Fuelling a healthy pregnancy: Dr Linia Patel (PhD), RD sorts through the most common nutrition misconceptions surrounding pregnancy and brings you essential nutrition guidelines for pregnancy.
Pregnancy comes with an overwhelming amount of advice – some well meaning, some unsolicited – and it’s often filled with myths that can be difficult to separate from evidence-based facts. That’s why I’ve taken the time to sort through the most common nutrition misconceptions surrounding pregnancy, providing clear, practical and science-backed guidance. To make this as helpful as possible, I’ve organised the advice by trimester, addressing the most frequently asked questions and common symptoms experienced along the way, so that you can give clients the essential nutrition guidelines for pregnancy and health.
Trimester one
The symptom: Morning sickness
The hormonal shifts during this trimester can lead to fluctuations in blood sugar levels, often triggering morning sickness. Nausea is more likely to occur on an empty stomach – hence the term ‘morning sickness’ – as it typically strikes when you’ve gone the longest without eating.
Practical strategies for easing nausea:
- Eat small, regular meals: Going too long without food can worsen nausea, so aim for a steady intake of easy-to-digest foods.
- Prioritise nourishment, but don’t stress about perfection: If you’re struggling to keep food down, just focus on getting something in rather than achieving the ideal balanced diet. Nutrient-dense choices can come later.
- Ginger can be a game-changer: Studies support its role in reducing nausea. Try ginger tea, cordial, dried ginger chews or flat ginger ale. Lemon slices and dry crackers can also help settle the stomach.
- Trust your body’s signals: Aversions are your body’s way of guiding you. Strong smells or spicy foods may trigger nausea, so opt for room-temperature or cold foods, which tend to have milder aromas.
Trimester two
In the second trimester, hormone levels begin to stabilise, bringing relief from early pregnancy symptoms. This is often when the renowned pregnancy glow appears – along with a natural and necessary increase in weight as your baby grows.
Common myth: I’m eating for two
Sadly not. While you do need extra nutrients like calcium and iron when you are pregnant, you do not need many extra calories until the third trimester and it’s only 350 calories each day. And guess what? Those extra calories need to be nutritious calories, not junk calories. If you do end up ‘eating for two’, you will simply just gain excess weight.
Myth 2: I should always give in to my pregnancy craving
While pregnancy cravings are a real thing (caused by hormonal changes), there is no evidence to suggest that cravings are a sign of what your body needs, as the old wives’ tales makes us believe. Spoil yourself in moderation. If you have non-food related cravings (such as ice or clay) this is a condition called pica that you need to discuss with your doctor.
Myth 3: A mug of coffee is a no-no when I’m pregnant
It can take pregnant women 1.5-3.5 times longer to eliminate caffeine from the body. However, moderate amounts of caffeine (200mg per day) have not been found to have a negative effect on pregnancy, so your daily cup of coffee is OK to keep having if you still fancy it. However, it’s not just coffee that contains caffeine. Chocolate does too, so keep track of your intake across your day. If you are experiencing or have a history of high blood pressure, you should consider reducing your caffeine intake and speak to your doctor about it.
Myth 4: The occasional small glass of merlot is not allowed when you are pregnant
It is not clear cut how much alcohol it takes to cause health problems. The current advice is therefore that women should avoid alcohol if they are pregnant. Although, that said, it’s up to each mum-to-be to consult her doctor and decide if she’ll have the occasional drink or not.
Myth 5: If I avoid some foods (like peanuts, wheat or cow milk) during my pregnancy, I can prevent my child from developing food allergies
As the research in this area is inconclusive, it is recommended for mums-to-be not to avoid foods. Those mums who have a history of severe atopic disease (eczema, asthma, etc.) should still be vigilant about their intake of peanuts while more research is done.
Trimester three
As your bump starts to get bigger, you do experience more symptoms like constipation, heartburn and fatigue.
The symptom: Constipation
Constipation is a common concern during pregnancy, primarily due to hormonal changes that slow down digestion. Increased levels of progesterone relax the muscles of the digestive tract, causing food to move more slowly through the intestines. This allows for greater nutrient absorption but can also lead to harder, drier stools. Additionally, as pregnancy progresses, the growing uterus places pressure on the intestines, further slowing bowel movements. Other factors, such as increased iron intake from prenatal supplements and reduced physical activity, can also contribute. Staying hydrated, consuming fibre-rich foods and maintaining gentle movement can help alleviate discomfort.
Practical strategies to ease constipation:
- Keep an eye on your fibre intake. Aim for 30g per day from a variety of sources to support healthy digestion. Incorporate a mix of whole grains (such as oats, brown rice, wholegrain bread and sweet potatoes), legumes (beans and lentils) and fibre-rich fruits and vegetables like kiwi, berries, mushrooms and leafy greens. Nuts and seeds, particularly ground flaxseeds and chia seeds, are also excellent choices for promoting regularity.
- Keep your water bottle close. Hydration is just as important as fibre needs water to work effectively, so keep a water bottle with you throughout the day. If additional support is needed, psyllium husk can be a gentle, natural option to aid digestion and prevent constipation.
The symptom: Heartburn
Heartburn during pregnancy is primarily caused by hormonal and physical changes. Increased progesterone relaxes the lower oesophageal sphincter, allowing stomach acid to rise into the oesophagus more easily. As pregnancy progresses, the growing uterus presses against the stomach, further contributing to acid reflux.
Practical strategies to ease heartburn
- Eat small, frequent meals vs large meals. Focus on smaller, more frequent meals rather than large portions, which can put added pressure on the stomach and increase acid reflux.
- Minimise trigger foods. Identify and avoid common trigger foods, such as spicy dishes, citrus fruits, caffeine, carbonated drinks and high-fat or fried foods, as these can relax the oesophageal sphincter or stimulate acid production.
- Pay attention to what you eat and when you eat it. You might want to skip spicy foods and not eat too close to bedtime, as this will exacerbate it. Also, don’t lie down for at least an hour or so after eating a meal.
- Stay upright after eating. Remain upright for at least 30-60 minutes to allow food to digest properly and reduce the likelihood of acid rising into the oesophagus. Sleeping with your upper body slightly elevated and wearing loose-fitting clothing can also help prevent discomfort.
The symptom: Fatigue
Fatigue is a common symptom during pregnancy, especially in the first and third trimesters, due to significant hormonal, metabolic and physiological changes. Increased progesterone levels promote relaxation and sleepiness, while the body works harder to support the developing baby, leading to higher energy demands. Additionally, increased blood volume and iron needs can contribute to fatigue, particularly if iron levels are low. In later pregnancy, disrupted sleep from physical discomfort, frequent urination and hormonal shifts can further exacerbate tiredness.
Practical strategies to ease fatigue:
- Stay hydrated: Even mild dehydration can reduce blood flow and oxygen delivery, leaving you feeling sluggish. Aim for at least two to three litres of water per day and increase intake if you’re active.
- Prioritise iron-rich foods: Low iron levels can lead to anaemia and exacerbate fatigue. Include iron-rich foods such as lean red meat, beans, lentils, dark leafy greens (e.g., spinach, kale) and fortified cereals. Pairing these with vitamin C-rich foods (like citrus fruits or bell peppers) enhances absorption. If needed, consult your doctor about iron supplementation.
- Maintain balanced nutrition: Keep blood sugar levels stable by focusing on nutrient-dense meals with a mix of complex carbohydrates, protein and healthy fats. Avoid excessive processed sugars, which can cause energy crashes.
- Prioritise rest and recovery: Acknowledge the immense energy demands of growing a human. Listen to your body, nap when needed and don’t hesitate to slow down. Good-quality rest is just as important as good nutrition.
- Follow the 3:2:1 rule for optimal sleep hygiene:
- 3 hours before bed – Avoid large meals and caffeine.
- 2 hours before bed – Reduce screen time to support melatonin production.
- 1 hour before bed – Wind down with a relaxing routine, such as reading or deep breathing.
References
- British Dietetic Association. Food factsheet. Pregnancy and diet. Accessed here: https://www.bda.uk.com/resource/pregnancy-diet.html
- Jouanne M et al (2021), Nutrition requirements during pregnancy and lactation, Nutrients, 13(2): 692.
- Khammarnia M et al (2024), Maternal macronutrient and energy intake during pregnancy: A systematic review and meta-analysis, BMC Public Health, 24(1): 478.
Discover more about supporting your clients in this FitPro blog post on Supporting your pregnant clients through exercise
