The Institute of Medicine’s guidelines currently advise all pregnant women to increase calorie intake by 340-450 calories/day during their second and third trimesters, regardless of their body size at conception. Approximately 2/3 of women with obesity at the time of pregnancy will gain more weight than recommended, highlighting a need for evidence-based guidelines to optimize the health of this population and their offspring.
Results of clinical trial evaluating weight gain and two primary determinants in 54 women with obesity throughout pregnancies
The JCI, Most et al. describe the results of a clinical trial evaluating weight gain and its two primary determinants — calorie intake and energy expenditure– in 54 women with obesity throughout their pregnancies. The study, led by Leanne Redman at Pennington Biomedical Research Center, provides new and important insights into calorie recommendations for pregnant women.
Most et al.’s results contradict the Institute of Medicine’s recommendation that women with obesity should increase calorie intake during pregnancy, showing that mobilization of maternal fat stores provided sufficient energy to support fetal development.
Researchers also observed the following in gestational weight gain
The researchers also observed that gestational weight gain due to the increased blood volume, expansion of breast tissue and fetal mass, accounted for the 5-9 kg (11-20 pounds) that the Institute of Medicine advises women with obesity to gain during pregnancy. Therefore, even small increases in daily calorie consumption (~200 calories) led to excess weight gain in these women.
This study’s findings
This study’s findings refute the assumption that pregnant women with obesity require excess calorie intake to support a healthy pregnancy, instead suggesting that they would likely benefit from maintaining pre-pregnancy calorie intake and to focus on improving diet quality.
Discussion
Discussing the results of the trial, Most et al. emphasized that this and other studies of pregnant women with obesity are a crucial step to improving health outcomes associated with gestational weight gain for mothers and babies.
Source:
- Most, J. et al. (2019) Evidence-based recommendations for energy intake in pregnant women with obesity. Journal of Clinical Investigation. doi.org/10.1172/JCI130341.
Razi Berry is the founder and publisher of the journal Naturopathic Doctor News & Review, which has been in print since 2005, and the premier consumer-faced website of naturopathic medicine, NaturalPath. She is the host of The Natural Cancer Prevention Summit and The Heart Revolution-Heal, Empower and Follow Your Heart, and the popular 10 week Sugar Free Summer program. From a near death experience as a young girl that healed her failing heart, to later overcoming infertility and Chronic Fatigue Syndrome and Fibromyalgia through naturopathic medicine, Razi has lived the mind/body healing paradigm. Her projects uniquely capture the tradition and philosophy of naturopathy: The healing power of nature, the vital life force in every living thing and the undeniable role that science and mind/body medicine have in creating health and overcoming dis-ease. Follow Razi on social media: Find her on Facebook at Razi Berry, on Instagram at Razi.Berry, join her Love is Medicine group to explore the convergence of love and health, and find more Love is Medicine podcast episodes here.