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The Remedies

Tuesday, February 22, 2005; Page HE05

Because fetal development requires a steady supply of nutrients supplied by the mother, pregnancy is decidedly not the time to sharply reduce food intake. Nor is it the time to take up a punishing workout regimen. Instead, experts recommend that women interested in having a baby achieve a healthy weight before trying to conceive.

Once pregnant, here are some do's and don'ts about healthy weight gain from obstetricians and experts in maternal-fetal medicine:

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Watch your portion size. Friends and family may say you need to eat for two, but that doesn't mean two full-sized people, said Vivian Dickerson, president of the American College of Obstetricians and Gynecologists. Adding 300 calories in healthy foods to your daily diet -- for example, three cups of 1 percent milk or three ounces of lean meat and one slice of bread -- should be plenty.

Try to stay within the weight guidelines that you and your doctor determine are right for you. Generally, experts recommend limiting weight gain in pregnancy to 25 to 35 pounds for women already at a healthy weight, and 28 to 40 pounds for women who are underweight. For overweight women, experts set a lower weight gain target: 15 to 25 pounds. For obese women, the recommended weight gain is 15 pounds, though in some cases doctors recommend no weight gain at all.

Try to get some moderate exercise each day, even if it's just 30 minutes of walking. Exercise in pregnancy discourages weight gain, just as it does for people who aren't pregnant. But if you're overweight, don't exercise vigorously after the first trimester, said Ronald Feinberg, medical director of in vitro fertilization at Reproductive Associates of Delaware and author of "Healing Syndrome O: A Strategic Guide to Fertility, Polycystic Ovaries and Insulin Imbalance" (Avery Publishing Group, 2004). Many overweight women are at high risk for preterm labor, and too much exercise can serve to bring that on.

Get screened early in pregnancy for diabetes, a condition often tied to being overweight. High blood glucose levels that characterize the condition increase the risk of birth defects. Diabetes also puts women at increased risk of miscarriage and stillbirth. Most OB/GYNs screen women for diabetes 24 to 28 weeks into a pregnancy, but an earlier screening can get you started sooner on measures to control the condition (healthier eating, exercise, blood-sugar monitoring and possibly medication) -- particularly important if you're overweight, said Feinberg.

Follow general advice on good nutrition, such as: Eat smaller, more frequent meals to keep your blood sugar at a steady level. Aim to consume six to eight ounces of lean protein daily -- the amount in, for example, a serving of tuna or two meat patties plus two eight-ounce glasses of milk and a cup of corn. Choose carbs wisely, said Laura Riley, an assistant professor of obstetrics and gynecology and reproductive pathology at Harvard Medical School. For instance, eat whole-wheat toast instead of a croissant, or non-instant oatmeal over cornflakes. Drink water or low-fat milk instead of sugary juice or soda. For further guidance, seek a dietitian's help.

Don't undertake a diet in pregnancy except in close consultation with a doctor or nutritionist. Doing so can deprive your baby of nutrients and lead to developmental problems.

-- Suz Redfearn


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