Daily calorie intake requirements during pregnancy: Does one size fit all?
Women with obesity can maintain their daily calorie intake during pregnancy, according to the results of a prospective observational study of 54 pregnant women with obesity. For women with obesity who gained the recommended 11 to 20 lb during pregnancy, mean (SD) daily energy intake was 2,698 (99) kcal/day and energy expenditure was 2,824 (105) kcal/day. Therefore, to meet the recommended amount of weight gain, women had a negative energy balance (-125 [52] kcal/day).
Study strengths and limitations
It is important to note that this study by Most and colleagues was not a health behavior intervention for gestational weight gain. Women who participated in the study did not receive specific directions or advice on diet or physical activity. Furthermore, the study used the current gestational weight gain guideline as a reference to determine energy intake. As such, findings from this study alone cannot be used to adapt the current gestational weight gain guideline for women with obesity.
The study methods were rigorous in terms of the energy intake measurements, but a larger and more diverse sample size is needed to confirm the study findings.
Most and colleagues’ data suggest that maintaining energy balance can support obligatory growth and development of women and their fetuses during pregnancy (fat-free mass). In doing so, women with obesity meet the current gestational weight gain guideline. It is hoped that this important research will be used in future studies, with larger sample sizes, to evaluate energy requirements during pregnancy, especially in women with different classes of obesity. Ultimately, these new recommendations for energy requirements should be combined with studies of health behavior interventions for gestational weight gain.
The study by Most and colleagues supports the concept that energy requirements need to be individualized for women to meet the recommended amount of gestational weight gain. If women meet their gestational weight gain goals, they have the potential to improve their health and the health of their offspring.
MICHELLE A. KOMINIAREK, MD, MS
