Preventing Preeclampsia: Practical Tips
- Cristina R. de La Mar, M.S., L.Ac., Doula
- 4 days ago
- 10 min read
Chances are you’ve heard of preeclampsia - perhaps through a conversation with your doctor, a friend went through it, or perhaps a coworker or family member.
It's a condition most pregnant people dread and hope to prevent - as it puts the parent and child at risk.
There are multiple signs and symptoms of preeclampsia, but two main factors simultaneously occur for initial diagnosis:
1. Two or more High Blood Pressure readings (over 140/90 mm HG), taken at least four hours apart - generally after 20th week of pregnancy.
2. Proteinuria (protein in the urine)
Other symptoms can and often include:
Headache
Abdominal Pain
Nausea
Changes in Vision
Edema - Swelling due to fluid retention - especially in hands, feet, lower limbs.
Remember - it's actually possible to have preeclampsia without feeling any of the physical symptoms, so blood-pressure monitoring throughout pregnancy is very important.
While most pregnant people are usually aware of and concerned about preventing preeclampsia - in actuality, it only impacts between 2% - 8% of pregnancies (American Pregnancy Association). On the other hand, when preeclampsia does occur, it's serious - and places significant risk to both parent and child.
Most commonly, preeclampsia is diagnosed beyond the 20th week of pregnancy, but it can also develop after delivery - "postpartum preeclampsia." During pregnancy, the concern with preeclampsia is how it may impact proper blood flow and nutrient transfer to the baby in utero. Restricted blood flow increases the risk of a whole host of complications during pregnancy, labor, and postpartum for both the parent and child.
Learning how to reduce your risk-factors for preeclampsia can put your mind at ease and give you some tools to stay healthy. If you're pregnant, or thinking about getting pregnant in the future - here are some tips to think preventatively!
1. SUFFICIENT SALT INTAKE
Salt is a vital electrolyte to many functions in your body - and is even more essential during pregnancy, during which electrolyte needs significantly increase (for extended discussion on electrolytes and pregnancy health, click here).
Contrary to conventional advice, reducing your salt intake has not generally proven reduce the risk of preeclampsia.
A Cochrane review, a highly respected source for evidence-based research, concluded that lowering salt intake during pregnancy is no longer a valid recommendation.
As early as 1958, in a study of over 2,000 women, researchers noted lower levels of preeclampsia in women who consumed higher levels of salt (Ref). A notable reduction in both blood pressure and edema (fluid retention and swelling in the limbs, hands or feet) was also observed in pregnant women when salt was added into their diets. This resulted in “spontaneous recovery” from preeclampsia (called toxemia in this era) for the majority of the women. They noted that the “ . . .dose of salt had to be taken up to the time of delivery; otherwise the symptoms [...] recurred,” which suggests that salt was indeed playing a crucial role in treating their condition.
Recent studies have replicated this finding, noting that sufficient salt intake during pregnancy is more highly associated with lower blood pressure and reduced severity of preeclampsia. (Pub Med).
While I'm not suggesting eating spoonfuls of salt, and I generally don't recommend salt intake in isolation - but with a range of electrolytes (i.e. potassium, magnesium, etc.) - just keep in mind a balance of salt during pregnancy.
It turns out that excessive intake of starchy, refined carbohydrates and foods with added sugars are primary drivers of increased blood pressure.
In one study of over 33,000 pregnant women, those who consumed the most added sugars were the most likely to develop preeclampsia. In addition, research has shown a diet low in starchy-carbohydrates tends to reduce the severity of high blood pressure.
If you want to lower your chances of developing preeclampsia, it’s wise to be proactive about your food choices and switch to a lower-carb, low-glycemic diet. This just means eat fewer foods that turn into sugar: processed sugar, bread, fruit juice, pasta, pizza, potatoes, rice, sweets, alcohol, etc.
A low-starch, low sugar, nutrient-dense diet during pregnancy supports better blood sugar regulation and ensures the optimal development of your baby.
This does not mean all carbohydrates need to be eliminated from your diet, just that their intake should be carefully balanced with other foods (such as foods high in protein and fats as well as plenty of vegetables) to minimize spikes in blood sugar. It’s also wise to choose the most nutrient-dense carbohydrates (those found in whole foods) while avoiding processed, refined carbohydrates.
Carbohydrates that have been “refined” are those that have been processed heavily - most often to remove the natural fiber, such as making flours or starch. Examples are when whole wheat is refined into white flour, or whole corn which is refined into corn starch.
Refined carbohydrates to limit:
White Flour Products: pasta, bread, tortillas, pancakes, crackers, cereals, granola, etc.
Sugar: Both added or naturally occurring sugars.
Sweet Drinks: sodas, juice
3. EAT PLENTY OF PROTEIN, SPECIFICALLY GLYCINE-RICH PROTEINS
Protein intake is especially important when it comes to maintaining normal blood pressure. Your entire cardiovascular system is under a tremendous amount of stress during pregnancy, as it has to cope with higher levels of fluids, hormonal shifts, and expanding blood vessels.
Protein-rich foods supply the raw materials to help your body meet these demands, so it’s no surprise that low protein intake is a risk factor for developing preeclampsia. For preeclampsia prevention, eat plenty of glycine-rich proteins!
One amino acid, called glycine, can be especially helpful for regulating blood pressure. Your body's need for Glycine increase dramatically during pregnancy. One of the functions of glycine is in the production of elastin, a structural protein that allows your blood vessels to expand and contract.`
Glycine is also protective against oxidative stress, a hallmark of preeclampsia, and glycine has been shown to reduce blood pressure and blood sugar in studies.
Women with preeclampsia excrete less glycine in their urine, suggesting increased demands for glycine and/or depleted stores in the pregnant body.
The best sources of glycine are the connective tissues, skin, and bones of animal foods, like you consume when you eat bone broth, slow-cooked meat (like pot roast and stews), chicken with the skin, fried pork skin, and collagen or gelatin powder.
Good sources of glycine-rich foods include legumes, fish, dairy, and meat.
Among the best food sources of glycine are:
Red Meat: (1.5 to 2 g per 100 g serving) Seeds (1.5 to 3.4 g per 100 g)
Turkey (1.8 g per 100 g) Chicken (1.75 g per 100 g)
Pork (1.7 g per 100 g) Peanuts (1.6 g per 100 g)
Canned Salmon (1.4 g per 100 g) Granola (0.8 g per 100 g)
Quinoa ( 0.7 g per 100 g) Hard cheese (0.6 g per 100 g)
Pasta (0.6 g per 100 g) Soybeans (0.5 g per 100 g)
Bread (0.5 g per 100 g) Almonds (0.6 g per 100 g)
Eggs (0.5 g per 100 g) Beans (0.4 g per 100 g)
4. CONSIDER ADDING MORE MAGNESIUM
Magnesium deficiency is quite common. In fact, according to recent estimates, 48% of Americans consume inadequate magnesium from food. This may be an occasion that you both focus on magnesium rich foods AND consider taking a supplement.
Magnesium deficiency is even more common during pregnancy, and research has found that magnesium depletion, especially in the presence of calcium excess, can predispose women to vascular complications of pregnancy - such as preeclampsia. Women with gestational diabetes are also more commonly deficient in magnesium — and gestational diabetes is linked to a higher risk for developing preeclampsia.
Your best food sources of magnesium are seaweed, green leafy vegetables, pumpkin seeds, Brazil nuts, sunflower seeds, sesame seeds, almonds, cashews, chia seeds, avocados, unsweetened cocoa powder (or dark chocolate), bone broth, and green herbs including chives, cilantro, parsley, mint, dill, sage, and basil.
You can also absorb a significant amount of magnesium through your skin by taking Epsom Salt baths or foot soaks (Epsom salt is magnesium sulfate). This is a wonderful way to relax in a warm soak at the end of a day, or to ease tired, swollen "pregnancy" feet.
5. BE SURE TO CONSUME PLENTY OF CHOLINE
Choline is another key nutrient that helps protect against preeclampsia.
It appears that choline plays a role in placental function and may enhance the transfer of nutrients to your baby, a process that’s disrupted in preeclampsia.
In both animal and human studies (PubMed), supplementation with choline reduces placental inflammation and helps prevent preeclampsia.
For example, supplementing pregnant women with high amounts of choline in the second and third trimester has been shown to improve vascular function of the placenta and “mitigate some of the pathological antecedents of preeclampsia.” (Pub Med) In this study, researches gave 930 mg of Choline, which is approximately twice recommended intake when not pregnant.
Theoretically, this makes sense - as the placenta shares many similar functions to liver function - and choline is particularly protective to liver function.
Eating foods with high amounts of choline also will also give you a wide variety of micronutrients that are generally good for your overall health. Choline rich foods include: egg yolk, beef, fish, liver, beans, poultry and nuts. If you’re not already doing so, try adding in some of these nutrient-dense foods into your diet.
6. CALCIUM
Most think of calcium in regards to bone health - but, it also has essential functions in regulating blood pressure, thus preeclampsia prevention.
Added benefits beyond preventing preeclampsia are ensuring both parent and child have sufficient calcium to make and maintain strong bones.
Multiple studies over the past 30 years reflect the importance of sufficient calcium to a healthy pregnancy. A 2015 study (Ref) confirmed that high-dose calcium supplementation (i.e. at least 1,000 mg per day) during pregnancy reduced the risk of developing hypertension and preeclampsia.
The most significant reduction occurred in women already at-risk of hypertensive disorders and those with low-calcium diets (Ref). According to the World Health Organization, over 50% of women of childbearing age do not have sufficient calcium intake. Given this, why not prepare ahead of time - but, most especially once pregnant.
For some great suggestions on calcium rich foods during pregnancy - click here!
7. REGULAR MOVEMENT & EXERCISE
Regular physical activity during pregnancy is a wonderful way to relieve stress, improve circulation and cardiovascular health, regulate hormones, and improve sleep.
This does not have to be mountain climbing, HIIT, nor long hours of cardio - but, can be as simple as just plain walking for 30 minutes, three times a week. The more regular you are, the more benefit you gain.
Exercise has been shown to lower your risk of all-cause hypertensive disorders according to several systematic reviews and meta-analyses. (PubMed) This includes reducing the risk of gestational hypertension and preeclampsia, likely due to improvements in blood pressure regulation, vascular function, cortisol and oxidative stress. All of these aspects support healthier placental blood flow, thus mitigating the pathophysiology of preeclampsia. (BioMed Central)
A recent systematic review and meta-analysis (2010–2023) of Randomized Clinical Trials also found that physical activity in pregnancy is significantly associated with a reduced risk of hypertensive disorders (RR = 0.44), showing a moderate reduction of both systolic and diastolic blood pressure. (PubMed)
Women who reported any regular recreational physical activity during the first 20 weeks of pregnancy had 35% lower odds of preeclampsia compared to inactive women, and more vigorous activity was associated with even greater risk reduction. (PubMed)
While it's not always easy to feel motivated to exercise - most of us simply feel better when they do. Knowing that it adds to preeclampsia reduction may give you the push needed to get out and move.
THINGS TO KEEP IN MIND
Preeclampsia prevention is key! While there is no full-proof way to avoid any or all complications - integrating some (or all) of these suggestions will lead you along a preventative path and support optimal pregnancy health for both you and the baby.
Whichever stage in life you're in - Acupuncture & Traditional Chinese Medicine is uniquely positioned to support you to stay healthy, recover quickly and ultimately thrive.
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