Pregnancy and Weight Gain

By the end of this session you will:
• Understand the relationship between weight and increased risk of hypertension.
• Understand the relationship between weight and increased risk of gestational diabetes.
• Identify 3 tips to decrease fat in your diet.

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Activity 1:

List two diseases related to weight/obesity:
1.
2.

Pre-pregnancy Weight

The following table has the weight in pounds that you started at pregnancy. You can use this to determine if you are gaining too much weight.

Remember!! Dieting is not the best way to maintain a healthy weight. It is better to make healthy eating changes. Become aware of portion sizes and eat a variety of foods from the food guide pyramid.

Activity 2:
True or False

Hypertension
• Hypertension is high blood pressure, a serious problem that affects one out of every six people. Many people are not aware they have high blood pressure because they don't have any symptoms.  During pregnancy, it can be more serious because it can affect both you and the baby.

• Blood pressure is the measurement of the pressure of blood against the walls of blood vessels as it's pumped through the body. The top number (systolic) measures pressure during a heartbeat. The bottom number (diastolic) measures pressure between heartbeats. Non-pregnant hypertension is classified as the top number over 130 and the bottom number 80 and above.

Activity 3:

How Does High Blood Pressure Affect Pregnancy?

Serious complications can occur during pregnancy because of high blood pressure. It can cause a decreased supply of blood and oxygen to mom and baby. It can also lead to:

• Kidney problems in mom
• Breathing problems
• Stroke
• Growth problems for baby

Nearly 5-10% of pregnant women will develop high blood pressure. It usually develops after the 24^th week of pregnancy. The women more at risk are:

• 1^st pregnancy under 17 or over 35
• Family history of high blood pressure
• Multiple fetuses (twins or triplets)
• Poor diets
• Overweight
• Smoking
• Health problems (diabetes, kidney disease)

High blood pressure in most women will go away after the baby is born.  Women with kidney disease, diabetes or other health problems may continue to experience high blood pressure after the baby is born.

Toxemia and pre-eclampsia are complications from high blood pressure. Warning signs include migraine type headaches that won't go away, blurred vision or spots, dull aching pain in your upper abdomen, heartburn, increased swelling (face and hands), decrease in baby's movements. If you experience any of the above signs or symptoms contact your physician.

What can you do to prevent or control hypertension?
We can do something about some of the risk factors for hypertension like diabetes, over weight, too much salt in the diet or inactivity.  Other risk factors may be genetic and it's hard to do anything about genes.

So what can you do?
• Watch what you eat (eat the right amount of foods).
• Watch how much you eat (know your portion sizes).
• Eat a variety of foods from the food guide pyramid.
• Check fat grams in diet.  No more than 30% of calories should come from fat and less than 12% from saturated.
• Increase your activity level.
• Follow a diet rich in fruits and vegetables, grains and low fat dairy products.
• The DASH diet is a good diet for control of high blood pressure.  To find out more about this diet click on the links below:

National Institutes of Health
Center for Science in the Public Interest

There are several kinds of diabetes:
• Insulin dependent or Type 1 normally begins at birth or early in life. Type 1 is usually regulated by insulin injections.
• Non-insulin dependent or Type 2  characterized by high blood sugar levels and obesity. Type 2 is treated through diet, exercise and oral medication.
• Gestational diabetes begins during pregnancy and usually ends after birth. About 3-5 percent of all pregnant women in the United States are diagnosed with gestational diabetes.
     • Gestational diabetes usually begins in the 20^th- 24^th week of pregnancy.

If the baby is too big, a cesarean delivery may be necessary. The baby is also at risk of developing type 2 diabetes later in life.

What are the risk factors?
Any woman can develop gestational diabetes during pregnancy. The risk factors identified as increasing the risk are:

How is gestational diabetes treated?
A diet for gestational diabetes is the first course of action. Your health care professional will send you to see a dietitian for an individualized diet. This special diet helps keep the mom's blood sugar levels in the normal range. Gestational diabetes is also treated with insulin injections if diet alone does not work.

What is an appropriate meal plan for gestational diabetes?

If you gain too much weight the extra fat gained makes your body produce more insulin to keep your blood sugars normal. Its' important to eat a proper diet to keep blood sugars normal.

Activity 4:

Its' important to get all the nutrients that you will need for you and the baby. The best way to cut calories without depriving you or the fetus of needed nutrients is to cut back on fats and fatty foods.

Choose lean cuts of meat:
• Beef = top round, tenderloin, sirloin, chuck arm
• Pork = tenderloin, top loin, rump half
• Veal = arm steak, cutlet, sirloin chop
• Lamb = leg, sirloin roast, loin & blade chops
• Fish = fresh, or packed in water if canned
• Poultry = fowl with skin removed

• Avoid fried foods. Bake, Broil or roast.

• Avoid chips, fries or doughnuts. Try pretzels, low-fat popcorn or breadsticks.

• Use vinegar, lemon juice or low calorie dressings instead of mayonnaise.

• Use butter and margarine sparingly.

• Use more spices and herbs to liven up food tastes.

• If you eat out try to stay away from  battered and deep-fried foods.

Healthy Snacks

• Plan snacks as a part of the day's food plan.
• Set aside a "snack spot" in the refrigerator and cupboard; keep it stocked with nutritious ready-to-eat snacks.
• Eat healty snacks at regular times, such as midmorning and mid-afternoon.
• Avoid snacks that are high in sugar, fatty and salty snacks, (candy and soda pop).

• Use the Food Guide Pyramid to Plan snacks. Balance the suggested number of servings per day with regular meals:

     • 6 to 11 servings from the breads, cereal, rice and pasta group
     • 3 to 5 servings from the vegetable group
     • 2 to 4 servings from the fruit group
     • 2 to 3 servings from the milk, cheese and yogurt group
     • 2 to 3 servings meat, poultry, fish, eggs, nuts and dry beans group.

Simple Healthy Snack Ideas

• Raw vegetables, such as celery, carrots, cauliflower, broccoli, green pepper, green beans, cucumbers, mushrooms or zucchini. Use a low-fat dip for a change of pace.

• Fresh fruit in season, cut in slices or halves, such as apples, oranges, bananas, peaches, grapefruit, grapes, melons, pears, plums or strawberries.

• Non-sugared cereals, snack mixes made with popcorn and whole grain cereal.
• Low-fat yogurt with fresh, frozen or canned fruit.
• Shakes with low-fat milk or yogurt and fruit.
• Unsweetened fruit juices.
• Low fat cheeses like mozzarella, string cheese.
• Low fat milk 1% or skim.

Activity 5:

Low-fat Cooking
The best way to reduce fat in the diet is change the way you cook:

• Buy lean cuts of meats, trim excess fat before cooking. Use low fat cooking methods: Bake, broil, grill, microwave, roast or stir-fry.
• Use non-stick skillets and vegetable cooking spray.
• Limit use of added flour, sugar, sauces or gravies in cooking.
• Season with spices and herbs instead of butter, margarine or cream sauces.
• Substitute plain low fat yogurt for sour cream or mayonnaise, tomato juice for tomato sauce, and skim milk for whole milk or cream. Use low fat or part skim cheeses.
• Remove drippings after browning meats.
• Remove any layer of fat from stews or soups after cooking.
• Be creative in combining foods to add new variety in your meals.