A Diet for Preeclampsia: Foods to Eat and Avoid

No single food prevents preeclampsia, but the overall pattern of what you eat during pregnancy can meaningfully shift your risk. Research consistently links diets rich in fruits, vegetables, whole grains, healthy fats, and adequate calcium and vitamin D with lower rates of the condition, while ultra-processed foods and certain nutrient gaps push risk in the other direction. The connection runs through the same processes that drive preeclampsia itself: inflammation, oxidative stress, and blood-vessel dysfunction, all of which are influenced by what ends up on your plate.

Why Diet Matters in Preeclampsia

Preeclampsia involves a cascade of problems that typically start with abnormal placental development and spill over into the mother’s blood vessels, kidneys, and liver. A scoping review of the nutritional risk factors for preeclampsia found that inadequate nutrition likely feeds into the condition through oxidative stress, inflammation, and damage to the lining of blood vessels.¹ That means diet is not just background noise during pregnancy. The nutrients you take in, and the inflammatory compounds you don’t, can either calm or amplify the very pathways that lead to dangerously high blood pressure.

Two Dietary Patterns With the Strongest Evidence

The Mediterranean-Style Diet

If you had to pick one eating pattern with the most consistent data behind it, it would be a Mediterranean-style diet: heavy on vegetables, fruits, whole grains, legumes, nuts, olive oil, and fish, with modest amounts of dairy and limited red meat. A 2025 review of the clinical evidence found that higher adherence to a Mediterranean diet was associated with a risk reduction for preeclampsia ranging from roughly 22 to 69 percent across observational studies.² A study from the Boston Birth Cohort reported that women in the highest adherence group had about 22 percent lower odds of preeclampsia after adjusting for other factors, and the benefit held among Black women as well.³

The DASH Diet

The DASH diet (Dietary Approaches to Stop Hypertension) was originally designed to lower blood pressure in the general population, and its principles carry over well to pregnancy. It emphasizes fruits, vegetables, low-fat dairy, whole grains, and lean protein while limiting saturated fat, added sugar, and sodium. A case-control study found that women in the highest quartile of DASH adherence had about 47 percent lower odds of preeclampsia compared with the lowest quartile, even after adjusting for major confounders.⁴ That same study reported significantly lower blood pressure and fewer cases of preeclampsia and preterm delivery in the DASH group after one and two months of intervention.

A large Dutch cohort study found a somewhat more modest picture: higher DASH scores were associated with lower mid-pregnancy diastolic blood pressure and better fetoplacental blood flow but did not reach significance for preventing gestational hypertensive disorders overall.⁵ That cohort was relatively low-risk to begin with, which may explain the weaker signal. The takeaway is that DASH-style eating consistently helps blood pressure during pregnancy, and in higher-risk women the preeclampsia benefits appear more pronounced.

Calcium Deserves Special Attention

Calcium is one of the few single nutrients where the evidence for preeclampsia prevention is strong enough for global health organizations to issue formal recommendations. Supplementation is especially urged for pregnant women in populations where dietary calcium intake is low, defined roughly as where a quarter or more of people consume less than 800 mg per day.⁶ If your diet regularly includes dairy products, fortified plant milks, canned fish with bones, or leafy greens like kale and bok choy, you may already be meeting the target. If not, supplementation is worth discussing with your provider.

On dosing, a pair of large randomized trials in India and Tanzania tested whether 500 mg of calcium daily was just as effective as the traditional 1,500 mg dose. Both trials found preeclampsia rates around 3 percent in each group, consistent with the lower dose being noninferior.⁷ That is good news for women who struggle with the large tablets required for higher doses or who experience constipation as a side effect.

Vitamin D and Preeclampsia Risk

Vitamin D deficiency during pregnancy has been repeatedly linked to higher preeclampsia risk. A systematic review and meta-analysis found that women with adequate vitamin D levels had roughly half the odds of developing preeclampsia, while deficiency was associated with a four-fold increase in risk in some analyses.⁸ Another review came to a similar conclusion, though it cautioned that more studies are needed before the relationship can be considered fully settled.⁹

Food sources of vitamin D are limited. Fatty fish like salmon and sardines, egg yolks, and fortified milk or cereal contribute some, but most people living at northern latitudes or spending little time outdoors need supplementation to maintain adequate levels during pregnancy. Your prenatal vitamin likely contains some, though many prenatal formulas provide only 400 IU, which may not be enough if you start pregnancy already deficient. A blood test early in pregnancy can clarify where you stand.

Omega-3 Fatty Acids From Fish and Supplements

The omega-3 fats found in oily fish, particularly EPA and DHA, have anti-inflammatory properties that are relevant to preeclampsia’s underlying biology. A 2024 meta-analysis combining data from multiple trials found that omega-3 supplementation reduced total preeclampsia risk by about 37 percent and severe preeclampsia risk by about 55 percent.¹⁰ An earlier meta-analysis of 14 comparisons similarly concluded that omega-3 supplements played a protective role, particularly in low-risk pregnancies.¹¹

You can get omega-3s through food by eating two to three servings per week of low-mercury fish such as salmon, sardines, anchovies, herring, or trout. If fish is not your thing, a quality fish oil or algae-based DHA supplement is a reasonable alternative. The key caveat with fish is mercury: high-mercury species like shark, swordfish, king mackerel, tilefish, marlin, orange roughy, and bigeye tuna should be avoided during pregnancy entirely.¹² Raw fish carries additional infection risk and is also best skipped.

Magnesium, Zinc, and Other Trace Minerals

Calcium and vitamin D get the most attention, but magnesium and zinc quietly show up as risk factors too. A case-control study found that women with preeclampsia had significantly lower serum levels of both minerals compared to healthy controls, and each unit increase in magnesium or zinc was associated with meaningfully lower odds of the condition.¹³ Both minerals play roles in vascular function. Magnesium helps blood vessels relax, while zinc supports immune regulation and antioxidant defenses.¹⁴

Good food sources of magnesium include nuts, seeds, dark chocolate, avocados, and whole grains. For zinc, look to meat, shellfish, legumes, seeds, and dairy. A well-rounded prenatal vitamin covers some of the gap, but food remains the most reliable delivery system for these minerals because the forms found in whole foods tend to be better absorbed.

Fruits, Vegetables, Fiber, and Nitrate-Rich Foods

A diet providing at least 400 grams of fruits and vegetables per day, roughly five servings, along with 25 to 30 grams of fiber appears to help reduce blood pressure and inflammation during pregnancy.¹² Fiber is relevant not just for blood pressure but also for gut health. Women who meet the pregnancy fiber recommendation tend to have greater gut bacterial diversity, which is increasingly understood to influence immune function and inflammation.¹⁵

One interesting subcategory is nitrate-rich vegetables. Beetroot, spinach, arugula, and other dark leafy greens contain dietary nitrate, which the body converts into nitric oxide, a molecule that relaxes blood vessels and lowers blood pressure. A feasibility trial of beetroot juice in hypertensive pregnant women explored this mechanism, building on evidence that dietary nitrate lowers blood pressure and improves vascular function in non-pregnant adults.¹⁶ While the pregnancy-specific evidence is still emerging, eating these vegetables as part of a varied diet aligns with every other recommendation on this list.

Folate and B Vitamins

Most pregnant women already know about folate for preventing neural tube defects, but B vitamins also intersect with preeclampsia through a compound called homocysteine. High homocysteine levels damage blood-vessel linings and contribute to the endothelial dysfunction that characterizes preeclampsia.¹⁷ Folate, vitamin B12, and vitamin B6 all help keep homocysteine in check. Dark leafy greens, legumes, eggs, and fortified grains are good sources. If you are taking a standard prenatal vitamin, you are likely getting the folate you need, but B12 can be a concern for women who eat little or no animal protein.

Foods and Ingredients to Limit

Ultra-processed foods deserve the biggest caution flag. These are products that go well beyond basic processing: think packaged snacks, sugary cereals, instant noodles, soft drinks, and fast food. Ultra-processed foods tend to be loaded with refined sugars, trans fats, and sodium, all of which promote inflammation and oxidative stress, the very processes that drive preeclampsia forward.¹⁸ Research also suggests that ultra-processed food consumption during pregnancy increases oxidative stress markers and may impair endothelial function.¹⁹

You do not need to achieve perfection. The goal is to tilt the ratio so that most of what you eat comes from minimally processed whole foods rather than packages with long ingredient lists. Swapping a bag of chips for a handful of nuts, or a sugary drink for water with lemon, adds up over weeks and months.

The Sodium Misconception

Many people assume that cutting salt is an obvious step to prevent preeclampsia, since the condition involves high blood pressure. The reality is more complicated. A Cochrane review of two trials involving over 600 women found no reliable evidence that advice to reduce dietary salt prevented preeclampsia or its complications.²⁰ The confidence intervals were wide, meaning the data simply could not distinguish benefit from harm.

Some researchers have suggested that aggressive sodium restriction could actually be counterproductive in early-onset preeclampsia, while it may be feasible in late-onset cases.²¹ The blood-volume dynamics of pregnancy are different from those of ordinary hypertension, and slashing sodium during a time when your body is expanding its blood supply can backfire. The sensible approach is to avoid excessive sodium intake from processed foods while not going out of your way to restrict salt beyond what a healthy diet naturally provides.

Supplements That Did Not Pan Out

Given that oxidative stress is central to preeclampsia, it was reasonable to hope that antioxidant supplements, particularly vitamins C and E, would help. Multiple large trials have now dashed that hope. A randomized trial of high-risk women found preeclampsia rates of about 17 percent in the vitamin group versus 19 percent in the placebo group, a difference that was not statistically meaningful.²² A trial published in the New England Journal of Medicine reached the same conclusion in first-time mothers: supplementation with vitamins C and E did not reduce preeclampsia, growth restriction, or infant death.²³

Perhaps most concerning, a large trial published in The Lancet found that while preeclampsia rates were similar between the antioxidant and placebo groups, more low-birthweight babies were born to women who took the supplements.²⁴ The researchers concluded that high-dose antioxidant supplementation is not justified in pregnancy. This does not mean dietary antioxidants from food are harmful. Eating berries, peppers, tomatoes, and leafy greens is entirely different from megadosing pills. The lesson is specifically about supplement megadoses, not about the nutrients themselves as they occur in food.

Caffeine, Iron, and Knowing Your Own Risk Profile

Caffeine is a common worry during pregnancy, but its connection to preeclampsia appears to be minimal. A study that measured both self-reported caffeine intake and plasma caffeine levels found no significant association between moderate caffeine consumption and preeclampsia risk.²⁵ Standard guidance to keep caffeine under about 200 mg per day during pregnancy, roughly one 12-ounce cup of coffee, remains reasonable for other reasons, but preeclampsia prevention is not one of them.

Iron is a more nuanced story. Pregnant women need iron to support increased blood volume and fetal development, and iron-deficiency anemia is common. But emerging research on the other end of the spectrum, iron overload, has raised questions. A recent study found that excess iron can trigger a form of cell death in placental tissue that drives placental dysfunction in preeclampsia, leading researchers to call for more individualized iron-management strategies in high-risk pregnancies.²⁶ The practical implication is straightforward: take iron when you need it, based on blood work, rather than assuming more is always better.

Preeclampsia is not purely a dietary disease. Genetics, placental biology, immune factors, pre-existing conditions like chronic hypertension or diabetes, and even the interval between pregnancies all play roles that no amount of kale can override. But diet is one of the few modifiable levers you actually have. If you are building a plate with whole grains, colorful vegetables, legumes, fish, nuts, and adequate dairy or calcium-rich alternatives, while steering clear of heavily processed foods and unnecessary supplement megadoses, you are already doing what the best available evidence supports.

L-Arginine and Vascular Research

One dietary compound that occasionally surfaces in preeclampsia discussions is L-arginine, an amino acid that the body uses to produce nitric oxide. A small study of women already diagnosed with preeclampsia found that prolonged oral L-arginine supplementation significantly lowered blood pressure by boosting nitric oxide production.²⁷ L-arginine is found in foods like turkey, pork, chicken, pumpkin seeds, soybeans, and peanuts. This line of research is still early, and no one is recommending L-arginine supplements as a standard preventive measure. But it offers another reason why protein-rich whole foods may be quietly beneficial: they supply the building blocks your blood vessels need to function properly.