It’s hard to make a list of the most important first trimester nutrients because eating a healthy wholesome diet matters so much throughout pregnancy. Still, some nutrients are more specific to what’s going on in the first trimester: your baby develops its complete nervous system and some vital organs. Your uterus grows, and your placenta fully forms.
This post breaks down the roles of some “famous” and some less known nutrients, along with a list of the most nutrient-dense foods you may want to add to your diet in the first trimester.
Contents
What Happens in the First Trimester
Most major fetal development takes place in the first trimester, although you might not even feel like you’re pregnant yet. By the end of the first trimester, you probably won’t even have a visible bump (although you might–and that’s totally fine!).
Yet, your baby will start developing its vital organs. Its complete nervous system will grow. Natural folate is a famous first trimester nutrient that supports the development of the nervous system and prevents so-called neural tube defects. Folate is NOT the same as synthetic folic acid (Scaglione & Panzavolta, 2014).
Your baby’s heart tissue will form in the first trimester, and its heart will beat. Small structures that will become eyes and ears will develop. You need plenty of nutrients from a diverse diet to support these physiological processes (see Pascual & Langaker, 2021 as a reference for this section).
Your heart becomes stronger. The amount of blood your heart pumps increases 30 to 60% in pregnancy, with the majority of the increase occurring during the first trimester.
Your blood volume increases almost by a third too. Your kidneys start working faster, which gives you that feeling that you need to pee too often. Now you know why proper hydration is a must when you’re pregnant.
Your uterus will slowly start to grow. The bag that will hold the waters your baby will be submerged in until birth will form.
The placenta will have formed by the end of the first trimester. The placenta is a fascinating organ that will directly nourish your baby through its in utero life, filtering out exactly what it needs.
The placenta tells your fatty tissues to release fatty acids that you can use as fuel. That’s one more reason why you need healthy fats in pregnancy. Plus, good fats like olive and coconut oil are anti-inflammatory and great for your gut microbiome. Fish oil supports the development of the nervous system and brain.
Your immune system also starts working a bit differently. It shifts from “microbe-fighting” Th1 to a more passive Th2 immunity. This shift occurs in the first trimester. It ensures that your body doesn’t mistakenly attack the baby as foreign tissue. In fact, women who are more prone to miscarriages may have an overdominant Th1 response (Reinhart et al., 1998; Raghupathy, 2001).
This immune shift is beneficial, but it also means you might feel a worsening in allergy-like symptoms if you’re prone to them.
Immune system adaptations are one of the reasons why it’s important to maintain healthy vitamin D levels in pregnancy. This physiological shift also calls for foods and gentle herbs that support a healthy immune response.
Pregnancy Diet Basics
Relax and eat good food
In a nutshell, your body knows exactly what it’s doing in the first trimester. It’s working hard even if you don’t notice. There’s no need to fret about getting the perfect amount of every single nutrient mentioned in this post.
The most important thing is to make sure your diet is wholesome and diverse. You want to get enough healthy macronutrients–carbs, protein, and fats–from good, clean sources.
There’s nothing to worry about as long as you are eating green leafy vegetables, cruciferous vegetables, eggs, fish and seafood, grass-fed meat, legumes, nuts, and locally available fruits.
You can absolutely have a healthy pregnancy if you’re vegetarian or vegan, you just may need to pay extra attention to some nutrients like vitamin B12, vitamin A, zinc, and choline.
Try the Mediterranean diet
I don’t think there’s a diet that suits everyone. You need to find what feels right for you.
If you need some ideas, looking up the Mediterranean diet is a great place to start. The Mediterranean diet suits most people. It relies on tons of healthy olive oil, fish, a small to moderate amount of meat, great salads, and medicinal spices.
The Mediterranean diet also supports heart and brain health and helps balance hormones and combat oxidative stress. It provides lots of antioxidants that may even help protect against preeclampsia or high blood pressure in pregnancy (the data on antioxidants for preventing preeclampsia is mixed, though) (Tosti et al., 2018; Cohen et al., 2015; Cohen et al., 2015).
What if I get morning sickness?
I know it’s tough to eat healthy when you feel nauseous. It’s a huge challenge if you have hyperemesis gravidarum, which is severe morning sickness with vomiting and weakness.
Do your best. Try naturally sourced liquid supplements if you’re not getting enough food down. You can also add ginger and vitamin B6 (supplement or from food) to your diet. Eat a bit at a time (Shrim et al., 2006; Viljoen et al., 2014).
Acupuncture or acupressure might also be helpful in some cases (Norheim et al., 2001).
You might even want to give some gentle cleanses a try, based on anecdotal evidence and folk practices. Have in mind that there are no studies to back up this approach.
The cleanse might include kaolin/clay, oral bentonite, activated charcoal, or zeolite. These remedies bind toxins in the gut. They should be taken between meals and only for a short time. Check with your provider first, since these remedies can interact with nutrients and drugs.
Only one study described that Black African women in North London take clay during pregnancy to curb morning sickness and nausea and to satisfy cravings, based on indigenous knowledge. The authors say clay can be dangerous in pregnancy. However, this is true only if it’s used in excessive amounts and if certain precautions aren’t taken (Madziva & Chinouya, 2020).
Two “Famous” First Trimester Nutrients
1) Natural Folate
Natural folate or vitamin B9 is perhaps the most important first-trimester nutrient. It’s necessary for neural tube development, which forms the basis of the baby’s nervous system and brain. It also helps the body make DNA, red blood cells, and proteins. Folate helps cells divide and tissues grow (Scaglione & Panzavolta, 2014).
Folate deficiency has been linked with an increased risk of neural tube defects, cardiovascular disease, cancer, and cognitive dysfunction (Scaglione & Panzavolta, 2014).
During pregnancy, there is a 10- to 20-fold increase in folate requirements! (Pillay et al., 2016)
There are several possible causes of deficiency: low dietary intake, poor absorption of ingested folate, and alteration of folate metabolism (due to genetics or drug interactions) (Scaglione & Panzavolta, 2014).
Folate, methyl-folate, and folic acid are not the same thing
Folate is not the same as folic acid that you’ll find in most prenatal supplements.
I know this will cause some confusion if you don’t have a background in chemistry, but it’s important–so bear with me.
Foods contain folates, a category of chemically similar natural variations of this nutrient. One type of naturally occurring folate is 5-methyltetrahydrofolate (5-MTHF), also known as methyl-folate for short) (Scaglione & Panzavolta, 2014).
Supplements may contain:
- Folic acid
- Folinic acid (5‐formyl tetrahydrofolate)
- Methyl-folate
Methyl-folate is the active form of folate your body can directly use. Folinic acid is also an active form of folate, but it’s not common and there’s less research on it. Folic acid is a synthetic form not found in nature that your body has to convert into methyl-folate using an enzyme called methylenetetrahydrofolate reductase or MTHFR (Scaglione & Panzavolta, 2014; Shea et al., 2013).
If your MTHFR is sluggish, synthetic folic acid can build up in your body (and in the baby growing in your belly too).
MTHFR mutations that cause MTHFR to work less efficiently are very common. About 30 to 40 percent of the American population may have these common MTHFR mutations (especially C677T) (NIH).
Methyl-folate is active in people with MTHFR mutations. Compared to folic acid, naturally occurring folate has better absorption and bioavailability (even when the gut pH is altered). It’s not affected by your metabolism. Additionally, natural folates like methyl-folate (Scaglione & Panzavolta, 2014):
- Don’t mask the symptoms of vitamin B12 deficiency
- Cause fewer drug interactions (with drugs that inhibit dihydrofolate reductase/DHFR)
According to studies, high intake of folic acid, but not natural folates, has also been linked with leukemia, arthritis, bowel cancer, and ectopic pregnancies (Iyer & Tomar, 2009).
Research also revealed an association between taking high doses of folic acid during pregnancy and an increased risk of childhood asthma in the offspring (Woude et al., 2014).
Food sources
Rich sources of natural folate are green leafy vegetables, asparagus, sprouts, fruits, brewer’s yeast, and liver (Scaglione & Panzavolta, 2014).
2) Vitamin A (Retinol)
Vitamin A is important for your baby’s proper heart, nervous system, and eye development. Most people know it’s needed to maintain healthy eyesight, but many haven’t heard that the baby’s heart can’t develop properly without it.
Vitamin A is crucial very early on when your baby is still tiny and technically called an embryo.
The active form of vitamin A, retinol, turns on developmental genes–including the ones that participate in building the heart. A lack of vitamin A causes the embryonic heart to develop abnormally, which can cause the embryo to die and lead to miscarriages (Zile, 2010).
A lack of vitamin A can also cause the nervous system to develop improperly (Zile, 2010).
Animal vs. plant-based sources
The best food sources of active vitamin A are liver, oily fish, cod liver oil, cheese, grass-fed butter, and egg yolk (Gilbert, 2013).
Carotenoids (beta-carotenoids) are bright-orange pigments found in vegetables. The best sources are carrots, sweet potatoes, mangoes, and dark leafy greens.
Carotenoids are provitamin A: your body needs to convert them to active vitamin A using a gut enzyme. Carotenoids are also antioxidants on their own, so they carry some unique health benefits (Gilbert, 2013).
Plant-based sources of provitamin A are healthy, but they can’t always replace readily available retinol. This is especially true in some people that are slower at making retinol from provitamin A (Tang, 2010).
All the sources of vitamin A need some fat in the diet to aid absorption (Gilbert, 2013).
Less Known First Trimester Nutrients
3) Thiamine (Vitamin B1)
Thiamin or vitamin B1 is key for nervous system and brain development. It helps make myelin, the protective sheathing around brain cells. Thiamine is also involved in producing neurotransmitters like acetylcholine, GABA, and glutamine. Thiamine deficiency increases oxidative stress and causes brain cells to go haywire (Kloss et al., 2018)
Some studies suggest that the worst negative effects on the fetus arise when there is a lack of thiamine and alcohol exposure (Kloss et al., 2018).
Thiamine food sources include whole grains, meat (especially liver and other organ meats), yeast, eggs, fish, legumes, and nuts (Kerns & Gutierrez, 2017).
4) Riboflavin (Vitamin B2)
Riboflavin or vitamin B2 has been called “a forgotten natural vitamin.” It has antioxidant, anti-aging, anti-inflammatory, painkilling properties (Suwannasom et al., 2020).
Riboflavin is required for healthy embryonic development, along with choline (another overlooked nutrient). A mice study suggested that low dietary choline and riboflavin during pregnancy impair embryonic growth and heart development in mice (Chan et al., 2010).
This nutrient may also have a protective effect on your baby’s developing immune system. In an older mice study, the fetuses of animals lacking riboflavin were more prone to pneumococcus infection (Wooley & Sebrell, 1942).
It would be great to see more human data, but it seems like riboflavin is more important than previously thought.
Luckily, riboflavin is found in a variety of foods like milk, organ meats, egg, fish, nuts, certain fruits and legumes, wild rice, mushrooms, dark green leafy vegetables, yeast, beer, and cheese (Suwannasom et al., 2020).
However, it’s stored in the body only for a short time, so you need to be conscious of getting enough on a regular basis.
5) Choline
Choline is another nutrient you don’t hear about often. Yet, dietary requirements for it are high during pregnancy. It’s especially important during the first and third trimesters because it plays a huge role in the development of the nervous system (first trimester) and more complex brain circuitry (third trimester) (Freedman and Ross, 2015).
Choline is a building block for the neurotransmitter acetylcholine.
It is also involved in producing brain cell membranes and helping acetylcholine achieve its roles in the developing fetus. In a way, acetylcholine is the “lazy” neurotransmitter because it orchestrates your parasympathetic “rest and digest” nervous system. But acetylcholine is also the number one neurotransmitter involved in cognition.
Studies suggest that adequate choline intake during pregnancy may help prevent mental illness in the newborn. Research is focusing on its potential protective effects on schizophrenia and attention deficit disorder (ADD). Since it takes 20 years for these diseases to manifest and the research is young, we have yet to see the clinical trial results in the future (Freedman and Ross, 2015).
Most pregnant women in the U.S. are not achieving choline intake recommendations of 450 mg/day and would likely benefit from boosting their choline intake through diet. Women who can’t get enough choline from food may want to consider supplements (Korsmo et al., 2019).
Choline-rich foods include beef, chicken, pork, eggs, fish, and soybeans (Korsmo et al., 2019).
6) Vitamin B3 (Niacin)
Vitamin B3 or niacin may help prevent birth defects by replenishing the body’s NAD, according to a recent genetics-based human study. This happens in the first trimester, while main embryonic development is taking place (Shi et al., 2017).
There’s been a lot of hype about NAD in the anti-aging and biohacking world since its levels have been linked with longevity. Its higher levels in younger people are thought to contribute to better fitness, cognitive function, and cellular repair and regeneration (Johnson & Imai, 2018).
NAD is short for nicotinamide adenine dinucleotide. It’s found in every cell in the body. NAD is a coenzyme, which means that various important enzymes and thousands of metabolic reactions in the body need it to work.
NAD is produced by two pathways: one requires dietary tryptophan, and the other requires dietary niacin.
During development, embryos receive niacin from the mother and generate their own. This means that embryos can, in part, make up for a lack of niacin in the mother’s diet by making some NAD on their own (Shi et al., 2017).
Some embryos are not good at producing enough of their own NAD. In those cases, niacin from the mother’s diet prevents embryo defects (Shi et al., 2017).
Niacin deficiency seems to be common during pregnancy (Shi et al., 2017).
Good sources of niacin are liver, meat and meat products, fish, peanuts, and whole grains (Mielgo-Ayuso et al., 2018).
All-Around Pregnancy Nutrients
The following nutrients are important throughout pregnancy (more about this in a separate post coming soon):
- Vitamin D
- Protein
- Copper
- Iron (especially toward the end of the 2nd trimester)
- Calcium (most in the 3rd trimester)
- Magnesium
- Omega-3 fatty acids (most in the 3rd trimester)
- Vitamin B12
- Iodine
- Zinc
- Fiber
- Antioxidants
Curious about using herbs in pregnancy?
Check out these posts:
- Chamomile Tea Pregnancy & Breastfeeding Safety + Benefits
- Maca Pregnancy & Breastfeeding Safety + Side Effects
Are you struggling to maintain a healthy diet during pregnancy? Let me know in the comments. If you liked this post, please like and share.
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Ana
The founder of Herbal Doula.
Home-birthing mama, independent scientist, natural pharmacist, doula, birthkeeper, and holistic health and birthrights advocate. Endlessly passionate about creating and sharing empowering health information and birth support. Ana has written 150+ and edited 800+ articles, some of which reached over 1 million people
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