Dietary needs can change for many reasons; blood sugar, blood pressure, illness, age, and even simply aesthetic reasons can push individuals to make significant changes to their diet. However, pregnancy is one of the largest possible stressors on one’s diet. The nutritional needs of raising another human being are unfathomable, and change throughout the roughly 9-month process. Thus, it can be difficult to keep up. In fact, according to a study from the Current Developments in Nutrition journal, the diets of pregnant women in the United States are on average extremely lacking in key nutrients, falling below the nutrient levels seen in the general population given the other stressors of pregnancy. So with all of this in mind, how can one keep up?
PRENATAL/FIRST TRIMESTER
While the first trimester requires no extra calories, the weeks leading up to pregnancy are vital for ensuring the fetus develops normally. Besides taking prenatal vitamins, these nutrients can also be found in everyday foods.
FOLIC ACID
Folic acid, a form of vitamin B9, is essential in neurological development. The neural tube, which develops in just the first few weeks of pregnancy, forms the fetal brain and spinal cord. Since the neural tube forms so early, it’s often recommended that women who plan to become pregnant begin taking folic acid supplements from before conception well into the first trimester. Folic acid may also play a significant role in reducing the risk of pregnancy complications such as heart disease, some cancers,, stroke, Alzheimer’s disease, and preeclampsia. Leafy greens, legumes (such as beans and lentils), citrus fruits, fortified grains, and animal liver are rich and accessible sources of folic acid. The recommended daily dose of folic acid for pregnancy lies between 400 and 800 micrograms, which can be supplemented by:
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Spinach (262 mcg per cup, cooked)
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Black-eyed Peas/Cowpeas (210 mcg per cup, cooked)
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Fortified Breakfast Cereal (100 mcg per serving)
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Fortified White Rice (90 mcg per serving)
IRON
Iron is essential for the production of hemoglobin, the protein in red blood cells that carries oxygen. Adequate iron levels ensure sufficient oxygen supply to the fetus, which is indispensable when it comes to healthy birth weight, neural development, and overall growth. Low iron levels can also lead to anemia in pregnant women, which is known to cause fatigue, weakness, and shortness of breath. Both plant and animal sources are rich in iron; fortified cereals, leafy greens, legumes, mollusks, gamier poultry and red meat are good choices.
The recommended daily dose of iron for pregnancy is 30 to 60 milligrams, which can be supplied by:
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Spinach (6.4 mg per cup, cooked)
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Soybeans (8.8 mg per cup, cooked)
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Beef (2.5 mg per 3 oz. serving)
It’s extremely important not to rely exclusively on meat for iron, as excessive red meat consumption is both costly and significantly increases risk of cardiovascular disease, type 2 diabetes, and cancer.
CALCIUM
As is commonly known, Calcium is extremely important for developing the bones of a fetus. Like both folic acid and iron, inadequate calcium intake can have negative effects on the mother as well, including decreased bone density and preeclampsia. Pasteurized dairy, milk substitutes, leafy greens, and certain fish are all rich sources of calcium. The WHO recommends 1500 to 2000 milligrams of daily calcium during pregnancy, which while often provided by supplements, is also present in:
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Yogurt (488 mg per 8 oz. serving)
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Low Fat (1%) Milk (305 mg per cup)
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Soy Milk (301 mg per cup)
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Collard Greens (268 mg per cup, cooked)
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Spinach (245 mg per cup, cooked)
Plenty of foods are often found fortified with calcium in grocery stores, including citrus juices, milk substitutes, and tofu prepared with calcium sulfate. As always, remember to check nutrition labels before purchasing any food item!
SECOND TRIMESTER
While it’s important to still incorporate folate, iron and calcium into one’s diet into both the second and third trimesters, every nutrient necessary for pregnancy is also essential for the mother and baby’s health. However, the second trimester presents more needs.
OMEGA-3 FATTY ACIDS (DHA)
Omega-3s help to continue development of a baby's brain, skin, and eyes. Maintaining adequate omega-3 levels helps to prevent preterm birth, pre-eclampsia, and postpartum depression in the mother. Docosahexaenoic acid, or DHA, is an omega-3 essential for skin development, and is also extremely important in the first trimester. Doses from 200-300 to up to 1,000 milligrams of DHA are recommended for pregnant women, especially to prevent preterm birth. Both fish and seeds have extremely high levels of omega-3s, but only fatty fish—such as salmon, tuna, and sardines—contain DHA.
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Chia Seeds (5.06 grams ALA per oz.)
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Walnuts (2.57 grams ALA per oz.)
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Farmed Atlantic Salmon (1.24 grams DHA, 0.59 grams EPA per 3 oz, cooked)
VITAMIN D
Vitamin D builds the bones and teeth of the fetus, and contributes greatly to a strong immune system. The recommended daily dose of Vitamin D for pregnant women is 15 micrograms or 600 IU. Besides being exposed to direct sunlight, various foods can help to supply vitamin D, including fish, eggs, mushrooms, and fortified foods such as milk, cereal, and orange juice.
PROTEIN
In the second trimester, as the baby grows more rapidly, increased protein intake is vital for fetal tissue growth and the strengthening of maternal breast and uterine tissue. Of course, meat, eggs, soy and dairy are the most common complete proteins, but protein levels can also be reached through protein combination (eating legumes along with grains).
THIRD TRIMESTER
INCREASED CALORIC INTAKE
Overall but especially in the third trimester, pregnancy demands increased caloric intake. Typically, second trimester pregnancy demands an extra 340 calories a day, while the third trimester demands about 450 calories beyond your recommended daily intake. Look for foods that are calorie dense like complex carbohydrates, eggs, and avocados.
A good way to plan a diet for pregnancy across trimesters is to look at specific nutrients and how pregnancy can affect needs for those nutrients over time. A fetus develops key organs at different times, and as birth approaches, the fetus demands increased calories and nutrients. These food options can satisfy your needs throughout your pregnancy. As with all of these tips, speak with your doctor, dietitian/nutritionist, or fertility clinic before making significant diet choices towards pregnancy.
