What one eats while pregnant is important for both the parent and the baby’s wellbeing. In addition, for those who aren’t currently expecting but who may want children later on, studies have shown that eating well now can also prevent negative outcomes in future pregnancies.

“Many people don’t realise that you already need to optimise your nutritional status before falling pregnant. Both males and females need to have an optimal nutritional status if they are looking to fall pregnant, it takes two to tango!” says Maya du Plessis, a registered dietician with Stellenbosch-based Imagine Dietitians.

“Diet has been shown to have an impact on a baby’s health as well as [on their] health as an adult. If a developing infant is malnourished in the womb, [they are] more likely to develop heart disease, diabetes, and high blood pressure later in life,” explains Marelize van der Schyf, a registered dietician from Alta Kloppers and Associates, in Gauteng.

Heard the phrase “eating for two” when pregnant? This is a misconception of what food and how much of it pregnant people should be eating. As Du Plessis explains, “during the first and second trimester the body of a pregnant person only requires a small amount of additional calories — more or less the equivalent of one extra snack a day. The baby does most of its growing in the third trimester so this is the period that nutritional needs to greatly increase. In the third trimester, pregnant people should increase their calorie intake by 15% and their protein intake by around 50% to support the rapidly growing baby.”

What should you eat during pregnancy? 

It might be overwhelming to look at a list of everything one should and shouldn’t eat. Rather, here are some nutrients to look out for instead. 

Folic acid for healthy cell growth

Folic acid, or vitamin B9, helps form red blood cells and is important in healthy cell growth and function. It is especially important during pregnancy to reduce the risk of birth defects of the brain and spine, also called neural tube defects (NTDs). “If you are planning to get pregnant it would be a good idea to take extra folic acid,” Van der Schyf says. “NTDs happen in early pregnancy, before people even know that they are pregnant, so it’s good to take a folic acid supplement just as a backup.” 

Folic acid can be found in green leafy vegetables like spinach and kale, beans and citrus fruits as well as in some foods that are enriched with it, such as fortified cereals. 

Iron to help with carrying oxygen in the blood

The body uses iron to carry oxygen in the blood. As a baby grows, the body needs to supply enough oxygen to both the foetus and parent. To accommodate this increased demand, the Mayo Clinic recommends consuming around 27 milligrams of iron a day. Without it, there is a risk of developing anaemia. 

For the pregnant parent, anaemia can cause symptoms such as fatigue, weakness, dizziness, headaches and shortness of breath. For the baby, a severe iron deficiency can restrict growth and increase the risk of preterm birth, and could also result in significant blood loss during labour, warns Du Plessis.

Just as with folic acid, green leafy vegetables and beans are good sources of iron. Other iron-rich foods also include nuts, lean meat and chicken. Foods that are rich in Vitamin C also help the body be absorbed better into the body, so fruits like oranges, tomatoes and strawberries are good to include, says Van der Schyf. It’s also worth keeping in mind that calcium-rich foods such as dairy products decrease iron absorption. Don’t cut them out, but Van der Schyf recommends avoiding pairing iron-rich foods with dairy products, so that one can get the best benefits out.

Calcium for strong bones and teeth

Calcium is important for the development of bones and teeth. Without it, the body draws calcium from the parent’s bones for the baby, which could result in the parent developing bone diseases such osteoporosis. says Van der Schyf. To avoid this, dairy products like milk, cheese and yoghurt are rich in calcium, as are broccoli, fish, eggs and bread made with fortified flour. But there are alternatives if you don’t want to or cannot consume dairies. 

Du Plessis also has a handy list of things to look out for: 

• Fruits and vegetables provide the mother with vitamins and minerals;
• Whole grains are an important energy source and are also high in fibre which helps regulate blood sugar levels and plays an important role in gut health;
• Meats, chicken, fish, eggs and dairy are high in protein, calcium, Vitamin D and
• B vitamins; and
• Nuts, seeds, avocados, oils, olives, fish etc are important sources of unsaturated fats, which play a crucial role in the baby’s brain development.

Foods you should consider cutting out 

Just as there are foods to include, there are also foods that should be rather left off the menu while pregnant. The first step, Du Plessis says, is to replace foods that are low in nutrients, such as processed meals, with foods that are nutrient-dense. “A healthy pregnancy diet should primarily consist of whole foods with enough nutrients to meet your and your baby’s nutritional needs. Processed food and junk food are high in calories, sugar, and added fats while lacking in nutrition — these are not nutrient-dense foods,” Van der Schyf says. 

“Eating an unhealthy diet during pregnancy can increase your risk for several pregnancy-related symptoms such as heartburn, gestational diabetes (diabetes during pregnancy), constipation and fatigue. Sugar, trans fats and processed foods are some of the things that pregnant people should limit in their daily diet.”

In addition, watch out for these.

Raw fish and fish high in mercury 

While some fish are good for brain and bone development, Van der Schyf warns against fish such as swordfish and mackerel as they contain high amounts of mercury, which can be toxic to the kidneys and the nervous system. 

Raw or undercooked fish which can be sometimes found in sushi is a no-go, as they can spread a variety of viral, bacterial, and parasitic infections such as norovirus, salmonella and listeria. “Some of these infections can just impact you, leaving you dehydrated and feeble. Other infections could be transmitted to the baby, resulting in serious or even deadly effects,” Van der Schyf warns. 

“Smoked fish, raw fish, oysters, unpasteurised milk or cheese (such as camembert, feta, blue cheese and brie), raw or undercooked meats, cold meats, smoked meats, hot dogs and pate” are all examples of foods Du Plessis warns against. 

This said, Professor Miriam Clegg recently wrote that, “Iodine is another important nutrient, especially for pregnant women and young children as it’s important for brain development. It also helps make thyroid hormones, which are important for both growth and metabolism. Despite milk and dairy products being the main source of dietary iodine, only a small handful of plant-based dairy products are fortified with iodine. Again, it’s important to read the product’s label to see if it’s been fortified with iodine or not. Otherwise, focus on eating foods that contain iodine, such as fish, shellfish or seaweed – or if this is not possible by taking a supplement.”

No alcohol

Currently, there are no established levels of alcohol that are safe for pregnant people to consume, Du Plessis says. Therefore, it’s best to avoid it completely. “Alcohol raises the chance of miscarriage and stillbirth,” Van der Schyf explains. “Even a modest amount of alcohol might have a harmful impact on your child’s brain development.” 

Consuming alcohol during a pregnancy can also cause foetal alcohol syndrome, which can result in facial deformities, heart issues and intellectual incapacity. South Africa has the highest reported prevalence rates of foetal alcohol syndrome in the world, with an overall national rate of 6% and 28% in some communities. 

Water over caffeine

Drinks with caffeine are also beverages that should be avoided while pregnant. 

“Caffeine is quickly absorbed and easily passed into the placenta. Because newborns lack the key enzyme required for caffeine metabolism, excessive quantities can accumulate. Caffeine consumption during pregnancy has been demonstrated to limit foetal growth and raise the risk of delivering a baby with a low birth weight,” Van der Schyf explains. 

Instead of caffeine, it is important to make sure one is getting enough water and staying hydrated. In fact, the American College of Obstetricians and Gynaecologists recommends eight to 12 glasses of water per day.

Some myths debunked

Both Van der Schyf and Du Plessis noted that in South Africa traditional beliefs can lead to misconceptions over which foods to avoid. 

A 2019 study, dubbed “Food Taboos and Cultural Beliefs Influence Food Choice and Dietary Preferences among Pregnant Women in the Eastern Cape, South Africa,” found that “cultural beliefs and food taboos followed by some pregnant women influence their food consumption, which impacts the health of mothers and children during pregnancy and immediately afterwards.” It included meat, fish, potatoes, fruit, beans, eggs, butternut, pumpkin and more. 

“These foods were avoided due to fears of having a disabled child, a baby behaving like an animal, a child becoming a thief, and a youngster reaching adulthood too soon. These foods were also avoided to protect a kid from being born prone to a variety of illnesses, including respiratory problems, eczema, ear problems, boils, rashes, sores, hair loss/no hair, always losing nails, and umbilical cord disorders,” Van der Schyf explains. 

“Alarmingly, some of the banned foods are from the most important food groups, leaving these pregnant women with little dietary variety and leaving them prone to nutrient deficiencies, especially micronutrient deficits, which can contribute to malnutrition during pregnancy.

“There’s a very common myth in South Africa that if you eat orange or yellow coloured foods (such as naartjies, peppers, pumpkins, guavas, carrots, butternuts and more) during pregnancy the baby will have jaundice at birth. This is absolutely not true at all. In actual fact, orange coloured fruits and vegetables are very important as they are very high in important vitamins and minerals,” says Du Plessis. 

Satisfying those cravings

Ever wondered why some pregnant people crave some strange and unusual things? “Cravings are most common in the first trimester and peak in the second and decrease as the third trimester progresses, but they can occur at any point during pregnancy,” Van der Schyf explains.

“Pregnancy cravings aren’t much different than everyday cravings. Since the body is expanding slightly more calories while pregnant, the body might just be sending hunger signals which may be interpreted as ‘pregnancy cravings’. Contrary to popular belief, pregnancy cravings haven’t been linked to having a deficiency,” says Du Plessis.

Van der Schyf has a few tips to control cravings:

• Eat well-balanced meals throughout the day.
• Focus on healthier snacking options such as dark chocolate, fruit, and yoghurt.
• Eat small regular meals to control blood sugars, to prevent cravings.
• If possible, keeping junk food/ processed foods out of the house is the simplest approach to prevent eating it.
• Exercise regularly.

Van der Schyf also has a few healthier replacements for cravings: these include swapping potato chips for vegetable chips, cake, sweets or chocolate for fruits like apples, mango and peaches and choosing yoghurt instead of ice cream. DM/ML

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