Table 1.
Summary of evidence regarding macronutrient and micronutrient intakes during pregnancy.
| Nutrient | Recommendations for Interventions/Supplement Use 1 | Non Pregnant Adult Females (19–50 years) 2 | Pregnant Adult Females (19–50 years) 2 |
|---|---|---|---|
| Macronutrients | |||
| Energy | Energy restriction reduces GWG but could adversely affect birthweight and is currently not recommended in pregnancy | EER (kcal/day) 3 = 354 − (6.91 × age [year]) + PA × [(9.36 × weight [kg]) + (726 × height [m])] | Non pregnant EER + 340 and 452 kcal/day in 2nd and 3rd trimesters |
| Protein | Balanced energy/protein supplements (≤ 25% total energy from protein) are recommended only in undernourished women to prevent stillbirth and SGA | 0.8 g/kg/day (46 g/day) |
0.8 increasing to 1.1 g/kg/day in 2nd half of pregnancy (71 g/day) |
| Total fibre 4 | Fibre-rich diet may reduce preeclampsia and GDM but no specific recommendations are currently available; fibre supplements can be used to relieve constipation if diet modification is unsuccessful | 14 g/1000 kcal (or 25 g/day) |
14 g/1000 kcal or (or ~28 g/day to account for GWG) |
| Carbohydrates (GI and GL) |
Low GL or GI diets may be beneficial for women at risk of GDM or LGA but can increase risk of SGA. No specific recommendations are currently available | 130 g/day of carbohydrates | 175 g/day of carbohydrates |
| Essential fatty acids 4 (linoleic acid [n-6] and α-linoleic acid [n-3]) | n-3 PUFAs may prevent preterm birth but can increase post-term birth and LGA. No specific recommendations are currently available | 12 g/day (linoleic) 1.1 g/day (α-linoleic) |
13 g/day (linoleic) 1.4 g/day (α-linoleic) |
| Micronutrients | |||
| Folate/folic acid | Recommended (400 µg/day) from preconception until at least 12 weeks to prevent NTDs | 400 µg/day | 600 µg/day |
| Vitamin A | Not recommended except in areas with severe deficiency/night blindness | 700 µg/day | 770 µg/day |
| Thiamine (B1) | B-complex vitamins are not recommended to improve pregnancy outcomes until further evidence is available | 1.1 mg/day | 1.4 mg/day |
| Niacin (B2) | 14 mg/day | 18 mg/day | |
| Riboflavin (B3) | 1.1 mg/day | 1.4 mg/day | |
| Pyridoxine (B6) | 1.3 mg/day | 1.9 mg/day | |
| Cyanocobalamin (B12) | 2.4 µg/day | 2.6 µg/day | |
| Vitamin C | Not recommended until further evidence relating to safety and PROM is available | 75 mg/day | 85 mg/day |
| Vitamin E | 15 mg/day | 15 mg/day | |
| Vitamin D 4 | Not recommended for improving pregnancy outcomes but should be given to women with deficiency (200 IU/day) | 5 µg/day | 5 µg/day |
| Calcium 4 | Recommended (1.5–2.0 g/day) to prevent hypertensive disorders in women with low dietary calcium intake or who are at high risk of hypertension | 1 g/day | 1 g/day |
| Iodine | Recommended only in women at high risk to prevent IDDs (i.e., in countries where < 20% of households have access to iodized salt) | 150 µg/day | 220–250 µg/day |
| Iron | Recommended (30–60 mg/day) to prevent maternal anaemia, puerperal sepsis, LBW and preterm birth | 18 mg/day | 27–60 mg/day |
| Zinc | Not recommended for improving pregnancy outcomes until more rigorous research is available | 8 mg/day | 11 mg/day |
| Alcohol | Not recommended during pregnancy until safe upper limits are established | NA | None |
| Caffeine | Reducing intake is recommended in women with high caffeine intake (> 300 mg/day) to prevent pregnancy loss and LBW infants | NA | <200 mg/day |
1 Based on World Health Organization recommendations [79]; 2 dietary reference intakes derived from Institute of Medicine guidelines [18] and expressed as recommended dietary allowance (RDA) unless otherwise indicated; 3 EER = estimated energy requirement for adult women, reflecting the average energy intake predicted to maintain energy balance in a healthy adult of a defined age, weight, height and level of physical activity [18]; 4 values reflect average intakes (AI) as RDAs are not available. GWG, gestational weight gain; EER, estimated energy requirement; PA, physical activity; SGA/LGA, small-/large-for-gestational-age; GI, glycaemic index; GL, glycaemic load; GDM, gestational diabetes mellitus; PUFAs, polyunsaturated fatty acids; NTDs, neural tube defects; PROM, premature rupture of membranes; IDDs, iodine deficiency disorders; LBW, low birthweight; NA, not applicable.