Eating for two…or eating for you? Nutrition Insights on Foods to Eat during pregnancy
Eating for two…or eating for you? Nutrition Insights on Foods to Eat during pregnancy
Carene Congratulations if you are expecting a little bundle of love or planning ahead to ensure that your body is ready to take on this magnificent task. Pregnancy might just be the single most intricate, miraculous and often demanding task the female body can perform. If you really think about it, your body has been preparing for this task since you were a teenager going through puberty. Each menstrual cycle bringing you closer to this point…growing a real human life! Cell by cell your body is building a little human for a total of 270 days.
If we consider the bodily and nutritional preparation of an athlete prior to a big event, we might better understand the increased nutritional demands of a pregnant woman. Closely matching the energy intake to meet the increased expenditure, while focusing on specific nutrients to allow the body to perform at it’s best is very similar for the athlete and the pregnant woman. But because we often don’t consider pregnancy to be a high demand, extreme bodily task, we often miss the opportunity to properly prepare and fuel the body to grow a strong, healthy baby and recover optimally.
So, let us refer to pregnancy as a marathon and find out how best we can prepare for this spectacular event.
"70% of pregnant woman was found to exceed the recommended allowance of sugars, salts and saturated fats”
Why does nutrition during pregnancy matter?
Nutrition is important in all stages of life, from infancy to seniority, but especially during pregnancy. Your diet will not only affect your own body, but that of your baby. Poor nutrition during this phase poses significant risks to both mother and baby, such as increased risk for preterm birth, gestational diabetes, hypertension, excessive weight gain and other birth complications. It is interesting to note that 70% of pregnant woman was found to exceed the recommended allowance of sugars, salts and saturated fats. These in turn contribute to excessive weight gain during pregnancy (The University of Alabama at Birmingham, 2024).
Diet during pregnancy is a delicate balance between meeting the increased nutritional requirements and gaining just enough weight with nutrient dense foods to sustain the growing fetus. It is very easy to go full on cowboy mode and eat junk food because you may think you have an excuse to do so. The research suggests that the flavors of foods that you consume during pregnancy and lactation primes your baby to have an affinity for this food when they get older. It is thought that the flavors can transfer to the baby, causing them to become accustomed to it and enjoy those familiar tastes and smells as they mature.
So, a healthy and nutritious diet not only meets the baby’s changing demands, but also essentially primes your baby’s dietary behavior as early as pregnancy.
Consider the diet during pregnancy to perform 3 major functions:
- Create a healthy environment for growth in the uterus.
- Meeting the higher nutrient demands for the baby’s growth.
- Meeting your nutritional requirements as you prepare for birth.
Creating a Healthy Environment in the Uterus
When we think about the uterus and the surrounding structures that will be supporting the fetus, we can immediately picture the muscles providing structural support, the fluid surrounding the fetus and of course blood flow. This leads me to focusing on energy, protein and fluid intake. Let’s call them macronutrients.
Your energy requirements will dramatically increase during the second and third trimester. You may require over 300 to 450 extra calories as you progress to the third trimester. To put these numbers into food, you may need to eat an extra slice of toast with peanut butter and a 125ml tub of full cream yogurt.
We cannot discuss energy requirements without touching on adequate weight gain during pregnancy. The weight that you gain during pregnancy should be that of the growing baby and not necessarily your own body fat. The following image should give you a clearer indication of the recommended weigh gain based on your own weight category:
As with body builders, just remember to…add some protein. All jokes aside, protein is an extremely important component during pregnancy. Proteins form the building blocks for the physical structures of the growing fetus, such as the brain, organs and muscles. The additional protein requirements also form part of the mother’s uterine and breast tissue growth. It is estimated that pregnant woman requires about 71g of protein daily to meet these requirements. Proteins can be found in various food sources such as lean meat, poultry, fish, eggs, beans, lentils, tofu, and dairy products.
Did you know that the amniotic fluid can equate to approximately 1 kg in weight? Pregnant woman should aim to consume at least 2L of water per day. You might need even more water on hot summer days or during exercising. Finding a trusty water bottle may be a valuable attribute to both your pregnancy and breastfeeding journey.
Taking a closer look at those increased nutrient requirements
Now that we have discussed the macronutrients, we can take a deeper look at the micronutrients that play a crucial role during pregnancy.
- Folic Acid (Vitamin B9)
Folic acid is one of the most important nutrients to focus on during pregnancy. It helps in the early stages of pregnancy to prevent neural tube defects such as spina bifida and anencephaly. This vitamin is vital for the development of the baby’s brain and spinal cord. There is new evidence emerging linking folic acid supplementation with a reduced risk of developing gestational diabetes in pregnant woman as well as a reduction in autism spectrum disorders by 33% in children (Obstet Med. 2018).
Recommendation: Aim for 400-800 mcg of folic acid daily, starting before pregnancy and continuing through the first trimester. Many prenatal vitamins contain this essential nutrient.
Food sources: Leafy green vegetables (spinach, kale), fortified cereals, lentils, beans, and citrus fruits.
- Iron
Iron supports the production of red blood cells and helps prevent iron-deficiency anemia, which is common during pregnancy. Adequate iron levels ensure that your blood can carry enough oxygen to both you and your growing baby. It is often recommended to supplement iron in an appropriate dose due to low bioavailability in certain foods. Reduced incidence of preterm births and low birth weight infants have been found when iron is supplemented during pregnancy (Obstet Med. 2018).
Recommendation: Pregnant women need about 30 mg of iron per day. The requirement may increase from 0.8-5mg/d as pregnancy progresses. Ideally the dosage should be tailored based on the preconceptual serum ferritin levels. Excessive iron supplementation may cause harmful side effects.
Food sources: Red meat, poultry, beans, lentils, tofu, spinach, and fortified cereals. Pairing iron-rich foods with vitamin C sources (like citrus fruits or bell peppers) can help enhance absorption.
- Calcium
Calcium is crucial for the development of your baby’s bones and teeth. If you don’t consume enough calcium, your body will draw it from your own bones, potentially weakening them. Additionally, calcium supports muscle function, heart health, and the nervous system. Calcium deficiency is common amongst pregnant women, contributing to the prevalence of pre-eclampsia and other hypertensive disorders. A recent systematic review found that the supplementation of pregnant woman with calcium and vitamin D can reduce the risk of pre-eclampsia by up to 50% (Obstet Med. 2018).
Recommendation: Pregnant women need about 1,000 mg of calcium per day (1,300 mg for teens under 18).
Food sources: Dairy products (milk, yogurt, cheese), fortified plant-based milk (almond, soy, oat), leafy green vegetables, and fortified tofu.
- Vitamin D
“D” stands for Darn good! Vitamin D is often underrated but it deserves so much more attention. Vitamin D works in tandem with calcium to support the development of your baby’s bones and teeth. It also is responsible for maintaining magnesium and phosphate homeostasis, basically responsible for preventing cancer growth and boosting your immune function. Vitamin D is mainly obtained through the skin with exposure to sunlight. Unfortunately, vitamin D deficiency among pregnant woman is very common, contributing to the high incidence of pre-eclampsia, gestational diabetes, fetal bone disorders, caesarian section and preterm birth (Obstet Med. 2018).
Recommendation: Pregnant women should aim for 600 IU of vitamin D daily.
Food sources: Fatty fish (salmon, mackerel), fortified milk and cereals, and exposure to sunlight (though it’s difficult to get enough through sunlight alone).
- Omega-3 Fatty Acids (DHA/EPA)
Omega-3 fatty acids, especially DHA (docosahexaenoic acid), are essential for the development of the baby’s brain, eyes, and nervous system. These healthy fats also support heart health for both you and your baby. In the modern world it is difficult to eat the recommended amounts of fatty fish, therefore it is recommended to supplement the diet with Omega 3. High fat processed foods containing large amounts of cholesterol and trans fats should be limited. A high consumption of these fats can lead to liver and metabolic abnormalities for the baby. There is a big difference between good fats and bad fats, so don’t get confused between them.
Recommendation: Aim for 200-300 mg of DHA daily.
Food sources: Fatty fish (salmon, sardines, mackerel), chia seeds, flaxseeds, walnuts, and algae-based supplements.
- Vitamin A
Vitamin A is important for your baby’s immune system, vision, and skin development. However, it’s important not to get too much vitamin A from animal-based sources such as liver, as high levels can be harmful.
Recommendation: Pregnant women should get about 8000 IU of vitamin A daily. There is a risk of toxicity if supplementation exceeds 10000 IU per day or 25000 IU per week.
Food sources: Sweet potatoes, carrots, spinach, and other colorful vegetables.
- Iodine
Iodine supports thyroid function, which is critical for regulating metabolism and supporting fetal brain development. Adequate iodine intake can help prevent developmental delays and cognitive impairment in the baby.
Recommendation: Pregnant women need about 220 to 250 mcg of iodine per day.
Food sources: Iodized salt, dairy products, eggs, seafood, and seaweed.
- Magnesium
Magnesium is an important trace element that supports muscle and nerve function. It also plays a role in energy production and helps maintain a steady heartbeat. Magnesium deficiency is quite rare, but the requirement increases during pregnancy and might require attentive dietary intake or supplementation as part of a multivitamin.
Recommendation: Pregnant women should aim for about 250 mg of magnesium daily.
Food sources: Nuts (especially almonds), seeds, leafy green vegetables, whole grains, and legumes.
- Zinc
Zinc supports the immune system, wound healing, and cell division, all of which are important for fetal growth and development.
Recommendation: Pregnant women need 11 mg of zinc daily.
Food sources: Meat, shellfish, legumes, seeds, nuts, dairy products, and whole grains.
- Selenium
Selenium might not sound familiar to you. It is a trace element responsible for antioxidative protection, immune system regulation and protein synthesis. During pregnancy the selenium levels in the blood can significantly decrease. Deficiencies are not as common or well reported because dietary intake varies greatly due to varying levels of selenium in the soil of food crops. Deficiency during pregnancy may lead to early pregnancy loss and pre-eclampsia.
Recommendation: Pregnant women require about 60 mcg of selenium per day as part of a multivitamin.
Food sources: Mainly found in protein rich foods such as lean meats, poultry, eggs, seafood, beans, peas, and lentils, nuts and seeds, and soy products.
A prenatal vitamin can help fill any nutritional gaps in your diet, especially for key nutrients like folic acid and iron. Always consult your healthcare provider before starting any supplements.
I have shared a lot of do’s thus far, but there are a few foods that are not recommended during pregnancy. This is mainly due to food safety aspects such as salmonella, parasites and other bacteria that may transfer to the developing fetus. It is recommended to limit or avoid caffeine, alcohol, and raw or undercooked foods (such as eggs, fish, and deli meats) to reduce the risk of foodborne illnesses. Unpasteurised dairy products may also pose some risk to pregnant woman as they carry the risk of being contaminated by E.Coli or listeria. Considering heavy metals and other contaminants, it is recommended to avoid high mercury containing fish such as swordfish and unregulated herbal supplements and shakes.
Final Thoughts
Good nutrition actually starts prior to falling pregnant. Nurturing your own body as the mother-to-be is the key to ensuring that you are at optimal health for the task of growing a healthy, strong baby. While supplementation of these nutrients plays an important role during pregnancy, the dietary intake of these nutrients should be the main source. Always consult with your healthcare provider to personalize your dietary needs, and remember that every pregnancy is unique.
Happy eating, and take good care of yourself and your growing little one!
References:
- Am J. The importance of nutrition in pregnancy and lactation: lifelong consequences. Obstet Gynecol, 2022 May ; 226(5): 607–632. doi:10.1016/j.ajog.2021.12.035
- A Jones, H Echols. Prenatal nutrition: How diet impacts maternaloutcomes. The University of Alabama at Birmingham, 2024
- F Parisi, I di Bartolo, VM Savasi, I Cetin. Micronutrient supplementation in pregnancy: Who, what and how much? Obstetric Medicine. 2019, Vol. 12(1) 5–13
