How to maintain a healthy diet during pregnancy

Maintaining a healthy diet during pregnancy is crucial for both you and your developing baby. Although a special diet is not necessary, consuming a variety of foods ensures a balanced intake of nutrients. This guide, provided by esteemed consultant in obstetrics and maternal and foetal medicine, Dr Panicos Shangaris, gives advice on maintaining a healthy diet and highlights foods to avoid during pregnancy.

Essential nutrients and supplements

Folic acid: Essential for reducing the risk of neural tube defects like spina bifida. A daily intake of 400 micrograms is recommended from before conception until the 12th week of pregnancy. Women at higher risk may need 5 milligrams and should consult their GP if they have a family history of neural tube defects, a previous pregnancy affected by these defects, diabetes, or are on anti-epilepsy or anti-retroviral medication.

Vitamin D: Vital for regulating calcium and phosphate levels, supporting healthy bones, teeth, and muscles. A daily intake of 10 micrograms is recommended, especially between September and March when sunlight exposure is limited. Sources include oily fish, eggs, red meat, fortified breakfast cereals, fat spreads, and non-dairy milk alternatives. Avoid exceeding 100 micrograms (4,000 IU) daily.

General guidelines: Avoid supplements with vitamin A, as excessive vitamin A (retinol) can harm your baby. Steer clear of supplements and foods rich in vitamin A, such as liver and cod liver oil.

Dietary guidelines

Balance and variety: You do not need to "eat for two." Focus on a balanced diet with various foods from different food groups. The Eatwell Guide can help you understand the proportions of different food groups you should consume.

Healthy breakfast: Start your day with a nutritious breakfast to avoid snacking on unhealthy foods.

Detailed food group breakdown

Fruits and vegetables: Provide essential vitamins, minerals, and fibre, aiding digestion and preventing constipation. Aim for at least five portions a day, including fresh, frozen, canned, dried, or juiced forms, and wash fresh produce thoroughly.

Starchy foods (carbohydrates): Provide energy, vitamins, and fibre, helping you feel full without excessive calories. Sources include bread, potatoes, breakfast cereals, rice, pasta, noodles, maize, millet, oats, yams, and cornmeal. Opt for whole grain or higher-fibre options like whole-wheat pasta and brown rice.

Protein: Crucial for your baby's growth and development. Sources include beans, pulses, fish, eggs, meat, poultry, and nuts. Choose lean meats, remove skin from poultry, avoid adding extra fat or oil, and cook thoroughly. Eat two portions of fish weekly, including one portion of oily fish like salmon, sardines, or mackerel, but limit oily fish to two portions a week to avoid pollutants. Avoid high-mercury fish and raw or partially cooked eggs unless produced under the British Lion Code of Practice.

Dairy: Provides calcium and other essential nutrients. Sources include milk, cheese, fromage frais, and yoghurt. Choose low-fat varieties and if using dairy alternatives, opt for unsweetened, calcium-fortified versions. Avoid unpasteurized cheeses to prevent listeriosis.

Foods high in fat and sugar: Can lead to weight gain, increased cholesterol, and a higher risk of heart disease. Limit intake and opt for healthier snacks like fruits, vegetables, and wholegrain cereals.

Foods to avoid

Avoid high-mercury seafood, raw or undercooked seafood, undercooked meat, poultry, and eggs, unpasteurized dairy, unwashed fruits and vegetables, excessive caffeine, certain herbal teas, and alcohol to prevent risks like miscarriage and foetal alcohol syndrome.

Healthy snacks

Opt for nutritious snacks between meals, such as small sandwiches or pitta bread with lean fillings, salad vegetables, low-fat, lower-sugar yoghurt or fromage frais with fruit, ready-to-eat dried fruits like apricots, figs, or prunes, vegetable and bean soups, a small bowl of unsweetened cereal or porridge, fresh fruit, baked beans on toast or a small baked potato, and a small slice of malt loaf, fruited tea cake, or toasted fruit bread.

Safe food preparation

Practice hygiene by washing fruit, vegetables, and salads thoroughly, use separate utensils and chopping boards for raw meats and ready-to-eat foods, store raw foods separately from ready-to-eat foods, ensure food is cooked thoroughly and reheated until steaming hot, and check use-by dates, avoiding food past these dates.

Insights from research on maternal diet quality

Research underscores the importance of maintaining a high-quality diet throughout pregnancy and beyond. Many women do not meet dietary guidelines during pregnancy, adversely affecting fetal development and long-term health. Factors associated with poor diet quality include smoking, low educational attainment, unemployment, and single-marital status. Diet quality tends to remain stable from pregnancy to postpartum, highlighting the need for early dietary interventions.