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Overweight Prior to Pregnancy
by Jennifer J. Francis, MPH, RD/LD

Jennifer FrancisQ. I just found out that I am pregnant. I am very excited, however I am a little concerned about how much weight I should gain. I am about 50 lbs overweight and I weigh more now than when I delivered my other two children. How can I keep my weight gain under control without harming the baby?

A. Women who are overweight prior to pregnancy should aim for a 15-25 pound weight gain. Remember that you are not just putting on weight, you are building tissue--the baby and all of the support it needs. The baby needs a constant supply of glucose, which it can't get from maternal fat stores, and it has to come from food that you eat.

The best way to keep the weight gain under control is to consciously choose nutrient-dense foods, meaning foods that have a lot of vitmains, mineral and fiber for the amount of calories that they have. A common example: an 8 oz glass of skim milk has the same amount of calcium as an 8 oz glass of whole milk, but for much less calories. The skim milk is more nutrient dense than the whole milk. A baked potato is more nutrient dense than french fries.

You don't need to eat fat-free, or never have the foods you like, but you should try to make healthy lean choices from all of the food groups most of the time, and really keep sweets and high fat snacks for special occasions or dire emergencies only.

Keep lots of healthy snacks around, and drink plenty of water.

If your doctor and you fear that you are putting weight on too fast, keep a diet journal for a few days. Then examine it for the following issues:
- over-snacking
- portion sizes
- poor choices versus nutrient dense choices
- added fats (butter, salad dressing, etc)
- emotional eating

See what areas are causing you the most trouble, and then work out some reasonable strategies for overcoming your problem ares.

Talk to your doctor about exercise as well.

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