Healthy eating in pregnancy

What is a balanced diet?

We all need a diet that is varied and has foods in the following proportions:

• One third fruit and vegetables
• One third energy-packed starchy carbohydrate foods like bread, potatoes and pasta
• One sixth protein foods like meat, poultry, cheese, pulses and dairy products
• The tiniest amount of sugar and fat. All washed down with plenty of water

During pregnancy you can continue to eat most of the foods that you enjoy now, so long as you vary what you eat and keep a balance between food types over the course of one or two days. Finding it hard to eat? For times when you are finding it hard to eat proper meals you can still eat and drink healthily by snacking on the right foods e.g. try vegetable sticks which are good for roughage, protein and minerals and vitamins, grab a bowl of high-fibre, fortified breakfast cereal and you can also grab goodness in a milky drink. Eating well in pregnancy and afterwards simply means getting the balance right.

Folic acid – what you need to know

One nutrient key to a healthy pregnancy is worth special consideration: folate or folic acid, one of the B group of vitamins, also known as B9. We all need folic acid to make DNA. DNA carries the genetic information that controls the correct development and function of every single cell in our bodies. A good intake of folic acid when you are trying for a baby and /or at least during the first 12 weeks of pregnancy (when the baby’s neural tube is forming), significantly reduces your baby’s risk of developing a neural tube defect, such as spina bifida or anencephaly (when the brain does not develop).

Foods with folic acid

The UK government advises pregnant women to also increase the amount of folic acid in their diet. All of these foods are good sources of folic acid:

• Green leafy vegetables such as Brussels sprouts, spinach and broccoli (see recipes for pregnancy)
• Other vegetables – especially beans, peas, cabbage, potatoes and cauliflower
• Canned pulses such as kidney beans, chickpeas, butter beans, baked beans, borlotti beans, flageolet beans and peas are a fantastic source of folic acid.
• Tinned baked beans
• Fruits – particularly citrus fruits and kiwi fruit
• Fortified breakfast cereals and bread (check the nutritional information charts on packets or look for the ‘contains folic acid’ symbol)

Iron

Iron is needed to make haemoglobin, the chemical that carries oxygen in blood cells. Your body makes more haemoglobin during pregnancy, so automatically takes more iron from the food you eat. However, as long as you eat a balanced diet you will probably not need an iron supplement. Iron supplements can cause problems with the absorption of other nutrients from your food. They may also cause sickness or constipation.

Try to include an iron-rich food with every meal. These foods are all good sources of iron, but the ones at the top of the list have the most available iron:

• Beef, lamb, kidney, dark chicken meat
• Sardines
• Fortified breakfast cereals (in the UK)
• Wholemeal bread
• Pulses like red lentils, chickpeas, baked beans, kidney beans
• Leafy vegetables: broccoli, peas, curly kale, spring greens, spring onions, spinach
• Cashew nuts
• Sunflower seeds
• Dried fruits like apricots, prunes and figs
• Baked potatoes
• Eggs

To help your body make best use of the iron in your food, eat some food rich in vitamin C with every meal, especially if you do not eat meat. Green or red vegetables and most fruit contain vitamin C.

Avoid drinking tea and coffee with meals. Both drinks contain chemicals that reduce the amount of iron you take from your food. Drink them an hour before you eat or two hours afterwards.

Some women may become genuinely short of iron during pregnancy and need treatment to prevent harm to themselves and their babies. If you do not have enough iron, you may not produce healthy haemoglobin and the transport of oxygen around your body may be affected. You may begin to feel tired, breathless, dizzy and miserable. These are some of the signs of anaemia.

Your midwife or doctor will take some blood to check your iron levels at one or more of your antenatal clinic visits. If you are showing signs of anaemia you may be prescribed iron supplements.

Vitamins in pregnancy

Everyone knows that vitamins are important in order to stay strong and healthy. But, which vitamins do you need in pregnancy – and how much is too much?

Vitamin A

A normal balanced diet will give you all the vitamin A that you and your baby need. Too much vitamin A may harm your developing baby. During pregnancy it is best if you:

• Don’t eat liver, or liver products such as liver pate (liver may contain a lot of retinol vitamin A due to the type of food the animals have been fed on)
• Don’t take any vitamin supplement that contains the retinol form of vitamin A (check the labelling)
• There is no need to limit your intake of the carotene form of vitamin A. This is found in dark green, orange and red vegetables. Carotene is a valuable antioxidant

Vitamin B12

A good intake of vitamin B12 (or cobalamin) is particularly important during pregnancy – to make new cells (especially blood cells) and build a healthy nervous system.

Vitamin B12 is found in:

• Meat
• Fish
• Eggs
• Milk
• Hard cheese
• Fortified breakfast cereals
• Soya products

Getting enough vitamin B12 can be difficult if you eat a vegan diet with no animal foods at all. If this is so, it may be a good idea to take a B12 supplement. Have a word with your pharmacist or family doctor.

Vitamin C

The role of Vitamin C in keeping us healthy has been somewhat contentious recently as recent research has shown that very high doses of vitamin C (greater than 500mg daily) might actually be doing us more harm than good. But, there should be no problems in taking the manufacturers’ recommended dose of Vitamin C during pregnancy, although do not exceed the 500mg without consulting your doctor. Eating fresh oranges or drinking fresh orange juice is a good way of taking a safe amount of Vitamin C in your diet and will also help with the constipation that can affect many women in
pregnancy.

Vitamin D

Vitamin D is sometimes called the sunshine vitamin because we can make it under our skin when exposed to light. Calcium and vitamin D are particularly important during pregnancy as they help your baby’s bones and teeth develop. These two nutrients go hand-in-hand, since our bodies need vitamin D in order to use calcium. Although vitamin D is stored in our bodies, some pregnant women may not have enough stored to meet both their own needs and those of their developing baby. Talk with your family doctor about taking a vitamin D supplement if:

• You drink little or no milk and do not eat other dairy products, oily fish or eggs
• You do not go out of doors between 11am and 3pm each day (it doesn’t matter if the sun isn’t shining)
• You usually cover your arms, legs and head when out of doors
• You live in the north of England, Scotland or other places where the winter days are short

Essential fatty acids (Omega 3)

Essential fatty acids are nutrients that we need to take direct from food; our bodies cannot make them. In the past decade or so, the importance of Omega 3 during pregnancy has been acknowledged. It is now known that Omega 3 actually plays a large role in the development and growth of your baby when it is in your uterus. Omega 3 helps to:

• Build the brain
• Form the retinas
• Develop the nervous system

Omega 3 is also necessary for your own pregnancy health and wellbeing. Omega 3 helps to:

• Reduce your chances of developing pre-eclampsia
• Reduce your risk for postpartum depression
• Minimize the chance of preterm labour

Good sources of essential fatty acids include:

• Oily fish, like mackerel, herring, sardines, anchovies, salmon, and pilchards (it is important to keep in mind that fish can be contaminated with mercury and PCBs, so make sure that you choose safe types of fish)
• Omega 3 fish oil supplements (check to make sure that your supplements are not made from fish livers. Liver can contain high amounts of retinol vitamin A, which has been linked to birth defects. Omega-3 supplements not derived from fish livers but rather from the body of the fish are less likely to contain this type of vitamin A. If you would prefer to err on the side of caution, you can always look for supplements that are made specifically for pregnant women)
• Dark green vegetables
• Canola, sunflower, and flaxseed oils
• Walnuts