Why You Need More Protein Than You May Think During Pregnancy
We know nutrient needs are elevated throughout pregnancy, and we often hear that mamas-to-be need additional protein. But estimates for how much more you need aren’t exactly clear. So we’re taking a look at what we know: what are the current recommendations and what new research exists around optimal protein needs in pregnancy that might cause us to rethink recommendations?
The importance of protein
First things first - why is more protein needed anyway?
Protein provides us with the basic building blocks for the formation of enzymes, antibodies, muscles, collagen, skin, bones, blood vessels, and other body tissues. Proteins are made up of chains of amino acids - often referred to as the building blocks of human life.
In a person who isn’t pregnant, the amino acids in protein work to sustain your life and the continuous creation of new cells throughout your body. But in pregnancy, your need for protein isn’t just sustaining your own health and changing body, you’re also creating a human from scratch. That takes a lot of cells, which demands a lot of amino acids, which requires you to consume more protein to support a healthy pregnancy.
But how much more? Well, that’s what we’re about to get into.
If you try to figure out how much protein you need in pregnancy, you’ll see that there’s quite a range of info out there, and unfortunately, most of it isn’t backed by research on the unique needs of pregnant women and growing babies.
Instead, most recommendations are based on the Dietary Reference Intakes (DRIs) established by the Institute of Medicine (IOM). The DRIs are a set of reference values that include the following:
- Recommended Dietary Allowance (RDA): the average daily dietary intake level that is sufficient to meet the nutrient requirement of nearly all (97 to 98 percent) healthy individuals in a group. Note: the RDA is simply calculated based on the EAR (below). If an EAR cannot be determined, no RDA is provided.
- Estimated Average Requirement (EAR): a nutrient intake value that is estimated to meet the requirement of half the healthy individuals in a group. When selecting the criterion, reduction of disease risk is considered along with many other health parameters.
- Adequate Intake (AI): a value based on observed or experimentally determined approximations of nutrient intake by a group (or groups) of healthy people—used when an RDA cannot be determined.
- Tolerable Upper Intake Level (UL): the highest level of daily nutrient intake that is likely to pose no risk of adverse health effects to almost all individuals in the general population. As intake increases above the UL, the risk of adverse effects increases.
Again, the RDA for protein in pregnancy is based on the EAR. This means that the number is an estimate for the general population, adjusted based on some broad assumptions to attempt to cover the needs of half of pregnant women, and then extrapolated to result in a number that is slightly higher, so as to attempt to “reduce the risk of disease” of a broader group of pregnant women.
If you’re curious (and feel like recalling some statistics knowledge), here’s how it’s calculated:
The RDA is set at the EAR plus twice the standard deviation (SD), if known (RDA = EAR + 2 SD). If data about variability in requirements are insufficient to calculate a SD, a coefficient of variation for the EAR of 10% on either side of the mean is assumed (RDA = 1.2 x EAR).
The current RDA for pregnancy is set to 1.1 grams of protein per kilogram of pre-pregnancy body weight in the Second and Third Trimesters (this amounts to about 68 grams for a 150 pound woman). The RDA suggests no additional intake is needed during the First Trimester, meaning pregnant women in their First Trimester should default to the amount recommended for the general population of adult females of 0.8 grams per day.
You may also see blanket ranges for all women. For example, the American Pregnancy Association simply lists a target range of 75-100 grams per day for all pregnant women.
Still other recommendations target a range based on macronutrient composition. However, the ranges suggested by the Acceptable Daily Macronutrient Range (AMDR) in pregnancy are so incredibly wide they’re almost useless. The AMDR suggests pregnant women get 10-35% of their calories from protein. This means a woman eating 2,000 calories per day would 50 grams of protein daily on the low end at 10% and 175 grams of protein daily on the high end at 35%.
Shortcomings of these recommendations
Clearly, none of the current recommendations out there are terribly precise, and they’re also not terribly reliable. Most approaches to estimating protein needs are lacking for one or more reasons:
- There is a gap in research specifically on the needs of pregnant women: the unique needs of pregnant women unfortunately have not been a focus priority of research due to challenges associated with safely and reliably studying this population. Rather, most estimates of needs, like the RDAs, are simply general estimated increases based on estimates on the population as a whole.
- They have not kept up with new research: the Dietary Reference Intake (DRI) for protein in pregnancy was last updated in 2002.
- They are not aligned to optimal health: RDAs and other guidelines are generally established to avoid a disease condition, not promote optimal health.
- They don’t factor in different lifestyles: women who are active require more protein than those who are less active or engage in lower impact activities like walking.
The good news is, we have a bit more insight into protein needs for pregnant women thanks to newer research. As is often the case, the takeaways from this new research have not yet made their way into any “official” recommendations.
The first ever study to directly measure protein needs in pregnant women was published in 2015 (yes, it really is that recently). It used a technique called the indicator amino acid oxidation (IAAO) to measure protein needs and found that actual protein needs were 39% higher in early pregnancy (before 20 weeks) and 73% higher in late pregnancy (after 20 weeks) compared to the EAR. They concluded that the EAR should be set at 1.22 grams per kilogram in early pregnancy (about 83 grams for a 150-pound person) and 1.52 grams per kilogram in late pregnancy (about 104 grams per day for a 150 pound person).
However, as we discussed, the EAR is lower than the RDA and then adjusted up. So, if the RDA were to be adjusted based on this updated EAR recommendation, it would be higher - approximately 1.9 grams per kilogram in late pregnancy, or about 130 grams of protein per day in late pregnancy (after 20 weeks) for a 150 pound woman. Yes, that’s almost double the current RDA of 68 grams per day in late pregnancy for a 150 pound woman!
A research article published in 2016 on increased protein needs acknowledges that “the nitrogen balance approach used to determine the EAR (and thus the RDA) defines a minimal level of protein intake needed to avoid a deficiency This approach does not consider protein intake in relation to physiological functions responsive to the level of dietary protein intake or the relation of protein to the intake of other macronutrients. Thus, although the RDA is often interpreted as a target for the desired level of intake, in reality it better reflects a minimal amount that will prevent symptoms of deficiency in most individuals.”
But unfortunately, research suggests that most pregnant women aren’t meeting their protein needs. A study released in 2021 evaluated protein intake of pregnant women from 2013-2016. It found that 40% to 67% of pregnant women fell below optimal intake levels as recommended by the updated 2015 study. The study also noted that “many pregnant women, in particular those beyond the first trimester of pregnancy, consumed suboptimal levels of protein relative to recommendations established by the IOM.” That means even at the lower, likely insufficient recommendations established by the RDA, many women are falling short.
How protein supports mama and baby beyond growth and development
Protein needs are often discussed with respect to pregnancy outcomes and optimal development and health for both mama and baby. But it’s also worth acknowledging that protein has benefits beyond those discussed in the research around protein needs:
- Blood sugar balance: Protein does not tend to raise blood sugar but does stimulate the release of insulin. This is key to blood sugar management and quite helpful when paired with a meal or snack containing carbohydrates. Note: plant sources of protein like grains and legumes tend to be high in carbohydrates. While they may provide a good source of fiber, they don't balance blood sugar in the same way as animal sources of protein.
- Satiety: Protein is quite filling and satisfying. It is even more satiating when consumed with some fat - either cooked in a healthy fat, or paired with its own natural fat source, like salmon or chicken thigh cooked on the bone with skin.
- Nutrient density: Foods rich in protein, primarily animal foods, tend to be rich in other important micronutrients, like B vitamins, Zinc, Choline, Iron, and Vitamin A. They are also rich in important amino acids that are needed for a healthy pregnancy, and supporting healthy pregnancy outcomes, like reducing gestational diabetes risk (even as early as the First Trimester).
- Blood pressure management: Protein intake is important when it comes to maintaining normal blood pressure. This is because the cardiovascular system is under a tremendous amount of stress during pregnancy, dealing with higher levels of fluids, hormonal shifts, and expanding blood vessels. Protein provides the raw materials to help your body meet these demands, and low protein intake is a risk factor for developing preeclampsia. One amino acid in particular, glycine, can be especially helpful for regulating blood pressure. Glycine aids in the production of elastin, a structural protein that allows your blood vessels to expand and contract.
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How to meet your protein requirements
When you compare your protein needs to your intake through food, the amount you need to eat can be a bit overwhelming. Meeting protein needs can be a particular challenge in the first trimester due to strong food aversions, and in the third trimester due to baby crowding your abdomen and feeling full quite quickly.
Even if you eat a solid serving of protein at each meal as outlined below in this illustrative example, you’re likely to still come up short in your protein needs in pregnancy.
- Breakfast: 2 eggs - 12 grams
- Lunch: 4 oz chicken breast - 32 grams
- Snack: ¼ cup almonds - 7 grams
- Dinner: 4 oz salmon - 23 grams
Total: 69 grams
It gets even more difficult for mamas who avoid animal protein, for example:
- Breakfast: Oatmeal with flax and chia seeds - 12 grams
- Lunch: ½ cup cooked lentils with veggies - 9 grams
- Snack: ¼ cup almonds - 7 grams
- Dinner: 1 cup cooked quinoa with ½ cup chickpeas and veggies - 16 grams
Total: 44 grams
This is why we love Collagen Protein during pregnancy and have included it in our lineup of supplements to support optimal perinatal health. Collagen is also easy to add to so many types of food and drink, from oats and smoothies to tea and coffee. Of course, as with all supplements, quality varies, so be sure that you trust the company behind the product. Our Collagen contains 14 grams of high quality protein per serving.
In addition to its convenience, Collagen during pregnancy is also a smart source of protein. In fact, one-third of the protein in your body is actually in the form of Collagen, and Collagen as a supplement is an excellent source of protein and important amino acids to give back to your body. Incredibly, your uterus at term contains 800% more Collagen than in a non-pregnant state!
One of the important amino acids in Collagen, Glycine, has particularly elevated needs in pregnancy. Baby needs glycine to support the development of its bones, connective tissue, internal organs, blood vessels, and more. And mama requires glycine to support the maintenance and changing structure of her own body.
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The bottom line
Protein is essential to a healthy pregnancy and favorable pregnancy outcomes. Protein needs are elevated in pregnancy, and the current recommendations almost certainly understate your true needs.
Boost your protein intake and support yourself and your baby with a collagen supplement to help you meet your higher protein needs.
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