Fit for Two

WIN Weight-control Information Network

TIPS FOR PREGNANCY

Healthy Eating & Physical

Activity Across Your Lifespan

Fit for Two
Index

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1

Healthy Eating

What is a healthy eating plan for pregnancy? . . . . . . 2

How many calories should I eat? . . . . . . . . . . . . . . . 4

Why is gaining a healthy amount of

weight important? . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

How much weight should I gain during

my pregnancy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Do I have any special nutrition needs

now that I am pregnant? . . . . . . . . . . . . . . . . . . . . . . 8

Can I continue to follow my vegetarian diet

during pregnancy? . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Tips for healthy eating . . . . . . . . . . . . . . . . . . . . . . . 10

What foods should I avoid during pregnancy? . . . . 12

Physical Activity

Should I be physically active during

my pregnancy? . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

What physical activities should I avoid

during pregnancy? . . . . . . . . . . . . . . . . . . . . . . . . . 16

Tips for getting physically active . . . . . . . . . . . . . . . 17

What habits should I keep up after

my baby is born?. . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Why should I try to return to a healthy

weight after delivery? . . . . . . . . . . . . . . . . . . . . . . . 20

Be good to yourself . . . . . . . . . . . . . . . . . . . . . . . . . 21

Resources . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22

Fit for Two
Fit for Two 1

Introduction

Eating well can help you have a

healthy pregnancy and a healthy newborn.

Being physically active may help you have a

more comfortable 9 months and an easier delivery.

Use the ideas and tips in this booklet to improve

your eating plan and become more physically

active before, during, and after your pregnancy.

Make changes now, and be a healthy example

for your family for a lifetime.
Healthy Eating

2 Fit for Two

What is a healthy eating plan

for pregnancy?

A healthy eating plan contains a wide variety of foods

from the five basic food groups*. Every day, you

should try to eat:

6 or more servings of bread, cereal, rice, or pasta.

One serving equals one slice of bread, 1 ounce of

ready-to-eat cereal (about 1 cup of most cereals), or

1/2 cup of cooked cereal, rice, or pasta. If you are

physically active, you can eat more servings (up to

11 servings if you are very active).

3 to 5 servings of vegetables.

One serving equals 1 cup of raw

leafy vegetables such as spinach

or lettuce, or 1/2 cup of chopped

vegetables, cooked or raw.

2 to 4 servings of fruit.

One serving equals one medium piece of fruit like an

apple, banana, or orange; 1/2 cup of chopped fresh,

cooked, or canned fruit; 1/4 cup dried fruit; or 3/4 cup

of 100-percent fruit juice.

* Adapted from the U.S. Department of Agriculture/

Department of Health and Human Services Food Guide

Pyramid.
Healthy Eating

Fit for Two 3

2 servings of milk, yogurt, or cheese.

One serving equals 1 cup of milk or yogurt, 1 1/2

ounces of natural cheese like cheddar or mozzarella,

or 2 ounces of processed cheese like

American. If you are 18 years or

younger and pregnant, you need at least

3 servings of milk, yogurt, and cheese.

Choose low-fat or fat-free dairy products

most often.

2 to 3 servings of meat, poultry, fish,

dry beans, eggs, or nuts.

One serving equals 2 to 3 ounces of cooked meat,

poultry, or fish—about the size of a deck of cards.

Choose lean cuts and eat no more than 5 to 7

ounces of meat, poultry, or fish a day. One cup of

cooked beans such as kidney beans or 2 eggs count

as a serving. Four tablespoons of peanut butter or

2/3 cup of nuts also equals a serving.

At least 8 glasses of water.

Drinking milk, 100-percent juice, seltzer or other

non-alcoholic beverages counts toward your amount

of daily water.
4

Healthy Eating

Fit for Two

How many calories should I eat?

Eating the right number of calories lets you and your

baby gain the proper amount of weight. During the

first 3 months of your pregnancy, you do not need

to change the number of calories you are eating.

Normal-weight women need an extra 300 calories

each day during the last 6 months of pregnancy. This

totals about 1,900 to 2,500 calories a day. If you were

underweight, overweight, or obese before you became

pregnant, or if you are pregnant with more than one

baby, you may need a different number of calories.

Talk to your health care provider about how much

weight you should gain and how many calories you

need.
5

Healthy Eating

Fit for Two

Each of these healthy choices

has about 300 calories:

● 1 cup of non-fat

fruit yogurt and

a medium apple

● 1 piece of whole wheat toast

spread with 2 tablespoons peanut butter

● 1 cup of beef and bean chili sprinkled

with 1/2 ounce cheddar cheese

● 1 cup of raisin bran cereal with 1/2 cup

of non-fat milk and a small banana

● 3 ounces roasted lean ham or chicken

breast and 1/2 cup sweet potatoes

● 1 flour tortilla (7-inch), 1/2 cup refried

beans, 1/2 cup cooked broccoli, and

1/2 cup cooked red pepper.
6

Healthy Eating

Fit for Two

Why is gaining a healthy amount of

weight important?

Gaining a healthy amount of weight may help you

have a more comfortable pregnancy and delivery.

It also may help you have fewer pregnancy

complications, such as diabetes, high blood pressure,

constipation, and backaches.

How much weight should I gain

during my pregnancy?

Talk to your health care provider about how much

weight you should gain during your pregnancy.

General weight-gain recommendations listed

below refer to pre-pregnancy weight and are for

women expecting only one baby.

If you are: You should gain:

underweight about 27 to 40 pounds

normal weight about 25 to 35 pounds

overweight about 15 to 25 pounds

obese about 15 pounds or less
7

Healthy Eating

Fit for Two

Gaining too little weight during your

pregnancy makes it hard for your baby to

grow properly. Talk to your health care

provider if you feel you are not gaining

enough weight.

If you gain too much weight, you are

more likely to have a longer labor and

more difficult delivery. Also, gaining a lot

of extra body fat will make it harder for

you to return to a normal weight after you

have your baby. If you feel you are

gaining too much weight during your

pregnancy, talk with your health care

provider.

Do not try to lose weight if you are

pregnant. If you do not eat enough

calories or a variety of foods, your baby

will not get the nutrients he or she needs

to grow.
8

Healthy Eating

Fit for Two

Do I have any special nutrition needs

now that I am pregnant?

Yes. During pregnancy, you and your growing baby

need more of several nutrients. By eating the

recommended number of daily

servings from each of the five

food groups, you should get

most of the nutrients you need.

Be sure to include foods high in

folate, such as orange juice, strawberries,

spinach, broccoli, beans, and fortified breads and

breakfast cereals. Or get it in a vitamin/mineral

supplement.

To help prevent birth defects, you must get enough

daily folate before as well as during pregnancy.

Prenatal supplements contain folic acid (another form

of folate). Look for a supplement that has at least 400

micrograms (0.4 milligrams) of folic acid.

Although most health care providers recommend

taking a multi-vitamin/mineral “prenatal”

supplement before becoming pregnant, during

pregnancy, and while breastfeeding, always talk

to your health care provider before taking any

supplements.
9

Healthy Eating

Fit for Two

Can I continue to follow

my vegetarian diet

during pregnancy?

Yes, you can continue a

vegetarian eating plan during

pregnancy, but talk to your health

care provider first.

If you do not eat any animal

foods, it may be difficult to get

enough of important nutrients,

including protein, iron, vitamin

B12, and vitamin D.

Your health care provider may

ask you to meet with a registered

dietitian who can help you to plan

meals, and may also recommend

that you take supplements.
10

Healthy Eating

Fit for Two

Tips for healthy eating

Meet the needs of your body and help avoid common

discomforts of pregnancy by following these tips:

● Eat breakfast every day. If you feel sick to your

stomach in the morning, choose dry whole-wheat

toast or whole-grain crackers when you first wake

up—even before you get out of bed. Eat the rest

of your breakfast (fruit, oatmeal, cereal, milk,

yogurt, or other foods) later in the morning.

● Eat high-fiber foods. Eating whole-grain cereals,

vegetables, fruits, beans, whole-wheat breads,

and brown rice, along with drinking plenty of water

and getting daily physical activity, can help you

prevent the constipation that many women have

during pregnancy.

● Keep healthy foods on hand. A fruit bowl filled

with apples, bananas, peaches, oranges, and

grapes makes it easy to grab a healthy snack.

Fresh, frozen, and canned fruits and vegetables

make healthy and quick additions to meals, as do

canned beans.
Healthy Eating

Fit for Two 11

● If you have heartburn during your pregnancy, eat

small meals more often, eat slowly, avoid spicy

and fatty foods (such as hot peppers or fried

chicken), drink beverages between meals instead

of with meals, and do not lie down right after

eating.
12

Healthy Eating

Fit for Two

What foods should I avoid during

pregnancy?

There are certain foods and beverages that can

harm your baby if you eat or drink them while you

are pregnant. Here is a general list of foods and

beverages that you should avoid:

Alcohol. Instead of wine, beer, or a

mixed drink, enjoy apple cider, tomato juice,

100-percent juice mixed with sparkling water,

or other non-alcoholic beverages.

Fish that may have high levels of

methylmercury (a substance that can build

up in fish and harm an unborn baby). Do not

eat shark, swordfish, king mackerel, and

tilefish during pregnancy. Eat no more than

12 ounces of any fish per week (equal to four

3-ounce servings—each about the size of a

deck of cards).

Soft cheeses such as feta, Brie, and goat

cheese and ready-to-eat meats including

lunch meats, hot dogs, and deli meats.

These foods may contain bacteria called

listeria that are harmful to unborn babies.

Cooking lunch meats, hot dogs, and deli

meats until steaming hot can kill the bacteria

and make these meats safe to eat.
Healthy Eating

Fit for Two 13

Raw fish such as sushi, sashimi, or ceviche

and raw or undercooked meat and

poultry. These foods can contain harmful

bacteria. Cook fish, meat, and poultry

thoroughly before eating.

Large amounts of caffeine-containing

beverages. If you are a heavy coffee, tea,

or soda drinker, talk to your health care

provider about whether you should cut back

on caffeine. Try a decaffeinated version of

your favorite beverage, a mug of warm lowfat or fat-free milk with honey, or sparkling

mineral water.

Anything that is not food. Some pregnant

women may crave something that is not

food, such as laundry starch or clay. Talk to

your health care provider if you crave

something that is not food.

Ask your health care provider for a complete list of

foods and beverages that you should avoid.

?
Physical Activity

14 Fit for Two

Should I be physically active

during my pregnancy?

Almost all women can and should be physically active

during pregnancy. Talk to your health care provider

first, particularly if you have high blood pressure,

diabetes, anemia, bleeding, or other disorders, or if

you are obese or underweight.

Whether or not you were active before you were

pregnant, ask your health care provider about a level

of exercise that is safe for you. Aim to do at least 30

minutes of a moderate activity (one that makes you

breathe harder but does not overwork or overheat

you) on most days of the week.

Regular, moderate physical activity during pregnancy

may:

● Help you and your baby to gain the proper

amounts of weight

● Reduce the discomforts of pregnancy such as

backaches, leg cramps, constipation, bloating,

and swelling

● Improve your mood, energy level, and feelings

about the way you look

● Strengthen your muscles and improve your

blood flow
Physical Activity

Fit for Two 15

● Improve your sleep

● Help you have an easier, shorter labor

● Help you to recover from delivery and return to a

healthy weight faster.

Follow these safety precautions while being active

during your pregnancy:

● Choose moderate activities that are unlikely

to injure you, such as walking, aqua aerobics,

swimming, yoga, or using a stationary bike.

● Stop exercising when you start to feel tired,

and never exercise until you are exhausted or

overheated.

● Drink plenty of water.

● Wear comfortable clothing that fits well and

supports and protects your breasts.

● Stop exercising if you feel dizzy, short of

breath, pain in your back, swelling, numbness,

sick to your stomach, or if your heart is beating

too fast or at an uneven rate.
Physical Activity

16 Fit for Two

What physical activities should

I avoid during pregnancy?

For your health and safety, and for the health of your

baby, there are certain physical activities that you

should not do while you are pregnant. Some are

listed below. Talk to your health care provider about

other physical activities that you should avoid during

your pregnancy.

● Avoid being active outside during hot weather.

● Avoid steam rooms, hot tubs, and saunas.

● Avoid physical activities, such as certain yoga

poses, that call for you to lie flat on your back

after 20 weeks of pregnancy.

● Avoid contact sports such as football and

boxing, and other activities that might injure

you such as horseback riding.

● Avoid activities that make you jump or change

directions quickly such as tennis or basketball.

During pregnancy, your joints loosen and you

are more likely to hurt yourself when doing

these activities.
Physical Activity

Fit for Two 17

Tips for getting physically active

Get physically active for your health and the health of

your baby by using the tips below:

● Go for a walk around the block or through a

shopping mall with your spouse or a friend.

● Sign up for a prenatal yoga, aqua aerobics,

or fitness class. Make sure you let the

instructor know that you are pregnant before

beginning.

● Rent or buy an exercise video for pregnant

women. Look for videos at your local library,

video store, health care provider’s office,

hospital, or maternity clothing store.

● At your gym, community center, YMCA,

or YWCA, sign up for a session with a

fitness trainer who knows about physical

activity during pregnancy.

● Get up and move around at least once an hour if

you sit in a chair most of the day; get up and

move around during commercials when watching

TV.
Physical Activity

18 Fit for Two

What habits should I keep up after my

baby is born?

Following healthy eating and physical activity habits

after your baby is born may help you return to a

healthy weight more quickly, provide you with good

nutrition (which you especially need if you are

breastfeeding), and give you the energy you need.

You can also be a good role model for your growing

child. After your baby is born:

● Continue eating well. Eat a variety of foods from

the five food groups. If you are not breastfeeding,

you will need about 300 fewer calories per day

than you did while you were pregnant.

● If you are breastfeeding, you will need to eat

about 200 more calories a day than you did while

you were pregnant. Breastfeeding may help you

return to a healthy weight more easily because it

requires a great deal of energy. Breastfeeding can

also protect your baby from illnesses such as ear

infections, colds, and allergies, and may help

lower your risk for breast and ovarian cancer.
Physical Activity

Fit for Two 19

● When you feel able and your health care

provider says it is safe, slowly get back to

your routine of regular, moderate physical

activity. Wait for 4 to 6 weeks after you have

your baby to begin doing higher levels of

physical activity. Doing physical activity that

is too hard, too soon after delivery, can slow

your healing process. Regular, moderate

physical activity will not affect your milk

supply if you are breastfeeding.

● Return to a healthy weight gradually. Lose

no more than 1 pound per week through a

sound eating plan and regular physical

activity after you deliver your baby.
Physical Activity

20 Fit for Two

Why should I try to return to a healthy

weight after delivery?

After you deliver your baby, your health will be better

if you try to return to a healthy weight. Not losing

weight after your baby is born may lead to overweight

or obesity later in life, which may lead to health

problems. Talk to your health care provider about

reaching a weight that is healthy for you.
Physical Activity

Fit for Two 21

Be good to yourself

Pregnancy and the time after you deliver your baby

can be wonderful, exciting, emotional, stressful, and

tiring, all at once. Experiencing this whirlwind of

feelings may cause you to overeat, not eat enough,

or lose your drive and energy. Being good to yourself

can help you to cope with your feelings and to follow

eating and physical activity habits for a healthy

pregnancy, a healthy baby, and a healthy family after

delivery. Here are some ideas for being good to

yourself:

● Try to get enough sleep.

● Rent a funny movie and

laugh.

● Take pleasure in the miracles

of pregnancy and birth.

● Invite people whose company

you enjoy to visit your new

family member.

● Explore groups that you and

your newborn can join, such

as “new moms” groups.
22 Fit for Two

Resources

The following organizations offer information about

pregnancy and health:

American College of Obstetricians and

Gynecologists (ACOG)

www.acog.org or 1-800-762-2264

American Dietetic Association

www.eatright.org or 1-800-877-1600

Health Resources and Services

Administration (HRSA) Information Center

www.ask.hrsa.gov or 1-888-ASK-HRSA

(888-275-4772)

March of Dimes

www.modimes.org or 1-888-MODIMES

(888-663-4637)

National Diabetes Information Clearinghouse

(NDIC)

www.niddk.nih.gov/health/diabetes/ndic.htm or

1-800-860-8747

National Institute of Child Health and Human

Development (NICHD)

www.nichd.nih.gov or 1-800-370-2943
Healthy Eating and Physical Activity for Adults Fit for Two 23

For information about food safety during pregnancy,

contact the following:

Food and Drug Administration (FDA)

Food Information Line

1-888-SAFE FOOD (888-723-3366)

U.S. Department of Agriculture (USDA)

Meat and Poultry Hotline

1-800-535-4555

U.S. Government’s Food Safety Web site

www.foodsafety.gov
24 Fit for Two

Weight-control Information Network

1 WIN WAY

Bethesda, MD 20892-3665

Phone: (202) 828-1025

FAX: (202) 828-1028

Toll-free number: 1-877-946-4627

Email: WIN@info.niddk.nih.gov

Internet: www.niddk.nih.gov/health/nutrit/nutrit.htm

The Weight-control Information Network (WIN) is a

service of the National Institute of Diabetes and

Digestive and Kidney Diseases of the National
Institutes of Health, which is the Federal

Government’s lead agency responsible for biomedical

research on nutrition and obesity. Authorized by

Congress (Public Law 103-43), WIN provides the

general public, health professionals, the media, and

Congress with up-to-date, science-based health

information on weight control, obesity, physical

activity, and related nutritional issues.

WIN answers inquiries, develops and distributes

publications, and works closely with professional and

patient organizations and Government agencies to

coordinate resources about weight control and related

issues.

Publications produced by WIN are carefully reviewed

by both NIDDK scientists and outside experts. This

publication was also reviewed by Denise Sofka, MPH,

RD, Health Resources and Services Administration,

Maternal and Child Health Bureau, and Katrina Holt,

MPH, MS, RD, Georgetown University, National

Center for Education in Maternal and Child Health.

This publication is not copyrighted. WIN encourages

users of this brochure to duplicate and distribute as

many copies as desired.

This publication is also available at

www.niddk.nih.gov/health/nutrit/nutrit.htm.

Fit for Two 25
WIN Weight-control Information Network

Healthy Eating &

Physical Activity

Across Your Lifespan

Fit for Two

❑ Talk to your health care provider about

how much weight you should gain

during your pregnancy.

❑ Eat foods rich in folate, iron, calcium, and protein, or get

these nutrients through a prenatal supplement.

❑ Talk to your health care provider before taking any

supplements.

❑ Eat breakfast every day.

❑ Eat high-fiber foods and drink plenty of water to avoid

constipation.

❑ Avoid alcohol, raw fish, fish high in mercury, soft cheeses,

and anything that is not food.

❑ Aim to do at least 30 minutes of moderate activity on most

days of the week. Talk to your health care provider before

you begin.

❑ After you deliver your baby, continue eating well. Return to

a healthy weight gradually.

❑ Slowly get back to your routine of regular, moderate

physical activity.

❑ Take pleasure in the miracles of pregnancy and birth.

TIPS FOR PREGNANCY
National Institute of Diabetes and

Digestive and Kidney Diseases

NIH Publication No. 02-5130

December 2002

U.S. Department of Health

and Human Services

National Institutes of Health RAPED

MT ENT OF HEALTH & HUMAN SERVICES • USA