How Should Nutrition Be During Pregnancy?

Balanced nutrition in pregnancy is one of the basic elements of protecting the mother’s health and supporting the baby’s development. “Eating for two” is a misconception; what matters is the variety and quality of foods rather than the quantity. This article summarises the main principles.

Energy needs and weight gain

Extra energy needs in the first trimester are negligible; about 340 kcal per day extra is advised in the second trimester and about 450 kcal in the third. The target weight gain depends on pre-pregnancy body mass index: 11.5–16 kg for women of normal weight, 7–11.5 kg for overweight women and 5–9 kg for women with obesity. Weight is checked at every visit.

Key nutrients

• Folic acid: reduces neural tube defects. Found in green leafy vegetables, legumes and fortified cereals; a supplement of 400 mcg daily is recommended.
• Iron: requirements rise in pregnancy; red meat, legumes and dried fruit are sources. Vitamin C increases absorption, tea and coffee reduce it. The Ministry of Health recommends iron supplementation from week 16.
• Calcium and vitamin D: dairy products, green vegetables, almonds. A daily target of 1000 mg calcium; vitamin D supplementation is considered according to blood levels.
• Iodine: essential for the baby’s brain development; iodised salt and seafood are sources.
• Omega-3 (DHA): two portions a week of low-mercury fish (salmon, sardines, anchovies) are recommended.
• Protein: daily needs rise to about 70 g; met by meat, fish, eggs, legumes and dairy.

Foods to avoid

• Raw or undercooked meat, raw fish (sushi), sauces containing raw egg
• Unpasteurised milk and cheeses, mould-ripened cheeses
• High-mercury fish: swordfish, shark, king mackerel
• Unwashed fruit and vegetables
• Alcohol (there is no safe amount) and more than 200 mg caffeine per day
• Herbal teas and supplements: not without consulting the physician

A sample daily pattern

Three main meals and two or three snacks; vegetables or fruit at every meal; fibre-rich carbohydrates such as wholegrain bread, bulgur and oats; a portion of legumes or the meat group every day; 2–3 portions of dairy and 8–10 glasses of water provide a general framework. Small frequent meals help with nausea; more fibre and fluid help with constipation.

Gestational diabetes and diet

If gestational diabetes is detected at the glucose screening at weeks 24–28, the diet is adjusted with the support of a dietitian and the physician. Limiting simple sugars, spacing meals regularly and a daily walk are the first steps in blood glucose control.

About supplements

Apart from folic acid and iron, routine multivitamins are not necessary for every pregnant woman. Supplements are recommended individually by the physician on the basis of blood tests and dietary assessment; some, such as high-dose vitamin A, can be harmful in pregnancy.