EAT FOR HEALTH Australian Dietary Guidelines

ACHIEVE AND MAINTAIN A HEAlTHY WEIGHT

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Guideline 1

Appropriate steady weight gain during pregnancy is important to optimise the health outcomes (short term and
long term) for the infant and the mother.288,289 Steady weight gain helps to avoid adverse effects on specific foetal
organ systems during critical periods (e.g. neural tube 6–8 weeks, kidney development 28–30 weeks).

Weight loss diets are not recommended at any time during pregnancy.^289

Mothers who gain excess weight during pregnancy are unlikely to lose it later,^290 although dietary patterns that
comprise regular meals, plenty of fruit and vegetables, high-fibre bread and restricted high sugar snacks^291 may
help women reach a healthy weight after giving birth.

In recent years there has been increasing awareness of the importance of perinatal nutrition in terms of the
development of disease in adulthood, known as foetal origins of disease or Barker hypothesis.^292 There is also
increasing evidence of the importance of growth and optimum nutrition in relation to cognitive development^293
and future bone mass.^294

Evidence of a probable association between babies born to mothers who smoke during pregnancy and a higher
risk of overweight or obesity in adolescence and adulthood supports recommendations that pregnant women
should not smoke cigarettes (Grade B; Evidence Report, Section 17.5).52,54,59-61,243

For further information on pregnant and breastfeeding women, see the Infant Feeding Guidelines.^295

Table 1.2: 2010 Institute of Medicine recommendations for total and rate of weight gain during pregnancy, by
pre-pregnancy BMI

Pre-pregnancy BMI Total weight gain in kg

Rates of weight gain* 2nd and

3rd trimester in kg/week

Underweight (< 18.5 kg/m^2 ) 12.5–18.0 0.51 (0.44–0.58)

Normal weight (18.5–24.9 kg/m^2 ) 11.5–16.0 0.42 (0.35–0.50)

Overweight (25.0–29.9 kg/m^2 ) 7.0–11.5 0.28 (0.23–0.33)

Obese (≥ 30.0 kg/m^2 ) 5.0–9.0 0.22 (0.17–0.27)

Multiple pregnancy

Twin pregnancy 15.9–20.4 0.7

Triplet pregnancy 22.7 —

Note: *Calculations assume a 0.5–2kg weight gain in the first trimester

Source: Institute of Medicine 2009.^289

Table 1.3: Weight gain during pregnancy: recommendations for Asian women, by pre-pregnancy BMI

Pre-pregnancy BMI (kg/m^2 )

Total weight gain in kg

(during pregnancy)

Weight gain per week in kg

(after 12 weeks)

<18.5 12.5–18.0 0.5

18.5–22.9 11.5–16.0 0.4

23–27.5 7.0–11.5 0.3

>27.5 ≤ 7.0 —

Source: Adapted from Institute of Medicine^289 and matched with Asian BMI cut-offs.