Eating for two doesn’t mean eating more, it means eating better

Pregnancy Nutrition_StocksyDo’s and Don’ts

Often we hear about the don’ts – don’t eat undercooked meat, sushi and unpasteurized juices and cheeses – but what about the do’s? In my opinion – and in our current “food-like substance” food supply – telling an expectant mother to “eat a varied, balanced diet” is not enough. We’ve all heard the saying “you are what you eat,” but at no other time is it more important than during pregnancy. In fact, your baby is what you eat.


Eating for Two?

As women, many of us spend a good deal of our lives trying to keep our weight at bay. So when the numbers quickly creep up during pregnancy, it can be a lot to take in. Let’s not forget that blood volume increases by about 60% during the course of pregnancy – that’s a lot of extra fluid! And a healthy pregnancy includes fat gain. Women at a healthy pre-pregnancy weight should expect to gain between 25-35 pounds – more for underweight, less for overweight. This may sound like a lot, yet it only takes about 300 extra calories per day during the 2nd and 3rd trimesters. In terms of caloric intake, by no means does pregnancy lend a reason to “eat for two.” But it’s important to think beyond the calories, and consider the nutrients and phytonutrients that will keep mom healthy and serve as the building blocks for the tiny human being growing inside.


Quality, Not Quantity

The standard American diet is packed with empty calories and simple sugars, which contributes to the growing incidence of gestational diabetes and sets the stage for a life of struggles with overweight for both mother and baby. It’s also devoid of crucial vitamins and minerals needed to build healthy fetal tissues. And food is more than just calories, it’s information. Research on nutrigenomics suggests that what we eat even before conception impacts methylation status, turning certain genes on and off, thereby bestowing a mother with the power to flip the switches of her baby’s genetic destiny. So what’s a mother to eat?


The 3 Ps and Omega-3s

In a perfect world, a pregnant woman would eat only nutrient-packed, organic, whole foods to nourish her and her growing babe. Beyond the standard recommendations for a well-balanced, whole-foods based diet, there are four mainstays to pregnancy nutrition which I call the “3 Ps and omega-3s” – plants, protein, probiotics and omega-3s.


Plant foods like fresh vegetables, fruits and whole grains should be the foundation of the diet. They provide all-star prenatal vitamins, minerals and phytonutrients like folate for preventing neural tube defects, iron to sustain the increased blood volume, calcium for bone formation and fluid regulation, and vitamin C for tooth and bone development. They also offer a steady supply of fiber which is crucial to maintaining healthy digestion during this constipation-prone time.


Protein should be top of mind during this period of tissue development, because it determines fetal growth. In fact, a mother who’s eating adequate calories but inadequate protein can gain plenty of weight herself but end up with a low birth weight baby. Inadequate intake can also contribute to swelling. Good sources are beans, legumes, nuts and seeds, poultry, lean meats, dairy and fish.


With over 70% of the immune system located in the gastrointestinal tract, a healthy gut helps fight colds, flus and other threats to an already weakened immune system. Baby gets his first inoculation from mom’s gut microflora upon conception and during the passage through the birth canal. Some evidence shows this first exposure is what sticks with the child for life, so it’s worth establishing a healthy gut in mother before the baby is born. Fermented foods such as Greek yogurt, kefir, kimchi and sauerkraut are excellent probiotic foods. And the plant foods mentioned earlier serve as crucial prebiotics to feed these healthy “bugs.”


The standard American diet is already greatly lacking in anti-inflammatory omega-3s and brimming with inflammatory fats, and pregnancy is a time of even greater need for DHA – the omega-3 that contributes to brain development. While plant foods such as flax seeds and walnuts provide a precursor to DHA, the conversion is slow and inefficient, so marine sources are necessary.


Fish is an infamous food during pregnancy. Many expectant mothers avoid it for fear of mercury and other toxins, parasites (as with raw fish), and just simply because of the smell when it’s cooked. But with all that brain development in the growing fetus, fish – especially those high in omega-3 fats – may be one of the most important foods to eat during pregnancy. Supplementation with a highly purified fish oil is wise for those who are unable to regularly consume 12 ounces per week of cold water fish like wild salmon, trout, anchovies and sardines.


Coping with Symptoms

While a well-balanced diet that focuses on the 3 Ps and omega-3s is ideal, it’s not always realistic. Every woman experiences some degree of nausea, food aversions, constipation, bloating and just feeling “off” during pregnancy. So, for many of us, the eating strategy is focused on coping. To make matters worse, the immune system is weaker during pregnancy. As a result, common colds are more likely to turn into more complicated infections like bronchitis or pneumonia. While we all have our remedies, and it goes without saying that eating a nutrient-packed diet is important, these tips can help keep symptoms at bay.



  • Eat small, frequent meals to keep blood sugar stable and prevent nausea from arising.
  • Sip ginger tea or agave sweetened ginger ale and carbonated drinks to settle an upset stomach.

Gas and Bloating

  • Eat small, frequent meals and chew thoroughly to avoid swallowing excess air.
  • Consume a steady intake of fiber to keep things moving. Try prunes and flax seeds regularly.
  • Try avoiding beans and legumes or limit consumption during flare-ups.
  • Maintain a low-impact exercise routine to strengthen the digestive system.

Heartburn and Indigestion

  • Try avoiding spicy foods which can be a trigger.
  • Drink water between meals instead of right before or with meals to maximize digestive juices.
  • Eat smaller, more frequent meals.
  • Avoid laying down right after a meal. Maintain good posture to enhance digestion.


  • Drink water to prevent dehydration, which is often a trigger.
  • Have regular bowel movements to eliminate toxins by eating stool-bulking fiber from fruits and vegetables on a regular basis.


For those times when mom-to-be is just feeling “off” and all else fails, she should do her best to at least stay hydrated. Dehydration can lead to limb deformities, heat exhaustion, muscle-cramping, fatigue and even premature labor. Advise her to continue her prenatal vitamins and get rest to support her body as it works to correct the imbalance.


Making Healthy Choices

No one can prepare you for the changes you’ll experience during pregnancy. I started down this journey 3 years ago and it’s awakened my senses to how expectant mothers are informed. As a dietitian, I’ve doled out plenty of nutrition advice. But it wasn’t until I became pregnant that I realized how confusing this time can be in terms of food choices. Advice comes in tid-bits from doctors – who know surprisingly little about nutrition – magazines, books, mothers, mothers-in-law, and anyone on the street who was pregnant at one time. In a time when numerous body changes happen beyond your control, finding comfort in knowing you’re at least making the best food choices can be the difference between an okay and a truly amazing pregnancy.