Disclaimer: This is the first guest post from Dr. Leanne Redman, associate professor of women’s health studies at Pennington Biomedical Research Center. You can get to know her more here. Her facts and opinions are based on her personal research. Red Stick Moms Blog was not paid to promote any specific medical viewpoints or studies. Always consult your physician with any medical questions.
One of the most accepted wives tales for pregnant women is that pregnancy is a time to let go of any inhibitions related to nutrition, and to over-indulge in every food craving since we are now ‘eating for two’. While this dogma was probably true back in the 1950’s when only 1 in 10 women were dealing with health issues related to being overweight, this is certainly not true for 21st century moms.
There are many well-informed reports now in medical journals that show the amount of weight a woman gains throughout her pregnancy can enhance her risk for poor pregnancy and birth outcomes. While counseling women on weight gain in pregnancy is not new and ‘healthy weight gain’ guidelines were initially developed in 1990, the focus of weight gain for the last twenty years was on ensuring that women, especially those in women low and middle income countries, achieved a healthy weight gain to support a healthy and nourished infant.
So how much weight should you gain in pregnancy?
In 2009, the Institute of Medicine convened a consensus workshop and issued a report as well as revised guidelines for how much weight a woman should gain during pregnancy. As shown below, the weight recommendations are now targeted for all women on the basis of her weight at the start of pregnancy.
To interpret the weight gain guidelines, newly expectant women should first identify their body mass index group. Body mass index, or BMI, is a simple calculation that health care providers use to understand health risks. Several BMI calculators are available online. To calculate your BMI enter your weight at the time you became pregnant and your height, then the recommended amount of weight to be gained can be learned. For example, a newly pregnant women with a BMI of 27.5, falls into the overweight category and the advised weight gain for her pregnancy is 15-25 pounds or 0.5-0.7 lbs per week.
Even though these recommendations have been published for five years, many women are not aware that they exist and given the most recent statistics from the Pregnancy Nutrition Surveillance Survey, as many as half of all women who become pregnant are exceeding the pregnancy weight gain recommendations defined by the Institute of Medicine.
Unfortunately, with the drastic changes to the food industry, and the availability of foods that are more dense in calories (particularly calories from sugar and fat), it is becoming harder for women to manage gestational weight gain. From a practical perspective it is easy to overeat in pregnancy with our body (often times) telling us to eat, eat, eat! If we add 3 snacks each day to our typical pregnancy diet (snack foods are usually around 300 calories each), it is quite easy to eat an additional 900 calories a day while pregnant!
So what are the tricks to a healthy weight gain?
The Institute of Medicine’s report strongly advocates the importance of a healthy diet and regular participation in physical activity for all pregnant women. If we can take lessons learned from many large clinical trials in weight management and adapt them for pregnant women, we know that one of the easiest tools for successful weight gain is self-monitoring. Rather than being intimidated to step on the scale, we know that the individuals who track their progress (whether it be weight or counting calories or counting steps on a pedometer) are the most successful at managing body weight.
The Institute of Medicine has made it easy for moms. They have published pregnancy weight gain charts and encourage pregnant women and care providers to use them to monitor changes in weight during pregnancy. If your pre-pregnancy BMI puts you in the normal weight category, you should follow the green zone for healthy gestational weight gain. If you’re in the overweight category, follow the orange zone to success!
If you want to count calories…There are very few clinical trials that have used the right scientific methods needed to measure calorie intake in women who gain a healthy amount of weight in pregnancy. Using the available information, a group of researchers, including myself and others at LSU’s Pennington Biomedical Research Center, created a nifty mathematical model that can tell women how many calories they need during each trimester of pregnancy to achieve a healthy weight gain in accordance with the Institute of Medicine guidelines. Using the Pennington Biomedical Gestational Weight Gain Calculator, simply enter in your pre-pregnancy weight, height and age. Then toggle with different calorie goals in each trimester of pregnancy until the solid blue line, falls within the green zone, which reflects the zone of healthy weight gain for you according to the Institute of Medicine Guidelines and your pre-pregnancy BMI.
If you are pregnant or planning to become pregnant, try to learn all you can on the importance of weight gain in pregnancy and how a healthy weight gain can help to achieve your best birth and a healthy baby. Pregnancy is the threshold of the future health of both you and your growing baby.