Healthy eating during pregnancy

Healthy eating is essential at every stage in your life. But during pregnancy, it’s even more important. Your body is going through some big changes – and not all of them are as obvious as your baby bump and many aren’t even physical.

We understand there’s a lot to think about during this exciting time, but with the right knowledge and eating strategies in place, you’ll find it much easier to adjust.

What are the changes I’ll experience?

Things like your breathing, heart rate and blood flow will change during pregnancy to meet your increasing oxygen needs. As your baby grows, your organs start shifting around; your ligaments loosen up, and even your posture changes. And with increases in your estrogen and progesterone levels, you’ll start noticing hormonal fluctuations – things like tiredness will set in, and you may become more emotional.

It’s important to remember that these changes are completely normal. But because so much is happening to your body, getting the right nutrition is important to help make sure you’re in the best physical condition you can be in.

Why is a healthy diet so important?

Healthy eating during pregnancy is important to ensure that your developing baby is getting the best possible start to life, with everything they need to build a strong immune system, bones, and organs. And it’s not just your baby that benefits. A healthy balanced eating plan may keep you feeling strong, and help fight the fatigue and other pregnancy related changes you’re facing – like morning sickness, constipation, heartburn and mood swings.

It’s about quality, not quantity

There’s a lot of information out there – from health professionals, well-meaning friends, and family members. And we know it can be a little overwhelming to take it all in. But there’s one simple thing to remember. Great nutrition during pregnancy is about eating a healthy, balanced eating plan and the truth is, it’s more about what you eat, rather than eating more.

Of course, your body does require some additional food. But it’s probably much less than you think. In fact, during the first trimester you won’t need any additional calories. In the second you’ll only need 300 calories more per day, and in the third just an additional 450. To give you an idea, 300 calories would be two Ryvita crackers with half a medium avocado and tomato. And 450 calories would be equal to a peanut butter sandwich with a hard-boiled egg, or a bowl of muesli with trim milk and 10 raw almonds.

So it’s just a matter of eating a little bit more of the right foods as your body changes and your appetite increases. Keep in mind, your needs will depend on your pre-pregnancy weight. The good thing is your health professional can help you out with advice – especially if you’re uncertain about what food you’ll need to suit you and your pregnancy.

Healthy eating strategies to help you on your journey

Remember the four food groups

If you can manage to eat a variety of foods from each of these groups, you’re well on your way to a healthy pregnancy.

Fruit and vegetables – well-washed and preferably fresh, although frozen and canned (with no added sugar) count towards your 5+ a day. Be creative and choose a variety of colours, keeping the skin on where possible. The New Zealand Ministry of Health Guidelines recommend you consume around four servings of vegetables a day and two servings of fruit. This could be a medium potato or kumara; 1/2 cup of cooked vegetables or salad; one tomato, apple, pear or banana; two small apricots or plums; 1/2 cup of stewed fruit or fruit pieces.
Dairy – milk and milk products such as yoghurt are great sources of protein (important for growing tissue), and contain essential vitamins and minerals like calcium and vitamins B2 and B12. There’s also a range of trim and reduced-lactose milks, which means you can find one just right for you. The New Zealand Ministry of Health Guidelines recommend you consume at least three serves of milk or milk products a day such as a 250 mL glass of milk, a 150 g pottle of yoghurt, a 250 mL glass of calcium fortified soy or rice milk, or 2 slices of hard cheese (40 g).
Protein foods – lean meats like chicken and seafood, as well as eggs, cooked dried beans, peas and lentils, nuts and seeds all provide protein, iron, zinc, omega-3 and other nutrients that you and your developing baby need. New Zealand Ministry of Health guidelines recommend at least two serves a day of protein-based foods. This could be 2 slices of cooked meat (approx. 100 g), 1 medium steak or fish, 2 chicken drumsticks, a small can of tuna, 1 egg, 3/4 cup cooked dried beans or 1/3 cup of nuts or seeds. When it comes to fish, choose sardines, terakihi, blue cod, hoki or warehou and flounder.
Bread and cereals – particularly the wholegrain varieties. They’ll provide carbohydrates, fibre, B-vitamins and minerals to help maintain wellbeing. New Zealand Ministry of Health guidelines recommend you eat at least six serves of carbohydrate-based foods each day. This could be 1 bread roll, 1 medium slice of bread, 1 cup of cereal, 1/2 cup muesli or 1 cup of cooked pasta or rice.

Snack well, and snack wise

With all the changes that can happen during your pregnancy – fatigue, nausea, and increased appetite – choosing the right snack becomes crucial. Snacking can help you meet your nutritional requirements during pregnancy. Here are some suggestions:

Canned tuna on wholegrain toast or corn thins
Avocado and tomato on wholegrain toast or corn thins
Fruit smoothies using trim milk or yoghurt
Wholemeal sandwiches with a variety of fillings such as banana, hard cheese, marmite/vegemite, or peanut butter.
Well washed vegetable sticks served with peanut butter
Hard boiled eggs
Raw nuts, seeds and small amounts of dried fruit
Homemade popcorn (without added salt)
Well washed fruit
Wholegrain based breakfast cereal like muesli and wheat biscuits with trim milk
Yoghurt
Homemade soup

Make the most of breakfast time

We all know that breakfast is the most important meal of the day. But during pregnancy, it is really beneficial. A great breakfast helps kick start the day by providing your body with key nutrients such as carbohydrates, protein, fibre, calcium, iron, folate and other B-vitamins. Here are some ideas:

Scrambled eggs on wholegrain toast (eggs well-cooked)
Muesli, cereal or wheat biscuits with milk and fruit
Baked beans on wholegrain toast
Avocado or tuna on wholegrain toast
Fruit and yoghurt
Porridge
Fruit smoothie

Keep the fluids up

Just like with food, you’ll need to drink additional fluids, especially water, during pregnancy. Use thirst as an indicator, consume water as a first choice, but if you’re after something different, milk is another great option. When it’s hot outside, or you’re experiencing constipation or vomiting, you’ll need to drink a little extra.

Sugary beverages like flavoured waters, soft drinks, energy drinks and fruit drinks are best avoided. Caffeinated beverages should be limited (i.e. no more than 1-2 cups of coffee/day or its equivalent). No safe level of alcohol consumption during pregnancy has been established and so, because of risk of harm to the developing baby, experts recommend that it is safest to not consume alcohol at this time.

Some further help

When it comes to healthy eating during pregnancy, food safety is just as important as choosing the right foods. For more information, check out our article, Eating safely during pregnancy, or jump onto the NZ Foodsmart website. However, if you’re really concerned, or you’re feeling ill, you should speak to your health professional immediately.

The vitamins, minerals and fats you should know about

During pregnancy, there are certain vitamins, minerals and fats that serve specific purposes – for you and your developing baby. While many of them can be found in a healthy and balanced diet, supplementation can play an important role in achieving optimal intakes.

Folate and Folic Acid

Folate is an essential B-vitamin, and plays an important role in making new cells. Links have been found between low folate status and the increased rate of neural tube defects (NTD), such as spina bifida.

Folic acid is simply the name used for folate found in supplements and fortified foods. So if you’re planning to become pregnant, it’s recommend by the Ministry of Health to begin taking a daily supplement containing 800 µg of folic acid – from four weeks before you might become pregnant, to 12 weeks after you do. Improved folate status from folic acid supplements helps to reduce the risk of NTD. But it’s still a good idea to choose foods that are rich in folate too, like fresh, raw or lightly-cooked green, leafy vegetables (spinach and broccoli), raw fruit (especially citrus), cooked dried peas and beans, yeast extracts, or folate-fortified wholegrain bread and cereals.

Importantly, if you’ve had a previous NTD-affected pregnancy, or have a family history of NTD or Type 1 diabetes (on insulin medication), make sure you speak to your health professional – as you might need a higher daily dose.

Vitamin D

It’s one of the most important vitamins, and for pregnant women, even more so. Vitamin D is a fat-soluble vitamin, produced in the skin from an exposure to sunlight, or obtained from your diet. It plays an important role in your developing baby’s musculoskeletal health, helping with the building of strong bones, teeth and joints, as well as healthy muscle growth. It’s also essential for the absorption of calcium and phosphorus in the gut, and even has a role in brain and immune development.

While the sun is your main source of vitamin D, consuming it from sources like fortified milk, oily fish (tuna, salmon or sardines) and eggs, can also help achieve optimal status.

While the sun is an important source of vitamin D for our bodies, New Zealand has the highest rate of melanoma skin cancer in the world, so we need to be safe in the sun at all times. Always “Slip, Slop, Slap and Wrap”.

Always check the “Sun Protection Alert” at sunsmart.org.nz before venturing out in the sun to avoid sunburn and stay safe. If you have a personal or family history of melanoma take extra care in the sun and speak to your health care professional.

If you have any concerns about how best to achieve optimal vitamin D status, simply speak to your health professional.

Iodine

During pregnancy, it can be hard to get the right amount of iodine from a healthy eating plan alone. But small amounts are essential – particularly to support your baby’s growth and development.

Some great sources of iodine are well-cooked seafood, eggs and commercially made bread. It’s worth knowing that bread in New Zealand is fortified with iodine, except for organic and salt-free breads, and some home-baked mixes. Iodised salt is an option in New Zealand. While it’s definitely best to limit our overall intakes of salt, if you are adding salt to food during cooking or at the dinner table, choose iodised salt rather than non-iodised salt. It is also recommended for you to take a daily iodine-only supplement of 150 µg while you’re pregnant.

Iron

To help you meet the needs of your increase in red blood cell production, as well as the needs of your growing baby, placenta, and increased blood volume, you’ll need more iron in your diet during pregnancy. The good thing is, your body adapts during this time, and actually absorbs iron better. But because pregnancy creates a higher risk of developing iron deficiency and iron deficiency anaemia, you need to ensure your diet is full of iron-rich foods.

Some great sources of easily absorbable iron include red meat, poultry, eggs and fish. While not as easily absorbed by the body, foods like legumes, tofu, green vegetables, nuts and seeds are also good sources of iron. An easy way to increase iron absorption is by eating foods rich in vitamin C, like fruits and vegetables, during the same meal.

Docosahexaenoic acid (DHA)

DHA is an omega-3 fatty acid, and it is important for your growing baby’s normal brain and eye development – particularly during your third trimester. The most well-known source of DHA is oily fish. Some types of fish are high in mercury, therefore it’s recommended that you choose fish low in mercury which you can consume up to 4 serves per week. Some guidance on which fish are high or low in mercury is found on the NZ Foodsmart website. It’s a good idea to try and eat a variety of foods rich in Omega-3 such as flaxseed, canola or soybean oils, and choose low-mercury fish such as canned tuna, sardines, terakihi, blue cod, hoki, warehou and flounder. Fish such as salmon, mackerel, kahawai and tuna are longer living fish, so may have higher levels of mercury.

Calcium

Essential for your bone strength and your developing baby’s growth, calcium is an important mineral. Amazingly, your body adapts during pregnancy, and becomes better at absorbing calcium. While there’s no increased need for calcium during this time, it’s really important for your own bone health and to support the demands that pregnancy puts on your body.

The best sources of calcium include milk and milk products such as yoghurt or hard cheese. You’ll need 2-3 servings a day. If you don’t eat dairy products, calcium can also be found in calcium-fortified soy or rice milks, canned fish with bones, nuts, some green leafy vegetables and wholegrain breads and cereals.

References

Ministry of Health Food and Nutrition Guidelines for Healthy Pregnant and Breastfeeding Women – A Background Paper - 2006.

Ministry of Health Eating for Healthy Pregnant Women - 2014.

Ministry of Health Healthy weight gain during pregnancy - Accessed 30th November 2015.

Health Promotion Agency How to be sunsmart - Accessed 09 February 2016.

National Institutes of Health Health Information for Health Professionals – Iron - Accessed 30th November 2015.

HealthEd – Ministry of Health Folic Acid and Spina Bifida/Iodine and Iodine Deficiency - Accessed 30th November 2015.