein not only to continue our own body’s regular maintenance, but also to grow a new little person, a uterus, support a hugely expanding blood volume, and literally develop an entirely new organ – the placenta. While protein can be found in some plant-based sources, few of these sources are considered “complete” proteins. Complete proteins are proteins that contain all of the essential amino acids (building blocks of protein that we have to get from our diet because our body can’t make them or can’t make enough of them). Plant protein sources tend to be lacking in at least one amino acid, while animal sources are all complete. One of the amino acids that’s considered essential during pregnancy is glycine. This particular amino acid is required for DNA formation, as well as integral to the development of organs, connective tissues, blood vessels, skin, and joints. You can probably see why we would need more of it during pregnancy! This particular amino acid is incredibly low in plant-based foods. You’d literally have to eat POUNDS of spirulina to get the same amount as you can get from some slow-cooked pulled pork. And for those concerned about eating “too much” protein, know that animal studies suggest it would take upwards of 240 grams of protein PER DAY to see negative effects in an otherwise healthy individual!

TO NOURISH THE BABY, NOURISH THE MOTHER

This can feel overwhelming, I know. Remember, it’s really pretty simple. It when you’re hungry. Choose veggies first, paired with a good source of protein and fat (which often come together!). Avoid processed foods as much as possible. Focus on whole foods (as unprocessed as possible) to get the most nutrients you can. Every step of processing tends to remove some of the nutrients from the food. Light, heat, etc. all begin to degrade the quality of a food and the nutrition therein. You are what you eat, and baby is what you eat, too! So every time you choose nutrient-rich foods, you’re not only supporting your own health, but your baby’s, not just for the pregnancy, but for their entire life!