The Paleo Diet And Pregnancy - The Second Trimester

This articles forms part of a series covering the Paleo diet and lifestyle to support reproduction from fertility to conception, pregnancy and nursing.

PART 4 - Micronutrients during the second trimester. 

There is no question that the most important thing you can do when you are pregnant is to eat well and the Paleo diet can provide a solid nutritional foundation for you and your growing baby.

The second trimester of pregnancy refers to weeks 13 through 28. By this point many women have begun to overcome many of the initial symptoms of the first trimester and start to feel less nauseous and have more energy, although this not necessarily the case for everyone.

Many of the food aversions experienced during early pregnancy often begin to dissipate by this time giving an expectant mother a great opportunity to work on correcting any deficiencies that may have arisen during the first few weeks.

The Paleo diet is one of the most nutrient dense approaches to eating. It encourages avoiding all food toxins like industrial seed oils and grains, especially gluten containing grains and excess fructose and soy while eating a diet rich in organ meats, muscle meats, a variety of vegetables, fruits and starchy tubers and a moderate amount of nuts, seeds, cold water fish. If you find that your gut tolerates dairy then some high fat yoghurt, milk, and cheese can also be beneficial if you are able to source it correctly.

During your second trimester, ensuring you are getting adequate macronutrients (proteins, fats and carbohydrates) is essential and making sure you have all the necessary micronutrients (vitamins, minerals and nutrients) is just as important in providing your body and your growing baby all the’tools’ necessary for health and strength.

Micronutrients are dependent on a strong, resilient digestive tract and sufficient stomach acid (HCL) in order to be properly absorbed. If you think you may be struggling with issues related to low stomach acid, you may want to consult with your healthcare provider and possibly consider something like an HCL supplement. 

Important Micornutrients

Vitamin A

Vitamin A prevents placental insufficiency, low birth weight babies and preterm birth. And is an important component of fetal development.


  • Liver from all animals (including cod liver oil) is your best and most bioavailable source.
  • Well sourced, whole fat, grass-fed dairy, if tolerated.
  • While yellow/orange coloured vegetables such as sweet potatoes, squash and apricots contain Beta-carotene (the inactive form in vegetables) most of it is not efficiently converted into the form Vitamin A used by the body. Huge amounts of these vegetables would need to be consumed to provide adequate vitamin A needed for optimal fertility,  pregnancy and breastfeeding.

B Vitamins

This family of nutrients is important for the prevention of open neural tube defects (spina bifida), energy metabolism and healthy baby growth & development.


  • B12: Highest in animal proteins with the richest sources being found in liver, clams, fish, beef and grass-fed dairy.
  • B9 (folate): Dark leafy greens, asparagus, broccoli, citrus fruits, avocado, nuts/seeds, squash and beets. Folate is the key nutrient important in protection against neural tube issues, like Spina Bifida. It needs to be part of the diet BEFORE getting pregnant as well as during gestation.


Betaine (a choline derivative) is important in the formation of methionine, which helps with detoxification and protects the fetus. It also assists in promoting healthy neural development.


  • Beet skins
  • Spinach
  • Shrimp (wild caught)

Vitamin C

Vitamin C supports immune function and plays a role in the absorption of iron from food sources.


  • Citrus fruits
  • Berries
  • Peppers
  • Cauliflower


Critical for development of little baby bones and nervous systems, your dietary calcium needs go up in pregnancy. While babies will always get what they need, they do so by depleting the stores of the mother. If you become calcium deficient in pregnancy it can pre-dispose you to osteopenia (or low bone density) later in life. Although supplementation is often recommended, it is not well metabolized and absorbed, can cause constipation and has shown little evidence to support supplementing for bone health. Food sources are more effective.


  • Sardines (bones included)
  • Dark leafy greens including collard greens, kale, swiss and rainbow chard
  • Grass-fed full fat dairy (if tolerated)
  • Nuts (like Almonds) however, due to the phalate content of nuts and seeds the calcium may not be well absorbed. Soaking nuts for 24 hours does help.

Note: Calcium blocks the absorption of iron, and is best eaten alone or separately from iron containing meal.


Choline supports fetal brain development. Some studies show that it may also reduce the risk of nervous system dysfunction and mental illness.


  • Egg yolks from pastured hens

  • Beef liver and cube steak.

  • Smaller amounts are found in spinach and potatoes

Vitamin D

This sunshine nutrients helps you absorb calcium is important for bone health and metabolic and immune function (which is reduced in pregnancy). Babies born to Vitamin D deficient mothers may also be predisposed to Type-1 diabetes.


  • Egg yolks
  • Wild caught, small, fatty fish
  • Cod liver oil
  • Sunshine supports your own vitamin D production!


During pregnancy blood volume expands by up to 50%  diluting iron stores and resulting in anemia being one of the most common nutrient deficiencies during gestation Iron is important for energy levels and most metabolic functions in the body. Remember to consume iron rich sources along with vitamin C and away from calcium rich meals to maximize absorption.


  • Red meats and dark turkey from pastured animals
  • Pumpkin seeds

Vitamin K2

Vitamin K2, along with co-factors Vitamin D and calcium protect the brain, nervous system and skeletal system. Vitamin K2 is he nutrient required for calcium absorption and plays a role in gene expression.


There are two forms of Vitamin K2

  • MK-4 which is available in grass-fed butter and egg yolks
  • MK-7 which is found in fermented foods.
  • Check out this comprehensive list of Vitamin K2 sources


Magnesium helps build strong bones and teeth, regulates insulin and blood-sugar levels and supports digestive enzyme function. Furthermore is can help reduce anxiety, aid with sleepless nights, relieve constipation and prevent painful leg cramps.


  • Bananas
  • Spinach and Swiss chard
  • Pumpkin seeds
  • Almonds (soaking is important for optimal nutrient absorption)
  • Topical and oral supplementation have also been found to be useful

Omega 3 Fatty Acids

DHA, an Omega 3 fat, aids in brain and eye development as well as providing a protective mechanism against cardiovascular disease for the expectant mother. DHA can also prevent mood imbalance during pregnancy and specifically postpartum


  • Cold water, small, oily fish. When choosing your fish, especially in pregnancy, but also beyond, choose wild caught fish rather than farmed fish and aim for species that are low on the food chain: think sardines, herrings, mackerel, trout, salmon, shrimp, lake fish.
  • Krill oil, fish
  • Blue green sea algae (especially if you have an allergy to fish)


During pregnancy there is a higher need for zinc and it is important to focus on getting adequate amounts through your diet. Zinc is pivotal in DNA and gene expression and needs to be consumed regularly as your body cannot store it.  


  • Oysters
  • Liver
  • Beef, lamb, goat and dark meat from poultry
  • Pumpkin seeds
  • Dark Chocolate

Special Mention: Probiotcs

Although not technically a micronutrient, both live and supplementation based probiotics are essential for optimal digestion, immune system function and the vaginal flora your baby will soon be passing through.


  • Raw fermented vegetables including sauerkraut and pickles (although you can make or purchase numerous options
  • Kombucha and other fermented beverages
  • Raw, grass-fed yogurt and kefir (if tolerated) as well as many non-dairy based ferments

Cooking and food options, variety and choices can still feel overwhelming and Pete’s Paleo meals delivery and menu options can save much needed time and energy with the assurance that all products are of the highest quality providing you with the best micronutrient (as well as delicious, chef inspired food).

The most important element of good nutrition for your second trimester of pregnancy is a diet of micronutrient-dense whole foods. No magic pill, supplement, or superfood can make up for a shaky foundation. A Paleo diet provides a solid backdrop on which to continue to be a healthy and resilient mother-to-b whilst providing your baby with the nourishment for optimal development.

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