Why Nutrition is Important During Pregnancy

Approximately 8 Minutes Reading Time 

Brief Article Overview

• Nutrition is important for good health, which is especially important during pregnancy. 
• Nutrition guidance can be confusing and it’s difficult to know what to prioritise when it comes to eating to support pregnancy. 
• Before worrying about counting calories, we find that building healthy eating habits, monitoring portions and eating mindfully are the foundations of any good nutritional strategy.
• In general, calorie intake will increase throughout the pregnancy to provide the extra energy needed for the baby to grow and for you to carry it.
• There are certain foods and eating behaviours that may contribute to heartburn and morning sickness.
• There are also certain foods and chemicals which should be limited or avoided altogether. 
• Specific supplement advice should be given by a medical professional off the back of a full medical history and blood tests, however, there are supplements that are commonly recommended specifically to support pregnancy.

Introduction

Trying to master healthy eating practices can be difficult at the best of times. It feels like there are new studies being published almost every day that offer conflicting guidance to the diets we once thought were healthy. Trying to understand what a healthy diet is when you’re pregnant can be even more confusing. It’s likely that you’ll become more focused on eating healthily and, perhaps, start to do your own research in regards to eating specifically for pregnancy. 

You’ll hear and read conflicting (and often misleading) advice about what to eat. This might include things like “you should be eating X more calories” or “you need to be eating for two”. We hope the information in this article helps guide you through this topic and gives you a full and comprehensive picture of what eating healthily looks like and general recommendations for supporting a healthy pregnancy.

Healthy Habits vs Calories

We recommend you focus on practising basic foundational eating habits rather than counting calories. This may seem a little contradictory since it’s relatively common knowledge that pregnancy requires more calories (and more nutrients) during trimester two, three and whilst breastfeeding. Counting calories isn’t an exact science and there can often be a significant disparity in the calories your body utilises, as well as the reported calorie content on the packet (which can carry up to a 25% error rate).

Setting daily calorie targets can provide additional stress for some, which may be counterproductive as the body probably doesn’t need more stress throughout pregnancy. Getting the required calories and nutrients is easy enough when practising healthy portion control within a varied diet and eating mindfully.

Above is an overview of the ‘Hand Sized Portion Guide’ that was made popular by Precision Nutrition (1). Following this system allows you to easily portion out your plate using your hands as measuring tools. If you manage to eat 3 square meals a day like this, you’ll likely meet your calorie and nutrient targets. Also, listening to your body and recognising your eating patterns helps you become mindful of hunger, satiety (feeling satisfied) and cravings. Here are some mindful eating techniques to help you on your way;

• Eat slowly and enjoy your food – eating slowly with attention and intention helps you to be mindful of signals that will tell you when you’re feeling full up and satisfied.
• Eat when hungry – Remember to listen to your body and if you’re feeling physically hungry (as opposed to craving) when you’re pregnant, it’s wise to satisfy this signal.
• Eat a portion of protein at every meal or snack – Typically we find most clients under-eat protein and it’s especially important when supporting the growth of a baby.
• Eat the colour of the rainbow when thinking about vegetables, fruits, herbs and spices – We like to advise our clients to go beyond the ‘5 a day guidance’ and think about food colour. By eating a varied amount of vegetables, fruits, herbs and spices you’ll ensure you consume a varied vitamin and mineral profile which are vital for healthy bodily functions and the development of your pregnancy.
• Stay hydrated– drink roughly 2.5ltrs to 3ltrs of water a day is often given as a target, however, 4ltrs is advised when you’re breastfeeding.

Heartburn and Morning Sickness

Heartburn and morning sickness are the most common ailments during pregnancy. There are a few supplements and techniques you can try to help reduce their frequency and intensity.

Below are some foods that can cause heartburn. Limiting or avoiding these foods during pregnancy may be recommended, especially if they have caused heartburn in the past…

• Tangy citrus foods
• Garlic
• Onion
• Spicy foods
• Peppermint
• Caffeine
• Chocolate 
• Fizzy drinks

Morning sickness is always a tough one to combat. It’s relatively unknown as to what triggers it, however, it’s likely due to fluctuating hormone levels during the first trimester. Meal timing and eating smaller meals more frequently may be useful strategies. 

There are some studies that suggest supplementing ginger (250mg every six hours) and pyridoxine/vitamin B6 (10-25mcg every eight hours) has been found to be somewhat helpful. In addition, antihistamines have been found to be beneficial in mild cases of morning sickness (2). If morning sickness and nausea become so intense that you stop eating or keep vomiting and begin to lose body weight, then consult your doctor immediately.

Trimester Calorie Guidance

After all the advice we have just given about healthy portion control vs counting calories, we still thought it was worthwhile giving you some guidance on the additional calories needed over the trimesters to provide a bit of context. It’s a topic that often comes up with our clients. General recommendations for calorie (kcal) increases during pregnancy are as follows;

• 2nd trimester 300-400kcal per day above normal maintenance.
• 3rd trimester 400-500kcal per day above normal maintenance.
• Breastfeeding 450-550kcal per day above normal maintenance.

However, it’s important to take these calorie guidelines with a pinch of salt (excuse the pun) because if you’re following healthy habits and eating mindfully, you’ll instinctively and gradually increase your intake over the course of your pregnancy. We’ve found some clients almost forcing themselves to eat more as they transition between each trimester because they feel they have to. This can create additional stress and sometimes a feeling of not being able to meet a target, which can be demotivating.

Foods to Limit or Avoid

This topic is a slightly contentious one, however, we aim to provide you with the most evidence-based advice. As previously mentioned, this information is continually changing based on current research, however, we know this to be true at the time of writing this article. If there are any foods that you personally want to avoid and have valid reasons to do so; we support your decision. Here are some foods to limit or avoid during pregnancy;

• Foods linked to listeriosis – processed meats like hot dogs, lunch hams and some seafood too.
• Raw or uncooked proteins – sushi, unpasteurised eggs, raw cookie dough or cake mixture, runny eggs, raw seafood and rare cuts of meat.
• Raw vegetable sprouts – alfalfa, clover, radish and mung bean sprouts carry a risk of foodborne illness when eaten raw.
• BPA (bisphenol A) – an industrial chemical that has been used to make certain plastics and resins since the 1960s. Society has started to use less plastic in packaging nowadays. However, it should be noted that high amounts of BPA have been linked to poor fetal development and health. 
• Lead and Mercury – tuna, swordfish, king mackerel, tilefish and some fish oils contain mercury. Basically, all the big game fishing! The Environmental Agency states that it is safe for a pregnant woman to consume 340g of fish or seafood low in mercury per week. Safe selections include shrimp or prawns, salmon, pollock, catfish, anchovies and trout.
• Alcohol – The UK advice is to completely avoid alcohol however there are some countries that give guidelines for small amounts. Again we’d err on the side of caution here and go teetotal. 
• Caffeine – The American College of Obstetricians and Gynaecologist suggest a daily limit of 200mg, which is the equivalent of 2 cups of coffee. 
• High doses of certain supplements – Blue cohosh, rosemary, turmeric, vitamin A, St john’s wort, echinacea.

Supplements

Obtaining the necessary number of vitamins and minerals by following healthy eating habits and recommended portioning is possible. However, sometimes you may find it difficult to reach the recommended levels through diet alone. Supplements should not (and cannot) replace a nutritious diet, they should supplement one. 

You may have pre-existing conditions/deficiencies which need to be managed. If so, take regular blood tests with your doctor or medical practitioner, which can guide your choice of supplementation. Having said that, here is a quick overview of the supplements that are often generally advised to support a healthy pregnancy:

• Specific prenatal vitamins – A reputable lab will provide a well-rounded blend of vitamins and minerals needed during pregnancy. You’ll commonly find that prenatal vitamins have higher amounts of choline, iron and collagen.
• Fish oils – EPA and DHA (omega 3s) are beneficial fatty acids found in oily fish and support cardiovascular function, nervous system function, immune health and brain development
• Vitamin D – Depending on the time of year, our vitamin D levels can drop down quite low in the UK (especially those with darker skin types). Pregnant woman safely can take up to 4,000IU each day
• Supplemental protein – sometimes it can be hard to eat enough protein, especially if you’re vegetarian or vegan. It’s advised you do your research here and find the purest one with the fewest ingredients and matches your dietary requirements.

If you’re interested in starting your health and fitness journey with us…

Disclosure: This article is not to be used as medical advice. If you are currently experiencing physical or mental health issues, please seek professional advice from a fully qualified Nutritionist, GP or Physiotherapist.

References

1. Precision Nutrition – Calorie control guide
2. McParlin C, O’Donnell A, Robson SC, Beyer F, Moloney E, Bryant A, et al. Treatments for Hyperemesis Gravidarum and Nausea and Vomiting in pregnancy: A systematic review. JAMA. 2016 Oct 4;316(13):1392-401.