Eating well during pregnancy: the diet guide
When you are pregnant, you don’t need to eat for two. The European Food Safety Authority (EFSA) estimates the extra energy needed at about 70 kcal a day in the first trimester, 260 kcal in the second and 500 kcal in the third. What really changes is a handful of nutrients (vitamin B9, iodine, iron, omega-3) and a series of precautions against listeriosis, toxoplasmosis and salmonellosis. This guide brings together the official French and European guidance, and points you to our « food by food » pages for specific cases.
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What changes in your needs
Pregnancy doesn’t multiply every need: for some nutrients, the reference intake stays the same. The table below compares Anses (2021) reference intakes for an adult woman and for a pregnant woman.
| Nutrient | Adult woman | Pregnant woman | What it means |
|---|---|---|---|
| Vitamin B9 (folate) | 330 µg/day | 600 µg/day | Almost double, hence the supplement |
| Iodine | 150 µg/day | 200 µg/day | Iodised salt and sea fish |
| Iron | 11 or 16 mg/day (depending on periods) | 16 mg/day | Keep an eye on it, but don’t take supplements on your own initiative |
| Calcium (25 years and over) | 950 mg/day | 950 mg/day | No increase, but no decrease either |
| Vitamin D | 15 µg/day | 15 µg/day | Sunshine and oily fish, a supplement if your healthcare professional thinks it useful |
| Vitamin B12 | 4 µg/day | 4.5 µg/day | A critical point if you are vegan |
| Vitamin A | 650 µg/day | 700 µg/day | A slight increase, but excess is dangerous (hence avoiding liver) |
| Choline | 400 mg/day | 480 mg/day | Well-cooked eggs, meat, fish |
As for protein, EFSA adds 1 g a day in the first trimester, 9 g in the second and 28 g in the third, on top of the usual reference of 0.83 g per kilo of body weight. To put that in perspective, Ciqual gives 22.3 g of protein per 100 g of oven-baked cod and about 4.8 g for a 125 g pot of plain yoghurt: the third-trimester extra fits on your plate, with no protein powder needed. EFSA also recommends about 300 ml more water a day, and 100 to 200 mg of DHA (an omega-3) on top of the 250 mg of EPA + DHA advised for adults.
Vitamin B9: the only supplement prescribed to every woman
Vitamin B9 is at work from the very first weeks, when the neural tube closes, the early form of the brain and spinal cord. Neural tube closure defects (spina bifida, anencephaly) affect nearly 1 in 1,000 pregnancies in France, according to the Haute Autorité de santé (HAS, the French national health authority).
The Santé publique France booklet is clear: only folic acid is normally prescribed to all women, from the moment you plan a baby and throughout the first three months of pregnancy. For women with no history of neural tube defects, the HAS recommends a dose of 0.4 mg a day, starting 4 weeks before conception and continuing for 8 weeks afterwards. Women at high risk (a previous affected pregnancy, certain anti-epileptic drugs) are given a higher dose of 5 mg a day, on prescription.
The problem is timing. In the 2021 French National Perinatal Survey, only 28.3% of women had started folic acid before pregnancy. So it is the first thing to raise with your doctor as soon as you plan a baby. Our guide to diet and planning a pregnancy covers this period in detail.
The supplement doesn’t replace your plate. Here are some common foods rich in folate, based on the Anses Ciqual table:
| Food (Ciqual) | Folate per 100 g | Iron per 100 g |
|---|---|---|
| Spinach, cooked | 125 µg | 2.14 mg |
| Walnuts, shelled, dried | 120 µg | 2.2 mg |
| Chickpeas, boiled | 84.4 µg | 1.3 mg |
| Broccoli, steamed | 81.7 µg | 0.58 mg |
| Avocado, raw flesh | 70.4 µg | 0.34 mg |
| Green asparagus, boiled | 69.9 µg | 0.64 mg |
| Broad beans, boiled | 65.3 µg | 1.5 mg |
| Lentils, boiled | 50.1 µg | 2.45 mg |
| Lamb’s lettuce, raw | 45.5 µg | 0.4 mg |
Cooking matters: Ciqual gives 81.7 µg for steamed broccoli, against 24.7 µg for broccoli boiled until soft. Short cooking, little water and vegetables that are still crisp are what keep the most. Chicken liver is very rich in folate, but it is not recommended during pregnancy (see below).
Iodine, iron, calcium and vitamin D: the other priorities
Iodine, for your baby’s thyroid and brain
Your iodine needs rise from 150 to 200 µg a day. Santé publique France points out that iodine is essential for the working of your thyroid and for your child’s brain development during the first months. Two simple habits: cook with iodised salt (it says so on the label) and eat well-cooked sea fish. In Ciqual, 100 g of oven-baked cod provides 130 µg of iodine, and 100 g of cooked mussels 106 µg. Semi-skimmed milk provides about 24 µg per 100 g. To go further: foods rich in iodine.
Iron, without self-medicating
Anses sets the reference at 16 mg a day during pregnancy. Santé publique France states that taking iron on your own initiative, as a supplement or a fortified food, is pointless: it is for your doctor or midwife to assess any risk of deficiency, with a blood test if needed. On your plate, meat, pulses and green vegetables all contribute. One useful tip from the booklet: avoid tea during meals or just before, because it limits the absorption of iron from plant foods. Our guide to iron and anaemia explains how to absorb it better.
Calcium and vitamin D, for your baby’s skeleton
Santé publique France recommends 2 dairy products a day during pregnancy and breastfeeding, while following the precautions on cheese. Vegetables, pulses and a small handful of almonds also provide calcium. Vitamin D is mainly made by the skin in sunlight: the booklet suggests 15 to 30 minutes a day with your face and arms uncovered, avoiding the period from midday to 4 pm. Well-cooked oily fish provide some (12.3 µg per 100 g of grilled sardine in Ciqual). Your doctor or midwife will decide whether you need a supplement. More details in our guide to vitamin D.
Fish: twice a week, choosing your species
Fish provides iodine, vitamin D and DHA, an omega-3 whose reference intake EFSA raises during pregnancy, notably to make up for its build-up in the foetus. Santé publique France recommends eating it twice a week, including one oily fish (sardine, mackerel, herring, salmon), varying species and sources. Some species concentrate pollutants such as mercury:
- To avoid during pregnancy: swordfish, marlin, rock salmon (siki), shark and lamprey.
- To limit: eel, monkfish, sea bass, sea bream, skate, tuna (including canned).
- To favour, well cooked and not smoked: pollack, hake, saithe, cod, salmon, sardine, mackerel, herring, trout, whiting, anchovy, sole.
| Cooked fish (Ciqual) | DHA per 100 g | Iodine per 100 g | Vitamin D per 100 g |
|---|---|---|---|
| Mackerel, oven-baked | 1.34 g | 45.8 µg | 7.72 µg |
| Salmon, grilled or pan-fried | 1.5 g | 13.5 µg | not measured |
| Herring, grilled or pan-fried | 1.23 g | 47.7 µg | 10.8 µg |
| Sardines in tomato sauce, canned | 1.24 g | 45.1 µg | 12.5 µg |
| Trout, oven-baked | 0.66 g | 6 µg | not measured |
| Cod, oven-baked | 0.19 g | 130 µg | 1.2 µg |
100 g of mackerel or salmon therefore more than covers the extra DHA suggested by EFSA. Raw, smoked or marinated fish should still be avoided for a different reason, listeriosis: this is covered in our pages on smoked salmon in pregnancy, sushi in pregnancy and canned tuna in pregnancy. For the place of omega-3 in your diet, read our guide to omega-3.
Listeriosis, toxoplasmosis, salmonellosis: foods to avoid
These infections are rare but can be serious for the baby. The rules below come from the Santé publique France booklet.
Listeriosis
The Listeria bacterium grows in the cold, including in the fridge, and changes neither the smell nor the taste of food. For all 9 months, avoid:
- raw milk and raw-milk cheeses;
- soft cheeses with a bloomy rind (camembert, brie) or a washed rind (munster, pont-l’évêque), and uncooked pressed cheeses with a short ripening time (reblochon, morbier);
- grated cheese in bags (grate it yourself);
- cooked cured meats kept chilled (rillettes, pâtés, products in jelly, cooked ham unless it is cooked again);
- raw shellfish, raw, smoked or marinated fish, taramasalata (tarama), and peeled crustaceans sold cooked.
You can, however, eat hard cooked pressed cheeses (comté, beaufort, emmental, gruyère, parmesan), even if made with raw milk, after removing the rind, and raw-milk cheeses that have been thoroughly cooked in a dish. Individual cases are covered in camembert and brie in pregnancy, mozzarella in pregnancy, feta in pregnancy and raclette in pregnancy.
Toxoplasmosis
A blood test early in pregnancy shows whether you are immune. If you are not, regular checks are prescribed, and a few rules apply: don’t eat raw or undercooked meat, or smoked or marinated meat (game) unless well cooked, wash fruit, vegetables and herbs thoroughly, wear gloves for gardening, and avoid changing the cat’s litter yourself (otherwise, wear gloves and wash your hands afterwards). Well-cooked meat loses its red colour and turns pinkish beige in the centre.
Salmonellosis
No raw or undercooked eggs (soft-boiled, medium-boiled, sunny-side up), and no homemade dishes made with raw eggs: mayonnaise, chocolate mousse, tiramisu. No dry-cured sausage or dry-cured ham. The same product made industrially is not normally a risk. See soft-boiled egg in pregnancy, raw ham in pregnancy and cured meats in pregnancy.
Liver and liver products
Liver is rich in iron, but also in vitamin A. Very high doses of vitamin A can cause malformations: as a precaution, Santé publique France advises avoiding liver, liver pâté and foie gras. If you ate some before you knew, don’t panic, the booklet says so itself.
Caffeine, alcohol, soya: what you need to know
Alcohol: none. It passes into the baby’s blood through the placenta, and no safe threshold is known. This also applies to dishes and desserts cooked with alcohol: even after more than two hours of cooking, some remains. In the 2021 French National Perinatal Survey, about 97% of women said they had never drunk any during pregnancy.
Caffeine: in moderation. Santé publique France advises against going over 3 espresso-sized cups of coffee a day, and recommends avoiding energy drinks. EFSA, for its part, puts the safe threshold for the foetus at 200 mg of caffeine a day, from all sources (coffee, tea, fizzy drinks, chocolate). Our page on how much coffee per day gives the content of each drink.
Soya: as a precaution, leave it out. Soya-based foods and drinks contain phytoestrogens, which are classed among endocrine disruptors. Santé publique France recommends not consuming them during pregnancy and breastfeeding, including in supplements; soy sauce is fine from time to time. Products enriched with phytosterols (« to reduce cholesterol ») are also not recommended.
Weight gain: benchmarks based on your starting BMI
Gaining weight is normal, and the gain is greater in the last trimester. The benchmarks most often cited are those of the American Institute of Medicine (2009), which depend on your BMI before pregnancy:
| BMI before pregnancy | Recommended total weight gain |
|---|---|
| Under 18.5 (underweight) | 12.5 to 18 kg |
| 18.5 to 24.9 (normal weight) | 11.5 to 16 kg |
| 25 to 29.9 (overweight) | 7 to 11 kg |
| 30 and over (obesity) | 5 to 9 kg |
A meta-analysis of more than 1.3 million women (Goldstein et al., JAMA, 2017) shows that weight gain was below these benchmarks in 23% of pregnancies and above them in 47%. Insufficient gain was associated with more babies small for gestational age and more premature births; excessive gain with more macrosomia (very large babies) and caesarean sections. In France, the 2021 National Perinatal Survey counted 23% of women overweight and 14.4% with obesity before pregnancy. To work out your starting point, use our BMI calculator.
Two messages from Santé publique France: weigh yourself once or twice a month, no more, and no slimming diet during pregnancy. If you are losing weight, if you have stopped gaining, or if you are gaining « too much », talk to your doctor or midwife.
Gestational diabetes
It has risen sharply: 16.4% of women in 2021 against 10.8% in 2016, according to the National Perinatal Survey. The risk factors cited by Santé publique France are being over 35, being overweight or gaining too much weight, a family history of type 2 diabetes, and diabetes in a previous pregnancy. If it is diagnosed, specific follow-up is put in place; general guidance on carbohydrates can be found in our glycaemic index guide.
Nausea, reflux, constipation, cravings: solutions on your plate
- Nausea: it usually stops at the end of the first trimester. Eat what you can, when you can, and speak up if it seriously disrupts your daily life.
- Acid reflux: eat slowly, split your meals up (dessert can become a snack), avoid fatty, acidic or spicy dishes and don’t lie down straight after eating. See also our guide to acid reflux.
- Constipation: drink enough, increase your fibre (pulses, fruit and vegetables, wholegrain starchy foods) and keep moving. No laxatives without medical advice.
- Cravings: a snack prevents grazing. Santé publique France suggests a yoghurt or a piece of permitted cheese with wholemeal bread, fromage blanc with a piece of fruit, or stewed fruit with a small handful of unsalted nuts. Ideas in healthy snacks.
Vegetarian or vegan during pregnancy
A well-planned vegetarian diet can meet your needs, as long as you focus on pulses, dairy products and well-cooked eggs. If you are vegan, Santé publique France is explicit: only animal products contain vitamin B12, and a supplement is essential, to be arranged with your healthcare professional. As soya is not recommended, plant protein will come mainly from lentils, chickpeas and beans, combined with cereals: our guide to plant protein explains the combinations.
A typical day, for inspiration
- Breakfast: wholemeal bread, hard cooked pressed cheese (comté), a whole piece of fruit, a hot drink.
- Lunch: lentil and spinach dahl (folate, iron), rice, plain yoghurt.
- Afternoon snack: fromage blanc, a handful of almonds or walnuts, a clementine.
- Dinner: well-cooked salmon with broccoli (DHA, vitamin D, folate), potatoes, lamb’s lettuce salad, a piece of fruit.
Over the week, aim for two fish meals, one of them oily, pulses at least twice, and iodised salt in your cooking. The Santé publique France poster adds two benchmarks: limit meat other than poultry to 500 g a week and cured meats to 150 g, and no more than one glass of sugary drink a day (fruit juice included). More ideas: the spinach, egg and avocado salad (with a well-cooked egg, firm yolk), the warm chickpea and spinach salad, the grilled sardines with lemon or the oven-baked cod. All our recipes for pregnant women are gathered here.
Common myths
- « You have to eat for two. » False. The extra estimated by EFSA is 70 kcal a day in the first trimester, roughly a 125 g pot of plain yoghurt (about 63 kcal according to Ciqual), and 500 kcal in the third. Santé publique France says the same: you don’t have to eat twice as much.
- « Freezing raw fish makes it safe. » False for listeriosis: Santé publique France states that freezing does not kill Listeria.
Precautions
Some situations call for specific support: twin pregnancy, gestational diabetes, anaemia, a history of neural tube defects, obesity surgery, eating disorders, a vegan diet. Don’t take any supplement (iron, vitamin D, omega-3, herbal remedies) without talking to your doctor or midwife.
Frequently asked questions
When should I start folic acid?
As soon as you plan a pregnancy. The HAS recommends 0.4 mg a day, starting 4 weeks before conception and continuing for 8 weeks afterwards, and Santé publique France refers to the first three months of pregnancy. It is prescribed by your doctor or midwife.
How many coffees a day during pregnancy?
Santé publique France advises against going beyond 3 cups of espresso a day. EFSA sets the caffeine intake with no risk to the foetus at 200 mg a day, from all drinks, including tea and fizzy drinks.
Can you eat tuna when pregnant?
Yes, in limited amounts: tuna, including canned, is among the fish to limit because of pollutants. The fish to avoid completely are swordfish, marlin, rock salmon (siki), shark and lamprey. Details on our page on canned tuna in pregnancy.
Should I take omega-3 supplements?
Not routinely. Two portions of fish a week, one of them oily, provide the recommended DHA: 100 g of cooked mackerel contains 1.34 g according to Ciqual. A supplement should only be taken on the advice of your healthcare professional.
This article is for information only and does not replace the advice of your doctor, your midwife or a dietitian.
Can you eat it when pregnant? The series
Food by food, what is allowed, allowed under certain conditions or to be avoided during pregnancy: cheesecake in pregnancy, foie gras in pregnancy, feta in pregnancy, mozzarella in pregnancy, raclette in pregnancy, surimi in pregnancy, cured meats in pregnancy, smoked salmon in pregnancy, tiramisu in pregnancy, chorizo in pregnancy, taramasalata in pregnancy, honey in pregnancy, camembert and brie in pregnancy, prawns in pregnancy, soft-boiled egg in pregnancy, sushi in pregnancy, raw ham in pregnancy, hummus in pregnancy, canned tuna in pregnancy.
Our sources
- Anses. Avis et rapport relatifs à l’actualisation des références nutritionnelles françaises en vitamines et minéraux (saisine 2018-SA-0238). Mars 2021.
- Santé publique France. De la grossesse à l’arrivée de bébé, avec sérénité. Alimentation, activité physique et bien-être. Brochure Manger Bouger, 2026.
- Haute Autorité de santé, Commission de la transparence. Avis Acide folique CCD 0,4 mg (prévention primaire des anomalies de fermeture du tube neural). 18 décembre 2002.
- EFSA (Autorité européenne de sécurité des aliments). Dietary Reference Values for nutrients, Summary report. EFSA supporting publication 2017:e15121.
- EFSA NDA Panel. Scientific Opinion on the safety of caffeine. EFSA Journal 2015;13(5):4102.
- Inserm, Santé publique France, DREES. Enquête nationale périnatale, résultats de l’édition 2021. 2022.
- Goldstein RF, Abell SK, Ranasinha S, et al. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis. JAMA. 2017;317(21):2207-2225. PMID 28586887.
- Anses. Table de composition nutritionnelle des aliments Ciqual 2025.
Can you eat it when pregnant? The series
Food by food, what is allowed, allowed under certain conditions or to be avoided during pregnancy: cheesecake in pregnancy, foie gras in pregnancy, feta in pregnancy, mozzarella in pregnancy, raclette in pregnancy, surimi in pregnancy, cured meats in pregnancy, smoked salmon in pregnancy, tiramisu in pregnancy, chorizo in pregnancy, taramasalata in pregnancy, honey in pregnancy, camembert and brie in pregnancy, prawns in pregnancy, soft-boiled egg in pregnancy, sushi in pregnancy, raw ham in pregnancy, hummus in pregnancy, canned tuna in pregnancy.
Further reading
Food pages: Egg, Broccoli, Salmon, Almond
Recipes to try: Rolled omelette with salmon and spinach, Vegetarian bibimbap, Spinach and avocado omelette
