Nutrition Counseling For the Pregnant Woman Who Is Gaining Excess Weight
Do nutrition and weight evaluation to try to determine the cause of excess weight gain.
Important to teach on first visit:
Avoid sugary foods and sugary drinks.Give them a list of sugary foods and sugary drinks that should be avoided – it is best to keep these out of the house so they are not a temptation:
cakes, cookies, candies ,ice cream, chocolate, sweet breads, lollipops,
popsicles, Jello, flan, sugary cereals, flavoredyogurts,(Hispanic favorites:
’pan dulce’, ‘arroz con leche’),
and sugary drinks:
soda , Gatorade, Koolaid, fruit punch, Sunny Delight , Tampico, Tang,
Caprisun, lemonade, instant iced tea from powder, bottled iced tea,
Powerade, Kern’s, Schnapple,Quik, ‘high energy drinks’,(Hispanic favorites:
‘agua de jamaica’, ‘agua de tamarindo’ , ‘horchata’, ‘maicena’, ‘atole’,
‘champurrado’, ‘Chocomil’, ‘Jackult’ ‘aguas de fruta’),
“and there are many more”
Limit fruit juice to 4 ounces per day or less
Review exercise level – 30 minutes of walking is recommended per day unless atypical discomforts or contraindicated by doctor (other types of exercise may be OK; the walking should be in addition to regular chores)
May be important to teach on the first visit:
Aim for the WIC (Women, Infants, and Children Supplemental Food Program) Daily Food Guide recommended number of servings for all food groups as a minimum (this is especially important to teach if they are afraid of weight gain and are not eating enough)
Recommend reduced fat (2%), lowfat (1%), or nonfat (0%) instead of regular milk (3.5%).
Optional teaching for first visit:
Water is the best beverage.
Have fruit available/eat fruit instead of the sugary foods or sugary drinks.
If you are not used to eating vegetables, try different vegetables and different vegetable recipes. If you like only 1 or 2 or 3 types of vegetables, it’s okay to eat the same ones every day.
Choose foods lower in fat more often. Ask them if they know which foods are high in fat. Wait for a response from them. Give them examples of high fat foods (butter, oil, cream, margarine, lard, fried foods, red meats) and low fat foods (vegetables, fruits, legumes, chicken, nonfat milk). Use lowfat cooking methods (bake, broil, roast, barbecue, steam, poach) or use only small amounts of fat in cooking.
Eat whole grains instead of processed grains (examples of whole grains include 100% whole wheat bread, brown rice, 100% rye or 100% whole wheat crackers, oatmeal, 100% whole wheat pasta, corn tortillas)
The benefits of exercise during pregnancy are:
-along with proper diet, it helps prevent excess weight gain
-less discomforts in pregnancy – for example, less chance of back pain because abdominal and back muscles are stronger
-it helps all the hormones work better, so we feel better and have less chance of developing diabetes during pregnancy (better control of blood sugars)
-delivery is easier for those who have exercised regularly during the pregnancy
Information for the professional:
Possible causes of excess weight gain in pregnancy:
-too much juice
-sugary foods and sugary drinks
-lack of exercise
-high intake of high fat foods
-eating out frequently
- recent weight loss or inadequate weight gain during the pregnancy
This happens if a woman initially lost weight in her pregnancy, or didn’t gain enough (as with nausea/vomiting), then her appetite returns. This high rate of weight gain is called “catch-up” weight gain and is considered acceptable (this patient should also be counseled regarding exercise and to avoid sugary foods and sugary drinks, and to limit fruit juice to 4 ounces per day or less)
- previous high weight before the pregnancy
In some cases the patient is following all of the recommendations to avoid excess weight gain, and still gains too much weight. This is typically because in her past she used to weigh more, then lost weight (in other words, her pre-pregnancy weight was lower than her highest non-pregnant weight). Her body is trying to recoup the weight that was lost in the past. Explain this to her while giving guidance to optimize diet and exercise. Emphasize the importance of eating the recommended number of portions from the Daily Food Guide as a minimum, choosing lower fat foods more often. Counsel her that she may continue to gain weight at a greater rate than expected even if her diet and exercise are excellent. At this point it is not recommended to cut back on the amount of food eaten, but, rather, to wait until after delivery to begina weight loss plan.
Excessive weight gain can increase the chance of developing gestational diabetes or high blood pressure, or of having a bigger (large for gestational age) baby, and potential problems with delivery.