Diet in Pregnancy: A Review of Current Challenges and Recommendations. A British Nutrition Foundation Briefing Paper.

Pregnancy is a crucial period during which maternal nutrition, weight and lifestyle behaviours have a direct impact on both maternal and fetal health. This briefing paper describes dietary and lifestyle recommendations for women during the preconceptional period and throughout pregnancy, identifying specific factors that can be modified to improve health outcomes for both mother and child. It considers key areas such as nutrient intakes, supplementation, food safety and weight management, and highlights how dietary choices can help reduce the risk of common pregnancy-related conditions. Despite widespread recognition of the importance of a healthy, balanced diet, many women in the UK fall short of recommended intakes for important nutrients, including iron, folate, iodine and vitamin D. These shortfalls are particularly evident among nutritionally vulnerable groups, such as teenagers, women from lower-income households and those experiencing food insecurity; such groups may face barriers to accessing healthy foods and adhering to supplementation guidance. An increasing interest in plant-based diets presents an opportunity to consider a range of dietary patterns that support both maternal health and environmental sustainability. However, such shifts must be carefully managed to ensure adequate intake of nutrients commonly found in animal products, such as vitamin B12, iron, iodine, calcium and long-chain fatty acids. Rates of overweight and obesity among women of childbearing age remain high, reflecting trends in the general population and contributing to growing concern about maternal obesity. Maintaining a healthy weight before and during pregnancy plays a key role in supporting maternal and fetal wellbeing. Both insufficient and excessive weight gain are associated with elevated risks of complications. Excessive weight gain during pregnancy is associated with an increased risk of developing gestational diabetes, hypertensive disorders such as pre-eclampsia, preterm birth and a greater likelihood of long-term obesity in both mother and child. Supporting women to achieve and maintain a healthy weight in the periconceptional period and throughout pregnancy is therefore a public health priority. The antenatal period presents a unique window of opportunity to promote healthier and more sustainable eating patterns, as women are often highly motivated to improve their health and are in more regular contact with healthcare professionals at this time. Yet, research indicates that many women are unaware of dietary recommendations or receive inconsistent advice. To fully harness this opportunity, healthcare providers must be equipped with culturally appropriate, accessible and evidence-based resources to support perinatal conversations around diet, supplementation, physical activity and body weight. Providing appropriate support during the periconceptional and early pregnancy period is essential to addressing health inequalities, improving long-term wellbeing and positively influencing the health of future generations.