Can I Eat for Two?

There are a lot of rumors around how much a person can and should be eating during pregnancy. I often hear, I can eat whatever I want because I am eating for two. The truth is the focus should be more about nourishing for two, rather than just increasing your overall food intake. What this means is that your body needs certain vitamins and minerals in larger quantities, but calorie needs only increase slightly in the second and third trimesters and postpartum if breastfeeding.

Now for a quick nutrition lesson. There are macronutrients and micronutrients. Micronutrients are vitamins and minerals. Macronutrients are protein, carbohydrates and fat and they provide calories. Let’s break them down, look into their functions, and also a few examples to help you better plan your meals!

A dive into macronutrients: roles and recommendations

As mentioned, there are 3 macronutrients. Protein, Carbohydrates and Fat. Your body needs all of these to function.

Protein

Roles in the body: needed for growth and repair of skin, bones, muscle and hair, needed to make enzymes, plays a role in immune health and acts as hormones.

Food sources: meat (poultry, beef, pork, etc.), fish and eggs. Nuts and beans (including soy) also contain moderate amounts of protein.

It is difficult to suggest how much of each macronutrient to recommend because it is very individualized. Recent research has shown that protein recommendations may be set too low. One study found that protein needs may be as high as 1.22 grams per kilogram in the first part of pregnancy and 1.52 later in pregnancy. According to this study, a pregnant person should be eating 78-97 grams of protein a day.

Carbohydrates

Roles in the body: needed for energy production, used as a storage form of energy, help promote healthy bowel function and gut microbiome health in the form of fibers

Food sources: starchy vegetables, fruits, legumes, some dairy foods, grains, pasta/breads, sugary foods. Non-starchy vegetables contain carbohydrates as well, but in smaller amounts than the starchy ones.

When it comes to carbohydrates, I focus on quality versus quantity. The current guidelines recommend 45-65% of your diet come from carbohydrates. That’s roughly 225-325 grams of carbohydrates based on a 2000 calorie per day diet. For some, this amount may be fine, but the problem with this amount is that carbohydrates affect blood sugar. During pregnancy, your ability to handle blood sugar is lessened.

Focus on keeping everything balanced. Too many carbohydrates at one time or the wrong type of carbohydrates can lead to blood sugar complications such as increased risk for gestational diabetes. High quality carbohydrates include fiber rich foods such as fruit, veggies and whole grains. Try to limit carbohydrate sources such as breads, pastas, sugar sweetened beverages and sweets.

Fats

Roles in the body: needed for hormone production, can be converted and used for energy, form the structure of our cell walls (our brains are 60% fat!) and help carry fat soluble vitamins (A, D, E and K).

Food sources: meat, full fat dairy, fish, nuts, seeds, avocados and more. Fats also make up the majority of cooking oils, butter and lard.

When it comes to fat intake, don’t be scared. Filling your diet with healthy fats and avoiding the harmful ones will help promote satiety and overall health. Some examples of healthy sources of fats include low mercury fish, nuts/seeds, grass fed dairy and meat, pasture raised eggs, avocados and olive oil. Sources that should be limited include shelf stable baked goods, fried foods, Crisco, margarine, corn and soybean oil.

Keep it simple

I don’t know about you, but planning meals while counting grams of protein and carbohydrates sounds daunting. When planning your meals, the simplest way to include each macronutrient is to divide your plate. Half of your plate will be non-starchy veggies. This could be a serving of broccoli with a side salad. Then, one quarter will come from protein (plant or animal). Then the final quarter will be your starchy foods (grains, beans, fruit etc.).

Listening to hunger cues: intuitive eating

During your first trimester you do not require any extra calories than your normal needs. During your second trimester, it is said that you will need around 340 calories extra a day. This is equivalent to a moderate sized snack. During your third trimester the guidelines say around 450 extra. Adding a couple extra small snacks or a small meal can help you meet this amount.

While all of these recommendations exist, they can be overwhelming. Hunger during pregnancy can be intense and confusing, and it can be hard to stick to specific dietary recommendations. But that doesn’t have to be the case. Your body can be trusted and you can honor and listen to your hunger cues. This is where intuitive eating can come in and be a helpful practice. Intuitive eating involves eating according to when you are hungry or full, rather than following specific diet rules or eating when provoked or feeling a certain emotion.1 This is not to say you should never eat when you have strong emotions. We all like to eat fun foods when celebrating or feeling happy and sometimes, yes ice cream when feeling down. Think of intuitive eating as a practice to learn what your body needs throughout each day.

Intuitive eating has been shown to have a range of health benefits during pregnancy. Excess weight gain is linked to an increased risk of complications during pregnancy. One study investigated whether there is a relationship between intuitive eating and gestational weight gain (GWG) and found that intuitive eating appeared to be associated with lower weight gain during pregnancy, but not babies’ birth weight. Another study investigating the associations between intuitive eating and trimester-specific GWG found that higher levels of intuitive eating and adequate first trimester GWG. The same study also investigated the association between intuitive eating and diet quality at each trimester and found that intuitive eating was associated with better diet quality in the second and third trimesters.

Practicing intuitive eating can also lead to improved body image. One study found that people who had positive attitudes toward weight gain reported practicing healthier eating behaviors in late pregnancy. Listening and trusting your body is extremely important. Your body is undergoing so many changes; after all it’s growing a baby. Recognize that you are the expert of your own body. It’s important to listen to what it needs and know how to respond.

Balance

It’s all about balance. Practice eating consistent meals that are balanced with protein, carbs, and fat and listening to those hunger cues. Hunger during pregnancy doesn’t have to be scary!

Resources:

Stephens TV, Payne M, Ball RO, Pencharz PB, Elango R. Protein requirements of healthy pregnant women during early and late gestation are higher than current recommendations. J Nutr. 2015;145(1):73-78. doi:10.3945/jn.114.198622
Paterson H, Treharne GJ, Horwath C, Haszard JJ, Herbison P, Hay-Smith EJC. Intuitive eating and gestational weight gain. Eat Behav. 2019 Aug;34:101311. doi: 10.1016/j.eatbeh.2019.101311. Epub 2019 Jul 9. PMID: 31330479.
Plante AS, Savard C, Lemieux S, Carbonneau É, Robitaille J, Provencher V, Morisset AS. Trimester-Specific Intuitive Eating in Association With Gestational Weight Gain and Diet Quality. J Nutr Educ Behav. 2019 Jun;51(6):677-683. doi: 10.1016/j.jneb.2019.01.011. Epub 2019 Feb 12. PMID: 30765299.
Savard C, Yan E, Plante AS, Bégin C, Robitaille J, Michaud A, Lemieux S, Provencher V, Morisset AS. Positive attitudes toward weight gain in late pregnancy are associated with healthy eating behaviours. Eat Weight Disord. 2021 Aug;26(6):2051-2058. doi: 10.1007/s40519-020-01057-5. Epub 2020 Oct 31. PMID: 33128720.