High dietary energy intake during pregnancy increases net gestational weight gain in overweight and obese women

Abstract

Limited information is available about the relationship between dietary energy intake and gestational weight gain. Three hundred and twenty‐six women from rural New York participated in a prospective observational study. Dietary intake (Willet FFQ), physical activity level and SES were assessed once with mail‐in questionnaires between the 1st and 3rd trimester; maternal gestational weight gain (GWG), maternal height and infant birth weight were collected with chart reviews. Women with underweight BMI, inadequate GWG or inconsistent reporting of dietary intake were excluded. Energy balance (EB) was created by subtracting estimated total energy expenditure from dietary energy intake (EI); EB was categorized into negative, adequate and positive balance groups (cutoffs −300 and 300 kcal). Women were on average 28 years old, and 43% had a high BMI of >26 kg/m2. Mean GWG was 33.7±9.5 lbs, and 54% experienced excessive GWG. Mean net GWG was 25.6±9.4 lbs. Reported mean EI was 2480±756 kcal, mean EB was −102±817 kcal. EB and EI were highly correlated (r=0.9, p=0.03). EI tertiles were associated with net GWG in the overall group (trend p<0.05), but not in the BMI subgroups. Energy balance was associated with GWG and net GWG (trend p<0.05) in the overall sample; however, when separating normal and high BMI women, only the group with BMI >26 kg/m2 showed a significant increase (trend p<0.05) of GWG and net GWG with EB. High BMI women had a mean GWG of 29, 32, and 33 lbs for the negative, adequate and positive balance groups, respectively. Mean net GWG was 20, 24, and 25 lbs, respectively. In conclusion, increased dietary energy intake results in greater net GWG, but only in high BMI women.This research was supported by the NIH postdoctoral grant R21 DK69448.