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Appropriate Weight Gain During Pregnancy 67
Omega 3 fats/long-chain calcium intakes. Care should be taken that during
polyunsaturated fats pregnancy adequate calcium is consumed by eating
2–3 servings daily of any of the following:
Docosahexanoic acid (DHA) and eicosapentanoic
acid (EPA) are the long-chain polyunsaturated ●● milk – 1 glass (200 mL)
(LCP) omega-3 fats that are vital for brain growth,
visual and neurological development in the fetus ●● cheese – 25 g
and young infant. Women who do not eat fish may
not get enough of these fats. ●● yogurt – 1 pot of 120–150 g
The International Society for the Study of Fatty ●● tofu – 50 g
Acids and Lipids (ISSFAL) recommends that
pregnant women should consume: ●● calcium-enriched soya milk – 1 glass (200 mL).
●● 200 mg DHA/day as is recommended for the Pregnant adolescents have higher needs, however,
general adult population (Koletzko et al. 2007) as they will not have achieved their peak bone mass
and should be encouraged to eat at least three
●● >500 mg/day of DHA + EPA. servings of these calcium-rich foods each day.
This can be achieved by eating one or two portions Women who do not eat dairy products or
of oily fish a week. A portion is about 100 g cooked calcium-enriched soya products should be advised
weight. Oily fish includes salmon, trout, mackerel, to take a calcium supplement of about 700 mg
sardines, pilchards, herring, kippers, eel, whitebait calcium to ensure an adequate calcium intake.
and fresh tuna. Canned tuna does not count as an
‘oily fish’ as the fat content is reduced prior to Appropriate Weight Gain During
canning. Pregnancy
Pregnant women who do not eat oily fish may Additional energy is needed during pregnancy to
choose to take supplements of omega 3 fats to support the growth of the fetus and to enable fat to
ensure an adequate intake of long-chain omega 3 be deposited in the mother’s body for later use
fats. Supplements containing: during lactation. However, considerable reductions
usually occur in physical activity and metabolic
●● 200 mg–1 g DHA/day and rate to help to compensate for these increased
needs. Pregnant women do not need to increase
●● 500 mg–2.7 g in total of omega 3 LCPs (DHA their energy intake and certainly should not ‘eat for
+ EPA) two’. The Department of Health recommends an
extra 200 kcal per day from food for the final
have not caused harm in pregnant women three months only (Department of Health 1991)
(Koletzko et al. 2007). (e.g. two slices of buttered bread provide 200 kcal).
Note: There is currently no standard preparation There are currently no UK evidence-based
for the above dosage. Retail pharmacies stock fish recommendations on appropriate weight gain
oil supplements and women should look for a during pregnancy. However, the American Institute
suitable preparation which provides quantities of Medicine (IOM) recommends (Institute of
within the range above but without vitamin A. Medicine 1990) the weight gains listed in Table 3.2.4.
Calcium Women who gain weight within the IOM ranges
are more likely to have better maternal and infant
Despite high fetal requirements for calcium, outcomes than those who gain more or less weight
additional calcium is not usually needed as the (Viswanathan et al. 2008). Gaining too little weight
mother’s calcium absorption increases during during pregnancy can result in infants being born
pregnancy. However, some women, particularly with a low birthweight, which is associated with
teenagers, avoid dairy products and have low
