Overweight in Pregnancy? Here's How to Keep Excess Pounds at Bay
TUESDAY, Sept. 25, 2018 -- Heather Kinion never spent much time thinking about her weight. But when she got pregnant, that changed.
"My sister had a baby a few years before me and had gained a bunch of weight, and she still hadn't lost it when I got pregnant," Kinion said. So the Chicago-area mom-to-be was happy to sign up for a nutritional counseling program her doctor's office was offering as part of a study.
The study program from Northwestern University is dubbed Momfit. It encourages expectant mothers to eat healthy foods, gain the recommended amount of weight, exercise regularly, and sleep seven to nine hours a night.
Women received in-person nutritional counseling. They also had help from technology: Telephone, text message prompts and e-mail reminders kept pregnancy goals on their minds. The women also tracked what they ate in a smartphone app.
The goal was not to lose weight, but to gain weight within recommended guidelines. Overall, the Momfit participants gained about 4 fewer pounds throughout pregnancy than those given standard care.
As for Kinion, she only gained 20 pounds throughout her pregnancy. "I was really concerned that I would gain a bunch of weight. It was winter, and I like comfort foods, but because I was reporting what I ate, I made sure to eat three servings of vegetables and two fruits, along with whole grains and a decent amount of dairy."
She got better at portion control, too, she said. And the program "left me room to be indulgent, so I didn't feel deprived. I was able to eat a good balance of foods," she added.
After her daughter's birth, Kinion chose to breastfeed. She said the pregnancy weight came off quickly.
Study author Linda Van Horn said the study aimed to see if women could safely avoid excess weight gain during pregnancy.
"The majority of pregnant women are overweight or obese at the time of conception. It's a major public health concern," said Van Horn, a professor of preventive medicine at Northwestern's Feinberg School of Medicine in Chicago.
The U.S Institute of Medicine recommends that normal-weight women gain 25 to 35 pounds during pregnancy, but just 15 to 25 pounds if they're overweight at the start of pregnancy. Women who are obese should only gain 11 to 20 pounds while expecting, the IOM says.
Gaining too much weight during pregnancy can have consequences for both mom and baby.
"Weight gain is definitely a big concern," said Dr. Navid Mootabar, chairman of obstetrics and gynecology at Northern Westchester Hospital in Mount Kisco, N.Y.
"Proper attention to appropriate amount of weight gain results in better pregnancy outcomes. It leads to a decreased risk of high blood pressure and gestational diabetes. Appropriate weight gain also decreases the risk of a cesarean section birth," Mootabar said.
Van Horn added that appropriate weight gain can help new mothers avoid obesity after pregnancy. It can also help children avoid overweight and obesity.
"The old saying is, 'You are what you eat.' Now it may be, 'You are what your mother ate,' " she said.
The study included nearly 300 pregnant women between 18 and 45 years old. All fell into the overweight or obese range. About 62 percent were white.
The nutritionists gave half the women advice based on a modified version of the DASH (Dietary Approach to Stop Hypertension) diet that focuses on fruits and vegetables, whole grains and lean proteins. It limits saturated fats and discourages sugar-sweetened beverages and snack foods. The "MAMA-DASH" diet added more dairy and limited fish that might contain mercury, according to the study.
Walking was important, too, with Momfit participants asked to walk at least 30 minutes or take 10,000 steps a day.
Van Horn acknowledged that Momfit isn't a magic bullet.
"Moms who were obese were recommended to gain between 10 and 15 pounds, and very few were in that range. But they did gain less than the usual care group. It's a challenge to have moms make those changes in daily dietary calories," she said.
The study also found a higher rate of C-sections in moms who participated in the program. The researchers aren't sure why that is, however.
One of the bright spots in the study is that moms are using the nutritional lessons with their children.
"I definitely make better food choices now, and my daughter Julia eats a lot better than she might have if I hadn't been in the study. She eats lots of vegetables," Kinion said.
The study was published Sept. 24 in the American Journal of Preventive Medicine.
The American College of Obstetricians and Gynecologists has more on nutrition during pregnancy.
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Posted: September 2018