Episode 46 – What Adjustments Did I Make During My First Pregnancy? Time Restricted Eating, Carbohydrate Intake, Weightlifting, Morning Routine, Sleep, and Recovery.

Follow Ann Tsung MD, MPH on

https://www.instagram.com/anntsungmd/

https://www.facebook.com/AnnTsungMD/

EPISODE 46

00:06 Announcer If you’re struggling with your vitality, energy, mood, focus, or sleep, this podcast is for you. Your host Dr. Ann Tsung, ER doctor and aerospace flight surgeon, will help you reach for the stars and remove the barriers or blockades that have been holding you back from living your best life. If you’ve been challenged by your health, relationships, or productivity, then it’s time for a breakthrough. So here’s your host Dr. Ann Tsung.

00:42 Dr. Ann Tsung Hello, welcome to It’s Not Rocket Science Show and I am your host, Doctor Ann Tsung. In today’s episode, I want to share with you my story of my first pregnancy. At the time of this recording, I am currently thirty-eight and a half weeks pregnant, almost thirty-nine weeks. And I have, you know, all these routines prior to pregnancy, like time restricted eating and low carb and I have a certain sleep routine and schedule and supplements and I weight lift for the past like nine, ten years. And I like to discuss how that has changed throughout my entire pregnancy and how I have adjusted. And as a disclaimer, of course, every pregnancy is different. Every woman is different in terms of pre-pregnancy activity levels and nutrition, etc. So please, this is only my own experience and speak to your OB physician before you make any changes at all whatsoever in terms of what you’re eating and your physical activity, your supplements, etc. So, but I like to share with you because a lot of people are low carb and a lot of people do weight lift already. And how can you still do it or not? Can you still go low carb or not? And what exactly are the supplements that you want to take? Etc. So let’s go ahead and dive in.

02:02 So in pregnancy, I used to be fairly low carb. So maybe like 75 grams to 100 grams of carbs a day, and I use a MyFitnessPal tracking app. But essentially though I don’t eat refined carbs, I don’t eat any rice or pasta, really rarely pizza or treat, or if I eat pasta, it’s going to be made from Italian flour, typically. And I, yeah, don’t eat rice noodles, every so often I go get pho, that Vietnamese beef noodle soup. Essentially, I don’t eat it regularly. But because I know exactly what it does to my glucose level in the body and insulin level. If I do choose to eat it, I accept what it’s going to do. I accept the food coma that I’m going to get after. And because of the Dexcom, the continuous glucose monitor I have.

02:54 So after pregnancy, well, when I found out I was pregnant, that was also when I was first diagnosed with COVID around week six of my pregnancy. And so it was a very, like, there were confounding variables. I was super tired, I couldn’t go up the stairs and I had no motivation to even meal prep or wash vegetables or cut vegetables, which is unlike me. And I thought at the time, like, “Oh my goodness. Is this like what the first trimester is like?” And I had this, like, weird nausea in my pelvic region. It’s kind of like morning sickness. But except this morning sickness is not in my stomach region, it’s like in my uterus region. It was really strange. So at that time, I did increase my carb intake at the time. Just anything I could try to get the glucose up and to, to see if that would help or maybe some more sweet potatoes or maybe some more like flour chips.  It may have helped a little bit. But really after COVID, I recovered from COVID two weeks later, then another thing I experienced was that I had this weird meat aversion. And all I was craving was vegetable broth and tofu, that’s all I wanted. So, we went to hot pot a lot during that time because all I wanted was vegetable broth with tofu and mushrooms. And I could not stand meat anyway. So after COVID, I recovered from COVID. Then the morning nauseated type feeling in my pelvis, it was gone. And then I started eating normally again, as in, when I say, normally I didn’t really trial anymore, like increased carbs.

04:37 Actually, for the rest of the pregnancy, I didn’t really change my nutrition at all whatsoever. Like 100 grams of carbs is more than enough for the baby, really. You only need like 200 to 350 calories extra throughout pregnancy. And that’s just like some olive oil, some nuts, perhaps some more sweet potatoes, complex carbs, and that’s it. And because I have the Dexcom monitor, my glucose is always staying in the right range. It’s never dipping below what it needs to be, which is 60 or below. And so whenever I have trialed, like increasing, like maybe I’ll try this rice or this like this noodle and it always increases my glucose and when it drops, I’m so sleepy, I’m so tired, I don’t feel well. So I went based on my own feeling, my energy and honestly, I didn’t really change much. So lots of nuts still 50-75% fat, maybe 50-60 now. Lots of olive oil, olives, lean protein like wild Alaskan salmon, pasture-raised chicken, and I usually love dark meat, bone-in and also a shank. Anything with bones basically. Cooked a lot of shank, braised shank or bone broth and the carbs typically, if I do, oh, lots of avocado as well. If I do eat carbs, they’re the slow complex carbs and my go-to is the sweet potato, typically. If it’s whole, usually it’ll process a little slower, if you mash it, it will process faster and your glucose rise faster. If you put it in the fridge overnight, after it gets cold, it could turn into something called resistant starch. And actually, your glucose doesn’t rise as fast. So, I also put a lot of butter on my carbs and lots of, or olive oil. Because fat or vinegar, anything acid really will decrease the absorption of the carbohydrates and lead to a slower rise in your glucose. So that’s essentially my nutrition changes.

06:45 I’ll talk about my supplements, so what I take is the Thorne Basic Prenatal. I essentially look for brands that are USP-certified or NSF-certified. So you can always Google that brand and search NSF or USP. So they’ve gone through testing and inspection and their manufacturing process has been vetted. So I look for those brands and I also take Magnesium Threonate, I’ve been taking it since before pregnancy, I just continued. And also, I take vitamin D 2000 units in addition to the prenatal to make 3000 international units total. So I use the Thorne and also I take lots of lots of lots of Omega three. The Nordic Naturals 2000, it’s a very high intensity, I actually take three of those so technically, I’m getting 3000 a day and it’s to help the baby’s brain grow because it is just growing exponentially, especially at the third trimester and your bowels will slow down, your intestines will slow down and your stools might get hard. And especially if you are, because of the congestion in the, the lower area, you might get hemorrhoids too. So if you have hard stool, you have hemorrhoids going to hurt. So daily, I’ve been taking stool softener, Docusate, and that has helped a ton. So those are the supplements I’ve been taking during pregnancy. Intermittently, I have taken ginger extracts, I have taken garlic extract, but I don’t take those all the time, okay?

08:29 And then I like to talk about how your body has changed and in terms of the physical activity you can do. So because I have been doing Olympic weightlifting for 9 to 10 years before the pregnancy. I spoke with my OB and the another OB who is in maternal-fetal medicine, and because I’ve been doing it for so long, I already have good form and I already am used to high-level activity. They told me just to go ahead and keep going and just listen to your body because it’s about effort level. You know, 35 pounds for somebody might be a lot, but 35 pounds to me is the backpack I carry every day and it’s the kettlebell, I’ve been carrying for the past year or so whenever I take a walk. So the level of effort is what’s important, and of course, talk to your OB, determine your health level, determine your pregnancy status. At the time, my pregnancy was going fine. Early first trimester, there was a little bit subchorionic hemorrhage, so just a little bit of blood collection under the placenta and I stopped weightlifting for about a week or so until that result, and then I resumed again. So I dropped my weights to about 60 to 70%. Sometimes 50% depending on the day I feel, and I continued on with my snatches, cleans and jerks, squats, overhead presses, all the way until 36 weeks because it just based on my, my level of effort, really, I just change weights as needed. And whenever I do get a weightlifting session in, I feel so energized, I feel so good. Though, because your joints get a little bit loose during pregnancy, I did feel that my SI joint, which is your tailbone area near the pelvis in the back where your tailbone is, where your spine connects to your tailbone. To me, I was a little sore whenever I do a deadlift, after I do a deadlift, typically or after a squat. So that essentially required me to get, you know, regular massage sessions or regular chiropractic sessions. So that was the only difference that I felt during lifting and also I couldn’t squat as low as my belly got bigger, which makes sense.

10:45 And I had a coach who watched me. He is an Olympic level coach, so it’s important to get a good coach who can actually watch you as you’re moving about your form and your form will change. Like I had to for the snatch and clean and jerk, of course, I had to avoid my belly, but instinctively I was able to do it. So again, it is only my experience though, I want to share with you that it is possible to keep lifting and my pregnancy throughout with all the checks, the growth had been on track and there’s been no issues at all whatsoever, really. So that’s why I continued on with each check, until 36 weeks. And then when 36 weeks hit, now I’m at the end of 36 weeks, I’m now I’m early term. I wanted to make it until full term, which is end of 38 weeks, so I had two more weeks to go. And at that time, my cervix is already starting to phase or thin out quite a bit, actually started like 50%. And also I was one centimeter dilated already. So the laboring process has already started and then it can happen a few weeks before actual active labor and especially somebody who is active. So I wanted the baby to stay in two more weeks, so I stopped lifting at that time. So at the, in just a few days, the baby will reach full term and I’m going to go back to the gym again and I’ll probably first start by doing light bar exercises and light squats and see how I feel. Then I really don’t care when the baby comes anymore.

12:25 So I’m gonna try to go back to be active again. I just feel like labor is a workout. Like you have to push so hard with your core, with your pelvic floor muscles. The baby is not going to push himself, you’re the one doing it. Your uterus is contracting and it’s your body who needs to be strong and be prepared for this, it’s like a whole exercise. And I know especially in the asian culture that you’re not supposed to do anything during pregnancy, you’re supposed to be on bed rest. My mom told me that my two-liter Hydro Flask was too heavy for me and that somebody else should be carrying that. So I think there’s so many various opinions on how much weight that you can carry, what you should be doing, you shouldn’t run, you should run, you etc. No jumping, whatever. It’s based on your activity level, again. Talk to your OB see how you feel, only do what instinctively feels right to you and not too much effort when it comes to this, okay?

13:34  And the next thing I want to talk about is sleep, how my sleep has changed. Well, so of course, when the baby is pressing on your bladder for the first trimester, I woke up at like 4 a.m. religiously to urinate and then second trimester got a little better. Third of my trimester, yeah, just the past from maybe 35 weeks and on. Intermittently, I would wake up at 3:45 or 4 a.m. to either urinate or I’m just like wide awake. And you know, what I have found lately that could address that. And also the sun is coming up earlier too, so once the sun comes up, starts coming up, I cannot sleep anymore. So and also when you get up to urinate, you’re exposed to light. So I actually started recently wearing my really intense TrueDark blue light blockers to sleep. When I wake up and you know, to urinate, there’s a nightlight, but even that I didn’t want it to stimulate me. I will wear the dark glasses into the restroom, come back and I found that it actually allowed me to go back to sleep a lot easier and I could actually sleep through the sunlight. Well, if you have a blackout curtain, that works too. But for me, we don’t have one in the bedroom and so wearing that actually allowed me to sleep a few more hours after. And I have the Oura ring to track my sleep. And I will say that, yeah, the sleep has been okay, all the way until probably the late trimester. Once or twice a week, I will want to wake up at 4 a.m. for some reason, but not all the time, which is great.

15:10  The next thing I wanted to talk to is your recovery. So you might have these aches, pains, back pain, sciatica pain, round ligament pain in your pelvis, the stretching, the bloating so many things, right? So, I do go to a chiropractor weekly or biweekly and I try to get a massage, so far has been a biweekly or monthly. And I will say, if I could get a massage weekly, it would be amazing. And all I’m saying is just do something that gives you a little me-time. Oh, and the sensory deprivation tank, the float tank is amazing for me. I usually can lay flat on my back, I prefer it, I don’t like laying on my side. So if you’re floating, if you can’t lay on your back, there’s an option: you can kind of lay in forward and they have a pillow in front of you or a floaty in front of you that you can kind of prop your arms up if you don’t want to lay on your back.

16:09  And I just think me-time, self-recovery time during pregnancy is so important just because, you know, after this, you’re not going to be alone anymore and you’re always going to be thinking about the baby. You’re not going to have really have a lot of time for me-time. It’s quiet alone time and those are really precious. And I would suggest of course, spend time with your loved one, your significant other, go do all the things that you probably will not get to do. Like we watched a movie, we watched a lot of movies in the movie theater. We tried out many restaurants that may not be as good, you know, to bring kids. We went on picnics in the parks, on swings, on ferris wheels, etc. Just you know, find time to create new experiences, because if you and your significant other have a loving relationship, a stable relationship, then your child is going to feel stable, secure and they’re going to feel safe essentially and be able to grow and develop as they should. So it’s really important.

17:18 First thing is to work on the relationship between you and your significant other. If you don’t have a significant other, make sure that you work on the relationship, your recovery with yourself. For example, I actually took a babymoon on my own to an international trip to Italy on my own. So it was like the most amazing me-time I could give myself before the baby comes, and I did anything I wanted to do. I went anywhere I wanted to, ate whatever I wanted to, it was just amazing. And I met a lot of people as a solo traveler versus when you’re traveling with your significant other. So highly suggest it, you don’t have to go solo, but highly suggest it if you wanted to.

18:04 And regarding the recovery, I would say just do something, pick anything that brings you joy that you’ve always wanted to do, and make sure that, you know, you are also thinking about recovery and self-care even after the baby is born. Because your, somebody can always watch the baby perhaps for an hour or two just for you to go out, take a walk on your own, to look at nature, to meditate maybe for 10 minutes, perhaps. Wear noise-canceling earphones and just kind of zen out, just get that quiet time, okay? And some of my other routines like cold showers, I kept. Because I mean, it was two minutes, it gets me going. I don’t jump up and down as much anymore. I just put my arms during that, and then so as the baby got bigger. And then hydration is another thing that’s important. I usually drink 2-3 liters and I still do drink 2-3 liters and you know, work that stress level. That’s something that you know, it’s a continuous work in progress for me because the later I got in my pregnancy, the more I actually wanted to work, the more I worked because I just felt like, this is like the last time I’ll be able to work this much. So I actually gave a lot myself a lot of stress and decided, you know, because of that, I’m gonna do more frequent massages, more frequent chiropractor, more frequent float.

19:33 So, anyway, so that’s my experience. I kept my low-carb diet in terms of just keeping it to around 100 grams, maybe sometimes 150 grams or so, occasional treat of pizza that’s made with Italian flour and pasta, and same hydration, still meditate, still have the cold shower. I do sensory deprivation tanks for recovery, meditation, chiropractor, and massage. We talked about the supplements, fish oil, prenatal vitamins, stool softener, and also vitamin D, and magnesium. Talked about continued physical activity based on your prior activity level and the effort, it’s based on your effort level. How much you can do before versus like what you can do now. And also how to optimize your sleep so that you can decrease your stress even more.

20:31 And I would say if there’s something that can bring you joy that can help you recover, that can help you make this pregnancy a little bit easier, a little bit happier for you. I would say write it down and is there something you can do today? Like say, go on a walk today or perhaps you can schedule a massage today. Call around right now and see who can do prenatal massages. In Houston, there’s something called The Motherhood Center and they have classes on prenatal newborn classes, lactation classes, massages, etc. Look for something in your city where there’s like a center that kind of caters to new moms or pregnant moms. And maybe there is something your pantry that you like to incorporate or eliminate as an increase the amount of healthy oil or nuts that you eat or avocado etc. or you go to the pantry and look at the labels and decrease the amount of added sugar that you’re eating so that you’re not feeling tired when you’re, after you eat it or when you’re feeling like like the food coma symptoms. Again, everybody metabolized things differently, if you want to hear a little bit more about in terms of obesity, why it’s caused by insulin cortisol, you can go to episode 34 and also in episode 33, I talk about healthy fats. So if you want more detail on what is considered healthy fat, different types of fat, go to episode 33. And 32, I talk about time-restricted eating and feeding windows, and that’s another thing I actually didn’t mention. My usual feeding window is about eight hours. I eat usually maybe 11 a.m. to 7 p.m. or 10 to 6. But after the pregnancy, I expanded it to about 10 to 12 hours, so it just depends how I felt that day. So that’s another thing you can experiment with your eating window.

22:31 Again, thank you so much for your attention, your presence, and if you want to look at the episode show notes go to itsnotrocketscienceshow.com. You can follow me at all social media like Facebook, Linkedin, Instagram at Ann Tsung MD. And on Facebook, I have created a private Facebook group and uploaded my seven-day video master class on how to boost your productivity in just half the time. I explained all of the tactics that I have used, that I’ve learned throughout the years and they’re videos that are like 10-15 minutes with action steps so that you can get more time back for your kids, your family or your work, whatever you need to do, automate delegate or eliminate, and so you just like can do the things that you love instead of spending time doing the things you don’t like. So please go check it out on Facebook and I really, really thank you again. Remember that everything we need is within us now, thank you.

23:35 Announcer That’s it for today’s episode. Head on over to iTunes and subscribe to the show. One lucky listener every single week that posts a review in iTunes will win a chance in the grand prize drawing to win a private VIP Day for a health and life makeover with Dr. Ann Tsung herself. Then be sure to head on over to itsnotrocketscienceshow.com, and pick up your free gift from Dr. Tsung. Then join us on the next episode.