Eating for two unhealthy, not recommended during pregnancy — Gynaecologists

Pregnant women do not need to double their food intake because they are “eating for two,” gynaecologists have said, stressing that pregnancy requires a balanced diet rather than excessive eating.

The maternal health experts explained that while pregnant women need more nutrients to support their health and the growth of their babies, this does not mean they need to eat twice as much food.

They noted that the notion of “eating for two” during pregnancy was a myth and unhealthy, stressing that it was neither recommended by maternal health specialists nor the World Health Organisation.

The physicians warned that excessive weight gain during pregnancy could increase the risk of gestational diabetes and high blood pressure, urging expectant mothers to focus on nutritious foods instead.

 In an exclusive interview with PUNCH Healthwise, a Consultant Obstetrician and Gynaecologist in the Department of Obstetrics and Gynaecology, Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Osun State, Professor Ernest Orji, explained how a pregnant woman’s calorie needs change as the pregnancy progresses.

“No, ‘eating for two’ by doubling your food intake is not recommended during pregnancy,” he stated.

Orji said women who begin pregnancy at a healthy weight generally do not need additional calories during the first trimester.

“In the second trimester, an addition of about 340 extra calories per day is recommended. In the third trimester, an addition of about 450 to 500 extra calories per day is recommended,” he stated.

The professor warned that gaining excessive weight during pregnancy could have health consequences.

“Excessive weight gain can lead to complications like gestational diabetes. It can cause high blood pressure,” he said.

He urged pregnant women to pay attention to the nutritional value of their meals, rather than simply increasing the amount of food they eat.

“Instead of eating twice as much, focus on nutrient-dense foods that support your baby’s development and your own health,” he advised.

Orji recommended fruits, vegetables, lean proteins and whole grains, while highlighting folic acid, iron, calcium and vitamin D as important nutrients during pregnancy.

He also advised pregnant women to take prenatal vitamins as recommended by their doctors and drink enough water throughout the day.

The WHO recommends that pregnant women receive advice on healthy eating and physical activity to help them maintain a healthy weight during pregnancy.

The global health body says a healthy diet should provide enough energy, protein, vitamins and minerals from different foods, including vegetables, meat, fish, beans, nuts, whole grains and fruits.

It also notes that women who are undernourished may need more energy and protein during pregnancy, showing that the amount of food a pregnant woman needs should depend on her individual nutritional needs rather than the belief that she must eat for two.

According to the 2024 Nigeria Demographic and Health Survey, 50 per cent of pregnant women aged 15–49 were anaemic, compared with 46 per cent of women who were not pregnant.

The survey also found that only 30 per cent of women ate foods from at least five of 10 food groups on the day before the survey.

The 2024 NDHS further reported that 30 per cent of women aged 20–49 were overweight or obese, while 13 per cent were thin, highlighting the different nutritional challenges women may face.

The United Nations Children’s Fund promotes healthy eating, micronutrient supplementation (iron and folic acid or multiple micronutrients, and calcium), deworming prophylaxis, weight gain monitoring, physical activity, and rest to improve the nutrition of pregnant women.

Another Consultant Obstetrician and Gynaecologist and Medical Director of Living Spring Hospital and Maternity Home, Ejigbo, Lagos, Dr Joseph Akinde, described the belief that pregnant women should eat for two as a myth.

“It is a myth for the pregnant woman to believe she is eating for two,” he stated.

Akinde, a former Chairman of the Society of Gynaecology and Obstetrics of Nigeria, Lagos chapter, told PUNCH Healthwise in an exclusive interview that some pregnant women experience vomiting and morning sickness, especially during the early months of pregnancy, which can make it difficult for them to eat or keep food down.

The gynaecologist added that as the pregnancy progresses, the growing uterus leaves less room for the stomach to accommodate large amounts of food.

“In later months, the womb with the baby would not allow the stomach to be overdistended,” he explained.

Rather than focusing on eating more, Akinde said pregnant women should pay attention to getting the nutrients they and their babies need.

“All that a pregnant woman needs is a balanced diet in adequate quantity that she can tolerate,” he advised.

“The emphasis on eating during pregnancy should be on sufficiently nutritious feeds having the five classes of food in a balanced ration,” the gynaecologist stated.

Akinde also noted that gestational diabetes is influenced by factors including genetics, advanced maternal age and higher-order pregnancy, rather than by how much a woman eats.