Healthy eating during pregnancy

Eating well during pregnancy is simple. In fact, most women won’t need to make any significant dietary changes when they conceive. That said, some changes are highly recommended. We discuss these and more in the following article.

Why is diet important during pregnancy?

Eating well during pregnancy is essential, as your body is providing your unborn baby with everything it needs to develop: proteins, good fats, sugars, vitamins, and minerals. For this reason, your energy and nutrient requirements are greater during pregnancy. Plus, a pregnant woman who eats well has a better chance of having a healthy baby.

A healthy diet is also important for the mother. Pregnant women who eat well usually experience less fatigue and have fewer energy crashes. They’re generally healthier, and are therefore more likely to have a smooth pregnancy. They’re also less likely to suffer from gestational diabetes, and can manage the condition more easily if it does develop.

In addition, they have an easier time gaining the recommended weight (without exceeding it) and returning to their pre-pregnancy weight after giving birth.

Tips for eating well during pregnancy

To meet your nutritional needs and those of your unborn baby, it’s important to do the following:

• Eat three meals a day and listen to your body’s hunger cues. Plan each meal according to the plate shown in Canada’s food guide.
• Have two or three snacks a day if you feel hungry. For example, a snack may be a piece of fruit, a small bowl of yogurt or applesauce, a glass of milk, or a handful of almonds.
• Eat a balanced diet that includes vegetables, fruit, whole grains, and protein-rich foods. Make sure the food on your plate is varied and colourful as the days go by.
• Eat regularly. Eating at regular intervals prevents your energy levels from dropping during the day, as your blood sugar (also called glucose) levels are kept stable. Try to not go more than 12 hours without eating.
• Avoid unnecessary deprivation and dieting. It might hinder your baby’s development and make you tired.
• Avoid highly processed foods, which usually have too much fat, sugar, and salt.
• Drink water when you feel thirsty.
• Follow precautionary measures to avoid foodborne infections such as listeriosis and toxoplasmosis. To learn more about these two infections, consult our fact sheet, Pregnancy and foodborne illnesses: Listeriosis and toxoplasmosis.

Is it necessary to eat for two during pregnancy?

“Eating for two” during pregnancy doesn’t mean eating twice as much, but twice as well. While it’s true that you need to consume more calories during pregnancy, the difference is small. Above all, pay attention to the quality of the food you eat. Remember, every meal should be varied and colourful.

Pregnant women need more calories at the end of their pregnancy than at the beginning. Daily calorie requirements increase by up to 100 calories in the first trimester, 340 calories in the second trimester, and 450 calories in the third trimester.

Since calorie requirements increase very little at first, you may not feel the need to eat more until you’ve been pregnant for several weeks. Don’t force yourself to eat more. The important thing is to choose foods that are varied and as fresh as possible.

However, your vitamin and mineral requirements are very high in early pregnancy. In fact, “making a baby” requires at least 50 nutrients, such as iron, folic acid, calcium, and vitamin B12. Yet another reason why a healthy diet is so important!

What and how much should you eat during pregnancy?

Canada’s food guide provides guidelines on healthy eating. It’s a good guide to follow before, during, and after pregnancy.

Canada’s food guide is easy to use, as it clearly illustrates what a balanced meal looks like. On the website, you’ll see a plate divided into three food categories. Vegetables and fruits make up half the plate. The second half is composed of whole grain and protein foods (e.g., legumes, nuts, seeds, eggs, meat, fish, and dairy products). The guide demonstrates that a healthy diet is mainly composed of produce and other plant-based foods.

It does not recommend any specific amounts or serving sizes. Rather, it emphasizes that each person must learn to recognize when they feel hungry and full to know how much food to eat.

For advice specific to pregnancy, you can check out Health Canada’s The Sensible Guide to a Healthy Pregnancy.

Fruits and vegetables

Fruits and vegetables should account for about half of the food you eat each day. For one, they contain many essential nutrients (e.g., minerals, vitamins, fibre) and water.

Plus, fruits and vegetables add colour, flavour, and crunch to your meals. During pregnancy, these low-calorie foods help expectant mothers gain the recommended amount of weight without exceeding it.

You should ideally be eating vegetables of different colours throughout your pregnancy: green (broccoli, spinach, romaine lettuce, green beans), orange (carrots, winter squash, sweet potatoes), purple (beets, eggplant), white or beige (mushrooms, parsnips, potatoes), and more. To better preserve their nutritional value, it’s best to steam or bake vegetables that you don’t eat raw, or sauté them in a little olive or canola oil.

Wash fruits and vegetables thoroughly with a brush under running water to rinse away any pesticides and microorganisms that may be present. If you can, buy some organic produce, especially fruits and vegetables that tend to contain high amounts of pesticide residues when grown with conventional agriculture. Every year, the Environmental Working Group publishes an annual ranking of the 12 most contaminated and 15 least contaminated fruits and vegetables. Of course, the important thing is to eat lots of fruits and vegetables, whether they’re organic or not.

To save money, opt for seasonal and local produce. You can also buy them frozen or canned (without added salt). Finally, choose whole fruit over juice, which contains too much sugar and not much fibre. Furthermore, juices aren’t very filling.

Whole grain foods

Whole grain foods include grains and grain products, such as bread, pasta, rice, quinoa, oatmeal, homemade muffins, and more. They should make up about a quarter of your plate at mealtimes.

Try to choose whole grain products, as they provide more energy and are rich in vitamins and minerals. In addition, the fibre they contain facilitates digestion, helps prevent constipation, and feeds the good bacteria in your digestive system.

While cookies and pastries are sources of grains, they contain a lot of fat and sugar and are usually made from white flour, so they should be eaten in moderation. If you want, make healthier versions of these goodies to control the quality and quantity of the ingredients.

Protein foods

This food group includes: legumes like chickpeas and lentils, tofu, eggs, nuts, seeds, peanut butter, meats like beef and chicken, fish like salmon and sardines, milk, soy milk, cheese, and yogurt.

These should make up about a quarter of your plate at each meal. Prioritize plant-based foods such as legumes.

This food category not only contains protein, but also healthy fats (in fish) and numerous vitamins and minerals, including calcium, vitamin D, and vitamin B12.

Oils and fats

To integrate different types of fat into your diet, use at least two different oils when you cook. For example, use olive oil in salad dressings and canola oil when you sauté food. You can also use butter in moderation.

Fish and mercury: Recommendations

Most fish available in grocery stores does not pose a health risk to pregnant women. However, certain types of fish may contain contaminants, such as mercury. Mercury can cause damage to a baby’s brain.

Women who are pregnant or planning to become pregnant and those who are breastfeeding should limit their consumption of the following:

• Fresh or frozen tuna, shark, swordfish, and marlin (up to 150 g per month).
• Canned albacore tuna (up to 300 g or about two 170 g cans per week). Note that this information doesn’t apply to canned light tuna, which is of a different variety and safe for pregnant women.

The following fish and seafood can be safely consumed without restriction during pregnancy: Trout (except lake trout), haddock, canned light tuna, sole, mackerel, sardines, char, herring, salmon, plaice, smelt, anchovies, pollock, tilapia, cooked oysters, mussels, clams, scallops, crab, shrimp, and lobster.

If you eat freshwater sport fish, consult the Government of Quebec’s guide to eating freshwater sport fish (link in French). Certain species may contain contaminants.

What foods should pregnant women avoid?

Eating certain foods during pregnancy can be risky for the expectant mother and her unborn baby (e.g., miscarriage, preterm birth, infections). If you’re pregnant, it’s best to avoid the following foods:

• Raw or barely cooked eggs and any foods that contain them (e.g., homemade Caesar salad dressing).
• Unpasteurized dairy products (e.g., milk, cheese made from raw milk).
• Soft cheeses (e.g., Brie and Camembert) and semi-soft cheeses (e.g., Saint-Paulin), as well as blue, feta, and creamy goat cheeses, even if they’re made from pasteurized milk, as they can also spread listeriosis.
• Unwashed fresh fruits and vegetables.
• Raw fish and seafood, including shellfish and molluscs (e.g., oysters, clams). Sushi, sashimi, tartare, and ceviche containing raw fish should also be avoided, as well as smoked fish if not cooked or reheated (e.g., smoked salmon).
• Undercooked meat, poultry, fish, or seafood, including unheated hot dogs or smoked sausages.
• Uncured deli meats, sliced prepared meats (e.g., ham for sandwiches), and refrigerated pâtés and meat spreads.
• Liver (although it’s an excellent source of iron, it contains too much vitamin A).
• Raw sprouts, such as alfalfa and bean sprouts.
• Ready-to-eat foods prepared and displayed in a grocery store (e.g., pasta salads, cooked chicken).
• Unpasteurized fruit or vegetable juices (e.g., apple cider), unless they’re freshly squeezed by hand or made with an extractor and consumed immediately.
• Kombucha.
• Alcohol. For more information, read our fact sheet, Alcohol use during pregnancy.

To learn more about restrictions related to drinking coffee, tea, herbal teas, soft drinks, and energy drinks, please see our fact sheet, Pregnancy: Coffee, Tea, and Herbal Teas.

Diet products and sugar substitutes

Sugar substitutes make foods taste sweeter without adding calories. Pregnant women need energy, so there’s no need to replace sugar with sweeteners, except in cases of diabetes or if recommended by a nutritionist.

Sugar substitutes added to diet products and soft drinks are harmless in small quantities. These include sucralose (Splenda®), aspartame (NutraSweet®, Egal®), and acesulfame potassium (Ace-K or Sunett®). However, they’re generally added to foods with poor nutritional value that have few dietary benefits, so it’s best to limit your intake of these products.

Sweeteners in powder or tablet form, such as cyclamate, should be avoided (e.g., Sucaryl®, Sugar Twin®, Sweet’N Low®, Weight Watchers® Table Top Sweetener).

Vegetarianism and veganism during pregnancy

If you’re a vegetarian or vegan, you can maintain your usual diet throughout your pregnancy. However, for your health and the health of your unborn baby, pay special attention to your intake of iron, vitamin B12, vitamin D, calcium, and omega-3. Don’t hesitate to consult a nutritionist to help you plan your vegetarian or vegan diet.

Since vitamin B12 is found almost exclusively in foods of animal origin, make sure you eat foods that are rich in vitamin B12 every day, such as eggs, dairy products, and fortified foods (meat alternatives or fortified soy beverages). If you’re vegan, discuss your diet with your prenatal care provider. They may prescribe a supplement to prevent vitamin B12 deficiency.

During pregnancy, you need to consume more iron than usual, and your risk of anemia is also higher. Be aware, however, that the iron in meat is absorbed more easily than the iron in vegetables and fortified foods (e.g., legumes, cereal, pasta, spinach).

To make it easier for your body to absorb iron, eat a vitamin C-richfood (e.g., citrus fruits, broccoli, strawberries, melons, peppers) at each meal. For example, you can add peppers to a spinach and white bean salad and have a kiwi for dessert. For breakfast, you can have peanut butter on toast and an orange. To avoid deficiencies, your health care provider may prescribe an iron supplement for the second and third trimesters. Discuss this option together.

What to do if you don’t have an appetite

You may experience low appetite during pregnancy. Lack of appetite may be triggered by fatigue or hormones, but the most common cause is nausea.

When you don’t have much appetite, pay attention to your hunger cues to know when and how much to eat. Don’t force yourself to eat unless you experience prolonged appetite loss.

If you’re hungry but don’t have an appetite because you’ve developed a heightened sense of smell or food aversion, simply eat whatever nutritious foods are appetizing. When in doubt, consult Canada’s food guide for advice. Don’t worry—missing one meal or fasting for a day won’t put you or your baby’s health at risk.

To learn more about how to reduce the frequency and severity of nausea, check out our fact sheet, Nausea and vomiting during pregnancy.

Financial difficulties during pregnancy

If you have a low income, you may be eligible for a food assistance program. Contact the Integrated Health and Social Services Centre (CISSS) in your area (formerly known as a CLSC). Thanks to the OLO program, underprivileged pregnant women can receive essential food for free (one egg, one litre of milk, and one glass of orange juice per day). These foods are sufficient to meet many of the unborn baby’s needs in terms of protein, calcium, and vitamins C and D. The program also offers daily multivitamin supplements.

The Montreal Diet Dispensary also helps women in financial difficulty. The organization offers underprivileged pregnant women in Montreal regular follow-ups with a dietician to increase their chances of giving birth to a healthy baby. The women also receive free milk, eggs, and multivitamin supplements.

Things to keep in mind

• Eating well during pregnancy is important for both the mother and her baby.
• During pregnancy, you should eat a balanced diet that includes vegetables, fruit, whole grains, and protein-rich foods while respecting your hunger cues.
• Some foods should be eaten in moderation during pregnancy, while others should be avoided altogether.

Scientific review: Stéphanie Côté, M.Sc., Nutritionist Research and copywriting: The Naître et grandir team Updated: April 2019

Photos: GettyImages/Drazen_, mihailomilovanovic, Jorn Georg Tomter, Dejan_Dundjerski and Barcin