Concentrating all your efforts on nutritious foods for the healthy development of your baby can easily become your number one priority when pregnant, but don’t neglect your own health in the meantime. It is quite common for mums-to-be to experience morning sickness, eczema, diabetes and low mood during pregnancy. To avoid these health issues, you really need to focus on a healthy balanced diet, with nutrient-dense foods for both you and your developing baby. Calorie consumption during pregnancy is surprisingly not much higher than usual, only around 200 kcal in the last trimester. In contrast, nutritional requirements are around 1.5 times for many vitamins and minerals.
Eating everything you lay your eyes on when pregnant may seem a good idea when listening to your body’s cravings; in reality, however, our bodies do not always crave the foods we need for good health. If you start craving crisps and biscuits during pregnancy, or in fact at any time in your life, this does not translate to satisfying nutritional requirements. This is possibly one of the worst choices women make during pregnancy; when eating for two, it may seem a good idea to say yes to all foods, including the sugary kind. The reality is that your body requires extremely nutrient-dense foods during pregnancy, certainly not empty calories. Empty calories are considered to come from foods which provide calories but very little or no nutritional benefit, such as sweets, cakes and biscuits.
Pregnancy is a wonderful experience for the majority of women, but it does not come with no downside. The first 3 months are most commonly associated with morning sickness, ranging from mild nausea for some women, to vomiting and weight loss for others. Nausea and vomiting can prevent adequate nutritional intake during this precious time in which a significant amount of essential development occurs. Fear not, there are many tactics to reduce feelings of nausea.
Later on during pregnancy, often in the last 2 trimesters, dry skin, brittle nails and even eczema may present. Low mood during pregnancy, and post natal depression may also be linked with fatty acid deficiencies, which are required for proper brain functioning. A low protein intake, which may be a result of nausea reducing dietary intake, can also contribute to low mood and depression..
If, during pregnancy and most commonly in the last trimester, you experience extreme thirst and frequent urination, you may be suffering from type 2 diabetes, known as gestational diabetes when it occurs during pregnancy. This is not permanent, but it should be acknowledged where possible.
Causes of nausea, dry skin and gestational diabetes
Nausea or vomiting during pregnancy (known as morning sickness, but can be experienced at any time of day) is due to the increase in hormones, including oestrogen and progesterone. It may seem like a signal that something is wrong, but you can rest at ease knowing that this is fairly common and perfectly normal. The body’s senses are extremely heightened during pregnancy, a sensible mechanism to warn the body of any potential dangers to your developing baby. If food is slightly off, your heightened sense of smell is most likely to make you turn your nose up at food which is not at its best.
Dry skin, brittle nails and eczema are often a sign that your developing baby is taking the fatty acids such as omega-3 that it needs from your body, therefore your current diet may not be sufficient for both of you. Your baby will generally get what it needs as long as your diet is reasonably healthy, although this may result in you suffering as a result.
Gestational diabetes is at increased risk if you have a BMI over 25 (overweight) at the start of your pregnancy, if you are inactive or if you smoke. (1) Poor dietary choices throughout pregnancy can also affect your ability to balance blood sugars, also associated with increased risk of gestational diabetes. (1) A poor diet consisting of refined carbohydrates including white bread, chips, crisps and other refined carbohydrate foods will impose an additional strain on your body which may eventually lead to gestational diabetes.
You can still continue exercising during pregnancy, although it may not be advised to take part in extreme contact sports which pose a risk to your unborn baby. Exercises such as swimming, fast walking and yoga are perfect when pregnant. It is still possible to continue with weight training if practised with caution, particularly in the first trimester when you do not want to exert your body because of the risk of miscarriage.
It is generally advised that alcohol is completely avoided during pregnancy, given the well documented adverse effects. Alcohol, even in the very early stages of pregnancy, can have a significant impact, resulting in foetal abnormalities. Alcohol consumption also increases risk of miscarriage. There is no considered safe level of alcohol during pregnancy; although some advise that one drink per day may be ok, 4 alcoholic drinks per week has been associated with a significant increased risk of miscarriage (2), so the odd drink throughout the week may not be worth the risks associated.
The immune system is weakened during pregnancy, bringing increased risk of food poisoning. This is the reason for caution against certain foods which may be at high risk of contamination. Ensure that you keep raw meats separate from other foods at all times, and make sure that you wash your hands thoroughly when handling raw meat because of this risk of infections.
When preparing fruit and vegetables, ensure that they are scrubbed clean of any dirt to reduce risk of toxoplasma, a parasite found in soil which can cause toxoplasmosis, which may harm your unborn baby. This parasite can also be found in the stools of cats (if they have not had flea/parasite preventative medication), so be careful when cleaning out cat litter trays.
A general rule of dietary advice during pregnancy is to not do anything extreme. If you already eat quite well, you do not need to significantly change your diet or cut out food groups. Obtaining a balanced diet from a range of different foods will widen your intake of important nutrients for you and your developing baby.
You may find in the early stages of pregnancy that you are very sensitive to strong foods as your sense of smell will be heightened. As a result, you may wish to stick to simpler foods if you feel certain flavours are too much, or if you feel nauseous. If you can’t handle the strong flavour of mackerel, for example, try substituting with white fish and then move on to salmon or trout. Foods such as rice cakes, oat cakes and rye crackers are sometimes all that you may be able to manage when feeling nauseous; combine these with something easy to eat such as mashed avocado or cottage cheese. Keep drinking separate from eating to optimise the functioning of your digestive system when feeling nauseous. Consider liquid supplements including a protein powder, essential fats and liquid multivitamin if you are really struggling to keep food down.
Food and drinks to avoid
- Caffeine (in moderation is ok, i.e. 1 tea / coffee per day)
- Unpasteurised soft cheeses such as feta, brie and blue cheeses due to high risk of listeria bacteria infection (note: soft cheese made from pasteurised milk is fine to include)
- Cold meats, raw meat, pate (high risk of toxoplasmosis parasite)
- Uncooked eggs which have not been pasteurised (although rare, salmonella can increase risk of miscarriage)
- Large fish such as swordfish (due to methyl-mercury content and other toxic contaminants)
- Liver (due to vitamin A toxicity). Can be eaten very occasionally, i.e. once per month
Foods to optimise brain development
Optimising foetal brain development is often high on the priority list for mums due to the huge impact diet can have on brain health. The brain structure is mostly made up of omega-3 DHA and omega-6 AA. We generally obtain plenty of omega-6 AA in our diets, especially if we are eating meat and eggs, however omega-3 DHA is commonly deficient in our diets. Omega-3 DHA is one of the beneficial fatty acids found in oily fish, and the reason oily fish is an excellent addition to your diet during pregnancy.
Although oily fish is essential for optimising brain development, it is wise to be aware of the contaminants and heavy metals such as methyl mercury contained in fish. Limits on fish consumption during pregnancy are solely due to the fact that toxins found in fish may cause harm to your baby if eaten in excess. The majority of toxins found in fish are actually man-made chemicals leaked into the sea. To reduce your intake of contaminants while obtaining a good intake of omega-3 fatty acids, it is best to eat smaller fish. As larger fish eat smaller fish, then the larger the fish the higher the levels of toxins. Oily fish such as anchovies, mackerel and herring are ideal. Please don’t be put off by small levels of contaminants, as the health benefits of including fish in your diet during pregnancy far outweigh any risks of very low levels of contaminants. Our world today is full of toxic chemicals, but thankfully we have our wonderful livers to filter them out to help keep us healthy.
Omega-3 DHA helps to build your baby’s developing brain structure, improves visual and cognitive function (3) and may also help to reduce risk of allergies, which are becoming increasingly common amongst young children. There is no single food that stands out as having a significant impact on the risk of allergies for your baby, however a Mediterranean-type diet rich in fruits, vegetables and fish is associated with a lowered risk of allergic disease in infancy. (4)
If you are finding it difficult to get enough oily fish in your diet, you may want to consider purified omega-3 EPA and DHA fish oil. The ability to purify fish oils results in a very clean oil free from heavy metals and contaminants, meaning that you can put your mind at rest when it comes to risk of toxicity.
Taking a concentrated high dose fish oil supplement will not only help to support your baby’s brain development, but it will also help to prevent dry skin and pregnancy-prone eczema. In addition, you may also want to include evening primrose oil which provides GLA, a specific and beneficial type of omega-6 fatty acid, and triterpenes, antioxidants particularly beneficial for dry skin. (5) Omega-3s EPA and DHA and omega-6 GLA will also keep your skin supple during pregnancy, therefore possibly reducing development of stretch marks – a bonus for your own body to help you feel good about yourself! Pharmepa MAINTAIN is a perfect option for pregnancy as it contains concentrated sustainable wild anchovy oil, certified free from contaminants combined with organic evening primrose oil.
Taking a good all-round pregnancy-specific multivitamin is also a good idea for all mums to ensure that you are taking in basic requirements of all vitamins and minerals. One of the most well-known vitamins to include at higher levels during pregnancy is folate, or folic acid, to reduce risk of birth defects. 400µg of folate or folic acid should be provided in all pregnancy supplements. Iron is also required in much higher doses during pregnancy due to increased blood volume. Note that iron in high doses is actually toxic, so more is not always better. Vitamin A can also be toxic in high doses so don’t take high dose antioxidant supplements containing vitamin A. A safer option is to include the antioxidant beta-carotene which is safely converted to vitamin A in the body when your body needs it, and therefore cannot be toxic. B vitamins will most likely be included in a multivitamin; taking additional vitamin B6 has actually been shown to reduce nausea (6), so is worth considering if you are prone to this.
(1) Zhang C, Tobias DK, Chavarro JE, Bao W, Wang D, Ley SH, et al. Adherence to healthy lifestyle and risk of gestational diabetes mellitus: prospective cohort study. BMJ 2014;349:g5450.
(2) Avalos LA, Roberts SC, Kaskutas LA, Block G, Li DK. Volume and type of alcohol during early pregnancy and the risk of miscarriage. Subst Use Misuse 2014 Sep;49(11):1437-45.
(3) Brenna JT, Carlson SE. Docosahexaenoic acid and human brain development: evidence that a dietary supply is needed for optimal development. J Hum Evol 2014 Dec;77:99-106.
(4) Netting MJ, Middleton PF, Makrides M. Does maternal diet during pregnancy and lactation affect outcomes in offspring? A systematic review of food-based approaches. Nutrition 2014 Nov;30(11-12):1225-41.
(5) Kawamura A, Ooyama K, Kojima K, Kachi H, Abe T, Amano K, et al. Dietary supplementation of gamma-linolenic acid improves skin parameters in subjects with dry skin and mild atopic dermatitis. J Oleo Sci 2011;60(12):597-607.
(6) Matok I, Clark S, Caritis S, Miodovnik M, Umans JG, Hankins G, et al. Studying the antiemetic effect of vitamin B6 for morning sickness: pyridoxine and pyridoxal are prodrugs. J Clin Pharmacol 2014 Dec;54(12):1429-33.