By Joseph Hazan,M.D.,FACOG
The IOM (Institute of Medicine) has
issued
new recommendations on
nutrition during pregnancy in 2009.
BMI of 19.8 to 26 prior to pregnancy is
considered normal.
If it is below or above these numbers,
efforts should be made to adjust
weight gain during pregnancy to the
prepregnancy BMI.
If the Prepregnancy BMI is below 18.5
a total pregnancy weight gain of
28-40 lbs is recommended.
This is usually feasible with a weekly
weight gain of about 1- 1.3 lb during
the second and
third trimesters.
If the Prepregnancy BMI is between
18.5 and 24.9 (normal) then a 25-35 lb
weight gain during pregnancy is
recommended.
This is usually accomplished
by a 0.8-1 lb per week weight gain
during the second and third trimesters.
If the Prepregnancy BMI is 25-29.9
(overweight) a total pregnancy weight
gain of 15-25 lbs is adequate.
This can be accomplished by gaining
0.5-0.7 lbs per week during the second
and third trimesters.
If the Prepregnancy BMI is over 30 (obese),
the total weight gain during
pregnancy should not exceed 11-20 lbs
and this can be accomplished by
gaining 0.5 lbs per week during the second
and third trimesters.
During pregnancy high-fat foods,
saturated fats and sweets should be limited.
Regular meals with adequate caloric intake
is recommended.
Calorie intake can be increased by
340 kcal per day during the second
trimester and 452 kcal per day in
the third trimester.
Excessive amounts of vitamin A
(over 10,000 IU)
should be avoided.
Iron supplementation is needed
in cases of iron deficiency anemia.
Folic acid 0.4 mg per day before and during
pregnancy is needed.
Calcium intake of 1 Gm per day is required.
Carbohydrate intake of 130 Gm per day is
recommended.
Protein intake of 0.6 Gm per pound
per day is recommended.
Fish safety with regards to mercury
contamination is important.
Information on fish and seafood
contaminants can be obtained at
www.fda.gov/Food/Food Safety/
Product-SpecificInformation/Seafood.
Also the Environmental Protection
Agency has information about local
mercury threat.
More information is available at
www.who.it/foodsafety/publications/chem/mercury.
Caffeine, alcohol,smoking and drugs
should be avoided.
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