Guidelines Dietary - Eat For Health

Appropriate steady weight gain during pregnancy is important to optimise the health outcomes (short term andlong term) for the infant and the mother. 288,289 Steady weight gain helps to avoid adverse effects on specific foetalorgan systems during critical periods (e.g. neural tube 6–8 weeks, kidney development 28–30 weeks).Guideline 1Weight loss diets are not recommended at any time during pregnancy. 289Mothers who gain excess weight during pregnancy are unlikely to lose it later, 290 although dietary patterns thatcomprise regular meals, plenty of fruit and vegetables, high-fibre bread and restricted high sugar snacks 291 mayhelp women reach a healthy weight after giving birth.In recent years there has been increasing awareness of the importance of perinatal nutrition in terms of thedevelopment of disease in adulthood, known as foetal origins of disease or Barker hypothesis. 292 There is alsoincreasing evidence of the importance of growth and optimum nutrition in relation to cognitive development 293and future bone mass. 294Evidence of a probable association between babies born to mothers who smoke during pregnancy and a higherrisk of overweight or obesity in adolescence and adulthood supports recommendations that pregnant womenshould not smoke cigarettes (Grade B; Evidence Report, Section 17.5). 52,54,59-61,243For further information on pregnant and breastfeeding women, see the Infant Feeding Guidelines. 295Table 1.2: 2010 Institute of Medicine recommendations for total and rate of weight gain during pregnancy, bypre-pregnancy BMIPre-pregnancy BMITotal weight gain in kgRates of weight gain* 2nd and3rd trimester in kg/weekUnderweight (< 18.5 kg/m 2 ) 12.5–18.0 0.51 (0.44–0.58)Normal weight (18.5–24.9 kg/m 2 ) 11.5–16.0 0.42 (0.35–0.50)Overweight (25.0–29.9 kg/m 2 ) 7.0–11.5 0.28 (0.23–0.33)Obese (≥ 30.0 kg/m 2 ) 5.0–9.0 0.22 (0.17–0.27)Multiple pregnancyTwin pregnancy 15.9–20.4 0.7Triplet pregnancy 22.7 —Note: *Calculations assume a 0.5–2kg weight gain in the first trimesterSource: Institute of Medicine 2009. 289Table 1.3: Weight gain during pregnancy: recommendations for Asian women, by pre-pregnancy BMIPre-pregnancy BMI (kg/m 2 )Total weight gain in kg(during pregnancy)Weight gain per week in kg(after 12 weeks)27.5 ≤ 7.0 —Source: Adapted from Institute of Medicine 289 and matched with Asian BMI cut-offs.Achieve and maintain a healthy weightNational Health and Medical Research Council25