Monday’s medical myth: eat for two during pregnancy

We’ve all heard people sprout the phrase, “go on, you’re eating for two now” at barbecues, dinner parties and wherever food is being served, forcing pregnant women to decline offers of more and more food from well-meaning friends and family. While pregnant women don’t have to eat twice as much food…

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Most pregnant women only need to eat the equivalent of an extra two pieces of fruit and half a glass of milk a day. Flickr/flequi

We’ve all heard people sprout the phrase, “go on, you’re eating for two now” at barbecues, dinner parties and wherever food is being served, forcing pregnant women to decline offers of more and more food from well-meaning friends and family.

While pregnant women don’t have to eat twice as much food, the growth and development of a baby certainly does rely heavily on its mother’s nutrient stores and intake during pregnancy. The Dutch Famine during World War II demonstrated that poorly nourished mothers were more likely to give birth to babies with restricted growth. Their children were also more susceptible to chronic diseases in adulthood.

During pregnancy, a woman’s nutrient requirements increase by between 10% and 50%, depending on the specific nutrient. But her energy intake only needs to increase in the range of 15% to 25%. In Western societies, excess energy and body weight are more common than nutritional inadequacies.

The amount of food a woman consumes during pregnancy shouldn’t increase substantially. Generally, it should only increase by the equivalent of two medium-sized pieces of fruit and half a glass of reduced-fat milk averaged over the pregnancy term. But everyone is different.

If women do kick back and eat for two, they’re likely to gain too much weight, particularly if there’s not a substantial increase in physical activity. Recently, my colleagues and I found that one third of Australian women who were a healthy weight and just over half of women in the heavier-than-healthy category gained too much weight during their pregnancy.

The complications arising from gaining too much weight during pregnancy include a greater risk of developing gestational diabetes, problems during labour for the mother and baby, weight retention after delivery for mothers and an increased likelihood that the child will become overweight later in life.

Women who were a healthy weight before pregnancy should gain around 11.5 to 16kg. Image from shutterstock.com

This is not to say weight gain should be restricted. Not gaining enough weight can have negative consequences for both mother and baby, so it’s important to achieve a healthy balance.

There are several resources available to guide a healthy weight gain in pregnancy. Your doctor, nurse or dietitian will be able to give you information specific to you and your pregnancy, but here is a starting guide, based on pre-pregnancy body mass index (BMI):

  • women who are underweight (with a pre-pregnancy BMI of less than 18.5) should gain around 12.5 to 18 kilograms,

  • women of a healthy weight (pre-pregnancy BMI 18.5 to 24.9) should gain around 11.5 to 16 kg,

  • women who are overweight (pre-pregnancy BMI 25 to 29.9) should gain around seven to 11.5 kg,

  • women who are classified as obese (pre-pregnancy BMI above 30) should gain around five to nine kilograms.

So how do women meet the extra nutrient needs without piling on the kilos?

A pregnant body becomes more efficient at absorbing nutrients. A high-quality diet is still important but there is not as much room for those discretionary foods that have few nutrients but loads of energy.

It’s important to eat four serves of fruit and five serves of vegetables every day. Lean meat, reduced-fat dairy products and wholegrain breads and cereal products will ensure women get plenty of nutrients without overdoing the kilojoules.

There’s not much room for junk food during pregnancy. Frlick/What is in us

Physical activity is also important – maintaining an active lifestyle and getting 30 minutes of physical activity each day will help achieve a healthy weight.

It’s difficult to meet folic acid and iodine requirements during pregnancy through a regular diet. So folic acid and iodine supplements are now routinely recommended for at least one month prior to pregnancy and for the first trimester. Ideally, the iodine supplementation should continue during pregnancy and breastfeeding.

There is insufficient evidence to support taking other vitamins or a multivitamin unless low levels are diagnosed.

While it might be nice to indulge during pregnancy, the “eating-for-two” myth should be discarded to give babies the best chance of optimal development and future health.

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6 Comments sorted by

  1. Dale Bloom

    Analyst

    "We’ve all heard people sprout the phrase, “go on, you’re eating for two now” at barbecues, dinner parties and wherever food is being served,"

    No I haven't actually.

    But it is important information regards "The amount of food a woman consumes during pregnancy shouldn’t increase substantially. Generally, it should only increase by the equivalent of two medium-sized pieces of fruit and half a glass of reduced-fat milk averaged over the pregnancy term."

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  2. Mark Amey

    logged in via Facebook

    Most women of child bearing age seem to be eating for two (or three) prior to the conception.

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  3. Colin MacGillivray

    Retired architect

    Good article I hope doctors read it.
    "maintaining an active lifestyle and getting 30 minutes of physical activity each day will help achieve a healthy weight."
    Before I broke my ankle on Dec 3rd '12, I played golf every morning- 8 kms of walking and waving a metal stick around. A major concern at the time of the break was to not put on weight despite doing no exercise. The method I used was eating less (a smaller plate, reduce carbs) and weighing myself every day or two. My weight is the same as 6 weeks ago.
    I really miss daily exercise psychologically but I'm unconvinced it affects weight much. It's the amount one eats that matters.

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    1. Regan Forrest

      logged in via Twitter

      In reply to Colin MacGillivray

      Food would appear to be the more potent side of the equation. I've never played golf but what you described would probably burn fewer calories than a typical sticky bun.

      I've been undoing the Christmas pounds by both cutting back food (and alcohol!) and upping the exercise. So far, so good. But I fell into a trap last year - despite plenty of walking and using the stairs, my weight slowly climbed. For really shifting the fat, I suspect you need a high-intensity workouts like interval training. No amount of walking (with or without metal sticks) is going to get the heart rate where it needs to be. That's not to discount the other health and wellbeing aspects of being active, of course. There's more to health than how many pounds you're carrying.

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    2. Colin MacGillivray

      Retired architect

      In reply to Regan Forrest

      Just for the record playing golf pushing one's clubs and walking for 4 hours stopping and starting 100 times (vs riding a cart) consumes 1400 calories apparently. (3 or 4 sticky buns?)
      I'm still really suspicious about this high heart rate thing. Primitive people don't do it. Nobody on the planet advocated it as a requirement for good health before about 1950 (?). Lots of older people, particularly Asians, the Japanese for example, live long lives and rarely raise their heart rate above 100.

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    3. Regan Forrest

      logged in via Twitter

      In reply to Colin MacGillivray

      so about 350 cal an hour then? When you put it that way it sounds about right (Fyi I think a sticky bun is about 500-600 so maybe two! :))

      I'm no expert - I can only speak from my own experience which may not be universal. I can walk for hours and nothing happens. Dial up the intensity and off the weight goes.

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