Nutrition and Exercise During Pregnancy

Growing a human being is remarkable work, and your body needs quality fuel to do it well. But between food aversions, cravings, and conflicting advice from everyone with an opinion, figuring out what to eat during pregnancy can feel overwhelming.

Here's the reassuring truth: you don't need a perfect diet, and you don't need to "eat for two" (despite what your well-meaning relatives might say). What you need is good nutrition, reasonable activity, and some common-sense guidelines. This guide will help you navigate both eating and exercise during pregnancy with confidence. AAP

What Your Body Actually Needs AAP

Pregnancy increases your nutritional needs, but probably not as much as you think. During the first trimester, you don't need any extra calories at all. In the second trimester, you need about 340 extra calories daily, and in the third trimester, about 450 extra. ACOG

That's roughly an extra healthy snack or two—not an excuse to double your portions.

Key nutrients for pregnancy:

• Folate/Folic Acid: Critical for preventing neural tube defects. You need 600-800 mcg daily, starting before conception if possible. Found in leafy greens, fortified cereals, beans, and prenatal vitamins.

• Iron: Your blood volume increases significantly during pregnancy. You need 27 mg daily (nearly double the non-pregnant amount). Found in lean red meat, poultry, beans, spinach, and fortified cereals.

• Calcium: Baby is building bones, and will take calcium from yours if you don't get enough. You need 1,000 mg daily. Found in dairy products, fortified plant milks, leafy greens, and canned fish with bones.

• Vitamin D: Works with calcium for bone development. You need 600 IU daily. Found in fortified milk, fatty fish, egg yolks, and sunlight exposure.

• DHA (Omega-3): Important for baby's brain and eye development. Aim for 200-300 mg daily. Found in fatty fish, DHA-enriched eggs, and supplements.

• Protein: Building blocks for baby's growth. You need about 75-100 grams daily. Found in meat, fish, eggs, dairy, beans, nuts, and tofu.

• Choline: Supports brain development. You need 450 mg daily. Found in eggs, meat, fish, and some vegetables.

Building a Healthy Pregnancy Diet

You don't need to overhaul your entire diet—just make sure you're getting variety and hitting the key nutrients.

A balanced pregnancy plate includes:

• Half the plate: Fruits and vegetables (aim for variety and color)
• Quarter of the plate: Whole grains (brown rice, whole wheat bread, oatmeal)
• Quarter of the plate: Protein (lean meats, fish, eggs, beans, tofu)
• Plus dairy or calcium-fortified alternatives

Sample day of eating:

*Breakfast*: Oatmeal with berries, a glass of milk, and scrambled eggs

*Lunch*: Salad with grilled chicken, chickpeas, vegetables, and whole grain bread

*Snack*: Apple with peanut butter and a cheese stick

*Dinner*: Salmon, brown rice, and roasted broccoli

*Evening snack*: Greek yogurt with a drizzle of honey

Foods to Avoid or Limit AAP

Some foods carry higher risks during pregnancy and are best avoided:

Avoid completely:

• Raw or undercooked meat, poultry, and eggs: Risk of salmonella and other bacteria
• Raw fish and sushi: Risk of parasites and bacteria (California rolls with cooked crab are fine)
• High-mercury fish: Shark, swordfish, king mackerel, tilefish, bigeye tuna
• Unpasteurized dairy and juices: Risk of listeria
• Deli meats and hot dogs (unless heated until steaming): Risk of listeria
• Raw sprouts: Risk of E. coli and salmonella
• Alcohol: No amount is proven safe during pregnancy ACOG

Limit:

• Caffeine: Keep under 200 mg daily (about one 12-oz cup of coffee)
• Low-mercury fish: 8-12 ounces per week of salmon, shrimp, catfish, tilapia is healthy and encouraged
• Herbal teas: Some are safe, others aren't—check with your provider

Common myths debunked:

• Soft cheeses are fine if made with pasteurized milk (most in the US are)
• Lunch meat is fine if heated until steaming
• Runny eggs are fine if pasteurized (check the carton)

Dealing with Pregnancy Symptoms

First trimester nausea:

• Eat small, frequent meals (empty stomach makes nausea worse)
• Try bland, carb-heavy foods: crackers, toast, plain pasta
• Ginger (tea, candies, or supplements) may help
• Stay hydrated—sip water, try ginger ale or lemon water
• Eat before getting out of bed in the morning
• If you can't keep anything down, call your doctor

Food aversions:

• They're normal and usually temporary
• Don't force foods that disgust you—find alternatives with similar nutrients
• Prenatal vitamins fill gaps when your diet is limited

Heartburn:

• Eat smaller, more frequent meals
• Avoid lying down right after eating
• Skip spicy, acidic, and fatty foods if they bother you
• Sleep slightly propped up

Constipation:

• Increase fiber gradually (whole grains, fruits, vegetables)
• Drink plenty of water
• Stay physically active
• Talk to your doctor about safe stool softeners

The Prenatal Vitamin Question

A good prenatal vitamin is an insurance policy, not a replacement for healthy eating. AAP

What to look for in a prenatal:

• 400-800 mcg folic acid
• 27 mg iron
• 150 mcg iodine
• DHA (200-300 mg) or take separately
• Vitamin D (600 IU)
• Calcium (you may need a separate supplement)

Tips for taking prenatals:

• If they make you nauseated, try taking them at night or with food
• Gummy vitamins often lack iron, so you may need a separate supplement
• Generic prenatals are usually fine—compare labels to name brands

Exercise During Pregnancy ACOG

Unless your doctor advises otherwise, exercise during pregnancy is not only safe—it's beneficial for both you and your baby.

Benefits of pregnancy exercise:

• Reduces back pain and improves posture
• Boosts energy and mood
• Helps you sleep better
• Reduces risk of gestational diabetes
• Prepares your body for labor
• Helps with postpartum recovery
• May reduce risk of cesarean delivery

How much exercise?
Aim for 150 minutes per week of moderate-intensity activity—that's about 30 minutes, 5 days a week. ACOG You don't have to do it all at once; three 10-minute walks count.

Safe exercises during pregnancy:

• Walking (the easiest to maintain throughout pregnancy)
• Swimming and water aerobics (great for aching joints)
• Stationary cycling
• Low-impact aerobics
• Prenatal yoga and Pilates
• Light strength training
• Dancing

Exercises to modify or avoid:

• Contact sports (soccer, basketball, hockey)
• Activities with fall risk (skiing, horseback riding, gymnastics)
• Hot yoga or hot Pilates (avoid overheating)
• Scuba diving
• Exercises lying flat on your back after the first trimester
• Anything that causes pain, dizziness, or shortness of breath

Starting an exercise routine:
If you weren't active before pregnancy, start slowly. Walking is a great beginning. If you were already active, you can usually continue your routine with modifications.

Warning Signs to Stop Exercise ACOG

Stop exercising and contact your doctor if you experience:

• Vaginal bleeding
• Regular, painful contractions
• Fluid leaking from your vagina
• Dizziness or feeling faint
• Chest pain
• Headache that won't go away
• Calf pain or swelling
• Muscle weakness affecting balance

Weight Gain During Pregnancy

Weight gain is normal and necessary—your body is building a baby, a placenta, extra blood volume, amniotic fluid, and stores for breastfeeding.

Recommended weight gain (based on pre-pregnancy BMI): ACOG

• Underweight (BMI < 18.5): 28-40 pounds
• Normal weight (BMI 18.5-24.9): 25-35 pounds
• Overweight (BMI 25-29.9): 15-25 pounds
• Obese (BMI ≥ 30): 11-20 pounds

Where the weight goes:

• Baby: 7-8 pounds
• Placenta: 1-2 pounds
• Amniotic fluid: 2 pounds
• Uterine enlargement: 2 pounds
• Breast tissue: 2 pounds
• Blood volume: 4 pounds
• Fat stores: 5-9 pounds
• Fluids: 4 pounds

Weight gain isn't linear—you may gain nothing in the first trimester (especially with nausea) and more later. Your doctor will track your pattern.

What Other Parents Ask

Q: I have terrible morning sickness and can barely eat. Will my baby be okay?
A: In the first trimester, baby's nutritional needs are small. As long as you're staying hydrated and taking prenatal vitamins, your baby is likely fine. If you can't keep anything down or you're losing weight, contact your doctor—you may have hyperemesis gravidarum and need treatment. AAP

Q: Can I diet to lose weight during pregnancy?
A: Pregnancy is not the time for weight loss diets. Even if you're overweight, extreme calorie restriction can be harmful. Focus on nutritious foods and reasonable portions, and let your doctor guide healthy weight gain. ACOG

Q: Is it safe to run while pregnant?
A: If you were a runner before pregnancy, you can usually continue with modifications. Listen to your body, stay hydrated, and stop if anything feels wrong. As your belly grows, you may need to switch to walking. ACOG

Q: What about vegetarian or vegan pregnancy?
A: You can absolutely have a healthy vegetarian or vegan pregnancy with planning. Pay special attention to protein, iron, B12, zinc, and omega-3s. Work with your doctor or a dietitian to make sure you're meeting all nutritional needs. AAP

The Bottom Line

Growing a baby doesn't require perfection—it requires reasonable nutrition, moderate activity, and listening to your body. Some days you'll eat a beautiful balanced meal; other days you'll survive on crackers and ginger ale. Both are okay.

Focus on getting enough of the important nutrients, staying active in ways that feel good, and not stressing over every bite. Your body knows how to do this—your job is to give it the support it needs.

If you have questions about specific foods, exercise routines, or symptoms you're experiencing, talk to your healthcare provider or ask Clara for help thinking through your options.