A healthy diet and good nutrition during pregnancy ensure that your baby gets the best start possible. The best diet is a balanced one that provides ample amounts of protein, carbohydrate, and healthy types of fat, as well as vitamins and minerals. While you will probably be taking a prenatal multivitamin to ensure that you get the basic requirements, vitamin-packed, fresh foods will help your baby get the best start in life.
What Constitutes a Healthy Diet During Pregnancy?
A healthy diet during pregnancy contains much the same balance of vitamins, minerals, and nutrients as a healthy diet in general. If you already have healthy eating habits, it will be easy to make slight adjustments to ensure a healthy pregnancy.
Most experts recommend that pregnant women consume an additional 300 calories over their normal intake requirements. Avoid dieting and the urge to binge eat during pregnancy. The key is moderation.
Whenever possible, eat complex carbohydrates (like whole-grain breads and pastas, vegetables, beans, and legumes) rather than their nutritionally deficient cousins, the simple carbohydrates (white bread, cookies, pretzels and chips, and sugar and sweeteners).
Eat four servings of protein daily (60 to 75 grams daily). If your pregnancy is a high-risk one, your doctor may recommend more. It is easy to add more protein to your diet. For example, a serving of protein is provided by all of the following:
Vegetables provide many nutrients: calories, vitamins and minerals, antioxidants, phytochemicals, and fiber. Eat three or more servings daily of green and yellow vegetables, which contain significant amounts of Vitamin A, beta-carotene, fiber, Vitamin E, riboflavin, folic acid, Vitamin B6, calcium, and trace minerals. Four additional servings per day should come from fruits and other (non-green/yellow) vegetables. These provide fiber, vitamins, potassium, and magnesium.
Grains and Legumes
Whole grains and legumes (dried peas and beans) should comprise nine or more servings a day; they provide B vitamins and trace minerals (zinc selenium, magnesium). Grains and legumes are full of nutrients, especially the B vitamins (including B1, B2, and niacin) your growing baby needs for the development of just about every part of the body. These foods supply energy for your baby's development and help build the placenta, among other tissues, in your body.
Eat whole grains during pregnancy. Refined grains-white bread and instant white rice-have fewer vitamins and fiber. Whole grains, such as whole wheat, oats, barley, corn, rice, and soy, are packed with nutrients.
Size of One Serving of Whole Grains and Legumes
- 1 slice of whole-wheat, French, or sourdough bread
- 1/2 whole-wheat or plain bagel or English muffin
- 1/2 cup cooked wheat, oatmeal, or barley cereal
- 1/2 cup cooked brown rice
- 1/2 cup ready-to-eat whole grain cereal
- 1/2 whole-wheat pita pocket (6 inches across)
- 1 rice cake
- 1/2 cup cooked whole-wheat noodles or pasta
- 1/2 cup kidney, garbanzo, or black beans
- 3/4 cup soybeans or lentils
- 1 corn or whole-wheat tortilla
- 3 tablespoons wheat germ
Iron-rich foods should be consumed daily. Since many women don't get enough iron in their diet, iron is an important part of prenatal supplements. Iron is often poorly absorbed from foods, which is why it is difficult for many people to reach the proper requirement. For example, while many vegetables have a significant iron content, only 3 to 8% of the iron in these foods is absorbed, as compared to 20% of the iron in meat and fish. This means you may need to consume more than you would think from just looking at iron content.
High-fat foods should be limited to four servings daily (no more than 30% of total calories from fat). However, eliminating all fat is dangerous; essential fatty acids are important, including omega-3-fatty acids.
Salty foods should be consumed in moderation.
Fluids are an important part of a healthy diet. At least 64 ounces (eight glasses) should be consumed per day, and more is better, preferably 80 ounces; don't count caffeinated drinks, which act as diuretics. Water also reduces your chance of constipation and the subsequent hemorrhoids that can develop from straining during defecation. The increased flow of urine also reduces your risk of developing a urinary tract infection, which can be dangerous for you and your baby.
What Vitamins Do I Need During Pregnancy?
The Recommended Daily Allowances (RDAs) for pregnant women, established by the Food and Nutrition Board of the National Research Council, act as a baseline for determining vitamin and mineral requirements. These are suggested levels of vitamin and mineral intake intended to prevent nutrient deficiencies without risking overdoses and side effects.
Warning: Do not take megadoses of vitamins during pregnancy. Your baby is susceptible to vitamin toxicities and is likely to be even more sensitive to these toxicities than you are. Stay within 100-300 percent of the RDA for individual vitamins and minerals.
Recommended Daily Allowances for Pregnant Women
Calcium is important for strong bones and teeth, as most people know, but it is also critical for proper development and function of the heart and other muscles, as well as for the blood clotting system. The fetus demands a huge supply of calcium during development and is thought to have a total body store of 25 grams of calcium at birth, all of which is received from the mother. Pregnant women need 1,000 milligram (mg) of calcium daily. Milk and dairy products are great sources of calcium, as is calcium-fortified orange juice and bread. Rice, tofu, and corn tortillas also provide calcium. Prenatal supplements usually contain 150 to 200 mg of calcium, so clearly prenatal vitamins alone cannot provide sufficient calcium to a pregnant woman.
Chromium is important for your baby's development. You should get 50 micrograms (mcg) per day. Whole-wheat bread, peanut butter, asparagus, spinach, and wheat germ all contain significant amounts of chromium.
Copper stimulates the growth of cells and tissues, hair growth, and general metabolism. It is a critical component of the baby's major systems: the heart and circulatory system, the skeleton, and the nervous system. Two to three mg of copper daily is recommended and if you eat a healthy diet and take a multivitamin, you are certain to get enough.
Folic acid is an important vitamin that stimulates red blood cell formation and the production of important chemical signals in the nervous system. It is also important in the process of making DNA. Perhaps more importantly, folic acid has been identified as a critical vitamin to prevent neural tube defects in your baby, such as spina bifida. Most doctors recommend that pregnant women get at least 400 mcg daily, while others recommend 600 to 800 mcg. Vitamins you take beyond your body's needs are excreted in the urine, so don't worry about taking too much. If you are at risk for Vitamin B12 deficiency, excess folate may mask this problem, so talk to your doctor. Since women who have a child with a neural tube defect are at higher risk of having a second child with the problem, doctors recommend 4 mg per day (five times the normal recommendation) before they even get pregnant. Good sources are green leafy vegetables, wheat germ, chicken liver, lentils, papaya, cereal, and asparagus.
Iodine is critical for the development and functioning of the thyroid gland and regulation of metabolism. The RDA for pregnant women is 200 mcg per day. You can get iodine from fluoridated drinking water, iodized (table) salt, eggs, milk, and brewer's yeast.
Iron is a crucial element in many of the body's processes. It is present in every molecule of hemoglobin, the protein that helps red blood cells carry oxygen to your body. Iron supplements are important for most women, as few women get enough iron through their diet. Often, women who lack iron become anemic. Iron-deficiency anemia, one of the most common forms of anemia, is regulated through iron supplements. Your best dietary source of iron is red meat, such as beef. Non-heme iron (the kind of iron found in vegetables) can be obtained from lentils, spinach, black strap molasses, and many kinds of beans.
Magnesium is an important element for teeth and bones, regulation of blood-sugar levels, and for the proper functioning of body proteins. Magnesium is also important for tissue growth and repair. The RDA for magnesium for pregnant women is 300 mg. A good diet usually provides enough magnesium, so it is not present in most prenatal vitamins. Best food sources are seeds such as sunflower and pumpkin, wheat germ, tofu, almonds, and yogurt.
This vitamin is involved in many of the body's regulatory and metabolic activities. The RDA for the average person is 4 to 7 mg. Pantothenic acid is present in organ meats, soybeans, mushrooms, collard greens, and brewer's yeast.
Potassium is a mineral that affects cellular function, fluid balance, and blood pressure regulation, as well as proper nerve and muscle function. While there is no RDA for nonpregnant adults, most doctors agree that pregnant women require at least 2,000 mg per day. Prenatal vitamins can provide potassium, but potassium is present at high levels in foods such as bananas, cantaloupe, oranges, watermelon, meats, milk, grains, and legumes.
This element is an important part of the development of the muscular, circulatory and skeletal systems. The RDA is 1,200 mg for pregnant women. The RDA for nonpregnant women is 800 mg for adult women and 1,200 mg for younger women.
Riboflavin (B2 )
This vitamin is important for fetal development and growth. The RDA for pregnant women is 1.6 mg and 1.8 mg for nursing women. A prenatal vitamin may be your best consistent source, but B2 can be found in liver, with smaller amounts present in soybeans, yogurt, and mushrooms.
Thiamine is important for metabolism and development of the brain, nervous system, and heart. When you are pregnant you need increased amounts of many vitamins, including B1. The RDA for pregnant women is about 1.3 mg. Thiamine is present in many foods, with highest amounts in brewer's yeast, pork and ham, wheat germ, and peas.
Vitamin A is critical for proper cell growth and the development of the eyes, skin, blood, and immunity and resistance to infection.
Vitamin B6 (pyridoxine)
Vitamin B6 is important for your body's metabolism and for the development of the fetal brain and nervous systems. The RDA for pregnant women is 2.2 mg. There are a number of good food sources of vitamin B6, including bananas, chickpeas, potatoes, and chicken.
The RDA of zinc for pregnant women is 20 mg per day and 25 mg for nursing women. Oysters, beef, and liver are good sources of zinc. It is a good idea to make sure your prenatal vitamin contains enough zinc to prevent problems if you do not eat these foods. Smaller amounts of zinc (4 to 6 mg) are contained in fish, wheat germ, and miso.
Because Vitamin B12 is found mainly in meats and dairy products, it can be a problem for vegans or strict vegetarians. If you have dietary restrictions, make sure that your vitamin supplement has adequate B12.
Vitamin C (ascorbic acid)
Vitamin C is not stockpiled by the body, so you need regular sources to fulfill your daily requirement. Vitamin C is essential for wound healing and the production of the body's connective tissue. Vitamin C also helps the body absorb iron. The RDA for pregnant women is 80 mg per day. The best sources of vitamin C include fresh oranges and orange juice, strawberries, grapefruit and grapefruit juice, broccoli, tomatoes, and cabbage.
Humans produce vitamin D in their skin in response to sunlight. Vitamin D itself is found naturally only in some fish liver oils. Since exposure to sunlight is variable and this vitamin is so important for pregnant women and growing children, all milk is now fortified with 400 mcg vitamin D per quart as regulated by the U.S. government. Vitamin D in a supplement is especially important if you don't drink milk.
Should I Take Vitamin Supplements?
The majority of doctors strongly recommend a prenatal vitamin and mineral supplement during pregnancy. Officially, the American College of Obstetricians and Gynecologists states that a healthy diet can provide all essential nutrients, but it never hurts to take extra precautions. Supplements can sometimes worsen nausea during early pregnancy. If you think your supplement is causing nausea, talk to your doctor. Switching vitamin formulas often helps.
What Foods Should I Avoid During Pregnancy?
It's not clear what amount of daily alcohol is completely safe (if there is such an amount), so the best advice to ensure the baby is not affected by your alcohol consumption is to abstain from drinking completely. There is no evidence that a few drinks are harmful, but drinking heavily (five to six drinks a day) can result in obstetrical problems, such as fetal alcohol syndrome and subsequent learning, social, and behavioral problems. The alcohol effect is dose related, meaning that the more alcohol a fetus is exposed to over time, the worse the effect. Even moderate drinking (one to two drinks per day or occasional binge drinking of five or more drinks) can lead to a milder, but still serious condition called fetal alcohol effect (FAE), which causes developmental and behavioral problems in the baby. Also, with this level of moderate drinking, the risk of miscarriage is higher, as are the risks of stillbirth and developmental problems. There is some evidence that drinking in the second and third trimesters increases the infant's risk of developing leukemia.
Research into the effects of caffeine use during pregnancy is inconclusive. Animal studies suggest that caffeine causes birth defects, increased risk of miscarriage, and increased risk of SIDS, although studies in humans have not shown these effects. It has been shown, however, that caffeine increases the heart rate and metabolism, acts as a diuretic, and decreases the body's ability to absorb iron and retain calcium, both important nutrients during pregnancy. There have been no beneficial effects of caffeine use shown. Most clinicians err on the side of caution and recommend that pregnant women avoid caffeinated drinks.
Caffeine Content of Common Beverages
There has been no data showing harmful effects of this artificial sweetener and most physicians agree that moderate use during pregnancy is okay. However, the “why worry” rule again applies: avoid consuming unnecessary substances that could possibly harm you or your baby.
Commonly contaminated foods
Raw seafood, unpasteurized milk, and soft cheeses like Brie or Camembert could be dangerous for your baby. Raw fish carries the risk of contamination with parasites, and the other foods may harbor dangerous bacteria like Listeria monocytogenes that can cause serious problems in a baby.
In 2004, an FDA/EPA joint consumer advisory committee issued guidelines warning that women who are or may become pregnant and those who are breastfeeding should avoid eating large game fish (including swordfish, shark and king mackerel) which are known to contain relatively high amounts of mercury. The panel also recommends limiting ingestion of most seafood to 12 ounces per week, which is considered to be two average meal portions per week. These recommendations include seafood that is categorized as relatively low in mercury and includes: shrimp, salmon, pollock, catfish, and canned light tuna. In addition, the committee has recommended that of those 12 ounces per week, no more than six ounces should be canned Albacore (white) tuna which has been found to contain significantly more mercury than canned chunk light tuna.
How Can I Eat Healthily If I Am a Vegetarian?
A woman can maintain a vegetarian diet and have a healthy pregnancy and a healthy baby. This is assuming, however, that she eats a balanced diet. A vegetarian diet of lettuce and bread can be just as unhealthy as a diet of processed meats and cheese. The key is variety and balance. There are a few areas where vegetarian women need to be a bit more careful to ensure they are getting enough important nutrients. The body requires 15% more protein during pregnancy than usual, so you should consume 60 mg/day of protein.
It is important for pregnant women to get adequate protein. For women who are lacto-ovo vegetarian (meaning they include dairy and eggs in their diet), this is usually not a problem because eggs, cheese, milk, and yogurt provide plenty of protein. Pregnant women should also focus on other protein sources such as tofu and other soy proteins, beans and rice, legumes, and some nuts. Vegans (no animal products) who are pregnant have to focus on non-animal sources of protein.
Again, for lacto-ovo vegetarians, there are plenty of sources of calcium. Don't forget, however, that many vegetables and other foods provide calcium-such as nuts, dark leafy greens like kale and collard greens, broccoli, and dried fruit. Corn tortillas and calcium-added orange juice are also good sources of calcium.
Dairy Sources of Calcium and Protein
Low-fat chocolate milk
Plain low-fat yogurt
Plain nonfat yogurt
Low-fat or nonfat fruit-flavored yogurt
Nonfat or low-fat cottage cheese
Natural low-fat cheeses
Should I Eat Differently at Restaurants?
It is often harder to find nutritious meals when you are eating at restaurants. If you are going on a trip, pack healthy snacks. If you are going to a restaurant, you can suggest restaurants that have healthier food or a larger menu that offers more healthy choices. Eating dishes high in fat occasionally will not compromise your baby's health in a significant way, but every meal counts. When possible, order salads with dressing on the side, clear soups, and grilled or broiled chicken or fish. Avoid fried or breaded foods when possible and limit desserts to fruit salads and sorbets.
What If I Can't Keep Food Down Due to Nausea and Vomiting?
The nausea of morning sickness usually begins to recede for most women after the first three months of pregnancy. For some women, however, the nausea continues. This can impair nutrition if a woman is not able to take in (or keep down) enough food. Persistent morning sickness and persistent vomiting, called hyperemesis gravidarum, occurs in less than 1% of pregnancies. It is more common in multiple gestation (twins, triplets, etc.), first pregnancies, and in women who have had vomiting in previous pregnancies. It is believed this condition is caused by a heightened sensitivity of the vomiting center in the brain. Other causes of persistent vomiting need to be ruled out by a physician before the diagnosis is made. The problem may last for several months or throughout the entire pregnancy. Persistent vomiting can lead to malnutrition, dehydration, and electrolyte imbalances. If the disorder is mild, the woman may be treated with rest, antiemetic medications (medications that prevent vomiting), and antacids. If she cannot gain an appropriate amount of weight, it may be necessary for her to be monitored in the hospital where she can be given intravenous nutrition.
How Do Eating Disorders Affect Pregnancy?
Some women experience particular difficulties with food and nutrition during pregnancy because of a pre-existing eating disorder, such as bulimia or anorexia nervosa. Continuing to suffer with an eating disorder during pregnancy can be dangerous for the fetus because of both the poor quality of the mother's food intake and the danger of laxatives or other medications a woman may be taking to lose weight. Some of these drugs may lead to birth defects. The first step for a pregnant woman with an eating disorder is to recognize the problem. It is important to inform your health care provider of the illness and find a way not to consume these medications. Remember, weight gain during pregnancy is necessary. If you find you cannot manage this on your own, seek professional help.