Dieting Guidelines for Pregnancy -- Fight Obesity, Avoid Complications

by Della H. Harris

For years, overweight and obese women have been told they can't diet during pregnancy. With obesity threatening women of childbearing age and their babies, what are the recommended dieting guidelines for pregnancy?

Currently, half of the U.S. population is either overweight or obese. In Europe and the United States, 20 to 40 percent of women gain more than the recommended weight during pregnancy.

That extra weight comes with potential risks. Pregnant women who are struggling with obesity often have:

• An increased risk for gestational diabetes, preterm labor, preeclampsia and high blood pressure
• Difficulty hearing the heartbeat, and reading the size of the uterus
• Difficulty with delivery if the baby is much larger than average

A recent study, published in British Medical Journal, observed obese women who dieted, did physical exercise programs or both during pregnancy to manage weight gain.

Compared with control women, those in the intervention groups showed a reduction in weight gain of 3.1 pounds. The largest reduction occurred with dietary intervention, where women's weight gain was 8.4 pounds less.

Dietary advice in the study focused on limiting overall calorie intake, balancing protein, carbohydrates and fat, and eating foods such as whole grains, fruits, vegetables and legumes.

The research did not show what a healthy amount of weight gain was for pregnant women or how many calories a woman should eat daily during pregnancy.

The researchers found that dietary intervention in particular was effective in cutting down the risk of these four pregnancy complications, while having no harmful effects to the mother or child after delivery.

• Preeclampsia risk dropped by 33 percent
• Gestational diabetes risk dropped by 61 percent
• Gestational hypertension risk dropped by 70 percent
• Preterm delivery risk dropped by 32 percent

Any adverse effects from dieting during pregnancy were noted only on extremes of weight reduction diets or those on intake of food with a very high- or low-glycemic index.

Typical interventions suggested a balanced diet consisting of carbohydrates, proteins, and fat and maintenance of a food diary.
Ideally, the calories came from 15 to 20 percent protein, and 50 to 55 percent carbohydrate with a maximum of 30 percent fat. the total calorie intake was individualized to the needs of the mother.

Eating for a Healthier Pregnancy

Many experts consider pregnancy as an ideal time to suggest new menus and ideas. Moms stop smoking for their baby's well-being and also limit or abstain from alcohol. Mothers are more motivated during pregnancy to make changes that could improve their health and their baby's.

Would limiting weight gain improve your pregnancy outcome and your baby's health now and in the future? If you're starting your pregnancy journey overweight or obese, it could.

Your doctor and nutritionist might suggest you limit your calorie intake and eat plenty of whole grains, lean proteins, milk products and legume, fruits and vegetables and focus on healthy fats and oils.

They'll probably recommend that you go easy on refined flours and sugar, processed foods and fast food meals. You don't have to give up the foods that you love. Instead you can eat smart and make most of your choices healthy ones.

Nutritionist Kimberly Tessmer says a balanced diet during pregnancy includes all of the food groups each day: fruits and vegetables (at least 5 servings daily); low fat or fat free dairy products; lean meats like poultry, fish, dry beans, eggs and nuts; and bread, cereal, rice and pasta (mostly from whole grains).

It means eating at least three meals a day with two or three healthy snacks in between and not skipping meals. It means eating a lower fat diet, going easy on sweets and processed foods like fast food.

"Being and eating healthy also means drinking plenty of water and watching other beverages such as soft drinks or alcohol," according to Tessmer.