The questions have been rolling in from practically everyone I meet, and now it’s time to answer.
The questions have been rolling in from practically everyone I meet, and now it’s time to answer.
“Why didn’t you compete in Honu? Are you signed up for the Hilo Triathlon? How much longer do you plan to exercise? Is it safe for you to be running? How come the sunburn on your cheeks never goes away?”
For those who haven’t heard the news, I am pregnant. That swelling belly that I’ve begun to sport over the last few months is not from overeating pizza at Bianelli’s, gorging on veggie sushi rolls at Kenichi’s, or indulging on spicy chicken stir fry from Original Thai – all of which I crave and truly guilty of, especially now.
At nearly six months and having already gone through pregnancy once before with my son who is now 2 years of age, I feel like it’s much easier this time around. The worries and stress over what I should and shouldn’t be eating, and whether it’s okay that I’m still running or swimming on a daily basis have all been answered before by someone who I am honored to know as a close friend, Dr. Michael Traub.
As a well known, highly respected, and top naturopathic physician in the country, Dr. Traub is the medical director of his Naturopathic practice, Lokahi Health Center, located in Kailua-Kona. He has been practicing naturopathic medicine in Kona for 34 years, with 10 years focused on home birth deliveries.
Traub is also an avid runner and triathlete and just recently completed the IRONMAN 70.3 Hawaii two weeks ago. Although he no longer helps with home birth deliveries, his vast knowledge and expertise on prenatal care, exercise and nutrition makes him my top choice to answer any questions that I have.
Pregnancy can be both a very happy yet stressful time, often filled with confusing and contradicting information. We now know the old wives’ tale that discourage healthy pregnant women from exercising — or risk losing their baby — is certainly not true.
This is why I asked Traub to share his expertise about prenatal care, benefits of exercise and nutrition, and the role hormones play with skin changes as it would help to answer the many concerning questions posed toward the pregnant athlete.
Q: What are the benefits of exercise and safe guidelines to follow for the pregnant athlete?
Whether a woman is an athlete or not, exercise is an important part of taking good care of yourself during pregnancy. If you are an athlete, the guidelines that are agreed upon across the world is that you should continue to do what you have been doing at the time you became pregnant.
For triathletes, there would be no reason at all why one couldn’t continue to swim or run intensely during their pregnancy. However, there is a recommendation to not engage in any high-risk activities where you could fall or collide with someone. So cycling competitively or for training would not be recommended during pregnancy.
In terms of safe guidelines, it would depend on the individual, as there are some conditions that would make exercise during pregnancy not a good idea. For example a woman who is experiencing a lot of bleeding during pregnancy, or conditions that include anemia, high blood pressure, a problem with her cervix, heart disease, twins, premature labor, premature rupture of the membranes, and thyroid conditions, exercise would not be recommended.
For someone who is healthy, she should continue what she’s been doing at the time of getting pregnant if she is an athlete. If she were swimming at Masters everyday, training for a 5K, or doing Buti Yoga, those activities would be fine. I wouldn’t recommend races such as Ultraman because it’s so hard on the body, or triathlons because it would be contraindicative due to the bike portion. You could still do run and swim training but I would recommend a pregnant triathlete to stay off of their bike during pregnancy for safety to avoid risk of a fall.
Benefits of exercise known to have for pregnancy include a reduced risk of the following: excess weight gain of the mother and baby, gestational diabetes, preeclampsia, pre-term labor, varicose veins, blood clots, shorter labors, and less complications of delivery.
Psychological benefits include more energy, less stress, anxiety, depression and just overall improved well-being. There is also strong evidence that women who are active during their pregnancy will more likely be active after pregnancy.
Q: What would be a pregnant athlete’s nutrition/hydration requirements?
Both nutrition and hydration are important during pregnancy. Pregnant women generally require an additional 300-500 calories per day, and if you are planning to exercise and sweat a lot then obviously hydration is important.
A woman’s metabolism changes a lot during pregnancy and the cardiovascular load changes as well because there is a lot more blood that is being pumped in the body. So hydration is important to replenish for the blood to have the fluid portion it needs in order for it to carry the blood cells.
I tell my patients regardless if they are pregnant or not, that they should take their weight, divide it by half, and that’s how many ounces they should at least be drinking a day. If you are training and losing additional fluids, then you need more.
Q: What are the benefits of choosing whole, organic foods?
Your nutritional requirements increase while you are pregnant and so you need to get as much nutrients from your food as possible. So having whole foods or organic foods will provide you with more nutrients than if you are having junk foods, processed or fast foods and non-organic foods. It’s pretty clear that organic foods have a higher nutritional value than non-organic foods.
Organic foods are by definition free of pesticide residues and that is important when you are pregnant as you don’t want to be passing on pesticide residue through your blood stream to your baby. For animal products, you don’t want non-organic dairy, chicken or beef because those animals may be given hormones that can cause problems for your baby too.
Q: Besides prenatals, are there additional supplements women should take?
In the second half of pregnancy it becomes important to start supplementing with calcium depending on how much of calcium one gets from their diet. As the baby begins to grow bigger, a lot of nutrients are drained from the mom to help the baby grow. A woman can actually sustain a certain amount of bone loss during pregnancy if she is not getting enough, to give to her growing baby, and later when she is breastfeeding. Vitamin D is also important as it helps calcium to be absorbed.
There are other two things that I would recommend is if there is family history of allergy. Probiotics and fish oil during pregnancy and while breastfeeding is important because those two supplements may help prevent and reduce the development of allergy in the baby.
Iron would be recommended if one became anemic during pregnancy and Vitamin C helps with the absorption of Iron into the body. Iron wouldn’t be recommended for someone who is not anemic as it can potentially do more harm than good by causing oxidative stress or free radical damage that can be harmful to the body.
Q: Why do I have pregnancy melasma and how do the role of hormones play with changing skin conditions?
Melasma is hyperpigmentation of the skin that often occurs during pregnancy in as many as half of the women who get pregnant. It depends on their genetics and skin type. Women who have darker skin are way more prone to melasma because they already have a lot of pigment or melanin in their skin to begin with. When women are pregnant, the influence of hormones in combination with exposure to sunlight, and even natural light, cause the skin to produce more pigment and causes the hyperpigmentation rash (pregnancy mask) of melasma on the face.
Several things can help to provide relief. One is being really good in using sunblock to prevent the ultraviolet light from activating the pigment cells of the skin. Then getting your hormonal balance restored after pregnancy. There are certain tests that can be done to see if your thyroid and sex hormones are within the normal ranges. There are also lightening agents that can be used to decrease melasma. But typically melasma will begin to fade or lighten after a woman’s hormones returns to its normal balance.
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And so I will continue. Continue to run with my son and pregnant belly while enjoying the expansive ocean views along Alii Drive, swim with the playful dolphins I often encounter in Kailua Bay, eat healthily and take my vitamins on a daily basis, and wear good sunblock to prevent further hyperpigmentation of my cheeks. Why? Because it makes me feel good and it’s just what my doctor ordered.
Editor’s note: The opinions expressed here are not designed to and do not provide medical advice, opinion, treatment or services to you or any other individual. Reliance on any information provided here are solely at your own risk. Check with your own physician.