In this episode of the Nutrition Diva podcast, I discuss  how much weight it’s OK to gain during pregnancy as well as the dangers of not gaining enough weight. Unfortunately, there are some dangerous trends at both ends of this spectrum.  Pregnancy isn’t an excuse to stop paying attention to your weight—but it’s also not a time to obsess about staying thin. This is the time to find a safe and healthy middle path.

This article is available as a podcast. Click to listen:

As the number of overweight and obese Americans has risen, so has the number of expectant mothers who are overweight or obese. In fact, according to the American College of Obstetricians and Gynecologists, fully 50% of pregnant women are now overweight or obese.

Some women are overweight or obese when they become pregnant. Others start out at a healthy body weight but gain too much weight during their pregnancies. Either way, maternal obesity has a host of negative effects on both the mother and the baby.  For the mom, obesity and/or excessive weight gain during pregnancy dramatically increases your risk of gestational diabetes and pre-eclampsia, and other serious complications. You’re also more likely to require a Caesarean section. Things don’t go any better for the babies. They are at increased risk of miscarriage, stillbirth or premature delivery. They are also much more likely to struggle with childhood obesity.

If you are overweight or obese and pregnant, you can reduce the risks for both you and baby by limiting the amount of weight you gain during your pregnancy. Instead of the usual 25-35 pounds, your doctor may suggest that you limit your weight gain to 10-20 pounds instead.

But this needs to be done carefully. The last thing you want to do is to deprive your baby of the nutrients she needs to grow and develop. If you are restricting your calorie intake in order to limit your weight gain during pregnancy, it is extra important that you make every calorie count by choosing wholesome, nutrient dense foods such as fruits, vegetables, lean protein, whole grains, legumes, and healthy fats.

I’m equally concerned about another less common but growing trend: women who begin their pregnancies slim or even underweight and are so determined not to get “fat” during their pregnancies that they actually diet and exercise to extremes to avoid gaining weight. These misguided moms—who often have a history of eating disorders or disordered body image—are egged on by unrealistic media coverage of celebrities who stay impossibly slim during their pregnancies and are photographed in bikinis, seemingly minutes after delivery.

Refusing to eat enough to sustain the appropriate amount of weight gain during pregnancy puts your baby at extreme risk. When you aren’t eating enough calories, you likely not to be getting enough protein, iron, and other nutrients that are essential to healthy development. When mom is undernourished, the babies are more likely to be born pre-term and may suffer from learning and behavioral disorders and other disabilities. And how’s this for irony? A recent study found that babies born to mothers who do not gain enough weight during pregnancy are at increased risk of childhood obesity. In fact, they are almost as likely to be obese as babies born to obese mothers.

When pregnant women don’t consume enough calories, the fetus essentially develops a starvation metabolism, programmed to grab and hang onto every calorie that comes its way. That metabolism becomes permanently encoded and sets him/or her up for a lifetime of weight struggles. Sometimes, of course, a mother’s inability to enough gain weight is due to factors beyond her control. If you’re having trouble gaining weight, please consult your OB or a nutrition professional for support. But please don’t intentionally put your baby at risk in order to preserve your figure. You’ll only be pregnant for 9 months but your baby could be affected for a lifetime.  If you have had an eating disorder or feel uncomfortable about pregnancy weight gain, please enlist your OB as well as a nutrition and/or mental health professional to give you the medical, nutritional and emotional support you need throughout your pregnancy.

The ideal scenario, of course, is to be at a healthy weight when you get pregnant and to monitor your weight gain carefully throughout your pregnancy…gaining neither too much nor too little. Then again, 50% of pregnancies are unplanned. So, why wait? Even if you’re not trying or planning to get pregnant, here’s one more good reason to prioritize achieving and maintaining a healthy body weight.  (Please check out the resources I’ve put together at Weighless.life.)

Guide to Calories and Weight Gain During Pregnancy

This chart shows how much weight you should gain during your pregnancy and about how many calories you should be eating to stay on course.

First, you’ll need to calculate your pre-pregnancy BMI to find out how much weight you should gain over the course of your entire pregnancy. Then, use this calculator to estimate your baseline (non-pregnancy) calorie needs, if you don’t already know them. Finally, see how many calories you should add to your baseline during each trimester of pregnancy.

NOTE: These numbers are only general guidelines; please discuss these recommendations with your obstetrician and/or nutrition professional and adjust your intake as needed to stay within recommended weight gain ranges.

Please do not attempt to lose weight during your pregnancy. The lower number in the recommended range is just as important as the upper one!

BMI at Beginning of Pregnancy	Recommended Weight Gain During Pregnancy	Approximate Increase in Daily Calories
<18.5	28-40 pounds	1st trimester: Baseline + 100 – 200 2nd trimester: Baseline + 300 – 400 3rd trimester: Baseline + 400 – 500
18.5-25	25-35 pounds	1st trimester: Baseline + 0 – 100 2nd trimester: Baseline + 200 – 300 3rd trimester: Baseline + 350 – 450
25-30	15-25 pounds	1st trimester: Baseline 2nd trimester: Baseline + 150 – 200 3rd trimester: Baseline + 250 – 350
>30	11-20 pounds	1st trimester: Baseline 2nd trimester: Baseline + 100 – 200 3rd trimester: Baseline + 200 – 300

More resources:

Healthy Weight During Pregnancy (Academy of Nutrition and Dietetics)\

Pregnancy Weight Tracker (Baby Center)

 

References:

American College of Obstetricians and Gynecologists. Obesity in Pregnancy Committee Opinion 549, January 2013. Link to report.

Paden MM, Avery DM. Preconception counseling to prevent the complications of obesity during pregnancy. Am J Clin Med. 2012 Winter; 9(1): 30-35. Link to paper.

Sridhar SB, Darbinian J, Ehrlich SF, et al. Maternal gestational weight gain and offspring risk for childhood overweight or obesity. Am J Obstet Gynecol 2014;210. In press.  Link to Abstract.

Thangaratinam S, Rogozińska E, et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ 2012;344:e2088. Link to paper.

 

 

 

Happy New Year!

How are those resolutions coming along? One week into January and most of us are still sticking to our healthy diet and exercise regimens. By the time March rolls around, of course, almost 80% of those well-intentioned plans will have been abandoned.

I think the problem is that we place far too much faith in our willpower — which, as research shows, probably won’t be enough to power you through the tough times.

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Willpower: A Limited Resource?

According to researchers Roy Baumeister and Kathleen Vohs, most of us have a relatively limited supply of willpower. When we call on our willpower to help us resist a temptation, we actually deplete our reserves, leaving us less able to resist the next temptation. Not only that, but the mental energy we spend exercising our willpower drains our capacity to perform other cognitive tasks!

Let’s say, for example, that you show up at your weekly staff meeting to find that Linda has brought a batch of her famous homemade chocolate chip cookies. The cookies smell delicious and you know from previous experience that they taste every bit as good as they look and smell. Nonetheless, you’re determined to stick to your resolution to avoid sweets. Ninety minutes later, the meeting is finally over and you’ve made it through without a single cookie! Good for you!

Unfortunately, the effort it took to NOT eat those cookies during the meeting made you less able to concentrate, problem-solve, and contribute at the meeting. And then, on your way out of the conference room, you walk by a bowl of chocolates that someone left on the counter. They’re not even particularly good chocolates–nowhere near as tempting as Linda’s cookies. But the fact that you have just spent 90 minutes resisting those cookies actually makes it more likely that you’ll succumb to those cheap chocolates.

Oh, the humanity!

Strength Training for Your Willpower

Some psychologists argue that willpower is a bit like a muscle. When it’s asked to do some heavy lifting, your willpower can become fatigued, just like your bicep gets tired after too many curls,

However, just as you can gradually build up your bicep with strength training, you can also increase your willpower by exercising it. Baumeister believes that you can strengthen your willpower by consciously doing things that are contrary your usual habits — such as brushing your teeth with the opposite hand or driving a different route to work.

Carol Dweck, from Stanford University, on the other hand, thinks that the idea of willpower as a limited commodity becomes a self-fulfilling prophecy. When subjects are primed to think of willpower as a renewable, self-replenishing resource, they seem to have more of it.

Just as you can build up your bicep with strength training, you can also increase your willpower by exercising it.

Personally, I think that the truth lies somewhere in between. Some people seem to have greater reserves of willpower than others. This may be due to nature, nurture, or a bit of both. And I don’t doubt that willpower can be enhanced with the right kind of training — at least to a certain extent.

Nonetheless, instead of relying entirely or mostly on willpower, I think makes sense to supplement our resolve with other strategies to increase our chances of success.

3Tricks for the Willpower Challenged

Trick #1: Engineer your environment to remove temptation 

Don’t use up valuable willpower resisting those Oreos and potato chips in the cupboard. If you don’t want to eat it, don’t bring it into the house. If you must  have it in the house, put it in a cupboard or closet that is out of sight and difficult to reach. If, after all that, you decide to indulge, serve yourself a single portion into a small bowl and put the rest away. Most people think that they are far too smart for these sorts of simplistic things to make a difference. But study after study demonstrates that they work.

For more on engineering your environment for success, see my episode on Why We Overeat.

Trick #2: Use positive redirection

Anyone who has ever spent time with a 2-year-old knows the power of positive redirection.  Instead of telling a toddler to stop pulling the cat’s tail,  you distract him with a different toy or activity. And, let’s face it, when it comes to changing our eating habits, most of us are operating on the level of a 2-year-old.  So instead of obsessing about what you’re trying not to eat, focus on things you’d like to eat more of.

For more on positive redirection, see my article Shift Your Focus to Make Dieting Easier

Trick #3: Keep it simple

For some reason, when we make up our mind to lose weight or get in shape, we’re often attracted to complicated regimens that have lots of very specific rules and requirements. Subconsciously, we seem to believe that the more elaborate the program — and the bigger the departure from our current habits — the more likely it is to be the one that finally works.

This is a trap.

The more complicated the diet, the bigger the departure from our normal routine, the more rules and restrictions there are and the more decisions we’re required to make, the more likely we are to crash and burn.  If you want to make it stick, keep it simple.

Originally published at QuickandDirtytips.com

As the temperatures dip and the days get shorter, comfort foods may seem like just the thing. If you find yourself craving carbohydrates at this time of year, it may be due to a seasonal dip in serotonin levels. Eating carbohydrates tends to increase serotonin production, which can elevate your mood–but only temporarily. In a few hours, you need another fix. By the time winter is over, you may have packed on a lot of carbohydrate-fueled pounds.

A better way to stimulate serotonin is with regular exercise.  Exercise stimulates serotonin production with no carbohydrate hang-over. Instead of gaining winter weight, you might even trim down.  Overcoming your Fall fatigue and getting yourself moving may take some self-discipline at first. But the rewards, in the form of more energy and a brighter mood, come quickly.