Piling on pounds in pregnancy could lead to obesity in later life

ABU DHABI // Women who put on excessive weight during pregnancy are four times more likely to be overweight 20 years later, a study has found. Doctors say the problem is more acute in the UAE, where the culture encourages women to over-eat during pregnancy, and to have large families. Dr Abdullah al Mamun, a public health researcher at the University of Queensland, found weight gain during pregnancy has a "profound and long-lasting impact on future obesity".

The study, published in the American Journal of Clinical Nutrition, tracked the weight of more than 2,000 women who gave birth between 1981 and 1983 in Brisbane, Australia. One in three put on excessive weight in pregnancy. Two decades later, they were on average more than 20kg heavier than those who put on less. Dr Kiran Mehndiratta, a specialist obstetrician and gynaecologist at the New Medical Centre Speciality Hospital in Abu Dhabi, said the ideal weight gain for a pregnant woman of normal body weight is between 10kg and 12kg.

"For women who are overweight, we advise them right from the start to control their carbohydrates and fat intake," she said. Overweight or obese women should not gain more than six to eight kilogrammes during their pregnancy, she said. Dr Gowri Ramanathan, a consultant obstetrician and gynaecologist at Corniche Hospital in Abu Dhabi, said women must be more aware of health issues. "The belief that a pregnant woman has to eat for two is unfounded, unfortunately," she said.

"It will only increase a mother's risk of diabetes during pregnancy, which then increases her risk of type 2 diabetes later in life." Few women manage to regain their pre-pregnancy figures, with most gaining a few kilos with each pregnancy, she said. The problem was exacerbated in the UAE by the tradition for large families. "A few years down the line, these women are now obese and at risk of diabetes, heart disease, high blood pressure and so on."

Culture also demanded an increase in sweets, honey and sugar during breast feeding, with mothers believing that the sugar intake will increase the production of breast milk. "That is also unfounded," said Dr Ramanathan, who is also a foetal medicine specialist. "There is no evidence for this. A breastfeeding mother needs no more than an extra 500 calories a day." A pregnant women, she said, needs a maximum of 150 extra calories a day in the first three months of pregnancy - the equivalent of two biscuits. Towards the end of pregnancy, 200 extra calories is the maximum. "We are strict with what our expectant mothers eat and what they should avoid," said Dr Ramanathan.

Eating in response to cravings is discouraged. Dr Mehndiratta said that the problem sometimes lay with the husband and his family. "Pregnant women are pampered by their families and even forced to eat, and often not the right kind of food and not in the right proportion," she said. "I had a patient who ate one litre of ice cream a day to satisfy her cravings, resulting in gestational diabetes." Dr Mehndiratta warned against traditional beliefs, including one where a mother who does not satisfy her cravings gives birth to a baby with a birthmark in the shape of the food she craved.

Another concern with increased calorie intake was the baby's size. "If the baby is too big, it leads to delivery complications, labour problems, haemorrhaging after delivery, and more need for a Caesarean section," she said. "The mother's entire well-being, and her baby's, is related to controlled weight gain." [e-mail]