The options below outline some dietary changes that you can explore. You can mix and match based on what feels best for you. It may help to review this information before you speak with your healthcare provider. That way, you can feel prepared to address all your needs.

Add more calcium-rich food to your diet

Calcium-rich foods can be very effective in helping reduce your risk of preeclampsia, and there are plenty to choose from! Here’s a list to get you started: 

• Dairy products: Cheese, milk, yogurt, and cottage cheese 
• Fruits and vegetables: Broccoli, cabbage, bok choy, dark leafy greens, and dried figs
• Nuts: Brazil nuts, hazelnuts, almonds 
• Fish: Sardines, canned salmon, and oysters 
• Tofu 

Add calcium supplements to your diet

Studies suggest that all pregnant people should take 1 gram of calcium supplementation per day from 20 weeks gestation to delivery. Those who are more at risk will want to take 1-2 grams a day during their whole pregnancy.

Add other foods and supplements to your diet

It’s always great to understand the wide range of options you have. Here are some of the other foods and supplements that help reduce your risk of preeclampsia: 

• Fiber 
• Probiotics and prebiotics 
• Fatty acids
• Vitamin D 

Avoid food/diets known to increase risk

While some foods reduce your risk, others may do the opposite. Try to avoid: 

• High-fat diets 
• High-sugar diets
• Salt-rich diets
• Red meat
• Processed meat
• Fried potatoes
• Pickles 

The bottom line 

There is no one-size-fits-all approach. However, some foods may be more effective at reducing your risk than others. Remember, there are lots of options out there. If one doesn’t work, you can always try something else!

Read more

• Preeclampsia: What you need to know 
• Being your own health care advocate
• Exercise and reducing your risk of high blood pressure and preeclampsia
• Smart ways to work calcium into your diet

Reviewed by the Ovia Health Clinical Team

Sources 

• Perry, Abigail. “Dietary factors that affect the risk of pre-eclampsia.” National Library of Medicine. 5(1): 118-133. Web. June 2022.

But what if you found out that BMI is not a useful indicator of your health? BMI is actually a deeply flawed calculation that was only intended to be used for populations, not for individuals.

Let’s break down the fraught history behind BMI.

BMI: The backstory

BMI (first called the Quetelet Index) was invented by a Belgian mathematician (you read that right, not a doctor) named Lambert Adolphe Jacques Quetelet in the early 19th century. He set out to find the “average man” by studying the height and weight of (mostly) European men. His work excluded women and people of color. 

BMI, a calculation of weight (in kilograms) divided by height in (meters squared), was later picked up by health insurers and medical providers in the U.S. They used various BMI categories (underweight, normal weight, overweight, obese, and morbidly obese) to determine insurability and individual health. 

Is this starting to raise some red flags for you?

OK, but does it work?

The short answer is no, it does not work and there are a few reasons why.

1. BMI was originally created to indicate population health, not to determine individual health.

Quetelet was a statistician. His intention was to collect large amounts of data to uncover population-level trends, not to assess an individual’s health or risk factors. 

2. These categories are problematic for individuals who were left out of the original studies

Given the fact that so many groups were excluded from the development of BMI in the first place, it doesn’t make much sense to apply it to them retrospectively. Further, BMI suggests that there is an ideal height/weight ratio. This is simply not true.

3. BMI equates muscle, fat, and bone

The body is made up of (among other things): bones, muscles, and fat. BMI groups all these categories together into one, treating bone, muscle, and fat the same. Not only that, but which out of these three parts of the body weighs the most? Bone. The least? Fat.

So is there a better way to calculate health?

There are alternative calculations of health informed by weight, but the issue at play here goes far beyond the biased history of BMI or its misguided application to individuals, because even weight itself is not a strong indicator of health. Research has shown that simply changing one’s body weight is not a reliable measure of improvement in one’s health. 

If you’re looking to feel stronger and healthier, there are things you can do, like starting a health promoting behavior. 

Here are a few examples of health promoting behaviors

• Setting a goal to drink more water
• Figuring out what type of exercise you enjoy and doing it consistently
• Finding a mindfulness practice that helps you tune into your inner needs
• Intuitive eating: listening to your body’s requests for nourishing food

Setting goals like these – that are based on how you feel, how your body functions, and what you personally need to be living in a healthier body – is more reliably associated with improvement in overall health. 

Providers that rely too heavily on BMI might be missing the whole picture of your health. If you’re concerned that your provider isn’t understanding the whole picture of your health, seek out a HAES (Health At Every Size) aligned healthcare provider. There are therapists, body image coaches, doctors, nurses, and dietitians who are all trained in HEAS. You deserve to feel seen and cared for by your provider, regardless of your BMI or the size of your body. 

Reviewed by the Ovia Health Clinical Team

Read more

• Pregnancy in a bigger body
• Tracking your weight during pregnancy

Sources

• Brazier, Yvette. “How Useful Is Body Mass Index (BMI)?” Medical News Today. MediLexicon International. September 6, 2021. https://www.medicalnewstoday.com/articles/255712.    
• Jackson-Gibson, Adele. “The Racist and Problematic Origins of the Body Mass Index.” Good Housekeeping. Good Housekeeping. November 1, 2021. https://www.goodhousekeeping.com/health/diet-nutrition/a35047103/bmi-racist-history/. 
• “Adult BMI Calculator.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. January 21, 2022. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/english_bmi_calculator/bmi_calculator.html. 
• “About Adult BMI.” Centers for Disease Control and Prevention. Centers for Disease Control and Prevention. August 27, 2021. https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html. 
• The MNT Editorial Team. “BMI calculations and charts.” Medical News Today. Medical News Today. May 3, 2021. https://www.medicalnewstoday.com/articles/323586. 
• Devlin, Keith. “Top 10 Reasons Why the BMI Is Bogus.” NPR. NPR. July 4, 2009. https://www.npr.org/templates/story/story.php?storyId=106268439. 
• Eknoyan G. Adolphe Quetelet (1796-1874)–the average man and indices of obesity. Nephrol Dial Transplant. 2008 Jan;23(1):47-51. doi: 10.1093/ndt/gfm517. Epub 2007 Sep 22. PMID: 17890752.

If you are deciding to focus more on plant-based meals, try to include: 

1. Protein

Proteins are composed of amino acids and are important building blocks for DNA, immune system cells, muscle cells and many more. Protein can be found in quinoa and soy, for example. Dark leafy greens, whole grains, nuts, and legumes (beans, peas, lentils, etc.) are also excellent sources of protein. 

2. Calcium

Most people are aware that calcium is important for bone health. But did you know it’s also essential for nerve and muscle function too? To boost this mineral in your diet, try broccoli, kale, chickpeas, navy beans, wheat bread, raisins, and/or fortified orange juice. 

3. Iron

Iron is needed for building healthy red blood cells. It helps build the part of the cell that carries the oxygen. There is a much higher demand for oxygen when you’re pregnant because you’re breathing for two. It is found in soybeans, spinach, tofu, chickpeas, and several other types of beans. If you have low iron stores, check in with your doctor and make sure they approve of your prenatal vitamin. Many gummy vitamins do not contain iron.

4. Zinc

Zinc is essential for your baby’s developing brain and immune system, it also helps keep your sense of smell and test intact. Good sources of zinc are whole grains, tofu, tempeh, legumes, nuts and seeds and fortified foods like cereal.

5. Vitamin B12

Vitamin B12 is important for the development of your baby’s nervous system. This one comes from animal products. So if you’re eating dairy, that’s a good source. If not, you’ll need to take a supplement in order to get enough for you and your baby. It’s a good idea to speak to your provider about the best way to make sure you’re getting enough of this one. 

6. Fats

Fats are necessary for making hormones that support all of your body systems, and very importantly for you right now, your reproductive system. During pregnancy, your body’s fat requirement increases. Good sources of fats during pregnancy are full fat dairy products, nuts, olives and olive oil, avocado, and fish (if you eat fish, be careful to avoid those high in mercury content particularly when pregnant and nursing).  

Remember, when it comes to nutrition during pregnancy, everyone may need something a little bit different. The good thing is that you aren’t alone. You can talk to your provider or a nutritionist to get support.

Reviewed by the Ovia Health Clinical Team

Read more

• Nutrition in pregnancy
• Why you should track your nutrition during pregnancy

 

Talia Glickman-Simon Contributing writer

Weight gain during pregnancy can be difficult for many people. Some have trouble because of decreased appetite or morning sickness. Others are working through anxiety, depression, and/or eating disorders. The good news is there are ways to support yourself. Here are some tips to get you started. 

Learn the facts

The best first step is to figure out why you’re having trouble gaining weight. The cause could be physical, emotional, mental, or a combination. Identifying the “why” can help you take action. You can start unpacking this question by reaching out to a trusted provider. This clinically validated screening tool is another option to learn about your mental health. 

Be mindful of eating disorders

If you’ve dealt with anorexia, bulimia, orthorexia, purging, or any other eating disorder, the thought of gaining weight might be particularly scary. Watching your body change can be triggering even without this specific history — when you add in the cultural stressors and shame surrounding weight, it can become even more difficult. For some, gaining weight simply may not feel doable, if that’s your experience, it is not your fault. Speaking with a mental health professional who has a background in eating disorders is a good way to find support. Addressing your feelings with someone who understands, might allow you to dedicate more mental energy to taking care of yourself during these exciting but challenging months. 

Be gentle with yourself

Pregnancy isn’t easy, and sometimes gaining weight takes time. Try to remember that you’re doing your best. And, while weight gain can be important, taking care of your other health needs also matters. If you’re looking for new ways to feel emotionally and mentally supported, try out these tips: 

• Move your body
• Call a friend or family member
• Focus on your sleep
• Start a meditation practice
• Check out Ovia’s Self-care Checklist for more ideas

Add in some snacks

Small meals throughout the day may help you slowly get the nutrition you’re looking for and keep your energy up. Try to have food easily available or ready to eat that you’ll look forward to and enjoy. It can be helpful to pair protein and carbs with some fat to help you feel satisfied. If you are struggling with what or how to eat, it’s best to speak with a trusted registered dietitian, who can recommend foods based on your preferences and goals. In the meantime, here are some food options to consider: 

• Greek yogurt with fruit and nuts
• Fruit smoothies including yogurt, dairy or dairy substitute
• Hard boiled eggs with pretzels
•  Cheese and crackers with fruit

Soothe any discomfort

Sometimes nausea makes it difficult to gain weight during pregnancy. If that is your experience, you could try ginger and Vitamin B6 supplements. Food aversions can be another obstacle to weight gain. Try to learn which foods, if any, are making you feel sick. Then you can avoid those foods and focus on what feels most nourishing. 

Find support

Registered Dietitians, mental health professionals, and/or a trusted primary care provider can make a great team when helping you address weight gain during pregnancy. Reaching out to friends and family is another excellent option. Remember — anything that’s coming up for you around gaining weight is valid. Your support network can help. 

Reviewed by the Ovia Health Clinical Team

Read more

• Appetite decrease during pregnancy 
• Morning sickness during pregnancy 
• Food aversions

Myth #1: Avoiding peanuts and other allergenic foods while pregnant can help prevent food allergies for your baby

Fact: According to the National Institute of Allergy and Infectious Diseases (NIAID) Guidelines for Diagnosing a Food Allergy, expecting mothers should not restrict their diets in order to prevent a food allergy. There is new evidence from the landmark LEAP study to show that, in infants with severe eczema and/or egg allergy, avoiding or delaying introducing peanuts was linked to an increased risk of peanut allergy. 

This myth comes from outdated recommendations causing confusion. In 2000, the American Academy of Pediatrics advised allergy-prone moms to avoid peanuts and tree nuts during pregnancy to help prevent their babies from developing food allergies. Now we have more information and based on current recommendations, expecting mothers should not restrict their diet to prevent a food allergy for their baby.  

Myth #2: Eating peanuts and other allergenic foods while breastfeeding can help prevent food allergies for your baby

Fact: In the 2019 Guidelines from the American Academy of Pediatrics (AAP), there was insufficient evidence to show that eating allergenic foods while breastfeeding might be able to  prevent your child from having food allergies.  

“No conclusions can be made about the role of breastfeeding in either preventing or delaying the onset of specific food allergies.” – American Academy of Pediatrics (AAP), March 2019.

Myth #3: My baby isn’t at risk for food allergies if they don’t have a family history

Fact: Over 50% of children with food allergies do not have any family history or a direct family member with a food allergy. Also, babies aren’t born with food allergies — they develop them over time. So in fact, all babies are at risk of developing a food allergy. 

Reviewed by the Ovia Health Clinical Team

Content provided by Ready, Set, Food!. Ready, Set, Food! is a complete guided system that gently introduces your baby to the top 9 most common childhood food allergens, including peanut, egg, and milk. 

Read more

• Food allergies vs. food sensitivities
• Does breastfeeding prevent food allergies?

Lindsay worked for a high end luxury dessert boutique until having her son, Graham, two years ago, when she decided to be a “bake at home mom.” She got inspired by the Parisian Bakery baby size theme in Ovia while pregnant with her second child and decided to bake along week by week. So, of course, we had to know more about this sweet, sweet project. 

What inspired you to start this project? 

When I was pregnant with Graham, I loved seeing what size fruit/vegetable he was every week. Even from the first week when he was just a poppyseed, I found myself always craving the food it mentioned and baking with it that week. 

So from lemon poppyseed madelines to watermelon lollipops, I baked all 39 weeks. I found out about the Parisian bakery size comparison later on, and remember thinking: man, that would’ve been fun! So when I found out I was pregnant again, I couldn’t wait to do it all over again with an even sweeter twist.

How did this project (if at all) impact your experience of pregnancy?

I loved baking along every week — it was always a time for me to connect and reflect on my pregnancy. Every dessert made me feel closer to and more excited to meet whoever was in there. I also loved busting out my pastry school cookbooks, and having an excuse to make some really traditional pastries that I wouldn’t ordinarily bake, like the charlotte royale and brioche a tete. 

Did anything unexpected happen throughout the project?

You know, I’m shocked to say nothing too unexpected happened! The timing was always interesting — like getting a buche de noel the week after Christmas, or beignets during Passover. I also try really hard to not be wasteful and be sure there were people around to eat along with me (which was pretty hard to do in a pandemic! and what am I to do with 3 dozen cream puffs, or 2 clafoutis!?) so I’d drive and deliver to my family and friends. It was always an adventure driving around with 6 crème brûlées and texting my friends at 2pm on a Tuesday asking if they want one!

What was your favorite week? 

Probably the croquembouche week! I was so excited to have an excuse to make something so involved and such a showstopper. My son saw it in the morning and kept pointing to it and saying: ‘Mommy made that!’ 

If someone else wants to try this, any tips? 

Don’t stress! Just enjoy the project, and the sweets. Also, don’t be afraid to make a few ‘edits’ based on your cravings, and the calendar. For example, I had a baguette the week of St. Patrick’s day and had already had a lot of bread in the house, so I made rainbow bread pudding. A win win! 

My entire pregnancy journal is my Parisian bakery goods instead of bump pictures, and I wouldn’t have it any other way! 

Want to check out the baby size themes in Ovia? Tap here.

Helpful information about iron-deficiency (anemia)

Iron-deficiency anemia is easily diagnosed and treated — and very common in females, especially those of childbearing age. The World Health Organization estimates that more than 42% of pregnant women and 30% of nonpregnant women and suffer from this condition.

Why do so many women of childbearing age have iron-deficiency anemia?

Women who are of childbearing age are at high risk for the condition because of the blood lost during monthly periods. If you have a heavy period, you might be at high risk for this condition. Women who are pregnant are also at high risk for the condition because their bodies are in need of even more iron than usual due to their increased blood volume and the iron and hemoglobin needed for a baby’s growth.

A number of other conditions and risk factors can lead to iron-deficiency anemia. Individuals who don’t consume enough iron — found in foods like meat, leafy greens, eggs, and iron-fortified foods — could be at risk. People who suffer blood loss for other reasons — such as ulcers or hernias — or even frequent blood donors can also be at risk. And because iron is absorbed by the body in the small intestine, individuals with disorders that affect the small intestine’s ability to absorb such nutrients can be at risk too.

What are some of the symptoms of anemia? And how is it diagnosed and treated?

Mild anemia usually goes unnoticed as some of the common symptoms of iron-deficiency anemia can be easily attributed to other issues or overlooked. But when the condition does worsen, common symptoms may include:

• Fatigue or lack of energy
• Generalized weakness
• Pale or yellow skin
• Headache, lightheadedness, or dizziness
• Pounding in the ears
• Shortness of breath
• Rapid heartbeat or chest pain
• Cold hands and feet
• Brittle nails
• Hair loss
• Sore tongue
• Poor appetite
• Pica, unusual cravings for non-nutritive substances (like ice, dirt, or starch)

Your healthcare provider can run blood tests to diagnose iron-deficiency anemia. Because the condition is often under-diagnosed, being your own healthcare advocate can go a long way. If you’re suffering from any of these symptoms, ask your provider if they think such tests are warranted.

Once diagnosed, your provider will work to understand the underlying cause of the condition. Fortunately, for many, anemia can easily be treated with over-the-counter iron supplements or dietary changes. Many people do start to feel better after a few weeks, and your healthcare provider will likely have you retake the same blood tests a month or so after starting treatment to see if your iron levels are improving.

What can iron-deficiency anemia lead to?

If iron-deficiency anemia is left untreated, it can cause a number of complications such as heart problems and a greater susceptibility to infection.

In pregnant women, the condition is linked to premature births, babies with low birth weight, and greater blood loss after birth. Luckily, blood tests at initial prenatal healthcare appointments include blood tests that will look for signs of anemia. Based on these test results, for many women their prenatal care may very well include iron supplements.

Read more

• Foods to fix iron-deficiency anemia
• Why preventive care is essential for better health

Sources:

• AJ Friedman et al. “Iron deficiency anemia in women: A practical guide to detection, diagnosis, and treatment.” Obstetrical & Gynecological Survey. 70(5): 342-53. May 2015. Retrieved August 28 2017. https://www.ncbi.nlm.nih.gov/pubmed/25974731.
• Mayo Clinic Staff. “Iron deficiency anemia.” Mayo Clinic. Mayo Foundation for Medical Education and Research, November 11 2016. Retrieved August 28 2017. http://www.mayoclinic.org/diseases-conditions/iron-deficiency-anemia/home/ovc-20266507.
• “Iron-Deficiency Anemia.” American Society of Hematology. American Society of Hematology. Retrieved August 28 2017. http://www.hematology.org/Patients/Anemia/Iron-Deficiency.aspx.
• “What Is Iron-Deficiency Anemia?” National Institutes of Health: National Heart, Lung, and Blood Institute. U.S. Department of Health and Human Services. March 26 2014. Retrieved August 28 2017. http://www.apa.org/helpcenter/emotional-support.aspx.

Pamela DeGregorio Women’s Health Writer at Ovia Health

Alyson Roux worked for a decade in the arts and entertainment industry, when, spurred by her own health challenges, she chose to return to her science roots to help others live as healthily as possible, reconnect with nourishment, and grow to have a positive relationship with food. I spoke with the L.A.-based nutritionist about why you may want to both open up with and establish boundaries with your healthcare providers, how new parents can feel good about their bodies, and why you may want to pare down your Instagram feed to do just that. 

Recently we had a great conversation about body positivity and how new moms and birthing parents can feel good in the bodies they’re in. You also told me that for many individuals – especially those with a history of chronic dieting, disordered eating, or struggling with body image – there are a lot of points in the healthcare process, sometimes even before pregnancy and when beginning the process of trying to conceive, that can potentially be rather triggering. And because of this, establishing boundaries during this process can be immensely helpful. So if a patient is working to establish healthy boundaries with a healthcare provider, what might that actually look like in practice? 

So I think it’s really important that if you know that you have some risk for disordered eating or an eating disorder or negative body image to talk about that with a therapist or qualified nutrition professional to develop those boundaries. But if you can’t afford to do that because of time, money, whatever, to just think on your own, “Okay, what are my healthy boundaries with my care provider?” 

Know that you have the right to say, “I would really prefer that before you give me any food or exercise advice, please know that I’m struggling with my body image and I’m doing all the things that I can do to work on that.” So that’s really important. Because we absolutely have the right to do that. 

We also have the right to refuse to be weighed at a medical appointment. Evelyn Triboli, the author of Intuitive Eating, once said that you can ask your provider to put in your medical chart, “patient politely refuses to be weighed.” So if you find the weighing process really triggering and you’re noticing it makes you feel really uncomfortable, you can say that. 

Those boundaries seem like they could be such a meaningful – and empowering – advocacy tool for patients. I also have to say that – as someone with a history of disordered eating myself – these suggestions both surprise and resonate with me. They surprise me because, well, weigh-in is such a standard check-in process with most healthcare providers that I just never would have thought I could ask to not be weighed. I feel like I had really supportive medical care during both of my pregnancies, but my reproductive healthcare providers didn’t know about that history. And I remember a few weigh-ins during pregnancy with my second child where I just gained a little more weight than with my first, and even though I knew this was fine and I knew that I was eating food that was nourishing my body, it was definitely triggering – I was really surprised by how much I didn’t feel good about it, and I remember some of that old disordered thinking popping up again. And I had – and still have – such a great relationship with those providers and typically feel pretty comfortable advocating for myself! I think I would have been entirely comfortable saying, “Hey, by the way, here’s some of my medical history that you’ve never asked about. I’m in a good place now, but can we maybe skip those weigh-ins?” 

Unfortunately, I think there’s a lot of pressure from what are traditionally viewed as safe, supportive places – like with a physician or even a nurse or medical assistant who’s doing the weigh-ins. And those little moments – when it’s supposedly a health care environment – can actually be extremely triggering.

We know that every single body is different with every single pregnancy, in terms of how that body is going to gain and lose weight.

We also know that all of those points of potential risk – the risk of triggering body dissatisfaction – they increase the risk of disordered eating. That’s concerning because disordered eating and chronic dieting actually increases the risk of weight cycling and chronic dieting overall increases the risk of weight gain over time.

I realize I keep talking about disordered eating, and it’s very much because there was a study that showed that almost a third of new parents who were in an intensive outpatient program for postpartum depression had disordered eating or an eating disorder. It’s extremely common and may contribute to risk of depression, or vice versa.

And when there’s stigma and bias from a medical professional, it means there’s a missed opportunity for adequate care. Fortunately, there’s more research happening around how to educate clinicians around weight stigma and ways to remove bias so that people can have more quality care. But, unfortunately, in the meantime the responsibility comes to the patient to develop those healthy boundaries.

What other sort of boundaries or filters can be meaningful?

Honestly, one easy place to filter is your social media. I think we all might have that friend from high school who is constantly selling some kind of multilevel marketing cleanse program and they actually have no health education training whatsoever. For an individual who doesn’t struggle with disordered eating or hypervigilance, they might not be impacted by that, but for a lot of people, that’s super triggering. So you want to be okay with saying, “Okay, I’m going to quiet that in my feed for a little while.” In the long run, all of that sort of stuff – cleanses, all that saran wrap fat-busting stuff – is potentially going to cost you a lot of money, shame, and stress.

So focusing on getting your health information, ideally, from actual professionals who have training in eating behavior can be very meaningful. 

For example, even a well-intentioned, high-quality, very experienced lactation consultant may recommend removing a food to help a baby’s colic – and that potentially could be really triggering for somebody. There’s absolutely nothing wrong with being able to have conversations like that, but again, it comes back to making sure that you disclose, “Okay this is triggering me or making me uncomfortable.” 

So in a lot of instances, it’s incredibly helpful to build those healthy boundaries and to disclose this sort of information if you’re comfortable doing so. And if you’re struggling with that, it can be really beneficial get help from a therapist.

Read more

• Maintaining healthy relationships
• How to advocate for yourself as a patient to get the care you deserve