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Safe Food: What to eat and drink in pregnancy
We can get enough protein from just two servings of meat protein foods each day. A serving of animal protein is equivalent to:
How much vegetable protein?
Aim for 2–3 servings of vegetable protein foods each day. A serving of vegetable protein is equivalent to:
What about milk foods?
The second of the small sections on our imaginary plate is for milk-based foods, or dairy products. Milk – and foods made from it, such as cheese, yoghurt and fromage frais – is an excellent and convenient source of calcium, zinc, some B group vitamins and protein.
Milk and milk products contain varying amounts of fat, depending on the type of milk and the way in which it has been processed. ‘Skimmed’ milk has had all the fat removed and ‘semi-skimmed’ milk has had half the fat removed. Both have the same amount of protein as whole milk – and slightly more calcium.
Liquid milk also contains plenty of water, so a glass of chilled, semi-skimmed milk is a refreshing and nutritious drink. If you do not like the taste of milk, try flavouring it with mashed banana or pulped mango. Use unsweetened cocoa powder in hot milk for a comforting evening drink.
The calcium in milk and other foods is very important. Calcium is a mineral needed by our bodies to ensure strong bones and teeth. A good supply of calcium is especially important during pregnancy (when your baby’s bones and teeth are developing) and while breastfeeding.
Can’t drink milk?
Some people strongly dislike milk and feel that it disagrees with their digestion. They may be allergic to milk or they may react badly to lactose, the sugar in milk.
In order to digest lactose, our bodies need an enzyme (special chemical) called lactase. Babies have plenty of lactase, but some adults have very little. These adults are unable to drink milk – but may find they can eat cheese and yoghurt because the lactose in these foods has been changed or removed. They may also be able to tolerate butter.
All of these nutrients in milk can be found in other foods, but it may be hard to get enough calcium if you dislike all dairy products. We suggest other sources of calcium in Chapter 2.
How much milk?
We need three servings of milk, or milk-based food, each day. A serving of milk is equivalent to:
What is so bad about fats and sugar?
The tiny section remaining on our plate is for fatty and sugary foods. Fats and sugar are found in many, many foods – not only in butter, cream and all types of sugar, but ‘hidden’ in lots of processed foods. Did you know, for example, that a large sausage contains the equivalent of 3 teaspoons of fat, and a can of soft drink 8 teaspoons of sugar?
We do need some fat in our diet. Fat is a source of vitamins A, D and E and essential fatty acids. But we don’t need to deliberately choose fatty foods – because we get quite enough of both from other, more healthy foods.
The problem with fats
There are several different types of fat; some are more healthy than others. The three main types of fat are:
The basic building blocks of fat are called fatty acids. Each type of fat is made up of different fatty acids.
Most adults in the UK eat too much fat – especially saturated fat. Too much saturated fat increases our risk of heart disease. All types of fat can contribute to an unhealthy weight gain. This is because fats are a very concentrated source of energy. They also tend to make foods taste good.
Saturated fats
Saturated fats are found mainly in foods that come directly, or indirectly, from animals – lard, butter, cream, fatty meat, hard cheese, and foods made using animal fats, like biscuits and ready-made pastry. Coconut oil, palm oil and ghee are also rich in saturated fats – as is chocolate. We should all eat a lot less saturated fat.
Meat and cheese, however, supply other valuable nutrients as well as containing saturated fat. The way around this dilemma is to try to choose lean cuts of meat (we only need a little, remember). It is also a good idea to trim away visible fat, and avoid using extra fat when cooking the meat. If you eat a lot of cheese, you may like to choose a low-fat variety. And, if you enjoy the taste of butter, try a low-fat, ‘buttery’ spread instead. Semi-skimmed milk (or normal milk with the cream poured off) contains a lot less fat than whole milk – and is just as nutritious.
Mono and poly: the unsaturated fats
Monounsaturated fats are found in many foods, including vegetable oil, olive oil, soft margarines, meat, fish, avocado, eggs and peanuts. Check the ‘nutritional information’ label on packaged food to see what type of fat each food contains.
Monounsaturated and polyunsaturated fats are better for you than saturated fats. Polyunsaturated fats tend to be liquid at room temperature – in contrast to saturated fats which are usually hard (think of butter, lard, fat on meat and so on). Polyunsaturated fats are found in soya and sunflower cooking oils, sunflower margarine, oily fish, nuts and seeds.
Essential fatty acids
Polyunsaturated fats are important because they contain essential fatty acids. These special fatty acids are called ‘essential’ because (unlike other fatty acids) they cannot be made in our bodies – we have to get them from our food. The essential fatty acids are needed for normal brain development and the production of some of the hormones necessary for a healthy pregnancy. (Hormones are special chemicals working in our bodies.)
There are two essential fatty acids: linoleic acid and linolenic acid. Linoleic acid is found mainly in nuts, and in plant oils such as sunflower, soya or corn oil. Good sources of the other essential fatty acid – linolenic acid – are oily fish (tinned or fresh sardines, mackerel and salmon), eggs and lean meat.
It is important to take in a balance of the two fatty acids. Unless you are on a very low-fat diet, you are probably taking enough linoleic acid, but most of us would benefit from eating more oily fish and so increasing our intake of the second essential fatty acid, linolenic acid. Scientific research suggests that women who eat more oily fish tend to have longer pregnancies and bigger babies. There may also be a link between taking fish oil during pregnancy and a reduction in the risk of pre-eclampsia, a serious disorder of pregnancy.
Trans fats
Finally, we need to mention a special group of fatty acids called ‘trans fats’. You may notice on some low-fat spreads a label stating that ‘This product contains virtually no trans fats’. These products are good ones to choose because high intakes of trans fats have been linked with heart disease.
Trans fats are found in polyunsaturated fats that have been artificially processed in some way. For example, reheating vegetable oil changes the (healthy) fatty acids in that oil to (unhealthy) trans fats. A similar thing happens when liquid fats are hardened to use in factory-produced pastry and hard margarine. Butter, cream and cream cheese also contain some trans fats. The words ‘hydrogenated vegetable oil (or fat)’ on food labels means that the food probably contains trans fats.
We talk more about avoiding the unhealthy types of fats in Chapter 8.
What’s wrong with sugar?
There are two main types of sugar:
The main problem with added sugar is that, although it gives us an energy boost, it contains no other nutrients at all. In fact, because our bodies need to work to digest sugar, nutrients from other foods eaten at the same time are wasted. Too much added sugar actually drains nutrients from our bodies.
Eating sugary foods fills us up – so we can’t eat other, healthier foods. Too much added sugar contributes to tooth decay and to an unhealthy weight gain. Sugary foods don’t satisfy us for long – so we soon feel hungry again. Finally, sugary foods – cakes, chocolates and sweets – tend to be expensive. So, bad food value all round!
The problem is that many of us really like the taste of sugar. Some women find that they want to eat more sugary foods at certain times of their menstrual cycle – or at different stages of pregnancy. It can be very hard saying ‘no’ to a tube of sweets or bar of chocolate at times like this. Try to think instead about the other type of sugar – the natural sugar found in fruit or in milk. Foods containing this kind of sugar are rich in many nutrients. When you crave a sugary snack, reach for things like kiwi fruit, bananas and cherries, dried fruit, a slice of fresh bread, a couple of digestive biscuits or some unsalted nuts.
We talk more about cutting down on sugar and sugary foods in Chapter 8.
Last, but not least – water!
We all need to drink plenty of water and other fluids. A good intake of liquid throughout the day helps with the smooth running of virtually every part of our body. When we drink enough water our digestion works better, our joints ache less and our skin is softer. Drinking plenty of water can relieve and help prevent many ailments – headaches, constipation, urine infections.
Drinking more while you are pregnant may seem odd, because many women already find they need to go to the toilet more often, especially at night. But there is a reason for this. When you are pregnant, your body contains extra blood and other fluids, to meet the needs of your baby – and your kidneys need to work harder to cope with the additional demands. It is important that you drink plenty to meet your baby’s needs, and to keep yourself in good health. Cutting back on what you drink to avoid getting up to go to the toilet at night can be harmful. Pregnant women are prone to urine infections and constipation and a good intake of fluid will help prevent both of these problems.
During pregnancy, try to drink 6–8 glasses of water, or other fluids, each day – not counting milk or alcohol. Some women find cold tap water very refreshing; others prefer bottled or fizzy water, unsweetened fruit juices or weak squash (avoid those with added sugar!). Many women enjoy coffee or tea, including the fruit and herbal types, or alcohol-free wines and beers. (More about tea, coffee and alcohol in Chapter 7.) The main thing is to find drinks that you enjoy.
Urine infection
Signs of a urine infection may include pain when passing urine, needing to go to the toilet often, or needing to go very urgently. Your urine may be dark in colour, cloudy or smelly. If you are worried that you may have a urine infection, start drinking plenty of water to wash out the germs, and contact your family doctor or midwife.
In this chapter we have described a basic plan for balanced eating: plenty of starchy carbohydrates, lots and lots of fruit and vegetables, small amounts of protein and milk foods, tiny quantities of fatty and sugary food – and plenty of water and other fluids. Enjoy your food!
Key points
2 More about healthy eating
In this chapter, we talk in more detail about some of the vitamins, minerals and other nutrients mentioned in Chapter 1.
Eating the kind of balanced diet described in Chapter 1 will ensure that you take in plenty of most vitamins and minerals without worrying about any extra foods or supplements. There are a few exceptions to this – the most significant one being folic acid, one of the B group of vitamins. This is a very important vitamin for pregnant women – and for women planning a pregnancy.
There are a few other vitamins and minerals that certain groups of women may need to take special note of: for example, vitamin B12 if you eat a vegan diet, iron if you had very heavy periods before pregnancy, and vitamin D if you rarely go out of doors. Read on to find out more.
Folic acid: a very important vitamin for babies
Important: if you suffer from epilepsy, it is important to see your doctor before taking a folic acid supplement. Better still talk to him or her before you become pregnant.
Our bodies need folic acid (sometimes called folate) to make DNA. DNA carries the genetic information that controls the correct development and function of every single cell in our bodies. When you are pregnant, you need extra folic acid – especially in the first 12 weeks while your baby’s body is being formed.
Insufficient folic acid at this time can contribute to problems with the neural tube of your developing baby. The neural tube develops in the very early weeks of pregnancy. It eventually forms your baby’s brain and spinal cord (the long bundle of nerves inside our backbones that connects our brains with the rest of our bodies). You may have seen, or heard, the abbreviation NTD – this stands for neural tube defect. The most common type of neural tube defect is spina bifida. If you decide to have an ultrasound scan during your pregnancy, your baby’s spine will be checked for signs of spina bifida.
Although NTDs are rare, the UK government advises all pregnant women to take folic acid supplements and eat more foods rich in folic acid. Extra folic acid is particularly important for women who have already had a baby with a neural tube problem.
Folic acid supplements
Folic acid supplements are available on prescription from your GP or midwife. NHS prescriptions are free to pregnant women. If you are not pregnant, you may have to pay for your prescription. In this case, it is cheaper to buy a folic acid supplement from a chemist or supermarket. Ask the pharmacist for advice.
Most folic acid supplements are small, white tablets. The recommended dose is 0.4mg each day. (This is sometimes written as 400μg, 400mcg or 400 microgrammes.) Much higher doses are given to women who have already had a baby with an NTD – ask your GP for guidance.
As well as taking a folic acid supplement, increase the amount of folic acid in your diet. This is good advice for all women – pregnant or not! Remember that folic acid, like most vitamins, is easily destroyed by cooking. It is therefore best to steam, microwave or stir-fry vegetables rich in folic acid – or cook in the minimum of water. Don’t overcook!
Planning a pregnancy?
The government also advises that women planning to become pregnant should take folic acid supplements. This is because the neural tube develops during the first four weeks of pregnancy – when a woman may not realise she is pregnant. However, because many pregnancies are unplanned, this is not always possible. If you find yourself in this position, start taking a folic acid supplement as soon as possible, and increase the amount of folic acid in your diet. Remember that NTDs are relatively uncommon.
Foods rich in folic acid (best first)
Vitamin B12: another B group vitamin
There are many B group vitamins. Eating a balanced diet will give us plenty of all of them – except perhaps for folic acid and vitamin B12.
Vitamin B12 (or ‘cobalamin’) is needed, like folic acid, for the production of new cells – especially new red blood cells. It also contributes to a healthy nervous system and is involved in the making of fatty acids. Vitamin B12 is therefore particularly important during pregnancy.
Vitamin B12 is found naturally only in foods that come from animals – meat, fish, eggs, milk and so on. It is also added to some breakfast cereals during their manufacture. It is very rare for women who eat animal foods to be deficient in vitamin B12.
