including vitamin C, beta-carotene, folate and potas-
sium, as well as fibre.
Meat, fish and alternatives. Alternatives include eggs,
nuts, pulses (such as beans, lentils, chickpeas) and
textured vegetable protein. These should be con-
sumed in moderate amounts and lower fat versions
selected whenever possible. They are a major source
of protein, vitamins and minerals. Atleast one por-
tion of oily fish (e.g. sardines or salmon) a week will
ensure an adequate supply of omega-3 fatty acids.
Milk and dairy foods. These should be consumed in
moderate amounts and lower fat versions are pref-
erable. These foods are particularly high in calcium
and good sources of protein. Skimmed and semi-
skimmed milk contain just as much calcium and pro-
tein as whole milk.
Foods containing fat and sugar. These foods add palat-
ability to the diet but should be eaten infrequently.Energy intake and weight gainEnergy (calorie) requirements increase during
pregnancy by a small amount. The body’s increased
need for some other nutrients, such asironandcal-
cium, can be met without increasing intakes. This is
because the body adapts and becomes more efficient at
absorbing and using these nutrients during pregnancy.
However, for some nutrients, an increase in intake is
necessary, includingprotein, the B vitamins -thiamin
(vitamin B 1 ),riboflavin(vitamin B 2 ) andfolate, and
vitamins A, C and D. For some of these nutrients, such
as for protein, the majority of women will already be
consuming enough. However, for others, such as
folate, dietary adjustments may be necessary in order
to make sure that adequate amounts are consumed,
and these are discussed in more detail below.
The total energy cost of pregnancy has been esti-
mated at around 321 MJ (77,000 kcal). However, in
reality, there are wide variations in individual energy
requirements during pregnancy as women vary greatly
in basal metabolic rate, body fat and physical activity
levels. In the UK, the recommendation is for women
to consume an extra 200 kcals per day during the third
trimester only. But this assumes that women reduce
their physical activity levels during pregnancy and
women who are underweight or who do not reduce
their activity level may require more. The American
Dietetic Association recommends the additional energy
needs during the second and third trimesters of preg-
nancy to be approximately 300 kcal per day in adults
and older adolescents and 500 kcal per day in young
adolescents (<14 years) but individual differences are
also emphasised.A good approach is for pregnant women to eat
when they feel hungry. If weight gain is appropriate,
then energy intake is likely to be adequate.
For women with a healthy pre-pregnancy weight,
an average weight gain of 12kg (range 10–14kg) is
associated with the lowest risk of complications during
pregnancy and labour and with a reduced likelihood
of having a low birth weight infant. However women
who are normally a healthy weight vary widely in the
amount of weight they gain during pregnancy.
Women who gain an excessive amount of weight are
more likely to remain overweight or obese following
the birth. But pregnancy isn’t a time for faddy diets or
restricting food intake as this may lead to inadequate
nutrient supplies for both the mother and fetus. Med-
ical advice should be sought if there is concern about
excessive weight gain during pregnancy.Important nutrients
Folate is essential for the normal development of
the neural tube in the fetus. The neural tube develops
into the brain and spinal cord and closes between the
third and fourth week after conception. InsufficietKEY TERMS
Basal metabolic rate—basal metabolic Rate is the
number of calories the body burns at rest to main-
tain normal body functions.
DHA—A long-chain omega-3 fatty acid found pri-
marily in oily fish. It is important for the develop-
ment of the brain and the retina of the eye.
Folic acid—The synthetic form of the B vitamin
folate, found in supplements.Folate is needed to
produce red blood cells.
Iron deficiency anemia—The inability to make suf-
ficient red blood cells that results in fatigue, short-
ness of breath, headaches and in ability to fight
infections. It is common in pregnancy.
Low birth weight—A low birth weight infant is one
who is born after the the normal gestational period
(38-42 weeks) but weights less than 2.5 kgs (5.5
pounds) at birth.
Neural tube defects—Neural tube defects are seri-
ous birth defects that involve incomplete develop-
ment of the brain, spinal cord and/or protective
coverings for these organs.
Retinol—Also known as vitamin A. This is a fat
soluble vitamin found in animal food sources.Pregnancy diet