Updated: Jun 29
Eating for Pregnancy: Your Guide to Ultimate Pregnancy Nutrition
By Carrie Bonfitto, NC, BCHN®, TwoHeartsNutrition.com
Pregnancy can be a confusing time when it comes to knowing what to eat and what not to eat. Your body is changing, and you need to support those changes with the right healthy foods. Your growing baby needs different nutrients during different stages of pregnancy. Plus, cravings, morning sickness, and stress all factor into what you are actually going to be putting into your mouth!
That’s why we decided to put together an ultimate guide to nourishing yourself and your growing baby during pregnancy. Our pregnancy diet guide provides important nutrients essential for your baby’s development and your healthy pregnancy. It points out key foods to focus on and lets you know why to avoid others. And to make things simple, this guide is a comprehensive diet plan that can be used throughout your pregnancy or even to increase fertility or support your body postpartum.
By eating our whole foods pregnancy diet, you will build and replenish your nutrient reserves, promote proper weight gain, and increase your chances of a healthy outcome for both you and your child.
Why It’s Important to Eat Well During Pregnancy
We’ve all heard someone say that you can “eat for two” when you’re pregnant. But consuming excess nutrients and calories during pregnancy can actually be just as damaging as eating too few and can increase a pregnant woman’s risk of miscarriage, gestational diabetes, and pre-eclampsia while also increasing the risk of obesity and type 2 diabetes for their children in adulthood .
It’s important to remember that pregnant women who are at a healthy BMI (between 19 and 25) only need to increase their calorie intake by about 250-300 calories starting at 13 weeks, the second trimester. And those whose BMI is over 25, need to increase their calorie intake even less. [Check your BMI here.]
300 calories isn’t eating for two or even for 1 and a half. It’s having a cup of bone broth (120 calories), a banana (100 calories), and 11 almonds (77 calories) extra to eat in your day. But keep that in mind that all calories are not created equal, some are more nutrient-dense like healthy fats and don’t cause weight gain in the same way that unrefined carbs like sugar will. So don’t get obsessive about counting calories. The important thing to do is focus on eating nutrient-dense foods that contain the vitamins and minerals that are in extra demand during pregnancy.
And remember: A pregnant woman’s body will deplete her own vitamins and mineral reserves in order to make sure the baby has all the nutrients it needs. This means that requirements for many nutrients are at a lifetime high during pregnancy and lactation.
What Nutrients Do I Need Increase Folate Vitamin B9 is also known as folate. This vitamin is well known to help prevent neural tube defects and should be in good supply before conception. In addition, throughout pregnancy, there is a 70% increased need for folate to support DNA synthesis, optimal growth and development of the fetus, and blood volume expansion and tissue growth of the mother. There is also increased demand for folate during lactation.
Some people have difficulty processing the synthetic form of folate called folic acid. Folic acid is also controversial because some studies have linked it to adverse health effects such as infertility, high blood pressure, and breast cancer. That is why we recommend consuming folate through food sources and in supplements that contain methyl folate or 5-MTHF, which the body does not have to convert.
Good Sources: lentils, beans, sunflower seeds, flax seeds, spinach, collard greens, turnip greens, mustard greens, romaine lettuce, asparagus, papaya, oranges, grapefruit.
Iron Iron requirements are 150% higher during pregnancy. It is essential in making hemoglobin, the protein in red blood cells that carries oxygen to the other cells. And since you are manufacturing another human, you’re making a lot of hemoglobin. Your body contains 50% more blood when you are pregnant.
Iron-deficient anemia is linked to preterm delivery, low birth weights, and infant mortality. There are two types of iron: heme and non-heme. Heme is easier for your body to absorb and is only found in animal sources. Plants, supplements, and fortified foods contain non-heme iron. Red meat, liver, poultry, and seafood contain both types of iron.
Good Sources: Liver, fish, meat, eggs, beans, nuts, seeds, dried fruit, brown rice, dark green leafy vegetables like kale.
Vitamin C Vitamin C helps the body to absorb iron from plant sources. It’s also necessary for the body to make collagen, a structural protein in bones, skin, cartilage, and tendons. Both mom and baby need vitamin C daily for tissue growth and repair (think about preventing stretch marks, too), to keep their immune systems healthy and protect their cells from damage. And vitamin C demands are 70% higher during pregnancy, and needs go up even more during lactation.
Good sources: Papaya, red bell pepper, broccoli, strawberries, Brussels sprouts, pineapple, oranges.
DHA Docosahexaenoic acid or DHA is an essential omega-3 fatty acid. DHA helps to build your baby’s brain, eyes, and nervous system, which really start to form during the third trimester half of pregnancy. At this time most of the mom’s DHA is transferred to her baby. But that doesn’t mean you should only be focusing on this nutrient later in pregnancy, you need to start building this nutrient up in your system before your baby needs it. Most people’s diets are already deficient in DHA because it is most abundant in fish. This is why most health care providers recommend fish oil supplements for pregnant women.
Keeping levels high to reduce the risk of postpartum depression and support breastfeeding so don’t stop focusing on DHA after you’ve given birth.
Good Sources: Fish, algae, eggs.
Calcium Your baby needs calcium to build strong bones and teeth, grow a healthy heart, nerves, and muscles, and develop proper heart rhythm and blood clotting. During pregnancy making sure you have enough calcium reduces your risk of high blood pressure and preeclampsia. And if you aren’t consuming enough calcium your body will steal the calcium your baby needs from your bones and teeth to ensure your baby gets enough.
You’ll need about 1,400 mg of calcium per day while pregnant, which is equivalent to 4 8 oz glasses of milk. But there are plenty of other non-dairy food choices, too. One cup of steamed collard greens has about the same amount of calcium as 1 cup of milk.
Good Sources: tofu, sardines, sesame seeds, yogurt, collard greens, spinach, cheese, turnip greens, beet greens, and organic dairy products.
Protein When you’re pregnant or breastfeeding, your protein demands go up by about 25%. Your body uses the amino acids in proteins to build the cells for your baby’s body and to support your organs that need to grow bigger to accommodate the needs of your baby. You can use this calculator to estimate your protein needs: http://www.globalrph.com/protein-calculator.htm
Increasing protein also helps you to better regulate your blood sugar, control your weight, and decreases your chance of developing gestational diabetes.
Good Sources: bone broth, grass-fed meat, organic poultry, pasture-raised eggs, quinoa, nuts and seeds, lentils, and beans, organic dairy products.
7 Best Foods to Eat During Pregnancy
Bone Broth Rich in collagen protein and the amino acids glutamine and glycine bone broth is super supportive of pregnancy.
During the second trimester, bone broth helps you meet your increased calorie needs while providing the amino acids your baby needs to build your baby’s body. The collagen also helps to reduce stretch marks and support your joints, which are being impacted by your pregnancy weight. The glutamine helps to curb unhealthy cravings, helping you to not overeat. And the glycine is beneficial for calming your mind, reducing stress, and helping you sleep.
Recommendation: 1 cup daily.
Salmon Salmon has the highest concentration of the omega 3 fatty acid DHA of any fish. And DHA is so important for supporting the brain and nervous system development of your baby and the mental functioning of you, the mother.
We know that many people are cautious about seafood during pregnancy because they are concerned about mercury levels in fish. But we believe that the nutritional benefits of eating moderate amounts of seafood outweigh the risk of toxins. That said, it is important to choose fish low in mercury.
The Environmental Defense Fund (EFD.org) advises eating: Salmon from Alaska, Arctic Char, Atlantic mackerel, sardines, sablefish, anchovies, US farmed rainbow trout, and albacore tuna from the US & Canada. These fish are low in contaminants and eco-friendly.
Updated regional lists of which fish are the best choices and which ones to avoid can be found on the Monterey Bay Aquarium’s Seafood Watch Website: www.seafoodwatch.org.
Recommendation: Two 6 oz servings per week.
100% Grass-fed Beef Red meat contains the highest amount of heme iron, the easily absorbable form. Iron is in high demand and used to create all that extra blood we need when pregnant. Plus, beef contains more protein per ounce than any other food and we need that extra protein, too. But please note that we are very careful to specify 100% grass-fed beef.
Research spanning three decades suggests that grass-based diets can significantly improve the fatty acid composition and antioxidant content of beef. Grass-fed beef contains less fat overall and specifically less saturated fats that cause elevated cholesterol levels. Plus the healthy omega 3 fatty acid CLA is much greater in 100% grass-fed beef. In addition, it contains elevated levels of cancer-fighting glutathione, vitamin A, vitamin E, and superoxide dismutase.
This is also why Kettle and Fire sources 100% grass-fed beef bones for our beef bone broth.
Recommendation: Three 4 oz servings per week.
Lemons We wanted to be sure to include Vitamin C-rich food in this list. Lemons made the cut because they are one of the foods most commonly craved during pregnancy. Their acid vitamin C helps your body to absorb iron, especially from plant sources. C also helps you to naturally generate collagen to build your baby’s body and support your growing organs, and stretching skin. The zest (skin) of the lemon contains 5x more Vitamin C than the juice. So don’t be afraid to plop a few slices, skin and all, into your blender when making a smoothie. Using the zest and juice will brighten up your grains, greens, salad dressings, and that mug of bone broth, too.
Recommendation: minimum zest and juice from 1⁄2 lemon daily.
Leafy Greens Full of folate, iron, and calcium, leafy greens are a must for our ultimate pregnancy diet. But don’t get stuck on just one kind; they all have their strengths. For example, did you know that Romaine lettuce actually has more folate than kale?
Spinach, swiss chard, beet greens, mustard greens, and collards are all wonderful braised in a bit of bone broth or mixed into a soup.
Recommendation: At least 1 cup of cooked greens or 2 cups of raw daily.
Flaxseeds Flaxseeds are a powerhouse food. They contain omega 3 fatty acids, protein, calcium, and fiber.
During pregnancy, the extra progesterone in your system can make your gut sluggish and slow down digestion causing constipation. Adding the lignin fiber in flax helps prevent constipation and soothe the digestive tract.
Ground flax is a wonderful booster to mix into smoothies, oatmeal, and mugs of bone broth.
Recommendation: 1 TBSP ground flaxseed daily.
Blueberries While it’s important to eat a rainbow of fruits and vegetables (all the different colors give you different nutrients) We absolutely love blueberries. Their dark purple skin contains powerful flavonoids and is packed with antioxidants needed to prevent birth defects.
Plus, blueberries are a low-sugar, high-fiber fruit and are a good choice to keep gestational diabetes and constipation in check.
Recommendation: 1⁄4 cup per day.
Full Fat Organic Plain Yogurt Yogurt is rich in calcium and unlike milk contains good healthy bacteria to help you balance your gut flora. These probiotics reduce inflammation and infection and support the immune system of the mother. There is a growing body of evidence that suggests that the health of a mother’s digestive tract may influence the neurological development of her offspring.
So including probiotic-rich foods like sauerkraut, kimchi, miso, kefir, and yogurt is a great idea during pregnancy.
We’ve specifically chosen full-fat organic yogurt because it contains tons of calcium. Full-fat dairy contains less lactose than lower-fat varieties making it much easier to digest. And because toxins and chemicals are trapped in fat cells, make sure that you are choosing organic dairy to keep your diet as clean as possible.
If you can’t tolerate any dairy, choose another probiotic-rich food and a calcium supplement.
Recommendation: 1 cup per day.
What Not to Eat When Pregnant
Foods with High Listeria Risk Getting food poisoning when you are pregnant is unpleasant for you but very dangerous for your growing baby. Listeria infection increases your risk of miscarriage, premature delivery, infection to your baby, and infant mortality. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2621056/
Listeria infection is rare, but 27% of cases are diagnosed in pregnant women. Eating freshly cooked and freshly prepared foods is the best way to avoid this bacteria. Foods that are more likely to contain listeria include: · Soft cheeses such as brie, blue cheese, and gorgonzola. · Unpasteurized milk · Pate, including vegetable pate · Raw or partially cooked egg whites. · Raw or undercooked meat, fish, or seafood · Pre-Packaged Salads or Salad Bars · Pre-cooked packaged meats and deli meats
Unwashed Vegetables We want you to eat tons of veggies when you are pregnant. But just make sure they are thoroughly washed. Some soil can contain parasites that can cause toxoplasmosis. Again this is more dangerous to your developing baby than to you, and risks are similar to those of listeria infection.
Make sure your vegetables are scrubbed clean, and your cutting boards and work surfaces are disinfected. Avoiding eating raw vegetables when eating out can also decrease your risk of this infection. (Raw and undercooked meat can also carry these parasites.)
Too Many Carbs Here we are really thinking about sugar. Avoiding sugar during pregnancy is a really great way to decrease your risk of developing gestational diabetes. Women who develop gestational diabetes are at an increased risk for pregnancy complications. Gestational diabetes also increases the likelihood that your child will be overweight and develop type 2 diabetes.
If you have a family history of diabetes or have been diagnosed as prediabetic, keeping sugar out of your diet is strongly recommended.
But don’t forget, carbs can really pile up in other foods as well, such as bread, pasta, juice, dairy, rice, beans, and potatoes.
A healthy balanced diet should include about 3-4 servings of carbs per day. A serving of carbs is equivalent to 1⁄2 cup of cooked pasta, rice, quinoa, oatmeal, beans, or lentils; 1 slice of bread; or one fist-sized potato. And these can add up fast. Having 1 cup of oatmeal in the morning and a sandwich for lunch gets you to your four servings before dinner. It’s easier for you to keep your blood sugar balanced by eating smaller servings of carbs throughout the day – 1 serving at each meal plus a snack.
*Note, if your doctor tells you that you need to be gaining more weight to sustain your pregnancy, then adding more servings of healthy whole grains like oatmeal, brown rice, and quinoa can help.
Too much Caffeine We know that research is mixed about pregnancy and caffeine. But most studies conclude that it is safe to drink less than 300 mg per day, which is equivalent to about two 8 oz cups of drip-style coffee.
But most people report feeling more energetic when they quit caffeine. And since coffee can often be a trigger for heartburn, a common pregnancy side-effect, we suggest limiting your caffeine consumption.
Switching out just one cup of coffee for one mug of bone broth can be a wonderful way to start your day and add protein to your morning routine.
Alcohol We don’t think we even need to mention this here, but alcohol and pregnancy don’t mix. Beyond the risks to the baby, alcohol is a high carbohydrate food that does not provide enough nutritional benefits to outweigh the risks. We know that pregnancy is stressful. So if you need to unwind at the end of the day, try a lovely chamomile herbal tea or one of our soothing bone broth tonics.
Prenatal Supplements While foods provide the most absorbable forms of nutrients that are needed for pregnancy, adding a prenatal supplement is recommended.
Prenatal supplements are the fastest way to replenish any nutritional deficiencies and should be started before you conceive and continued for three months after delivery or weaning if you are breastfeeding.
Supplements are becoming a more important recommendation from health care providers because fruits and vegetables grown decades ago were richer in vitamins and minerals than the varieties most of us eat today. Soil depletion and industrial farming practices designed to select for size and pest resistance over nutritional content have declined the amount of protein, calcium, phosphorus, iron, riboflavin (vitamin B2) and vitamin C in our produce. Studies have found that iron has dipped as much as 37%, Vitamin C averages about 30% lower, and calcium is down by 27%.
Ask your health care provider for a recommendation for a good quality prenatal vitamin-mineral supplement. DHA will often need to be taken as a separate supplement.
About the Author: Discover more about Carrie Bonfitto, NC, BCHN®, and her book, “What To Cook Why To Eat It” at TwoHeartsNutrition.com