Eating Right During Pregnancy

What to eat when pregnant – health tips for each trimester: By Alex Royal

Meet Alex Royal, a registered dietitian, health and nutrition expert based in South Africa, but more importantly a new mom to baby Nate. Alex has a cutting-edge knowledge and genuine passion for Dietetics and Nutrigenomics. In this post, Alex gives us advice on what to eat when pregnant and some health tips for each trimester.

Her fresh approach in the field is motivational and has successfully encouraged clients to reach their goals at her busy Cape Town practices. She focuses on genetic testing (nutrigenomics), weight management, sports nutrition, specialized diets and pregnancy nutrition, and has also presented at workshops around the country, has been featured on television, in magazines and online sources.


Mom and baby alex royal

Nicole’s Experience:

So you’ve just found out that you’re pregnant and you’re bouncing off the walls with joy (or not), but you just can’t understand why you feel like death. You’re tired, rundown, nauseous and feel sapped of every bit of energy. Don’t get me wrong, there are some lucky ladies who sail through their first trimester without any of these symptoms (so unfair) and eating healthily is not an issue. As for me, I suffered badly with nausea, so much so that I could only stomach Coco Pops for breakfast, lunch and dinner – yip, that was pretty much my diet for 3 months. I tried everything from ginger sweets, peppermint tea and salty cracks, but nothing seemed to give me any relief. I had to call in the reinforcements and contacted Alex Royal, our Cape Town-based dietician who has been giving us health tips and nutritional advice since we started Wellness in the City 4 years ago.

Alex has kindly given us her top nutrition and health tips for each trimester, guiding you on what you can expect to feel e.g. nausea and health tips to combat these symptoms.

Health tips for each trimester.

First Trimester:

The first Trimester may be tough to achieve the recommended calorie intake due to the nausea. You will probably only stomach salty dry foods, so then opt for gluten-free crackers such as rice cakes and seed crackers or a freshly sliced apple. Juices and smoothies are usually your best bet to cover your basis. Folate and protein are important in this trimester so a good protein shake blended with some spinach is an absolute winner.

The neural tube and neural system also start to develop during the first Trimester. This is why it is so important to get enough folate from green leafy veg and green juices and omega 3’s. If you can’t stomach fish to get your omegas then opt for flaxseed and chia seed puddings and smoothies.

Recipe inspiration:


Second Trimester:

The second trimester is prime time. Most of the symptoms have subsided, you generally have more energy and your cravings and aversions have generally passed by now. So use this time well, and eat nutritiously dense foods like salads, eggs, fish and protein-rich dishes.

Recipe inspiration:


Third Trimester:

This is your heavier, slower, slightly (or very) uncomfortable stage. Baby is mopping up the energy that you are so be aware that you can eat a bit more now. The difficulty is that you might have indigestion as baby pushes against your stomach or nausea may attack again as baby kicks into your liver or cervix releasing prostaglandins.  Again, fresh juices and smoothies are your best friend and you can sip on these slowly throughout the day. Small energy dense meals including egg muffins, veggie and chicken soups, mild stews are excellent options. Keep portions small, nibbling and grazing throughout the day is key to success to avoid that dreaded indigestion.

A note on cravings:

When you feel yourself craving sugar during the pregnancy do your absolute best to avoid this. We have some wonderful sugar free recipes such as cacao smoothies, date balls, sugar free cheesecakes etc. that you should have instead. The reason why this is so important is because the sugar crosses the placenta directly into the baby’s circulation, which can impact their development and even act on their genes in something called epigenetics.

Recipe inspiration:


Superfoods during pregnancy: which foods and superfoods are beneficial for oneself and the baby to consume during pregnancy

There is very little conclusive scientific research around superfoods in pregnancy. What we do know is that natural, pure foods benefit pregnant moms and the baby especially over any processed, refined foods. For example, organic heirloom cocoa is a fantastic antioxidant mopping up free radicals in mom. This, in turn, helps to protect the developing baby against oxidative damage keeping the DNA duplication in tip-top shape. It is important not to have too much at one go though as there is a bit of caffeine in the cocoa so rather go slow and use more of a sprinkle than a full spoon.

Maca powder is a herb than Peruvian woman have been eating for centuries, even while pregnant, and its nutritional content is off the charts. Again we don’t know the effect on pregnant women or the growing baby so tread lightly with caution.

Foods such as goji berries and chia seeds are considered superfoods and they are excellent for both mom and baby so don’t hold back there. The antioxidants and the omegas are great for baby’s development.

Extra from my “Pregnancy Bites” Book (coming soon)


You can get them from your diet if you aren’t severely deficient or restricting it in any way, but supplements can definitely help. Be wary, some supplements may cause nausea and vomiting and even anxiety, which may be overlooked as a “usual” symptom. So let’s see if you can get in enough nutrition through your food first. If not, a good supplement is a great back up.


  1. Folate:

Most pregnant moms hear the words folic acid being thrown around. This is poorly absorbed and not the form that you should be supplementing. The best is folate. Folate is a B-vitamin that helps the baby’s neural tube to develop. It is also important for healthy DNA production. You need 400-800 ug per day. Anything above this may elicit anxiety, so try to avoid high doses unless stipulated by your doctor.

*400-800ug in food:

3 cups green leafy veg = 200 ug

Green leafy vegetables: herbs, basil, rocket, bok choy

  1. Iron:

Your iron requirements have rocketed from 18mg to 30mg or even more if you were deficient to start off with. This is to support your greater blood capacity and, of course, to prevent anemia after the birth which may occur with blood loss. Just be careful of the type of iron you choose to supplement. Often iron tablets can cause constipation while the liquid form is better for the gut.

*30mg in food:

Animal iron is better absorbed in the heme form:

  • 75g Beef: 3mg
  • 75g beef / lamb mince: 2mg
  • 75g chicken: 2mg
  • 75g Pork: 1mg
  • 75g liver (chicken / lamb): 6-9.5mg
  • 7g sardines: 2mg
  • 75g fish: 1.2mg
  • 150g tofu: 2.5-8
  • ¾ c lentils: 4
  • ¾ c chickpeas: 2-3.5
  • ¾ c beans: 2.5-49
  • ¼ c nuts: 1.2 – 2.2
  • 2 large eggs: 2
  • ¼ c hummus: 1.5
  • 2 Tbsp almond butter 1.1

Vegetable sources: non-heme:

  • ½ c spinach: 2 – 3mg
  • 6 spears of Asparagus, raw: 2mg
  • ¾ c Oatmeal: 4.5
  1. Omega 3:

Oily fish, flaxseeds, walnuts, chia seeds

  1. Calcium: 1300mg
  • 1 cup yog = 400mg, 90g sardines = 320mg, 3 cups spinach =300mg, 1 cup almond milk = 310mg
  • 100g bone broth = 190mg ca
  1. Vitamin D: 600-1000IU: 90gsardines = 164, 1 egg = 37
  2. Choline: 450mg: 1 egg: 150mg, 90g chic: 70mg, 100g sardines: 100mg
  1. Probiotics: Sulforphane – opt for dietary sources, but do not promote excessive detox PQQ.

Note: If you are low on certain vitamins or minerals or if you have a genetic predisposition to a condition such as low iron or spinal bifida then rather be safe and supplement to cover all bases. This is a general guide and if you are concerned or confused please speak to your health care practitioner about your specific case.

For more tips and nutritional advice for expectant moms, check out this interesting article by Alex Royal. Online here.

For nutritional advice, health tips and eating plans, contact Alex Royal:

Contact: Email: | Tel: (+27) 60 689 4275
Offices: The Renaissance Body Science Institute – 183 Bree Street, Cape Town | The Health Team – 129 Beach Road, Mouille Point

Photo credit: Ayeh Photography 

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