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Healthy Weight Gain in Pregnancy, the Role of Diet and Exercise

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"Now you're eating for two" is a common adage during pregnancy. This myth has been around for many years and has created a social norm that has contributed to the growing concerns surrounding the obesity epidemic in the United States.Β 

But how do you achieve healthy weight gain in pregnancy, and what role do diet and exercise play? This article aims to provide some insight into healthy pregnancy weight gain and the role of diet and exercise.

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Understanding Healthy Pregnancy Weight Gain Guidelines

Any health decisions during pregnancy should start with a discussion with your prenatal care team. The American College of Obstetrics and Gynecology (ACOG) and the Institute of Medicine (IOM) recommend some general guidelines.

Weight gain during pregnancy generally depends on pre-pregnancy BMI and whether the pregnancy is singleton or multiples. For a singleton pregnancy, pre-pregnancy BMI and weight gain recommendations are as follows:

  • BMI < 18.5: 28-40 lbs.
  • BMI 18.5-24.9: 25-35 lbs.
  • BMI 25-29.9: 15-25 lbs.
  • BMI β‰₯ 30: 11-20 lbs.

The weight gain recommendation for twin gestation is 25-62 lbs. depending on pre-pregnancy weight. Recent studies suggest that almost 50% of women gain more weight than is recommended during pregnancy, while around 20% of women gain too little.

Risks of Inappropriate Weight Gain in Pregnancy

Both too little and too much weight gain in pregnancy can have risks for both mom and baby.

Risk of Inadequate Weight Gain

Inadequate weight gain during pregnancy heightens the risk of premature birth or a small for gestational age (SGA) baby. This risk appears dose-dependent: The further below the recommended weight gain, the higher the risk of small infant size or preterm birth.

Risk of Excessive Weight Gain

Conversely, excessive weight gain during pregnancy carries other risks, including:

Excessive weight gain in pregnancy can also increase the risk of weight retention in the mother after delivery and is a predictor of excessive weight gain and complications in future pregnancies.

Risks Factors for Inappropriate Weight Gain in Pregnancy

Many factors may contribute to too much or too little weight gain in pregnancy. According to a recent meta-analysis, being underweight before conception is linked to an increased risk of inadequate or severely inadequate weight gain in pregnancy, while being overweight or obese carries an increased risk of excessive weight gain.

Other risk factors for low weight gain in pregnancy are:

  • Smoking
  • HIV infection
  • Diarrhea or nausea
  • Malaria infection
  • Lower level of education
  • Lower socioeconomic status

Risk factors for excessive weight gain in pregnancy include:

  • Quitting smoking
  • Lower education level
  • Lower socioeconomic status
  • Excessive weight gain in previous pregnancy
  • Unhealthy dietary patterns

Role of Diet During Pregnancy

The idea of "eating for two" is a social construct that increases the risk of obesity in pregnancy by promoting the idea that pregnancy is a time to gain weight freely. While there are two people to consider, nutritional needs only increase by 300-500 kcal/day during pregnancy.Β  The focus of diet during pregnancy should be on high-quality food with adequate macro and micronutrients.

MacronutrientsΒ 

Protein needs vary by trimester and increase throughout pregnancy. One study suggests that 10-35% of energy consumption during pregnancy should be protein, equating to about 71 grams daily. In the first trimester, intake should be around 1g/day of additional protein, but this need is closer to an extra 26g/day by the third trimester.

During pregnancy, carbohydrates comprise 45-65% of energy consumption, while fat makes up 20-35%.

Fat consumption should focus on healthy fats like omega-3 fatty acids to promote fetal brain and eye development.Β 

Micronutrients

Other nutrients that are important during pregnancy:

  • Iron (30-60 mg/day)Β 
  • Folate (at least 600 mcg/day)Β 
  • Calcium (1.5-2 g/day)
  • Vitamin D (at least 600 IU/day)

The diet during pregnancy generally focuses on whole fruits and veggies, whole grains, proteins, low-fat or fat-free dairy, and healthy oils such as omega-3 fatty acids.Β 

To enhance omega-3 fatty acid intake, consume seafood that is low in mercury, such as anchovy, catfish, crab, salmon, whitefish, or tilapia. Prenatal vitamins can help improve the intake of some micronutrients recommended during pregnancy.

Other Dietary Considerations

Alcohol consumption during pregnancy is not recommended according to the American College of Obstetricians and Gynecologists (ACOG) due to the risk of fetal alcohol syndrome. This condition is associated with abnormal facial features, impaired brain development, small head size, and small stature.

Role of Exercise During Pregnancy

Engaging in moderate exercise is generally considered safe during pregnancy, but women must seek guidance from their prenatal care providers before starting an exercise program.

Benefits

There are several proven benefits of exercise during pregnancy.Β  Some of these include:Β 

  • Decreased back pain
  • Less constipation and bloating
  • Less swelling
  • Improved sleep, energy, and mood
  • Improved posture
  • Increased muscle tone and endurance, which may help with the labor process
  • Improved ability to lose weight after pregnancy
  • Reduced risk of excessive weight gain
  • Decreased risk of gestational diabetes, preeclampsia, and cesarean section

Risks

While exercise is generally beneficial during pregnancy, some women with higher-risk conditions may need to avoid it. Conditions such as bleeding in pregnancy, preterm labor, or high blood pressure may require caution.Β 

For most women, the benefits outweigh the risks, but pregnant women consult their obstetrical team before starting any exercise program.Β 

[signup]

Key Takeaways

  • Most women gain too much or too little weight during pregnancy.
  • The best way to assess healthy weight gain in pregnancy is a discussion with a prenatal care provider.
  • A balanced diet with the recommended macro and micronutrients can support healthy weight gain.
  • For most low-risk women, exercise is safe, healthy, and beneficial.Β Β 
  • It is essential for healthcare providers to educate patients about healthy weight gain at all stages of pregnancy, from preconception to delivery.

"Now you're eating for two" is a common saying during pregnancy. This idea has been around for many years and has contributed to misunderstandings about healthy weight gain during pregnancy in the United States.Β 

But how do you achieve healthy weight gain in pregnancy, and what role do diet and exercise play? This article aims to provide some insight into healthy pregnancy weight gain and the role of diet and exercise.

[signup]

Understanding Healthy Pregnancy Weight Gain Guidelines

Any health decisions during pregnancy should start with a discussion with your prenatal care team. The American College of Obstetrics and Gynecology (ACOG) and the Institute of Medicine (IOM) provide some general guidelines.

Weight gain during pregnancy generally depends on pre-pregnancy BMI and whether the pregnancy is singleton or multiples. For a singleton pregnancy, pre-pregnancy BMI and weight gain recommendations are as follows:

  • BMI < 18.5: 28-40 lbs.
  • BMI 18.5-24.9: 25-35 lbs.
  • BMI 25-29.9: 15-25 lbs.
  • BMI β‰₯ 30: 11-20 lbs.

The weight gain recommendation for twin gestation is 25-62 lbs. depending on pre-pregnancy weight. Recent studies suggest that almost 50% of women gain more weight than is recommended during pregnancy, while around 20% of women gain too little.

Risks of Inappropriate Weight Gain in Pregnancy

Both too little and too much weight gain in pregnancy can have risks for both mom and baby.

Risk of Inadequate Weight Gain

Inadequate weight gain during pregnancy may increase the risk of premature birth or a small for gestational age (SGA) baby. This risk appears dose-dependent: The further below the recommended weight gain, the higher the risk of small infant size or preterm birth.

Risk of Excessive Weight Gain

Conversely, excessive weight gain during pregnancy may carry other risks, including:

Excessive weight gain in pregnancy can also increase the risk of weight retention in the mother after delivery and is a predictor of excessive weight gain and complications in future pregnancies.

Risks Factors for Inappropriate Weight Gain in Pregnancy

Many factors may contribute to too much or too little weight gain in pregnancy. According to a recent meta-analysis, being underweight before conception is linked to an increased risk of inadequate or severely inadequate weight gain in pregnancy, while being overweight or obese carries an increased risk of excessive weight gain.

Other risk factors for low weight gain in pregnancy are:

  • Smoking
  • HIV infection
  • Diarrhea or nausea
  • Malaria infection
  • Lower level of education
  • Lower socioeconomic status

Risk factors for excessive weight gain in pregnancy include:

  • Quitting smoking
  • Lower education level
  • Lower socioeconomic status
  • Excessive weight gain in previous pregnancy
  • Unhealthy dietary patterns

Role of Diet During Pregnancy

The idea of "eating for two" is a social construct that may increase the risk of obesity in pregnancy by promoting the idea that pregnancy is a time to gain weight freely. While there are two people to consider, nutritional needs only increase by 300-500 kcal/day during pregnancy.Β  The focus of diet during pregnancy should be on high-quality food with adequate macro and micronutrients.

MacronutrientsΒ 

Protein needs vary by trimester and increase throughout pregnancy. One study suggests that 10-35% of energy consumption during pregnancy should be protein, equating to about 71 grams daily. In the first trimester, intake should be around 1g/day of additional protein, but this need is closer to an extra 26g/day by the third trimester.

During pregnancy, carbohydrates comprise 45-65% of energy consumption, while fat makes up 20-35%.

Fat consumption should focus on healthy fats like omega-3 fatty acids to support fetal brain and eye development.Β 

Micronutrients

Other nutrients that are important during pregnancy:

  • Iron (30-60 mg/day)Β 
  • Folate (at least 600 mcg/day)Β 
  • Calcium (1.5-2 g/day)
  • Vitamin D (at least 600 IU/day)

The diet during pregnancy generally focuses on whole fruits and veggies, whole grains, proteins, low-fat or fat-free dairy, and healthy oils such as omega-3 fatty acids.Β 

To enhance omega-3 fatty acid intake, consider including seafood that is low in mercury, such as anchovy, catfish, crab, salmon, whitefish, or tilapia. Prenatal vitamins can help improve the intake of some micronutrients recommended during pregnancy.

Other Dietary Considerations

Alcohol consumption during pregnancy is not recommended according to the American College of Obstetricians and Gynecologists (ACOG) due to the risk of fetal alcohol syndrome. This condition is associated with abnormal facial features, impaired brain development, small head size, and small stature.

Role of Exercise During Pregnancy

Engaging in moderate exercise is generally considered safe during pregnancy, but women should seek guidance from their prenatal care providers before starting an exercise program.

Benefits

There are several potential benefits of exercise during pregnancy.Β  Some of these include:Β 

  • Decreased back pain
  • Less constipation and bloating
  • Less swelling
  • Improved sleep, energy, and mood
  • Improved posture
  • Increased muscle tone and endurance, which may help with the labor process
  • Improved ability to manage weight after pregnancy
  • Reduced risk of excessive weight gain
  • Decreased risk of gestational diabetes, preeclampsia, and cesarean section

Risks

While exercise is generally beneficial during pregnancy, some women with higher-risk conditions may need to avoid it. Conditions such as bleeding in pregnancy, preterm labor, or high blood pressure may require caution.Β 

For most women, the benefits outweigh the risks, but pregnant women should consult their obstetrical team before starting any exercise program.Β 

[signup]

Key Takeaways

  • Most women gain too much or too little weight during pregnancy.
  • The best way to assess healthy weight gain in pregnancy is a discussion with a prenatal care provider.
  • A balanced diet with the recommended macro and micronutrients can support healthy weight gain.
  • For most low-risk women, exercise is safe, healthy, and beneficial.Β Β 
  • It is essential for healthcare providers to educate patients about healthy weight gain at all stages of pregnancy, from preconception to delivery.
The information provided is not intended to be a substitute for professional medical advice. Always consult with your doctor or other qualified healthcare provider before taking any dietary supplement or making any changes to your diet or exercise routine.
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Lab Tests in This Article

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American Pregnancy Association. (2018, July 20). Exercise During Pregnancy: Safety, Benefits & Guidelines. American Pregnancy Association. https://americanpregnancy.org/healthy-pregnancy/is-it-safe/exercise-during-pregnancy/

Blake, K. (2024). Integrative Approaches to Tackling Childhood Obesity and Metabolic Concerns. Rupa Health.Β  https://www.rupahealth.com/post/integrative-approaches-to-tackling-childhood-obesity-and-metabolic-concerns.

CDC. (2024, May 15). Weight Gain During Pregnancy. Maternal Infant Health. https://www.cdc.gov/maternal-infant-health/pregnancy-weight/?CDC_AAref_Val=https://www.cdc.gov/reproductivehealth/maternalinfanthealth/pregnancy-weight-gain.htm

Cloyd, J. (2023). Macro and Micronutrients Uncovered: Understanding Their Role, Deficiencies, and Clinical Relevance. Rupa Health. https://www.rupahealth.com/post/macro-and-micronutrients-uncovered-understanding-their-role-deficiencies-and-clinical-relevance

Danielewicz, H., Myszczyszyn, G., DΔ™biΕ„ska, A., Myszkal, A., BoznaΕ„ski, A., & Hirnle, L. (2017). Diet in pregnancyβ€”more than food. European Journal of Pediatrics, 176(12), 1573–1579. https://doi.org/10.1007/s00431-017-3026-5

Darling, A.M., Wang, D., Perumal, N., Liu, E., Wang, M., Ahmed, T., Christian, P., Dewey, K. G., Kac, G., Kennedy, S. H., Vishak Subramoney, Briggs, B., & Fawzi, W. W. (2023). Risk factors for inadequate and excessive gestational weight gain in 25 low- and middle-income countries: An individual-level participant meta-analysis. PLOS Medicine, 20(7), e1004236–e1004236. https://doi.org/10.1371/journal.pmed.1004236

Goldstein, R. F., Abell, S. K., Ranasinha, S., Misso, M., Boyle, J. A., Black, M. H., Li, N., Hu, G., Corrado, F., Rode, L., Kim, Y. J., Haugen, M., Song, W. O., Kim, M. H., Bogaerts, A., Devlieger, R., Chung, J. H., & Teede, H. J. (2017). Association of Gestational Weight Gain With Maternal and Infant Outcomes. JAMA, 317(21), 2207. https://doi.org/10.1001/jama.2017.3635

Hinman, S. K., Smith, K. B., Quillen, D. M., & Smith, M. S. (2015). Exercise in Pregnancy. Sports Health: A Multidisciplinary Approach, 7(6), 527–531. https://doi.org/10.1177/1941738115599358

Ho, A., Flynn, A. C., & Pasupathy, D. (2016). Nutrition in pregnancy. Obstetrics, Gynaecology & Reproductive Medicine, 26(9), 259–264. https://doi.org/10.1016/J.OGRM.2016.06.005

Institute of Medicine, & National Research Council. (2009). Weight Gain During Pregnancy: Reexamining the Guidelines (K. M. Rasmussen & A. L. Yaktine, Eds.). PubMed. https://pubmed.ncbi.nlm.nih.gov/20669500/

Kalaichandran, A. (2024, March 19). Unveiling the Shadow: How Smoking casts a Long-Term Impact on Immune Health. Rupa Health. https://www.rupahealth.com/post/unveiling-the-shadow-how-smoking-casts-a-long-term-impact-on-immune-health

Kominiarek, M. A., & Peaceman, A. M. (2017). Gestational weight gain. American Journal of Obstetrics and Gynecology, 217(6), 642–651. https://doi.org/10.1016/j.ajog.2017.05.040

Kraschnewski, J. L., & Chuang, C. H. (2014). "Eating for Two": Excessive Gestational Weight Gain and the Need to Change Social Norms. Women's Health Issues, 24(3), e257–e259. https://doi.org/10.1016/j.whi.2014.03.004

Marshall, N. E., Abrams, B., Barbour, L. A., Catalano, P., Christian, P., Friedman, J. E., Hay, W. W., Hernandez, T. L., Krebs, N. F., Oken, E., Purnell, J. Q., Roberts, J. M., Soltani, H., Wallace, J., & Thornburg, K. L. (2021). The Importance of Nutrition in Pregnancy and Lactation: Lifelong Consequences. American Journal of Obstetrics and Gynecology, 226(5), 607–632. https://doi.org/10.1016/j.ajog.2021.12.035

Murphy, M. M., Higgins, K. A., Bi, X., & Barraj, L. M. (2021). Adequacy and Sources of Protein Intake among Pregnant Women in the United States, NHANES 2003–2012. Nutrients, 13(3), 795. https://doi.org/10.3390/nu13030795

PleΔ‡as, D., Plesinac, S., & KontiΔ‡ VuciniΔ‡, O. (2014). Nutrition in pregnancy: basic principles and recommendations. Srpski Arhiv Za Celokupno Lekarstvo, 142(1-2), 125–130. https://doi.org/10.2298/sarh1402125p

Poston, L. (2024). Gestational Weight Gain. Retrieved from https://www.uptodate.com/contents/gestational-weight-gain

Preston, J. (2022, November 10). What's The Difference Between Good And Bad Dietary Fat? Rupa Health. https://www.rupahealth.com/post/dietary-fat-the-good-the-bad-and-the-misunderstood

Preston, J. (2023a, July 11). Integrative Medicine and Preterm Labor: A Holistic Approach to Reducing Risk. Rupa Health. https://www.rupahealth.com/post/integrative-medicine-and-preterm-labor-a-holistic-approach-to-reducing-risk

Preston, J. (2023b, July 20). An Integrative Comprehensive Approach to Preeclampsia: Risk Factors and Preventative Lab Testing. Rupa Health. https://www.rupahealth.com/post/an-integrative-comprehensive-approach-to-preeclampsia-risk-factors-and-preventative-lab-testing

Preston, J. (2023c, August 1). The Role of Integrative Nutrition in Supporting Pregnancy. Rupa Health. https://www.rupahealth.com/post/the-role-of-integrative-nutrition-in-supporting-pregnancy

Rasmussen, L., Poulsen, C. W., Kampmann, U., Smedegaard, S. B., Ovesen, P. G., & Fuglsang, J. (2020). Diet and Healthy Lifestyle in the Management of Gestational Diabetes Mellitus. Nutrients, 12(10), 3050. https://doi.org/10.3390/nu12103050

Santos Monteiro, S., S Santos, T., Fonseca, L., Saraiva, M., Pichel, F., Pinto, C., Pereira, M. T., Vilaverde, J., Almeida, M. C., & Dores, J. (2023). Inappropriate gestational weight gain impact on maternofetal outcomes in gestational diabetes. Annals of Medicine, 55(1), 207–214. https://doi.org/10.1080/07853890.2022.2159063

Suliga, E., Rokita, W., Adamczyk-Gruszka, O., Pazera, G., CieΕ›la, E., & GΕ‚uszek, S. (2018). Factors associated with gestational weight gain: a cross-sectional survey. BMC Pregnancy and Childbirth, 18(1). https://doi.org/10.1186/s12884-018-2112-7

The American College of Obstetricians and Gynecologists. (2019, July). Exercise During Pregnancy. Www.acog.org. https://www.acog.org/womens-health/faqs/exercise-during-pregnancy

The American College of Obstetricians and Gynecologists. (2020). Weight Gain During Pregnancy. Www.acog.org. https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2013/01/weight-gain-during-pregnancy

The American College of Obstetricians and Gynecologists. (2023, February). Alcohol and Pregnancy. Www.acog.org. https://www.acog.org/womens-health/infographics/alcohol-and-pregnancy

U.S. Department of Health and Human Services: Office of Disease Prevention and Health Promotion. (2023, May 19). Eat Healthy During Pregnancy: Quick tips - MyHealthfinder | health.gov. Health.gov. https://health.gov/myhealthfinder/pregnancy/nutrition-and-physical-activity/eat-healthy-during-pregnancy-quick-tips

Weinberg, J.L. (2024). The Power of Omega-3s: Incorporating Healthy Fats into Your Diet. Retrieved from https://www.rupahealth.com/post/the-power-of-omega-3s-incorporating-healthy-fats-into-your-diet

Yoshimura, H. (2023a, August 21). A Root Cause Medicine Approach To Gestational Diabetes. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-approach-to-gestational-diabetes

Yoshimura, H. (2023b, August 21). A Root Cause Medicine Approach to Gestational Hypertension. Rupa Health. https://www.rupahealth.com/post/a-root-cause-medicine-approach-to-gestational-hypertension

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