Table of Contents
During pregnancy, an avalanche of questions starts in the future mom’s head. What to eat for the baby to grow healthy? Do I need vitamins? And which ones? Is a healthy diet enough or do I have to supplement everything? Maybe you’re also in a situation where you want to give your baby only the best, but don’t know how to navigate through the endless flood of advice and tips.
Let’s sort this out together. The truth is, a pregnancy diet is not rocket science. Even during this period, the foundation is a varied and balanced diet, but several specific nutrients deserve extra attention. You’ll learn which ones they are, why they’re so important, and how to get enough of them in the following lines.
If you’re also interested in whether it’s necessary to eat for two or if you should fear weight gain during pregnancy, read the article Nutrition in Pregnancy: What to Eat, when to Lose Weight, and how much is Healthy to Gain?
Which Nutrients are Key During Pregnancy?
During pregnancy, the need for almost all nutrients increases – from carbohydrates that provide energy through proteins needed for tissue growth to healthy fats important for the development of the baby’s brain.
Gradually, the caloric (energy) need also increases. In the 2nd trimester, by approximately 250 kcal daily, and in the 3rd trimester by up to 500 kcal. In addition to macronutrients, the body also calls for a higher intake of certain vitamins and minerals. Especially those that directly affect fetal development and ensure that pregnancy proceeds as smoothly as possible. We’ll discuss which ones these are step by step.
1. Proteins
Proteins are essential for the growth and development of the baby’s tissues. After all, they are the basic building blocks of the human body. At the same time, they also support changes in the mother’s body, such as growth of the uterus, breast tissue and increased blood volume.
These macronutrients also participate in the production of hormones, enzymes and antibodies, which are essential for the healthy functioning of the organism during pregnancy. Moreover, their sufficiency contributes to stable blood sugar levels, a feeling of satiety and can also help with weight gain regulation. In a period when the body is working for two, quality protein intake is therefore an important part of nutrition. [12]
Best Food Sources of Protein
- meat (cooked or otherwise heat-processed)
- fish (except for species high in mercury)
- eggs (well-cooked)
- cheeses, yoghurts and other dairy products
- legumes
- plant-based meat alternatives (tofu, seitan, robi, etc.)
- pseudocereals (quinoa, amaranth)
You can get proteins from animal-based as well as plant-based foods. Both sources should definitely not be missing from your diet. Just keep in mind that plant sources don’t have enough of all essential amino acids. Therefore, it’s important to alternate and combine plant sources.
Recommended Daily Intake for a Pregnant Woman
- EFSA (European Food Safety Authority) recommendation: Basic minimum 0.83 g/ kg body weight (calculated with pre-pregnancy weight) needs to be further increased by 9 g of protein in the 2nd trimester and 28 g of protein in the 3rd trimester. [12,20]
- DACH (Nutrition Society of German-speaking countries) recommendation: The basic minimum 0.8 g/ kg BW needs to be further increased by 10 g of protein daily in both the 2nd and 3rd trimesters. [12,19]
These recommended protein doses are the necessary minimum that you should consume daily during pregnancy. However, the need substantially increases if you’re active, exercise or are dealing with some health issue with higher protein requirements.
If you’re looking for inspiration for good protein sources, you can find it in the article Foods that Make It Easy to Add Protein to Your Diet.
You might be interested in these products:
2. Omega-3 Fatty Acids
In up to 64% of countries worldwide, pregnant women likely have a low intake of omega-3 fatty acids. Yet, for example, essential DHA (docosahexaenoic acid) is crucial for brain development and the vision of the baby. Moreover, its insufficient intake is associated with an increased risk of premature birth. [2]
DHA, along with EPA (eicosapentaenoic acid), also support proper heart function, so it shouldn’t be overlooked either. However, omega-3 healthy fats are often missing in our diet because there aren’t many food sources where we can find them. Not to mention that fatty sea fish, which are richest in them, should be eaten in limited quantities by pregnant women. Therefore, it’s often worth reaching for a dietary supplement, especially from the beginning of the second trimester. [2,15,21]
Best Food Sources of Omega-3 Fatty Acids
- Essential alpha-linolenic acid (ALA): walnuts, flaxseed oil, flaxseeds, chia seeds, canola oil
- EPA and DHA: fatty sea fish (salmon, mackerel, herring), fish oil
Recommended Daily Intake for a Pregnant Woman
- EFSA recommendation for EPA and DHA: dose for a normal healthy person, 250 mg EPA and DHA, increased by another 100 – 200 mg DHA
- EFSA recommendation for ALA: 0.5% of total daily energy intake (10 kcal from the reference intake of 2000 kcal, i.e. about 1 g ALA) [20]
- DACH recommendation for EPA and DHA: there are no available recommendations
- DACH recommendation for ALA: 0.5% of total daily energy intake
3. Folic Acid
Folic acid, also called folate or vitamin B9, is one of those vitamins for pregnant women that is recommended to be supplemented. Even before pregnancy itself. This essential nutrient supports the development of the fetus itself, as it participates in the growth of embryonic tissues and especially in the first trimester, its sufficient intake is important for preventing neural tube defects.
In addition, it also affects, for example, normal blood formation or the proper functioning of the psyche. It’s worth having enough of it even before getting pregnant, so that your body is well prepared for pregnancy. It’s particularly essential one month before the start of pregnancy. [21]
Are Folate and Folic Acid the Same Thing?
These two names are commonly interchanged. However, there is a difference between them that can help you decide which supplement to reach for.
- Folates can have several forms. They are naturally found in foods and most of them need to be converted in the body to the active form 5-methyltetrahydrofolate (5-MTHF) for the body to use them.
- 5-MTHF is also formed in foods, which is a form of folate ready to fulfil its role in the body immediately. The best sources also contain 5-MTHF.
- Folic acid (pteroylmonoglutamic acid) is a synthetic form and you’ll commonly find it in supplements. For it to be used in the body, it also needs to be converted to 5-MTHF.
- However, in supplements today, synthetic 5-methyltetrahydrofolate (5-MTHF), which doesn’t need further conversion and is better bioavailable, is often used.
There are many options. So, how to properly supplement this vitamin? First, make sure you eat enough natural food sources of folate. As a supplement, both synthetic folic acid and the active form of folate, 5-MTHF, will serve you well; both will ensure sufficient intake of this nutrient. It’s up to you which one you choose.
Women with folate metabolism disorder should definitely supplement the active form, but for healthy women, there is no significant difference in how well the body utilises these forms. [1,23]
Best Food Sources of Folic Acid
Recommended Daily Intake for a Pregnant Woman
- EFSA recommendation: 600 μg [20]
- DACH recommendation: 550 μg [7]
- The average adult woman who is not pregnant should, according to EFSA, consume 330 μg of folic acid daily.
4. Iron
According to World Health Organisation (WHO) data, more than 20% of pregnant women worldwide have anaemia (low blood count) due to iron deficiency. Yet it’s a nutrient that a woman’s body desperately needs during pregnancy. It plays a key role in energy metabolism, and especially during pregnancy, its consumption is high because the body uses it for the growth and development of the fetus.
Iron also participates in the transport of oxygen in the body and the function of the immune system. [17]
Best Food Sources of Iron
- animal foods: beef, pork, egg yolk
- plant foods: leafy vegetables (e.g. spinach), nuts and seeds (sunflower seeds, almonds), legumes (lentils, peas), oatmeal
Animal foods contain so-called heme iron, which is better utilised by the body than non-heme iron from plant sources. However, its absorption can be increased, for example, by vitamin C, which is abundant in peppers, citrus fruits, berries, or kiwi, for instance. [18]
Recommended Daily Intake for a Pregnant Woman
- EFSA recommendation: 16 mg [20]
- DACH recommendation: 30 mg [9]
5. Calcium
Calcium is the most abundant mineral in the body – it makes up 2% of body weight, with up to 99% stored in the bones. The remainder, however, performs equally important functions – it is involved in, for example, muscle contraction, nerve signal transmission or hormone activity and enzyme function.
In pregnancy, it is indispensable from the very beginning. It supports cell division, tissue formation and later bone mineralisation of the fetus. As the baby grows, it draws increasingly larger amounts of calcium from the mother’s body, so it’s important for the mother-to-be to maintain sufficient intake to protect her own bones as well. [14]
Best Dietary Sources of Calcium
- dairy products, especially hard cheeses
- egg yolk
- poppy seeds
- almonds
- cabbage
- spinach
- broccoli
Calcium is found in both plant and animal foods, but it is better absorbed from animal sources. Plant sources contain antinutrients such as phytic acid, oxalates and other substances that reduce its bioavailability. Nevertheless, they are still quality sources, but we must take into account that while 30% of calcium is absorbed from animal sources, we only get about 5% of its content from plant sources. [4,22]
Recommended Daily Intake for a Pregnant Woman
- EFSA recommendation: 950 – 1000 mg [20]
- DACH recommendation: 1000 mg [6]
6. Vitamin D
According to a 2016 review study, about 57% of pregnant women in Europe have a vitamin D deficiency. Although it is produced in the skin through exposure to sunlight, in our latitudes, conditions for its production are favourable only for a few months of the year and it occurs only in limited amounts in food.
Yet it is a micronutrient that is essential for calcium metabolism and healthy bone development of the fetus. Some studies even link its deficiency to an increased risk of preeclampsia (a serious condition in pregnant women associated with high blood pressure) and premature birth. That’s why expectant mothers are advised to have their vitamin D levels checked and, based on the results, supplement with appropriate foods or dietary supplements. [16]
Best Dietary Sources of Vitamin D
- fatty sea fish (e.g., salmon, herring)
- fish oil
- egg yolk
Recommended Daily Intake for a Pregnant Woman
- EFSA recommendation: 15 μg (600 IU) [20]
- DACH recommendation: 20 μg (800 IU) [5]
7. Iodine
The need for iodine also increases during pregnancy, which is crucial for proper brain development of the child and its cognitive functions, such as thinking, learning, and memory. In addition, it plays a significant role in thyroid function and the production of its hormones, which affect metabolism, the cardiovascular system, and oxygen consumption. [18,21]
The risk of deficiency is particularly high for women who do not consume dairy products, eggs or fish. Therefore, the WHO introduced iodisation of table salt, which is mandatory only in some European Union countries.
Salt must be iodised, for example, in Slovakia, Romania, Poland, Slovenia, or Italy, while in the Czech Republic, Germany, or Greece, salt iodisation is voluntary. That’s why it’s important to monitor your iodine intake and consult with a doctor about appropriate supplementation if necessary. [11,24]
Best Dietary Sources of Iodine
- iodised salt
- fish (salmon, tuna)
- seafood
- eggs
- milk and dairy products
Recommended Daily Intake for a Pregnant Woman
- EFSA Recommendation: 200 μg [20]
- DACH Recommendation: 200 – 230 μg [8]
8. Magnesium
Although magnesium is discussed less in pregnancy than iron or calcium, it plays an indispensable role during this period. It supports cell division and fetal development from the very first days, maintains stable blood pressure, and has been shown to help prevent preeclampsia or premature birth.
In addition, it has a relaxing effect on muscles, which can alleviate unwanted cramps and can also be useful in fighting migraines. Therefore, expectant mothers should not forget about this mineral. When supplementing magnesium, it is best to choose well-absorbed forms, such as liposomal magnesium or its chelated forms, like magnesium bisglycinate or malate. [3,13]
You can read more about magnesium in the article Cramps, Fatigue, Irritability or Sleep. What Else Does Magnesium Affect?
Best Food Sources of Magnesium
- whole grain products
- oatmeal
- legumes
- nuts and seeds
- leafy greens
- fish
- seafood
Recommended Daily Intake for a Pregnant Woman
- EFSA Recommendation: 300 mg [20]
- DACH Recommendation: 300 mg [10]
What Should You Remember?
During pregnancy, nutritional demands increase. The body needs more energy, protein, vitamins, and minerals. At the same time, some nutrients require more focus than others, as they are directly essential for fetal development and a healthy course of the entire pregnancy. For example, we are talking about folic acid, omega-3 fatty acids, or iron.
Even if you are pregnant, the foundation of nutrition is a varied and balanced diet. Ideally, most nutrients should come from it. However, in some cases, it may be appropriate to supplement selected nutrients in the form of supplements.
To ensure you are getting everything you and your baby need, it is important to monitor blood test results and, in case of a nutrient deficiency, to intervene promptly by changing your diet or taking a supplement.
[1] CARBONI, L. Active Folate Versus Folic Acid: The Role of 5-MTHF (Methylfolate) in Human Health. – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9380836/
[2] CETIN, I. et al. Omega-3 fatty acid supply in pregnancy for risk reduction of preterm and early preterm birth. – https://www.ajogmfm.org/article/S2589-9333(23)00393-2/fulltext
[3] DALTON, L.M. et al. Magnesium in pregnancy. – https://pubmed.ncbi.nlm.nih.gov/27445320/
[4] DUYFF, R.L. Complete Food & Nutrition Guide. . New York: Academy of Nutrition and Dietetics, 2017. ISBN 978-0-544-52058-5.
[5] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Dietary reference values for vitamin D. – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2016.4547
[6] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Scientific Opinion on Dietary Reference Values for calcium. – https://www.efsa.europa.eu/en/efsajournal/pub/4101
[7] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Scientific Opinion on Dietary Reference Values for folate. – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2014.3893
[8] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Scientific Opinion on Dietary Reference Values for iodine. – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2014.3660
[9] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Scientific Opinion on Dietary Reference Values for iron. – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2015.4254
[10] EFSA PANEL ON DIETETIC PRODUCTS, NUTRITION AND ALLERGIES (NDA) Scientific Opinion on Dietary Reference Values for magnesium. – https://onlinelibrary.wiley.com/doi/abs/10.2903/j.efsa.2015.4186
[11] EUROPE, W.H.O.R.O. For Prevention and control of iodine deficiency in the WHO European Region: adapting to changes in diet and lifestyle: web annex A: legislation and/or regulation for salt iodization in the WHO European Region. – https://iris.who.int/handle/10665/377743
[12] EUROPEAN FOOD SAFETY AUTHORITY Scientific Opinion on Dietary Reference Values for protein. – http://onlinelibrary.wiley.com/doi/10.2903/j.efsa.2012.2557/epdf
[13] FANNI, D. et al. The Role of Magnesium in Pregnancy and in Fetal Programming of Adult Diseases. – https://pmc.ncbi.nlm.nih.gov/articles/PMC8360883/
[14] GEREDE, A. et al. Calcium Supplementation in Pregnancy: A Systematic Review of Clinical Studies. – https://www.mdpi.com/1648-9144/61/7/1195
[15] LAVIANO, A. et al. Omega-3 fatty acids in cancer. – https://pubmed.ncbi.nlm.nih.gov/23299701/
[16] Background. In Guideline: Vitamin D Supplementation in Pregnant Women – https://www.ncbi.nlm.nih.gov/books/NBK310616/
[17] Daily iron and folic acid supplementation during pregnancy. – https://www.who.int/tools/elena/interventions/daily-iron-pregnancy
[18] Dietary Guidelines for Americans, 2020-2025. – https://health.gov/our-work/nutrition-physical-activity/dietary-guidelines/previous-dietary-guidelines/2015
[19] Dietary recommendations for protein intake for pregnant and lactating women | Knowledge for policy. – https://knowledge4policy.ec.europa.eu/health-promotion-knowledge-gateway/dietary-protein-dietary-intake-pregnant-4_en
[20] Dietary Reference Values | DRV Finder. – https://multimedia.efsa.europa.eu/drvs/index.htm
[21] EU Register of nutrition and health claims made on foods (v.3.6). – https://ec.europa.eu/food/safety/labelling_nutrition/claims/register/public/?event=search
[22] Office of Dietary Supplements - Calcium. – https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/
[23] (PDF) Supplementation with (6 S )-5-methyltetrahydrofolic acid appears as effective as folic acid in maintaining maternal folate status while reducing unmetabolized folic acid in maternal plasma: A randomized trial of pregnant women in Canada. – ttps://www.researchgate.net/publication/373057289_Supplementation_with_6_S_-5-methyltetrahydrofolic_acid_appears_as_effective_as_folic_acid_in_maintaining_maternal_folate_status_while_reducing_unmetabolized_folic_acid_in_maternal_plasma_A_randomized_
[24] Reaching optimal iodine nutrition in Pregnant and Lactating Women and Young Children. – https://www.who.int/publications/m/item/WHO-statement-IDD-pregnantwomen-children
Add a comment