We started last week with ACOG's (American Congress of Obstetricians and Gynecologists) recommendations and if you read the pamphlet provided by ACOG you would have noticed a theme: weight gain and calorie restriction. ACOG puts a big emphasis on how much you gain and how many calories you take in.
Most likely, unless you go to a midwife or your care giver tends to take a less "medical" approach to pregnancy, your doctor will suggest the ACOG diet.
As a side note:
I personally respect ACOG and realize that they do serve a purpose but I also do not believe them to be the 'be all and end all' to pregnancy and birth issues. They are of the medical field and look at pregnancy as a medical issue that needs to be controlled and sometimes that is true but for most women and most pregnancies that is not the case.
So without further ado I give you another (better) approach to nutrition in pregnancy.
The diet made famous by Dr. Thomas Brewer and Gail Sforza Brewer in The Brewer medical diet for normal and high risk pregnancy: A leading Obstetricians guide to every stage of pregnancy is out of print and quite expensive to buy used, however Brewer
in 1999, in order to reach out to more women, set up Blue Ribbon Baby, the official website for all things Brewer diet. There is also another website hosted by a friend of the late Dr. Brewer who answers a lot of questions about, discusses myths regarding and dissects the brewer diet quite thoroughly that I will also be siting.
Dr. Brewer through medical school and in his practice studied diet and how it effected Metabolic Toxemia (preeclampsia, HELLP syndrome, pregnancy induced high blood pressure). Dr. Brewer was not the first to suspect that nutrition played a major role in the health of pregnant women (a time line can be seen here of 130 years worth of research on the topic). He found that it wasn't genetics, it wasn't random but malnutrition that caused these problems. While most Doctors were treating these conditions with drugs, reduced calorie diets, salt restriction and bed rest, Dr. Brewer was adding salt, encouraging patients to eat more healthy food and protein, drink water when thirsty and get active.
To read more about his toxemia research go here
The reason the diet works?
in short... very short: A pregnant woman needs to increase her blood volume by 50-60%, she needs protein to keep that up. A high protein but low calorie diet would burn the protein to use as calories and would put her in danger, but a high protein with adequate calories (Brewer suggests 2,600 calories a day) and unrestricted salt would mean she had enough protein to build a baby and keep her blood volume up.
want more detail? look here.
The brewer diet has 4 main components:
1. 2600 calories a day
2. 80- 120 grams of protein a day
3. salt to taste
4. unrestricted weight gain
It breaks down further to 14 categories that you would aim to eat daily:
1. 1 quart milk per day (that is 4 cups of milk, any kind, or milk substitute product (ie: yogurt)
2. 2 servings extra calcium IF using unfortified soy milk in the category above
3. 2 eggs every day
4. 6 (7 gram) servings of protein or 6 (1 ounce) servings of protein. This sounds like a lot but a 3-5 ounce chicken breast, about the size of your fist, would be 3-5 servings.
5. 2 servings dark green vegetables
6. 5 servings whole grains
7. 2 servings vitamin c
8. 3 servings fats and oils
9. 1 serving vitamin A
10. 1 serving Liver once a week, if you like it or an extra 4 oz of protein in its place (Brewer was apparently aware people weren't a fan of liver but recommended it for people who could stomach it).
11. Salt to taste
12. Water to thirst
13. 1 snack
14. vitamin supplements
*do not eat one food and mark it off in 2 categories (ex: a snack in the afternoon of a hard boiled egg is either one egg serving or one snack... not both)
For more detail of what this diet consists of go here.
for your own checklist go here.
This diet was devised to help patients in Dr. Brewers practice. He practiced in an area that was poorer and the mothers were often malnourished as a result. His diet's base of milk and eggs were readily available and cheap. Just consuming the 4 cups of milk and 2 eggs every day would give you 44 grams of protein or half of what you need.
Uncertain that this diet really works?
From 1963- 1976 Dr. Brewer ran a program in Contra Costa County,CA. 25,000 women in that time followed his program with success. Where other hospitals in the country had a 25% rate of incidences of toxemia Dr. Brewers program had the rate down to .5%.
Dr Brewer based his research on Toxemia but found that following his diet and good nutrition in general helped combat a number of other issues such as; low birth weight, placental abruption, cerebral palsy, low intelligence, premature labor, edema (swelling), and gestational diabetes to name a few.
Yes, this diet seems kind of... umm... hyper.
but...
While I was pregnant with Fia, around 26 weeks, I found that I was feeling quite unwell. I felt dizzy and my fingers were constantly going numb. My Dr., who follows a more midwife approach, suggested I up my protein to Dr. Brewers requirements. I believed at the time that I was eating plenty of protein (although I am not a huge fan of protein and was unsure of how much I was actually consuming) and was disappointed in her recommendation. In an effort to prove to her that it was not my lack of protein causing my symptoms I increased my protein to 100 grams a day for 2 weeks keeping track of every morsel I ate in a food journal. After 2 weeks I felt great and I never mentioned it again to my Doctor for fear I would have to admit that I had been wrong and she was right.
And now you know, sometimes I am wrong, but not about The Brewer Diet.
Questions about the diet or other pregnancy related issues? Or do you have a subject you would like me to cover on TMI? Contact me at megantew @ gmail . com
