Diet in pregnancy: second trimester

Starting from the fourth month the caloric needs of a pregnant woman increases. Here’s how to satisfy it.

For many women, the second trimester is the least problematic phase of pregnancy: nausea and fatigue disappear, and the energy available is more.

Despite this feeling of well-being, even in this period we must not forget that we are pregnant and it is necessary to pay particular attention to some fundamental aspects, including nutrition.

Eat adequately, but don’t eat for two

The diet followed during pregnancy must provide mother and baby with the energy and nutrients they need, but it must also allow them to maintain an ideal body weight.

In fact, not gaining too much weight is essential to reduce the risk of being struggling with diseases such as gestational diabetes and protect the future health of the baby.

On the other hand, underweight can also create problems. In fact, the adipose tissue accumulated during pregnancy is used to ensure that the “fresh” nutrients introduced with the diet are diverted to the fetus, while the future mother draws energy from the fat reserves set aside.

The accumulation of maternal fat occurs largely between the 10th and 30th week, taking up the entire second trimester. This does not mean, however, that once the nausea is gone, you should eat for two.

In general, a woman who was normal weight before conception is recommended to gain weight between 11.5 and 16 kg, while underweight women are allowed to gain a little more weight (between 12.5 and 18 kg). More specifically, during the second trimester for women with a normal weight an increase of 440 grams per week is expected, while underweight women should gain weight about 490 grams per week.

In overweight situations, on the other hand, a weight gain of about 300 grams per week is expected throughout the second trimester. The advice is to get to the end of pregnancy only with 7-11.5 kg more, but in case of obesity this recommendation becomes even more stringent: weight gain should not exceed 7 kg and the gynecologist may even suggest losing weight before conception.

	Weight gain in the second trimester	Weight gain in the nine months
Underweight	490 grams/week	12.5-18 kg
Normal weight	440 grams/week	11.5-16 kg
Overweight	300 grams/week	7-11.5 kg

How many calories and nutrients?

Starting from the second trimester, both the growth of the child and the increase in maternal tissues impose the need to increase energy intake, but for a normal-weight woman the calories taken should only increase by about 340 per day.

However, it is also important to take into account the physical activity carried out by the future mother, and if it is reduced it is good to increase the energy intake of only 150 calories a day.

As for macronutrients, the requirements increase only for proteins (+7 g per day). The recommended intake is about 62 g per day and the indication is to take 50% of animal origin and 50% of vegetable origin, bearing in mind that a low consumption of sea fish from the 16th-20th week of gestation could be associated with the risk of preterm birth and low birth weight.

Carbohydrates should instead correspond to 45-60% of daily calories. It is good to limit the consumption of sweets and other sources of simple sugars, while sources of fiber (also useful against constipation) and complex carbohydrates are recommended, especially legumes (at least 3 servings a week, varying for example between beans, chickpeas and soy), vegetables such as eggplant, zucchini, broccoli and artichokes (to be brought to the table every day for lunch and dinner, preferably choosing those rich in fiber), fruit (ideal snack) and whole grains (for example in the form of rusks, pasta and wholemeal bread). And always on the subject of carbohydrates, potatoes are also allowed.

The best sources of fat, which should account for 25-35% of calories, are those rich in monounsaturated fats (such as olive oil) or polyunsaturated fats (especially DHA, docosahexaenoic acid, contained in fatty fish such as mackerel and salmon). Instead, limit foods of animal origin rich in saturated fats and cholesterol and avoid sources of trans fats (such as some baked goods) as much as possible.

Vitamin and mineral requirements can be met with a varied diet and limiting foods that could interfere with iodine absorption, such as cabbage, arugula, onions, radishes and nuts.

Generally this strategy is enough to provide the future mother and her baby with the vitamins and minerals they need. With small precautions (for example cooking tomatoes with extra virgin olive oil) you can also take useful antioxidants.

Only in some cases are supplements necessary. Many women, for example, need to take iron, and those who do not eat milk and derivatives (eg yogurt) calcium.

Vitamin D supplements also seem to be useful, especially in cases of heavy overweight, while supplements of other vitamins (B1, B2 and B12) are only necessary in special cases.

Remaining on the subject of supplements, some women may be useful to those of omega 3, but it is important to remember that those from microalgae are not recommended during pregnancy.

As for folic acid supplements, their intake is generally recommended only until the end of the first trimester of gestation.

Some precautions

Finally, it is good to pay attention to possible contamination and avoid, therefore, raw or undercooked foods of animal origin (including cold cuts and sausages) and fruit and vegetables not properly washed or peeled.

By cleaning vegetables and fruit well, for example with baking soda or special products, it is possible to eat them throughout pregnancy, thus exploiting their richness in fiber, vitamins and mineral salts.

It is also good to reduce added salt and foods rich in sodium (such as cheese and nuts), limit caffeine to no more than 300 mg per day and large predatory fish to no more than 150 g per week, avoid alcohol (which can cross the placenta and for which there is no maximum limit of consumption considered safe either during pregnancy or lactation) and drink 350 ml of water in more than the recommended 2 liters when you are not pregnant.

As for caffeine in particular, it is also good to remember that it is not only present in coffee, but also in other drinks, for example tea and cola, and in some foods, such as chocolate.

Eating large predatory fish such as swordfish and tuna too often increases the risk of taking dangerous amounts of mercury, which is harmful to the development of the nervous system. Therefore, to fill up on the good fats present in fish it is advisable to bring to the table two portions of fatty fish a week, but being careful not to exceed the recommended amounts for large predators.

In general, fish should be consumed within 48 hours of purchase, and like mollusks and crustaceans, it should not be eaten raw.

In fact, the consumption of fish products carries with it the risk of contamination with parasites (Diphyllobothrium, Pseudoterranova or Anisakis) that can trigger allergic reactions, lower the immune system, cause malnutrition, anemia, intestinal obstructions, inflammation of the gallbladder, preterm birth and compromise the growth and development of the fetus.

Proper treatments at very low temperatures allow to kill these parasites. For this reason, in order to consume raw fish, molluscs and crustaceans safely, they must have been frozen at -35 ° C for at least 15 hours or frozen at -20 ° C for at least 7 days.

Raw meats could instead be contaminated with Listeria monocytogenes, a bacterium that can cause serious complications, such as preterm births and miscarriages. And always to avoid the risk of miscarriage it is good to cook the chicken thoroughly, which could be contaminated with Campylobacter.

Listeria could also contaminate pâtés, blue cheese (such as gorgonzola) or flowery rind cheese (i.e. covered with mold, such as brie) and raw milk. Other bacteria, such as Salmonella, which can also contaminate eggs, could also be hidden in the latter. For this reason, food containing raw or undercooked eggs should be avoided throughout the second trimester of pregnancy.

Cured meats and sausages should be excluded from the diet of all pregnant women not immune to toxoplasmosis; To find out if it is necessary to do this, it is enough to undergo simple blood tests.

According to some opinions, the consumption of liver (too rich in vitamin A, a nutrient that should not be taken in excessive doses due to the risk of malformations in the fetus) should also be avoided.

Finally, with regard to dried fruit, as already mentioned it is better to avoid nuts because they could reduce the absorption of iodine, whose need increases during pregnancy. For this reason it is better to prefer iodized type salt.

As regards, however, the distribution of meals it is advisable to add to breakfast, lunch, dinner and the two classic snacks an additional snack in the evening to avoid reducing the energies that reach the child during the night hours.

In particular, it would be advisable to take 10-15% of the daily calories at breakfast, 20-30% at lunch, 20-30% at dinner and 5-10% at each snack.