A Nutritionist Shares What to Eat When You're Pregnant—and What to Avoid

Updated 05/08/17

From the minute those two blue lines appear on your home test (or the word "pregnant" on some), your whole world turns upside down. For many people, that's when the craziest roller coaster ride they've ever taken begins. It's filled with ups and downs and everything in between, but just like the theme park version, it's also incredibly exhilarating. Nothing compares to that magical feeling of growing a new life inside of you. It is truly a miracle. But as your body changes, so too do your cravings, your mood, and your energy levels.

It goes without saying that your appetite increases now that you're feeding two people, but how much your current diet should change now that you're pregnant is the big question. 

One thing's for sure, the food you put in your mouth now doesn't just impact you anymore. According to Stephanie Middleberg, MS, RD, CDN, founder of Middleberg Nutrition and author of The Big Book of Organic Baby Food, this is when you really need to ramp up your nutrient intake and load up on whole foods (along with plenty of water). With so much noise around what to eat (and what not to), we asked Middleberg to set the record straight. Be sure to scroll to the end for her top supplements and food groups to eat or a healthy (and happy) pregnancy. 

Original Illustration by Stephanie DeAngelis

MYDOMAINE: Being pregnant for the first time (even second, third times) can be daunting for any woman. There are so many things to consider, and your health isn't just about you anymore. What are some of the diet guidelines or food philosophy you advise women to stick to when they discover they're pregnant?

STEPHANIE MIDDLEBERG: This is such an exciting time and can also be incredibly overwhelming, as your decisions don't just impact you. I am often the first (okay, maybe second or third) phone call my clients make as they want to ensure they are on a healthy path. I help weed out the myths and give them a structure during a fairly unpredictable time. This is really a time to start nourishing your body and your baby to be with nutrient dense, whole foods.

I recommend all pregnant woman:

Increase Healthy Fats

This is probably the hardest for moms-to-be and new moms because it seems counterintuitive. But it is really essential for many reasons. It's vital to baby's organ and brain development, YOUR metabolism, absorption of key nutrients like (A, D, E, and K), and future milk supply and quality of your milk. Women should focus on healthy sources like avocado, fish oils, eggs, olive/oil, coconut/oil, nuts, and full-fat dairy (no low-fat foods!).

Focus on Quality

When possible, aim for organic produce (or look at the Dirty Dozen to help choose which fruits and veggies to go organic), grass-fed meats, pasture raised, organic eggs, wild fish (check out Seafood Watch from the Monterey Bay Aquarium for a nice rundown on what fish to select). This can be overwhelming, so control the controllable, meaning I'd rather you eat non-organic produce if you can't find organic options.

Stabilize Blood Sugar

Stay armed with snacks! We often feel nauseous and low energy during pregnancy when really our blood sugar is low. Have a breakfast rich in what I call the two P's: protein and produce. Morning is when our blood sugar is the lowest, and if you start the day with sugar, it can increase your hunger hormone ghrelin, which in turn leads to increased hunger and blood sugar issues during the day. Protein will keep your appetite and energy consistent throughout the day. Good options include eggs, full-fat plain yogurt, and nut butters.

Have a protein/fat with every meal, including your afternoon snack. Think apple with almond butter, crackers with cheese, veggies with hummus, dates with goat cheese.

Foodstock USA

MD: What are the top five supplements we should avoid?

SM: Neither the FDA, nor any other government agency, reviews, investigates or regulates what goes into a vitamin. Meaning when you read that ingredient list, there is no official verifying that what the manufacture says is actually true. Pretty crazy, right?  (Yes there are some third-party verification labels, but, again, the FDA does not regulate this industry). So it is vital that you go with trustworthy brands that go above and beyond what is required of them by the law. If you want to do your own research, check out Consumerlab.

It's basically the only 100% independent verification of supplements, and it is a fantastic resource.

MD: There are multiple and conflicting stories out there about what not to eat when pregnant, such as soft cheeses and raw fish. Can you set the record straight and list a few of the foods that women should steer clear of/avoid when pregnant and why?

SM: I know many people who eat whatever they want. When I was pregnant I didn't want to put myself in any unnecessary risk just because I was craving some lox. I'm not going to preach here, but I would stay clear of raw fish, cured meats, unpasteurized cheeses, undercooked anything (meat, fish, eggs), and deli meats. I’d also stay away from any open salad bars. The risk being picking up some sort of food-borne illness. Since you're pregnant, your immune system is compromised, meaning a bug you could have shrugged off can now be very dangerous.

It's just 10 months, you can enjoy all the sushi you want once that beautiful newborn is resting comfortably swaddled next to you. I asked for a huge spread of lox as my first meal once my son was born.

MD: There is now evidence to support the fact that what women eat when pregnant affects the baby's future health and that "avoiding overindulgence and eating healthily" should be a priority. What is your advice to women who are craving sweets or fatty junk foods when pregnant?

SM: We crave what we eat. It is very easy to go down the path of just eating carbs, cheese, and sweets. I certainly understand in the stages when you're not feeling well to rely on certain carbohydrates more often, but I highly recommend to try and get in (even small) amounts of nutrient-dense foods like fresh veggies, fruits, and high-quality protein early on (even when you're not feeling great).

Even if that means starting with two bites of a Bolognese sauce at dinner and three slivers of cucumbers. Slowly work your way up. You will have a much healthier pregnancy and recovery period. Then we need to look at why you're having these cravings. Are you letting yourself get too hungry, not eating enough during the day, or not eating the right balance of foods to stabilize blood sugar? Are you overly stressed and tired, etc.? Once we get to the root, we can work how and where to make changes.

Research is showing that what you eat can also affect your babies’ palate and food preferences later on. Try to include a variety of flavors and herbs like ginger, turmeric, sage, rosemary, etc. Try not to rely on bland foods because this is the first exposure your baby has to enjoy flavors. This also holds true for consuming too many sweets and fried foods.

Top 5 Supplements to Take While Pregnant

Cheetah is the New Black

This acts as an insurance policy to ensure you are meeting your needs, as they are much higher while pregnant. Key here is ensuring it is a high-quality prenatal (from a trusted brand) and that it contains folate and not folic acid (which is the synthetic form). You want to aim for at least 600 micrograms. The rest you can obtain from green leafy vegetables in your diet. I personally recommend Mega Food.

Cod liver oil is really a preferred source of DHA and omega-3 fatty acids (EPA) and is rich in vitamins A and D.

They increase good bacteria to support of gut health of the mom and baby. Research is also indicating that improving gut health in the womb can help minimize the incidence of food allergies as well as minimize infections and illness. 

This helps minimize muscle contractions and preeclampsia and helps with sleep and constipation—all concerns during pregnancy.

But remember, these are meant to supplement and not replace foods in your diet. While they can provide boosts in certain gaps in your diet, aim for food first.

Top 8 Foods for a Healthy Pregnancy

Half Baked Harvest

Omegas

They are vital for brain development. Wild fish is your best bet. Try to eat two to three servings per week of wild salmon, cod, halibut, and, if you like the taste, sardines. Stay away from fish with high mercury like tuna and swordfish. 

High-Quality Protein

Eggs—preferably pasture-raised and organic. I always aim to have hard-boiled eggs in my fridge along with Greek yogurt or goat's milk yogurt and hemp hearts. Protein helps the body recover and satisfies a ravenous appetite. Think about aiming for 15 to 20 grams of protein per meal.

Egg: 6 grams
A piece of chicken: 25 grams
1 cup of beans: 15 grams
3 tablespoons hemp hearts: 10 grams
1 serving of Greek yogurt: roughly 15 grams 

Egg: 6 grams
A piece of chicken: 25 grams
1 cup of beans: 15 grams
3 tablespoons hemp hearts: 10 grams
1 serving of Greek yogurt: roughly 15 grams 

Fat

This is probably the hardest for moms-to-be and new moms because it seems counterintuitive. But it is really essential for many reasons. It's vital to bab'’s organ and brain development as well as your metabolism and milk supply and the quality of your milk. Women should focus on healthy sources like avocado, fish oils, eggs, olive oil, coconut oil, nuts, full-fat dairy, etc. 

Seeds

Think hemp, chia, pumpkin, and flax seeds. Filled with fiber, omegas, and magnesium and zinc, these seeds are superstars for pre- and postnatal health. Magnesium helps combat constipation, headaches, and aids in sleep. The fiber, protein, and fat help stabilize blood sugar levels. Tahini, made from sesame seeds, is an excellent source of calcium, which is a key nutrient (along with magnesium and vitamins D and K) for bone health. During pregnancy and breastfeeding, the body draws from mom's bones to provide for the baby, so it is key for mom to keep up her stores.

 

Try the Eden individual pumpkin seed snack packs for when you're on the go. 

Veggies Galore

Your Sweetgreen rewards will be off the charts. You can never have enough, especially green leafy veggies, which are rich in folate (necessary for fetal growth) in addition to being extremely high in antioxidants and other key nutrients like potassium, fiber, vitamin C, etc. In the beginning stages of pregnancy, it can be tough to get in vegetables. I find that raw veggies are easier to take in at the start with a simple dressing of oil and lemon juice. I also recommend a cucumber salad with some rice wine vinegar, sesame seeds, and olive oil.

Or try blending veggies into a smoothie.

Fermented Veggies

These are essential for gut health, and a happy gut means a happy mom. Plus probiotics increase good bacteria in your stomach, which aids in absorption of nutrients and boosts the immune system in you and your baby. 

Iron

Get to know your local butcher. About one to two servings of grass-fed meat or pasture-raised poultry supply an absorbable form of iron. I also recommend bone broth: Delicious and comforting, it has become known as a bit of a cure-all, as it builds strong bones, boosts the immune system, improves digestion, and supports joints, hair, skin, and nails. It's also an excellent source of calcium, magnesium, and phosphorus (which make it great for our bones and teeth). It is rich in chondroitin, glucosamine (which is good for our joint health and inflammation), glutamine, and other amino acids that are especially healing to the gut (and thus help nutrient absorption) and your immune system.

 

Water

In addition to these foods, please hydrate! In pregnancy, your blood volume thickens and fluid is needed, especially for amniotic fluid. It also helps prevent constipation. Most preterm labor is due to dehydration. Plus, breast milk is 70% water. You want to aim for consuming half your body weight in ounces of water. When water wasn’t enough, I found watermelon water and coconut water to be life savers. I would also blend coconut water, watermelon, lime, and mint for a refreshing beverage.

Related Stories