It used to be, as in the golden age of “Mad Men,” that pregnancy was considered a time when figure-conscious ladies could finally let loose a bit and indulge. (Remember Betty Draper, from the period drama TV series, after she gave birth to Eugene?) The mantra of “eating for two” was once used to justify what we would now consider to be excessive weight gain. Culturally, pregnancy has long been considered a time where women could afford to be laxer with their diets in the name of ensuring that their growing baby was “getting enough.”
Fast forward to today, a period in our history when 1 in every 5 American women starts off her pregnancy clinically obese and 40 percent of pregnant women gain more weight than is medically recommended. There is now widely available ultrasound technology that enables doctors to determine just how well a baby is growing, without needing to use the mother’s weight gain as a proxy. And we have much more specific guidance as to the added nutritional needs of women in pregnancy, which mathematically speaking, is much more like eating for one and one-fourth than it is eating for a full two.
[See: The Best and Worst Exercises for Pregnant Women.]
While it may not seem like gaining extra weight in pregnancy is such a big deal, in fact, it really is. For starters, women who gain too much weight during pregnancy are at increased risk for developing gestational diabetes and preeclampsia — dangerously high blood pressure that contributes to premature labor. They are also at greater risk for complications during labor and delivery from having excessively large babies.
A lesser known — but highly concerning — consequence of a woman’s food choices and weight gain in pregnancy is that she can predispose her unborn child to an increased risk of obesity and Type 2 diabetes later in life. A baby’s pancreas develops early in pregnancy, and it begins producing insulin by mid-gestation. If mom’s blood sugar is too high based on her food choices, more sugar will pass through the placenta and into the developing baby’s bloodstream. If this happens consistently, the fetal pancreas becomes overworked, making extra insulin to help absorb the extra sugar. This can result in unnecessary “wear and tear” of the cells that produce insulin, increasing the child’s risk for diabetes later on. In addition, current research suggests the environment within the womb can help “program” the baby’s metabolism by altering genes that will dictate hormonal pathways for appetite stimulation, insulin production and more — creating a genetic predisposition for metabolic disease separate from any physiological stress on the pancreas during gestation.
So what can you do to make your uterus a healthy home environment for the next nine months as your baby prepares for his or her debut?
Focus on quality over quantity. In the first trimester particularly, you have a greater need for nutrients like folate, despite having no additional calorie requirements. You’ll require more iron and zinc throughout pregnancy as well. So instead of doubling down on cookies, you’ll really want to double up on portions of folic-rich fruits and veggies, such as avocado, citrus fruits, strawberries, asparagus and leafy greens. Beans are an especially good choice, since they’re rich in both folate as well as iron and zinc, while peanuts or peanut butter and cashews also deliver the nutritional goods.
Know how much extra you actually need. A woman entering pregnancy at a healthy weight will need to consume approximately 300 to 400 extra calories per day in the second and third trimesters. That’s basically an extra snack of yogurt, fruit and nuts or a PB&J. In other words, it’s not even close to double your day’s calories. (If you do choose to indulge in something sweet, be aware that 300 calories only buys you a measly 1/2 cup portion of Haagen Dazs.)
[See: How to Cope With Gestational Diabetes.]
If you start off your pregnancy overweight, your recommended weight gain is going to be lower, so your extra calorie needs are likely to be lower as well. For some women in this camp, the extra needs may be as little as 150 to 250 calories per day — roughly the equivalent of 2 tablespoons of peanut butter. Again, the emphasis should be improving the quality of each calorie you eat, rather than increasing the number of calories. Your doctor will be monitoring the weight gain of both you and your baby, and that should provide the best feedback as to whether you’re eating too little, too much or just the right amount.
Get your calcium and vitamin D. Studies of pregnant women consistently demonstrate deficiencies of certain nutrients, including vitamin D and calcium. For women whose pregnancies take place mostly in the fall and winter months, getting enough Vitamin D is of particular importance, since they’ll be exposed to much less sunlight to make their own supply. Fortified milk and yogurt are excellent sources of these nutrients, and some cottage cheeses are fortified as well. Lactose-free milk has the same nutritional value for those moms who find that dairy doesn’t always agree with them. If you don’t care for dairy, seek out unsweetened calcium- and vitamin D-fortified soymilks or other plant-based milks, rather than fortified orange juice, if possible, as the latter is a concentrated source of sugar. If none of these foods are part of your regular diet, consider taking a separate calcium and/or vitamin D supplement in addition to your prenatal vitamin, which typically contains quite low levels of these nutrients.
Choose multi-tasking protein foods. Though we rarely have an issue getting enough protein in our diets in the U.S., pregnant women do require a little extra during the second and third trimesters — about 25 grams more per day — as the baby’s development intensifies. Since protein doesn’t affect blood sugar levels very much, getting some of your extra pregnancy calories from protein rather than, say, french fries, is probably a good idea.
To make each extra calorie count, it can be helpful to choose high-protein foods that are also rich in other nutrients that are important for a healthy pregnancy. A 0 percent plain Greek yogurt delivers anywhere from 14 to 17 grams of high quality protein in addition to being a good source of calcium. Eggs also contain choline for baby’s brain development and a little bit of Vitamin D to boot; lean steak is a rich source of zinc and iron, which are necessary for blood cell generation and immune function; lentil soup or chickpeas boast folate and iron; and sardines are a low-mercury fish rich in vitamin D, iodine and omega-3s for baby’s brain development.
Set appropriate goals and track them. Talk to you doctor about his or her expectations for your weight gain during pregnancy, and attend all check-ups to screen for gestational diabetes and other potential nutrition-related complications. By staying on top of your nutrition-related goals and tracking your progress closely, there should be no surprises — and that’s exactly what we’re looking for in a healthy pregnancy.
[See: The Fertility Preservation Diet: How to Eat if You Want to Get Pregnant.]
If this reality check feels like a buzzkill, there’s a silver lining: While pregnancy is not a time for reckless abandon with your diet, you get far more dietary latitude if you choose to breast-feed. Breast-feeding moms need about 500 to 600 extra calories per day — per baby!
Jennifer Senecal, a dietetic intern and master’s degree candidate at Teachers College, Columbia University in New York City, contributed to this article.
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The Dangers of ‘Eating for Two’ originally appeared on usnews.com
