Thursday, November 16, 2017

Q&A: Allowing for Diet and Exercise Changes During Pregnancy

I had an endurance planet question come in from a fellow preggo mama-to-be that really stuck with me, and I wanted to share the question and my written response. I normally never write replies to our fan's questions (that'd be a full-time job), and we just answer as many as we can on the podcast. But this Q was a bit different than any I've ever had before and I wanted to get back to her because, for one, her's is a situation where every day counts, and secondly, this topic is forefront on my mind and super relevant to my current theme of life too, hence why I'm sharing on the ol' blog...

R: "A followup... I didn't end up qualifying for Boston, because I found out a few weeks before the marathon that I was pregnant.  Now, I have a question for you about eating/training during pregnancy.

I am still in my first trimester (about 10 weeks), and I am having a hard time eating anything other than carbs (fruit, oatmeal, sprouted grain English muffins, Chex Mix and popcorn :0(. The thought of meat or vegetables is absolutely the most disgusting thing to me right now, and I feel pretty nauseous (but strangely starving) most of the time.  Over the past few years, I had reduced the amount of carbs I was eating to about 100 - 150 g a day (not super low, but lower than I used to eat), and noticed I felt much better and no longer got "hangry."  I know pregnancy increases your insulin resistance, so I am worried about getting carb-addicted again, or worse, getting gestational diabetes.  At the same time, though, I am also worried that I am undereating.  I think I have been averaging about 1600 calories a day while still running around 40 miles a week and lifting 3 times a week.  I'm 5'4 and about 113 pounds.

My question is - is it better to eat more (even if it is mostly carbs) or should I cut back on running until I can get back to a more balanced diet? I obviously want my baby to get the nutrients he or she needs, but I have had an eating disorder in the past so feeling out of control of my body and not being able to eat normally is bringing up a lot of mental demons." 

TPG: Thanks for reaching out on this, and congrats on your pregnancy!!! It sounds like you took a very sensible approach to the marathon, assuming you still ran, and that's great.

Ok.... (warning: a novel is about to ensue....)


Honestly, don't worry about the increased carb cravings. This exact thing happened to me in the first trimester (and is still happening at 30 weeks) and I just rolled with it, giving my body what it wants even if that's not my typical pre-pregnancy type of meal or snack. Your body is telling you something with these cravings and you have to listen; I say this with the best intentions: Don't let your brain get in the way ;) Trust your body -- and I know that can be hard with your background, but you're going to be a mama and I know you can do it!!!

When I asked my midwives & ND about my increased carb intake, they reassured me that a baby requires A LOT of glycogen to develop and properly grow, so it's up to us moms to supply baby with that, along with healthy fats and proteins -- all the macros are important here!! Protein needs are 80-100 grams a day. Fat is crucial in so many ways, including building a healthy brain. And obviously you're still making mostly all smart quality carb choices (with a some indulgences too, and I think that's ok; did I mention I've had several donuts while pregnant and usually have a GF dessert on hand at any given time?! LOL).

With my increased carbs (and even sugar), I definitely wondered if I was risking GD, but I just had my test two weeks ago and my results were phenomenal, which impressed me that even with essentially a much higher carb diet, my blood sugar regulation is still awesome, and I'm sure you'll be the same way from what it seems. So I say eat your carbs freely and without worry.... you clearly still know how to make smart food choices overall and aren't on a junk diet.

If it's hard to get in veggies and meats, look to smoothies, protein powders/collagen peptides and green juices to help you out. I drank a ton of green juices in the beginning to get in the greens/veggies I wasn't consuming otherwise. And now big-ass smoothies with greens, veggies, fruits and protein powders, (real) milk and sometimes even peanut butter are a staple for me to get in dense nutrients without wanting to gag when everything else sounds nasty ;) Plus, the aversions usually subside in the 2nd trimester too, and you'll enjoy meat and veggies again (I did). But there are still those days, and I'm sure there will be for you, where all you want are carb-based foods and no meats or veggies. In those cases, I just try to keep an overall smart balance and not worry about one meal -- it's the overall big picture that matters. 

I've actually been very liberal with my food intake during pregnancy, eating a huge variety of foods (more so than pre-pregnancy) and not stressing the small stuff (like if we eat out I know I can't control all the ingredients), meanwhile just making sure that overall there's a good foundation of healthy eating. For example, I also have struggled with eating fish (something I usually can't get enough of), but I know how healthy those fats are, so thankfully I found out that if I bake wild salmon in teriyaki sauce then it's delicious, and even though there's sugar and soy in the teriyaki, it's better than no fish or "gross plain fish" in my opinion! And for nearly 30 weeks now, I've pretty much hated salad, something I used to eat daily, so I'm just finding replacements and not worrying about it.

Get in a good prenatal that has FOLATE not folic acid; I use Thorne's prenatal. And fish oil (Nordic Naturals is my choice). Probably a good probiotic (I've been using Sound and Prescript Assist), and any other supplement you and your doc/midwife deem necessary. 


As for the running, it's my personal philosophy that pregnancy is a time to let go of your training and athleticism, and just put all your energy into building a healthy baby. That doesn't mean being inactive, but it means modifying your routine if you're an athlete. Right now you're training for something completely different.

I know everyone is different, but personally I think 40 mpw running is too much. That's just my opinion. Gwen Jorgenson was still running 70 mpw at some point in her pregnancy, but we don't all need to strive to be a Gwen. That was ok for her, she seems smart and I'm sure was working with her doctors on that, but just because she ran that much doesn't mean it raises the bar for the rest of us preggo ladies -- or that we're inadequate if we have to cut back and can't run all the miles. There's no shame in doing less.

I haven't run more than ~10-15 mpw since becoming pregnant, I had a 8-week break sandwiched in while letting the SCH heal, and after my 27th week I quit running because it was getting too uncomfortable and not feeling worth it. I'm walking a lot more instead these days (~10-15 miles a week walking, or about 2 miles a day at least), and usually 2x a week of relatively light strength training. That's it. It's not training mode whatsoever, but it is doing healthy activity that'll be best for my baby's health and mine.

Please don't feel like you need to "do it all," maintain some level fitness and keep a lean physique -- you need to gain healthy weight and let your body grow how it needs to support the baby!!! At 30 weeks, I weigh 165 lbs +/- right now.... that's 30+ more lbs than my wedding last year, and quite frankly I love my body more than ever right now and embrace the changes daily. Allow for the weight gain to start now in the first trimester even if all the articles say otherwise. Many articles/books will say that you shouldn't or don't need to gain weight in the first trimester, but that's general advice for the general population and you're not general, you're you :) I gained 8-10 lbs in my first trimester lol.

Pregnancy, from what I'm learning, is also so much about relaxation and not just for the 40ish weeks, but for the birth day and after. If you want to have a successful vaginal birth, it seems pretty clear from what I've been reading and learning in my class that being relaxed is the No. 1 way to achieve that. So practicing your relaxation -- mind and body -- starts now. You don't have to be perfect (god knows I haven't thus far) but just recognizing it and practicing is key!

That said, just being honest here, there will probably be a lot of little things that worry you along the way because this is all so new... but work through each of them, find peace and the ability to relax, and let it go, assuming everything is ok. Talk to your doctor/midwife, communicate with your partner/friends/family, and don't bottle it up. By even simply writing me this question, that's a big successful step in what I'm talking about! So I know you can do it.

It sounds like you successfully beat an ED, big congrats on that as well, and this chapter of your life should only serve to make you more confident in your own skin. When the mental demons arise, understand that you have the power to counteract them with positivity, smart logic and the same powers that got you through an ED, and if you still struggle, make sure you have a great team on your side who can help you through those moments.

So overall, I think you should both eat more and workout less, and find comfort that this is in your baby's best interest even it if feels weird to you personally.

Lastly, guess what: Pregnancy is just the beginning... after this we will have babies that need our full attention and love to thrive (and still eating good, dense calories if you plan to breastfeed). We'll worry, but we can't live in a state of worry. Whether you have a girl or a boy, you want to be a strong confident mom who's giving her baby the best vibes ever so he/she can grow up being strong and confident as well :)
Hope this helps. 


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