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New Beginnings – Nutrition during Pregnancy – Eating for two?

Nutrition is a cornerstone for maintaining good health throughout life. It is particularly important to ensure that nutrition is appropriate in pregnancy, both for the growth and development of the fetus and also for the maintenance of mom’s health.

The new Canada Food Guide that came out in January 2019 is less prescriptive than its predecessor.  There are no recommended serving sizes. The emphasis is on getting a variety of foods that are whole and less processed. Three food groups are emphasized – fruits and vegetables, whole grains and proteins. There is an emphasis on using more plant based proteins such as legumes and tofu.

There is a need for increased calorie intake in pregnancy. In the first third of pregnancy, no additional calories are needed and the focus is on getting a variety of nutrient dense foods. In the second third, an additional 340 calories is required and in the third trimester an additional 450 calories is required.

There are some nutrients that are of particular importance in pregnancy. The SOGC (Society of Obstetricians and Gynecologists of Canada) recommends that we pay attention to iron, folate, choline, iodine and omega-3 fatty acids.

Low iron causes moms to feel unwell, but also leads to low birth weight and has impact on baby’s development. A non iron deficient mom needs 27 mcg of iron in a day during pregnancy.  Most prenatal vitamins have close to this amount of iron.

Folic acid/folate is found in green leafy vegetables and is important for the prevention of neural tube defects and other birth defects. It should be started at least six weeks before pregnancy. The amount required by women not otherwise at risk for having a baby with these defects is 0.4 mg and this is again found in prenatal vitamins.

Choline is found in whole grains and in eggs, milk and dairy. It helps to prevent neural tube defects in baby. Iodine is needed for the production of thyroid hormone. Our table salt is iodized so a deficiency of iodine is unusual, though the reduction of salt in our diets may result in low iodine consumption.

Omega-3 fatty acids are important for baby’s vision and neurologic development. The more important type of omega-3 is called DHA and is found in salmon, rainbow trout and mackerel. Any consumed fish should be labelled with Health Canada’s seal of approval to ensure low levels of mercury. Other

omega-3 fatty acids are found in nuts and seeds such as walnuts and flax seeds.


This is the first in a series of articles looking at issues important to the first half of pregnancy. In the next part of this series we will look at special diets in pregnancy.

Dr. Bhooma Bhayana is a family physician in London and the mother of two young men and grandmother of one lovely princess! She continues to find wonder and enjoyment in family practice despite more than 30 years on the job!


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