What to eat and what to avoid during pregnancy

Proteins are the building blocks of the body and play a role in the regular repair of the wear and tear of the body tissues. They are needed for the proper growth of the baby, uterus, and placenta. Additionally, proteins aid in improving the total blood volume. Proteins can be obtained from foods like meat, fish, eggs, poultry, milk, cheese, dairy, and beans. For vegetarians, tofu, nuts, and seeds are good sources of protein.

Recommended daily allowance (RDA): 0.8 g/kg/day (79 g/day) to 1.1g/kg/day (108 g/day) in the latter half of pregnancy.

Carbohydrates are of two types: simple and complex. Simple carbohydrates increase blood sugar sharply as they are rapidly absorbed in the blood. Carbohydrates form almost 55% of the total food calorie requirement in pregnant women. Fruits, sugar, honey, and maple syrup are common examples of simple carbohydrates. As simple carbohydrates have a higher calorie count, it is best to keep away from drinks that have added sugars.

Complex carbohydrates require a longer time to be absorbed in the body, hence they provide energy for a longer period of time. Foods like bread, pasta, corn, potato, and rice contain starch and fibre. All carbohydrates are ultimately broken down into glucose, which provides energy to carry out day to day activities. Dietary fibre is a substance found in plant sources, which cannot be digested by the body. It helps to add bulk to the stools and prevent constipation, which is a common feature in pregnancy. Women with gestational diabetes should reduce their total food calorie intake to 40%-45%.

RDA: 175 g/day.

(Read more: Ways to relieve constipation during pregnancy)

Fats provide the much-needed energy and help to build the placenta and baby’s organs. Oils and fats, especially omega-3 fatty acids, also help in developing the baby’s brain. Essentially, fats form almost 20% to 30% of the total calorie intake, which is about 6 tablespoons a day. These fats help in blood clotting as well as aid in the metabolism and absorption of the vitamins A, D, E, and K.

Fats are digested in the liver and then converted into lipoproteins, which consist of cholesterol, proteins, and fats. There are different types of fats in foods that can be broadly divided into saturated and unsaturated fats.

Fats can be obtained from various oils, butter, dairy products, egg yolk, meat, nuts and more. As far as possible, saturated fats should be kept to a minimum (such as ghee and lard) and unsaturated fats should be opted for (vegetable oils of peanut, mustard, sesame, sunflower among others).

RDA: 6 to 8 tablespoons per day throughout pregnancy i.e., 20-30% of your daily calorie intake.

Iron is an essential nutrient required in the production of red blood cells, which help in carrying oxygen to the tissues and organs. It also helps fight fatigue, irritability, weakness, and depression. During pregnancy, more iron is needed to supply oxygen to the baby via the placenta. If the iron requirement is not met, it can lead to anaemia. The total iron requirement is about 1000 mg during pregnancy.

Iron supplements for all pregnant women are recommended by the World Health Organization (WHO). The quantity of iron intake should be increased with multiple pregnancies. The Government of India advises 100 mg of elemental iron, along with, 500 micrograms of folic acid for at least 100 days in the latter half of pregnancy. A low iron level due to irregular iron intake can increase the risk of low birth weight as well as preterm delivery. Iron is found in animal foods like red meat, fish, and poultry. It is also found in nuts, cereal, bread, and grains.

RDA: 27 mg of elemental iron daily.

(Read more: Anemia in pregnancy symptoms)

Folic acid or folate is a vitamin that is particularly important during pregnancy. It is advised to take folic acid tablets at least 1 month before and during pregnancy to prevent birth defects in the fetal brain and spine. Folic acid is found in dark green leafy vegetables, orange juice, fortified bread, cereals, and grains. Since adequate folic acid may not always be obtained from food sources alone, folic acid supplements are recommended during pregnancy.

RDA: 600 micrograms daily from the time of planning the pregnancy.

Calcium is needed for the development of bones and teeth of the baby. It is abundant in milk, dairy products, cheese among others. Various other foods like fortified orange juice, sardines, anchovies, and broccoli also are a good source of calcium for vegan and lactose intolerant mothers.

RDA: 1000 mg a day

Iodine is essential for producing the thyroid hormone, which helps in the growth and development of the baby. Insufficient amount of iodine can increase the chances of mental impairment in the newborn. Seafood, eggs, meat, dairy, and iodized salt are good sources of iodine.

RDA: 150 micrograms daily during pregnancy and lactation.

• Vitamin D
  Vitamin D and calcium work together to promote the growth of the baby’s teeth and bones. Vitamin D is also an important nutrient for healthy skin and eyes. Fatty fish like salmon, fortified milk and orange juice, cereal, and egg yolk are good sources of vitamin D. Exposure to sunlight helps to produce vitamin D in the skin. 10-15 minutes of daily exposure to the sun between 10 am – 3 pm should be able to produce adequate vitamin D in the body.
  RDA: 600 IU (15 micrograms) a day in pregnant and lactating women.
• Vitamin A
  Vitamin A is important for the development of healthy eyesight, bones, and skin.
  • Sources: Green leafy vegetables, carrots, sweet potatoes, bell peppers, capsicum, papaya, mangoes, red and yellow coloured fruits/vegetables.
  • RDA: 770 micrograms in adult women
• Vitamin C
  It is required to maintain healthy gums, teeth, and bones. It is a potent antioxidant.
  • Sources: Found in citrus fruits, gooseberry (“amla” is the richest source of vitamin C), strawberries, broccoli, tomatoes.
  • RDA: 85 mg.
• Vitamin B₆ 
  It is needed for the formation of red blood cells and metabolism of fats, proteins, and carbohydrates.
  • Sources: Liver, pork, beef, bananas, whole grains.
  • RDA: 1.9 mg daily.
• Vitamin B₁₂
  It helps to maintain the nervous system. Besides vitamin B_6, vitamin B₁₂ also helps in forming red blood cells. 
  • Sources: Milk, fish, poultry, meat.
  • RDA: 2.6 micrograms/day.

It is still not clear whether caffeine increases the risk of miscarriage or not. However, doctors mention that 200 mg of caffeine a day is safe during pregnancy. Apart from coffee, caffeine is also found in teas, chocolate, and carbonated drinks.

Shellfish and other seafood are excellent sources of omega-3 fatty acids, which are considered essential because they are supplied through diet alone and cannot be produced by the body. These essential fatty acids help in the development of the baby’s brain and nerves. Fish is also an excellent source of protein and it is advised to consume at least 3 servings of any seafood per week. However, some fish may contain higher levels of mercury, which has been linked to birth defects. To combat this, select fish that has low mercury content like shrimp, light tuna, salmon and sardines. Avoid mackerel, shark and swordfish, which have been found to contain higher levels of mercury.

Women who have trouble digesting milk and dairy are said to be lactose intolerant. Such women can fulfil their daily calcium requirement through other non-dairy sources like coconut milk, almond milk, nuts, and soy. Nowadays, lactose-free dairy products like milk and cheese are also available. If there is any difficulty in taking the recommended amount, doctors may prescribe calcium supplements.

As such, there is no safe limit or safe time to consume alcohol during pregnancy. Consuming alcohol in any form is harmful including beer and wine. Alcohol in a woman’s blood passes to the baby through the umbilical cord and increases the risk of miscarriage, stillbirths, and various physical, intellectual and behavioural disabilities, which together are termed as fetal alcohol spectral disorders (FASD). Consuming alcohol in the first 3 months of pregnancy can cause abnormal facial features in the newborn. Brain development may be arrested at any time during pregnancy due to alcohol. Such children may show the following characteristics after birth:

• A small size of the head.
• Low body weight.
• Lack of motor coordination.
• Hyperactive behaviour.
• Poor attention span and memory.
• Learning disabilities and speech delays.
• A low intellectual quotient (IQ).
• Vision and hearing problems.
• Difficulty in sucking milk.
• Inability to understand reasoning and analytical subjects such as maths.

Vegans are individuals who do not consume animal products, such as meat, eggs and dairy products. Vegetarians include dairy foods in their diet. Either way, it is possible that the daily requirement of nutrients is not fulfilled. However, to get all the nutrients needed by the mother and the baby throughout the pregnancy, some extra planning may be required in such cases. It is best to reveal the information to your doctor about food preferences during the first visit itself. Vegetarians and vegans can get proteins from soy milk, tofu, and beans. Green leafy vegetables, spinach, chickpeas, and kidney beans provide a good amount of iron. For calcium, fortified orange juices, tofu, rice, and soy milk can be consumed.

(Read more: Vegan diet benefits)

A few animal studies were conducted to know the possible effects of consuming papaya during pregnancy. It has been found that ripe papaya is safe, whereas unripe papaya contains latex, which causes contractions in the muscles of the uterus similar to that caused by the female sex hormones, oxytocin and prostaglandins. Hence, its consumption during pregnancy could be unsafe. However, further studies need to be conducted to estimate this risk.

Women who are gluten intolerant cannot eat wheat, rye, and barley. They can consume fruits, vegetables, potatoes, poultry, and beans as an alternative. There are many gluten-free foods available in stores these days.