What to eat in the second trimester
UPDATED JULY 2021
Generally throughout the three trimesters, many nutrition recommendations remain the same. But some might increase, like your protein or calcium intake. Because there are certain conditions that are more common in the second trimester, here are the nutrients that are especially important during weeks 13-28!
Macro-nutrients
Carbohydrates
In the first trimester, you may have eaten more carbs than usual - which is incredibly common (especially with food aversions). By the time the second trimester comes about, your eating habits may go back to normal.
As we covered in the first trimester, carbohydrates are groups of sugars and starches that are the body’s primary source of energy. They can mainly be found in fruit, root vegetables, grains and legumes.
When you eat carbs, they’re broken down into sugar, absorbed by your blood, and therefore raises your blood sugar. Once eaten, they are digested and broken down into sugar which can raise your blood sugar.
In the second trimester, you may be tested for gestational diabetes. You may simply do blood work (during the lockdown, some hospitals were doing simple blood tests to assess blood sugar levels) or the Oral Glucose Tolerance Test. This is a test where you drink a bolus of sugar (some say it tastes like an orange freezie), and have your blood tested after a couple of hours (you typically need to hang around the lab for this test).
If you fail these tests, your OB/Gyn or Midwife may have you do a two week trial of diet and exercise. If your blood sugar is still elevated after the two weeks, you may need to take medication for the duration of your pregnancy.
If you have any of the risk factors for gestational diabetes, you may want to pre-emptively focus on your diet as early as you can in the second trimester.
Risk Factors for developing gestational diabetes are:
Over 35 years old
Pre-pregnancy BMI is over 30 kg/m2
Ethnicity (Aboriginal, African, Asian, Hispanic, South Asian)
Family history of diabetes
Polycystic ovary syndrome, and acanthosis nigricans (a skin condition causing hyperpigmentation of skin, especially in the folds)
Corticosteroid use
Previous diagnosis of gestational diabetes
Previous 'big' baby
When eating carbohydrates: focus on whole grains, minimize ‘white’ carbs (pasta, bread, rice), avoid processed foods, and pair all carbs with a protein to better balance your blood sugar.
These are some general guidelines, so consider working with a Naturopathic Doctor if you’re concerned about gestational diabetes.
Protein
As we covered in the first trimester, proteins are essentially chains of amino acids. which act as the building blocks for your body. Protein requirements vary based on your body weight, and pregnancy stage. But you should aim for about 100g of protein in the last half (20-40 weeks) of your pregnancy.
Remember to have a significant portion of protein at each meal and snack - especially if you’re eating a lot of carbs (like pasta, bread, or rice). Protein will balance your blood sugar and prevent the levels from going too high or low.
PRO-TIP: Consider buying protein powder and adding it to your smoothies during the day. That’s about 20g+ of protein right there!
Nutrients
Calcium
Canadian recommended dietary intake: 1000 mg Best form: Calcium carbonate
Calcium is the most abundant mineral in your body because of your teeth and bones! As your baby's skeletal growth begins, it'll start to tap into your muscle stores. This may lead to leg cramps, that often happen at night.
Calcium is also helpful in reducing pre-eclampsia (high blood pressure, high protein in urine, swollen hands/legs/feet). If you have preeclampsia, you might also experience headaches, blurred vision, and pain in your upper right quadrant. Calcium may also reduce preterm birth.
Absorption typically doubles in the second trimester, but the requirements stay the same (as if you're not pregnant). You can take calcium at night, and also pair it with magnesium.
Iron
Canadian recommended dietary intake: 27 mg Best form: Iron bisglycinate
Iron is the most common nutritional deficiency in women! Do you know why? Periods! While you’re not currently menstruating, it’s likely that you had a deficiency prior to pregnancy. It’s necessary to have your levels tested because your baby will use your iron for itself – which may leave you even more deficient. A telltale sign of low iron is cravings for ice!
Your blood volume begins to increase during this trimester, and so you need more hemoglobin to transport oxygen (and therefore need more iron). A couple of signs of iron deficiency anemia are: paleness, fatigue, weakness, and shortness of breath.
If you have yet to have your iron tested, be sure to do so this trimester. Not only may it prevent pre-term delivery, low birth weight, and developmental delays, it may also play a role in preventing postpartum depression.
TO DO: Get your ferritin levels tested (and make sure your levels are optimal, not normal)
PRO TIP: Vitamin C helps with iron absorption
Magnesium
Canadian recommended dietary intake: 350 mg
Preferred form: Magnesium bisglycinate
This is one of my favourite minerals! Not only is it mostly found in bone and soft tissues, it's needed for over 300 reactions in the body (including energy production).In pregnancy, magnesium is important for hypertension, preventing pre-eclampsia, gestational diabetes, and leg cramps.
Magnesium is involved in brain cell activity, electrical properties of cell membranes, and heart cell function. It also helps to relax muscles, especially when they're cramping. Symptoms of magnesium deficiency include insomnia, muscle cramps or twitches, headaches and heart palpitations.
Selenium
Canadian recommended dietary intake: 60 ug
Preferred form: Selenomethionine
Selenium acts as an antioxidant and helps with thyroid metabolism. Postpartum thyroiditis is a condition that may happen after pregnancy, so it may be beneficial to make sure you're getting enough selenium before you give birth. Selenium helps to decrease inflammation associated with the thyroid and its antibodies.
There is an upper limit to how much selenium you can take per day, so be sure to consult with your doctor.
EAT THIS: Eggs, poultry, seafood and other muscle meats
Next Steps
If you're experiencing any of these conditions or symptoms, consider booking an appointment with me for a holistic approach!