The moment you find out you’re pregnant– focus shifts. It’s not just about you anymore. EVERYTHING  you do is discussed, scrutinized, planned out and talked about. A frantic flurry of information. The constant internal dialog, “will this be good for my baby?” It can be overwhelming and confusing. We talked with Dr Elizabeth Moran of CAROLINAS HEALTHCARE SYSTEMS  Eastover OB/GYN  to discuss the important topic of exercise and nutrition during pregnancy.
Exercise During Pregnancy
Who can exercise and what types of exercises are best during pregnancy?
“Almost all healthy women are encouraged to exercise during pregnancy. Your goal should be 30 minutes or more of moderate exercise a day, most days of the week. Your initial prenatal appointment is a good time to ask your doctor if you have any special restrictions  that would make exercise unsafe. Participation in a wide variety of activities is safe during pregnancy. Safe exercises- even for beginners include: *Brisk walking *Swimming *Cycling (stick to a stationary or recumbent bike like Flywheel) *Low-impact water aerobics *Body sculpting with light weights, Yoga or Barre classes”
Further discussion about Yoga/ Barre
“These in some ways are the ideal exercises in pregnancy. They strengthen muscles, improve flexibility, and can ease back pain. However, there are a few positions that require modifications to keep from lying flat on your back or belly. Most instructors will know how to help if you ask. It is usually a good idea to avoid Bikram (hot yoga)”.
Let’s do this! How do I get started?
“If you are feeling tired during the first trimester, or it has been a while since you exercised, start slowly. If you begin with as little as 5 minutes a day you can add 5 minutes a week until you reach your goal of remaining active for 30 minutes. Most pregnant women should exercise indoors when it is hot outside, and it is mandatory to pay attention to proper hydration. It is usually advised to carry a bottle of water with you. If you are already an elite or competitive athlete you should speak to your doctor about what your restrictions and modifications should be. Most pregnant women, whether athletes or not, benefit from exercising with a partner or group to help stay motivated, increase enjoyment and promote safety.”
How much is too much?
“While you exercise, pay attention to your body! Do not exercise to the point of total exhaustion. Drink plenty of fluids to remain hydrated. Your goal should never be weight loss. A good rule of thumb is the talk test….if you are able t carry on a conversation while exercising, that is a sign your heart rate is at an acceptable level.”
I had the baby! When can I resume exercising?Â
“It has been shown that a return to physical activity postpartum can reduce stress, decrease the risk of postpartum depression, and help in returning to pre-pregnancy weight. It is important to remember though, that many of the pregnancy related changes in your body persist for 4-6  weeks. Your pre-pregnancy exercise routine may be resumed gradually  as soon as it is safe. This will depend on the particulars of your delivery. Ask your doctor when you can resume activities and remember to build slowly.”
Nutrition During Pregnancy
What does eating for two really mean? How do I do this in a healthy way?
“Eat healthfully and let your hunger be your guide. An increase of 200-300 calories per day is all that is needed. Sometimes it is best to have several small meals focusing on protein. In the first trimester when nausea can be frequent try sipping on a protein drink (boost or ensure) which contains some protein and nutrients instead of  simple carbs and sugars (like ginger ale & crackers). Your doctor will monitor your weight gain throughout pregnancy and alert you to any issues.”
What foods should be avoided during pregnancy?
“Raw and unpasteurized foods should be avoided as well as seafood with high mercury content. Most cheese in NC is pasteurized so that should not be an issue. Deli meats can be heated slightly (like in a panini  press) to cut down on the possibility of listeria. If you have specific questions about food be sure to talk to your doctor.”
Essential foods for the pregnancy diet:
“A well balanced diet with plenty of protein is essential. Your doctor will prescribe a prenatal vitamin to be taken everyday along with an addition vitamin D supplement. The supplements are not a replacement for healthy eating. Be sure to get a variety of foods from all food groups- grains, fruits, vegetables, protein and dairy.”
Sample menu:
Breakfast: Pear & Cheese Breakfast Sandwich.
An English muffin turns this traditional lunch-time sandwich into a fun breakfast option. Separate the two sides of a whole wheat English muffin. Place 1/2 of a large pear, sliced, on one half and top with a 1-ounce slice of cheddar cheese. Put both halves under the broiler for 2-3 minutes, or until the top browns and the cheese is melted. Sandwich the two halves together. Serve with the remaining half of the pear spread with 2 teaspoons almond butter. Morning Snack – suggestions below.
Lunch: Egg, Veggie & Hummus Pita
This pita has veggies, eggs, hummus — and tons of flavor! Fill a 6-inch whole wheat pita with 1/4 cup hummus, 1 sliced hard-boiled egg plus one hard-boiled egg white, 1/3 cup chopped tomato, 1/2 cup baby spinach, a sprinkle of paprika and 1 tablespoon toasted pine nuts. Serve with a cup of grapes Afternoon Snack – suggestions below.
Dinner: Chicken and Pineapple Kebobs
Throw some of these kebobs on the grill for a healthier alternative to standard BBQ fare. Cut 4 ounces of chicken in 1.5 inch pieces. In a zip-lock bag add juice of 1/2 a lime, 1/2 clove of chopped garlic, 1/4 cup juice from pineapple canned in its own juices and 1 teaspoon olive oil. Let marinate for about 30 minutes. Cut 1/2 of a medium red bell pepper and 1/4 of a medium onion into 1″ pieces. Thread chicken, pepper, onion and 1/2 cup canned pineapple chunks in their own juices, onto 2 skewers. Grill on a medium high flame until chicken is cooked to an internal temperature of 160 degrees. Serve over 1.5 cups cooked bulgur wheat tossed with 2 teaspoons olive oil, 1/8 teaspoon salt and pepper to taste. ****sample menu from parents.com
What are your top 5 Healthful Snacks?
“Keeping blood sugar levels stable is important. Snacks high in protein will not only stave off hunger but it’s what a pregnant body needs. Mix carbohydrates with protein. Here are some choices: 1. Apple slices with peanut butter (or almond butter) and granola flakes 2. Babybel cheese  with a piece of fruit 3. Trail mix package 4. Hummus and veggies 5. Ants on a log (celery, peanut butter, raisins)”
Can I drink diet drinks?
“The artificial sweetener aspartame is considered safe during pregnancy however, it is best to drink diet sodas in moderation. Hydration is important and diet drinks don’t really hydrate. Water is best. Try sparkling water mixed with fruit juice for a refreshing alternative. Diet drinks containing saccharin should be avoided.Also, limit caffeine intake to <200 mg a day. For some comparison 8oz brewed coffee such as Folger’s has 133 mg (Starbucks has slightly more), 8oz brewed tea 50 mg, 12oz Coke 50 mg, Ben and Jerry’s coffee ice cream has 75 mg.”
Always consult a doctor before starting an exercise program or taking supplements. The doctor that is treating you knows your history and is best suited to give advice specifically for your pregnancy.
- Administrative Chief Resident (2008)
- E. Daniel Griffin Jr. MD award for surgical excellence (2008)
- Charlotte Magazine Top Doctor (2011)
Eastover OB/GYNÂ 1025 Morehead Medical Drive, Suite 450 Charlotte, NC 28204Â Phone: 704-446-7800
Elizabeth B. Moran, M.D. is a Board Certified in OB/Gyn and Fellow of the American Congress of Obstetrics and Gynecology. She is a native Charlottean who attended Charlotte Country Day School. She  completed her undergraduate work at Duke University and earned her Medical Degree from Wake Forest University School of Medicine in 2004. She currently serves on the Board of Directors of the Mecklenburg County Medical Society.
She has been the recipient of a Glasgow-Rubin Achievement Award, Berlex Best Teaching Resident Award, Administrative Chief Resident Award, E. Daniel Griffin Jr. MD award for Surgical Excellence and Charlotte Magazine Top Doctor. She is married with two young daughters and enjoys travel, food, wine and exercise in her spare time.
