In general, overweight women—those with a Body Mass Index of 25 to 29.9—should aim to gain between 15 and 25 pounds during pregnancy. Obese women—those with a BMI of 30 or higher—should aim for 11 to 20 pounds, according to the American College of Obstetricians and Gynocologists.
“A plus-size pregnancy is a higher-risk pregnancy, so following weight-gain guidelines is that much more vital,” says Margaret Wertheim, a registered dietitian nutritionist in Madison, Wisconsin. But keep in mind: Pregnancy isn’t the time to start dieting. “I definitely do not recommend pregnant women restrict themselves to the point of depriving their bodies or their babies of the calories they both need,” Wertheim says. Instead, focus on eating nutrient-dense real foods emphasizing protein, healthy fats, vegetables and fruit while limiting foods with added sugar. Read on for more tips on eating for two.
Tip #1: Go lighter on the carbs.
Overweight or obese women are more likely to have elevated blood sugar levels, which can lead to having a large baby, so Wertheim doesn’t recommend consuming lots of carbs. What’s more, many carbohydrate-rich foods, like sweets, soft drinks, bread, pasta and chips generally aren't super-rich in vitamins and minerals compared with beans, nuts, meats or veggies. But cutting them out altogether can lead to growth retardation, says Romy Block, MD, an endocrinologist who sees patients in a high-risk obstetrics clinic in Chicago. Stick to healthier sources of carbs, like fruit, dairy products and whole grains, which will give you and baby the nutrients you need.
Tip #2: Slash your sugar intake.
“I always suggest that mommies-to-be reduce refined sugars and starches,” says Julie Kabat Friedman, a health psychologist specializing in obesity and weight management and an assistant professor at the Northwestern University Feinberg School of Medicine. We’re not saying you have to go cold turkey—you can still have your treats. Just heed Friedman’s advice to be mindful of portion size and make eating sweets a planned part of your day, instead of whenever you feel like it.
Tip #3: Focus on lean protein.
While you’re cutting back on carbs and sugar, focus on filling your plate with more lean protein, like chicken breast, sirloin cuts of beef, beans, fish, tofu and low-fat dairy. “There’s evidence that doing this helps prevent excessive pregnancy weight gain, decreases the risk of gestational diabetes and helps you feel more full,” Friedman says.
Tip #4: Try dividing your plate.
Block suggests following this easy formula to get the right balance at every meal: Just divide your plate into quarters. Fill one quarter with lean protein, another with grains/complex carbs and fill the last two with veggies or a salad. Do this three times a day and you’ll have packed your day full of healthy nutrients, without overdoing it.
Tip #5: Stick to a meal schedule.
Stress eating can kick in for many pregnant women, especially in the third trimester when anxieties over big issues (delivery, child care, finances) pop up. Friedman suggests creating a schedule that includes eating three meals and two snacks each day at a set time. Eating according to the clock helps prevent skipping a meal or overindulging, and it can help reduce emotional decision making about food. Need a few more ways to fight those stress-induced cravings? Try changing your environment (take a walk around the block or go run an errand) or distracting yourself with an enjoyable activity that doesn’t involve food, like emailing a friend or browsing online for baby names.
Tip #6: Check your prenatal vitamin for iodine.
Getting enough folic acid and calcium during pregnancy is a no-brainer, but there’s another necessary mineral you probably haven’t heard about. “One especially important nutrient that has come to light recently is iodine,” says Wertheim. “It’s essential for proper thyroid function and for baby's brain development, but about one-third of pregnant women in the United States are iodine-deficient.” Check the label of your prenatal vitamin to see if it includes 150 microgams of iodine, and talk to your OB about the right dosage for your particular needs.
Tip #7: Get those ZZZ’s!
Have you ever noticed it’s like a thousand percent harder to eat right when you’re extra tired? Lack of sleep makes your body want to eat more, but then it’s too sleepy to burn off those extra calories, Friedman explains. Chances are, heartburn, leg cramps or vivid dreams are going to disrupt your sleep at least some nights, but you can make sure you get the best rest possible by having a set wake and sleep time, and taking a hot shower before bed. “Your body cools down after getting out of the hot shower, and that process has a relaxing, sleep-inducing effect,” she says.
Tip #8: Don’t try too hard to be “perfect.”
You and your body are going through a lot right now, and it’s important to be kind to yourself through this memorable—but stressful—experience. “Preventing excessive weight gain during pregnancy has health benefits for both mom and baby; but the same goes for preventing stress,” says Friedman. If “eating perfectly while pregnant” is stressing you out too much, take a step back and don’t beat yourself up if you have to give into the cravings once in a while. “No mother should feel overly pressured about weight during pregnancy,” Friedman says.
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