What Pregnancy Food Rules Should You Actually Follow?

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“During the first trimester, you don’t really have additional calorie needs, and then you only need about 340 more per day in the second trimester and 450 in the third trimester,” Tucker says. (Those ACOG guidelines are higher if you’re pregnant with multiple babies—about 300 more calories per additional fetus.) You can meet those needs by adding one or two extra snacks throughout the day. Of course, everyone’s calorie needs vary depending on things like body size and activity level, so it’s important to think of it as 340 or 450 calories more than your non-pregnancy norm, rather than looking for specific numbers that all pregnant people should aim for.

Navigating the calorie situation during pregnancy can be really tough, to say the least. “We know gaining too much weight [above the recommendation] puts someone at risk [for conditions like hypertension and gestational diabetes]. On the other hand, trying to avoid weight gain with behaviors like crash dieting can also increase the chances of pregnancy complications,” Dr. Valent says.

What constitutes healthy weight gain during pregnancy depends in large part on your weight going into it. For example, someone with a body mass index (BMI) of 18.5-24.9 going into pregnancy should gain about 25-35 pounds if they’re pregnant with one baby, according to the Centers for Disease Control and Prevention (CDC). The numbers are lower for someone with a higher BMI than this, and higher for someone with a lower BMI than this. The thing is that BMI is far from a perfect measure of health (more on that, here), and ultimately, a guideline is just a guideline. 

What’s more, the weight situation becomes even more complicated since some people may actually end up losing weight in the first trimester due to food aversions, nausea, or vomiting. Plus, weight gain isn’t exactly consistent through pregnancy, and some of what you are gaining is increased fluid and blood volume.

Dealing with confusing pregnancy guidelines surrounding the already fraught topic of weight is incredibly stressful. Focusing on developing a healthy lifestyle and healthy pregnancy overall is paramount to worrying about specific calorie counts (and if you do have aversions to “healthy” foods, getting some fuel in you is more important than being strict about what you are eating). This broader approach can also be especially helpful if you have issues with or difficulty with tracking your weight and calories.

That being said, you should always work with your health care provider whenever possible to make sure what you’re doing related to food during your pregnancy is helping instead of hurting you. (Though some health care providers can be unhelpful and stressful when it comes to anything weight-related, which only makes this more complex.) As long as your baby is growing properly on ultrasounds and you’re not excluding whole food groups or consistently deficient in any single nutrient, then you’re probably doing just fine, says Tucker. 

It’s true there are some foods you should try to avoid during pregnancy.

The following foods make this short list because they are associated with an elevated risk of foodborne illness or other potential risks to a baby’s healthy development. Foodborne illnesses, like listeriosis, salmonella, and E.coli, can make a person very ill and dehydrated, which can lead to poor pregnancy outcomes like preterm labor and contractions and even cause someone to pass out and fall, Dr. Kamyar says. Listeriosis, in particular, has been linked to more serious complications, including miscarriage and stillbirth.

Raw and smoked seafood, raw meat, raw eggs, deli meat, hot dogs, and unpasteurized dairy

The reason experts recommend avoiding these foods is because they all come with a higher-than-normal risk of contamination. “Sushi made with raw fish can have parasites that can make you ill; unpasteurized milk products (like some soft cheeses, though you can eat pasteurized versions) can carry listeria and other diseases,” Dr. Kamyar says. Ditto with raw meat, smoked seafood, deli meats, and yes, even hot dogs. “The problem with hot dogs and lunch meats is that if they’re left out and not refrigerated and they aren’t handled hygienically, that’s when you risk infection with bacteria,” Dr. Kamyar says. It’s also important to note that some conventionally “healthy” foods like sprouts, celery, and cantaloupe have also caused listeria outbreaks, the CDC says.

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