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Written by Lily Nichols, RDN, CDE, author of Real Food for Pregnancy and Real Food for Gestational Diabetes
Republished with permission from her website: https://lilynicholsrdn.com/protein-requirements-pregnancy/
Lately, I’ve been reading more and more about protein, how our guidelines were set for it, and specific amino acids and their roles in health (especially during pregnancy and early childhood).
Proteins are quite literally the building blocks of human life. Every cell in your body contains protein and you require the amino acids in protein to build new cells.
As you can imagine, there are a lot of new cells being created during pregnancy, making protein an absolute necessity to supply your growing baby (and your growing uterus and other tissues) with the raw materials to carry out the job effectively.
The last 20 years has seen a huge leap in understanding of protein and amino acid needs, particularly in pregnancy. Using a method known as the indicator amino acid oxidation method (IAAO), we’re now able to safely quantify needs for protein (and even individual amino acids, aka the “building blocks of protein”) in different stages of pregnancy.
Suffice to say, we now have a lot of re-education to do around protein, especially when it comes to pregnancy! Not only has my clinical/personal/anecdotal experience with higher protein intakes in pregnancy shown it to be beneficial, but we now have a lot of white paper research to support it. I’m not the first person to come to this conclusion and I won’t be the last.
The question is how long will it take for our guidelines to catch up?
It’s often assumed that protein intake in “developed” countries is adequate or even too high. However, a 2021 study questions this in regards to protein intake during pregnancy, highlighting the importance of getting this research out there. Before I get to that, let’s talk about protein requirements in pregnancy.
How much protein do you need in pregnancy?
If you search online for “protein requirements in pregnancy,” you’ll find mixed answers.
If you go by the dietary guidelines, you can define protein needs by a gram amount per body weight—this is called the recommended daily allowance (RDA). The current RDA for pregnancy is 1.1 g per kg of body weight after the first trimester (first trimester protein needs default to non-pregnant requirements for adult females of 0.8 g/kg).
Or, you can go by the acceptable daily macronutrient range (AMDR), which is given as a percentage of calories consumed. This results in a wide range of “acceptable” protein intake ranging from intakes close to the RDA to intakes that are more than triple the RDA. The AMDR for pregnancy is 10-35% of calories.
Finally, there are blanket statements, like “pregnant women need ~71 grams of protein per day” or “pregnant women need an extra 25 grams of protein per day in the third trimester.”
Generally, the most accepted standard for protein requirements is the RDA; however, protein researchers point out that the RDA is set at a bare minimum level and it’s likely that optimal protein intake is much higher than the RDA.
As I explain in Chapter 2 of Real Food for Pregnancy, the dietary guidelines for pregnancy were set with almost no data on pregnant women. Shocking, I know.
Protein requirements in pregnancy are higher than previously thought
The first ever study to directly measure protein needs in pregnant women (circa 2015) found that true protein needs were 39% higher in early pregnancy and 73% higher in late pregnancy compared to the estimated average requirement (EAR). They found the estimated average requirement should be set at 1.22 g/kg in early pregnancy and 1.52 g/kg in late pregnancy.*
Since nutrient requirements are calculated based on prepregnancy weight, this means a woman who started her pregnancy at 150 pounds would need 83 g of protein in early pregnancy and 104 g of protein/day in late pregnancy to meet this updated EAR.
For simplicity’s sake, let’s just round it to >80 g in early pregnancy and >100 g in late pregnancy.
Are you eating enough protein during pregnancy?
Recently, a study reported on usual protein intake among a nationally representative sample of U.S. pregnant women and compared it to both the current guidelines and the new “optimal” intakes identified by that 2015 study.
Of note, 40% of second trimester mothers and 67% of third trimester mothers fell below optimal intake levels, averaging only ~82 g protein/day.
Optimal intake would be a minimum of ~100 g/day (more if you’re a larger person or very active).
The researchers note that “pregnant women were more likely to meet the trimester-specific protein RDA as their percent protein intake from animal sources increased.” In fact, two-thirds of protein intake was met by animal foods.
Below are some high-protein foods. For reference, one ounce of meat or one egg provides about 7 g of protein.
- Beef, lamb, pork, bison, venison, etc. (ideally from pasture-raised animals)
- Chicken, turkey, duck, and other poultry (ideally from pasture-raised birds)
- Fish and seafood (ideally wild-caught)
- Sausage and bacon (ideally from pasture- raised animals)
- Organ meats (liver, heart, kidney, tongue, etc.)
- Homemade bone broth or stock (or powdered gelatin or collagen protein)
- Eggs (ideally from pasture-raised hens)
- Cheese (ideally from grass-fed or pasture- raised animals)
- Yogurt (Greek yogurt is especially high in protein and low in carbohydrates)
- Nuts: Almonds, pecans, peanuts, walnuts, hazelnuts, pumpkin seeds, sunflower seeds, cashews, etc.
- Nut butter, such as peanut butter or almond butter
- Beans, peas, lentils, and other legumes
How is eating more protein in pregnancy beneficial?
As I always point out, protein-rich foods are also naturally rich in many micronutrients required in higher amounts during pregnancy (B12, choline, zinc, iron, vitamin A, etc.). When you meet your protein needs (assuming an omnivorous diet), you’re also likely to meet vitamin and mineral needs from food as well. I recommend consuming a balance of animal-sourced and plant-sourced protein as they have unique nutritional profiles and benefits….
This article continues. Price-Pottenger members may read the full version in the Fall 2021 issue of the Price-Pottenger Journal. The article is also available at https://lilynicholsrdn.com/protein-requirements-pregnancy.
*Additional food for thought for nutrition nerds: An EAR is always lower than the RDA, so if we were to set a new RDA for pregnancy based on this research, it would be 73% higher than 1.1 g/kg, or approximately 1.9 g/kg in late pregnancy.
About the Author
Lily Nichols is a Registered Dietitian/Nutritionist, Certified Diabetes Educator, researcher, and author with a passion for evidence-based prenatal nutrition. Her work is known for being research-focused, thorough, and critical of outdated dietary guidelines. She is co-founder of the Women’s Health Nutrition Academy and the author of two books, Real Food for Pregnancy and Real Food for Gestational Diabetes. Lily’s bestselling books have helped tens of thousands of mamas (and babies!), are used in university-level maternal nutrition and midwifery courses, and have even influenced prenatal nutrition policy internationally. She writes at https://lilynicholsrdn.com.
Published in the Price-Pottenger Journal of Health and Healing
Fall 2021 | Volume 45, Number 3
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