Q: I know that pregnancy can cause weight gain and I’m really worried about it. What should I do or know to avoid this?
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A: Postpartum weight gain is indeed a burdensome issue, especially in our overly-developed world of obesity. A five-year prospective study published in 1994 compared women who had never been pregnant with those who have had at least one baby: The Caucasian moms gained two kilograms (4.4 pounds) and African-American moms gained three kilograms (6.6 pounds) more than the women who did not give birth. Another study from 1990 showed that 20 percent of women were overweight at one year postpartum, whereas only 13 percent were before pregnancy. One more statistic to weigh us down: As many as 25 percent of women will be at least five kilograms (about 11 pounds) heavier six to 12 months after their pregnancy than before. And that’s without carrying a baby in their arms!
Retaining even a pound or two (or four) of extra weight around your waistline can be more than a “my jeans won’t zip” issue. Waist-to-hip ratio (also called central adiposity or, less medically, the disappearing waistline) is correlated with an increased risk for heart disease and diabetes. And women who have had babies are, unfortunately, more likely to see their waistlines expand.
So what predicts postpartum weight gain? Here are some factors to consider:
- The amount of weight gained during the pregnancy: The more weight you gain, the more weight you're likely to retain.
- Race: African-American women retain more weight than Caucasian women.
- Parity (the number of pregnancies a woman has had): The first pregnancy has more of an effect on weight gain than subsequent ones.
- Pre-pregnancy weight: The heavier you are, the more weight you retain.
Some of my patients ask if their internal weight-control mechanisms (or their basal metabolic rates) undergo a permanent change after they have had their babies. The current data does not support this seemingly fitting excuse. Instead, there is ample evidence that once a woman has had a baby her activity lessens and her diet usually worsens as she raises her child. The latter is especially true if she eats what she feeds her progeny (and the unfortunate truth is that our kids are eating french fries and chicken fingers).
Recent research by the Obesity Prevention Program at the Harvard Medical School, published in the American Journal of Preventative Medicine this year, showed some interesting results. The researchers followed 902 women from their first prenatal visit until one year after their delivery. And what they were able to show was that watching television, walking, and eating trans fats each had an effect on the weight the women retained after pregnancy.
Just to summarize the results: For each hour of TV watched daily, the women increased by 25 percent their chances of retaining at least five kilograms (about 11 pounds) of weight one year postpartum. Each hour of walking a day decreased that chance by 34 percent. (So I guess if you watch TV for one hour and walk for one hour you come out ahead.) Additionally, each 0.5 percent increase in their daily calorie intake from trans fats, which are often found in foods such as margarine and fried foods, also increased their chance of retaining those five kilograms by 33 percent.
So it’s pretty simple ... According to this study if, after having your baby, you watch fewer than two hours of TV a day, walk at least 30 minutes per day, and limit your trans fat intake (to basically zero), there’s a 77 percent reduction in your odds of retaining those five kilograms one year later.
Dr. Reichman’s Bottom Line: Getting your weight down in the first year after you have your baby is crucial to your future shape, weight and health. Being a mother is hard work, but don’t let that be an excuse for hours of vegging in front of the TV (with the wrong foods) or omitting a daily brisk walk.
And to all my readers: This is my last column for TODAYshow.com. It’s been a privilege participating in your health. Have a happy and healthy New Year.
Until we meet again! Judith Reichman, M.D.
Dr. Judith Reichman, the TODAY show’s medical contributor on women’s health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, “Slow Your Clock Down: The Complete Guide to a Healthy, Younger You,” which is now available in paperback. It is published by William Morrow, a division of HarperCollins.
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.
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