A recent report in New York magazine highlighted the American phenomenon of “undergaining” — practised by women whose vanity is such that they strive to gain less than the recommended 25-30lb during pregnancy. There is even anecdotal evidence to suggest that some women pray for morning sickness in order to shed extra pounds, and book an elective caesarean in the eighth month in order to avoid that inconvenient final few weeks’ weight gain.
Think it couldn’t happen here? According to a study by the Medical Research Council (MRC), pregnant women in Britain are dieting like never before, and the health implications are alarming. The findings indicated that four out of ten women eat a diet that is likely to deprive a child of essential nutrients. This inhibits development of vital organs such as the liver, lungs and heart, and can put the baby at risk of heart disease, diabetes and stroke later in life.
The midwife and fertility guru Zita West is concerned at the large number of pregnant women who come to her who are on fad diets. “Some have a poor idea about what constitutes a healthy diet,” she says. “They’re confused, because they’ve learnt to regard carbs as a dirty word, and yet, during pregnancy, their bodies are screaming for them. This isn’t surprising when you consider how much energy a growing foetus demands. The last thing you want to be doing is restricting or overdosing on particular food groups.”
West points out that, unlike in France or the United States, doctors in Britain don’t routinely weigh pregnant women, so crash dieters are not being detected by GPs or hospital staff. “Women could do with a lot more support at the time they get their pregnancy-test results,” she says. “Supermodels and film stars give ordinary women unrealistic expectations as to what being pregnant is all about. Some women diet and exercise excessively, putting the baby’s health at risk. Others put on large amounts of weight in the misguided belief that they can eat what they like and shed it all later.”
Certainly, the celebrity success stories might lead us to believe it’s all blissfully easy. Liz Hurley miraculously — and healthily — shed the 53lb she gained in pregnancy in just three months. “For many women, the struggle to lose baby weight is so tough that the thought of getting pregnant again depresses them,” says West. “We encourage them to lose the weight, but we say that it takes at least six months to do so. Obviously, it will be easier if a woman breast-feeds, but, even so, it still takes time.”
Toni Steer, a nutritionist at the MRC, also has first-hand experience of pregnant women with weight issues. “There’s a lot of confusion about how much weight women should gain in pregnancy,” she says. “What they don’t realise is that it depends on how much they weigh at the outset. If they’re slim, they should gain more; if they’re obese, they should gain less. The notion that anyone should eat for two is misguided — at best, they should eat an extra two slices of toast in the last trimester.”
Professor David Barker, who is pioneering research in foetal health at Southampton University and who did the study for the MRC, is horrified by what he believes is an epidemic of dieting among expectant mothers. His research has established a link between low-birth-weight babies and coronary heart disease in later life. Babies weighing 2.5kg had double the risk of developing heart disease of those weighing 4.5kg.
“We know for sure that if an expectant mother is very thin,” Barker says, “it has long-term consequences for the baby. Apart from the risk of heart disease, it means the mother will have more resistance to insulin and, in turn, that ups the risk of the baby developing diabetes.” By “thin”, Barker means anyone with a BMI of less than 20, but he also highlights the dangers for women of any weight who follow fad diets, particularly high-protein, low-carb programmes, while pregnant. “Are these diets bad for the baby’s health? It’s a dead certainty,” he says. “They give the baby a diet that’s high in amino acids and low in the energy that’s needed to process them. That could cause the baby to have high blood pressure for life.”
Perhaps the greatest irony, however, is that mothers who diet are putting their unborn children at risk of obesity in later life. “When pregnant women diet, the metabolism of the growing foetus is permanently set to ‘get by’ on less food,” says Barker. “After birth, when the child is given plenty of food, its metabolism adapts accordingly and so is more prone to obesity.”
Barker feels strongly that not enough information is being given to pregnant dieters. “During pregnancy, women are meant to accumulate fat that they can then use when breast-feeding. The idea that you would jeopardise that for some short-term vanity is preposterous,” he says. “All the public-health information focuses on mothers-to-be not smoking or drinking — but nobody ever talks about dieting, which can have much wider long-term health implications.”
DON'T DIET DURING PREGNANCY, BUT DEFINITELY DITCH THE DOUGHNUTS
Nobody could ever accuse me of having dieted during my first pregnancy. I’ve never exactly been a sylph and, given an excuse to — as my grandmother put it — “eat for two and never run up stairs”, I did so with gusto.
In fact, I think my piggery probably reached its height after the birth: I’d heard somewhere that breast-feeding took off the pounds and that it was important to eat lots if you were to have a good milk supply. I did. During those 4am feeds, my husband and I took to snacking on whole packets of Green & Black’s organic chocolate biccies. Yummy. And since everyone who came round to visit the new baby seemed to bring us mountains of delectable treats, and I hadn’t been able to eat stilton or camembert for months, I indulged myself.
The upshot? Well, let’s put it this way: when I tried on some of my pre-pregnancy jeans a couple of months after the birth, it was clear they weren’t going to fit for quite a while (they barely went past my knees), and the baggy leggings that I’d sworn I’d burn after the delivery seemed still to be in circulation for an alarmingly long time. And, strangely, when they were on, they weren’t that baggy.
It didn’t really matter: my husband still loved me, and I was so happy that I glow in all those early pictures — most of which are taken from the waist up. But, post breast-feeding, it was a struggle to get back into my old clothes. My wardrobe options were pretty limited when I first returned to work (after all, I was damned if I was going to buy new fat clothes when I wasn’t even pregnant any more), which didn’t help my self-esteem, either.
The prospect of having to go to an important conference in a beach resort finally gave me the fear spur required to shift the flab, and I felt much better when it was gone. All I know is that if I am lucky enough to have another baby, I’m going to be more careful about what I eat — and give those midnight feasts a miss, or at least swap chocolate for something a little healthier. It’s certainly insanity to diet when you’re pregnant, but don’t assume that all the excess weight will magically vanish once the baby is born. It’s quite alarming to realise your tummy is nearly as big as it was with an 8lb baby in it several months after the birth. So, go easy on the doughnuts, girls.
Eleanor Mills
