Weight Debate

1. Nausea and Vomiting

For some women nausea and vomiting, often called hyperemesis or morning sickness, may occur in the early months of their pregnancy. It is a result of their body adjusting to the higher hormone levels of pregnancy. For women who experience this discomfort, there are some things they can try: read more »

There are certain foods and beverages that can harm your baby if you eat or drink them while you are pregnant. Here is a general list of foods and beverages that you should avoid while you are pregnant:

• Alcohol - Instead of drinking beer, wine, or a mixed drink, enjoy apple cider, tomato juice, sparkling water, or other nonalcoholic beverages.
• Fish that may have high levels of methyl-mercury - a substance that can build up in fish and harm an unborn baby. Don’t eat more than 12 ounces of any fish per week – that equals to four 3 ounce servings, each about the size of a deck of cards. During pregnancy, do not eat:
  • Shark
  • Swordfish
  • King mackerel
  • Tilefish
• Soft cheeses such as feta, Brie, and goat cheese and ready-to-eat meats including lunch meats, hot dogs, and deli meats. These foods may contain bacteria called listeria that are harmful to unborn babies. Cooking lunch meats, hot dogs, and deli meats until steaming hot can kill the bacteria and make these meats safe to eat.
• Raw or undercooked meat, fish, and poultry. Avoid raw fish dishes, such as sashimi and some types of sushi and ceviche. When raw or undercooked, these foods may contain harmful bacteria. Cook fish, meat, and poultry thoroughly before you eat them.
• Large amounts of caffeine in beverages. If you are a heavy coffee, tea, or soda drinker, talk to your doctor about whether you should cut back on caffeine. You can try a decaffeinated version of your favorite beverage, a mug of warm low fat or fat free milk, or sparkling mineral water.
• Anything that is not food. Some pregnant women may crave something that is not food, such as laundry starch or clay. Talk to your doctor if you crave something that is not food.

Ask your doctor for a complete list of foods and beverages that you should avoid while you are pregnant.

Source: www.win.niddk.nih.gov

If you are a healthy woman who is pregnant and you are not already highly active or doing vigorous intensity activity, you should get at least 150 minutes of moderate intensity aerobic activity a week during your pregnancy and the postpartum period. It is best to spread this activity throughout the week.

If you are pregnant and you engage in vigorous intensity aerobic activity or if you are highly active, you can continue physical activity during your pregnancy and the postpartum period, provided that you remain healthy and discuss with your doctor how and when activity should be adjusted over time.

Almost all women can and should be physically active during pregnancy, but talk to your doctor first, particularly if you have high blood pressure, diabetes, anemia, bleeding, or other disorders, or if you are obese or underweight.

Regular, moderate intensity physical activity during pregnancy may:

• Help you and your baby to gain the proper amounts of weight.
• Reduce the discomforts of pregnancy, such as backaches, leg cramps, constipation, bloating, and swelling.
• Reduce your risk for gestational diabetes – diabetes found for the first time when a woman is pregnant.
• Improve your mood and energy level.
• Improve your sleep.
• Help you have an easier, shorter labor.
• Help you to recover from delivery and return to a healthy weight faster.

“Fish to avoid” is for everyone – but especially for women who are pregnant or might become pregnant, nursing mothers, and young children. Some fish and shellfish contain higher levels of mercury that may harm an unborn baby or young child’s developing nervous system.

Knowing what fish to avoid will help you gain the health benefits from fish and keep your exposure to mercury, Polychlorinated biphenyls (PCBs), and other toxics low.

AVOID these fish due to mercury:
Women who are or may become pregnant, nursing mothers, and young children should NOT eat:

• Mackerel (King)
• Shark
• Swordfish
• Tilefish
• Marlin (imported)
• Tuna Steak
  • Bluefin
  • Bigeye (imported longline)
  • Yellowfin (imported longline)

( Red Text: Overfished, farmed, or caught using methods harmful to marine life and/or environment).

Safe to Eat
It is safe to eat 2 to 3 average meals a week of a variety of fish and shellfish that are lower in mercury. Some fish low in mercury are:

• Anchovies
• Butterfish
• Catfish
• Clams
• Cod (Pacific)
• Crab (Blue, King, Snow) (US, Canada)
• Crab-Imitation
• Flounder/Sole (Pacific)
• Herring
• Mackerel (canned)
• Oysters
• Pollock – Fish sticks
• Salmon
• Sardines
• Scallops
• Shrimp – Prawns (US, Canada)
• Squid – Calamari
• Tilapia (US, Central/South America)
• Trout
• Tuna – canned light

Albacore (“white”) tuna has more mercury than canned light tuna. When choosing your meals of fish and shellfish, you may eat 1 average meal of albacore tuna per week.

An average meal is:
A seafood serving or “average meal” is about the size and thickness of your hand, or 1 ounce for every 20 pounds of body weight. Example:

• 160 pound Adult = 8 oz.
• 80 pound Child = 4 oz.

Check local advisories about the safety of fish caught by family and friends in your local lakes, rivers, and coastal areas. If no advice is available, eat up to 1 average meal per week of fish you catch from local waters, but don’t consume any other fish during that week.

Remember:
Fish is a great source of protein, vitamins, and nutrients. Fish is loaded with omega-3 fatty acids, which provide protection from heart disease and are great brain food for you, your children and if you are pregnant, for your unborn child.

So… eat fish, but make smart choices and choose fish that are low in mercury, Polychlorinated Biphenyls (PCBs), and other contaminants.

Visit www.doh.wa.gov for more information.

Listeriosis is a serious infection caused by eating food contaminated with the bacterium called Listeria monocytogenes.

Listeria monocytogenes can be found in soil and water, and in a variety of raw foods.

• Raw unpasteurized and pasteurized milk, high fat and other dairy products like butter and cream.
• Cheeses – particularly soft ripened and unripened varieties – examples: feta, Brie, Camembert, blue-veined cheeses, queso blanco fresco, cottage and ricotta cheese.
• Ice cream
• Raw fruits and vegetables
• Fermented raw-meat sausages
• Raw and cooked poultry
• Raw meats (all types)
• Raw and smoked fish and seafood – examples: smoked finfish and mollusks.
• Cooked crustaceans – examples: shrimp and crab

Listeria is killed by pasteurization and cooking, but, in certain ready-to-eat foods, such as hot dogs and deli meats, contamination may occur after cooking by the manufacture but before packaging.

Important!! Listeria monocytogenes can survive at refrigerated temperatures.

Anyone can get listeriosis, but it is especially harmful to pregnant women, their fetuses, newborns, older adults, and adults with weakened immune systems.

Listeriosis can be passed to an unborn baby through the placenta even if the mother is not showing signs of illness. This can lead to:

• Premature delivery
• Miscarriage
• Spontaneous abortion
• Stillbirth
• Serious health problems for the newborn, even death

Reduce Your Risk

• Avoid raw (unpasteurized) milk and raw milk products.
• Eat precooked and ready-to-eat foods as soon as you can, and don’t eat hot dogs, luncheon meats, deli meats, or leftovers unless they are reheated to steaming hot.
• Don’t get fluid from hot dog packages on other foods, utensils, and food preparation surfaces.
• Wash hands after handling hot dogs, luncheon meats, deli meats, and uncooked foods.
• Don’t eat refrigerated pâté or meat spreads. It is safe to eat canned or shelf-stable pâté and meat spreads
• Wash fresh fruits and vegetables.
• Avoid meat and seafood cooked rare.
• Do not eat refrigerated smoked seafood unless it is an ingredient in a cooked dish such as a casserole. Examples: salmon, trout, whitefish, cod, tuna, and mackerel which are most often labeled as “nova-style,” “lox,” “kippered,” “smoked,” or “jerky.” It is safe to eat canned fish such as salmon and tuna or shelf-stable smoked seafood.

Symptoms of Listeriosis

• Fever
• Chills
• Muscle aches
• Diarrhea
• Upset stomach

If infection spreads to the nervous system, symptoms may include:

• Headache
• Stiff neck
• Confusion
• Loss of balance
• Convulsions

Also, more severe complications can occur. Check with your doctor if you have these symptoms. A blood test will show if you have listeriosis.

Treatment
Antibiotics are given to treat listeriosis.

Overweight and obesity raise the risk of pregnancy complications for both mother and baby.

Pregnant women who are overweight or obese may have an increased risk for:

• Gestational diabetes – high blood sugar during pregnancy
• Pre-eclampsia – high blood pressure during pregnancy that can cause severe problems for both mother and baby if left untreated
• Cesarean delivery or complications with cesarean delivery

Babies of overweight or obese mothers have an increased risk of:

• Neural tube defects (defects of the brain and spinal cord)
• Stillbirth
• Prematurity
• Being large for gestational age

Being Overweight
Pregnant women who are overweight are more likely to develop:

• Insulin resistance – Insulin resistance is when cells do not respond properly to the hormone insulin, which carries blood sugar to cells for energy. It may result in high levels of blood sugar.
• High blood sugar.
• High blood pressure.

Overweight also increases the risks associated with surgery and anesthesia, and severe obesity increases operative time and blood loss.

Some studies have shown that gaining excess weight during pregnancy – even without becoming obese – may increase risks. It is important to consult with your obstetrician or other health care provider about how much weight to gain during pregnancy.

Weight Loss
Women who are overweight or obese and want to become pregnant should speak with their doctor about losing weight before becoming pregnant, and being physically active during pregnancy. Pre-pregnancy weight loss significantly reduces pregnancy complications.

Losing excess weight after delivery may help women reduce their health risks. If a woman developed gestational diabetes, losing weight will lower her risk of developing diabetes later in life.

Also called: Folacin, Folate, Pteroylglutamic acid, and Vitamin B9.

Folic acid and folate mean the same thing. Folic acid is a manmade form of folate.

We all need the B vitamin folic acid everyday. Our bodies use it to make healthy new cells daily for hair, nails, skin, and other parts of our body, and it also helps keep our blood healthy.

Some Food Sources of Folate

• Cooked dry beans and peas
• Deep green leaves like spinach and mustard greens
• Oranges and orange juice
• Whole grains
• Some cereals have 100 percent of the daily value of folic acid in each serving

Especially Important!!
Most women don’t get all of the folic acid they need through food alone. It is very important for women who can get pregnant to make sure they get 400 micrograms (400 mcg) of folic acid every day, starting at least one month before getting pregnant. If a woman has enough folic acid in her body before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine – anencephaly and spina bifida – by 50 to 70 percent.

Two easy ways to get enough folic acid each day are:

• Take a multivitamin everyday that contains 400 micrograms (400 mcg) of folic acid. Or you can take a small pill (supplement) that has only folic acid in it each day.

OR

• Eat a bowl of breakfast cereal that has 100% of the daily value of folic acid every day. Not every cereal has this amount. Check the label on the side of the box, and look for one that has “100%” next to folic acid.

Anencephaly Pronounced an-en-SEF-uh-lee
Anencephaly happens when most or all of the brain does not develop. Babies with this problem die before or shortly after birth.

Spina Bifida Pronounced spy·nuh bif-i-duh
Spina bifida is the most common birth defect in the United States. It is a type of neural tube defect (NTD). The neural tube is a narrow channel that folds and closes during the third and fourth weeks of pregnancy to form the brain and spinal cord. Spina bifida happens if the portion of the neural tube that forms the spinal cord does not close completely during the first month of pregnancy. As a result, the nerves that control leg movements and other functions don’t work. Children with spina bifida often have lifelong disabilities, and they may need many surgeries.

Remember:
For folic acid to help prevent major birth defects, a woman needs to start taking folic acid at least one month before she becomes pregnant and while she is pregnant.

For your health and safety, and for the health of your baby, you should not do certain physical activities while you are pregnant. Talk to your doctor about all physical activities that you should avoid during your pregnancy. Some physical activities to avoid are: (incomplete list)

• Avoid being active outside during hot weather.
• Avoid steam rooms, hot tubs, and saunas.
• Avoid physical activities, such as certain yoga poses, that call for you to lie flat on your back after 20 weeks of pregnancy.
• Avoid contact sports and activities that may cause injury, such as football and boxing, and horseback riding.
• Avoid activities that make you jump or change directions quickly, such as tennis or basketball. During pregnancy, your joints loosen and you are more likely to hurt yourself when doing these activities.
• Avoid activities that can result in a fall, such as in-line skating or downhill skiing.

Spina bifida (pronounced spy·nuh bif-i-duh) is a major birth defect of a baby’s spine. It is one of the most common, permanently disabling birth defects in the United States. Spina bifida, which literally means “cleft spine,” is characterized by the incomplete development of the brain, spinal cord, and/or meninges. Meninges is the protective covering around the brain and spinal cord.

The human nervous system develops from a small, specialized plate of cells along the back of an embryo. Early in development, the edges of this plate begin to curl up toward each other, creating the neural tube – a narrow sheath that closes to form the brain and spinal cord of the embryo. As development progresses, the top of the tube becomes the brain and the remainder becomes the spinal cord. This process is usually complete by the 28th day of pregnancy. But if problems occur during this process, the result can be brain disorders called neural tube defects (NTDs), including spina bifida.

There is no cure for spina bifida. The nerve tissue that is damaged or lost cannot be repaired or replaced, nor can function be restored to the damaged nerves.

Preventing Spina Bifida
Most, but not all, cases of spina bifida can be prevented.

Folic acid is a B vitamin that the body needs to make healthy new cells. It is very important for all women of childbearing age to make sure they get 400 micrograms (mcg) of folic acid (also called folate) every day, starting at least one month before getting pregnant. If a woman has enough folic acid in her body before and during pregnancy, it can help prevent major birth defects of the baby’s brain and spine (anencephaly and spina bifida) by 50 to 70 percent.

Although taking folic acid cannot guarantee having a healthy baby, it can significantly reduce the risk of having a child with a neural tube defect, such as spina bifida.

Women who have a child with spina bifida, or have spina bifida themselves, or have already had a pregnancy affected by any neural tube defect are at greater risk of having a child with spina bifida or another neural tube defect. These women may require more folic acid before they become pregnant.

Children with spina bifida can lead relatively active lives. Prognosis depends on the number and severity of abnormalities and associated complications. Most children with the disorder have normal intelligence and can walk, usually with assistive devices. If learning problems develop, early educational intervention is helpful.

Sources High in Folic Acid Include

• Dark green vegetables
• Egg yolks
• Some fruits
• Fortified foods such as some breakfast cereals, enriched breads, flours, pastas, rice, and other grain products
• Some multivitamins

If you are pregnant and follow a vegetarian diet, you can continue a vegetarian eating plan during pregnancy, but make sure you talk to your doctor first.

Your doctor may ask you to meet with a registered dietitian who can help you plan meals to make sure you are getting enough important nutrients, including protein, iron, vitamin B12, and vitamin D. Your doctor may also recommend that you take vitamin supplements.