Nutrition

Eating a balanced diet during pregnancy

Being pregnant is a very special time in your life, and it’s a time when many women think about their diet. What you eat can not only influence your own health, but it can also affect the short and long term health of your baby so it is important that you eat a healthy, balanced and varied diet when you are pregnant.

The basic principles of a healthy diet stay the same. You should still eat a diet that is based on starchy foods (choosing wholegrain varieties or potatoes with their skins on when you can), and includes plenty of fruit and vegetables, moderate amounts of lean meat, fish and/or other protein sources such as eggs and pulses, and moderate amounts of dairy products, such as milk, yogurt and cheese (or calcium-enriched dairy-free alternatives). You should only eat limited amounts of foods and drinks that are high in fat and sugar. You can find more information on a healthy varied diet here.

As well as having a healthy diet it is also important to be aware of food safety and hygiene. There are certain foods and drinks that you should avoid or be careful with how much you eat when pregnant. For more information click here.

Beside all the nutrients you get from a healthy varied diet, there are some vitamins and minerals that are very important for the development of your baby.

In this section we will be looking at supplements during pregnancy, as well as nutrients that are important during pregnancy. We have also given examples of recipes that provide some of these key nutrients.

Supplements during pregnancy

Folic acid

You may have heard or read about needing to take a folic acid supplement or eat more folate (this is what folic acid is called when its naturally present in foods). This section will let you know why this is important.

A folic acid supplement is recommended prior to conception and up to 12 weeks of pregnancy to lower the risk of neural tube defects (NTDs). Don’t worry if your pregnancy was unplanned and you have not been taking a daily folic acid supplement, but do start taking it as soon as you can.

You should also try to consume more foods that contain folate (the natural form of folic acid). These are foods such as oranges, berries, green leafy vegetables, beetroot, beans and brown bread.

You should take a 400 µg folic acid supplement daily up to the 12th week of your pregnancy

Some women have an increased risk of having a pregnancy affected by a neural tube defect and are advised to take a slightly higher dose of folic acid. You have an increased risk if there is a family history of neural tube defects or you have diabetes. If you're taking anti-epileptic medication, you may also need to take a higher dose of folic acid. Talk to your GP if you think you may need to take a higher dose of folic acid.

Did you know…..?

Some Facts on Neural Tube defects

• Neural tube defects (NTDs) are a group of serious birth defects that affect the developing nervous system.
• The central nervous system (brain and the spinal cord) normally develops first as a flat sheet of cells (the neural plate) which rolls up (the neural tube) in weeks 3 and 4 of pregnancy and closes to form the central nervous system. If the tube doesn’t close properly this results in a neural tube defect (NTD).
• Some examples of NTDs are spina bifida, anencephaly or encephalocele

At present the precise cause of NTDs is unknown and research continues. However, we do know that taking folic acid supplements can reduce the risk of NTDs.

Vitamin D

This vitamin is particularly important for the growth and development of your baby’s bones and helps to maintain the health of your bones too. Your skin produces vitamin D when it is exposed to sunlight, but the sun in the UK is only strong enough in the summer months (April to mid-October). You can also get vitamin D from food but food sources are limited; sources include oily fish, fat spreads and eggs.

Most people should be able to get all the vitamin D they need by eating a healthy balanced diet and by getting some summer sun.

However, national surveys show that many women of childbearing age have low vitamin D status, particularly in winter months. As a pregnant or breastfeeding women, you are at risk of not getting enough vitamin D, particularly if you are not exposed to much sunlight (you cover up your skin or spend a large amount of time indoors) or you have darker skin (e.g you are of African, African-Caribbean or South Asian origin) as your skin will not produce as much vitamin D from sunlight.

To make sure that you get enough vitamin D all year round, all pregnant and breastfeeding women are advised to take a daily supplement containing 10 μg of vitamin D. This will also help to provide your baby with enough vitamin D for the first few months of his or her life.

Some pregnant women (all those under 18 and those on certain benefits) may be entitled to receive free vitamins that include folic acid and vitamin D under the Healthy Start scheme. You can find out more from www.healthystart.nhs.uk

Avoid too much vitamin A

Vitamin A is important for good health and for the healthy development of your baby, but large amounts can harm your unborn baby, causing malformations. You should not take any supplements containing vitamin A or retinol (also watch out for multivitamin supplements which may contain these and fish liver oil supplements such as cod liver oil). Furthermore, you should avoid eating liver and liver products (such as liver pate) because they are very high in vitamin A.

Nutrients for pregnancy

Iron

Did you know? Iron requirements are higher in pregnancy. Your body needs extra iron to ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients.

Iron supplements are not routinely offered to pregnant women because it has been increasingly recognised that the body becomes more efficient at absorbing iron as the pregnancy progresses. Without the loss of blood through monthly periods, you retain more of your body’s iron stores too.

However, it can be fairly common for women to develop iron deficiency during pregnancy so when you are pregnant you should eat plenty of foods containing iron. Iron is found in red meat (like beef and lamb), pulses, nuts, eggs, green leafy veg such as watercress, wholemeal bread, dried fruit and fortified foods such as breakfast cereals. Vitamin C helps your body absorb the iron from plant sources. So you will absorb more of the iron from a meal such as beans on toast if you have a glass of fruit juice with it. Tea or coffee can decrease the amount of iron your body absorbs from plant sources, so try not to consume these with meals.

Iron supplements may be recommended by your midwife or GP if the iron levels in your blood are found to be too low – ask your GP if you are worried about your iron levels.

Omega-3 fatty acids

Long chain omega-3 fatty acids, particularly decosahexanoic acid (DHA) found in oily fish (such as salmon, sardines and mackerel), are important for the development of your baby’s brain and eyes. However, pregnant women should eat oily fish in moderation with a maximum of 2 portions a week as oily fish can contain low levels of pollutants that can build up in the body. For guidance on how much and which type of fish you can eat, see table below.

*A portion = 140g
**Fresh tuna is classed as an oily fish but canned tuna is classed as a white fish because the oils are lost in the canning process

Omega-3 fatty acids are good for a baby's development. So remember, don't give up eating oily fish (1-2 portions a week is great) but don't eat more than the recommended maximum. If you don’t eat oily fish you could try to look out for products fortified with omega-3 DHA, such as eggs. If you decide to take a supplement make sure that the supplement is suitable for pregnant women, as some fish oil supplements contain a high amount of vitamin A (such as cod liver oil), which you should avoid during pregnancy.

Calcium

Calcium is really important for the growth and development of your baby’s bones and helps to maintain your bones.

Did you know? Calcium demands on the mother are high during the latter stages of pregnancy and during lactation. The skeleton of full-term infants contains 20–30 g of calcium, most of which is accrued during the last trimester of pregnancy. Nature is a clever thing and your body adapts so that it can absorb more calcium from the food you eat.

Dairy foods, such as milk, cheese and yogurt, are a great source of calcium so try to include these in your diet. Try to select low fat products, such as semi-skimmed milk and reduced fat cheese, where possible; they are still a great source of calcium. If you do not eat dairy foods, calcium can also be found in other foods, for example:

• calcium-fortified soya and dairy-free alternatives (check the label)
• calcium-fortified breakfast cereals (check the label)
• canned oily fish with soft bones (such as canned sardines or pilchards)
• some dark leafy green vegetables (such as kale, rocket, pak choi and watercress)
• Some nuts and seeds – including almonds, brazil nuts, hazelnuts and sesame seeds

Recipes

Spinach, chickpea and aubergine curry with brown rice

Leafy green veg like spinach are a good source of folate. Whether you are a meat eater, vegetarian or vegan this folate-rich recipe is nutritious and delicious.
Remember that, even though recipes like this are a good source of folate, it is still important to keep taking your folic acid supplements through to week 12 of your pregnancy.

Serves 2

Ingredients

• 500 g fresh spinach , chopped (alternatively use frozen spinach, defrosted beforehand or drained canned spinach)
• 1 tbsp vegetable oil
• 1 medium red onion, chopped
• 1 can of chickpeas, drained and rinsed
• 1 clove of garlic, finely chopped
• 1 tsp ground coriander
• 1 tsp ground cumin
• 1 small aubergine, cut into small cubes
• 400 g canned chopped tomatoes
• 125 g brown rice (uncooked weight)
• Black pepper to season, if required

Method

1. Set the brown rice to cook according to the instructions on pack.
2. Heat the oil in a large pan and cook the onion, chickpeas, garlic and spices for 5 minutes over a medium heat.
3. Add the aubergine and cook for 10 minutes until the aubergine is coloured.
4. Add the tomatoes and spinach and then cover the pan, lower the heat and simmer for 15 minutes until the aubergine is soft. Taste and add black pepper to season if you need it.
5. Serve with the rice.

 
Baked oriental salmon

When it comes to getting both your essential fatty acids and Vitamin D, oily fish provides two for the price of one. Remember not to overdo it though – pregnant women should have no more than 2 portions (weight 140g) of oily fish per week.

Serves 2

Ingredients

• 2 salmon fillets
• 2 tbsp chopped fresh root ginger
• 1 small onion, finely chopped
• 2 tbsp chopped fresh coriander
• 2 tbsp chopped fresh chives
• 2 tbsp reduced salt soy sauce
• 2 tbsp sesame oil
• 200 g rice
• 1 medium head of broccoli

Method

1. Preheat the oven to 200C/400F/Gas 6.
2. Put the rice on to cook according to the instructions on pack.
3. Take two pieces of foil approx 30cmx30cm and place one of the salmon fillets, skin side down, in the centre of each one.
4. Sprinkle over the chopped ginger and herbs and drizzle on the soy sauce and sesame oil.
5. Bring the sides of the foil up and crimp them together to make a sealed parcel for each salmon fillet.
6. Cook in the oven for 10-15 minutes until cooked through.
7. Meanwhile, chop the broccoli and boil or steam until just cooked.
8. Serve the broccoli and rice onto a plate or bowl and place the salmon straight from the parcel on top so that the juices flow over the dish.

Beef recipes

Red meat such as beef is a great source of iron. Choose lean cuts of red meat.

We have 2 recipes for you to try.

Hoi Sin and garlic beef noodles

Serves 2

Ingredients

• 1 tbsp vegetable oil
• 250g rump steak, trimmed of fat and thinly sliced
• 1 green pepper, sliced
• 150g mushrooms, halved
• 200g broccoli, chopped
• 120g Hoi Sin and garlic stir-fry sauce
• 200g noodles

Method

1. Heat the oil in a wok or large frying pan over a high heat. Stir-fry the beef for a few minutes and then set aside.
2. Stir-fry the pepper for three minutes. Add the mushrooms and cook for a couple more minutes. Add the broccoli and a splash of water, cover and cook until the broccoli is tender and the water has evaporated.
3. Meanwhile, cook the noodles according to the instructions on pack.
4. Stir in the sauce and return the beef to the pan. Warm through and serve with the noodles.

Beef and bean cottage pie with sweet potato mash

Ingredients

• 1 tbsp vegetable oil
• 1 onion, finely chopped
• 1 clove of garlic, finely chopped
• 1 large carrot, peeled and diced
• 1 stick of celery, diced
• 150g lean minced beef
• 1 tbsp of tomato puree
• 1 can of cannellini beans
• 1 reduced salt beef stock cube, made up with 200ml water
• 1 bay leaf
• 1 tsp mixed herbs
• 1 medium sweet potato (approx 200g), peeled and cubed
• 1 medium potato (approx 160g), peeled and cubed
• 50ml semi-skimmed or 1% milk
• 1 tbsp of reduced fat spread
• 50g grated mature cheddar cheese (you could try using reduced fat cheese)
• 200g frozen peas

Method

1. Pre-heat the oven to 200oC.
2. Heat a pan, add the vegetable oil and fry the onions and garlic for 2-3 minutes on a low heat until softened.
3. Turn up the heat and add the mince and fry for about 5 minutes until browned.
4. Add the carrots and celery and fry for a further 2-3 minutes.
5. Add the beef stock, tomato puree, bay leaf and mixed herbs and bring to the boil, reduce the heat and simmer for 15 minutes.
6. Meanwhile, boil the potatoes and sweet potatoes together in a pan for about 10 minutes, or until soft.
7. Drain and mash the potatoes and sweet potatoes together with the milk and low fat spread. Season to taste.
8. Spoon the mince mixture into an oven proof dish and top with the mashed potato and grated cheese.
9. Bake in the oven for 20 minutes or until the topping is beginning to brown.
10. Boil the frozen peas for about 2 minutes and serve with the cottage pie.

 For more information on the sources used in this text, please contact postbox@nutrition.org.uk

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