Fit for Two

A healthy eating plan contains a wide variety of foods from the five basic food groups.* Every day, you should try to eat:

6 or more servings of bread, cereal, rice, or pasta.

One serving equals one slice of bread, 1 ounce of ready-to-eat cereal (about 1 cup of most cereals), or 1/2 cup of cooked cereal, rice, or pasta. If you are physically active, you can eat more servings (up to 11 servings if you are very active).

3 to 5 servings of vegetables.

One serving equals 1 cup of raw leafy vegetables such as spinach
or lettuce, or 1/2 cup of chopped vegetables, cooked or raw.

2 to 4 servings of fruit.

One serving equals one medium piece of fruit like an apple, banana, or orange; 1/2 cup of chopped fresh, cooked, or canned fruit; 1/4 cup dried fruit; or 3/4 cup of 100-percent fruit juice.

2 servings of milk, yogurt, or cheese.

One serving equals 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese like cheddar or mozzarella, or 2 ounces of processed cheese like American. If you are 18 years or younger and pregnant, you need at least 3 servings of milk, yogurt, and cheese. Choose low-fat or fat-free dairy products most often.

2 to 3 servings of meat, poultry, fish, dry beans, eggs, or nuts.

One serving equals 2 to 3 ounces of cooked meat, poultry, or fish-about the size of a deck of cards. Choose lean cuts and eat no more than 5 to 7 ounces of meat, poultry, or fish a day. One cup of cooked beans such as kidney beans or 2 eggs count as a serving. Four tablespoons of peanut butter or 2/3 cup of nuts also equals a serving.

At least 8 glasses of water.

Drinking milk, 100-percent juice, seltzer or other non-alcoholic beverages counts toward your amount of daily water.


	Healthy Eating What is a healthy eating plan for pregnancy? How many calories should I eat? Why is gaining a healthy amount of weight important? How much weight should I gain during my pregnancy? Do I have any special nutrition needs now that I am pregnant? Can I continue to follow my vegetarian diet during pregnancy? Tips for healthy eating What foods should I avoid during pregnancy? Physical Activity Should I be physically active during my pregnancy? What physical activities should I avoid during pregnancy? Tips for getting physically active What habits should I keep up after my baby is born? Why should I try to return to a healthy weight after delivery? Be good to yourself Resources Eating well can help you have a healthy pregnancy and a healthy newborn. Being physically active may help you have a more comfortable 9 months and an easier delivery. Use the ideas and tips in this booklet to improve your eating plan and become more physically active before, during, and after your pregnancy. Make changes now, and be a healthy example for your family for a lifetime. Top
Tips for pregnancy	Talk to your health care provider about how much weight you should gain during your pregnancy. Eat foods rich in folate, iron, calcium, and protein, or get these nutrients through a prenatal supplement. Talk to your health care provider before taking any supplements. Eat breakfast every day. Eat high-fiber foods and drink plenty of water to avoid constipation. Avoid alcohol, raw fish, fish high in mercury, soft cheeses, and anything that is not food. Aim to do at least 30 minutes of moderate activity on most days of the week. Talk to your health care provider before you begin. After you deliver your baby, continue eating well. Return to a healthy weight gradually. Slowly get back to your routine of regular, moderate physical activity. Take pleasure in the miracles of pregnancy and birth. Top
HEALTHY EATING
What is a healthy eating plan for pregnancy?	A healthy eating plan contains a wide variety of foods from the five basic food groups.* Every day, you should try to eat: 6 or more servings of bread, cereal, rice, or pasta. One serving equals one slice of bread, 1 ounce of ready-to-eat cereal (about 1 cup of most cereals), or 1/2 cup of cooked cereal, rice, or pasta. If you are physically active, you can eat more servings (up to 11 servings if you are very active). 3 to 5 servings of vegetables. One serving equals 1 cup of raw leafy vegetables such as spinach or lettuce, or 1/2 cup of chopped vegetables, cooked or raw. 2 to 4 servings of fruit. One serving equals one medium piece of fruit like an apple, banana, or orange; 1/2 cup of chopped fresh, cooked, or canned fruit; 1/4 cup dried fruit; or 3/4 cup of 100-percent fruit juice. 2 servings of milk, yogurt, or cheese. One serving equals 1 cup of milk or yogurt, 1 1/2 ounces of natural cheese like cheddar or mozzarella, or 2 ounces of processed cheese like American. If you are 18 years or younger and pregnant, you need at least 3 servings of milk, yogurt, and cheese. Choose low-fat or fat-free dairy products most often. 2 to 3 servings of meat, poultry, fish, dry beans, eggs, or nuts. One serving equals 2 to 3 ounces of cooked meat, poultry, or fish-about the size of a deck of cards. Choose lean cuts and eat no more than 5 to 7 ounces of meat, poultry, or fish a day. One cup of cooked beans such as kidney beans or 2 eggs count as a serving. Four tablespoons of peanut butter or 2/3 cup of nuts also equals a serving. At least 8 glasses of water. Drinking milk, 100-percent juice, seltzer or other non-alcoholic beverages counts toward your amount of daily water. * Adapted from the U.S. Department of Agriculture/Department of Health and Human Services Food Guide Pyramid. Top
How many calories should I eat?	Eating the right number of calories lets you and your baby gain the proper amount of weight. During the first 3 months of your pregnancy, you do not need to change the number of calories you are eating. Normal-weight women need an extra 300 calories each day during the last 6 months of pregnancy. This totals about 1,900 to 2,500 calories a day. If you were underweight, overweight, or obese before you became pregnant, or if you are pregnant with more than one baby, you may need a different number of calories. Talk to your health care provider about how much weight you should gain and how many calories you need. Each of these healthy choices has about 300 calories: 1 cup of non-fat fruit yogurt and a medium apple 1 piece of whole wheat toast spread with 2 tablespoons peanut butter 1 cup of beef and bean chili sprinkled with 1/2 ounce cheddar cheese 1 cup of raisin bran cereal with 1/2 cup of non-fat milk and a small banana 3 ounces roasted lean ham or chicken breast and 1/2 cup sweet potatoes 1 flour tortilla (7-inch), 1/2 cup refried beans, 1/2 cup cooked broccoli, and 1/2 cup cooked red pepper. Top
Why is gaining a healthy amount of weight important?	Gaining a healthy amount of weight may help you have a more comfortable pregnancy and delivery. It also may help you have fewer pregnancy complications, such as diabetes, high blood pressure, constipation, and backaches. Gaining too little weight during your pregnancy makes it hard for your baby to grow properly. Talk to your health care provider if you feel you are not gaining enough weight. If you gain too much weight, you are more likely to have a longer labor and more difficult delivery. Also, gaining a lot of extra body fat will make it harder for you to return to a normal weight after you have your baby. If you feel you are gaining too much weight during your pregnancy, talk with your health care provider. Do not try to lose weight if you are pregnant. If you do not eat enough calories or a variety of foods, your baby will not get the nutrients he or she needs to grow. How much weight should I gain during my pregnancy? Talk to your health care provider about how much weight you should gain during your pregnancy. General weight-gain recommendations listed below refer to pre-pregnancy weight and are for women expecting only one baby. If you are: underweightxxxxxxYou should gain: about 27 to 40 pounds If you are: normal weight xx x You should gain: about 25 to 35 pounds If you are: overweight xxxxxx You should gain: about 15 to 25 pounds If you are: obese xxxxxxxx xxYou should gain: about 15 pounds or less Top
Do I have any special nutrition needs now that I am pregnant?	Yes. During pregnancy, you and your growing baby need more of several nutrients. By eating the recommended number of daily servings from each of the five food groups, you should get most of the nutrients you need. Be sure to include foods high in folate, such as orange juice, strawberries, spinach, broccoli, beans, and fortified breads and breakfast cereals. Or get it in a vitamin/mineral supplement. To help prevent birth defects, you must get enough daily folate before as well as during pregnancy. Prenatal supplements contain folic acid (another form of folate). Look for a supplement that has at least 400 micrograms (0.4 milligrams) of folic acid. Although most health care providers recommend taking a multi-vitamin/mineral "prenatal" supplement before becoming pregnant, during pregnancy, and while breastfeeding, always talk to your health care provider before taking any supplements. Can I continue to follow my vegetarian diet during pregnancy? Yes, you can continue a vegetarian eating plan during pregnancy, but talk to your health care provider first. If you do not eat any animal foods, it may be difficult to get enough of important nutrients, including protein, iron, vitamin B12, and vitamin D. Your health care provider may ask you to meet with a registered dietitian who can help you to plan meals, and may also recommend that you take supplements. Top
Tips for healthy eating	Meet the needs of your body and help avoid common discomforts of pregnancy by following these tips: Eat breakfast every day. If you feel sick to your stomach in the morning, choose dry whole-wheat toast or whole-grain crackers when you first wake up-even before you get out of bed. Eat the rest of your breakfast (fruit, oatmeal, cereal, milk, yogurt, or other foods) later in the morning. Eat high-fiber foods. Eating whole-grain cereals, vegetables, fruits, beans, whole-wheat breads, and brown rice, along with drinking plenty of water and getting daily physical activity, can help you prevent the constipation that many women have during pregnancy. Keep healthy foods on hand. A fruit bowl filled with apples, bananas, peaches, oranges, and grapes makes it easy to grab a healthy snack. Fresh, frozen, and canned fruits and vegetables make healthy and quick additions to meals, as do canned beans. If you have heartburn during your pregnancy, eat small meals more often, eat slowly, avoid spicy and fatty foods (such as hot peppers or fried chicken), drink beverages between meals instead of with meals, and do not lie down right after eating. Top
What foods should I avoid during pregnancy?	There are certain foods and beverages that can harm your baby if you eat or drink them while you are pregnant. Here is a general list of foods and beverages that you should avoid:
		Alcohol. Instead of wine, beer, or a mixed drink, enjoy apple cider, tomato juice, 100-percent juice mixed with sparkling water, or other non-alcoholic beverages.
		Fish that may have high levels of methylmercury (a substance that can build up in fish and harm an unborn baby). Do not eat shark, swordfish, king mackerel, and tilefish during pregnancy. Eat no more than 12 ounces of any fish per week (equal to four 3-ounce servings-each about the size of a deck of cards).
		Soft cheeses such as feta, Brie, and goat cheese and ready-to-eat meats including lunch meats, hot dogs, and deli meats. These foods may contain bacteria called listeria that are harmful to unborn babies. Cooking lunch meats, hot dogs, and deli meats until steaming hot can kill the bacteria and make these meats safe to eat.
		Raw fish such as sushi, sashimi, or ceviche and raw or undercooked meat and poultry. These foods can contain harmful bacteria. Cook fish, meat, and poultry thoroughly before eating.
		Large amounts of caffeine-containing beverages. If you are a heavy coffee, tea, or soda drinker, talk to your health care provider about whether you should cut back on caffeine. Try a decaffeinated version of your favorite beverage, a mug of warm low-fat or fat-free milk with honey, or sparkling mineral water.
		Anything that is not food. Some pregnant women may crave something that is not food, such as laundry starch or clay. Talk to your health care provider if you crave something that is not food.
		Ask your health care provider for a complete list of foods and beverages that you should avoid.
	Top
PHYSICAL ACTIVITY
Should I be physically active during my pregnancy?	Almost all women can and should be physically active during pregnancy. Talk to your health care provider first, particularly if you have high blood pressure, diabetes, anemia, bleeding, or other disorders, or if you are obese or underweight. Whether or not you were active before you were pregnant, ask your health care provider about a level of exercise that is safe for you. Aim to do at least 30 minutes of a moderate activity (one that makes you breathe harder but does not overwork or overheat you) on most days of the week. *Regular, moderate physical activity during pregnancy may:* Help you and your baby to gain the proper amounts of weight Reduce the discomforts of pregnancy such as backaches, leg cramps, constipation, bloating, and swelling Improve your mood, energy level, and feelings about the way you look Strengthen your muscles and improve your blood flow Improve your sleep Help you have an easier, shorter labor Help you to recover from delivery and return to a healthy weight faster. *Follow these safety precautions while being active during your pregnancy:* Choose moderate activities that are unlikely to injure you, such as walking, aqua aerobics, swimming, yoga, or using a stationary bike. Stop exercising when you start to feel tired, and never exercise until you are exhausted or overheated. Drink plenty of water. Wear comfortable clothing that fits well and supports and protects your breasts. Stop exercising if you feel dizzy, short of breath, pain in your back, swelling, numbness, sick to your stomach, or if your heart is beating too fast or at an uneven rate. Top
What physical activities should I avoid during pregnancy?	For your health and safety, and for the health of your baby, there are certain physical activities that you should not do while you are pregnant. Some are listed below. Talk to your health care provider about other physical activities that you should avoid during your pregnancy. Avoid being active outside during hot weather. Avoid steam rooms, hot tubs, and saunas. Avoid physical activities, such as certain yoga poses, that call for you to lie flat on your back after 20 weeks of pregnancy. Avoid contact sports such as football and boxing, and other activities that might injure you such as horseback riding. Avoid activities that make you jump or change directions quickly such as tennis or basketball. During pregnancy, your joints loosen and you are more likely to hurt yourself when doing these activities. Top
Tips for getting physically active	Get physically active for your health and the health of your baby by using the tips below: Go for a walk around the block or through a shopping mall with your spouse or a friend. Sign up for a prenatal yoga, aqua aerobics, or fitness class. Make sure you let the instructor know that you are pregnant before beginning. Rent or buy an exercise video for pregnant women. Look for videos at your local library, video store, health care provider's office, hospital, or maternity clothing store. At your gym, community center, YMCA, or YWCA, sign up for a session with a fitness trainer who knows about physical activity during pregnancy. Get up and move around at least once an hour if you sit in a chair most of the day; get up and move around during commercials when watching TV. Top
What habits should I keep up after my baby is born?	Following healthy eating and physical activity habits after your baby is born may help you return to a healthy weight more quickly, provide you with good nutrition (which you especially need if you are breastfeeding), and give you the energy you need. You can also be a good role model for your growing child. After your baby is born: Continue eating well. Eat a variety of foods from the five food groups. If you are not breastfeeding, you will need about 300 fewer calories per day than you did while you were pregnant. If you are breastfeeding, you will need to eat about 200 more calories a day than you did while you were pregnant. Breastfeeding may help you return to a healthy weight more easily because it requires a great deal of energy. Breastfeeding can also protect your baby from illnesses such as ear infections, colds, and allergies, and may help lower your risk for breast and ovarian cancer. When you feel able and your health care provider says it is safe, slowly get back to your routine of regular, moderate physical activity. Wait for 4 to 6 weeks after you have your baby to begin doing higher levels of physical activity. Doing physical activity that is too hard, too soon after delivery, can slow your healing process. Regular, moderate physical activity will not affect your milk supply if you are breastfeeding. Return to a healthy weight gradually. Lose no more than 1 pound per week through a sound eating plan and regular physical activity after you deliver your baby. Top
Why should I try to return to a healthy weight after delivery?	After you deliver your baby, your health will be better if you try to return to a healthy weight. Not losing weight after your baby is born may lead to overweight or obesity later in life, which may lead to health problems. Talk to your health care provider about reaching a weight that is healthy for you. Top
Be good to yourself
Be good to yourself	Pregnancy and the time after you deliver your baby can be wonderful, exciting, emotional, stressful, and tiring, all at once. Experiencing this whirlwind of feelings may cause you to overeat, not eat enough, or lose your drive and energy. Being good to yourself can help you to cope with your feelings and to follow eating and physical activity habits for a healthy pregnancy, a healthy baby, and a healthy family after delivery. Here are some ideas for being good to yourself: Try to get enough sleep. Rent a funny movie and laugh. Take pleasure in the miracles of pregnancy and birth. Invite people whose company you enjoy to visit your new family member. Explore groups that you and your newborn can join, such as "new moms" groups. Top
Resources	*The following organizations offer information about pregnancy and health:* American College of Obstetricians and Gynecologists (ACOG) http://www.acog.org/ or 1-800-762-2264 American Dietetic Association http://www.eatright.org/ or 1-800-877-1600 Health Resources and Services Administration (HRSA) Information Center http://www.ask.hrsa.gov/ or 1-888-ASK-HRSA (888-275-4772) March of Dimes http://www.modimes.org/ or 1-888-MODIMES (888-663-4637) National Diabetes Information Clearinghouse (NDIC) www.niddk.nih.gov/health/diabetes/ndic.htm or 1-800-860-8747 National Institute of Child Health and Human Development (NICHD) http://www.nichd.nih.gov/ or 1-800-370-2943 *For information about food safety during pregnancy, contact the following: Food and Drug Administration* (FDA) Food Information Line 1-888-SAFE FOOD (888-723-3366) U.S. Department of Agriculture (USDA) Meat and Poultry Hotline 1-800-535-4555 U.S. Government's Food Safety Web site http://www.foodsafety.gov/ Inclusion of resources is for information only and does not imply endorsement by NIDDK or WIN. Top
	Weight-control Information Network 1 WIN WAY BETHESDA, MD 20892-3665 Phone: (202) 828-1025 FAX: (202) 828-1028 Toll-free number: 1-877-946-4627 Internet: www.niddk.nih.gov/health/nutrit/nutrit.htm E-mail: win@info.niddk.nih.gov The Weight-control Information Network (WIN) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases of the National Institutes of Health, which is the Department of Health and Human Services' lead agency responsible for biomedical research on nutrition and obesity. Authorized by Congress (Public Law 103-43), WIN provides the general public, health professionals, the media, and Congress with up-to-date, science-based health information on weight control, obesity, physical activity, and related nutritional issues. WIN answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about weight control and related issues. Publications produced by WIN are carefully reviewed by both NIDDK scientists and outside experts. This publication was also reviewed by Denise Sofka, MPH, RD, Health Resources and Services Administration, Maternal and Child Health Bureau, and Katrina Holt, MPH, MS, RD, Georgetown University, National Center for Education in Maternal and Child Health. This e-text is not copyrighted. WIN encourages users of this e-pub to duplicate and distribute as many copies as desired. Top
	U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health NIH Publication No. 02-5130 September 2002 e-text posted: February 2003

Healthy Eating

Physical Activity

Tips for pregnancy

HEALTHY EATING

What is a healthy eating plan for pregnancy?

6 or more servings of bread, cereal, rice, or pasta.

3 to 5 servings of vegetables.

2 to 4 servings of fruit.

2 servings of milk, yogurt, or cheese.

2 to 3 servings of meat, poultry, fish, dry beans, eggs, or nuts.

At least 8 glasses of water.

How many calories should I eat?

Each of these healthy choices has about 300 calories:

Why is gaining a healthy amount of weight important?

How much weight should I gain during my pregnancy?

Do I have any special nutrition needs now that I am pregnant?

Can I continue to follow my vegetarian diet during pregnancy?

Tips for healthy eating

What foods should I avoid during pregnancy?

PHYSICAL ACTIVITY

Should I be physically active during my pregnancy?

What physical activities should I avoid during pregnancy?

Tips for getting physically active

What habits should I keep up after my baby is born?

Why should I try to return to a healthy weight after delivery?

Be good to yourself

Resources

Weight-control Information Network