Maintaining a healthy diet during pregnancy is essential, as this is a stage in which nutritional requirements are elevated in order to allow for the physiological adjustments in the maternal body and the baby’s development.
This cycle imposes increased needs, which require special care, and from a nutritional perspective, vitamins and minerals are the most affected by this change in metabolism1.
These micronutrients are often adjusted by the body, and it is common for pregnant women to have reduced amounts of iron, ascorbic acid (Vitamin C), and folic acid in their blood. This phenomenon occurs because the existing body stores of these substances are redirected to the fetus, and as a result, their concentration in the blood decreases.
Possible supplementation or specific diets during pregnancy will depend directly on the woman’s previous nutritional status, which can be influenced by genetic factors, lifestyle, diet, and maternal behavior.
Studies show that only 10% of the population includes fruits, vegetables, and greens in their diets. Other studies indicate that there is no significant difference between the diets of pregnant and non-pregnant women. In fact, pregnant women often have a higher inadequacy in the consumption of essential nutrients such as iron, folate, and calcium.
For good fetal development and growth, it is preferable that pregnant women consume foods in specific varieties and amounts. Recommendations from dietary guidelines and cultural and regional eating habits should be followed with the aim of achieving the right amount of energy, nutrients, and also proper weight gain.
- Ideal diet during pregnancy and the Food Pyramid
- Gestational weight gain
- Inadequate weight gain
- Adequate weight gain
- 10 tips for healthy weight gain during pregnancy
Ideal Diet During Pregnancy and the Food Pyramid
The World Health Organization (WHO) explains that the concept of healthy eating consists of a limitation in the consumption of fats, sugars, and salt (sodium) and an increase in the intake of fruits, vegetables, greens, whole grains, and dried fruits.
The food pyramid is a useful tool to raise this awareness, helping to simply illustrate how we can have a healthy diet in a balanced, adequate, varied, moderate, harmonious, and colorful way. It also guides us on the appropriate proportions of foods to be consumed daily, which is why we decided to explain it further for you.
The Pyramid Explained
If used correctly, the pyramid can be a mother’s best friend and help ensure this period is healthy, with greater well-being and fewer risks2. Below, we have an example of a food pyramid containing the appropriate amounts for eutrophic pregnant women (BMI: 18.5 – 24.9kg/m²) aged 19 to 30 years.
- First level:
This is made up of the cereal group. Foods from this group are the best sources of slow-absorbing carbohydrates. This nutrient provides the largest share of the total energy in the diet.
Recommended serving: 5 servings/day in the first trimester and 6½ servings/day in the second and third trimesters of pregnancy.
Where to find: rice, bread, pasta, couscous, cake, roots, and tubers.
- Second level:
This is the group of vegetables, greens, and fruits. Foods in this group are excellent sources of vitamins, minerals, and fiber.
Recommended serving: 5 servings/day of vegetables/greens and 4½ servings/day of fruit in the first, second, and third trimesters.
- Third level:
This level is composed mainly of foods that are sources of protein. There are three food groups at this level, and women can choose any food from these three groups to include in their menus:
Milk and dairy products: good sources of calcium, protein, and vitamins.
Where to find: yogurt, cheese, milk, etc.
Recommended serving: 3 servings/day throughout pregnancy.
Meat and eggs: these foods are sources of protein and iron.
Where to find: red meat, pork, goat, poultry, fish, seafood, organ meats, and eggs.
Recommended serving: 1½ serving/day throughout pregnancy.
Legumes: this group is a plant-based source of protein, minerals such as iron, and fiber.
Where to find: beans, soy, peas, chickpeas, lentils, and oil seeds.
Recommended serving: 1 serving/day throughout pregnancy.
- Fourth level:
Oils and fats: lipids, or as they are commonly known, fats, are nutrients that provide energy to the body and are present in many preparations. Always prefer polyunsaturated lipids, or as we know them, the good fats rich in HDL. Avoid saturated (bad) fats, which are a source of LDL.
Where to find LDL fats: butter, margarine, lard, animal fats.
Where to find HDL fats: olive oil, flaxseed oil, sesame oil, and seed oils in general.
Recommended serving: 2 servings/day in the first trimester and 2½ servings/day in the second and third trimesters.
Sugars and sweets: made up of fast-absorbing carbohydrates, such as sucrose (sugar), and with a high glycemic index. These should be consumed in moderation because, in addition to being at the top of the pyramid, they are present in many preparations.
Where to find: processed sweets, honey, sugars, chocolate, etc.
Recommended serving: just 1 serving/day throughout pregnancy.
Gestational Weight Gain
Gestational weight gain is estimated to provide the right amount of nutrients that will maintain the health of the mother and the fetus, calculated based on the mother’s BMI (Body Mass Index) before pregnancy.
This weight increase may vary among women, and for some, this period can represent a potential risk for excess weight and even obesity3. The main cause of these changes is the mother’s behavior, meaning an unbalanced diet, a sedentary lifestyle, unhealthy habits, among others.
The body mass index is calculated using the following mathematical formula: Weight ÷ (height x height).
With your BMI result, you can identify whether or not you are at your ideal weight based on the reference value table.
| Value | Classification |
| Below 18.4 | Underweight |
| 18.5 to 24.9 | Normal weight |
| 25 to 29.9 | Overweight |
| 30 to 34.9 | Obesity grade I |
| 35 to 40 | Obesity grade II (severe) |
| Above 40 | Obesity grade III (morbid) |
According to the World Health Organization (WHO), women who begin pregnancy with a BMI in the normal range, also known as eutrophic, and consume the ideal amount of energy to meet their nutritional needs, as well as ensuring ideal weight gain, stimulate the adequate development and growth of the baby.
However, women who begin pregnancy underweight, overweight, or obese may have gestational complications that cause problems for both the mother and child.
In Brazil, 90% of pregnant women have a high energy intake with excessive consumption of very high-calorie products and low intake of essential micronutrients, vitamin A and C, calcium, and iron.
The recommended diet for pregnant women is to increase intake of carbohydrates, fiber, protein, the aforementioned micronutrients, as well as B complex vitamins and folic acid. These substances can be found in fruits, vegetables, greens, roots, and tubers.
Studies show that pregnant women in Brazil have two to four meals a day, and not all food choices are appropriate. Foods like soda, rice, bread with margarine, and juice are examples of what makes up this diet.
It is concluded that there is inadequacy regarding the number of daily meals, energy needs, and recommendations for essential micronutrients.
Inadequate Weight Gain
Inadequate weight gain can have harmful effects both for mothers who gain excess weight and for those who do not gain enough. Gaining less than the recommended amount is often associated with low birth weight in newborns. On the other hand, excessive weight gain is linked to overweight/obesity in new mothers and a higher risk of complications during pregnancy, such as:
- Gestational diabetes;
- Preeclampsia;
- Complications during and after delivery;
- Risk of stillbirths;
- Shoulder defects;
- Neural tube defects;
- Fetal asphyxia;
- Childhood obesity;
- Increased risk of infant and maternal mortality;
Adequate Weight Gain
It is not recommended to follow restrictive diets during pregnancy; however, excessive food intake should also be avoided. To ensure weight gain is healthy and controlled, the WHO provides some recommendations, which we will illustrate from now on.
It is important to understand that the distribution of energy and nutrients varies in each trimester of pregnancy, as the needs of the mother and child are different. In addition, it should be remembered that every woman should have an individualized weight gain, calculated according to BMI, as shown below:
| Pregnant women underweight before pregnancy | 15.0kg |
| Pregnant women with ideal pre-pregnancy weight (eutrophic) |
12.5Kg |
| Pregnant women overweight before pregnancy | 9.0Kg |
| Pregnant women obese before pregnancy | 7.0Kg |
Based on the table above, it is also possible to estimate the weight to be gained in each trimester. In the first, the gain is not so great, totaling 1.5 to 2.0kg. From this stage on, an additional gain of 1.5 to 2.0kg per month is recommended so that by the end of pregnancy, the woman has gained 7.0 to 15.0kg at most.
10 Tips for Healthy Weight Gain During Pregnancy
- Choose a varied diet with foods from all groups of the pyramid and avoid monotony in your meals;
- Pay attention to how foods are prepared, giving preference to natural or baked, boiled in water or steamed, or grilled preparations;
- Read the labels of processed foods to know their nutritional value and how they are prepared;
- Include foods from the base of the pyramid in greater quantity in your daily diet;
- Use sugars, sweets, salt, and foods with high sodium content sparingly;
- Opt for mono- and polyunsaturated fats, the so-called good fats, which can be found in: vegetable oils, Brazil nuts, peanuts, almonds, walnuts, flaxseed, sesame, etc.
- Drink 6 to 8 glasses of water daily;
- Get frequent sun exposure (before 10 AM and after 4 PM);
- Avoid consuming alcoholic beverages;
- Be followed by a nutritionist from the beginning of pregnancy as a way to prevent complications during pregnancy.
Every pregnant woman should be encouraged to consume natural foods, also taking into account regionality, since seasonal and regional foods, in addition to being more readily available, have a lower cost, and are more nutritious, being sources of fiber, minerals, vitamins, and carbohydrates in the diet.
