Monday, February 26, 2007

By Rebecca B. Singson, MD, FPOGS

Whenever it’s holiday time, it becomes challenging for people to maintain their weights because of the frequent social engagements and office parties loaded with mouth-watering, irresistible goodies. It becomes particularly challenging for the pregnant woman who has an increased appetite and feels she “is eating for two” but is already overweight. If you are slim and non-pregnant, gaining extra weight and eating high calorie but low nutritional food may not be such a great issue. But to the infanticipating woman, there may be more serious consequences if she is not meticulous in watching what she eats so here’s the why and how of being more prudent with your palate during party time.

WHY YOU SHOULD NOT GAIN TOO MUCH WEIGHT

Too many calories and extra pounds can put you at a higher risk for pregnancy complications such as hypertension or diabetes, and may make labor and delivery more difficult. Although you do need extra calories during pregnancy, particularly during the last trimester, you also need lots of extra nutrients, so those extra calories need to be chosen wisely. A woman who is not pregnant needs between 1,800 and 2,200 calories per day. When you are pregnant, contrary to popular belief, you only need to increase your calories by about 300 per day so keep in mind that its quality not quantity is what matters. Remember that if you gain way beyond the prescribed weight, your chances of having a large baby also increases, which in turn may also increase your chances of ending up with a Cesarean section.

Besides all that, the latest, and by far the most disturbing finding by researchers at Lombardi Cancer Center in Washington, DC, and in Finland is that women who gain more than 50 pounds during pregnancy, and did not losing the excess weight after pregnancy, can triple their risk of developing breast cancer after menopause. A lesser pregnancy weight gain of 40 pounds can still increase breast cancer risk by 40%. Knowing that should stimulate you to be more watchful of the weighing scale.

Researchers have shown that pregnancy weight gain has been linked to increased estrogen levels, which in turn is believed to increase breast cancer risk in a similar way that postpartum obesity does too. Women who gained within the normal limit of 25-35 lbs. during pregnancy were not associated with increased breast cancer risk.

If despite eating moderately, you are gaining more than 2 lbs./wk., you must alert your obstetrician since any rapid weight gain, especially if associated with marked fluid retention and an increase in blood pressure and possibly protein in the urine, can be a marker for the onset of preeclalmpsia. This is a disorder that can be harmful, if not fatal to you and your baby.

HOW MUCH IS TOO MUCH?

If you are of average weight, it is recommended that you gain is about 25 pounds during pregnancy. Only two to four pounds of that goes on during the first trimester. By 20 weeks, you should have gained 7-10 lbs. and the remaining weigt is added at about a rate of half a pound to one pound per week after that. Some women even drop their weight during the first trimester due to nausea and vomiting but usually recover the weight loss in the course of pregnancy. Underweight moms can afford to gain more weight, at least 28 to 40 pounds, so they don’t end up with a low birth weight baby. But if you’re already carrying an extra baggage of fat by the time you get pregnant, its best that you limit your weight gain to 15-20 lbs.

If you want to know where all that weight goes, here's how the weight gain is ideally distributed:

Baby: 7 pounds
Placenta: 1 pound
Amniotic fluid: 2 pounds
Blood volume: 4 pounds
Body fluids: 3 pounds
Uterus: 2 pounds
Breasts: 1 pound
Fat & protein storage: 7 pounds

WHAT YOU CAN DO

So you can’t say no to these social obligations. At the same time, you’d hate to miss out on the fun. So here are tips to help you keep the scale from tipping over.

PRIORITIZE YOUR REQUIREMENTS. Make sure you meet your daily requirements first before you allow yourself the treats. Get your fill of the salads and protein sources while filling your healthy carbohydrate requirements. Ear your fruit first before you hover over the dessert table. Hopefully, that would have killed your craving for the pastry department.

AVOID STARVATION. It is truly difficult to control your appetite if you arrive ravenous during a party. You are bound to eat everything in sight! So before you go to the party, have a nutritious snack like a granola or muesli bar, veggie sticks with yoghurt-garlic dip or some dried fruits and nuts so you won’t be obsessing over the buffet table.

DRINK BEFORE YOU LEAP. If you have the urge to splurge, gulp down a glass of water, fruit juice or some soup (preferable clear than creamed). That will instantly appease your grumbling insides and allow you to be more sane and prudent in your choice of food.

CHEAT SENSIBLY. If you must absolutely give in to your sweet tooth, at least make the wiser, more nutritious choice, lower calorie choice. An oatmeal or ginger cookie is better than an empty sponge cake or a fatty cheese cake.

IF YOU MUST INDULGE, EAT ONLY A PORTION OF IT. If you cant resist the cheesecake, instead of gobbling up the whole slice, eat only half or a few bites of it. Remember, it doesn’t matter whether you have had fifty bites or only two. In the end, your mouth is empty. But the fifty bites will take your weight farther down the scale.

BURN WHAT YOU EAT. Just because you are pregnant doesn’t mean you can’t exercise. As a rule, you can still continue your exercises, dance or low impact sports (swimming, golf, tennis doubles). Remember that brisk walking for 20 mins., will raise your metabolism the rest of the day and cause you to burn calories faster than if you did not exercise at all.

DON’T BE A STRESS CHOMPER. Holidays can be stressful times especially when you have to socialize and beat you office deadlines at the same time. So resist the impulse to munch away your stress. Be prepared with your arsenal of anxiety busters like yoga, meditation, massage (caution: masseuse must be trained on pregnant women or premature labor may be induced), instead of taking it out on food.

Remember that staying within your prescribed weight will insure a more favorable outcome for your pregnancy as well as prevent your risk for breast cancer. That’s really worth dieting for.