Tag Archives: pregnancy

Q&A: Leg Cramps

Q: I’m pregnant and have been waking up every night with horrible leg cramps. My researching online says I maybe need more magnesium. Do you have any suggestions how to work this into my diet?

A: Ouch! That is no fun. I had leg cramps with my second pregnancy, and I can remember how much those hurt.

The hard fact is that no one 100% knows why leg cramps happen, because there are lots of things that can lead up to them. Here are four common nutrients that are suggested or that I have seen be helpful. The good news is that many of these are found in the same foods (another reason it can be hard to identify exactly the cause/solution). Also good news, the same answers apply to pregnancy leg cramps or non-pregnancy related leg cramps.

1) Magnesium. As your researching suggests, magnesium is commonly recommended for leg cramps. In general, good sources are nuts, dark leafy greens (like spinach), and whole grains.

2) Potassium. Potassium rich foods are bananas, citrus fruits/juices, potatoes, tomatoes, yogurt, and dark leafy greens.

3) Calcium. Calcium rich foods are dairy products, dark leafy greens, and broccoli.

All three of these nutrients are part of normal muscle function. If one is depleted, it can cause cramps. Since all three work together, it can be hard to know exactly which one is missing, unless you are on a specific medication that we know depletes that nutrient.

4) Water. Water requirements in pregnancy can be hard to determine. You need a lot. Most say at least 8-10 cups a day, others will say up to 16 cups. I personally found that if I was better hydrated, my leg cramps went away. It’s hard, because we tend to not drink water late in the day so we aren’t up in the night using the bathroom. But I’d rather have to go to the bathroom than be up in pain.

Good luck! Hope this helps!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Obesity, empathy, and body image thoughts

Occasionally, in all the media clutter we see and hear each day, a clear, concise message appears to you. That happened to me today. I listened to the most recent post on This American Life entitled “Tell Me I’m Fat”. It was riveting, thought provoking, and entertaining. Everything a great podcast episode should be. You should really listen to it here.

Also today, an article popped up on my Facebook feed about how dietitians need to have empathy and how that can be better “taught” in dietetics training programs. I totally agree with this being a problem. While I had very good education and training as a dietitian, the most “empathy” that ever came into my lessons was teaching you how to keep a straight face while taking down a diet history. As in, when a client/patient tells you that he/she ate an entire cake or 14 tortillas in a day, you smile and say, “ok”. That was a good skill, believe you me. And I’m not criticizing my professors because empathy isn’t something you can really “teach”. It has to be developed with time and experience.

Together, those have prompted me to write a few very open, honest thoughts here.

1) I have never in my life been obese. I have never had to struggle with so many of the daily trials that face obese people. The stories in the podcast highlight many of these: finding clothes, being comfortable eating out, criticism from complete strangers, worrying about breaking a chair, etc. So I can try to be empathetic and imagine how that feels, but I haven’t had that experience.

2) However, I have struggled with my weight. Multiple times in my rather short adult life, so I do have some measure of empathy about weight and body image and those struggles.

When I graduated from college, I didn’t like how I felt or looked or what the scale said. I spent an entire summer exercising and trying to cut back on junk food. The result was maybe 5 pounds of weight loss, which was incredibly disheartening. Luckily for me, I then started grad school. The stress and busy schedule helped me almost unconsciously shed the last 10 pounds I needed/wanted. And then cancer and endocrine instability helped me drop 10 more. I was back to what I weighed in middle school. I’ll admit, I liked how looked and wanted to keep it that way, even if was a bit on the light side of healthy.

Then school ended. Life changed. Thankfully, for a couple years, I was able to mostly maintain my weight.

Then babies happened. My first pregnancy, I gained a bit too much weight, but it seemed to just melt off after I had my baby. One month post-partum, thanks to breastfeeding and some postpartum depression inhibiting my eating, I was back to my pre-pregnancy weight and feeling really good. Fast forward about 4 months, and things weren’t so easy. But with some frequent exercise, I was able to stay in a good place for me.

Fast forward now to pregnancy number two. I gained more weight. I couldn’t stop gaining weight. When I would see how much the scale went up at a doctor’s visit, I’d feel sad and go home and eat a cookie. Smart, right? I was only about 5 pounds over the maximum recommended weight gain, but I had started pregnancy about 5 pounds up from my usual desired weight, too. This time, the weight did not melt off after I had the baby. 6 weeks out, my 2 year old was pointing to my tummy and asking about baby sister. My baby is almost 11 months old now, and I’m still not where I’d like to be.

Recently, I’ve challenged myself to nine weeks of exercise and limiting treats to try and feel better about myself for a family cruise. So far, I’ve kept to my plan (gloriously pictured below). But I’ll admit, I don’t think I’ve lost a single pound. And I still crave chocolate EVERY SINGLE DAY.

My current exercise and diet challenge

That is more about my life and weight history than maybe you wanted to know. But I hope it shows that I can have some empathy about weight, diet, eating struggles, etc.

3) While I understand it is a very complicated, multi-faceted issue, I am a big proponent (on face value) of the movement of accepting one’s weight, even if you are fat (as discussed in the podcast). I have posted multiple times on this site about research showing that healthy choices at any weight are beneficial, how the number on a scale is just a number, and so much more. AND IT IS STILL TRUE! Might you be better off if you hadn’t gained 30 (or 50 or 100) extra pounds in the first place? Yes. But can you go back and change that? No. What you can change is the future – not gaining more weight, maybe losing some weight, maybe just making healthier lifestyle choices.

In my own life, I have COMPLETELY found this to be true. When I was down to my middle school weight, I didn’t always feel great. Now that I’m up 15 pounds, but exercising six days a week and controlling my eating more, I do feel better. I stared down a plate of brownies all afternoon/evening one day last week and didn’t eat a single one. The mental boost it gave me to feel like I was in control of myself was immensely more beneficial than any endorphin rush from some sugar and chocolate.

No one sets out to become overweight or obese. I don’t think anyone would intentionally choose that life path for themselves, fully knowing the pain, discrimination, health issues and other struggles associated with it. But they can choose to change their future course. And we can choose to not contribute to the discrimination and to help people make better choices in their future.

I’d love to hear your thoughts about the podcast, obesity, obesity discrimination, and empathy in the comments!

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Q&A: Infertility and Nutrition

Q: I’m wondering if you have any nutrition tips for fertility/pregnancy. I’m struggling with infertility, and I’ve seen a lot of sites online with nutrition advice. Are there any fertility “super foods” I should consider adding to my diet? Or anything I should avoid, other than the usual culprits of sugary, fatty foods?

A: First, let me say I’m very sorry you are having this challenge in your life. I know it can be very taxing both physically and emotionally.

The general consensus I found on several nutrition and pregnancy expert sites don’t really suggest any super foods. A Mediterranean style diet – high in monounsaturated fats, fish, plant based proteins, whole grains, fruits, and vegetables – is the most commonly suggested diet. Avocado and olive oil would be two of the more common sources of monounsaturated fats. Beans and grains are good sources of plant proteins.

The biggest departure from normal nutrition advice is that one Harvard study found women who consumed high fat dairy had decreased risk of infertility. So, if you wanted to swap your skim milk for some 2% or even whole, it might help. The best results were seen for women with ovulatory infertility, although some benefit was seen for all sources.

I hope this was helpful and wish you the best!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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Aspartame

Everyone has an opinion on what you should or should not eat when you are pregnant, it seems.  Recently, a man at the grocery store told me I should not buy a certain light yogurt since “it contains aspartame which is toxic for the baby, you know”.  I tried to pleasantly smile and show him where it says on the front of the package that the yogurt contains no aspartame.  This made me stop and think more about aspartame.

Aspartame is a very common artificial sweetener.  Commercially, it is known as Nutrasweet and Equal.  It can be found in some sugar free products as well.  It is not found in products that have been heated to a high temperature however, since it is not very heat stable.

Aspartame is about 200 times sweeter than regular sugar.  It is made by combining two amino acids – aspartic acid and phenylalanine.  When we eat aspartame, it is broken down to these two amino acids and methanol.  The amino acids are clearly safe to have in our bodies, unless you have a special medical condition.  Methanol can be toxic in high amounts, but the amount generated in the breakdown in the regular consumption of aspartame is less than the amount of methanol created by digesting some natural foods.

Research to this point has not shown any adverse health effects from consuming aspartame, although it has been accused of causing cancer, Alzheimer’s disease, ADD, and many other issues.  While research is ongoing, it is considered safe to consume in moderation.

The FDA has a set a recommended upper limit for consuming aspartame at 50 milligrams per kilogram of body weight.  Few people would ever consume that much.  For example, a 200 lb person could consumer over 4500 mg of aspartame in a day.  That would be 23 cans of diet soda or 129 packets of tabletop sweetener.  Hopefully, you can see there are health consequences of consuming those amounts of these products beyond any concerns about aspartame.

What is my opinion?  I don’t like putting a lot of fake ingredients into my body, for sure.  However, I also know there are detrimental effects of consuming excessive sugar – such as excessive weight gain which can lead to diabetes and a multitude of other health problems.  I drink diet soda, on the rare occasions I drink soda.  I also see the benefit of sugar free products for those with diabetes.  As always, I think moderation is key.

Happy eating!

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Pregnancy and post-pregnancy weight

The day I went to the hospital to have my daughter.  Not a moment for skinny thoughts.

The day I went to the hospital to have my daughter. Not a moment for skinny thoughts.

In the last few months, at least 10 people I know have announced a new pregnancy. My social media is crammed with their announcements, ultrasounds, and puking reports. I also recently read a somewhat disturbing statistic. In a recent study, 75% of women followed were heavier one year after giving birth than before their pregnancy. The women studied gained an average of 32 pounds while pregnant, which is within the range of recommended weight gain for normal weight women. With this in mind, here are a few pointers on pregnancy weight gain and losing that weight once baby arrives.

-Embrace a healthy amount of weight gain. If you begin pregnancy at a normal weight, 25-35 pounds is considered a healthy amount of weight to gain. If you are overweight, aim for 15-25 pounds. But remember: the more you gain, the more you will have to lose postpartum.

-You are eating for two, but one of you has a pretty small appetite. Even during the third trimester, you only need an extra 300 or so calories a day. Adding a couple healthy snacks during the day will easily meet those needs.

-Breastfeed! Breastfeeding mothers may need up to 500 extra calories a day, which is more than during pregnancy. However, don’t use this as an excuse to overeat. Maintaining healthy snacks from pregnancy will keep up your intake while still managing a slight deficit to help with weight loss.

-Exercise. Exercising while pregnant can help prevent excess weight gain. Exercising after baby can help you shed pounds.

-Be patient. I have heard many mothers say “9 months on, 9 months off.” Even if you only gain 25 pounds with a healthy pregnancy, you will likely give birth to a 7-10 pound baby. That is 15+ pounds of other tissues that will take time to adjust back. Also realize your calorie needs may change as baby grows and your breastfeeding changes.

On a personal note, I gained close to 35 pounds with my pregnancy. My weight gain was on track for the first 7-8 months, but I kind of overdid it in the end. I was fortunate that I actually lost all my baby weight very quickly, within a month. However, when my baby was about 5 months, I was starting to gain some of that weight back. As she started eating more food and breastfeeding less, I needed to cut back on my intake and exercise more. It was a constant challenge, but worth it.

Good luck to all mothers-to-be!

Have any nutrition questions? Need help with meal planning or a special dietary need? Send your questions to me at kimberlykmarsh(at)gmail(dot)com, and I will answer them in upcoming posts!

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