Pregnancy nutrition

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It used to be thought that pregnancy is a time when women need to eat for two. This old chestnut has been proven wrong many times though as any urban myth, it still has some followers. The scientific evidence is, that it is not so much the quantity of food that needs to increase, so much as the quality of the nutrients contained in the food. 

The general recommendation from experts is that during pregnancy you will need more kilojoules in your diet than usual, but certainly not double. Generally the second trimester requires approximately an additional 1400 - 1500 kJ per day (normal BMI before conception) and the third trimester an additional 1800 - 1980 kJ (normal BMI before conception). 

What makes the difference during pregnancy?

During pregnancy, a mother’s metabolic rate increases and her body becomes much more efficient at utilising the nutrients in her diet. Because of the slowing down in most pregnant women’s activity levels, the extra kilojoules, which are not being used up in energy tend to be absorbed within her higher metabolic rate. 

Why can’t I eat what I want to?

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Too much energy (food) for the amount being used (exercise) will end up stored on your body as fat. Women who gain too much weight during their pregnancy tend to have more difficult births and a higher rate of caesarian section deliveries. 

Preeclampsia, PIH (Pregnancy Induced Hypertension) and Gestational Diabetes are all more common in women who gain more than the recommended 10-14 kg weight increase during pregnancy. 

Developing Gestational Diabetes increases the risk of developing Type 2 diabetes later in life. For a lot of women, gaining excess weight during their pregnancy is a catalyst for long-term weight issues. Conversely, limiting kilojoule intake during pregnancy with the mistaken belief that it will mean an easier or less painful childbirth is not true. Babies who are born small for their gestational age or underweight struggle with all sorts of problems; intellectually, developmentally and physically. Children of mothers who do not gain sufficient weight during their pregnancy are also at an increased risk of heart disease and diabetes as adults. 

Don’t be frightened of fats

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Two very important fats are necessary to include in your overall pregnancy nutrition. Docosahexanoic Acid (DHA) and Arachidonic Acid (AA). These fatty acids are vital for the development of your baby’s eyesight and brain. The best way to ensure you have a healthy intake is to eat oily fish such as sardines, salmon and mackerel. It you cannot tolerate fish, consider taking a quality supplement. But check with your healthcare provider first.

Increase these nutrients in your pregnancy diet

  • More iron, especially “haem” iron from animal sources. “Non-haem” iron from green leafy vegetables is not as well absorbed by the body and you will need to eat much more of it to gain the same nutritional benefits. Even some percentage of haem iron in your diet will help your body to be more efficient in absorbing the non-haem iron from your food.
  • Vitamin A, but only in small amounts. Too much Vitamin A is toxic to the body and can be lethal. Some experts warn against eating liver during pregnancy as it is very high in this nutrient. Yellow or orange fruit and vegetables are high in Vitamin A, so include some carrots, pumpkin and squash into your diet. 
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  • The B group vitamins will help you to maintain general good health and wellness. They support the nervous system and brain pathways to function effectively. Good sources are wholemeal cereals and grains, green leafy vegetables, nuts and bananas. Avocados and mangoes are other excellent sources. 
  • Vitamin C is what is known as a water soluble vitamin, which means your body doesn’t store it, so it is important that you have an adequate intake every day. Vitamin C will also help you fight infection, boost your immune system, help with the absorption of iron in your diet and will help your body heal after birth. Good sources are citrus fruits, berries, fresh fruit juices, pawpaw, Maziwa Mala, Terere, African Nightshade, Amaranth and vegetables such as broccoli.
  • Calcium and Vitamin D. Dairy foods, milk and fortified soy products are good sources, so try for 2-4 servings each day. A small amount of filtered sunlight each day, before 10 am and after 3 pm is good for boosting your Vitamin D intake. If you have dark skin, or cover a lot of your skin due to cultural or religious conventions, speak with your midwife or doctor regarding the need for a daily supplement.
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  • Vitamin E is what is known as a fat soluble vitamin, which means it can be stored in your body. Vitamin E helps to support healthy eyes and skin and is known to help the body rid itself of free radicals; those nasty aging compounds. In pregnancy, Vitamin E will help your baby’s nervous system development as well as its muscle growth. Nuts, vegetable oils including olive oil, legumes and seeds are all excellent sources.
  • Protein, to help your baby grow. Rich protein sources have generally walked on legs so think all sources of meat and chicken. Your protein requirements will increase by around 15-20% even in the early weeks of pregnancy, purely because of the muscles, bones and organs which your baby is developing. Aim for 2-3 serves of quality, lean protein every day.
  • Iodine, zinc, magnesium, copper and chromium. These elements are only needed in trace amounts and can be found in fresh fruit and vegetables, legumes and beans, nuts and peas. Try to eat foods that resemble their original source as much as possible. Be suspicious about foods wrapped in lots of plastic and which have ingredient lists a mile long.
  • Carbohydrates are vital for energy. Two different forms of carbohydrate are important but one more so than the other. Simple carbohydrates are in sugar, cakes and biscuits, the foods you may crave when you are pregnant. More complex carbohydrates are whole grain breads and rolls. Brown rice, wholegrain flour, wholemeal pasta and potatoes are also quality sources of complex carbohydrates and are good to prevent constipation.
  • If you are vegetarian or vegan, think about consulting with a dietician to ensure you are getting adequate, first class nutrition during your pregnancy. You need to ensure you are getting enough iron and vitamin B12 in particular, which are vital in preventing anaemia. You will also need to ensure your protein and calcium intakes are adequate.

How to maximise the nutrients in your diet

  • Follow the guidelines above to ensure you are eating sufficient quantities of each nutrient per day.
  • Think about taking your own lunch to work. Although it takes a little planning, foods prepared at home tend to be healthier than take-aways.  Avoid bringing too many convenience foods into the house and make lists before you go grocery shopping. Think about how important your pregnancy nutrition is, not only for your own health but for your developing baby as well.
  • When you prepare fruit and vegetables for eating, aim to peel and chop them just before you place them in your mouth. Vitamins can be oxidised and lost into the air as soon as their protective skins are removed. Buying fresh is best.
  • Remember, heavier fruits and vegetables usually contain more juice and taste better.
  • Use minimal water for cooking and if you’re particularly keen, you can drink this water afterwards or use it in soups or stock. Avoid cooking vegetables and fruit for long periods as this leads to excess vitamin destruction.
  • If fresh fruit is not available, then reasonable alternatives could be tinned, frozen, dried and stewed fruit.
  • Each colour in a vegetable or fruit indicates a different range of nutrients. So aim for a diverse range of colours on your plate. Not only will it look good but it will also offer a wider range of antioxidants and nutrients to you and your baby.
  • Avoid taking vitamin/mineral supplements unless they have been prescribed for you. Folic acid is the exception. Many nutrients are not stored by the body and are excreted.
  • The absorption of zinc can be interfered with by iron, particularly if you are taking supplements. If you have been prescribed iron tablets, try to avoid taking them when you are eating foods rich in zinc, e.g. meat, bananas, seafood and nuts.
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