Nutrition in Pregnancy: What to Include and What to Avoid

Nutrition in pregnancy is not about "eating for two"; it is about providing the variety and quality of nutrients for two. A balanced diet directly influences the baby's healthy development, the mother's energy levels, and the prevention of common complaints such as constipation, reflux, and anaemia, as well as postnatal recovery.

How many extra calories are needed during pregnancy?

Contrary to a widespread belief, calorie requirements do not increase immediately in early pregnancy. General guidance:

• First trimester (weeks 0–13): no additional calories are needed. Weight gain is often 0–2 kg because of nausea.
• Second trimester (weeks 14–27): approximately +340 kcal/day.
• Third trimester (weeks 28–40): approximately +450 kcal/day.

Total expected weight gain depends on pre-pregnancy body mass index (BMI): 11–16 kg for normal BMI, 7–11 kg for overweight, and 5–9 kg for obese women.

Food groups to include every day

1. Protein

Daily requirement is roughly 1.1 g/kg of body weight. Rotate between eggs, chicken, turkey, well-cooked red meat, fish, legumes (lentils, chickpeas, beans), yoghurt, and cheese.

2. Complex carbohydrates

Wholegrain bread, bulgur, oats, wholewheat pasta, brown rice, and quinoa. Choosing complex carbohydrates over refined flour and sugar reduces the risk of gestational diabetes and stabilises energy.

3. Vegetables and fruit

At least 5 servings a day (approximately 400–500 g). Prioritise dark-green leafy vegetables (spinach, purslane, rocket), orange vegetables (carrot, pumpkin), citrus fruits, berries, kiwi, and other fresh fruit.

4. Dairy products

3–4 servings per day (milk, yoghurt, kefir, cheese). Daily calcium requirement is 1000 mg and is essential for the baby's bone development. Ensure that cheeses are made from pasteurised milk.

5. Healthy fats and omega-3

Olive oil, walnuts, almonds, avocado, and flaxseed. Two servings a week of low-mercury fish (salmon, mackerel, sardines, anchovies) provide important DHA for brain and eye development.

Key vitamins and minerals

• Folic acid (400–800 mcg/day): prevents neural tube defects. Ideally started at least one month before conception and continued through the first 12 weeks.
• Iron (27 mg/day): prevents anaemia and preterm birth. Sources include red meat, liver, legumes, molasses, and dried fruits. Vitamin C (orange, pepper, parsley) enhances absorption; tea and coffee reduce it, so take them between meals.
• Calcium (1000 mg/day): dairy, sesame, tahini, broccoli.
• Vitamin D (600–2000 IU/day): supplementation is advised when sun exposure is inadequate; essential for calcium absorption and bone development.
• Iodine (220 mcg/day): iodised table salt is usually sufficient; critical for thyroid function and fetal brain development.
• Choline (450 mg/day): egg yolk, meat, milk.

Foods and drinks to avoid completely

To consume in moderation

• Caffeine: keep below 200 mg/day (roughly one cup of filter coffee or two small cups of Turkish coffee). Account for cola, energy drinks, tea, and chocolate.
• Sugar and sweets: restrict because of gestational diabetes risk; prefer water, ayran, or milk to sugary drinks.
• Salt: use iodised salt in normal amounts; excess salt increases oedema and blood pressure risk. Watch hidden salt in soups, canned foods, and crisps.
• Liver (high in vitamin A): only occasionally and in small amounts; very high vitamin A can harm the fetus.

Water intake

Aim for 2–2.5 litres of water per day. Adequate hydration helps prevent constipation, urinary tract infections, preterm labour, and headaches. Pale-yellow urine is a good indicator.

Practical trimester-by-trimester advice

First trimester (nausea and low appetite)

• Eat small, frequent meals; never let the stomach stay completely empty.
• Keep dry biscuits, unsalted crackers, or almonds by the bed before rising.
• Avoid strong-smelling foods; cold meals are often better tolerated.
• Ginger (fresh or as tea) can help with nausea.
• Discuss vitamin B6 supplementation with your doctor.

Second trimester (energy and appetite return)

• Increase protein and iron sources.
• Ensure daily dairy for calcium.
• The 50 g oral glucose challenge test is performed between weeks 24 and 28.

Third trimester (reflux and fullness)

• Divide intake into 5–6 small meals per day.
• Do not lie down for at least 1–2 hours after eating.
• Limit spicy, very fatty, and acidic foods.
• Increase fibre and water intake to reduce constipation.

A sample daily menu

• Breakfast: boiled egg, white cheese, olives, tomato, cucumber, walnuts, wholewheat bread, linden tea.
• Mid-morning snack: a piece of fruit + 5–6 almonds/walnuts.
• Lunch: lentil soup, grilled chicken, bulgur pilaf, seasonal salad with lemon and olive oil.
• Afternoon snack: yoghurt + 1 teaspoon of molasses or fresh fruit.
• Dinner: baked salmon, steamed broccoli and carrot, brown rice or quinoa, cacık (yoghurt with cucumber).
• Before bed: a glass of milk or a small banana.

Frequently asked questions

Are honey, molasses, and tahini safe in pregnancy?

Yes. Pasteurised or traditional honey, molasses, and tahini are safe during pregnancy; molasses and tahini are especially valuable sources of iron. The warning against honey applies only to infants under one year of age.

Can I follow a vegetarian or vegan diet?

Yes, but planning with your doctor and a dietitian is essential to cover protein, vitamin B12, iron, zinc, omega-3 (DHA), and vitamin D.

Can I eat tuna?

Canned light tuna is generally considered safe up to one small serving per week. Avoiding albacore (white) tuna is safer, as its mercury content is higher.

My weight gain is too low or too high — what should I do?

Weight gain should not be judged on the scale alone but alongside the baby's growth curve. If ultrasound and fetal measurements are reassuring, isolated variation in maternal weight is rarely a concern. When gain is markedly high or low, your doctor may refer you to a dietitian.

Can I start dieting immediately after birth?

Restrictive diets are not advisable, especially while breastfeeding. Nutritional needs during lactation are even higher than during pregnancy (+500 kcal/day). Aim for a gradual, balanced return to pre-pregnancy weight over 6–12 months.

Pregnancy care and nutritional guidance in Adana

Every pregnancy has its own nutritional profile: gestational diabetes, anaemia, thyroid disorders, and multiple pregnancies all call for an individualised plan. For comprehensive pregnancy monitoring, laboratory assessment, and, where needed, referral to a dietitian, you can consult Op. Dr. Sadık Kükrer in Adana.