Eating for two? Let’s chat pregnancy nutrition needs.
Co-Written by Emily Stevens, Dietetics Student
As your body changes during pregnancy, so do your nutrition and energy needs. Growing a baby is no easy feat, and it's important that your body is fuelled with enough energy and nutrients to meet your body's needs and your growing baby's needs. But this doesn’t mean it has to be complicated!
Eating for Two?
While we often hear that you should be eating for two when pregnant, but this isn’t exactly the case. While some micronutrient (vitamin and mineral) needs certainly increase significantly, your overall energy (calorie) needs stay about the same in the first trimester, and only start to increase during the second and third trimesters. The focus on calories isn't the most important piece, but ensuring that you are getting enough energy and nutrients to fuel your body and your growing baby! While we will briefly mention calorie needs, we want to emphasize that these are averages and that individual variations will occur depending on numerous individual factors.
Here’s a breakdown of nutrition needs by trimester:
First Trimester
We do not necessarily need to see an increase in energy intake during the first trimester (1), and many women may not even know they are pregnant until well into the first trimester.
During the first trimester, it is also common to experience an increase in food aversions and nausea (1,2), which may negatively impact your appetite and ability to consume food. The good news is that for many women, food aversions and nausea can decrease after the first trimester, but for some, it will continue throughout pregnancy (2). To ease nausea through the first trimester and beyond try some of the following tips:
- Eat smaller meals spread more frequently throughout the day
- Limit fried and fatty foods
- Limit drinking cold beverages with ice (try sticking to room temp or warm fluids)
- Aim to eat soon after getting out of bed in the morning
- Increase your protein intake
- And getting plenty of rest and try to minimize your stress levels (1,3).
One of the most essential nutrients to ensure you have adequate intake during the first trimester is folate. We recently posted another blog post all about folate, which you can read more about here. During the first trimester, folate ensures normal neural tube development for your baby, among other important roles (4). Make sure you are taking a prenatal supplement with adequate folate or folic acid (the amount that’s right for you can depend on your health and family history). In addition to the prenatal, make sure you’re eating sources of folate daily, such as legumes, leafy green vegetables, and enriched wheat products.
Choline is another important nutrient in the first trimester, and recent research shows that it may also play a role in preventing neural tube defects, similar to to folate. Choline is a very bulky nutrient, so many prenatal supplements to not contain significant amounts. In general, you want to aim for at least 450mg of choline per day during your pregnancy, with the best food sources being eggs, red meat, dairy, poultry, and some legumes and seafood. If you struggle to consume these foods regularly (particular eggs, which are the best source), you may want to consider an additional choline supplement.
Nutrition Tips for First Trimester:
Stick with foods that you enjoy and that make you feel good! Don't worry about increased energy needs during this trimester, and focus on consuming a varied diet rich in vitamins and minerals. If you are struggling with nausea during the first trimester, it's a good idea to seek additional help from your doctor and dietitian to help manage your symptoms to ensure you are able to nourish your body properly. There are additional supplements and medications that can help reduce nausea during pregnancy.
Second & Third Trimester
During the second trimester, energy intakes increase to roughly 340 additional calories per day, and approximately 452 calories in the third trimester (5, 10). As we mentioned earlier, these energy increases are merely a guide and are based on an average. Energy requirements will depend on various individual factors such as age, body mass, and daily activity (5).
In addition to increased energy needs, there is also a need to increase certain nutrients during the second and third trimesters. Most notably, we see an iron needs increase from 18 mg per day to 27 mg per day (6). This increase in iron is required to accommodate the body's expected iron losses and to provide sufficient iron to be used by the baby and mom for hemoglobin production and needs (6). It's a good idea to consume iron with a vitamin C source to assist with absorption, and avoid drinking tea with your meals which will inhibit iron absorption (5). Some more tips on increasing iron absorption can be found here.
Although the dietary allowance for calcium remains the same during pregnancy which is the same as non-pregnant women (1000 mg/day), it is important to prioritize calcium intake for proper bone maintenance and health (1). There has also been evidence to suggest that taking a calcium supplement or increasing calcium intake during pregnancy can help prevent pre-eclampsia and preterm birth, so focusing on getting enough calcium daily (from food and/or supplements) during the 2nd and 3rd trimester may be especially beneficial (7).
Omega-3 fatty acids are also incredibly important during pregnancy. Omega-3 is transferred across the placenta and is essential for proper growth and development of the baby (8). The best source for omega-3 fatty acids is fish (8). Although some fish should be avoided due to the risk of foodborne illness (sushi and raw or partially cooked fish) and mercury content (white tuna), including fish species such as salmon, trout, herring, haddock, or canned light tuna can be a great way to include omega-3 in your diet weekly (8).
Other nutrients that have increased requirements during pregnancy include Vitamin A, Vitamin C, Zinc, Vitamin B6, Magnesium, and Vitamin B12 (9).
Nutrition Tips for Second & Third Trimester:
Just as in the first trimester, eating a varied diet abundant in fruits, vegetables, proteins, and whole grains remains vital throughout the second and third trimester. Taking a daily prenatal supplement will also help meet the listed above nutrients. Continue to keep water intake high during pregnancy to prevent constipation, reduce swelling, and retain adequate hydration (1). Getting enough fibre, and moving regularly, can also help with any constipation you may experience.
In order to meet increased energy requirements:
During the second semester: add a small meal or snack to your day
During the third trimester: add a small meal or two extra snacks to your day
While you may find all of the above information helpful or informative, you may still be wondering, "Ok – but what should my meals actually look like?"
Here are a few examples of meals that would satisfy some additional energy requirements during pregnancy:
Fruit and Yogurt Parfait: 1 cup of plain or sweetened Greek yogurt, ½ cup mixed berries, and ¼ cup of granola. This is a great extra snack to have during the second trimester that could meet your additional energy needs while also providing calcium, protein, healthy fats and essential vitamins!
Avocado Toast: 1-2 slices of whole-grain bread, ½ mashed avocado, diced tomatoes, and 1 egg (scrambled or fried), topped with crumbled feta cheese. This meal provides many essential nutrients, including folate, iron, calcium, and vitamin C, with a good dose of healthy and essential fats!
Smoothies: Smoothies can be an excellent option for a quick source of nutrients on the go or if you're still experiencing any nausea or food aversions. Try choosing a leafy-green vegetable such as spinach, a fruit source such as frozen mango or bananas (or both!), a protein and healthy fat sources, such as Greek yogurt and hemp hearts, and use milk or plant-based soy milk as your liquid.
Pita Sandwich: A whole-grain pita sliced in half and cut open, fill generously with some leafy greens, vegetables, cheese, a protein source (chicken, turkey, or tofu), and your favourite dressing.
Veggie Frittatas: These are a great grab-and-go option to make ahead and leave in your freezer or fridge for the week! Packed with vegetables, eggs, and whatever ingredients suit you – these are a nutritious and light snack or addition to any meal!
To make one dozen – combine 12 eggs with chopped veggies of your choice, shredded cheddar cheese, and 1 cup of milk or plant-based soy milk. Whisk together and bake in well-greased muffin tins for 20-25 minutes.
As always, eat things you love, and that makes your body feel good! Consult with your dietitian for individualized meal recommendations, nutrient, and energy intakes throughout your pregnancy.
References
1. More J. Healthy Eating. Clin Paediatr Diet Fourth Ed [Internet]. 2014;715–43. Available from: https://health.ucdavis.edu/food-nutrition/pdf/Pregnancy - Healthy Eating During Pregnancy.pdf
2. Public Health Agency of Canada. Your guide to a Healthy Pregnancy [Internet]. Ottawa, Ontario; 2021. Available from: https://www.canada.ca/content/dam/phacaspc/documents/services/health-promotion/healthy-pregnancy/healthy-pregnancy-guide.pdf
3. Dietitians of Canada. Pregnancy - Nausea and Vomiting/Hyperemesis Gravidarum. In:Practice-based Evidence in Nutrition [PEN]. 2020 Mar 18 [Cited 2021 Jul 18] Available from:https://www.pennutrition.com/KnowledgePathway.aspx?kpid=13692&trcatid=42&trid=3237
4. Center for Disease Control and Prevention. Folic Acid [Internet] Centers for Disease Controland Prevention. 2018 [cited 2021 Jul 18] Available from: https://www.cdc.gov/ncbddd/folicacid/about.html
5. Kominiarek MA, Rajan P. Nutrition Recommendations in Pregnancy and Lactation. Med Clin North Am. 2016;100(6):1199–215.
6. Health Canada. Prenatal Nutrition Guidelines for Health Professionals: Iron [Internet]. 2009. [cited 2021 Jul 18] Available from: https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fn-an/alt_formats/hpfb-dgpsa/pdf/pubs/iron-fer-eng.pdf
7. Hofmeyr GJ, Lawrie TA, Atallah ÁN, Torloni MR. Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems. Cochrane Database of Systematic Reviews 2018. [cited 2021 Jul 18] Issue 10.
8. Health Canada. Prenatal Nutrition Guidelines for Health Professionals: Fish and Omega-3 Fatty Acids. [Internet] 2009. [cited 2021 Jul 18] Available from: https://www.canada.ca/content/dam/hc-sc/migration/hc-sc/fn-an/alt_formats/hpfb-dgpsa/pdf/pubs/omega3-eng.pdf
9. Public Health Agency of Canada. Your guide to a Healthy Pregnancy [Internet]. Ottawa, Ontario; 2021. [cited 2021 Jul 18] Available from: https://www.canada.ca/content/dam/phac-aspc/documents/services/health-promotion/healthy-pregnancy/healthy-pregnancy-guide.pdf
