Modern dietary guidelines for healthy pregnancy; maximising maternal and foetal outcomes and limiting excessive gestational weight gain

Abstract

Maternal dietary habits influence maternal and foetal health, representing a pathway for intervention to maximise pregnancy outcomes. Advice on energy intake is provided on a trimester basis, with no additional calories required in the first trimester and an additional 340 kcal d−1 and 452 kcal d−1 needed for the second and third trimesters. Energy intake depends on pre‐gravid body mass index (BMI); underweight women are recommended an increase of 150, 200 and 300 kcal d−1 during the first, second and third trimester, normal weight women an increase of 0, 350 and 500 kcal d−1 and obese women an increase of 0, 450 and 350 kcal day−1. The recommendations for carbohydrate and protein intake are 175 g d−1 and 0.88–1.1 g kgBM d−1, with no change to fat intake. The number of pre‐gravid obese women is rising; therefore, we need to regulate weight in women of childbearing age and limit gestational weight gain to within the recommended ranges [overweight women 6.8–11.3 kg and obese women 5.0–9.1 kg]. This can be achieved using nutritional interventions, as dietary changes have been shown to help with gestational weight management. As pregnancy has been identified as a risk factor for the development of obesity, normal weight women should gain 11.5–16.0 kg during pregnancy. While some research has shown that dietary interventions help to regulate gestational weight gain and promote postpartum weight loss to some extent, future research is needed to provide safe and effective guidelines to maximise these effects, while benefitting maternal and foetal health.