dietary guidelines from Britain-- interesting

[frugalmum]

These are dietary guidelines from Britain for pregnancy, it's interesting to see how they differ from the US:

http://www.babycentre.co.uk/pregnancy/nutrition/diethealthypregnancy/

Namely-- up to two alcoholic drinks up to to twice a week (4 a week!) is considered ok.

No calorie increase is recommended for the first two trimesters, and only 200 calories for the third trimester.

Recommended weight gain is 22-27 pounds. 

In lieu of prenatal vitamins 400 mcg folic acid for the first 12 weeks and 10 mcg vit D throughout pregnancy can be taken.

I find the calorie recommendations especially remarkable given that until recently American women were told to consume 500 extra calories a day for the whole pregnancy-- now they are saying 300 extra.  And unless I missed it-- there is no warning against preserved meats as I often hear in the US?

[bstandlee]

Very interesting about the alcohol...I'm tempted to become British!

I was a little disappointed to read about the soft cheeses...I was hoping that was just something American dr's were really anal about! Why is it I only seem to want foods on the banned list? Blue cheese, lunch meats, sushi...mmmmmmm!

[HappyMamaBeth]

After reading some recent research, I have enjoyed a couple glasses of wine this pregnancy (like half a glass on two occasions and a glass last week).  That's something I NEVER would have done with my first two pregnancies!!!

Unfortunately I'm so over the weight gain standards.  Part of my problem is that if I'm not constantly eating, I'm nauseous... and I know I don't always make the best choices (bad willpower!).  But I definitely can respect the recommendation.  I'm sure my pregnancy would probably be physically easier if I weren't as heavy as I am.

[erigeron]

I'm not sure I buy the weight guidelines on either side of the pond... I'm up 35 lbs over my dry weight (31 weeks right now) and as far as I'm concerned, I eat when I'm hungry (which, in the first trimester, was all the time), I eat stuff that's good for me, so clearly this is how much I was meant to gain and anybody who has a problem with it can go soak their head.

I don't see how they can recommend no calorie increase in the first two trimesters. Where are the calories to make baby supposed to come from? Ugh.

I read that some leaders in the UK medical community are starting to take a harder line on alcohol and advocate abstinence like they do Stateside.

And as for the cheese, my understanding has been that pasteurized cheeses are OK. I guess that depends on who you ask, though.

[lookingforaname]

I gained in the 40 pound range for all three of my previous pregnancies.  After a year of nursing, every time, I was back to being totally fine - 120 lbs at 5 foot 4 inches. 

In pregnancy #4 I'm up to 34 right now (at 30 weeks) and not worried at all.  

I just feel like a wider range is preferable - giving people a number like 25 seems so unreasonable, especially considering my experience.

Also - yes, it seems like you can have soft cheeses if it's pasturized, which is like all cheeses you find in America - I eat Feta and Brie all the time.  What I crave and can't wait for is Sushi!!! 

[erigeron]

I like salmon sushi, but can live without it... what I really, really love is the rice, nori, and vegetables. That's still okay! We had shrimp sushi a few months ago, which wasn't half bad.

[lookingforaname]

No - for me, it's the fish.  If I had the choice between sushi and sashimi, I'd choose Sashimi.

[Smokering]

Interestingly, my midwife said she wasn't so concerned about the fish aspect of sushi (which I don't like anyway - I always get chicken or vegetarian), but the rice. Rice that's left sitting out can get pretty icky , and is apparently a major source of food poisoning. I vaguely remember hearing that when I did a food health and safety course, years ago.

I have had sushi a few times while pregnant, though. Only from the less-dubious-looking establishments...

Isn't 10mcg of vitamin D a ridiculously tiny amount?

[frugalmum]

I don't see how they can recommend no calorie increase in the first two trimesters. Where are the calories to make baby supposed to come from? Ugh.

I assume, since the baby doesn't add much weight until the third trimester, the woman's body doesn't need many extra calories to "make" a baby since it is what the female body is designed to do.  I think the baby weighs less than two pounds at the beginning of the third trimester?  And as the baby grows the placenta grows, which adds weight too.

[katelove]

Originally Posted by frugalmum 

I assume, since the baby doesn't add much weight until the third trimester, the woman's body doesn't need many extra calories to "make" a baby since it is what the female body is designed to do.  I think the baby weighs less than two pounds at the beginning of the third trimester?  And as the baby grows the placenta grows, which adds weight too.

Pretty much. And I would also guess that the majority of us aren't eating the bare minimum of calories we need in the first place so there are probably already some "spare" calories in our diets anyway.

[erigeron]

I can see that about the rice. Our sushi was made by my husband so we knew exactly how long it had been kept under what conditions.

I suppose the body doesn't need many more calories to make baby, but what about making placenta, enlarging the uterus, adding more blood? I dunno, I know there has to be some reason I was starving in the first trimester. I know I'm atypical, but I'm not a freak of nature.

[Smokering]

Hmm. I think a pregnant woman definitely needs more nutrients... I mean, it's common as dirt for women to become anaemic in their second trimester once their blood volume increases, because the average diet just doesn't have enough iron in it to keep up. And most women need more iodine, folic acid and vitamin D than their diets can provide, as well. I guess you could swap empty calories for nutrient-dense food in the average Western diet and end up with a much healthier diet without any (or much) caloric increase... but the guidelines don't seem to be saying that, at least not very clearly.

Babies do only weigh a couple of kilos, but it's important to remember that those kilos contain stuff like bone (which requires a lot of calcium), blood (which I assume requires iron), eyes (which require a lot of zinc) and so on, and so forth. So again, in the average Western diet, it'd probably take a fair few extra calories to get those nutrients. We eat stuff that's so denatured, not bioavailable, full of phytates and antinutrients, etc, that our nutrients are often spread out over a whole bunch of empty calories. Like folic acid in "enriched" white bread... or iodine and fatty acids in fish that's covered in white breadcrumbs or white flour batter and served in a burger bun... or iron in sausagemeat that's again, mostly white breadcrumbs and artificial flavourings. You know?

I dunno. I come from a Traditional Foods-type perspective on this, so the British dietary guidelines seem pretty weedy to me. I don't like the emphasis on low fat, or the rather weak advice to "try" to eat wholegrain carbs... I'm no angel when it comes to refined carbs myself, but the guidelines imply that white flour and rice are almost as good as their "whole" counterparts, which I think is ridiculous.

[eclipse]

I'm a little confused because the numbers don't add up. With no increase in calories in the first two trimesters, you should be starting the 3rd at your pre-preg weight. If they only recommend 200 calories extra a day for the last 12 weeks, that's an extra 1400 calories a week, or 16800 for 12 weeks. Divide that by the 3500 calories per lb, and you only get a weight gain of 4.8 lbs - not the 22-27 they recommend. Is my math wrong, or are they just throwing out numbers at random and hoping no one does the math?

I get only 16 lbs weight gain for a 40 week pregnancy, even if you eat those 200 extra calories every day, not just the 3rd tri.

[fertilemyrtle]

To me, the interesting thing is that across countries and cultures, there are different "recommendations" but I'm not sure they produce healthier moms or babies.   In France, where I was visiting my partner's cousin who is a midwife, the MAX weight gain recommended is 25 pounds.   Whereas that's our minimum for a normal weight woman (25-35 pounds is the US rec).   She's happy with a patient who only gains 15 pounds, and mortified by one who gains 35.   Similarly, in Japan, the weight guidelines are even less than in France.

To me, it seems so obvious that the range of only 10 pounds for normal weight women is ridiculous (that all normal weight women should gain between 25-35 pounds).  I work with 50-60 pregnant women every week for the past 10 years (prenatal yoga teacher, but I'm also trained as a doula and CBE), and in general, yoga women are healthy and mindful.   Some gain 15 pounds, some gain 45.   And both of those numbers seem healthy - babies are a good size, moms return to prepregnancy weight eventually, there are the usual aches and pains of pregnancy but nothing too serious.   obviously, this is my anecdotal experience, but i really do watch carefully, and encourage people not to beat themselves up either way for too little or too much weight gain.

All that being said, we all know we have a problem in this country with an over-abundance of processed, crappy foods (great post Smokering!), and a resulting population that is too heavy to be healthy.   Even a "normal weight woman" that I mentioned above, based on the latest graphs and charts, might be carrying 10-15 pounds of extra weight she really doesnt need.  So, continuing to be mindful about eating, and being *more* mindful when you're growing a baby, is something I really advocate for.  

FWIW,  i've noticed that I really don't need to eat many extra calories in pregnancy (and I've gained an average amount of weight so far - 21-22 pounds in 31 weeks).   When I'm more hungry than usual, i eat more, but I exercise less intensively than i did before pregnancy, so I'm eating about the same amount.  Someone above was trying to figure out the math of calories and pounds, and I've always found it can't be boiled down to a math equation!    I take comfort in knowing that unless you're really restricting yourself, baby will take what s/he needs and you'll get the rest.  

thanks for all the info everyone - i found it really interesting!

[Maurine]

Just wanted to chime in and say that I totally eat all kinds of cheeses.  I do avoid raw cheese (which is pretty darn hard to time here in the US, so it's not really an option). 

[scottishmommy]

Originally Posted by Smokering 

Hmm. I think a pregnant woman definitely needs more nutrients... I mean, it's common as dirt for women to become anaemic in their second trimester once their blood volume increases, because the average diet just doesn't have enough iron in it to keep up. And most women need more iodine, folic acid and vitamin D than their diets can provide, as well. I guess you could swap empty calories for nutrient-dense food in the average Western diet and end up with a much healthier diet without any (or much) caloric increase... but the guidelines don't seem to be saying that, at least not very clearly.

Babies do only weigh a couple of kilos, but it's important to remember that those kilos contain stuff like bone (which requires a lot of calcium), blood (which I assume requires iron), eyes (which require a lot of zinc) and so on, and so forth. So again, in the average Western diet, it'd probably take a fair few extra calories to get those nutrients. We eat stuff that's so denatured, not bioavailable, full of phytates and antinutrients, etc, that our nutrients are often spread out over a whole bunch of empty calories. Like folic acid in "enriched" white bread... or iodine and fatty acids in fish that's covered in white breadcrumbs or white flour batter and served in a burger bun... or iron in sausagemeat that's again, mostly white breadcrumbs and artificial flavourings. You know?

I dunno. I come from a Traditional Foods-type perspective on this, so the British dietary guidelines seem pretty weedy to me. I don't like the emphasis on low fat, or the rather weak advice to "try" to eat wholegrain carbs... I'm no angel when it comes to refined carbs myself, but the guidelines imply that white flour and rice are almost as good as their "whole" counterparts, which I think is ridiculous.

I've always wondered why women have to gain weight during pregnancy. Why can't we just up our nutrients and gain 10-15 lbs or so?

[erigeron]

It takes calories to make a baby, not just vitamins.

10-15 lbs weight gain could be had in the changes to your body without even taking into account the weight of the baby.

[Smokering]

Sure, but a lot of people eat far more daily calories than they need... so a 10-15-pound weight gain during pregnancy could include the mother losing excess weight, right? Meaning that there could still be ample calories/weight going to the baby? Obviously that wouldn't work for everyone, though...

[tourist.]

Just to add my two cents...During my most recent first trimester I was absolutely starving and losing weight off of my already borderline underweight body.  I find it hard to believe that my body wasn't burning calories to undertake making a person, even in the early stages. 

This time, as well as last, I have made little adjustment to the overall amount of calories I consume yet I am right on track to gain about 40 pounds like I did last time.  I am pretty sure it would be next to impossible for me to gain less than 35 pounds, not to mention gaining only 20 lbs.  I would be literally starving myself.  Yikes!  I'm glad I live here where neither my OB nor midwife bat an eye at my gain (and espcially after my body's excessive pp weight loss last time, they encourage it).

Mmm sushi.  I eat it when I can find the time to get to the place I love.  I've also heard that about the rice being more risky than the fish.  Interesting.

[erigeron]

I don't think I buy that a lot of people eat WAY more calories than they need. I calculated it and for a person to gain 5 lbs/year they would have to eat around an extra 50 calories a day, which is, oh, a tangerine or a small piece of cheese. Someone would have to be gaining at the rate of 30 lbs/year or more to have enough "extra" calories in their diet to support a growing baby without altering their diet.

I don't know, this whole conversation sort of gets my back up a little just because the right to eat what you want and what your body asks for and not feel guilty is very much under fire for comparatively affluent women in contemporary "Western" society. In many places in the world today people are dying of starvation, but middle-class Westerners are guilting each other (and being guilted by the patriarchal-industrial complex) about eating a few extra potato chips, vilifying "carbs", and in general advancing this ethic that seems to treat food as this necessary evil. The natural endpoint of this seems to be the idea that calories and fat aren't really necessary and that if you eat them you're weak. And that way anorexia lies. I realize that nobody in this thread is advocating we go that far, but I do hear a bit of "why do we need those pesky calorie things, anyway?" sort of rhetoric and I think that has been stuffed into our brains from day one. Calories aren't the enemy. We need a certain number... and they taste good. And that's not bad. My sister is a very intelligent and logical person, but when she was in high school she drew the conclusion that if it's better to eat 50 grams of fat a day than 100, it's better to eat 0 than 50, and adjusted her diet accordingly. It really, really bothers me that we live in a society with such messages that somebody can even draw such a ludicrous conclusion.