Double Trouble

Inspired by their initial results, Badger's team is now focused on getting a follow-up study of human mothers-to-be and their children under way. In the meantime, Badger says women considering pregnancy should use these early results to motivate themselves to get into the best health possible before conceiving. "We'd recommend that women try to lose weight and increase their activity levels, and that their doctors should work with them on this prenatally," he says. "It's the rare mother who doesn't really want to do the right thing, if [she] understands what the consequences are and can take action to prevent it."

That advice can't be taken soon enough, says Anna Maria Siega-Riz, a public-health expert at the department of epidemiology and nutrition at the University of North Carolina School-Chapel Hill. Not only are too many women overweight before they get conceive, but studies indicate that most pregnant women—whether they started out normal-sized, overweight or obese—are gaining more weight during their nine months than the national guidelines currently recommend.

"Physicians are doing a poor job informing women how much they should gain during pregnancy," says Siega-Riz. "Most women are not aware of the existing guidelines or don't understand them." Pregnant women are all encouraged to gain weight during their pregnancies, but the specific amount should be tailored to the woman's height, build and preconception weight, she said. For example, underweight moms are encouraged to gain 28 to 40 pounds, normal-weight moms should gain 25 to 30 pounds, overweight women 15 to 20 pounds and obese moms at least 15 pounds. But a study done at UNC revealed that 60 percent of normal-weight moms, 80 percent of overweight moms and 75 percent of obese moms gained excessive amounts of weight during their pregnancies, while only 35 percent of underweight women gained more than they were supposed to.

To many women, "eating for two" implies doubling your intake, but in fact, Siega-Riz says, a pregnant woman only needs to add the equivalent of one healthy snack, such as a glass of milk and a peanut butter sandwich on whole wheat, to her daily pre-pregnancy diet. Siega-Riz says more doctors need to initiate the conversation about fitness and pregnancy before their patients conceive: "We've done a disservice to pregnant women because we wait too long to get them in good condition, and once they are pregnant, we don't do enough to support them."

In addition to concerns about childhood obesity, she adds, extra weight during pregnancy increases the risk of complications for both mother (higher rates of gestational diabetes, pre-eclampsia, and cesarean births) and child (increased risk of birth defects). Maternal obesity, says Siega-Riz, is now considered the "No. 1 problem facing prenatal-care providers in the new millennium."

Still, Badger says he is optimistic that the situation can be turned around. As they were preparing their rat study for publication, one of the women in his office was so influenced by their results that she decided to put off trying to get pregnant until she lost weight, improved her diet and began exercising more regularly. "She wanted a child in the worst way, but she decided to get on the ball, and she got into better shape before she got pregnant," he says. "We think that if more people could alter their behavior in the same way, they could save themselves and their children a lot of heartache." Or to put it differently, pounds of prevention could be worth many more pounds of cure.

© 2008