Pregnancy Nutrition in Europe: Foods to Eat and Avoid by Trimester

Eating well during pregnancy is one of the most meaningful things you can do for both your own health and your baby’s development — but the information available is often confusing, contradictory, or frustratingly vague. The reality is that pregnancy nutrition guidelines vary slightly between countries, and what your French cousin was told may differ from what your NHS midwife recommends. This guide brings together the best current evidence on pregnancy nutrition foods to avoid by trimester and the foods that actively support healthy development, drawing on NHS guidance, European Food Safety Authority (EFSA) recommendations, and the World Health Organisation’s antenatal nutrition standards. Whether you’re in the UK, Germany, France, Sweden, or anywhere else in Europe, this practical, trimester-by-trimester breakdown will help you eat confidently throughout pregnancy.

Nutritional Foundations That Apply to All Trimesters

Before diving into trimester-specific guidance, it helps to establish the nutritional foundations that apply throughout pregnancy. The NHS recommends that all pregnant women take two key supplements: folic acid (400mcg per day until at least 12 weeks) to reduce the risk of neural tube defects, and vitamin D (10mcg or 400IU per day throughout pregnancy and breastfeeding). Women at higher risk of neural tube defects — including those taking epilepsy medication or with a higher BMI — may be prescribed a higher dose of folic acid (5mg) by their GP.

Beyond supplementation, the broad nutritional priorities for pregnancy are:

• Adequate protein for fetal tissue growth (aim for approximately 70g per day, increasing slightly in the third trimester)
• Iron to support the expansion of blood volume and fetal iron stores
• Calcium for bone and teeth development — the NHS recommends 700mg per day
• Omega-3 fatty acids, particularly DHA, for brain and eye development
• Iodine, which is essential for thyroid function and neurological development — often overlooked in UK and European diets

A varied, whole-food diet with plenty of vegetables, whole grains, lean protein, dairy or calcium-rich alternatives, and oily fish (within safe limits) provides most of these nutrients. Pregnancy is not a time for extreme dietary restriction unless medically indicated.

First Trimester: Managing Nausea While Meeting Nutritional Needs

The first trimester (weeks 1–12) presents a specific nutritional challenge: nausea and food aversions can make it very difficult to eat well, precisely when the neural tube and major organs are forming and nutritional adequacy matters most. The priority in the first trimester is getting enough calories and maintaining folic acid intake above all else.

If nausea is severe, focus on foods you can tolerate rather than foods you feel you “should” eat. Plain crackers, toast, rice, and banana are often tolerable when other foods are not. Ginger — in tea, biscuits, or crystallised form — has the most consistent evidence of any dietary remedy for pregnancy nausea.

Foods to prioritise in the first trimester include:

• Fortified breakfast cereals (provide folic acid, iron, and B vitamins)
• Leafy green vegetables when tolerable (spinach, kale, broccoli)
• Eggs (a versatile, high-protein food that also provides choline, important for neural development)
• Legumes (lentils, chickpeas, beans — excellent plant-based iron and folate sources)
• Full-fat dairy or calcium-fortified alternatives

Foods to avoid in the first trimester include raw or undercooked eggs, unpasteurised dairy products, pâté, raw shellfish, and high-mercury fish such as shark, swordfish, and marlin. These restrictions are consistent across NHS and EFSA guidance.

Second Trimester: The Nutritional Opportunity

For many women, the second trimester (weeks 13–26) brings relief from first trimester nausea and a restored appetite. This is the nutritional opportunity of pregnancy — the time to focus on building a genuinely varied, nutrient-dense diet. Energy requirements increase by only approximately 200–300 calories per day in the second trimester (contrary to the “eating for two” myth), but nutrient demands increase significantly.

Key nutritional focuses for the second trimester:

• Iron: The body’s requirement for iron increases substantially from the second trimester. Red meat, chicken, fish, fortified cereals, legumes, tofu, and dark green vegetables are all good sources. Pair plant-based iron with vitamin C to enhance absorption, and avoid drinking tea or coffee with iron-rich meals as tannins inhibit absorption.
• Calcium and vitamin D: Bone mineralisation in the fetus accelerates in the second trimester. Dairy products, fortified plant milks, tinned sardines (with bones), and leafy greens all contribute. Remember that vitamin D is needed to absorb calcium effectively.
• Omega-3 fatty acids: Oily fish (salmon, mackerel, sardines, trout) are the richest dietary source of DHA. The NHS recommends up to two portions of oily fish per week during pregnancy. Women who don’t eat fish can consider an algae-based DHA supplement.

In the second trimester, gestational diabetes screening typically occurs around 24–28 weeks. Regardless of your result, reducing refined carbohydrates and sugar and increasing fibre is beneficial for all pregnant women at this stage.

Third Trimester: Preparing for Birth and Breastfeeding

In the third trimester (weeks 27–40+), the fetus is gaining weight rapidly and accumulating iron, calcium, and fat stores in preparation for birth and the neonatal period. Maternal nutritional needs are at their highest, and many women also begin thinking ahead to breastfeeding nutrition.

Energy requirements increase by approximately 200 calories per day in the third trimester. Protein needs also increase — aim for at least 71g per day. Practical eating can become more challenging as the growing uterus reduces stomach capacity; smaller, more frequent meals are often more comfortable and help maintain blood sugar stability.

Third trimester nutritional priorities:

• Iron: Iron deficiency anaemia is common in the third trimester. Your midwife should check your haemoglobin levels at approximately 28 weeks; supplementation may be recommended.
• Vitamin K2: Emerging evidence — and guidelines in several European countries including the Netherlands and Germany — support vitamin K2 for bone health. Though not yet routinely recommended by the NHS, it is worth discussing with your midwife.
• Dates: A small but interesting body of evidence (primarily from Jordan and the UK) suggests that consuming dates in the final weeks of pregnancy may support cervical ripening and reduce the need for labour augmentation. The evidence is preliminary but the risk is minimal.
• Hydration: Dehydration in the third trimester can trigger Braxton Hicks contractions and increase the risk of preterm labour. Aim for at least 8 glasses of fluid per day.

Foods to Avoid Throughout Pregnancy: A Clear Summary

While specific advice varies slightly by trimester, the following foods are recommended to be avoided throughout pregnancy by the NHS, EFSA, and most European national health authorities:

• Raw or partially cooked meat (risk of toxoplasmosis and salmonella)
• Raw shellfish including oysters, clams, and mussels (risk of norovirus and listeria)
• Unpasteurised dairy products including soft cheeses made from unpasteurised milk (listeria risk)
• Mould-ripened soft cheeses such as brie, camembert, and blue cheeses (listeria risk; hard blue cheese like stilton is considered lower risk)
• Pâté of all types including vegetable pâté (listeria risk)
• Shark, swordfish, marlin, and raw tuna sushi (high mercury; limit fresh/tinned tuna to four portions per week)
• Liver and liver products (excessive vitamin A, which can harm fetal development)
• Alcohol — no safe level has been established in pregnancy
• High-dose herbal supplements (many are contraindicated; always check with your midwife)

Frequently Asked Questions

Do I need to eat more calories in the first trimester?

No. Contrary to popular belief, calorie requirements do not increase in the first trimester. They increase by approximately 200 calories per day in the second trimester and 200 calories per day in the third. The focus in the first trimester should be on nutrient quality rather than quantity — particularly folic acid, iron, and calcium.

Can I eat sushi during pregnancy in Europe?

Raw fish sushi is generally not recommended during pregnancy due to the risk of listeria, parasites, and mercury. However, cooked sushi (prawn, cooked salmon, vegetable) is safe. In most EU countries, commercially prepared sushi that is blast-frozen meets EU food safety regulations that reduce parasite risk, but listeria risk from raw fish remains. The safest approach is to choose cooked options.

What should vegetarians and vegans focus on during pregnancy?

Vegetarian and vegan diets can absolutely support a healthy pregnancy with careful planning. Key nutrients to focus on include iron (from legumes, fortified cereals, tofu, and dark leafy greens), calcium (from fortified plant milks, tofu, and almonds), vitamin B12 (supplementation is essential for vegans), omega-3 DHA (algae-based supplement recommended), iodine (often low in plant-based diets; discuss supplementation with your midwife), and zinc. The NHS advises vegan pregnant women to discuss supplementation with their midwife or GP.

Is it safe to diet during pregnancy?

Calorie restriction or weight-loss dieting is not recommended during pregnancy. However, women with gestational diabetes or excessive weight gain may be advised by their healthcare team to moderate their diet under supervision. Making nutrient-dense food choices and reducing refined sugars and processed foods is appropriate for all pregnant women and is not the same as dieting.

Eating Well Is an Act of Care — For Yourself and Your Baby

The best approach to pregnancy nutrition is not anxiety or perfectionism, but informed, varied, and enjoyable eating. Your next practical step is to review your current diet against the key nutrients listed above, speak to your midwife about supplementation, and — if you have specific concerns such as a vegetarian or vegan diet, food allergies, or a history of eating disorders — ask for a referral to a registered dietitian. Evidence-based eating during pregnancy is genuinely one of the most powerful investments you can make in your and your baby’s long-term health.