Nutrition Counseling For High Blood Pressure During Pregnancy and Pregnancy Induced Hypertension (PIH)
Do nutrition and weight evaluation.
Important to teach on first visit:
q Avoid sugary foods and sugary drinks - it is best to keep these out of the house so they are not a temptation:
cakes, cookies, candies , ice cream, chocolate, sweet breads, lollipops,
popsicles, Jello, flan, sugary cereals, flavored yogurts, (Hispanic favorites:
’pan dulce’, ‘arroz con leche’),
and sugary drinks:
soda , Gatorade, Koolaid, fruit punch, Sunny Delight , Tampico, Tang,
Caprisun, lemonade, instant iced tea from powder, bottled iced tea,
Powerade, Kern’s, Schnapple, Quik, ‘high energy drinks’, (Hispanic favorites:
‘agua de jamaica’, ‘agua de tamarindo’ , ‘horchata’, ‘maicena’, ‘atole’,
‘champurrado’, ‘Chocomil’, ‘Jackult’ ‘aguas de fruta’),
“and there’s many more”
q Limit fruit juice to 4 ounces per day or less
q Aim for the WIC (Women, Infants, and Children Supplemental Food Program) Daily Food Guide recommended number of servings for all food groups as a minimum
q Emphasize the importance of meeting the minimum recommended daily intake of fruits (2) and vegetables (3), and the added benefit of eating 8 to 10 servings of fruits and vegetables per day (as in DASH diet*)
q Review exercise level – 30 minutes of walking is recommended per day unless atypical discomforts or contraindicated by doctor (other types of exercise may be OK; the walking should be in addition to regular chores; it is important for the patient to check with their doctor, as exercise is sometimes contraindicated with PIH)
q Avoid processed and high sodium/high salt foods (a strict ‘sodium restriction’ should not be imposed during pregnancy as this can interfere with the cellular electrolyte balance of pregnancy; it may limit the normal expansion of blood volume during pregnancy; there is no evidence that limiting sodium in pregnancy prevents toxemia; sodium requirements increase during pregnancy)
May be important to teach on the first visit:
q Recommend reduced fat (2%) or lowfat (1%) or nonfat milk (0%) instead of regular milk (3.5%)
Optional teaching for first visit:
q Water is the best beverage.
q Have fruit available/eat fruit instead of the sugary foods or sugary drinks.
q If you are not used to eating vegetables, try different vegetables and different vegetable recipes. If you like only 1 or 2 or 3 types of vegetables, it’s OK to
eat the same ones every day.
q Choose foods lower in fat more often. Ask them if they know which foods are high in fat. Wait for response. Give them examples of high fat foods (butter, oil, cream, margarine, lard, fried foods, red meats) and low fat foods (vegetables, fruits, legumes, chicken, nonfat milk). Use lowfat cooking methods (bake, broil, roast, barbecue, steam, poach) or use only small amounts of fat in cooking.
q Eat whole grains instead of processed grains. The nutrients in whole grains, in addition to those found in fruits and vegetables, will also reduce the chance of developing high blood pressure (Examples of whole grains include 100% whole wheat bread, brown rice, 100% rye or 100% whole wheat crackers, oatmeal, 100% whole wheat pasta, corn tortillas).
q The benefits of exercise during pregnancy are:
- along with proper diet, it helps prevent excess weight gain
- less discomforts in pregnancy – for example, less chance of back pain because the abdominal and back muscles are stronger
- it helps all the hormones work better, so we feel better and have less chance of developing diabetes during pregnancy (better control of blood sugars)
- delivery is usually easier for those who have exercised regularly throughout the pregnancy
- it generally helps with blood pressure (have the patient check with their physician)
*DASH diet: DASH stands for Dietary Approaches to Stop Hypertension (the DASH study showed that in people who had high blood pressure, there was a significant reduction in blood pressure after starting to eat 8 to 10 servings of fruits and vegetables per day)