Eating TOO Much for Two!

Being wise about weight gain during pregnancy

Gaining weight is a normal and important part of a healthy pregnancy. You will likely need to eat slightly more than you did before becoming pregnant, but the notion that you’re “eating for two” just isn’t true.

Gaining too little or too much weight can be detrimental to both you and your baby, so you need to know the guidelines for weight gain.

As an expectant Mom, you do require certain nutrients to help sustain proper growth of your baby. Extra protein is needed to help the baby's brain and body develop normally, and can be met from added meat, poultry, fish, low-fat dairy products, eggs, legumes, nuts and seeds. During pregnancy, a woman should plan for one extra serving per day of one of protein.

Calcium is an essential component of the growing baby's bones and teeth, and if there is not enough in the mother's diet, some may be taken from her own bones. The most common source of calcium is dairy products such as milk, yogurt and cheese and about one to two extra servings a day will provide enough. Calcium can also be found in spinach, broccoli, dried beans, almonds and canned salmon. If you cannot tolerate dairy products, you should discuss this with your doctor or a Dietitian, as a supplement may be necessary. There is some extra calcium and Vitamin D in your prenatal supplement, but you may need more.

Iron is part of the red blood cells (in both mother and baby), which transport oxygen throughout the body. It can be found in liver, eggs, red meat and dried beans. Vitamin C aids with iron absorption, so drinking a small amount of orange juice with the meal, for example, will maximize the benefits of iron-rich foods (especially plant sources of iron).

Folic acid is a B vitamin which has been found to be very important in preventing spinal cord defects (like spina bifida) in babies. These problems originate early in pregnancy, so many experts recommend increasing the intake of folic acid even before conception. Foods high in this nutrient include dark green vegetables, legumes, oranges, cantaloupes and honeydew melons.

It is also important to take your prenatal multivitamin. A good prenatal multivitamin will contain 0.4 to 1mg of  folic acid, 16-20 mg of iron, 200-300mg calcium and at least 400 IU’s of Vitamin D per supplement.

How many more calories should I be eating per day?

It takes about 71000 calories to grow a baby (good healthy calories of course). This is why Health Canada suggests that healthy weight women take in an extra 350 calories per day in the 2nd trimester and an extra 450 calories per day in the 3rd trimester of pregnancy. Many women are
not able to tolerate this much of an increase in calories due to morning sickness and other digestive issues. Don’t force yourself to eat when you’re not hungry or feel sick- this will only turn you off of food more.

Your body becomes more efficient when you're expecting a baby and makes even better use of the energy you obtain from the food you eat. Your own appetite is the best indication of how much food you need to eat. You may find your appetite fluctuates during the course of your pregnancy: In the first few weeks your appetite may decrease dramatically and you may not feel like eating proper meals, especially if you suffer from nausea. During the middle part of your pregnancy your appetite may be the same as before you were pregnant or slightly increased.
Towards the end of your pregnancy your appetite will probably increase, but if you suffer from heart burn or feeling full quickly, you may find it helpful to have small frequent meals.

The best rule to remember is to eat when you are hungry. Don't worry about your changing appetite as long as you are following the advice given about the type of food you need to eat and you are gaining weight at the appropriate rate, which your midwife or doctor will monitor. Every woman is different. Find out what your pre-pregnancy Body Mass Index (BMI) is and determine how much weight to gain from there. To determine your BMI, figure out your pre-pregnancy
weight in kg and divide this by your height in metres squared. There are many online tools to help you figure this out easily such as  http://www.babycenter.ca/tools/bmi/.

Women within a healthy weight range before pregnancy (BMI 18.5 to 24.9) should gain 11.5 to 16 kilograms (25 to 35 pounds). Women who were underweight before pregnancy (BMI<18.5) should gain 12.5 to 18 kilograms (28 to 40 pounds), and women who were overweight before pregnancy (BMI>24.9) should only gain 7 to 11.5 kilograms (15 to 25 pounds). It is recommended that pregnant women gain weight slowly over the entire pregnancy. This means approximately 1 to
3.5 kilograms (2 to 8 pounds)  during the first trimester and 0.3 kilograms (0.5 pounds) a week during the second and third trimesters.

There is new research from the Unites States Institute of Medicine that obese women can gain little or no weight during pregnancy — and even lose a few pounds — without harming their babies. It was found that obese mothers who put on less than the recommended 15 pounds were less likely to develop pregnancy-related high blood pressure or deliver by Caesarean section and more likely to have a normal-weight baby.

As a nutrition professional, the most important aspect of nutrition that I stress with my pregnant and breastfeeding clients is to focus on nutrient-dense foods and try to follow a balanced healthy diet, making sure to eat small frequent meals (every 2-3 hours). If your diet is poor to begin with, it is very important to make the transition to eating nutritious, well-balanced meals. Enjoy treat foods in moderation but don’t let them replace more nutrient-dense foods.

Eat small frequent meals

Try to eat every 3-4 hours. If you find that nausea, food aversions, heartburn or indigestion make eating a chore, you may find that eating five or six small meals, rather than the usual three larger ones, is easier on your body. You will also keep your metabolism (the rate at which you burn calories) fast and strong all day and avoid feeling “starving” and overeating. Try to include both carbohydrate and protein into each meal and snack. Carbohydrates come from Vegetables and fruit, whole grains and milk products. Protein comes from meats and alternatives and milk products. An example of a healthy snack would be a piece of fruit and a low-fat yogurt, or, raw carrots and hummus. Protein foods help to make us feel full and satisfied, that is why it is recommended to include them regularly throughout the day.

Remember, your developing baby needs regular sustenance, so try not to miss meals.

Don't diet

Dieting during pregnancy is potentially dangerous to you and your developing baby. Most diets leave important food groups out and are too low in calories. They also leave you low on energy and important vitamins and minerals such and iron, folic acid, and other important nutrients. Remember, weight gain is one of the most positive signs of a healthy pregnancy.

Women who eat well and gain an appropriate amount of weight are more likely to have healthy babies. So if you're eating fresh, wholesome foods and gaining weight, relax: you're supposed to be getting bigger! What you want to watch out for is getting too big. This can happen if you are eating junk food (calorie-dense foods high in fat and sugar) regularly, or just eating too much in
general.

Nutrition is a crucial part of a healthy pregnancy for both mom and baby. Pregnancy is a great time to refine the way you nourish your body and become more health conscious. Ensure that you eat a balanced diet with lots of variety and that you are gaining a healthy amount of weight
for you. Focus on nutrient-dense foods, eat small frequent meals everyday and let hunger be your guide.

Sarah Remmer, BSc, RD, CDE (Registered Dietitian and Certified Diabetes Educator)
www.sarahremmer.com

Sarah Remmer is a proud Mom of an active one-year-old boy and a Registered Dietitian in private practice. Sarah owns a private nutrition coaching practice in Calgary, specializing in pre- and post-natal nutrition for Moms, expecting Moms and Babies.
She believes in enjoying good food everyday while leading a healthy, balanced lifestyle. Sarah feels very fortunate to be able to share her passion and expertise in nutrition with her individual clients, the food industry and the media.
Sarah believes in achieving overall health realistically and provides practical and useful advice and tools for expectant and  new Moms.
Sarah is the Nutrition Contributor for Birth of a Mother Magazine in Calgary, AB and appears in local and national media regularly, spreading the word about healthy eating.
Sarah completed her Bachelors of Science in Nutrition at the University of Alberta. She then completed a 10 month internship program in Calgary and became a Registered Dietitian through the College of Dietitians of Alberta. Sarah is a nutrition expert in pre-natal and post-natal nutrition as well as healthy weight loss, Diabetes, Eating Disorders and Gastrointestinal health.