Nutritional Guide For Pregnant Women

Nutritional Guide For Pregnant Women

Everyone wants the best for their baby and yet many people overlook the importance of eating the sorts of foods and drinks that mean both mum and baby will have a healthy pregnancy. It is well known that, without the right sorts of foods and nutrients, women may deliver babies who will not achieve their full potential in life.

We believe that eating well matters – but enjoyable and delicious food matters too, so this guide is all about easy, tasty meals and snacks that don’t break the bank and that women can fit into their day whatever their circumstances. The ideas in this guide have been put together by experts in food and nutrition and are based on government guidelines for healthy eating.

Having a good diet in pregnancy and entering parenthood with an understanding of the importance of eating well for their new family is essential for ensuring current and future health for all. Some women don’t eat enough different types of foods, and the foods they do choose tend to be high in fat, salt, and sugar and low in the kinds of nutrients that are important for the baby’s growth and development. Some women may restrict their food intakes to stay slim, but choose foods that don’t provide the important nutrients they need in pregnancy. This practical guide is all about shifting the balance towards better food choices and making it clear what eating well really looks like – and how to do it both now and in the future.

Why does eating well in pregnancy matter?

There is a complex inter-generational relationship between the nutritional status of a mother and her newborn baby and the subsequent health and well-being of that child and the children they go on to have themselves. Evidence suggests that the root of many diseases of adulthood lies in the nutrient supply from conception through the first two crucial years. Everyone who has contact with women during pregnancy should be able to offer clear, consistent, evidence-based, and practical advice on what a good diet looks like. Supporting women to take their food choices seriously, to spend their money wisely on food, and to learn skills in food preparation has to be a priority if we are to reverse current trends in poor nutritional health and tackle health inequalities.

The nutritional status of a woman before she conceives and throughout her pregnancy will impact the health and well-being of her infant in both the short term and long term. The aim of all health advice in pregnancy is to ensure the best outcome for mother and infant, and that includes having a baby born at a good birth weight, with adequate nutrient stores. Poor diet in pregnancy has been associated with adverse pregnancy outcomes in a number of studies, and there is evidence that the diets of many women are lacking in some of the essential nutrients associated with good outcomes.

Despite a popular myth that a baby will take what it needs nutritionally from its mother, neither mother nor baby will thrive if the mother’s diet is poor.

Important nutrients do women need in pregnancy, why and their sources

NutrientWhy it is neededGood sources
Vitamin AVitamin A is needed for eye health, cell growth and to support the immune system. Extra vitamin A is needed during pregnancy, but too much of the animal form of vitamin A (retinol) can be toxic. 700 micrograms of vitamin A a day are recommended. Safe sources of vitamin A can be found via carotenoids in some types of fruits and vegetables. Fish is a good source of vitamin A. Some types of animal products such as liver and liver pâté or liver sausage have high levels of vitamin A and should be avoided. Intakes of retinol equivalents greater than 3,000 micrograms a day are considered potentially dangerous in pregnancy. This level of intake is most likely to come from supplements including the use of fish oils. A cod liver oil capsule containing 1,000mg or 1g of cod liver oil is likely to contain about 800 micrograms of retinol equivalents. A teaspoon of cod liver oil (5g) will, therefore, exceed the upper recommended level of 3,000 microgramsAnimal sources: butter, canned salmon, cheese, Egg, full-fat milk, herrings, kidney, pilchards, canned in tomato sauce, and smoked mackerel. Non-animal sources: apricots (dried, fresh or canned), blackcurrants, broad beans, broccoli, Brussels sprouts, cabbage (dark), cantaloupe melon, carrots, honeydew melon, mango, margarine, nectarine, orange, peach, peas, prunes, red peppers, runner beans, spinach, sweet potatoes, sweetcorn, tomatoes, watercress,
Riboflavin Also called vitamin B2An additional amount of riboflavin is needed during pregnancy. 1.4mg of riboflavin a day is recommended in pregnancy. Riboflavin helps to release energy from food and is important for eye and heart health. Many women get most of their riboflavin from animal sources and particularly dairy foods and so if they avoid these foods it is important that they regularly eat non-animal sources of riboflavin.Animal sources: bacon, cheese, eggs, kidney, lean meat or poultry, mackerel, milk, pilchards, salmon, sardines, tuna, and yogurt. Non-animal sources: almonds, fortified breakfast cereals, granary bread, mushrooms, soya beans, spinach, and wheat germ bread.
Folic acid: 'Folic acid' is the name given to the synthetic form of the B vitamins known as folates, but is used as a general term here for this vitamin.Folic acid is important before pregnancy and in the first few weeks of pregnancy to prevent neural tube defects, and in later pregnancy to prevent a particular type of anemia. 400 micrograms a day are recommended. Women should take a supplement of folic acid, but good sources of folic acid should also be included in any healthy diet.Broccoli, Brussels sprouts, cabbage, cauliflower, fortified breakfast cereals, green leafy salads, melon, oranges, Parsnips, peanuts, peas, potatoes, runner beans, spinach tomatoes, wholemeal bread, and yeast extract.
Calcium. Calcium is important for bone health and, although calcium needs are increased during pregnancy, the body adapts to ensure more calcium is absorbed, so higher intakes are not needed. 700mg of calcium a day is recommended for women. The exception to this is for teenagers in pregnancy where additional calcium is needed for the teenagers' own growth. A regular intake of dairy products (milk, cheese, and yogurt) throughout pregnancy will ensure that calcium needs are met. If women do not include these foods in the diet, it is important that they choose suitable alternativesDairy sources: cheese, cheese spread, yogurt, fromage frais, and milk. Non-dairy sources: canned salmon, dried fruit, egg yolk, muesli, orange, peas, beans and lentils, pilchards, sardines, soya drink fortified with calcium, spinach, tofu, and white bread/flour.
IronIodine helps regulate metabolism and plays an important role within the thyroid in controlling many body processes. Pregnant women are recommended to have 140 micrograms of iodine a day. Too little iodine in pregnancy is associated with learning disabilities in infants and children. Iodine deficiency is the biggest cause of mental retardation worldwide. The main source of iodine in the UK is dairy products. Iodine can also be found in seaweed, fish, and seafood. Smaller amounts can be found in meat and meat products and some types of vegetables (depending on the soil where they were grown). If someone does not have dairy products and does not eat any fish or seafood, it is very important that they have other sources of iodine in their diet. It is also important not to have too much iodine, and intakes should not exceed 940 micrograms a day.Dairy sources: butter, cheese, fromage frais, milk, ice cream, and yogurt. Non-dairy sources: egg, fish, fish paste seaweed*, and shellfish Note* Some types of seaweed have very high concentrations of iodine and these are not recommended.
Zinc.Zinc plays a role in enzyme and insulin production and is important for the baby's health and development. Zinc helps to form the baby's organs, skeleton, nerves and circulatory system. The current recommendation for pregnant women is for 7mg of zinc a day. Some women may have too little zinc in their diet if they don't eat well and if they don't regularly have foods such as meat, fish, eggs, milk, pulses, nuts, or cereal foods.Animal sources: bacon, canned sardines, canned tuna or pilchards, cheese, cold cooked meats, corned beef, eggs, ham, kidney, lean meat, milk, poultry, sausages, shrimps and prawns Non-animal sources: beans and lentils, brown or wholemeal bread, nuts, plain popcorn, sesame seeds, tofu, and wholegrain breakfast cereals, such as puffed wheat, bran flakes or sweet bisks.
Long-chain polyunsaturated fatty acids (Often called omega 3 fatty acids) and CholinePregnancy causes physiological changes in women, which mean that many nutrients and other dietary components are absorbed more efficiently, or taken from the mother's stores so that the developing infant will not be deprived of nutrients. There are some components - such as long-chain polyunsaturated fatty acids (or omega 3 fatty acids), and choline - that the body can make itself in small amounts, but which it is helpful to have sufficient of in the diet during pregnancy. This is to ensure stores are not depleted and that the infant has sufficient for brain and cell development. If women eat a variety of meals and snacks as recommended in this resource, it is likely that they will get enough choline and long-chain polyunsaturated fatty acids to meet their needs.Long-chain polyunsaturated fatty acids oil-rich fish, such as salmon, trout, herring, mackerel, sardines, and pilchards. Choline: eggs, lean meat, some vegetables, such as green leafy vegetables and peas, tomato paste, tofu, pulses nuts, and seeds.

Weeks 27–40 (the last trimester of pregnancy)

NutrientWhy it is neededGood sources 
EnergyAn additional amount of energy (calories) is needed during the final stage of pregnancy (weeks 27-40) to make sure the baby arrives at a good weight. Low birth weight is associated with more problems at birth, in the first few months and in later life. An extra 200kcal per day is recommendedThe best sources of energy are those that also provide other nutrients, for example - starchy foods such as potatoes, bread, pasta, and rice - dairy foods such as milk and yogurt - eggs.
Vitamin-CAn additional amount of vitamin C is needed during the final stage of pregnancy to increase intakes to 50mg a day. Vitamin C is one of the building blocks for skin and also acts as an antioxidant and protects cells from damage. Eating a range of the meals and snacks shown in this resource will ensure enough vitamin C is consumed.Apples, blackberries, blackcurrants, broccoli, Brussels sprouts, cabbage, canned guava, cauliflower, grapefruit, green and red peppers (raw), green beans, kiwi fruit, mango, Nectarines, orange (and orange juice), peaches, peas, potatoes, raspberries, satsumas, spinach, spring greens, strawberries, tomato, and watercress.
Thiamin also called vitamin B1An additional amount of thiamin is needed during the final stage of pregnancy to increase intakes to 0.9mg a day. Thiamin helps to release energy from food and plays an important role in the development of the baby's nervous systemAnimal sources: chicken and other poultry, eggs, lean meat, pork, bacon, and ham. Non-animal sources: fortified breakfast cereals, nuts, oatcakes, potatoes, white or brown bread, wholemeal bread, and yeast extract.

Important vitamins that all pregnant women should take as a supplement

Folic acid

Folic acid is needed before pregnancy and in the first few weeks of pregnancy to prevent neural tube defects and may help to prevent cleft lip and palate. In later pregnancy, folic acid is needed to prevent a particular type of anemia. While it is possible to get enough folic acid from the diet if you eat well, it is currently recommended that all women take a supplement of 400 micrograms of folic acid a day when planning a pregnancy, or as soon as they find out they are pregnant, and that they take it for at least the first 12 weeks of pregnancy. For those women who have poor or erratic diets that are low in good sources of folic acid such as green leafy vegetables and wholegrain cereal, it is prudent to continue taking the supplement throughout pregnancy. Healthy Start vitamins for pregnant women provide 400 micrograms of folic acid, 10 micrograms of vitamin D and 70 milligrams of vitamin C. Eating a range of meals and snacks as recommended in this guide will also help to ensure adequate folic acid intake.

Who might need a higher dose of folic acid? If there is any family history of neural tube defects (spina bifida or anencephaly), if women are taking some anti-epileptic drugs, if they are diabetic, have coeliac disease or are obese, they are likely to be advised to take a higher-dose supplement of folic acid of about 5 milligrams a day during the first 12 weeks. If you think a particular woman should be taking this higher dose of folic acid, encourage her to check with her GP.

Vitamin D

Vitamin D during pregnancy is very important for bone development in both the pregnant woman and the child, but needs cannot be met through diet alone. Most adults make the majority of their vitamin D through the action of summer sunlight on the skin. Women who are at a particular risk of low vitamin D status include those who have darker skin, who rarely go outside, who cover their skin with clothing or sunscreen, who avoid animal foods or who have a very poor diet.

It is currently recommended that all pregnant (and breastfeeding) women should take a supplement of 10 micrograms of vitamin D every day.

Healthy Start vitamins contain 10 micrograms of vitamin D and can be taken throughout pregnancy and while breastfeeding. Women who may be at particular risk of low vitamin D status should be given the vitamins at the first point of contact and should be encouraged to take them regularly.

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