By Guest Blogger, Dr. Koklanaris
If you flip through the latest tabloids during your next trip to the supermarket, you’ll quickly notice that weight is a popular topic. “Jessica loses 15 pounds in 2 weeks!” “Kate denies anorexia!” As a pregnant woman, you might look to your own shopping cart and wonder: What foods are best? How much should I gain? Is there such a thing as “eating for two?”
The Institute of Medicine (IOM) updated their guidelines for pregnancy weight gain in 2009. These guidelines are based on body mass index, or BMI. To determine your own BMI, check out the free calculator at http://www.nhlbisupport.com/bmi. Here is a summary of the recommendations:
Underweight (BMI <18.5)/ 28-40 pounds
Normal (BMI 18.5 – 24.9)/ 25-35 pounds
Overweight (BMI 25-29.9)/ 15-25 pounds
Obese (BMI > 30)/ 11-20 pounds
Overweight- 31-50 pounds
Obese- 25-42 pounds
When reviewing this table, keep in mind that the rate of weight gain is typically not steady throughout pregnancy. Gain is usually slowest in the first trimester and speeds up in the second and early third trimester. Weight gain usually slows again near term.
Inadequate gain is associated with a number of complications, including preterm birth and having a tiny baby. On the flip side, too much gain is linked to a number of adverse outcomes including blood pressure elevations, gestational diabetes, cesarean delivery, an over-sized baby and post-partum weight retention.
The usual recommendations remain true in pregnancy. It is best to put on weight by eating nutritious foods. Pregnant women need plenty of folic acid (orange juice, spinach) and iron (usually requires a supplement, but lean meats are a good source) and calcium (yogurt, cheese). Fruits and vegetables are a great source of vitamins, minerals, and fiber, which is key as pregnancy progresses. Lean meats (avoid undercooked meat and fish) and beans fill the need for protein. Fat is important, too, but try to keep your intake to less than 25% of total calories and avoid trans fats. After a day of nutritious eating, the occasional treat is fine for most women. When planning your meals in pregnancy, use the good judgment that you will bring to the table – literally and figuratively – as a new mom. Good luck!
Nikki Koklanaris, MD