What every healthy woman needs to know about eating for two..
There’s nothing quite like pregnancy to shake up a gal’s nutritional routine. For some typically clean eaters, bagels and potato chips are suddenly far more appealing than green juice and quinoa. Others find that morning sickness (or really, all-day-long sickness) makes their standard a.m. avo toast sound positively revolting. And then there are more extreme examples of eating habits gone wild—like die-hard vegetarians who spend those nine months dreaming about steaks.
Between the crazy cravings and unexpected food aversions, it can be tempting to just pop a prenatal vitamin and give in to the siren call of saltines and pickles. But while supplements are great for filling in the nutritional gaps, experts agree that healthy whole foods are just as critical for expecting moms. (At least, when they’re able to stomach them.)
While supplements are great for filling in the nutritional gaps, experts agree that healthy whole foods are just as critical for expecting moms.
“Taking a prenatal vitamin can help ensure that you get the nutrients that are important during pregnancy, but remember that it isn’t a substitute for eating a healthy diet,” says integrative nutritionist Jennie Miremadi, MS, CNS, LDN. “I recommend sitting down with your health care providers at the outset of your pregnancy and talking to them about what you’re eating. Together, you can determine the best supplements and diet for you.”
Luckily, there are certain foods that make it especially easy to get the vitamins, minerals, and macronutrients that moms and babies need during pregnancy. I asked Miremadi, along with other wellness experts, to outline some of the best—as well as the not-so-obvious foods that should be eaten in moderation (or avoided altogether).
Ready to make a grocery list? Here are the foods you should—and shouldn’t—be eating during pregnancy.
Salads are just about every healthy girl’s ride-or-die, but they become even more important during pregnancy because leafy greens are high in folate (AKA vitamin B9 or folic acid)—a super-important vitamin for a fetus’ developing nervous system and spinal cord.
“Folate is particularly critical during the first stages of pregnancy, when the baby’s neural tube is forming,” says Miremadi. But, if possible, it’s also important to load up on the nutrient before conception, says Marra Francis, MD, FACOG. “Women should ensure they have adequate levels of folic acid in their diet prior to pregnancy, because this vitamin is essential very early on—even before a woman knows she’s pregnant,” says Dr. Francis, medical director at home lab testing company EverlyWell. So if you’re still in the process of trying to conceive, definitely load up.
Spinach is a particularly solid choice. Not only will it contribute to your daily folate intake, but it’s also a good source of other important prenatal nutrients like iron, calcium, and vitamin A.
Chinese medicine practitioner Dara Barr usually takes a personalized approach to prenatal diet when she’s consulting clients at New York City’s YinOva Center. But the one food she tends to recommend across the board is ginger, particularly for women in their first trimester, when so many women either feel low-grade queasy all the time…or spend a good part of their days throwing up. (Side note: If you’re having really severe morning sickness, definitely talk to your OB-GYN or midwife. It could be a sign of rare, but serious hyperemesis gravidarum.)
“Our biggest go-to for morning sickness is ginger,” she says. “It’s the most effective herb for nausea and warms the spleen energy to help regulate digestion.” You can drink it as a tea, snack on ginger candies, or add it to your meals, like holistic chef Minna Hughes. (Her favorite preparation: broccoli soup with fresh ginger.)
Farmers’ market staples like sweet potatoes and carrots are rich in vitamin A, which helps the baby’s cells differentiate and develop into healthy organs. It’s best to get this nutrient from whole, plant-based foods, says Miremadi, since it is possible to get too much of it.
“Vitamin A has two forms in food—preformed vitamin A, or retinol, and provitamin A carotenoids, such as beta-carotene, which the body converts to vitamin A,” she explains. “Preformed vitamin A is found in animal products, whereas provitamin A carotenoids are primarily found in plant foods.”
She goes on to say that too much preformed vitamin A can lead to birth defects, so pregnant women should avoid using topical retinols on their skin, taking vitamin A supplements, or eating liver—and stay in the neighborhood of 770 mcg retinol activity equivalent (RAE) per day.
If the thought of a morning omelet doesn’t make you queasy, eggs are an ideal prenatal breakfast option—they’ve got vitamin D (necessary for healthy bone development), vitamin B12 (important for nervous system function), iodine (for thyroid function), and that all-important vitamin A.
But they’re also rich in another crucial nutrient that you don’t find in a lot of prenatal vitamins: choline. “Choline is important for healthy brain growth and cell formation in a baby,” says Miremadi, who notes that vegetarians can get it from nuts like almonds, cashews, and pistachios. (One study even suggests that choline can help prevent mental illness later in life.) She recommends shooting for 450 mg per day.
In those early days of pregnancy, bone broth can be a godsend for a lot of mamas-to-be. “Broth is a good way to keep up your nutrient intake when you’re feeling unable to eat,” says Hughes. She recommends opting for a broth made from grass-fed beef bones. “This is an easy way to consume the minerals in bone marrow,” she says. These reportedly include calcium, magnesium, and potassium—all nutrients that are just as necessary after the morning sickness passes.
If you’re a plant eater who’s suddenly craving double cheeseburgers and rotisserie chicken, it’s totally to be expected—after all, according to Miremadi, pregnant bodies require around 71 grams of protein per day to keep up with the growth and formation of both mom and baby’s muscles and tissues.
Iron is another reason why meat (particularly the red kind) can sometimes seem irresistible when you’re knocked up. “As a pregnancy grows, a woman’s blood volume expands up to 15 percent; therefore, a woman needs more iron to help prevent severe anemia,” says Dr. Francis. “A fetus also needs iron to help in the hematopoetic development of their own blood cells.” Vegetarian? She recommends you go on a vitamin supplement.
Beans and lentils
Beans are a surprisingly potent source of all sorts of must-have pregnancy nutrients—navy beans are high in choline and calcium, chickpeas are a powerhouse of protein and vitamin B6, kidney beans bring the iron, and black-eyed peas are rich in vitamin A and folate.
But out of all the legumes, lentils might just pack the biggest dietary punch. They contain iron, fiber, amino acids, and folate, and are a go-to for Hughes. “I love to make lentil and greens soup,” she says. “Lentils are a top source of folate, and while you’re making the soup, you can wilt in a cup or two of chopped leafy greens to really boost the nutritional content.”
Okay, so you’ve probably heard that sushi’s off-limits during pregnancy—and most providers tend to say that’s true, since raw meat and fish pose a food poisoning risk that could be harmful to the baby. But Miremadi notes that small amounts of cooked, low-mercury fish are actually highly beneficial for their omega-3 fat content, DHA in particular.
“DHA is essential for optimal brain and eye development in both a fetus and a newborn,” agrees Dr. Francis, who adds that it’s important while breastfeeding as well as during pregnancy. “Lack of DHA has been implicated in babies and children with increased cognitive delays, decreased visual acuity, and increased associations of asthma and skin conditions such as eczema.”
Miremadi’s favorite sources of DHA include salmon—it’s also high in protein, calcium, choline, and vitamins D and B12—and iron-rich sardines. But there’s a catch: The nutritionist says you should eat no more than 12 oz. of low-mercury fish per week. (That’s only about two pieces of salmon.) Because of this, it’s important to talk to your doctor to see if a daily omega-3 supplement is right for you. (Ditto if the smell of seafood makes you gag.)
Pregnant women need about 1,000 mg of calcium a day, and experts agree that dairy’s one of the best places to get it—especially since most prenatal vitamins don’t contain the full recommended daily allowance.
“Calcium is needed for normal cellular and muscle function, and as a mother’s need for energy increases as the pregnancy advances, she needs to ensure she keeps her calcium intake adequate,” says Dr. Francis. “It’s also extremely important for both the skeletal and cellular growth of the fetus.” Adds Miremadi: “It’s particularly important during the third trimester, during which time the baby absorbs increased levels of calcium.”
If your digestive system’s cool with dairy, you can load up on calcium from milk, yogurt, kefir, or cottage cheese. And if not, she recommends seeking out fortified almond milk instead.
According to Barr, constipation’s a common complaint among her pregnant clients. Her solution? Bananas. (Yes, really.)
“Eating one or two bananas helps stimulate bowel motility and moistens the stool,” says the Chinese medicine practitioner, who also suggests drinking honey in warm water.
And what if you’re watching your sugar intake? Miremadi notes that pregnant women should be getting about 28 grams of fiber per day, which can also help with digestion. She recommends opting for raspberries, quinoa, rolled oats, chia seeds, artichokes, and legumes to hit that goal.
What to avoid
Along with the usual suspects—shellfish, unpasteurized foods, raw or undercooked meats, deli fare, high-mercury fish, and raw sprouts—the pregnancy pros note that there are a few less obvious foods to avoid while you’re pregnant.
For one thing, you might have to shelve your regimen of adaptogens and other herbal supplements until after giving birth. “My pregnant clients are surprised to find out that many of the herbs they take regularly may not be safe during pregnancy,” says Miremadi. “As soon as a woman knows that she’s pregnant—or prior to conception, if possible—she should take every herbal product she consumes to her heath-care provider to find out which of them are safe and which of them she should stop during pregnancy.” The nutritionist says aloe vera juice is another seemingly healthy prenatal no-no, since it could cause uterine contractions.
And what about alcohol? Miremadi advises her clients to cut it out for the whole pregnancy, but she says some doctors will say it’s okay in the later stages—if you can’t bear the thought of a summer without rosé, talk to your provider to find out if it’s right for you. (Or just roll with the sober social scene that’s already trending in some circles.)
Finally: coffee. Many midwives and MDs, including the American College of Obstetricians and Gynecologists, will say a cup a day is fine. But Barr claims Chinese medicine has a different opinion. “It’s hot, drying, and stagnating, and often is best avoided,” she says. “Sorry, mamas!” Yes, that goes for decaf too, but hey—no one said beet lattes were off limits.