Joan Endyke: The importance of a healthy diet when pregnant

Great-grandmothers and grandmothers-to-be might recall a healthy pregnancy eating big bowls of ice cream and other excess food, and today often are seen pushing food on pregnant daughters, but times have changed.

Although it might be tempting to give in to the “eating for two” mentality and nosh with abandon when pregnant, gaining excess weight can cause serious problems and also negatively affect the health of mom and baby later.

Currently, 50 percent of women start a pregnancy overweight or obese, and gaining too much additional weight can cause medical complications like gestational diabetes, high blood pressure and pre-eclampsia. Excess pregnancy weight also increases the risk of the newborn being overweight later and mom becoming diabetic.

Today, pregnancy weight gain guidelines set by the Institute of Medicine of The National Academy of Sciences are based on the pre-pregnancy weight of mom. Body mass index is used to determine weight status and can be calculated by dividing pre-pregnancy weight (in pounds) by height (in inches) and again by height (inches) and multiply by 703. Online tools are also available.

A pre-pregnancy BMI of less than 18.5 is considered underweight, and greater than 25 as overweight. For women falling into the overweight category, a weight gain of 15 pounds might be perfectly fine for a healthy pregnancy, or if in the obese category, 11 pounds. All women are different, and should not use this guide as a hard and fast rule but rather talk to their doctor about their particular pregnancy weight gain.

Although not in the IOM guidelines, according to the Mayo Clinic, women with a pre-pregnancy BMI of greater than 35 can safely lose up to 11 pounds during pregnancy, and this loss appears to have more benefits than risks for the infant.

Pregnant women have more control in pregnancy outcomes than they believe. Being aware of weight gain and eating healthfully can make a big difference as exemplified by a recent patient, Melissa. Her BMI was 27 in her first pregnancy. She gained more than 40 pounds and developed gestational diabetes, high blood pressure and pre-eclampsia.

After Melissa delivered, she worked hard to change her diet, exercise and lose weight. She ate more fresh fruits and vegetables, cooked healthy dinners and limited take-out foods and excess sodium that had been driving up her blood pressure. She started her second pregnancy 10 pounds lighter and continued her healthy lifestyle habits.

Now, halfway through her pregnancy, she has only gained 8 pounds, and her blood pressure and blood sugar are normal so far. As a nurse, Melissa is surprised at how much her lifestyle changes are improving her second pregnancy, especially in keeping her blood pressure normalized, which she checks herself at home. She is vowing to empower her future patients with this message.

Joan Endyke is a registered dietitian with a master's degree in food and nutrition. Send your questions to her at wickedgoodhealth.com. This column is not intended to diagnose or treat disease. Check with your doctor before changing your diet.

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