Common Physical Changes
Common Physical Changes throughout Pregnancy
You know you’ re supposed to follow a "healthy" diet during pregnancy (think lots of fruit and veggies, low–fat forms of protein, high fiber, etc). But do you know why? Beyond the obvious–maintaining enough calories to keep you healthy and ensure the baby keeps growing–we’ re learning that in utero nutrition, including whether the mother is overweight or has pregnancy–related diabetes, can impact a child’ s health throughout life.
Just as rates of type 2 diabetes are on the rise in a country with an obesity epidemic, so, too, are rates of gestational diabetes. Gestational diabetes is a form of diabetes that occurs only during pregnancy and usually disappears after delivery. Currently, up to 9.2 percent of pregnant women develop gestational diabetes. The condition is more common in African Americans.
Left untreated, gestational diabetes increases the risk of having an unusually large baby, which could lead to delivery problems, as well as a baby with postpartum problems like low blood sugar and respiratory distress syndrome. It also doubles the risk of obesity later in the baby’ s life and significantly increases your risk of developing type 2 diabetes. Most physicians screen for gestational diabetes with an oral glucose tolerance test between the 24th and 28th weeks.
Your best bet for preventing gestational diabetes is to follow a healthy diet and maintain a healthy weight before you get pregnant. While there’ s no evidence that how you eat during your pregnancy makes a difference in regard to preventing diabetes, staying physically active is important. And once you’ re diagnosed with gestational diabetes, diet and exercise are crucial if you want to avoid diabetes medications or even insulin.
To maintain normal blood sugar levels if you are diagnosed with gestational diabetes, meet with a nutritionist to evaluate your dietary needs.
So here are the key issues to consider when it comes to nutrition during pregnancy:
Maintain a healthy weight. The impact of obesity on your health and your unborn child’ s health is significant. Obesity is an independent risk factor for neural tube defects, miscarriage and preterm delivery. It can predispose your child to diabetes later in life and, if you develop gestational diabetes, increase your own risk of diabetes. You don’ t need to increase your daily calories until your second trimester, at which point you only need an extra 340 extra calories (more if you’ re pregnant with multiples). By the third trimester, you need an extra 450 calories.
Often the healthiest way to add calories is by adding an extra small meal or snack during the day. Some examples of healthy snacks containing about 400 calories include:
- Whole wheat tortilla wrap filled with grilled or raw veggies, ¼ cup hummus or pesto, 2 tablespoons nuts and lettuce and tomato
- 6 ounces plain nonfat or low–fat yogurt mixed with ½ cup berries, 2 tablespoons nuts and ½ cup granola
- Smoothie made from 1 cup skim or non–dairy milk alternative, ¾ cup plain or vanilla nonfat yogurt and 1 cup frozen berries
Some quick snacks when you’ re on the run are:
- Peanut butter with apple, banana or whole–grain crackers
- Wasa–style whole–grain crackers with low–fat string cheese and a handful of nuts or sunflower seeds
- Light microwave popcorn and about 2 tablespoons peanuts
There are many healthy options for any time of day, but try to include a mix of mono–or polyunsaturated fats, whole–grain carbohydrates, low–fat dairy and, of course, fruits and vegetables.
- Follow dietary guidelines (www.health.gov/DietaryGuidelines) and eat a variety of foods. You can also find specific recommendations for pregnant and breastfeeding moms at the government’ s website, ChooseMyPlate.gov. And next time you’ re tempted to order the triple burger, cheese, special sauce and fries, keep this in mind: What you eat during pregnancy may influence your child’ s future taste buds!
- Avoid the following:
- Raw meat. Uncooked or undercooked meat, poultry or seafood can be contaminated with coliform bacteria, toxoplasmosis and salmonella, all very dangerous during pregnancy.
- Deli meat and certain cheeses. Deli meat can be contaminated with the listeria bacteria, which can cause miscarriage. If you’ re eating deli, make sure it’ s been heated to steaming. The same goes for smoked seafood (think lox), paté (unless it’ s canned or shelf stable) and soft cheeses like Brie, Camembert, Roquefort and feta, unless they’ ve been made with pasteurized milk.
- Certain types of fish. Avoid fish high in mercury such as shark, swordfish, king mackerel and tilefish. You can eat up 12 ounces (two average meals) a week of low–mercury fish and seafood such as shrimp, canned light tuna, salmon, pollock and catfish. Stay away from raw shellfish, sushi and any locally caught fish that may have been exposed to industrial pollutants.
- Caffeine. Moderate caffeine consumption of 200 milligrams a day or less is generally considered safe during pregnancy. A 12–ounce cup of coffee has about 200 milligrams; a 12–ounce serving of Coca–Cola has about 54 milligrams; a 1–ounce milk chocolate bar has about 6 milligrams; and a glass of chocolate milk or hot cocoa may have about 5 milligrams. Research is continuing on whether there is a higher risk of miscarriage associated with a higher intake of caffeine, so stick to one cup of coffee (or the equivalent) per day.
- Milk. Make sure your milk is pasteurized; unpasteurized milk can contain listeria.
- Alcohol. Forget about it. No amount of alcohol is safe during pregnancy.
- And, don’ t smoke … or ask for help to quit.
Pregnant Women Ask: How Much Weight Should I Gain?
That depends on how much you weigh when you get pregnant. If your weight is normal when you get pregnant, aim for about 25 to 35 pounds; if you’ re underweight when you get pregnant, bump that up to 28 to 40 pounds. If you’ re overweight when you get pregnant, try not to gain any more than 15 to 25 pounds; and if you’ re obese, aim for 11 to 20 pounds. If you’ re pregnant with twins, however, you should usually aim for 35 to 45 pounds for women of normal weight; for triplets, a gain of 50 to 60 pounds is recommended.
Exercise and Pregnancy
Pregnancy is no excuse for lying on the couch, especially once your energy returns. Moderate levels of physical activity are perfectly safe if you don’ t have any health problems (but always check with your health care professional first). Exercise is also the best way to reduce the insulin resistance that can lead to gestational diabetes and to maintain normal blood sugar levels if you do develop it.
Walking, bicycling, swimming and even weight training with relatively low weights are all fine. Skip intensive activities like ice hockey, soccer, basketball and downhill skiing; exercises like tennis and horseback riding that could lead to falls; and exercises that require you to lie on your back. And now is probably not the best time to take up jogging, although if you’ ve always jogged, you should be fine. As for intensity, take it down a notch from what you were doing pre–pregnancy. You should be able to comfortably carry on conversation while working out.
If you weren’ t exercising before your pregnancy, start slowly, gradually working your way up to 30 minutes a day, most days of the week. And be careful to drink plenty of water before, during and after you work out, and avoid becoming overheated.
Pregnant Women Ask...
What’ s the best exercise during pregnancy?
Although there’ s no evidence as to the "ideal" exercise during pregnancy, we suggest swimming. The water supports your belly, helps you feel lighter, reduces the risk of becoming overheated or falling and provides an excellent aerobic workout.
©2017. National Women’ s Health Resource Center, Inc. All rights reserved. All content provided in this guide is for information purposes only. Any information herein relating to specific medical conditions, preventive care and/or healthy lifestyles does not suggest individual diagnosis or treatment and is not a substitute for medical attention.