Is eating for two a myth? Yes and no.

Yes it’s a myth, because rather than doubling your calories – to 4,000 – research has suggested adding 300 calories at the beginning of your second trimester, which would mean 2,300 calories per day total if you were previously consuming 2,000 (1). Preconception, you should also be maintaining a reasonable weight. Trying to drop pounds at the same time you’re getting pregnant might not be providing your body – or possibly two bodies – with the ideal levels of nutrients. This is especially important because of possible birth defects which can happen at the very start due to folic acid deficiency (discussed below).

baby Asian boyNo, it’s not a myth in the sense that you are now responsible for two people. If it was just yourself then pigging out on empty calories and unhealthy food is within your right (we live in a free country). But once you also have another person’s life in your belly, you owe it to them to do the best you can while on your pregnancy diet… wouldn’t you agree?

The healthiest foods during pregnancy will be similar in many ways to what you would normally be eating as part of a healthy diet (whether you’re expecting or not, a woman or a man). Before we go over our list of the best pregnancy superfoods, it’s important for you to understand the key nutrients you need more of versus everyone else.

It involves a lot more than just buying organic foods. Ideally you should start the planning process not at your first trimester, but at preconception in order to reduce the risk of birth defects.

5 key nutrients pregnant women need

Increased amounts of some nutrients are recommended by the government (2). The Office on Women’s Health, which is part of the US. Dept. of Health and Human Services, addresses the following 5 on their website: folic acid, iron, calcium, vitamin A, and vitamin B12. We created our pregnancy diet list specifically based on those 5 key nutrients.

1. Folic Acid (Vitamin B9)

Beginning in the early stages or first trimester and continuing throughout the entire pregnancy, 400 to 800 micrograms (mcg) of folic acid per day is recommended. The government rarely seems to recommend supplements, but folic acid is so important the aforementioned website says “all women who are capable of pregnancy should take a daily multivitamin that contains 400 to 800 mcg of folic acid.”

Notice the keyword “capable” in that sentence. Whether it’s a daily multivitamin or another dietary supplement, you should consult your doctor before taking since not everyone is able to. Also on that note, ask your doctor before incorporating any of the superfoods for pregnancy discussed below into your diet. This is especially important since some minerals and fat-soluble vitamins you can actually overdose on.

Is folic acid the same as folate?

Nutritionally speaking, they are the same thing. The difference between them is that folate is the naturally occurring form of vitamin B9 found in foods. Folic acid is the synthetic version of vitamin B9 which was created in 1943 (3). In 1998, its use as a fortifier became mandatory for some types of foods sold in the US.

Why is folic acid necessary?

baby with open spina bifida diagramNeural Tube Defects (NTDs) are a category of birth defect which can happen at the very start of pregnancy, within the first month often times before the woman even knows she is pregnant (4). NTDs can affect the brain, spine, and spinal cord. The 2 most common are:

  • spina bifida – Incomplete closure of the baby’s backbone and membranes around the spinal cord.
  • anencephaly – A missing portion of the baby’s brain, scalp, or skull which occurs during the development of the embryo.

While the exact cause of NTDs is not understand, there are several risk factors which correlate with higher occurrence. Those include:

  • Being obese
  • Some types of medication for seizures
  • Diabetes which is not controlled well
  • Not getting enough folic acid

Regarding folic acid, there is overwhelming evidence which proves that getting the recommended amount before and during pregnancy can prevent most cases of Neural Tube Defects.

Worldwide there are more than 300,000 babies born with NTBs every year. 3,000 of those are in the US. In less developed countries, it is estimated that over half of the cases – 150,000 to 210,000 of them – could be prevented if folic acid intake was increased among females who are of childbearing age (5).

This is why over 50 countries now mandate fortification of wheat flour with folic acid. In the United States, the folic acid fortification law was enacted in 1996 and applied to enriched cereal grain products. Two years later in 1998, it went into full effect and required cereals to have 140 micrograms of folic acid per 100 grams (that’s about 3.5 ounces of cereal).

This chart shows the rates of NTDs spina bifida and anencephaly in the US before and after the law. As you can clearly see, it has had a positive benefit which cannot be disputed (6).

chart of NTDs birth defects before and after folic acid fortification

The US is actually on the low end of fortification compared to many other countries. For example Canada and South Africa require 150 micrograms, Chile is at 220.

The mandatory fortification is good news because even if you aren’t eating folate-rich superfoods or taking supplements, you are still getting it in many breakfast foods – mainly those which are processed and sold on the shelf.

Fortification in other forms for pregnant women have been suggested by some because “research has shown that they [the fortified products] do not reach all women of reproductive age adequately” (6). This is probably even more true now, given how little cereal people eat compared to earlier generations. Not to mention, the popularity of gluten free cereals may or may not involve grains that are fortified. Protein bars have become the new go-to breakfast for many.

Even if you are not currently pregnant, folic acid/folate is one of the essential vitamins

blood pressure meter

  • We need it for forming red blood cells.
  • It helps reduce levels of homocysteine in our blood. That’s an amino acid which almost entirely comes from meat and other animal proteins. It is linked to heart disease (7).
  • We need it for the production and repair of our DNA.
  • Many studies have suggested folate-rich diets help lower risks for certain types of cancers (8).

Folate deficiency side effects include gray hair, mouth ulcers, peptic ulcer, swollen tongue, diarrhea, and poor growth (9).

Since it is a water-soluble nutrient, any excess amount leaves your body through urination. This is both a benefit and a drawback.

A benefit since being water-soluble makes it quite hard for you to overdose on, since you pee out the extra which isn’t needed. Contrast that to fat-soluble vitamins, which your body stores and you can easily overdose on. That’s a good thing, because you want to be able to eat pregnancy foods in a relatively worry-free manner (at least as much as possible), so you don’t add another issue to your life to stress out about.

A drawback since your body isn’t able to store them, you regularly need to be getting sufficient amounts from your food or supplements. Unlike many animals, our bodies cannot produce it naturally, which means we must get it from dietary sources.

If you want a supplement with the natural form of folate and avoid the artificially created folic acid form, look for “5-methyltetrahydrofolate” or “5-MTHF” on the supplement label. It is sold under the brand name Metafolin, a source which Merck owns the patent for. They license it to many different vitamin manufacturers. However since organically sourced folate it is more expensive to isolate and refine, obviously most prenatal vitamins will use the artificial form instead.

Which foods are high in folic acid in its natural form? That brings us to the first top 10 superfoods on our list. The highest dietary sources are primarily leafy green vegetables, legumes and beans. Great news for vegans and vegetarians, bad news if you love meat. With the exception of some more unusual meats – like goose liver or chicken liver – healthy animal-based foods containing folate (at least in high amounts) are few and far between.

10 Best Folate Rich Superfoods
Food Serving Size Calories Folate in Micrograms (mcg)
1. Lentils (boiled) 1/2 cup 115 179
2. Asparagus (boiled) 8 spears 26 178
3. Brussels sprouts (boiled) 1 cup 56 156
4. Spinach (raw) 2.5 cups 18 145
5. Black eyed peas (boiled) 1/2 cup 80 105
6. Mustard greens (cooked) 1 cup 21 104
7. Broccoli (cooked) 1/2 cup 27 84
8. Peanuts (dry roasted) 2 ounces 328 82
9. Quinoa (cooked) 1 cup 222 78
9. Butter lettuce (raw, shredded) 1.5 cups 11 60
10. Avocado (raw, sliced) 1/2 cup 117 59

Sources: USDA National Nutrient Database, Release 21 (10) (11)

boy playing with avocadoThe amount will be nearly identical whether you’re buying organic or not.

Keep in mind these are not the highest dietary sources of folate based on concentration. Why? Because that type of ranking would be impractical. For example, if using a standardized ranking which orders them on a per 200 calorie serving, romaine lettuce ranks #3. The problem is 200 calories of romaine = 2 full heads! Our selection of superfoods for the first trimester (2nd and 3rd too, but most importantly at the start) is based on our following criteria:

  • Palatability – How good it tastes to most people. Raw chrysanthemum leaves are a top 10 folate dense food, but no one eats them because they taste awful. Also based on density per calorie, raw goose liver ranks #27 on the list but who the &@#$ wants to eat that, especially during a pregnancy diet?! We’re trying to avoid foods you will hate.
  • Serving size – Reasonable portions. Even if a food has a high density – such as parsley – it’s likely you are going to consume a tablespoon or two, not a cup. So even if it is one of the healthiest foods, you won’t get much. But you should still use it as a spice to get a little extra!
  • Accessibility – Because those chrysanthemum leaves are so awful, don’t plan on finding them at your local supermarket. Likewise for chayote fruit. Our focus is on what the average woman in America has access to.

2. Iron

adorable African-American babyAs an adult, your daily value for iron is 18 milligrams. How much iron do pregnant women need? The answer will vary depending on who you ask. Leave it to the government to give us 2 different answers!

The NIH recommends the same 18 mg amount for pregnant and lactating women (12).

The Office on Women’s Health, mentioned at the start, recommends 27 mg per day.

Meanwhile some non-government sources recommend even higher amounts. For example UCSF Medical Center also cites the 27 mg dosage, but then state that some ladies need even more – up to 60 mg per day if directed by a doctor – when they’re suffering from anemia (13).

Anemia is a deficiency of red blood cells and the most common symptom is fatigue. Of course we are all naturally “fatigued” in life to some degree or another, so this is definitely not something you can self-diagnose. A doctor can perform a simple blood test to check your levels and diagnose whether or not you have anemia.

The reason anemia is so common during pregnancy is because of changes taking place in your body.  To supply adequate amounts of blood to your womb, you will grow new arteries and circulatory pathways. Your blood volume increases to help your baby make his or her own bloody supply – up to doubling your need for iron.

Highest iron foods?

Everyone knows that meat – especially red meats like beef and lamb – are a good source of iron, but they aren’t good for much else, at least in our opinion. On average, plant based foods have 64 times more antioxidants than meat. Then there is the fact that processed red meats cause cancer, according to the World Health Organization (14). Since we’re talking about the healthiest pregnancy superfoods, we’re leaving those off our list! In fact, these are all iron rich vegetarian foods for pregnancy. Not to mention, being gluten free too.

dish of basilWhat is the highest iron food source? If you’re looking at iron content per calorie, surprisingly the answer is not meat. It’s a vegan food source… thyme. Many other spices like basil and parsley also have a lot.

Obviously though, consuming abundant amounts of those nutritious spices is not practical and therefore should not be thought of as a rich source given the typical portion size.

That caveat said, we’re including a few superfood spices because of their very high antioxidant content and the fact that you can enhance almost any meal simply by adding them. They’re good pregnancy foods when used in conjunction with others. Buy organic spices when possible.

Without further ado, here numbers 11 through 20 on our list, which were specifically chosen because of their iron content.

Iron Rich Superfoods
Food Serving Size Calories Iron (mg)
11. Tofu 1/2 cup 94 6.6
12. Thyme spice (dried and ground) 1 tbsp 12 5.3
13. Kidney beans (cooked) 1 cup 219 5.3
14. Hearts of palm (canned/bottled) 1 cup 41 4.6
15. Swiss chard (boiled) 1 cup 35 4.0
16. Parsley (dried) 2 tbsp 8 3.0
17. White mushrooms (cooked) 1 cup 44 2.7
18. Mulberries (raw) 1 cup 60 2.6
19. Spearmint (dried) 2 tbsp 8 2.6
20. Marjoram (dried) 2 tbsp 8 2.4

Since iron is a mineral, you don’t have to worry about it being destroyed by heat. So regardless of what form you eat these foods, you still get it.

Don’t be scared of buying the dried/frozen versions of these either. One of us at Superfoodly is absolutely addicted to dried mulberries which come in handy, since they’re rarely sold as fresh in US grocery stores.

We didn’t want list any top foods twice, but many of our folate rich favorites for pre-pregnancy and first trimester are also rich in iron, such as spinach and lentils.

3. Calcium

1,000 milligrams (mg); 1,300 mg if 18 or younger

Just as with the last nutrient, we’re not listing the obvious foods like milk. Numbers 11 through 20 on our list are superfoods you may not think of when it comes to high calcium content. All of these are vegan.

Superfoods High In Calcium
Food Serving Size Calories Calcium (mg)
21. Collard greens (cooked) 1 cup chopped 49 266
22. Goa/winged beans (cooked) 1 cup 253 244
23. Basil (dried and ground) 2 tbsp 22 190
24. Tempeh 1 cup 320 184
25. Chia seeds 1 ounce 137 177
26. Black beans (cooked, turtle soup style) 1 cup 241 102
27. Kale (cooked) 1 cup chopped 36 94
28. Almonds 1 ounce (23 nuts) 163 75
29. Figs (dried) 5 figs 105 67
30. Oranges (raw) 1 large fruit 69 65

Just like iron, calcium is a mineral so don’t worry about heat destroying it.

plate of tempehAlmost all soy products – whether its tofu or soy milk and yogurt – offer high amounts of calcium.

The reason we only listed tempeh (fermented soybeans) and not the more refined products is for a couple reasons. One, we believe tempeh is healthier, especially versus non-organic soy which often involve more chemical usage during their refinement process.

The second reason is that many of those refined soy products also include fortification with folic acid. There’s nothing wrong with that but since we’re listing natural sources of folate foods to eat when you’re pregnant, we thought it would be best to leave the soy and almond milks out. However we recommend those, too!

4. Vitamin A

770 micrograms (mcg); 750 mcg if 18 or younger.

Prenatal multivitamins and other supplements will often list vitamin A in International Units (IUs) instead of micrograms.

770 migrograms = 2,567 IU

Since vitamin A is a fat-soluble vitamin, you can overdose on it! The Office on Women’s Health website actually uses vitamin A as a cautionary tale of what can happen if you overdose; it can cause birth defects.

Because of the possible birth defect danger, they say a daily prenatal supplement should have “no more than 5,000 IU (International Units)” of vitamin A in it (2).

But when it comes to natural food sources, you may get more than that just from eating 1/4 of a sweet potato! So if you are pregnant, are you not supposed to eat foods high in vitamin A?

Plants contain vitamin A in the form of beta carotene. Can you overdose on beta carotene?

multivitamin supplement facts label

While not a prenatal multivitamin, this is our own daily organic multi which uses the food form of vitamin A; beta carotene

The NIH website says (we’re copy/pasting here) that “High intakes of beta-carotene do not cause birth defects or the other more serious effects caused by getting too much preformed vitamin A” (15).

That’s because beta carotene is a precursor to vitamin A. Your body has to convert it before it becomes vitamin A.

Your body regulates this conversion process so when you take in significantly more beta carotene than what you need, your body simply won’t convert it. Beta-carotene overdose or toxicity can cause temporary yellowing of the skin and nails, but as the NIH website states, not the “other more serious side effects” caused by getting preformed vitamin A, which is often found in dietary supplements as retinyl acetate or retinyl palmitate. Those you can definitely overdose on!

The best over the counter prenatal vitamins will use the natural precursor (beta carotene) rather than the final form of vitamin A (which is definitely dangerous for pregnant women in excess). This is why some of the cheaper prenatal multi’s are the worst, since they might use the form you can overdose on.

Superfoods High In Vitamin A
Food Serving Size Calories Vitamin A (IUs)
31. Sweet potato (baked) 1 medium potato 115 23,769
32. Carrots (raw) 1 cup 52 21,383
33. Butternut squash (cooked) 1 cup cubed 63 14,883
34. Pumpkin (cooked) 1 cup mashed 49 12,231
35. Goji berries (dried) 1 ounce 100 7,000
36. Broccoli raab (cooked) 3.5 ounces 33 4,534
37. Red bell peppers (raw) 1 medium pepper 37 3,726
38. Apricots (dried) 3 ounces 72 1,071
39. Tomato sauce, plain (canned/bottled) 1 cup 59 1,061
40. Peach (raw) 1 large peach 68 570

Many of these lend themselves well to pregnancy snack food ideas. Try organic goji berries and dried mulberries together… one is rich in A while the other in iron. When combined, they make a healthy snack to munch on!

5. Vitamin B12

poisonous salmon2.6 micrograms (mcg) per day

Recommending foods to eat which are high in B12 is not always easy. Why? For starters, you don’t get B12 from plants. It comes from meats and as mentioned above, we have a hard time classifying most of those as superfoods. The healthier animal sources of B12 like fish can be tricky when you are pregnant because of possible heavy metal contamination. They’re a food you need to avoid too much of.

For example the same Office on Women’s Health website says to never eat swordfish, tilefish, king mackerel, and shark if you are pregnant (2).

They say only a max of 6 ounces (about 1 serving) per week of canned albacore or chunk white tuna, since it has more mercury than canned light tuna.

For the other seafood listed, they still say only about 12 ounces (2 servings) per week max from the category overall, which includes salmon, shrimp, tilapia, pollock, scallops, oysters, canned light tuna, cod, crab, clams, and catfish.

They say “Keep in mind that removing all fish from your diet will rob you of important omega-3 fatty acids,” though we kindly point out the fact that on an equal-weight comparison, chia seeds actually contain more omega 3’s than salmon. Ground flax meal is another great source.

That brings us to the one and only we have in our B12 category…

41. Nutritional Yeast

Bragg's nutritional yeast bottle and nutrition facts labelIt’s not a meat and it’s not a plant. It’s a yeast.

Check out that nutrition facts label! This ingredient is often used in vegan cheeses because it has a similar flavor. Though you can use it on just about anything. Sprinkle on salads, pasta, you name it.

Almost all nutritional yeast on the market today is sold under just a small handful of brand names. Our favorite is the Bragg’s nutritional yeast. Not only do we trust that brand, but we like that it’s in a shaker – the bottle has a cap on top that flips open.

That makes it a lot more user-friendly versus the honking big 22 ounce can sold by Kal brand, which can be cumbersome to use and take up a lot of space in your cupboard.

To be clear we’re not suggesting you should or should not eat fish/meat for B12 (that’s a decision for you and your doctor to decide together). However given the heavy metal scares and the fact that we are focusing on superfoods here, there is really only one we feel comfortable endorsing and it happens be a vegan source of B12 for pregnancy, as well as other people regardless of diet.

Plus some other helpful foods

As you may or may not already know, constipation is a frequent symptom when you have a bun in the oven, especially as you get into the second and third trimester. It makes complete sense because obviously, with a big baby in there, your digestive tract is squished!

For this reason, high-fiber foods can help keep things moving. Fiber is not in meat, it’s only found in plants. For that reason the vast majority of superfoods listed above will also help you get much needed fiber, too. Especially chia seeds.

baobab fruit hanging on tree

Baobab fruit

In addition to those, a couple of our favorites for fiber…

42. Flaxseed meal

It’s also a very rich source of omega 3’s. We prefer the ground meal versus the raw flax seeds, because some research has suggested we may not be fully digesting the whole seeds (and therefore, not getting all the nutrients).

43. Baobab powder

This African superfruit is not only one of the highest ORAC foods on the planet, but also has a crazy amount of fiber! 50% of its fiber content is the soluble kind. Be careful because too much of the soluble form may cause you to go too much!
These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.