There is plenty of advice out there on what to not should eat during your pregnancy. Perhaps more important is what exactly you well should eat in pregnancy. Which nutrients help you and the foetus? In this article, I give you my seven most important nutrition tips for pregnant women.
1. Eat salt to taste
Almost all pregnant women crave more salt in the first trimester. Where does that pull come from?
When you are pregnant, the amount of blood in your body increases by more than half. That means as much as 1.5 litres of blood is added! All that blood is needed to supply your growing baby with nutrients and oxygen. With more blood in your bloodstream, you also retain more salt. Since you also lose some salt every day, you need more salt. Logical right?
Pregnant women are still told not to eat too much salt. But after many experiments with low-salt diets in pregnant women, there is only one conclusion: reducing salt makes no sense!1 So how much salt should you eat in pregnancy? As much as you are craving.
Read more in my article on salt in pregnancy.
2. Eat enough protein
Making a new human not only takes more energy, you also need more building materials. Proteins, in other words. In the 3the trimester almost 30 grams extra2! The advice to eat more plant-based foods can cause you to not get enough protein.
Animal proteins - as in dairy, meat, fish and eggs - are the most complete and therefore the easiest to meet your protein needs. You can also get there with plant-based ones. Besides legumes, mushrooms and even potatoes contain quite a bit of protein. Do you eat entirely plant-based? Then consult your midwife.
Some plant proteins have drawbacks. Like soya. Non-fermented soya - as in vegetarian burgers, contain small amounts of hormone-like substances. These can potentially affect the fragile hormonal system of the growing foetus. Daily large amounts of soy are therefore discouraged.
How much protein do you need now? Say your weight is 70 kg. In the first trimester, you then need about 60 grams. In the second trimester 70 grams and in the third trimester 90 grams. Are you pregnant with twins? Then the requirement is even higher. If you are breastfeeding, you will need about 77 grams for the first six months and then 71 grams per day. Again, this is more if you breastfeed more than one child.
What does 90 grams of protein look like? An example could be one egg, three glasses of milk, a piece of cheese, a portion of mussels and a mug of homemade chicken stock.
3. Enjoy fruit in pregnancy
Sugar, a carbohydrate found in fruits, honey and vegetables and called table sugar in its processed form, is in quite a bad light. Especially fructose - which sugar is half of. Funny because when you are just pregnant, fructose and other sugars are all around the embryo3. Yes really! During the most vital time in pregnancy, when all organs are starting to form, fructose seems to play a role in development.
Glucose, the other half of sugar, also has an important role. It is essential for foetal brain development. Glucose the foetus gets from the mother. She needs less of it herself because her own cells become good at burning fat. This leaves more glucose for the growing sprout.
So glucose and fructose - together they form the disaccharide 'sugar' - both play a role in pregnancy. But yes sugar, that white stuff, table sugar so to speak, doesn't that cause diabetes to develop?
Just because you cannot handle sugar well if you have diabetes does not mean that sugar is the cause. A little table sugar in an otherwise nutritious diet does not cause diabetes4. Table sugar makes food tastier, of course. You may then eat too much of it and gain weight. If you are overweight, you are more likely to develop gestational diabetes.
The funny thing is that sugar can lower a hormone that has a role in the development of gestational diabetes. Cortisol, one of the best-known stress hormones, you lower not only with relaxation, sport and breathing exercises but also with... sugar5!
White table sugar, of course, is not as nutritious. But sugars as found in fruits and vegetables, there is really nothing wrong with them at all! And I would hate for women to avoid fruit (and even delicious fresh-squeezed orange juice) because they are afraid of the sugars in it. You need those carbs (yes sugar is also a carbohydrate...)!
4. Skip the fish oil: eat fish when pregnant!
Most multivitamins for pregnant women do not contain it. This is because it has a foul taste. But staff at vitamin shops and orthomolecular therapists are happy to advise you on it.
If you google on it you will be bombarded with ads. It is said to be essential for brain and eye development and prevents eczema and allergies. It seems like you are a bad mother if you did not take this during your pregnancy.
Years of positive messages about fish oil and omega-3 fatty acids have created an image of some kind of miracle oil. The journal of choice for junior doctors recently featured a full-page advert for fish oil, and at a major nutrition conference organised by the Physician and Lifestyle Association, there was an entire stand promoting luxury fish oil. You don't even have to open the alternative magazines or new, better forms of fish oil come your way.
As nice as these messages sound, the best thing to do is to just eat fish and seafood. After all, fish contains so many other good nutrients besides omega-3 fats. Fish oil cannot match that. It is a bit of a caution in pregnancy with fish because of dioxin, mercury and PFAS, but fish oil suffers from those too. Fortunately, there is still plenty to choose from.
For example, eat fish once a week for dinner and once a week for lunch. For dinner, think sole, plaice and haddock and don't forget mussels! For lunch, you can have canned salmon or heated smoked trout. For more inspiration, check out the PregnantHap app.
5. Eat or drink dairy in pregnancy
Have you swapped cow's milk for almond milk, oat milk or another plant-based variety? You might want to consider switching back...
Calcium, like folic acid and vitamin D, is incredibly important during pregnancy. Not only for your bones (which you break down if you don't get enough calcium) but also for foetal growth and to prevent preeclampsia.
It is hard to get enough calcium (at least 1 gram!) if you don't eat dairy. However, 4 servings of dairy will get you there easy to. And voilà you get a lot of protein with that, too. Read more in my article 'Does nutrition affect foetal growth?‘.
6. Make sure your vitamin D is optimal in pregnancy
Daily 10 micrograms of vitamin D is the recommendation for pregnant women. Why? Vitamin D deficiency gives you a higher chance of all kinds of pregnancy problems.
Justifiable advice. The only problem? 10 micrograms is not enough to fix a vitamin D deficiency. For that, you need a dose 10 times higher. Vitamin D deficiency is quite common, especially if you don't get much sun. Think of an office job, dark skin or wearing a headscarf or other body-covering clothing. I recommend getting your vitamin D tested. That way, you will know for sure if you have enough of those 10 micrograms. Or keep this study in mind.
7. Keep eating nutritiously even when you have passed the recommended pounds
Eating too little causes the foetus to grow less well. But what if you have already reached the recommended 15 kilos?
At 37 weeks, I had gained exactly 15 kilos. Nice, right, said the midwife. But what she and I didn't know was that I still had almost 5 weeks to go. And in those last weeks the kilos flew on. Yet I continued to eat well (in my case, about 2,500 kcal a day). Even the brain continues to grow until the moment of birth. Just before giving birth I weighed almost 80 kilos, so 20 kg more! Not quite as much as Catherine Zeta-Jones. Somehow I was ashamed that I had gained so much weight. Wasn't it too much? Should I have restrained myself more? But my son was a wonderful weight and after a year I could fit into all my clothes again.
For women who already carry a lot of weight before becoming pregnant, the advice is to gain less. The heavier you are, the less. Very heavy women shouldn't actually gain anything. (So they should lose weight, because yes a child weighs a bit too!).
Don't let your weight come at the expense of the nutritiousness of your diet! Even if you are overweight, you need a whole range of nutrients every day. It is difficult to get all those nutrients if you eat less than 2000 kcal a day
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References
- Duley L, Henderson-Smart DJ, Meher S. Altered dietary salt for preventing pre-eclampsia, and its complications. Cochrane Database of Systematic Reviews. Published online October 19, 2005. doi:10.1002/14651858.CD005548 ↩︎
- Health Council. Advisory Dietary Standards For Protein - Reference Values For Protein Intake. The Hague, 2 March 2021. ↩︎
- Jauniaux E, Hempstock J, Teng C, Battaglia FC, Burton GJ. Polyol Concentrations in the Fluid Compartments of the Human Conceptus during the First Trimester of Pregnancy: Maintenance of Redox Potential in a Low Oxygen Environment. J Clin Endocrinol Metab. 2005;90(2):1171-1175. doi:10.1210/jc.2004-1513 ↩︎
- Tappy L. What nutritional physiology tells us about diet, sugar and obesity. Int J Obes. 2016;40(S1):S28-S29. doi:10.1038/ijo.2016.11 ↩︎
- Tryon MS, Stanhope KL, Epel ES, et al. Excessive Sugar Consumption May Be a Difficult Habit to Break: A View From the Brain and Body. J Clin Endocrinol Metab. 2015;100(6):2239-2247. doi:10.1210/jc.2014-4353 ↩︎
