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Eating TOO Much for Two! Being wise about weight gain during pregnancy

By: Sarah Remmer, RD, CDE

Gaining weight is a normal and important part of a healthy pregnancy. You will likely need to eat slightly more than you did before becoming pregnant, but the notion that you’re "eating for two" just isn’t true.

Gaining too little or too much weight can be harmful to both you and your baby, so you need to know the guidelines for weight gain. As an expectant Mom, you do require certain nutrients to help sustain proper growth of your baby. Extra protein is needed to help the baby’s brain and body develop normally, and is usually obtained from meat, dairy products, eggs, legumes, and grains. During pregnancy, a woman should plan for one extra serving a day of one of these foods.

Calcium is an essential component of the growing baby’s bones and teeth, and if there is not enough in the mother’s diet, some may be taken from her own bones. The most common source of calcium is dairy products milk, yogurt and cheese and about one to two extra servings a day will provide enough. Calcium can also be found in spinach, broccoli, dried beans, almonds and canned salmon. If you cannot tolerate dairy products, you should discuss this with your doctor or a nutritionist, as a supplement may be necessary.

Iron is part of the red blood cells (in both mother and baby), which transport oxygen throughout the body. It can be found in liver, eggs, red meat and dried beans. Vitamin C aids iron absorption, so drinking orange juice with the meal, for example, will maximize the benefits of iron-rich foods.

Folic acid is a B vitamin which has been found to be very important in preventing spinal cord defects (like spina bifida). These problems originate early in pregnancy, so many experts recommend increasing the intake of folic acid even before conception. Foods high in this nutrient include dark green vegetables, legumes, oranges, cantaloupes and honeydew melons.

It is also important to take your prenatal multivitamin. A good supplement for pregnant woman generally contains more folic acid, iron and calcium than a general multivitamin.

How many more calories should I be eating per day?

It takes about 71000 calories to grow a baby (good healthy calories of course). This is why Health Canada suggests that healthy weight women take in an extra 340 calories per day in the 2nd trimester and an extra 450 calories per day in the 3rd trimester of pregnancy. Health Canada is in the midst of revising the guidelines for weight gain for pregnancy (new guidelines should be out in 2010). Many women are not able to tolerate this much of an increase in calories due to morning sickness and other issues and to be honest, may not require this many extra calories to sustain a healthy pregnancy and a healthy baby.

Every woman is different. Health Canada suggests to find out what your pre—pregnancy Body Mass Index (BMI) is and determine how much weight to gain from there. To determine your BMI, figure out your pre-pregnancy weight in kg and divide this by your height in metres squared. There are many online tools to help you figure this out easily such as http://www.babycenter.ca/tools/bmi/.

According to Health Canada, women with a healthy weight before pregnancy (BMI 18.5 to 24.9) should gain 11.5 to 16 kilograms (25 to 35 pounds). Women who were underweight before pregnancy (BMI < 18.5) should gain 12.5 to 18 kilograms (28 to 40 pounds), and women who were overweight before pregnancy (BMI > 24.9) should only gain 7 to 11.5 kilograms (15 to 25 pounds). It is recommended that pregnant women gain weight slowly over the entire pregnancy. This means approximately 1 to 3.5 kilograms (2 to 8 pounds) a week during the first trimester and 0.3 kilograms (0.5 pounds) a week during the second and third trimesters.

There is new research from the Unites States Institute of Medicine that obese women can gain little or no weight during pregnancy—and even lose a few pounds—without harming their babies. It was found that obese mothers who put on less than the recommended 15 pounds were less likely to develop pregnancy—related high blood pressure or deliver by Caesarean section and more likely to have a normal-weight baby. There is growing concern in North America that weight-gain guidelines for pregnant women are outdated and don’t take into account the nation’s obesity epidemic. We will have to see if the new 2010 guidelines reflect this concern. Until then, I recommend that if you are overweight or obese, you should improve your diet by limiting junk food and including exercise (see your doctor first).

As a nutrition professional, the most important aspect of nutrition that I stress with my pregnant and breastfeeding clients is to focus on nutrient-dense foods and try to follow Canada’s Food Guide to Healthy Eating. If your diet is poor to begin with, it is very important to make the transition to eating nutritious, well-balanced meals. Limit junk food as much as possible, as it offers empty calories, which means that these foods are calorie-dense (high in calories) but offer little or no nutrition, and this might lead to excess weight gain. For pregnant women, Canada’s Food Guide to Healthy Eating recommends:

• 7 to 8 servings of vegetables and fruit (a serving is the equivalent of 1 cup raw veggies or fruit and ½ cup cooked veggies/fruit or 100% fruit or veggie juice).
• 6-7 servings of grain (a serving is the equivalent of 1 piece whole grain bread or ½ cup cooked rice, pasta or other grain)
• 3 to 4 servings of milk or dairy products (a serving is the equivalent of 1 cup of milk, ¾ cup yogurt or 1 ½ oz cheese)
• 2 to 3 servings of meat and alternatives (a serving is equivalent to 3 oz meat, poultry or fish or ½ cup beans/lentils or ¼ cup nuts/seeds).

Your body becomes more efficient when you’re expecting a baby and makes even better use of the energy you obtain from the food you eat. Your own appetite is the best indication of how much food you need to eat. You may find your appetite fluctuates during the course of your pregnancy: In the first few weeks your appetite may decrease dramatically and you may not feel like eating proper meals, especially if you suffer from morning sickness or nausea. During the middle part of your pregnancy your appetite may be the same as before you were pregnant or slightly increased. Towards the end of your pregnancy your appetite will probably increase, but if you suffer from heart burn or feeling full quickly, you may find it helpful to have small frequent meals.

The best rule to remember is to eat when you are hungry. Don’t worry about your changing appetite as long as you are following the advice given about the type of food you need to eat and you are gaining weight at the appropriate rate, which your midwife or dietitian will monitor.

Eat small frequent meals

Try to eat every 3-4 hours. If you find that nausea, food aversions, heartburn or indigestion make eating a chore, you may find that eating five or six small meals, rather than the usual three larger ones, is easier on your body. You will also keep your metabolism (the rate at which you burn calories) fast and strong all day and avoid feeling "starving" and overeating. Try to include both carbohydrate and protein into each meal and snack. Carbohydrates come from Vegetables and fruit, whole grains and milk products. Protein comes from meats and alternatives and milk products. An example of a healthy snack would be a piece of fruit and a low-fat yogurt, or, raw carrots and hummus. Protein foods help to make us feel full and satisfied, that is why it is recommended to include them regularly throughout the day.

Remember, your developing baby needs regular sustenance, so try not to miss meals.

Don’t diet

Dieting during pregnancy is potentially dangerous to you and your developing baby. Most diets leave important food groups out and are too low in calories. They also leave you low on energy and important vitamins and minerals such and iron, folic acid, and other important nutrients. Remember, weight gain is one of the most positive signs of a healthy pregnancy.

Women who eat well and gain an appropriate amount of weight are more likely to have healthy babies. So if you’re eating fresh, wholesome foods and gaining weight, relax: you’re supposed to be getting bigger! What you want to watch out for is getting too big. This can happen if you are eating junk food (calorie-dense foods high in fat and sugar) regularly, or just eating too much in general.

Treat yourself once in awhile

You don’t have to give up all your favourite foods just because you’re pregnant. But high calorie processed foods and snacks and sugar-packed desserts shouldn’t be staples in your diet either. So as far as snacks are concerned, try a low-fat yogurt rather than a pint of Ben and Jerries, or a frozen fruit sorbet instead of canned peaches in sugary syrup. But don’t feel guilty if you crave the occasional cookie. Enjoy every bite!

Nutrition is a crucial part of a healthy pregnancy for both mom and baby. Pregnancy is a great time to refine the way you nourish your body and become more health conscious. Ensure that you eat a balanced diet with lots of variety and that you are gaining a healthy amount of weight for you. Focus on nutrient—dense foods rather than calorie-dense junkfoods. Eat small frequent meals and let hunger be your guide.

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