“Eating for two” during pregnancy: myth or truth?

While women are often advised to “eat for two” during pregnancy, it is actually the quality rather than the quantity of food that future mothers should be mindful of. Women are encouraged to maintain a healthy weight and an optimal nutritional status during pregnancy, as this will result in better birth outcomes both for mother and baby.

What are the risks of ‘eating for two’?

According to the Maternity Services Dataset, in 2017, 27% of pregnant women in the UK were overweight, 18.3% were obese and 3.3% were severely obese. Obesity during pregnancy is linked to increased risk of almost all pregnancy related implications, including gestational diabetes and hypertension, delivery of high birth weight babies, and a higher likelihood of preeclampsia and congenital defects.

Why is "eating for two" a myth?

Nutritional status is fundamental to promote the health of both the mother and developing fetus. Nutritional requirements increase during pregnancy in order to support fetal growth and development, maternal tissue expansion and to prepare the mother’s body for lactation. However, as the pregnancy progresses, physical activity drops, meaning that the increased demands of energy to support fetal growth is compensated by reduced energy losses from physical activity - especially during the second half of the pregnancy, where more than 90% of fetal growth occurs. According to SACN (2011), pregnant women are advised to consume an additional 191 calories per day (equal to 2 medium apples!) in the 3rd trimester to reduce the risk of maternal obesity, which is far from "eating for two".

"Eat for two" or "nourish for two"?

Before and after conceiving, it is vital for women to stay well-nourished in order to support both themselves and their developing baby. Instead of increasing their overall caloric intake, pregnant women are advised to pay more attention to the nutrient value of their diet instead. Below are the key nutrient adaptations needed to support a healthy pregnancy and birth outcome:

Micronutrients:

The first 2-8 weeks of pregnancy are known as the ‘embryonic stage’ and are characterised as a critical period of development - any nutritional deficiencies during this period can cause congenital abnormalities to the fetus. 

It is recommended that all women take a daily supplement of 400 mcg of folic acid before conception and up to 12 weeks after. There is strong evidence to suggest that an increased intake of folic acid and vitamin B12 reduces the risk of neural tube defects (the structure that forms the brain and spinal cord).  Monitoring iodine intake is also crucial pre- & post-conception. Even a mild maternal iodine deficiency can have an adverse effect on the child’s brain development.

Other nutrients crucial for fetal skeleton growth include calcium and vitamin D. Supplementation with iron is also frequently recommended; however, it is important to always consult your doctor before starting supplementation, as some of the iron needed for the expansion of the maternal tissues is compensated by the cessation of menstrual bleeding during pregnancy.

Macronutrients:

With regards to carbohydrates, pregnant women are recommended to ingest low glycemic index foods; such as whole grains, fruits and vegetables. This reduces the risk of weight gain, as well as the risk of maternal and infant obesity and gestational diabetes.

It is also crucial for women to consume an adequate amount of protein to support the expansion of maternal tissues and the formation of placenta. High intake of omega-3 fatty acids are also recommended for the normal development of the brain, nervous system and retina of the fetus.

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_{Please always consult your doctor before supplementation if you are pregnant or trying to conceive.}