Nutrition Through The Ages: Pregnancy

Updated: May 24, 2023

The demand for certain nutrients increases and decreases with age, health status, and activity levels. Additionally, there are circumstances that require extra attention. Pregnancy is a time in life when nutrition is incredibly important as deficiencies can impact both mom and fetus. Generally, a balanced and varied diet will provide an adequate supply of all the nutrients needed; however, many women of childbearing age are not necessarily eating with this goal in mind.

Pre-conception nutrition and nutrition during the first trimester are considered some of the most integral months when it comes to development of the embryo. It is at this time that the embryo is most susceptible to any nutrient deficiencies mom might be experiencing AND any exposures to lifestyle and environment (smoking, alcohol, prescription medications, etc.). Although calorie needs remain the same during the first trimester, nutrient needs can increase by almost 50% because this is when the limbs, eyes, ears, and major organs are formed. Nutritional deficiencies early on can alter function and structure in later development.

Adequate nutrition also increases the likelihood that a newborn will be born at a weight that is appropriate for their gestational age. Undernourished moms are more likely to give birth to low-birthweight infants (increasing susceptibility to infection, and impaired physical and mental development). Undernourished moms also deplete their own nutritional stores during pregnancy, potentially to unhealthy levels which can not only influence their own health detrimentally, but it can also impact their ability to care for the baby.

Macronutrients

Macronutrients are the nutrients the body requires in large amounts. They are what makes up our total caloric intake.

Carbohydrates

NEEDED FOR: Carbohydrates are our brain’s primary source for energy. Carbs also help moms maintain normal blood glucose levels and avoid ketosis.
NOTE: Low-carb diets are NOT suggested for expecting mothers as carbs are also the main source of energy preferred by the developing fetus.
FOODS TO EAT: Whole-grain breads, crackers, and cereals, beans, legumes, brown rice, fruits, and veggies. Each of these foods additionally provide rich sources of fiber and micronutrients.

Fats

NEEDED FOR: Dietary fats are needed for all the new tissues and cells being built. The fetus also begins storing its own fat during the third trimester. This stored fat later becomes the source of fuel used to regulate body temperature during the newborn stage.
NOTE: Docosahexaenoic Acid (DHA), an omega 3 fatty acid, is especially important for neurological development, eye development, and fetal brain growth.
FOODS TO EAT: Avocado, nuts, seeds, eggs, olive oil, fish (DHA foods = cold water fish)

Protein

NEEDED FOR: Protein helps build structure in our bodies (skin, hair, nails, etc.) and it is needed for how our body functions in the form of hormones, transport proteins, and enzymes.
NOTE: Most adults in the U.S. consume ample protein. Vegans and vegetarians may have to make a concerted effort to incorporate more protein depending on their overall diet quality.
FOODS TO EAT: Fish, beans, peas, nuts, seeds, tofu, lean meats, and low-fat dairy.

Calories

*Not a macronutrient, but worth including here.

NEEDED BECAUSE: Calories are the fuel our bodies require to survive.
NOTE: Low-calorie dieting is absolutely NOT recommended during pregnancy.
FIRST TRIMESTER: Although the same amount of calories consumed during pre-pregnancy is suggested during the first trimester, expecting moms should seek out nutrient dense foods.
SECOND & THIRD TRIMESTER: During the second and third trimester, an increase of 350 to 500 calories per day is recommended to compensate for the rapid growth and development happening for both mom and fetus. As always, recommendations should be used as guide rather than a requirement, and always consider individual needs (especially activity levels).

Micronutrients

Micronutrients are the nutrients the body requires in small amounts. Although they are recommended in smaller amounts compared to macronutrients, they are equally essential.

Folate

NEEDED FOR: Folate is necessary for cell division, and cells divide so living things can grow.
NOTE: The first 28 days post-conception is when the neural tube (which later becomes the brain and spinal cord) is formed and closed. Incidents of neural tube defects (like spina bifida and anencephaly) can be reduced by up to 70% with adequate folate intake. Spina bifida is when the neural tube fails to close properly, allowing a fluid filled sac to protrude out; and anencephaly shows as an underdeveloped brain and/or incomplete skull.
FOODS TO EAT: Green, leafy veggies, lentils, orange juice; enriched grain products like breads, cereals, and pastas; and whole grains.

Vitamin B12

NEEDED FOR: During pregnancy, B12 is needed largely to metabolize folate.
NOTE: There is an increased susceptibility for deficiencies for vegan mom (and infant), but supplementation and fortified food consumption can address this.
FOODS TO EAT: Animal food sources (meat, dairy, eggs).

Vitamin C

NEEDED FOR: Vitamin C is largely connected to the reduction of free radicals, wound healing, and overall immunity. When pregnant, expecting moms need an increased amount due an increase in blood plasma volume.
NOTE: Vitamin C transferring to the fetus, decreases the concentration in maternal blood volume.
FOODS TO EAT: Citrus fruits and juices, peppers, and numerous other fruits and vegetables.

Vitamin A

NEEDED FOR: Vitamin A is needed for growth and development, vision, red blood cell, skin, and bone formation. Deficiency is linked to low-birth weight, growth problems and preterm delivery.
NOTE: Too much Vitamin A is not ideal! Supplementation is NOT recommended. A well-balanced diet will provide sufficient Vitamin A.
FOODS TO EAT: Dairy, eggs, green, leafy veggies, fortified cereals, and red/yellow fruits and veggies.

Vitamin D

NEEDED FOR: Vitamin D is needed for bone growth, hormone production, and nervous system function.
NOTE: Like Vitamin A, the recommendation does not increase during pregnancy. A well-balanced diet (and adequate sun exposure) should satisfy the need. However, it is worth noting that women with dark skin pigmentation, limited sun exposure, and/or regular adherence to a non-dairy diet can create susceptibility for deficiency.
FOODS TO EAT: Eggs, fish, and fortified foods.
NUTRITION TIP: Vitamin D is a fat soluble vitamin which means fat is required to enable absorption of the vitamin through the diet.

Calcium

NEEDED FOR: Calcium is essential for the fetal skeleton (which largely develops during the third trimester). Like Vitamin A and D, the amount of calcium recommended during pregnancy does not increase. A balanced and varied diet should provide an adequate supply.
NOTE: Pregnant women absorb dietary calcium more efficiently when compared to non-pregnant women.
FOODS TO EAT: Green, leafy veggies; tofu; fortified, alternative milks, juices, and cereals.

Iron

NEEDED FOR: Iron is necessary for red blood cell formation and a deficiency can harm the fetus’ development. There is an increased need for iron during pregnancy due to expanded maternal blood volume, growing uterus and placenta, and to support the growth of the fetus. The fetus also begins storing iron in the third trimester.
NOTE: Women of childbearing age often have poor iron stores due to menstruation and pregnancy can create a deficiency. Prenatal vitamins (including iron) and/or individual iron supplements are often prescribed during pregnancy.
FOODS TO EAT: Meat, fish, poultry, and iron-rich plant foods like legumes.
NUTRITION TIP: Vitamin C enhances iron absorption while coffee, tea, milk, and other oxalate-rich foods decrease iron absorption.

Zinc

NEEDED FOR: Zinc is needed for DNA, RNA, and protein synthesis. An adequate amount is needed for growth and development for both maternal and fetal tissues.
NOTE: Poor maternal zinc status is connected to prolonged labor, pre-term deliveries, and post-term deliveries.
FOODS TO EAT: Red meats, shellfish, and fortified cereals.
NUTRITION TIP: Iron will compete with zinc for absorption and iron will win. Since iron is often prescribed as a supplement, try to consume zinc-rich foods to avoid the supplementation competition.

Iodine

NEEDED FOR: Iodine is needed for growth and development. Needs increase during pregnancy, but just like vitamin A, D, and calcium, a varied and balanced diet should provide enough.
NOTE: Iodine is noted by the FDA as a nutrient of concern for pregnant women, meaning that low status of the nutrient has been identified by a large portion of the population.
FOODS TO EAT: Beans and peas, dark, green veggies, and whole grains.

Sodium

NEEDED FOR: Sodium is needed for blood pressure regulation, muscle contraction, and fluid balance.
NOTE: Too much sodium is associated with high blood pressure and it also encourages fluid retention and bloating. Additionally, a high salt diet can impact the fetus' renal function.
FOODS TO EAT: Cheese, soups, and savory snacks are all high in sodium.

Additional Considerations

Morning Sickness

What & Why

Nausea and vomiting occurs as a result of increased hormones (possibly connected to the development of the placenta).
More than 50% of women experience morning sickness, primarily during the first trimester.
Can impact overall nutrient and caloric intake.

Tips

Eat small, frequent meals.
Take prenatal vitamins whatever time nausea is least experienced.
Drink fluids between meals.
Eat what you can, when you can.
If possible, allow someone else to cook (to help reduce time spent around cooking smells and heat).

Heartburn

What & Why

Common during pregnancy due to an increase in hormones and changes in body shape.
Hormones relax some muscles, including the lower esophageal sphincter (LES). The LES typically opens to allow foods to pass and then closes, but when it doesn’t close properly acid moves into the esophagus and causes heartburn.

Tips

Avoid tight clothing.
Eat small, frequent meals.
Wait an hour before lying down.
Sleep with head elevated.
Eat yogurt with honey.
Avoid citrus, fried, spicy, and fatty foods.

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Resources

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7. Life Stages | MyPlate. https://www.myplate.gov/life-stages. Accessed 17 Feb. 2022.

Mao, Caiping, et al. “High-Salt Diets during Pregnancy Affected Fetal and Offspring Renal Renin–Angiotensin System.” The Journal of Endocrinology, vol. 218, no. 1, July 2013, pp. 61–73. PubMed Central, https://doi.org/10.1530/JOE-13-0139.

8. “Morning Sickness.” American Pregnancy Association, 20 Apr. 2020, https://americanpregnancy.org/healthy-pregnancy/pregnancy-health-wellness/morning-sickness-during-pregnancy/.

9. “Pregnancy and Heartburn: Causes & Management.” Cleveland Clinic, https://my.clevelandclinic.org/health/diseases/12011-heartburn-during-pregnancy. Accessed 30 Mar. 2022.

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