Many will blame the holiday season for burgeoning bulges of the midsection - but for some women, overindulgence at the table may not be at fault: pregnancy rates seem to rise during the winter months. Several theories exist to explain this phenomenon - some credit the abundance of snuggling on chilly nights and warm, fuzzy holiday feelings while research indicates that sperm quality improves in colder weather. Whatever the reason, pregnancy is a critical period for healthy eating and, as with Christmas shopping, getting an early start is best for all involved!

Understandably, moms-to-be may find advice about healthy pregnancy overwhelming - and nutrition is just one aspect out of many. However, research findings continue to emphasize the importance of proper nutrition for successful pregnancies as well as the long-term health of mother and child. In particular, gaining the right amount of weight - not too much, not too little - may promote optimal future weight status for the baby and the mom. According the CDC, there are twice as many obese children and three times as many obese adolescents in the US today compared to 1980, with one of every three youth considered overweight or obese. Those numbers are shocking but here’s the good news: women who eat right during pregnancy can improve their kids’ chances of living at a healthy weight as they grow up!

The myth that a woman should "eat for two" during pregnancy remains popular, but it’s closer to the truth that she should eat "twice as healthy". Eating too much may negatively affect the health of mom and baby. Recent research has investigated the effects of maternal weight gain on pregnancy complications and later obesity in moms and their kids. The lessons learned are essential for women who are, or want to become, pregnant. Unfortunately, several studies suggest that doctors fail to provide adequate or accurate information about weight management during pregnancy. Taking a proactive approach to health management during pregnancy can make a big difference - and this article is a good place to start.

Mothers who gain excessive weight during pregnancy may retain more weight after pregnancy - even up to 15 years after pregnancy - according to several studies from the International Journal of Obesity and Obesity Research and Clinical Practice. Moms who put on too many pounds may also increase their kids’ risk of obesity. Exactly why this happens is not fully understood but maternal overeating may affect appetite regulation and possibly even alter gene expression in the developing infant. The Lancet and other journals have featured studies indicating that pre-term delivery and high birthweight (which may result from excess maternal weight gain) seem to predispose children to obesity as well as other long-term health issues like cardiovascular disease and diabetes.

Furthermore, the danger posed by excessive weight gain to the developing baby cannot be understated. A study including data from approximately 500,000 mothers and 1.1 million infants in the US allowed researchers to determine that every kilogram (2.2 pounds) of weight gained by the mother increased the infant’s birthweight by 7.35 grams. Mothers who gained more than the maximum recommended weight gain (40 pounds) delivered infants weighing 100 to 150 grams more than mothers who gained about 20-25 pounds. High birthweight may increase the mother’s risk of caesarean delivery, lacerations and heavy post-partum bleeding, and the baby’s risk of injury during the birthing process.

Obviously, putting on too much weight during pregnancy is a significant short- and long-term health risk. What are moms to do? Avoid all weight gain while pregnant? Definitely not! The Institute of Medicine and the National Research Council have published evidence-based guidelines with optimal ranges for weight gain during pregnancy (see below).

Recommended Total Weight Gain & Rate of Weight Gain during Pregnancy by Pre-pregnancy BMI

Women pregnant with twins need to gain more. Provisional guidelines for moms expecting twins have been developed: women with a normal BMI should aim to gain 37-54 pounds; overweight women: 31-50 pounds; and obese women: 25-42 pounds. Women should communicate with their care provider regarding their individual needs. Prior to conception, women should strive for a normal BMI using healthy weight loss techniques (as explained in Mr. Cook-It’s book, The Slice Plan). Weight loss during pregnancy is not recommended as it may increase risk of some complications, including low birthweight babies.

Excess weight gain during pregnancy is not uncommon: over one-third of normal-weight women and greater than half of overweight and obese women in the US gain more weight than recommended. Fortunately, pregnant mothers can take steps to reduce their likelihood of ending up in this category. Research on the most effective ways to limit excess maternal weight gain indicates that women who receive education and counseling by trained health care providers (such as registered dietitians), set specific goals, and monitor their progress achieve the most success.

Quick tips for optimizing weight during pregnancy are included below!

o Pregnancy is not the time to start a fad diet or limit diet variety! Choose healthy foods from all food groups to deliver a mix of nutrients to the growing baby

o Gaining too much weight? Reduce foods with added sugars and solid fats while continuing to eat nutrient-dense foods (fruits, vegetables, whole grains, lean meats, low-fat dairy)

o Not gaining enough weight? Incorporate larger servings of healthy, calorie-dense foods like peanut butter, nuts, seeds, hummus, olive oil, and Greek yogurt

o Keep healthy food options on hand - that way junk food won’t be such a big temptation and a few late-night runs to the store may be avoided

o Avoid herbal teas and teas promoted for weight loss unless cleared by a health care professional because many herbs have not been evaluated for safety during pregnancy

o Caffeine is often promoted for weight control but pregnant women should limit intake to o Self-monitoring practices such as keeping a food diary and tracking weekly weights can uncover undesirable habits and provide positive feedback for good choices

o Don’t eat non-food items (known as "pica") for weight loss or any other reason during pregnancy - if pica becomes an issue, talk to a healthcare provider

o Find additional credible information with the USDA Nutrition during Pregnancy Resource List:

http://www.nal.usda.gov/fnic/pubs/bibs/topics/pregnancy/pregcon.pdf

Weight control and healthy eating can be challenging amidst the many pressures of pregnancy - don’t hesitate to seek help from a registered dietitian (RD), a certified nutrition professional who can provide guidance on issues from food safety to weight management to vitamins. In the meantime, direct any further questions to Mr. Cook-It’s Ask feature on the-sage.org!

-Nathan Myers, Registered Dietitian + Research Assistant for: