When it comes to pregnancy, one of the first things people tell you is, “You’re eating for two!” However, according to Dr. Elizabeth Kelly, Assistant Professor of Obstetrics and Gynecology at Tulane School of Medicine and Medical Student Clerkship Director, that long-standing phrase is due for a serious reality check.
“‘Eating for two’ has implied the need to eat a lot of extra food, and some have even interpreted [that as eating] twice as much,” Dr. Kelly says. “We now know that too much weight gain in pregnancy can add risk to the pregnancy. It then becomes difficult to return to a healthy weight postpartum, and over several pregnancies, weight gain can accumulate and lead to other health risks later in life associated with being overweight or obese.”
Instead of doubling their intake, most pregnant individuals only need an additional 340 calories a day (which is equivalent to half a glass of skim milk or a small snack). That’s a far cry from the double portions often envisioned.
Dr. Kelly emphasizes that nutritional needs shift throughout the pregnancy and should be guided not only by trimester, but also by the expectant person’s health status and pre-pregnancy weight. Morning sickness in the first trimester may reduce appetite, while smaller, more frequent meals often work best in the third trimester when a growing uterus compresses the stomach.
Essential Nutrients for a Healthy Pregnancy
Dr. Kelly breaks down the five powerhouse nutrients every pregnant person should prioritize and the best ways to get them. These nutrients are often bundled in prenatal vitamins, but whole foods provide important benefits too.
Folate: Crucial for early fetal nerve development. Find it in leafy greens, lentils, fortified cereals, and citrus fruits. A prenatal vitamin started one month prior to pregnancy helps prevent deficiencies.
Iron: Builds extra blood supply and supports fetal growth. Think beans, dark greens, meats, and fortified cereals paired with citrus to enhance absorption.
Calcium: Key for developing strong bones and teeth. Sources include dairy, broccoli, sardines, and almonds.
Vitamin D: Works alongside calcium for bone health. Found in fortified dairy, fatty fish like salmon, and egg yolks.
Choline: Supports brain development. Reach for eggs, chicken, soy, milk, and peanuts.
Managing Common Pregnancy Discomforts with Food
Nutrition can also play a helpful role in alleviating some of pregnancy’s less glamorous symptoms. For morning sickness, Dr. Kelly recommends trying ginger, vitamin B6, and sticking to simple, frequent meals. If heartburn is an issue, steer clear of acidic foods and consider Tums if needed. And when fatigue sets in? Stick with balanced meals, hydration, and light exercise.
Busting Pregnancy Nutrition Myths
Dr. Kelly often hears the same misconceptions, and she’s quick to set the record straight:
Eating for two: Still the most persistent. Remember: just one extra snack, not double meals.
No exercise allowed: Dr. Kelly encourages continued activity, with some safety precautions like avoiding heated rooms and high-fall-risk sports.
No caffeine at all: Unnecessary. Limit to 200mg per day (about two small cups of coffee).
A glass of wine is okay: Dr. Kelly is clear: There is no known safe amount of alcohol in pregnancy.
Foods to Avoid Entirely
Some foods are best left off the pregnancy menu due to safety concerns. High-mercury fish (like swordfish and king mackerel), raw or undercooked meats and eggs, unpasteurized dairy, and deli meats can carry harmful bacteria or toxins. Alcohol is a no-go, and Dr. Kelly also notes the importance of washing fruits and veggies thoroughly and skipping any food that’s been sitting out too long—especially dishes with mayo or dairy. When it comes to potlucks and holiday gatherings, just to be safe, “Bring something that you know you can eat,” she adds.
Don’t Forget to Hydrate
Proper hydration is vital during pregnancy. The general recommendation is 8 to 12 cups of water per day. Dr. Kelly suggests mixing it up with electrolyte drinks, seltzers, or coconut water, but advises against sugary beverages.
Cravings, Aversions, and Knowing When to Ask for Help
Cravings and aversions are a normal part of pregnancy, and Dr. Kelly encourages patients not to stress over them. Aversions are often temporary and tend to resolve after birth. She talks through cravings with each patient individually and helps them find ways to enjoy what they’re craving while still maintaining a balanced diet.
But one of her biggest takeaways? Don’t go it alone. Dr. Kelly emphasizes the importance of reaching out to your OB-GYN or a nurse before making any major changes, like cutting caffeine, starting a new diet, or stopping a medication. She notes that some patients stop things abruptly, not realizing it might not be necessary or could even have unintended consequences. When in doubt, ask questions early so your care team can offer guidance that supports both your health and your baby’s.
Bottom line: Pregnancy is not the time to go it alone, especially when it comes to food, movement, or lifestyle changes. Reach out. Ask questions. And remember, there’s no one-size-fits-all approach. Your OB-GYN is your partner on this journey.
