Should pregnant women eat for two?

“It’s okay, you are eating for two.” This myth has lingered since ancient times until now. Yes, pregnant women need extra calories and nutrients, however, it should not be doubled.

Physiologically, a pregnant woman is required to gain some weight to cover the extra nutrients and calories needed during pregnancy but it does not mean that she needs to eat for two.

It is important to adjust the mother’s diet to ensure nutrients are taken within the range. In 2014, 38.9 million pregnant women worldwide were either overweight or obese. In Malaysia, according to the National Health and Morbidity Survey 2016, 14.6 per cent of pregnant women were obese.

Overweight and obese pregnant women are prone to diseases such as gestational diabetes and eclampsia. Being obese will increase the risk of complications during delivery, and having comorbidities will make it worse.

The baby of a pregnant lady with a Body Mass Index (BMI) of more than 40 has three times the risk of developing brain and spine abnormalities. Later on in life, the child will be prone to become obese and have diabetes.

Being active and having a normal BMI prior to pregnancy is important. Pre-pregnant women need to be well informed and adequately educated on this. It is a must for them to know their BMI way before getting pregnant as it is a part of having a healthy pregnancy.

Achieving a healthy pre-pregnancy weight can improve the chances of getting pregnant and minimise the risk of complications during pregnancy.

In addition, pre-pregnancy BMI will affect recommendations for weight gain during pregnancy. The ideal weight gain is different for different BMI categories. The recommended total weight gain for a pregnant woman with a normal BMI is 11.5kg to 16kg, for those who are overweight, it is 7kg to 11.5kg while for those who are obese, it is 5kg to 9 kg.

How can this be achieved? It is crucial for all pregnant women to know what a healthy and balanced diet is. Essentially, they have to focus on eating high-quality food rather than eating food in large quantities.

This can be achieved by practising “Pinggan Sihat Malaysia” (Malaysian Healthy Plate), which teaches one to eat “Suku-Suku-Separuh” (quarter plate of proteins and carbohydrate and half plate of vegetables and fruits) for every main meal of the day.

Food items from carbohydrate should preferably be from complex carbohydrates such as basmati/brown rice and wholemeal bread, whereas chicken, eggs, meat and fish are high in protein. Vegetables and fruits are high in vitamins, minerals and fibres, thus making them a necessity in the diet.

Consumption of sweet pastries, cakes and biscuits plus beverages high in sugar needs to be controlled by eating a healthy and filling meal immediately when hungry. Adequate amount of protein may help to reduce cravings. Stay hydrated as dehydration may cause sugar craving.

Also, replace junk food with fresh fruit. Choose modest quantity of dark chocolate instead of milk chocolate, get enough sleep as sleep deprivation is associated with increased hunger, and get some exercise.

The belief that pregnant women cannot exercise is a myth. It is advisable to do mild exercise and keep fit during pregnancy to curb sugar craving and excessive weight gain.

Some of the preferred exercises are walking, swimming and gardening. Just 30 minutes per session and five sessions a week will do. For those who have just started, keep it even shorter. Start with five minutes a day and increase it gradually.

In summary, controlling the weight gain for pregnant women is critical to ensure both mother and baby are healthy, not only during the pregnancy but also for the rest of their lives.

The article was written by Dr Aishah Jamilah Mohd Salleh (Doctor of Public Health candidate), Professor Dr Moy Foong Ming and Professor Dr Noran Naqiah Hairi. It was first published on New Straits Times, Malay.news and Free Malaysia Today websites