Safe Food: What to eat and drink in pregnancy

Foods rich in vitamin B12 (best first)

Vitamin A: harmful if you have too much

We all need small amounts of vitamin A to keep our skin healthy. A balanced diet containing a range of fruit and vegetables, margarine and eggs will provide all the vitamin A we need. There is no need to take extra during pregnancy.

It may be harmful to your developing baby to have too much vitamin A. There are two ways in which this may happen: first, if you eat large amounts of liver, and second, if you take supplements of either vitamin A or fish oil.

Animal liver and liver products may contain high levels of vitamin A. This is related to the type of food on which the animals have been fed. It is therefore best that you do not eat liver, or foods made from liver (such as pate) while you are pregnant. It is OK to eat these foods once you have had your baby.

Fish oil supplements (tablets, capsules or medicine) may also contain high levels of the wrong type of vitamin A. Fish oil contains essential fatty acids – but it is better to eat oily fish like mackerel, herrings, pilchards and salmon, rather than take a supplement.

If you feel you need to take a vitamin supplement, avoid ones that contain the ‘retinol’ form of vitamin A. Too much (more than 3,300 microgrammes, or mcg or μg) of this type of vitamin A may harm your developing baby. The ‘carotene’ form of vitamin A is safe – so check the label carefully and ask your pharmacist for advice.

Vitamin C: needed every day

Our bodies need a good supply of vitamin C to help fight infection and disease, to repair damage within our bodies, and to help heal wounds. Vitamin C also plays a role in preventing anaemia (lack of iron in the blood). Unlike other vitamins, vitamin C cannot be stored in our bodies – so we need to eat some foods rich in vitamin C each day.

Some women may need more vitamin C than others. If you smoke, or cannot avoid the smoke of other people’s cigarettes, your body needs more vitamin C. Similarly, if you have been ill, or have had surgery, or have suffered an injury, your body will be using large amounts of vitamin C. In these circumstances, it is a good idea to increase your intake of foods rich in vitamin C.

Foods rich in vitamin C (best first)

Tips for preserving vitamins

Antioxidants: nutrients fighting pollution

Antioxidants are a special group of nutrients that work to protect our bodies by blocking the action of ‘free radicals’.

Free radicals are molecules (groups of particles) produced by our bodies. They are produced during many normal body processes – for example, the destruction of bacteria (germs) by our white blood cells, and the digestion of essential fatty acids. A certain level of free radicals is therefore normal.

The problem is that levels of free radicals within our bodies seem to be rising, as more and more are produced in response to pollutants such as cigarette smoke, exhaust fumes, and other toxic substances. If left unchecked, free radicals damage the cells of our bodies and weaken our defences against diseases such as heart disease and cancer.

The main antioxidants are:

Vitamin C is probably the most effective antioxidant. Most fruit and vegetables are good sources of vitamin C, especially citrus fruits, kiwi fruit, blackcurrants, peppers, tomatoes and green leafy vegetables. Vitamin E is found in vegetable oils, wholegrain bread and cereals, avocado pears and other green vegetables, eggs, butter and margarine.

We can get zinc from lean meat, cheese, milk, wholemeal bread and cereals. Cereals are also a good source of selenium, along with fish, pork, cheese, eggs and brazil nuts. Two other mineral antioxidants – copper and manganese – are found in wholegrain cereals, nuts, vegetables, meat and fish.

Beta carotene (and similar nutrients) are found in yellow and orange fruits such as mangoes, apricots, peaches and plums. Green leafy vegetables are rich in beta carotene, as are carrots, pumpkins and tomatoes. Cooked and processed tomatoes, in particular, are considered to be an excellent source of lycopene, another useful antioxidant.

Antioxidants are important for all of us, whether pregnant or not. A balanced diet, with plenty of fruit, vegetables and wholegrain bread and cereals will provide plenty of antioxidants.

Vitamin D: the sunlight vitamin

Vitamin D helps our bodies absorb and use a mineral called calcium. Calcium is needed for strong bones and teeth. A good intake of calcium is especially important during pregnancy when your baby’s bones and teeth are developing.

Vitamin D is found in oily fish, such as sardines and mackerel, eggs, milk and other dairy products, and fortified foods such as margarine and breakfast cereals. Vitamin D is also made within our bodies, a process started by sun-light on our skins. People who spend some time out of doors each day, and who eat plenty of foods rich in vitamin D, usually have good stores of the vitamin.

The UK government recommends that pregnant (and breastfeeding) women should take a supplement of 10μg of vitamin D each day (sometimes written as 10mcg or 10 microgrammes). This is because some women in the UK may not build up adequate stores of vitamin D to meet the extra needs of pregnancy. You may like to talk to your GP about a vitamin D supplement if:

Calcium: a mineral for strong bones and teeth

Calcium and vitamin D are closely connected because we need vitamin D to help our bones and teeth make use of calcium. Dairy products are the best source of calcium.

One piece of research suggests that not having enough calcium may mean that some women are more likely to develop pre-eclampsia – but more proof is needed.

Foods rich in calcium (best first)

Zinc: the fertility mineral

Zinc plays an important part in fertility (getting pregnant) and healthy pregnancy. It is also needed for growth and healing, and for good immunity to infections and disease. Meat, milk foods and seafood are all good sources of zinc. Some experts are concerned that the absorption of zinc by our bodies can be reduced by an excessive amount of fibre in our diets, and by unnecessary iron and folic acid supplements. This is one reason why it is important to consult your GP, midwife or pharmacist before taking any nutritional supplements during pregnancy.

Foods rich in zinc (best first)

Iron: for healthy blood

Iron is needed to make haemoglobin, a pigment that is found in our red blood cells. Haemoglobin carries oxygen around our bodies. If our red blood cells are not healthy, the transport of oxygen around our bodies may not be good enough. We may begin to feel tired, breathless, dizzy and miserable. These are some of the signs of anaemia.

Doctors and midwives used to give all pregnant women supplements of iron routinely. We now know that unnecessary iron supplements may interfere with the absorption of other minerals, such as zinc. They may also cause constipation. It is usually better to prevent anaemia by eating more iron-rich foods. Iron supplements are, however, necessary to treat anaemia; your doctor or midwife will advise you as to whether you need an iron supplement.

Foods rich in iron (best first)

Tips on getting plenty of iron from your food

What about salt?

Most of us eat more salt than we need. Processed foods – such as ham, cheese, bread, baked beans and biscuits – all contain lots of salt. Savoury spreads (like yeast extract and beef extract), crisps, olives and salted nuts are obviously salty foods. In the long term, too much salt in your diet may contribute to high blood pressure and related health problems later in your life.

During pregnancy, however, the situation is more complicated. Restricting your salt intake at this time has not been shown to reduce the risk of high blood pressure during pregnancy. But this does not mean that you should add extra salt to your food. Use salt to flavour your food, as you would normally.

When you have had your baby, you can try reducing the amount of salt you use in cooking and on your food. This will help when your baby starts taking solid food, since babies should not have any salt at all added to their food.

There is no proof that cutting your salt intake during pregnancy will reduce swollen ankles. Similarly, there is no proof that leg cramps during pregnancy are caused by a lack of salt or of any other minerals.

Understanding food labels

What are calories?

A calorie (cal or kcal, for short) is a measure of how much energy a particular food gives us. Calories are sometimes called ‘kilocalories’. They mean the same thing. A ‘kilojoule’ (kJ) is another measure of food energy. One calorie is equal to about 4 kilojoules.

What is the ‘RDA’?

RDA stands for ‘recommended daily amount’. The recommended daily amount of a certain nutrient is the amount that most of us need to keep healthy. RDAs vary from person to person. For example, children’s nutritional needs are different from those of older people, and pregnant women’s nutritional needs are different from those of men, or women who are not pregnant. Very active people need more energy than people who don’t exercise much. The RDAs given on food labels usually refer to adult men.

Food labels usually list the RDAs of vitamins and minerals. The percentage figure given after each nutrient tells us how much of our RDA would be met by a portion of that particular food. For example, ‘Folic acid 34mg (17%)’ means that the food would give us 34mg of folic acid – or 17% of the daily requirement. This sounds very good – but remember that the RDA used is that of an adult man, rather than a pregnant woman whose need is much greater.