Pregnancy Nutrition Guide: What to Eat for Each Trimester
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Increased Nutritional Demands in Pregnancy
Calorie needs increase only modestly: +0 kcal in T1, +340 kcal/day in T2, +452 kcal/day in T3. But micronutrient demands increase dramatically: iron +50%, folate +50%, iodine +50%, choline +7%, DHA +33%. “Eating for two” in calories is a myth; eating for two in micronutrients is real.
First Trimester Priorities
Folate/folic acid (400–800 mcg/day): neural tube closure complete by day 28. Start before conception. Iron: begin building stores early — many women start T1 already iron-deficient. Vitamin B6 (10 mg up to 4x/day with doxylamine): helps control morning sickness. Anti-nausea foods: cold foods (less smell), ginger, small frequent meals, crackers before getting out of bed.
Second Trimester: Growth Phase
Iron increases to 27 mg/day (RDA). Calcium: 1000 mg/day — fetal skeleton mineralizing rapidly. Vitamin D: 600 IU (RDA) but many experts recommend 1000–2000 IU given widespread deficiency. DHA: 200–300 mg/day for brain development. Protein: 1.1g/kg body weight (roughly 71g/day). Omega-3 sources: salmon (2–3× per week), algal oil.
Third Trimester: Final Preparation
Highest caloric need period. Iron is critical — anemia in T3 increases hemorrhage risk. Vitamin K: supports fetal clotting factor development. Choline: 450 mg/day — fetal brain development. Avoid: high-mercury fish (swordfish, king mackerel, tilefish, shark). Safe fish: salmon, sardines, tilapia, shrimp (< 12 oz/week).
Foods to Avoid During Pregnancy
Raw or undercooked meat/fish (Listeria, Salmonella, Toxoplasma risk). Unpasteurized dairy and soft cheeses (Brie, Camembert, feta, blue cheese — Listeria risk). Raw eggs and products (Salmonella). High-mercury fish. Liver (high vitamin A — risk of teratogenicity if eaten very frequently). Alcohol — no safe level established. Caffeine limit: < 200 mg/day.
Supplements in Pregnancy
Prenatal vitamin: cover the essentials. Check for: folate (400–800 mcg), iron (27 mg), iodine (150 mcg), DHA (minimum 200 mg). Many prenatals are iron-deficient or iodine-deficient — read labels. Vitamin D is often under-dosed in prenatals (400 IU vs the 1000–2000 IU many experts recommend). Choline is rarely included — add separately.
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