Pregnancy Pounds

A bun in the oven doesn’t mean you should fill up on rolls

Eating for two might not be such good advice for expectant mothers, according to new guidelines for how much weight women should gain during pregnancy, issued The National Institute of Medicine last week.

Most reporters were adept at explaining the new guidelines, as well as relevant studies about pregnancy and weight gain. But many could have done a better job by supplementing their reports with information for expectant mothers on staying healthy and maintaining a nutritious diet. Though the weight-gain guidelines—which are based on a woman’s pre-pregnancy body mass index—are pertinent, coverage would have been more useful to readers if there had been more information about how to stay within the new ranges.

Nearly every article stated that the guidelines released last week weren’t really different from the original version released in 1990. The biggest change seemed to be the addition of a very narrow weight-gain range for obese women. Some reporters went further and provided some much-needed context. An article in the Chicago Tribune noted that:

Such data on the increasing girth of pregnant women and the growing rates of obesity in children led to pressure on the Institute of Medicine of the National Academies to revise 1990 guidelines that were written primarily to prevent the birth of excessively small infants.

What’s particularly astute about this statement—a few other newspapers caught this too—is that readers learn not only told why the guidelines are changing, but also why the guidelines were initially implemented. The observation is also relevant to another oft-discussed health problem: obesity.

Several reporters managed to integrate a number of studies relevant to the dangers of being overweight while pregnant, to help readers better understand and interpret the guidelines. Time accomplished this in a single item, citing recent research from the Centers for Disease Control and Prevention and Harvard Medical School. U.S. News & World Report, on the other hand, published two articles: one that covered the updated guidelines, and a follow-up article that covered a new study on nutrition and pregnancy weight gain among obese women. The Los Angeles Times did a good job not only referring to studies, but also quoting health professionals who are critical of the revisions:

“In my opinion, the Institute of Medicine is missing an opportunity to address the issue of the obesity epidemic and the contribution that pregnancy makes to that epidemic,” said Dr. Raul Artal, chairman of the department of obstetrics, gynecology and women’s health at St. Louis University.

Nice catch. Pregnant women may not realize how few calories a growing baby needs, and overeat, leading to unnecessary weight gain. But newspapers still could have done better. It would have been helpful of journalists had bolstered reporting of the changes to them with quotes from doctors—or even nutritionists—on how to stay healthy during pregnancy. In fact, most newspapers, like The New York Times, had blog posts to supplement their newspaper story, but failed to provide any new news that could be helpful for an expectant mother. Readers chimed in on discussion boards to provide that information. Said one mother:

300 calories a day extra is ALL women need for each pregnancy.

Maybe that’s true, but it would have been nice to get that information from a health care professional, and in print.

Perhaps a more radical—and relevant—route would have been to question the very spirit of the guidelines, as some readers perceptively noted. One commenter at The New York Times’s Well blog stated:

I wish they would stop dictating an arbitrary number, and talk about the food women should be eating while pregnant.

Few media outlets elaborated on the weight-versus-nutrition controversy, which is too bad, because questioning why doctors stress the former might push the health field to reconsider what is deemed “healthy.” And while these new ranges for weight-gain are just guidelines, journalists should still treat them skeptically, emphasizing that what you eat matters as much, or more, than how much you weigh.

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Sanhita Reddy is a former Observatory intern currently living in Brazil on a Fulbright scholarship, studying the media sources people use to find health information.