Top 10 Tips for Healthy Eating During Pregnancy

Pregnancy is exciting, but figuring out what to eat can feel overwhelming. Between changing cravings, nausea, and conflicting information online, it is easy to feel unsure about what actually matters.

The good news is that healthy eating during pregnancy does not have to be perfect to make a difference. Current evidence is clear: the goal is to eat better, not necessarily more, focusing on food quality and nutrient density over quantity. Simple, consistent choices can support your baby's growth and help you feel your best.

As a registered dietitian and mom of three, here are my 10 practical, evidence-based pregnancy nutrition tips to guide you.

1. Follow a Mediterranean Diet Pattern During Pregnancy

If you are wondering what/how to eat during pregnancy, a Mediterranean-style approach is one of the best starting points the research has to offer. The Mediterranean Diet focuses on whole, minimally processed foods and encourages variety without strict rules. It includes primarily fruits, vegetables, whole grains, beans, olive oil, and fish.

The evidence here is substantial. Meta-analyses of randomized trials show that Mediterranean diet interventions during pregnancy reduce gestational diabetes, small-for-gestational-age births, and excessive gestational weight gain.

Observational research further links high adherence to a Mediterranean eating pattern with reduced risks of pregnancy-induced hypertension, preeclampsia, preterm delivery, and intrauterine growth restriction. 

Limit Ultra-Processed Foods When Possible

While focusing on what to include is most important, it is also helpful to be mindful of ultra-processed foods (UPFs), such as packaged snacks, sugary drinks, fast food, and heavily refined convenience items, and limit these as best you can.

Growing evidence suggests that higher intake of ultra-processed foods during pregnancy may be associated with less favorable outcomes. A 2024 meta-analysis of over 550,000 participants found that higher UPF intake was linked to a 19% increased risk of gestational diabetes and a 28% increased risk of preeclampsia, with risk increasing alongside intake levels. 

Higher consumption of ultra-processed foods has also been associated with excessive gestational weight gain, increased inflammation, and greater postpartum weight retention.

This does not mean you need to eliminate these foods completely! Perfection is not the goal. Instead, think of the Mediterranean-style pattern as your foundation, with ultra-processed foods playing a smaller, more occasional role.

2. Include Protein Regularly Throughout the Day

Protein needs increase during pregnancy because your baby is growing rapidly, and your own body is undergoing significant changes. It also helps support satiety and stable blood sugar, which can help manage nausea.

Pregnant women should aim for 1.1-1.5 g/kg/day of protein, with higher amounts needed in the third trimester. For most women, this means consuming about 75-110 g of protein daily, depending on body weight and gestational stage. As always, speak with your healthcare provider or registered dietitian about what's right for you.

Easy, protein-rich options include eggs, Greek yogurt, chicken, salmon, beans, lentils, and nut butters. Pairing protein with fat, fiber, and a complex carbohydrate at each meal or snack can help keep energy and blood sugar levels steadier throughout the day.

3. Why Choline Is Essential During Pregnancy (and Often Missing in Prenatals)

Choline is one of the most underappreciated nutrients in pregnancy. It is essential for fetal brain and spinal cord development, plays a critical role in cognitive function and memory, and also helps prevent neural tube defects.

The problem? Most people are not getting nearly enough. Research shows that only about 8.5% of pregnant women meet the adequate intake of 450 mg/day. And despite choline being crucial, most prenatal vitamins do not provide adequate amounts of it.

The stakes are high: low maternal choline intake is associated with a 36% increased odds of neural tube defects, with risk potentially reaching more than twice as high in some populations. On the other hand, higher maternal choline intake has been linked to improved child neurocognition and better sustained attention at age 7.

Check your prenatal label and if it doesn't list choline (or lists a very small amount), prioritize food sources every single day, and talk to your healthcare provider about a separate choline supplement.

The primary dietary sources of choline are animal-based products, such as meat, poultry, fish, dairy, and eggs (especially the yolk). Cruciferous vegetables, like broccoli and kale, and certain beans, like kidney beans and soybeans, are also rich in choline. 

4. Understand the Difference Between Folate and Folic Acid

Folate and folic acid are often used interchangeably, but they are not exactly the same thing. Folate is the naturally occurring form of vitamin B9 found in foods. Folic acid is the synthetic form used in supplements and fortified foods.

Folic acid is the only form of folate that has strong evidence showing it helps prevent neural tube defects. Taking 400 to 800 micrograms per day is the standard recommendation and is considered effective for everyone.

That said, our bodies have to convert folic acid into an active form that it can use. Some individuals have a genetic variation called MTHFR that may affect this conversion. For those people, a supplement containing 5-methyltetrahydrofolate (or 5-MTHF), a pre-converted active form of folate, may be a good fit. While 5-MTHF hasn't been shown to outperform folic acid for the general population, it's a reasonable option for those with specific genetic or absorption-related considerations.

The most important takeaway is consistency. Neural tube defects develop very early in pregnancy, often before you even know you are pregnant. That is why getting enough folate or folic acid before and during early pregnancy is so important.

The best food sources of folate are leafy green vegetables, lentils, chickpeas, asparagus, brussels sprouts, citrus fruits, avocado, strawberries, and liver.

5. Think of Prenatal Vitamins as a Safety Net — Not a Substitute for Food

Prenatal vitamins are an important tool for filling nutritional gaps, especially for nutrients like iron, folic acid/folate, and vitamin D. Still, they are not designed to replace a varied, nutrient-dense diet.

Research shows that almost no U.S. dietary supplements provide all six key pregnancy nutrients (vitamins A and D, folate, calcium, iron, and omega-3 fatty acids) in appropriate doses that meet pregnancy needs without risking excess intake of other nutrients. This is one reason why food-first strategies matter even when you're taking a prenatal.

A good prenatal vitamin should contain at least: 400 mcg folic acid, 30 mg elemental iron, 200–300 mg calcium, and 400–600 IU vitamin D (with newer recommendations suggesting up to 2500 IU of vitamin D per day to help lower the risk of preeclampsia, intra-uterine mortality, preterm birth, SGA birth, and neonatal mortality). Look for third-party-tested brands, check for adequate choline on the label, and always take it with food to reduce nausea.

Nutrients like fiber, protein, choline, and many antioxidants still come primarily from food, which is why what you eat every day continues to matter, even while taking a prenatal.

6. Manage Nausea with Gentle, Strategic Eating

Nausea and vomiting in pregnancy, commonly called morning sickness (though they can strike at any time of day), are experienced by the majority of pregnant women, particularly in the first trimester. For some (including myself!), symptoms persist much longer.

If you are navigating nausea, focus on what feels manageable rather than forcing yourself to eat perfectly. Some strategies backed by evidence and clinical experience include:

• Eat small, frequent meals every 2–3 hours to prevent both overfullness and hunger-related blood sugar dips, which can worsen nausea.

• Start with bland carbohydrates such as toast, crackers, rice, or potatoes, which are often well tolerated and easy to digest.

• Add protein and fat after carbs (nuts, avocado, cheese, or a protein-rich muffin kept at your bedside) to help stabilize blood sugar.

• Try vitamin B6-rich foods such as chickpeas, salmon, and sweetpotatoes. If supplementing, a common recommendation is 10-25 mg pyridoxine every 8 hours.

• Ginger, in tea, candy, or food form, has long been used to ease nausea and is generally considered safe in moderate amounts (up to 1g per day).

• Don't take your prenatal vitamin on an empty stomach, as this commonly causes nausea and GI upset.

Eating something, even something simple, is almost always better than waiting until symptoms become severe. If you are vomiting multiple times a day, losing weight, or unable to keep anything down for more than 12 hours, contact your healthcare provider immediately, as you may need medical treatment.

7. Support Baby's Brain Development with Key Nutrients

Your baby's brain undergoes rapid and critical development throughout pregnancy, and several nutrients are especially important for supporting it.

Choline and DHA are arguably the two most critical brain-building nutrients in pregnancy. As discussed earlier, choline supports neural tube closure, cell membrane formation, and cognitive development, while DHA (an omega-3 fatty acid) is essential for brain and eye development. 

Iron supports oxygen delivery to the developing brain and is linked to cognitive outcomes in children. Folate/folic acid is essential for DNA synthesis and neural development. Protein provides the amino acid building blocks for every organ and tissue. And iodine supports fetal brain development and helps prevent speech and hearing problems.

To cover these needs, aim to include a variety of these foods regularly: eggs, fatty fish like salmon and sardines, lean meats, beans, lentils, leafy greens, and dairy. For omega-3s specifically, the recommendation is 2–3 servings per week of fish high in DHA while avoiding high-mercury options like swordfish, shark, and king mackerel. Those who don't eat fish regularly should consider an algae-based DHA supplement.

8. Eat a Variety of Foods — Including Common Allergens

Many parents still wonder whether they should avoid peanuts, eggs, dairy, or other common allergens during pregnancy to protect their baby from developing food allergies.

The current evidence says: no restriction is necessary. Current guidelines do not recommend that mothers avoid peanuts or other common allergens during pregnancy to prevent childhood allergies, unless the mother herself has a documented allergy.

A more varied diet is generally more beneficial than a restrictive one. Eating a wide range of foods, including peanuts, eggs, and dairy, supports broader nutritional coverage and may contribute to the development of a healthy immune system.

Emerging research also suggests that specific nutrient-rich foods within a varied diet may play a role. For example, a recent cohort study found that avocado consumption during pregnancy was associated with about a 44% lower risk of food allergy in offspring at 1 year, highlighting that overall diet quality and diversity may matter more than avoiding individual foods.

Foods to avoid include those that carry foodborne illness risks, regardless of allergy concerns: unpasteurized dairy products, raw or undercooked eggs and meat, high-mercury fish (swordfish, shark, king mackerel, bigeye tuna), and deli meats unless heated until steaming.

Deli meats are often included in this category due to the risk of listeria. While the relative risk increase during pregnancy is substantial (about 13 times higher than the general population), the absolute risk remains low (fewer than 9 cases per 100,000 pregnancies); however, because the consequences of infection can be severe, guidelines recommend avoiding deli meats unless heated until steaming hot (165°F), which effectively eliminates the risk.

9. Support Digestion with Fiber, Fluids, and Electrolytes

Constipation is extremely common during pregnancy, partly due to hormonal changes that slow the digestive tract, and partly due to iron supplementation. Small dietary changes can make a meaningful difference. As a registered dietitian, these are my top tips to help support digestion during pregnancy:

Fiber: Fruits, vegetables, whole grains, beans, and lentils are your best allies. Aim for a variety of sources throughout the day rather than relying on one.

Fluids: The general target is 64–96 ounces of water or other hydrating fluids per day. Staying hydrated also helps prevent urinary tract infections, which are also more common in pregnancy.

Electrolytes: Pregnancy increases fluid needs, and with this increase comes a higher need for electrolytes (sodium, potassium, chloride, calcium, and magnesium). Contrary to old advice, there is little evidence to support routinely restricting salt during an uncomplicated pregnancy, although if you have high blood pressure or other medical conditions, talk to your healthcare provider. 

For those who find plain water hard to keep down during nausea phases, lightly salted broths, electrolyte drinks, lemon-infused water, or cold beverages can be easier to tolerate. During all three of my pregnancies, the only beverage I could keep down (and thus, the only way I could stay hydrated) was by drinking a specific brand of lemon-flavored, iced black tea—progress, not perfection!

10. Focus on Progress, Not Perfection

Speaking of progress over perfection, pregnancy is not the time for rigid food rules or all-or-nothing thinking. There will be days when you eat beautifully balanced meals and days when crackers and ginger tea are the best you can do, and both are okay.

Food aversions, fatigue, nausea, and cravings are all part of the process. What research consistently supports is flexibility and consistency over time, not perfection in any single moment.

If you are struggling with nausea, a specific nutrient deficiency, gestational diabetes, or other complications, working with a registered dietitian who specializes in maternal nutrition can provide individualized guidance tailored to your exact situation.

Final Thoughts…

Healthy eating during pregnancy is about nourishing your body in a realistic and sustainable way. You don't need to overhaul your entire diet overnight to make a meaningful difference.

By focusing on balanced meals built around whole foods, paying close attention to nutrients such as choline, folate, DHA, iron, and vitamin D, and maintaining a flexible mindset, you can feel confident that you are supporting your baby's development every step of the way.

Small, consistent choices really do add up.

Wishing you all the best on the exciting journey ahead! If you need guidance around a specific nutrition-related concern, I am currently accepting new clients in my virtual private practice and would love to meet with you one-on-one. 

And before you know it, your little one will be here. If you want to get ahead of the game, my new book, Safe and Simple Food Allergy Prevention: A Baby-Led Feeding Guide to Starting Solids and Introducing Top Allergens, boils down all of the latest research into a streamlined, simple, stress-free roadmap that makes starting solids and reducing the risk of food allergies with your little one easy and practical. Check it out now so you’re prepared!