Introduction: With a relentless focus on excellence in healthcare, Pullman Regional Hospital presents The Health Podcast.

Caitlin Whyte: We've all heard tales of all the crazy things, pregnant people, crave and eat, but how do you actually stay healthy and eat nutritiously during a pregnancy? Today, we're talking to Dr. Laura Baker, a family medicine physician at Pullman about your pregnancy diet. Now Dr. Baker, what is the expected amount of weight gain during a pregnancy?

Dr. Brodsky: So, have you ever heard the old adage that a pregnant patient is eating for two? Quote unquote? This is unfortunately very incorrect and can lead to excessive weight gain in pregnancy. So the actual increased caloric need is much less than that in the first trimester, the increased calories should be zero. We shouldn't actually change what we're eating at all. In the second trimester, a pregnant person should increase by about 340 calories per day. And in the third trimester by 450 calories per day. So it's really like an extra snack, essentially. It's not eating for two or double the amount of meals. So the expected weight gain is based off that person's specific, initial weight. So if a person's underweight it's recommended for them to gain between 28 to 40 pounds, if they're a normal weight between 25 to 35 pounds? If they're overweight between 15 to 25 pounds, and if they're obese between 11 to 20 pounds, but most of this weight gain will occur in the second to third trimesters. And these recommendations are made to allow adequate nutrition for the baby while not gaining too much weight that will be hard to get off after the pregnancy.

Host: So, what are some foods that actually need to be avoided during pregnancy?

Dr. Brodsky: So, this is a really good question because some of these are foods that we eat regularly. Some are foods that I have never eaten in my life, but it's just really good to have this in mind. The idea is to avoid eating things that might cause some sort of infection. So unpasteurized, dairy products, raw meats, even deli meats are things that we should avoid during pregnancy. Some of the more rare ones are certain fish that are very high in mercury. So this is shark, swordfish, King Mackerel, Marlon bigeye, tuna, tilefish. I haven't ever eaten any of these, but they might be on some people's regular diets. So avoiding those altogether, but then other fish are potentially having some mercury in them, but it's a lot lower. So it's safe to eat those in pregnancy, but would limit to about one to three servings per week. And then one that's really difficult for some people is caffeine. Some sources say that you should avoid caffeine altogether, but most others say that you limit it to less than 200 milligrams per day, that should be safe. That's equivalent to about one 12 ounce cup of coffee.

Host: Now, when we're looking at our diets during pregnancy, what does a healthy and balanced diet look like?

Dr. Brodsky: So, a healthy and balanced diet during pregnancy is not terribly different from a healthy, balanced diet outside of pregnancy. You want an appropriate amount of fruits and vegetables and all those fun things. So the recommended amounts based on the increased caloric needs is two to two and a half cups of fruit, three to three and a half cups of vegetables, six to 10 ounces of grain, six to seven ounces of protein, three cups of dairy. And then very importantly, a little over two liters of water is recommended per day. And this is important, especially if you live in a climate that's hot and dry to be drinking plenty of water every day. And then you want to avoid foods that have excessive calories with low nutritional value, such as soda, desserts, fry foods, high fat needs, or whole fat dairy. And lastly, it's very important for every pregnant person to be taking their prenatal vitamins every day, because there are extra nutritional requirements during pregnancy that are covered through this prenatal vitamin.

Host: And once our baby is born, of course, there's always that hurry to get back to our pre-pregnancy weight, but what are some safe ways you can lose that baby weight after having the baby?

Dr. Brodsky: So, the first step is actually to avoid gaining excessive weight during pregnancy. So, going back to that first question of avoiding eating too many calories that will cause excessive weight gain. And then you can also exercise during pregnancy and this can reduce excessive weight gain as well. So safe exercises during pregnancy are walking stationary, cycling, aerobic exercises, dancing resistance exercises, stretching water aerobics, but you should talk to your doctor about which exercises would be safe for you and your baby during pregnancy. And then after the baby's born, breastfeeding can actually have a slight benefit in decreasing weight retention. And the recommended amount is at least 20 weeks of breastfeeding. To see some of that decrease weight retention, it's shown that a healthy diet postpartum plus exercising is better for losing pregnancy weight than either one alone. So it is actually safe to diet and exercise in the postpartum period without decreasing the milk production, as long as you're consuming at least 1500 calories per day. And it is unclear exactly how quickly the weight should be lost, but many experts recommend that it'll take about six to 12 months, so be kind to body and give yourself the appropriate time to lose the weight.

Host: Well, this is all such great information. Thank you so much for your time, Dr. Baker. That was Dr. Laura Baker, a family medicine physician at Pullman. Find out more about Pullman Regional, as well as more episodes like this at pullmanregional.org. This has been The Health Podcast from Pullman Regional. I'm your host, Caitlin Whyte. We'll see you next time.