A pregnant woman needs to ensure that her diet provides enough nutrients and energy for her baby to develop and grow properly, and also to make sure that her body is healthy enough to deal with the changes that are occurring.
For a healthy pregnancy, the mother’s diet needs to be balanced and nutritious – this involves the right balance of proteins, carbohydrates and fats, and consuming a wide variety of vegetables and fruits. If you are pregnant and your diet may be impacted by ethical beliefs, religious requirements, or health conditions, you should check with your doctor.
A pregnant woman’s calorie intake grows during pregnancy. However, this does not mean she should eat for two, i.e. her calorie consumption does not double, it just goes up.
Pregnant woman with Doctor
A woman who is not overweight at the start of her pregnancy should gain between 25 to 35 pounds by the end of the nine months
Weight gain, if the mother is carrying just one baby, varies considerably. According to the Institute of Medicine, USA, a woman whose body mass index (BMI) is between 18.5 and 24.9 should gain from 25 to 35 pounds (11.4-15.9 kilograms) during the nine months. A woman who is overweight at the start of pregnancy should gain between 15 to 25 pounds (6.8 to 11.4 kg).
Weight gain recommendations may also vary, depending on the woman’s age, fetal development, and her current health.
Excessive or insufficient weight gain can undermine the health of both the fetus and the mother. (Up to the eighth week of pregnancy the baby is called an embryo, after that, when its major structures have formed, it is called a fetus)
What should I eat during pregnancy?
As mentioned above, the mother should follow a varied, balanced, and nutritious diet, and it must include:
Fruit and vegetablesA selection of fruits and vegetables
Plenty of fruits and vegetables are essential for a healthy pregnancy
Aim for five portions of fruit and/or veggies per day. They may be in the form of juice, dried, canned, frozen, or fresh.
Fresh and frozen (if frozen soon after picking) produce usually have a higher vitamin and other nutrient content.
Experts stress that eating fruit is usually better for you than just drinking the juice.
Starchy carbohydrate-rich foods
Starchy carbohydrate-rich foods include potatoes, rice, pasta, and bread.
Good animal-sourced proteins include fish, lean meat and chicken, as well as eggs. Vegan mothers should consider the following foods as good sources of protein: Quinoa (known as a “complete protein”, it is said to have all the essential amino acids), tofu and soy products. Beans, lentils, legumes, nuts, seeds and nut butter are also good sources of protein. (Beans, lentils and legumes are also rich in iron)
Eating seafood reduces anxiety during pregnancy – British and Brazilian researchers reported in the journal PLoS ONE (July 2013 issue) that pregnant women who regularly ate seafood had lower levels of anxiety compared to their counterparts who did not. Pregnant mothers who never consumed seafood had a 53% greater risk of suffering from high levels of anxiety, the authors wrote.
Fats should not make up more than 30% of a pregnant woman’s daily calories. Researchers from the University of Illinois reported in the Journal of Physiology that a high-fat diet may genetically program the baby for future diabetes.
Team leader, Professor Yuan-Xiang Pan, said: “We found that exposure to a high-fat diet before birth modifies gene expression in the livers of offspring so they are more likely to overproduce glucose, which can cause early insulin resistance and diabetes.” The typical Western diet, containing about 45% fat is the kind that can cause these changes.
Prof. Pan noted that in recent years, the Western diet has included more and more high-energy, high-fat, cafeteria-type fast foods.
A team at the Complutense University, Madrid, Spain, reported in the European Journal of Clinical Nutrition that a balance of fats, proteins and carbohydrates are important for the developing baby’s current and future good health. They wrote that “(in their study) more than half of women have low-quality diets that include a high amount of animal products rich in saturated fats yet a low amount of carbohydrates from vegetables and pulses. Furthermore, more than a third of women displayed eating habits that differ greatly from the Mediterranean diet.”
In the journal Endocrinology, a team from Oregon Health & Science University explained that a high-fat diet during pregnancy raises the risk of stillbirth because the blood flow from the mother to the placenta is reduced.
According to the University of California, San Francisco Medical Center:
the amount of fat a woman eats before becoming pregnant depends on each person, who should receive an individualized nutritional assessment. For the majority of women, no more than 10% of their daily calorie consumption should come from saturated fat, less than 10% from polyunsaturated fat. Monounsaturated fat is the best.
during pregnancy fat should make up between 25% and 35% of a woman’s daily calories. This depends on her carbohydrate goals. Monounsaturated fats are preferable to saturated fats.
Examples of foods high in monounsaturated fats include olive oil, peanut oil, sunflower oil, sesame oil, canola oil, avocados, and many nuts and seeds.
Whole grain foods, such as wholemeal (whole grain) bread, wild rice, whole grain pasta, pulses, fruit and vegetables are rich in fiber. Women have a higher risk of developing constipation during pregnancy; eating plenty of fiber is effective in minimizing that risk. Studies have shown that eating plenty of fiber during pregnancy reduces the risk (or severity) of hemorrhoids, which also become more common as the fetus grows. Fiber can also help prevent obesity; something the mother should try to avoid.
It is important to have a healthy daily intake of calcium. Dairy foods, such as milk, cheese, milk, and yogurt are rich in calcium. If the mother is vegan, she should consider the following calcium-rich foods, calcium-fortified soy milk and juices, calcium-set tofu, soybeans, bok choy, broccoli, collards, Chinese cabbage, okra, mustard greens, kale, and soynuts.
Zinc is a vital trace element. It plays a major role in normal growth and development, cellular integrity and several biological functions, including nucleic acid metabolism and protein synthesis. Since all these functions are involved in growth and cell division, zinc is important for the growth and development of the fetus.
The best sources of zinc are chicken, turkey, ham, shrimps, crab, oysters, meat, fish, dairy products, beans, peanut butter, nuts, sunflower seeds, ginger, onions, bran, wheat germ, rice, pasta, cereals, eggs, lentils, and tofu.
If you are concerned about your zinc intake, talk to your doctor who may advise supplements.
On the next page we look at why you may need an extra iron when pregnant and we look at additional supplements such as zinc, folic acid and vitamin D. On the final page we discuss foods to avoid when pregnant and alcohol and caffeine consumption.
Why do I need extra iron?
Iron makes up a major part of hemoglobin. Hemoglobin is the oxygen-carrying pigment and main protein in the red blood cells; it carries oxygen throughout the body. Iron also delivers oxygen to the muscles, so that they can function properly. Also, iron increases our resistance to stress and disease.
A woman’s body absorbs iron more efficiently when she is pregnant, so she has to consume more of it to make sure that both she and her baby have an adequate oxygen supply. During pregnancy, the amount of blood in the mother’s body increases by almost 50% – she needs more iron to make more hemoglobin for all that extra blood, as well as for the growing placenta and the developing baby. Healthy levels of iron will also help prevent depression, weakness, tiredness, and irritability during pregnancy.
Most women start their pregnancy without adequate stores of iron to meet the increasing demands of their bodies, particularly after the third or fourth month. If iron stores are inadequate, the mother may become anemic.
According to the United Nations, approximately 47% of non-pregnant females and 60% of pregnant females have anemia globally. If iron deficient women without anemia are included, the figure is 60% of non-pregnant and 90% for pregnant women. In rich nations, approximately 18% of non-pregnant and 30% of pregnant women are iron-deficient. In industrial nations, figures are higher among those with lower incomes.
If the pregnant mother is iron-deficient, there is a higher risk of:
- Preterm delivery – the baby is born early, a premature baby
- Delivering a low-weight baby
- Stillbirth – the baby dies before it is delivered
- Newborn death – the baby dies soon after it is born
- Tiredness, irritability, depression (in the mother) during the pregnancy
- If the mother is anemic later in the pregnancy, there is a higher risk of losing a lot of blood when she gives birth
- Some experts say there is a higher risk of post-natal depression(postpartum depression). This has to be scientifically proven with further studies.
- The brain of the developing baby could be profoundly affected if the mother has an iron deficiency, experts found in a study; the consequences can have a long-lasting impact. The risk is there even if the anemia is not severe, and occurs early in the pregnancy, researchers from the University of Rochester Medical Center reported in the journal PLoS One. They added that their findings are important because obstetricians may not detect or treat mild/moderate iron deficiency, especially if it occurs during early pregnancy.
Following an iron-rich diet can help prevent the problems and complications related to anemia during pregnancy.
The following foods are rich sources of iron:
- Dried beans
- Dried fruits, such as apricots
- Egg yolk
- Some cereals, if they are fortified with iron
- The liver is rich in iron, but doctors and most nutritionists advise pregnant women to avoid liver. The liver is very high in vitamin A, excess vitamin A may harm the baby during pregnancy.
- Lean meat
- Oysters (make sure they are cooked if you are pregnant)
- Lamb, pork and shellfish also contain iron, but less than the items listed above
- Legumes – lima beans, soybeans, kidney beans, dried beans and peas
- Seeds – Brazil nuts and almonds
- Vegetables, especially dark green ones – broccoli, spinach, dandelion leaves, asparagus, collards, and kale.
- Whole grains – brown rice, oats, millet, and wheat.
Non-animal sources of iron, even though their iron content may be high, are less easily absorbed by the human body. Mixing some lean meat, fish or poultry with them can improve their absorption rates by up to threefold.
Some teas, such as commercial black tea or pekoe teas have chemicals that bind to iron and make it much harder for the body to absorb the iron.
Do I need to take any supplements?
The information below should never supersede what your doctor tells you.
Iron and folic acid
The types of food that contain folic acid
Before a woman is pregnant, she should be consuming approximately 18 mg (milligrams) of iron each day, during pregnancy, this increases to 27 mg per day. The majority of women can get adequate amounts if they follow a healthy diet. Some, however, may need iron supplements to prevent iron deficiency.
Some women may experience heartburn, nausea or constipation when taking iron supplements. In order to avoid these problems, they should take their pills with meals, start off with smaller doses and then work their way up to the full dose slowly, switch brands if one seems unsatisfactory, and avoid taking their supplements when they go to bed.
The National Health Service (NHS), UK, recommends that supplements in the form of folic acid should be 400 mcg (micrograms) per day up to the 12th week of pregnancy. Ideally, women should have been on them before becoming pregnant, the NHS says.
Guidelines in the UK say that a pregnant woman should take supplements containing 10 mcg of vitamin D daily. Summer sunlight is a good source of vitamin D (the light does not have the vitamin, but triggers the skin to synthesize it) – however, exposure should be limited because too much sunlight on the skin can cause burning and raises the risk of developing skin cancer.
A study published in the Food and Nutrition Bulletin reported that observational studies have shown that “zinc deficiency during pregnancy may cause adverse pregnancy outcomes for the mother and fetus.” After assessing several studies they found that pregnant women on zinc supplements were 14% less likely to have a premature delivery.
They also found that more underweight women who were also zinc-deficient and had taken zinc supplements were more likely to have infants of normal birthweight. Zinc supplementation did not appear to influence infant birth weight among pregnant mothers of normal weight.
Avoid vitamin A supplements
This includes high-dose multivitamins. Unless your doctor tells you otherwise. Avoid cod liver oil supplements, unless your doctor tells you otherwise. Pregnant women should avoid having too much vitamin A, as this may harm their baby.
Foods to avoid during pregnancy
The following foods are best avoided during pregnancy:
- Soft mould-ripened cheese, such as blue-veined cheese, Brie or Camembert. There is a risk of listeria infection. Listeria is a group of bacteria that can cause potentially fatal infections in pregnant women and their babies.
- Any type of pate, be it vegetable or meat based – the risk here is also of listeria infection (listeriosis).
- Uncooked or undercooked ready-prepared meals. It is crucial that ready-prepared meals are cooked through until they are piping hot. The risk of listeriosis exists, as well as infection from other pathogens.
- Raw eggs, including any foods with raw or partially-cooked eggs in them. Eggs must be well cooked through. The risk here is of salmonellosis (salmonella infection).
- Uncooked or partially cooked meat should be avoided. Make sure it has cooked right through.
- Gardening – wear gloves and wash hands afterward. There is a parasite in the soil that can cause an infection, called toxoplasmosis, which can harm the unborn baby. Cat feces may also have this parasite; so, use gloves when cleaning the cat litter.
- Uncooked shellfish – there is a risk of bacterial or viral contamination which can cause food poisoning.
- Mercury in some types of fish – shark, swordfish and marlin should be avoided, or kept to an absolute minimum. They are at the top of the food chain and can have high levels of mercury. Many experts say that tuna should be limited to one serving per week.
- Empty calorie foods – cakes, biscuits, cookies and candy should be kept to a minimum. They are high in sugar and fat, have little nutritional content, and may undermine a pregnant woman’s efforts at maintaining a healthy body weight.
Should I stop drinking alcohol completely?
Public health authorities throughout the world have been progressively reducing the maximum amount of alcohol a woman should drink each week.
When a woman consumes alcohol, it passes from her blood, through the placenta and to the baby. A fetus’ liver is one of the last organs to completely develop – it does not fully mature until well into the second half of pregnancy. A fetus’ liver cannot process alcohol anywhere nearly as well as an adult’s can. Too much exposure to alcohol can seriously undermine the baby’s development. Most healthcare professionals advise pregnant mothers to avoid alcohol altogether.
The UK National Health Service says that if a pregnant mother does choose to drink alcohol, she should have no more than two units of alcohol once or twice a week. NICE (National Institute for Health and Clinical Excellence), UK, advice pregnant women to avoid alcohol completely during the first three months of pregnancy, otherwise their risk of miscarriage is increased.
Heavy drinking during pregnancy may harm both the mother and the baby. There is an increased risk the baby will develop FAS (fetal alcohol syndrome), which may include restricted growth, behavioral disorders later on, as well as learning problems – there is also a greater risk of facial abnormalities.
Should pregnant women avoid caffeine?
If a pregnant mother consumes too much caffeine during her pregnancy, there is a raised risk of giving birth to a low-birth-weight child, which can lead to health problems later on. There is also a higher risk of miscarriage. Many foods and drinks contain caffeine, not just coffee. Examples include some sodas (fizzy soft drinks), energy drinks, chocolate and tea. A number of cold and flu remedies also contain caffeine. A pregnant woman should talk to her doctor, nurse or pharmacists before taking a remedy.
Most health authorities around the world say that coffee does not need to be cut out completely, but should not exceed more than 200 mg per day. A standard mug of instant coffee contains 100 mg of caffeine, a mug of filter coffee 140 mg, a mug of tea 75 mg, one can of coke 40 mg, an energy drink can 80 mg, a 50 g bar of milk chocolate about 25 mg, and a 50 g bar of dark (plain) chocolate about 50 mg.