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Nutrition during Pregnancy

Written by Millie Rose

Changes during pregnancy

Pregnancy brings many changes to your body as well as symptoms, including constipation, nausea and indigestion (BDA, 2021). Pregnancy may bring worries about nutritional concerns, morning sickness, cravings and deficiencies. This blog will explore the symptoms, nutritional requirements, dietary advice, myths and how these link together. The blog will end with some key takeaway tips to allow you to have a well-balanced diet that will support you and your developing baby.

Key nutrients during pregnancy

Folic Acid

Folic Acid reduces the risk of neural tube defects. It is recommended to take 400mcg once every day from planning pregnancy to week 12 (BDA, 2021). Folic acid is also found in green leafy vegetables, fortified breakfast cereals and fat spreads.

Iron

There is increased demand for iron during pregnancy. Usually this can be added to your diet. However, your midwife will offer blood tests to detect anemia. If found, supplements can be taken safely (NHS, 2024). An iron rich diet is important; foods such as green leafy vegetables, fortified foods and red meat can support this.

Calcium

Calcium is essential for bone development in an unborn baby. Calcium can be found in dairy, green leafy vegetables and fish.

Vitamin D

In the UK, it is recommended to take 10mcg of vitamin D daily, due to the lack of sunlight. This is essential for bone, teeth and muscle health. Additionally, vitamin D can be found in oily fish, such as salmon and mackerel, eggs and red meat. Vitamin D is also fortified into breakfast cereals, fat spreads and non-dairy milks, however, it is difficult to get enough vitamin D from the diet alone.

Vitamin C

Vitamin C is essential for absorption of iron and to protect cells, keeping them healthy. Vitamin C can be found in citrus fruits and vegetables such as broccoli (NHS, 2020)

Zinc

Zinc is vital for growth, development and immunity (WHO, 2021). Zinc is also high in red meat, dairy, nuts and seeds including pumpkin seeds. A maternal zinc supplement has been found to reduce preterm births (Chaffee and King, 2012). Always check with a health professional before taking a supplement.

Riboflavin

Riboflavin, also known as vitamin B2, is vital for a healthy birth weight and length, and prevention of birth defects (NIH, 2022). Riboflavin is high in dairy, eggs, meat and nuts.

Iodine

Iodine is vital for the production of maternal and fetal hormones to regulate the development of an unborn baby’s brain and nervous system. The requirement for iodine increases during pregnancy (Darnton-Hill, 2017). Iodine can be found in dairy products, eggs, fish, cereals and grains (NHS, 2020).

Choline

Choline is a nutrient important for the brain and nervous system, to regulate memory, mood and muscle control (NIH, 2017). It is uncommon for pregnant women to reach the recommended intake (Jaiswal et al., 2023). Choline can be found in beef, egg yolks, fish, mushrooms and legumes such as beans and peanuts (The Nutrition Source, 2020).

Omega-3

Omega-3 is vital for the development of the fetal brain and retina. Fish is high in omega-3; however, limit oily fish to 2 portions a week due to potential high levels of pollutants affecting a baby’s nervous system (Coletta, Bell and Roman, 2024). Other foods such as nuts, seeds and plant oils are high in omega-3, without the concern for high mercury (NIH, 2022).

Foods to avoid during pregnancy

Avoid raw foods
  • Meats, uncooked or pink
    • This is because there is a risk of infection, which increases the risk of miscarriage
    • Instead, cook foods until they’re fully cooked through, if you’re worried about meats becoming dry, perhaps try slow cooking meat or marinating it in olive oil and herbs
  • Liver and liver products
    • This is because they are high in vitamin A, which in large amounts can be harmful to an unborn baby
    • Instead, swap liver for oily fish, such as salmon and mackerel, lean meats, such as chicken, eggs and beans, dairy, such as milk and cheese and foods high in folic acid, such as green leafy vegetables and fortified breakfast cereals
  • Eggs, raw or soft boiled, without a British Lion stamp (eggs that don’t have a stamp on them)
    • This is because these chickens are not vaccinated against Salmonella, meaning the eggs may contain bacteria which can cause food poisoning
    • Instead, look for the British Lion stamp when you’re shopping. Eggs with the British lion stamp may be eaten raw, partially cooked and fully cooked
  • Fish, uncooked cold-smoked or cured such as smoked salmon, raw shellfish, deli meats and unpasteurized dairy products such as soft ripened goats’ cheese or mold ripened soft cheeses with a white coating on the outside e.g. brie and camembert unless steaming hot
    • This is because these foods may contain listeria, a bacterium which can cause miscarriage or stillbirth
    • Unpasteurized cheeses also contain more moisture, allowing bacteria to grow more easily
    • Instead- cook cold-smoked and cured foods until steaming hot to kill any bacteria present, swap soft unpasteurized cheeses for alternatives, such as cheddar, feta, mozzarella

Reduce high mercury fish

  • Including Tuna, Swordfish, Marlin and Shark
    • This is because high levels of mercury can be harmful to an unborn baby as it affects a baby’s nervous system development
    • Instead, limit tuna to 2 tuna steaks or 4 medium-size cans per week
    • It is not recommended to consume more than 2 portions of oily fish a week, such as salmon, mackerel, trout or herring

Caffeine

  • The NHS recommend no more than 200mg of caffeine a day as higher amounts can increase risk of low birthweight and miscarriage
    • This may look like a mug of instant coffee or tea, a can of coke, a small can of an energy drink, or 50g of plain dark chocolate
    • Instead, try decaffeinated drinks or matcha, as this has less caffeine than coffee

Alcohol

  • Alcohol should be completely removed from consumption during pregnancy
    • Instead – try a mocktail or ask your partner or friend if they will be sober with you during pregnancy! (NHS, 2020)

How can I manage my symptoms through nutrition?

Morning sickness
  • Try eating little and often
  • A small snack in the morning
  • Have a dry snack on waking such as crackers
  • Avoid fatty or spicy foods or foods with strong smells
  • Add ginger into meals – in smoothies, salads, or soups
  • Stay hydrated, see blog on Nutrition and Hydration
  • See a medical professional if these do not work or you have severe vomiting
Heartburn or indigestion
  • Try eating smaller, regular meals and snacks
  • Some women find caffeine, fatty foods and spices can cause these symptoms
  • Try reducing or avoiding these to see if the symptoms improve
Constipation
  • Consume a high fiber diet
    • Swap white bread or rice for whole meal versions including quinoa, pearl barley, bulgar wheat
    • Increase your fruit and vegetable intake, try snacking on cucumber or carrot sticks with hummus instead of high sugar products
    • Stay hydrated, see blog on Nutrition and Hydration
    • Exercise regularly, try walking to the shops rather than driving (BDA, 2021)
Gestational diabetes
  • The risk of problems caused by gestational diabetes can be controlled by managing blood sugar levels (NHS, 2022)
    • Choose wholemeal options such as oats, wholegrain bread, pasta, pearl barley
    • Swap high sugar cereals for porridge or bran flakes
    • Increase vegetables, pulses and dairy
    • Try to decrease sweetened drinks, perhaps try sweeteners
    • Snack on yoghurt, nuts, seeds
    • Choose foods with a low glycaemic index (GI), meaning a gradual increase of blood sugar, rather than a spike
    • Work with a healthcare professional to manage your weight, too much weight gain can make it harder to manage blood sugar
  • (Diabetes UK, 2017)
Am I eating for two?

Put simply, no. Energy requirements only increase by 200kcal in the 3rd trimester, meaning energy requirements stay the same in the 1st and 2nd trimester

To ensure you stay full and don’t succumb to sugary cravings:

  • Include high fiber foods, including whole grains, nuts and pulses.
  • Don’t avoid fat! Fats are a vital part of the diet as they are rich in nutrients and contribute to satiety and fullness. Just be aware of portions sizes and choose unsaturated fat such as avocados, olive oil, oily fish, nuts and seeds
  • Try swapping sweet snacks for filling and satiating snacks, such as dark chocolate, nuts, fruits and vegetables, eggs
  • Ensure your meals are nourishing, this will keep you full for longer, meal preparation may help you to do this.

5 take away tips

  1. Take 400 micrograms of folic acid every day until week 12 of pregnancy (BDA, 2021) and a vitamin D supplement (10mcg per day)
  2. Include folate rich foods in your diet, including green leafy vegetables, fortified breakfast cereals and fat spreads
  3. Be aware of the foods you should avoid, generally raw foods and alcohol, if you’re not sure check the labels or ask a health professional
  4. Eating regular balanced meals each day including protein, carbohydrates, fibre and fats is key to a healthy pregnancy. Focus on your portion sizes and only increase your food intake by 200kcal in your 3rd trimester
  5. Eat little and often to help with morning sickness

If you’d like to get some support from a prenatal Nutritionist, you can book a free 15-minute consultation here

Follow @nutritiondunneright for more actionable tips!

References

BDA (2021). Pregnancy and diet. [online] www.bda.uk.com. Available at: https://www.bda.uk.com/resource/pregnancy-diet.html.

Chaffee, B.W. and King, J.C. (2012). Effect of Zinc Supplementation on Pregnancy and Infant Outcomes: A Systematic Review. Paediatric and Perinatal Epidemiology, 26(1), pp.118–137. doi:https://doi.org/10.1111/j.1365-3016.2012.01289.x.

Coletta, J.M., Bell, S.J. and Roman, A.S. (2024). Omega-3 Fatty Acids and Pregnancy. Reviews in Obstetrics and Gynecology, [online] 3(4), p.163. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC3046737/.

Darnton-Hill, I. (2017). Iodine in pregnancy and lactation. [online] www.who.int. Available at: https://www.who.int/tools/elena/bbc/iodine-pregnancy.

Diabetes UK (2017). What can I eat with gestational diabetes? [online] Diabetes UK. Available at: https://www.diabetes.org.uk/living-with-diabetes/eating/gestational-diabetes.

Jaiswal, A., Dewani, D., Reddy, L.S. and Patel, A. (2023). Choline Supplementation in Pregnancy: Current Evidence and Implications. Cureus, [online] 15(11), p.e48538. doi:https://doi.org/10.7759/cureus.48538.

NHS Choices (2020). Iodine – Vitamins and Minerals. [online] NHS. Available at: https://www.nhs.uk/conditions/vitamins-and-minerals/iodine/.

NHS (2020). Foods to avoid in pregnancy. [online] NHS. Available at: https://www.nhs.uk/pregnancy/keeping-well/foods-to-avoid/.

NHS (2020). Vitamins, minerals and supplements in pregnancy. [online] nhs.uk. Available at: https://www.nhs.uk/pregnancy/keeping-well/vitamins-supplements-and-nutrition/.

NHS (2022). Gestational Diabetes. [online] NHS. Available at: https://www.nhs.uk/conditions/gestational-diabetes/.

NHS. (2024). Iron intake in pregnancy and beyond – Leeds Teaching Hospitals NHS Trust. [online] Available at: https://www.leedsth.nhs.uk/patients/resources/iron-intake-in-pregnancy-and-beyond/.

NIH (2017). Office of Dietary Supplements – Choline. [online] Nih.gov. Available at: https://ods.od.nih.gov/factsheets/Choline-Consumer/.

NIH (2022). Office of Dietary Supplements – Omega-3 Fatty Acids. [online] Nih.gov. Available at: https://ods.od.nih.gov/factsheets/Omega3FattyAcids-Consumer/.

NIH (2022). Riboflavin. [online] Nih.gov. Available at: https://ods.od.nih.gov/factsheets/Riboflavin-HealthProfessional/.

The Nutrition Source. (2020). Choline. [online] Available at: https://nutritionsource.hsph.harvard.edu/choline/.

WHO (2021). Nutritional interventions update: zinc supplements during pregnancy. [online] Available at: https://www.who.int/publications/i/item/9789240030466.