Pregnancy Weight Gain
Got a baby on board? If you're not careful, you could be carrying extra cargo long after you've delivered.
That old adage about "eating for two" has misled generations of women into overindulging during pregnancy which can cause pregnancy weight gain. And in recent decades, as people have been getting heavier and heavier in general, the temporary gains of pregnancy have more and more often become permanent for women.
It's not at all uncommon to meet women who never had a weight problem at all until they became pregnant, even if their first baby wasn't until they were into their 30s. We hear it all the time from female patients: "I just never could get the pregnancy weight gain off again after my baby."
And if the weight sticks after a pregnancy, that story often holds true through several babies, with more and more gains. But overweight women have higher risks for pregnancy and delivery complications including pre-eclampsia and gestational diabetes. And that's to say nothing of how the maternal body chemistry of an overweight mom-with the elevated blood glucose and likely insulin resistance-might affect the developing fetus. Researchers are exploring whether those factors might eventually make the child more prone to weight problems.
Studies have already shown that for moms, there's a high correlation between being overweight before pregnancy and ending up with that long-term additional weight gain after a pregnancy. Because of this, overweight women in many European countries are advised to gain less weight during pregnancy than healthy weight women.
But that's not really a good idea for the little person who is trying to get bigger, the one who needs high-quality, ready nutrition for the hard work of growing and getting ready to be born. You're supposed to gain some weight during pregnancy; there's a whole other person in there! Trying to avoid long-term weight problems for mom shouldn't be done at the expense of the baby.
But a long-term study out of Sweden showed that's not where to focus the effort anyway. Overweight women apparently don't gain more weight during pregnancy than healthy-weight women, they just seem more likely to keep what they do gain for longer.
The 15-year study of more than 500 women was somewhat comically titled the Stockholm Pregnancy and Women's Nutrition study, or SPAWN. The SPAWN study gathered data about the relationship between weight and pregnancy and maternal and child health.
The women in the study were classed as either overweight or normal weight before pregnancy, and then classed as low, intermediate or high weight gainers during pregnancy, and finally, as low, intermediate or high weight retainers at one-year after the birth.
They checked the women again after 15 years to see what their long-term weight outcome was, and it seems the best indicator of whether a woman would have long-term weight problems was not whether she was heavy or not before her pregnancy, or even how much weight she gained during her pregnancy or pregnancies.
Rather, it was whether or not she'd lost her excess pregnancy weight gain within the first year after the baby's birth that had the strongest correlation with long-term excess weight. After that one-year window of opportunity, the chances of a woman ever returning to her pre-baby weight dropped off dramatically.
And that was true across the weight classes, and no matter how much the women gained during the pregnancy, though women who overgained during pregnancy, even if normal weight to start with, were also more likely to keep the weight long-term.
But the more a woman took off in her first year following pregnancy, the more likely she was to be of healthy weight years later. Is it any wonder the celebrities who trade on their looks and their healthy image invest a lot of money in personal trainers to help them drop their pregnancy weight gain as quickly as possible? Long-term weight retention could mean the end of a career.
Not that they're the only ones who promptly drop their post-baby weight. I see many women who come in for guidance with weight loss within just weeks of the baby's birth, and I often marvel at their determination. Having had three babies, I remember being wiped out just by caring for the new baby and dealing with the sleep deprivation, let alone trying to take on a new diet and exercise regimen.
But many more mothers fall into unhealthy patterns of inactivity once there's a baby to be looked after. And having grown accustomed to eating a little more, some women don't cut back to an appropriate eating-for-one level after birth. The study shows that getting back into healthy habits as soon as possible is key to avoiding that lifelong burden started by a pregnancy gain.
Of course, weight is like most health problems in that prevention is easier than a cure. If you're overweight and contemplating getting pregnant, think about bringing your weight down beforehand. Because of the serious risks to the baby that are associated with maternal obesity or diabetes, it's best to be at a normal weight before you get pregnant.
But at any weight, it's critical during pregnancy to eat particularly well, but that doesn't mean to eat a whole lot more. Because while a pregnant woman literally is "eating for two," it's important to remember that one of those two is a really, really tiny one.
Get plenty of fresh vegetables and good, low-fat dairy. The extra 300 calories a day a pregnant mom should be eating could easily be accounted for with a morning snack of yogurt and fruit, or by adding three glasses of milk to the daily intake.
And as soon afterward as you've started to normalize your schedule and get some good sleep, start getting your exercise and get right to work getting rid of that baby weight. Chances are awfully high that if you still have it after a year, you'll still have it even 15 years later.
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