What can your pregnant client drink?
When it comes to drinking during pregnancy, alcohol isn’t the only thing that needs to be taken into consideration, writes nutritionist and exercise scientist Brooke Turner.
THE QUICK READ
- Pregnant women should not consume more than 200mg of coffee per day
- Inclusions of protein and fat sources in smoothies are beneficial for tissue growth, cognitive and retinal development of the growing baby
- Smoothies are a great way to hit micronutrient requirements during pregnancy, particularly in women who become averse to fresh fruit and/or vegetables due to morning sickness or nausea
- Protein powders can be useful throughout pregnancy, however, not all are created equal and artificial sweeteners, additives, fillers and stimulants should be avoided
- Pregnant women should choose a diet high in fresh, whole, healthy foods and engage in regular physical activity.
It is well known that alcohol should be avoided during pregnancy as there is no safe limit – but what about caffeine, kombucha, smoothies or protein powder? With confusion surrounding these beverages during pregnancy, do you know what recommendations you can make for your expecting clients?
Australian guidelines recommend expecting women limit their caffeine intake to less than 200mg per day, which equates to about two instant coffees or three black teas. It is important for women to be mindful of their caffeine intake during the first trimester due to this time bearing the greatest risk of miscarriage, and higher consumption of caffeine having been linked to low birth weights.
There has been a reasonable amount of research into consumption of caffeine during pregnancy. Studies have reported that excessive caffeine intake has been associated with a reduction in birth weight, though the exact level is still unknown. One UK study involving more than 2,500 women confirmed that a maternal intake of more than 300mg per day was associated with low birth weight or foetal growth restriction, and that no ill effects were recorded in the babies of the women who consumed 100mg or less daily.
It is also important to consider other sources of caffeine, such as chocolate, soft drinks and energy drinks. Consumption of these contribute to daily caffeine intake. The table over the page lists some common sources of caffeine and their concentration levels.
With regards caffeine and micronutrients, tannins found in caffeinated substances, like tea and coffee, can inhibit the absorption of iron, as can calcium (think milky coffee). If clients are struggling with iron levels, then check in with them on how much coffee, tea or chocolate they are consuming per day, advise them to have any pre-natal vitamins they may take at a separate time from their coffee, and ensure they are meeting their recommended daily intake of vitamin C, which assists with the absorption of iron.
This is another controversial beverage during pregnancy, and one that comes down to personal choice. Although it’s been around for a long time, it’s only in recent years that it’s become a café and supermarket staple, so research into drinking kombucha during pregnancy is very limited. While kombucha is a great source of probiotics, promotes gut health and is a nice alternative to having a drink when you are trying to avoid alcohol, there are some things you should consider regarding consuming it during pregnancy.
Many people don’t realise that kombucha actually does contain a very small amount of alcohol, which is produced during the fermentation process. If stored improperly, too long, or brewed in unsanitary conditions, both unpasteurised kombucha and home-brewed varieties can also develop mould and bacteria. Unless a client was a regular ‘booch’ drinker prior to falling pregnant, it’s probably advisable for them to avoid it throughout their pregnancy. Many home brews are unpasteurised, so fall into the same category as soft cheeses that are recommended to be avoided during pregnancy due to the listeria and bacteria risk. Although the risk is low, it is important for clients to be aware of this. My recommendation would be to opt for store-bought varieties of kombucha rather than home brew throughout pregnancy, due to more controlled processing and decreased risk of bacteria.
Juices and smoothies
During pregnancy, juices and smoothies are a fantastic and convenient way to help get your daily dose of micronutrients, fruit and vegetables. However, not all smoothies or juices are created equal, with many being high in both energy and sugar. Cold pressed or freshly squeezed juices are much better options than many store-bought varieties, but can still be high in sugar. Consuming processed foods and those high in sugar can contribute to excess weight gain, high blood sugar levels and gestational diabetes.
Juice: When making or choosing a juice I recommend opting for a 2:1 ratio of vegetables to fruit if possible. The higher dose of vegetables helps to reduce the total amount of sugar compared to fruit juice alone, in addition to adding fibre and a wider range of micronutrients. I recommend avoiding, or limiting, pre-packaged juices due to their high sugar and energy content.
Smoothies: These are perfect go-to meals during pregnancy, particularly for women who already have children, work full time or have been suffering from a decreased appetite due to morning sickness. Women who fall into these categories are often associated with a decreased intake of fresh vegetables, so smoothies are a great way to hit RDI’s throughout pregnancy.
When it comes to smoothies, ensure some vegetables are included, along with sources of protein and fat which assist with tissue growth, cognitive and retinal development in the growing baby. Good sources include Greek yoghurt, protein powder, chia seeds, flax seeds/flaxmeal, nut butter, avocado and coconut yoghurt.
Many expecting training clients ask ‘can I take protein powder whilst pregnant?’ Supplements should never replace a balanced, healthy diet and whole foods, but there are times when it can be useful or advisable to supplement. Yes, it is safe to use protein powders during pregnancy, as long as you don’t have a ‘high’ consumption of protein already.
The Nutrient Reference Values for Australia and New Zealand for protein during pregnancy is 1g per kg of body weight per day. I recommend active individuals to aim for a minimum of 1-1.5g per kg per day: for someone weighing 70kg, that equates to about 70-105g of protein per day during pregnancy. An example of how a client may reach this level of protein intake might be:
- Breakfast of 3 boiled eggs, approximately 21g protein
- Lunch or dinner of one serve (100g) of chicken, approximately 30g protein
- Snack of one serve of almonds (15-20g), approximately 6-10g protein
- One serve of most protein powders is 25-30g
Protein powders can be useful during pregnancy to support the increased requirements and tissue development, but they are not essential. It is important to note that not all powders are created equal, and trusting the brand used, as well as reading and interpreting the nutrition label, is essential in understanding the ingredients within the product and if it is right for you. Clients should opt for brands that don’t contain artificial sweeteners, fillers or stimulants.
When it comes to alcohol during pregnancy, there is no safe limit. The National Health and Medical Research Council, Australia’s peak body on developing national health advice, recommends that for women who are pregnant, planning pregnancy or breastfeeding, not drinking alcohol is the safest option. This is because no amount of alcohol has been proven as safe. The evidence is clear: alcohol causes birth defects. All alcohol crosses the placenta, increasing the risk of miscarriage, stillbirth, premature birth, low birth weight, birth defects and brain conditions.
I recommend clients avoid soft drinks completely. While there are not a great deal of studies looking at soft drink and pre-natal women, the effects of excess sugar in any individual are well known. It goes without saying that these types of beverages are high in energy and sugar yet lacking in nutrients. A refreshing low-sugar alternative for those used to cracking open sweetened sodas could be chilled mineral or sparkling water with freshly squeezed lime, lemon or grapefruit, or even flavoured magnesium powder.
Your body is approximately 60% water, with the brain being made up of ~70% water. Inadequate water intake affects optimal functioning and can lead to digestive problems, constipation and weight gain. If you aren’t adequately hydrated, you may consume more calories and confuse thirst with hunger. This is because our thirst and hunger receptors are controlled by the same part of our brain, namely the hypothalamus. I recommend pregnant clients consume a minimum of 2-2.5L of water per day, and more on training days or if they live or work in a hot environment. Pre-natal women have the urge to go to the bathroom more regularly, so it helps to try and get at least half of their intake in before lunchtime, both to ensure that they meet their quota, and to help limit sleep disturbances through night time trips to the bathroom.
Sound nutrition can assist greatly in promoting a happy, healthy pregnancy, and in post-natal recovery. Regardless of where your clients are at with their pre-natal nutrition, it is never too late to start eating and drinking well.
Brooke is a nutritionist, exercise scientist, personal trainer, writer, presenter and mother of two with over ten years’ experience in the health and fitness industry. Brooke’s programs include her six-week STRIVE program and Happy, Healthy Pregnancy eGuides. Brooke is a believer in striving for a balanced approach to health and fitness and aims to inspire and empower others to see that healthy active living need not be a hindrance but a habit.