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Pregnancy Weight Gain- The Realities, Recommendations & Research

It’s been said that you remember feelings more than words. How true.  At about 36 weeks pregnant with my first daughter, I was at a routine midwife exam and made a joking yet serious comment to my midwife that I was “done gaining weight!”  She breathed out a laugh and replied, “Sorry.  This is when the baby does the most growing.”  My heart sank.

Of course I wanted a healthy baby.  And, of course, I wasn’t going to do anything to jeopardize the last few weeks of pregnancy.  But, I remember that feeling oh so well.. that belief that I couldn’t possibly get any bigger.  It felt like I was stuffed into my skin and simply couldn’t expand any further. Seriously?  I was going to grow even more?  I had gained weight gradually and was within the appropriate range, but could my body and mind accept anymore?  

No longer did I feel ‘cute.’  I felt that the pregnancy glow that I had for months was fading.

From conversation with other moms, most everyone gets to ‘that place’- the one where they are just ready to deliver.  The pure desire for their body to go into labor and be able to meet their little one for the first time is strong and powerful.  But I have also heard moms talk about that last month feeling like a “whale,” an extremely tired one.  The idea of more weight gain is quite unappealing.

I don’t have a history of an eating disorder or weight loss, but I definitely had some unkind body thoughts at the beginning and end of my pregnancy.  Now pregnant with my second little girl and finishing the last few weeks of pregnancy, those thoughts have returned- not as strong, but definitely made an appearance.  I don’t choose to meditate on them long but I sincerely understand the thoughts and feelings many women have about weight gain during pregnancy.  For those who do have a history of losing a significant amount of weight or have dealt with an eating disorder in their past, I can only imagine how challenging it might be to gain a healthy amount of weight over the course of 9 months.

Curious about the prevalence of weight gain concerns among pregnant women, I consulted my current Nurse Practitioner/Midwife about this topic.  She indicated that its quite common for females of all shapes, sizes, fitness levels and medical histories have significant concerns about weight gain.

While I think we all know that the old phrase “eating for 2” is false.  So, how much do you really need to gain?  More practically, how do you gain at a healthy rate?  What are the ramifications of too little weight gain or too much?  

Of course, weight is only 1 part of the challenge.  It’s not just about the number on the scale, but the foods you are using to gain the weight.  Nausea and sickness just adds another layer of complications.

As a Registered Dietitian Nutritionist, mommy and pregnant woman, I want to assure you that if you are feeling frustrated or insecure, I completely get it.  Even if this topic is not coming up in the mommy groups, pregnant women are dealing with it.  Today, I want to talk about the realities, recommendations and research regarding weight gain during pregnancy.  

 

How Much Weight Should You Gain During Pregnancy?

Weight gain recommendations are created by the Institute of Medicine and based on your BMI (body mass index) before pregnancy:

Body Mass Index (BMI) Single Baby Twins
<18.5 28-40 lbs n/a
18.5-24.9 25-35 lbs 37-54 lbs
25-29.9 15-25 lbs 31-50 lbs
30+ 11-20 lbs 25-42 lbs

*Consult your physician for weight gain recommendations for triplets.

**Calculate your BMI

According to the CDC, only about ⅓ of pregnant women gain an appropriate amount of weight during pregnancy.  Almost half (48%) gain too much and 21% gain too little.  

 

What If You Don’t Gain Enough?

If the mother doesn’t gain an appropriate amount of weight, there is a risk of a low birth weight baby.  This can contribute to:

  • Compromised infant immune system or increased risk of illness
  • Difficulty breastfeeding
  • Developmental delays for baby

In addition, some research, like this study, shows that inadequate weight gain during pregnancy can contribute to infant mortality within the first year of life. While the cause is unknown and can only be speculated, it does reinforce the goal to gain an appropriate amount of weight as recommended by the IOM regardless of your starting, pre-pregnancy weight.

 

What are the risks of gaining too much weight?

Excess weight gain often contributes to a larger baby, which can make delivery more challenging and stressful for the mother and baby.  There is a risk that the mother will have a difficult time delivering a large baby (baby could get stuck or struggle getting through the birth canal).  There is also an increased risk of:

  • postpartum weight retention for the mother
  • childhood obesity for the baby
  • cesarean delivery
  • future maternal overweight/obesity

 

Is it just about calories and weight?

In order to gain about 1# per week, a mother would need to consume around 300-450 additional calories per day.  Realize that a woman’s activity level significantly affects how many extra calories are needed.  And, during pregnancy, it is likely that activity level reduces somewhat, due to fatigue, getting additional rest and intensity of exercise/exertion.  

As a Registered Dietitian Nutritionist, I am not a big advocate of counting calories.  Personally and professionally, I feel that individuals can get hung up on numbers and when the numbers don’t produce the results we expect, it can be frustrating or discouraging.  YOUR body is amazing and can create life and nourish your baby for months!  But, it is not a machine.  It is complex.

In order to gain weight healthfully, think about how you can add nourishing foods into your current diet.  This might mean adding 1 additional healthy snack or using healthy fats a bit more liberally. Most women will need to consume 5-6 mini meals per day in order to consume enough calories and nutrients.  Do avoid making meals bigger.  Large meals and high-fat meals (fried, heavy gravies, etc) can exacerbate reflux, which is common later in pregnancy.  

Some nutrients highly important during pregnancy include iron, calcium, choline, DHA and folic acid. While nausea and food aversions can be common during pregnancy, it is important for the mother to do her best to consume as much variety as possible.

 

How can intuitive eating play a part in your eating plan?

Adding more calories and nutrients to your diet is not about “stuffing” yourself with more food.  The reality is that pregnant women will find that they get hungrier during the day- because they are growing a baby!!  It takes energy (ie. calories) and nutrients to do this.  While there may not be an increase in hunger in the first trimester, most mothers will find it does increase later in pregnancy.  

If you are have NOT noticed extra hunger, begin to pay more attention to your body signals during the day.  Sometimes our body is sending us messages but we are too busy to notice.

Personally, intuitive eating is the method I use to gain weight during pregnancy.  I do plan healthy meals and snacks for my day, and when my body says it is hungry, I nourish it.  However, I have also noticed that my portions are a bit smaller- I get full a bit faster.  Pregnancy has taken me to a new level of mindfulness, ensuring that I am eating as often as I need but not over-consuming when I do.  

 

Does it matter how fast or slow you gain weight so long as you reach your target range?

It’s ideal to gain weight gradually, about 1# per week for most women during the 2nd and 3rd trimester.  The baby grows at a gradual rate, placing more demands of the mother for nutrition and energy (calories).

Rapid weight gain during pregnancy, especially early on, can increase the risk of gestational diabetes mellitus.  Essentially, this rapid weight gain may lead to early insulin resistance within the mother and therefore, make it much more difficult for the body to manage blood glucose.

 

Where does the weight gain go?

Many women may wonder why they need to gain so much weight if the average baby is only 7-8 pounds.  Wouldn’t that be enough?  Not exactly…

  • Larger breasts: 1-3 lbs
  • Larger uterus: 2 lbs
  • Placenta: 1.5 lbs
  • Amniotic fluid: 2 lbs
  • Increased blood volume: 3-4 lbs
  • Increased fluid volume: 2-3 lbs
  • Fat stores: 6-8 lbs
  • Baby: 7-8 lbs (average size)

1st trimester: 1-4 lb weight gain total (no additional calories necessary)

2nd/3rd trimesters: ½-1 lb per week, depending on your recommended weight gain per char

 

What are some healthy ways to add nutrients (and calories) to your typical eating plan?

Here are some ideas I have found healthy and appetizing:

  • 6oz greek yogurt with 1 oz nuts
  • 1sl whole grain/sprouted grain bread with 1 tablespoon nut butter
  • 4 oz low fat cottage cheese with 1 cup fresh or frozen fruit
  • Smoothie with 1 cup fruit, 4-8oz milk, 4 oz yogurt, 1/2 tablespoon chia or flax seed
  • Cheese stick, 1 serving of whole grain crackers and a piece of fruit
  • 1 serving of edamame beans
  • 1-2 eggs with a piece of whole grain/sprouted grain toast*

*choose omega-3 eggs if you don’t eat 6 oz fatty fish at least 2x/week

A Registered Dietitian Nutritionist can help you devise a plan or additional easy meals that are nutrient dense and appeal to you.  This will ensure that you aren’t lacking any specific nutrients, while also eating foods that are appetizing to you during pregnancy.

 

What if you are on track for too much weight gain?  What should you do?

Don’t stress!  It’s not worth it!  The goal is a healthy baby and safe delivery.  But, it is wise to consider why you might be gaining additional weight.  Have a conversation with your healthcare provider and/or consider making an appointment with a Registered Dietitian Nutritionist to help you gain perspective and create a plan.

Here are a few questions to consider:

Am I drinking too many calories?

Am I eating at regular times during the day?

How often am I snacking or munching?

Are cravings contributing to excess calories?

Am I planning healthy meals for myself and my baby? (every time you eat, s/he eats too!)

 

Should you exercise to help manage your weight gain during pregnancy?

YES!!!  The American College of Obstetricians and Gynecologists recommends that pregnant women get 30 minutes of moderate activity (like walking) 5-7 days per week, just like any other person.  Pregnancy does not rule out exercise.  In fact, research shows that exercise during pregnancy has significant benefits and minimal, if any, risks.  While you might not be able to keep up the pace you could before pregnancy, continuing exercise patterns and working at the level your body can handle can actually help you:

  • Manage weight during pregnancy
  • Reduces risk of gestational diabetes
  • Improve or maintain physical fitness during pregnancy
  • Reduce postpartum recovery time
  • Lowers chances of cesarean delivery
  • May reduce issues with preeclampsia

There are many safe exercises during pregnancy including:

  • Stationary cycling
  • Low impact aerobics
  • walking/jogging
  • Modified yoga/pilates
  • Strength training

If low back pain becomes an issue during pregnancy, water exercise has been shown to be a fantastic alternative.  Definitely consult your physician or midwife about your exercise routine to ensure that if modifications are necessary, you are well-informed.  There are a few exercises that are not recommended listed here. 

 

Should you track your weight during pregnancy?

While it is ideal for women to gain the appropriate amount of weight during pregnancy, this is not an area to obsess about.  In fact, as a Registered Dietitian Nutritionist, I would rather have mommy giving more attention to the types of foods she is eating and loading up her meals with as many nourishing foods as possible rather than have her focus on weight.  

Your OB/GYN or Nurse Midwife measure weight and blood pressure during every routine checkup and that should be enough to monitor and see trends.  If you have concerns about how fast you are gaining, lack of weight gain or simply feel anxiety about your weight gain, definitely initiate the conversation.  This process of growing a baby takes more than 9 months!  You deserve to feel confident, well-educated and secure throughout this process!  

 

Concluding thoughts…

Weight gain might feel scary, or uncontrollable or it might just feel like a normal part of the pregnancy process.  We all have personal thoughts, feelings, and histories that influence how we mentally and emotionally handle this 9+ month process of growing and nourishing a baby.  If you are frustrated or feel nervous about weight gain, there are many women that identify and have similar concerns.

As a mommy, pregnant woman and Registered Dietitian Nutritionist, I believe there are some important steps to take to help you grow a healthy baby and gain an appropriate amount of weight:

TALK- Have an open and honest dialogue with your healthcare provider about how you feel about this topic.

EDUCATE YOURSELF- Become informed about the necessary reasons for weight gain.

REFRAME- It’s not about weight gain.  It’s about growing and nourishing a healthy baby.

SEEK OUT COMMUNITY- Have healthy conversations with other mommies and pregnant women.

DRESS UP- Put on cute maternity clothes or makeup or an amazing pair of shoes… whatever makes you feel confident!

MEDITATE ON TRUTH- Find a scripture, verse, quote, or mantra to think on every time you find your thoughts lingering on the number on the scale or the size of your belly.

 

TRUTH: Her children arise and call her blessed; her husband also, and he praises her: “Many women do noble things, but you surpass them all.”  –Proverbs 31:28-29 (NIV)

 

REFERENCES

Academy of Nutrition & Dietetics, Nutrition & Lifestyle for Healthy Pregnancy Outcomes

American Congress of Obstetricians & Gynecologists, Physical Activity & Exercise During the Pregnancy & Postpartum Period

Weight Gain During Pregnancy

Davis, R. R., Hofferth, S. L., & Shenassa, E. D. (2014). Gestational Weight Gain and Risk of Infant Death in the United States. American Journal of Public Health, 104(Suppl 1), S90–S95. http://doi.org/10.2105/AJPH.2013.301425

Hedderson, M. M., Gunderson, E. P., & Ferrara, A. (2010). Gestational Weight Gain and Risk of Gestational Diabetes Mellitus. Obstetrics and Gynecology, 115(3), 597–604. http://doi.org/10.1097/AOG.0b013e3181cfce4f

Mason, C., Foster-Schubert, K. E., Imayama, I., Kong, A., Xiao, L., Bain, C., … McTiernan, A. (2011). Dietary Weight-Loss and Exercise Effects on Insulin Resistance in Postmenopausal Women. American Journal of Preventive Medicine, 41(4), 366–375. http://doi.org/10.1016/j.amepre.2011.06.042

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Health
5 Ways to Make Healthy Eating Easier

Home improvement shows are notorious for showing off glamorous and organized kitchens that practically beg you to come and cook a gourmet meal.  The counters are clean, the pantry is tidy and everything about it feels refreshing, light and airy.  But, most of our kitchens are not that neat and orderly.  Do you have food on the counters?  Is your pantry bulging?  Does your fridge need some reorganization and a wipe down?

Compelling research shows that the way we organize our kitchen, the dinnerware we use each night, and even the kitchen environment play a significant role in our food and dietary behaviors.  Could eating on a smaller plate really help you eat less?

Mood, stress, and anxiety certainly contribute to our decisions over what to eat and how much.  But, what if you could make some simple changes in your own home so that eating healthier was not only easier but “mindless?”  

Could you set yourself up so that you didn’t have to choose between the doughnut and the oatmeal?

Brian Wansink and the Cornell University Food & Brand Lab have conducted dozens of studies looking at how a variety of factors affect our food buying and consumption choices.  Many of these studies simply confirm what Registered Dietitian Nutritionists have been talking about for years as creative strategies for overall health and weight management.  

These are 5 ways to make healthy eating easier…

 

01. Have Fresh Chopped Veggies (& Dip) Ready for Munching in the Fridge

Not a new idea, but definitely practical and effective.  This Dietitian Mom actually did an experiment with her kids keeping a platter of veggies with ranch dip in the fridge all week.  She found that they really did eat more veggies when they were chopped and available, without having to persuade or encourage!

This idea is not about forcing you to eat vegetables you don’t like.  Personally, I really don’t like raw broccoli or cauliflower, but I do like zucchini, squash, cucumbers, carrots and snap peas.  Review a list of veggies and find which ones are appealing to you and your family members.

Dip Ideas

  • Hummus– any flavor your family loves
  • Ranch– made with low-fat sour cream or greek yogurt and a seasoning packet
  • Guacamole– make your own OR buy
  • French Onion Dip– made with low-fat sour cream or greek yogurt and a seasoning packet
  • Salsa
  • Nut Butter– I love this with carrot sticks!
  • Yogurt Dip– stir in your favorite Mrs. Dash seasoning into low-fat greek yogurt

 

02. Remove All Other Food Packages & Snacks from the Countertop

Keeping your counters cleaned off at all times means that you won’t walk into the kitchen and be mentally stimulated (aka “triggered”) to grab the snack.  Many individuals eat when they are not hungry simply because it was within eyesight or reach.  Have you ever walked into the movie theater after dinner for an evening film and then walked right up to the popcorn counter for a giant tub?  Your sense of sight and smell were visually stimulated, persuading you of your “need” for popcorn!  

Walking into a co-worker’s office with the bowl of colorful M&Ms ready to be plopped into your mouth reinforces the power of this concept.  Regardless of whether you had a desire for chocolate or if it had even entered your mind, most individuals are compelled to reach for a handful.  They “melt in your mouth, not in your hand,” right?

Interestingly, the Cornell Food & Brand Lab quotes some of their research that of more than 200 women, those with cereal and soda lying on the counter weighed 20-26# more than those who did not.  WOW!!  Clearing off your countertops just might have dramatic effects on your health!

ACTION: Walk to the doorway of your kitchen.  Close your eyes for a moment and then open.  What do you see and notice?  What food boxes, labels or brands are within eyesight.  If you have several entryways into your kitchen, do this from each angle.  Sometimes food is out because pantry or cabinet space is sparse. Brainstorm and “google” creative ideas to address this issue and commit to clean countertops.

 

03. Keep A Bowl of Fruit in the Kitchen

Apple juice takes first place in the area of fruit consumption among Americans in 2015, according to the USDA.  Sadly, fresh fruit is not in the lead.  AND, even worse, when juice is considered “fruit,” people are still only meeting about 50% of the dietary recommendations for daily fruit consumption.  What a better way to help encourage us to grab a piece for our snack or snag one for our lunch box than to leave it on the counter.

Consider including several different types that appeal to all family members.  Think about color and physical appeal.  Yes, it will ripen quicker (and therefore go bad) on the countertops as opposed to the refrigerator.  But that fact can actually encourage us to grab a piece so that it doesn’t happen.  

The Cornell Food & Brand Lab state that in this study of 200 women, those with fruit bowls out on their countertops were 13# lighter than those who did not have fruit out and available.

Your fruit bowl is the 1 thing you should leave on your countertops!

 

04. Designate Appropriate Places to Eat & Sit Down

Several years ago I was working with a patient to lose weight and improve his cardiovascular health. He had successfully lost about 20# but had gotten “stuck” and he was perplexed as to why.  In our session we discussed the foods they were buying, making and what was in his lunch box each day at work.  But then… he realized something that was happening… on weekends and even during the week, he would grab little snack bars and 100 calorie snacks as he was walking through the kitchen, on his way to another room.  

These little snacks seemed insignificant and most of them were fairly healthy choices.  However, it took him a while to figure out he was eating MORE than what was reported in his sessions with me because he wasn’t seated.  Essentially, it wasn’t being considered a “meal.”  While this gentleman was grabbing mostly packaged snacks, quantity tends to be under-reported or poorly estimated when eating on the run.  How many crackers did you grab?  How big was the handful of nuts?  

Taking the time to sit down actually affirms that yes, this is a meal, and I am eating it.  Otherwise, it can become a fleeting memory.

While everyone could provide a reasonable exception or 2 to this strategy, the primary goal is to plan and acknowledge that you are eating AND ensure that you are eating at a calm pace.

 

One strategy that might work…

05. Use A Smaller Plate

The actual literature on this strategy is contradictory, some study conclusions claim that using a smaller plate does not effectively help reduce food consumption. In fact, this literature review commented that distractions, food serving mode (self-serve or being served), food containers and type of food all influence overall consumption.  It actually reported that individuals tended to eat more veggies when eating off the larger rather than smaller plate.

However, many individuals would claim this strategy works quite well to reduce excess calorie intake.  Once again, Brian Wansink and his team at the Cornell Food & Brand Lab have conducted some research concluding that this optical illusion gets us every time.  Essentially, their research claims that we miscalculate portions when using larger plates and therefore put more food on them and eat more.  Wansink also claims that simply ‘knowing’ this effect may not be enough to help most individuals eat less.  Therefore, smaller plates may be an effective strategy for some.

Applying this concept, we could hypothesize that serving healthy vegetables and fruit on larger plates and platters would be beneficial.  And, serving calorically dense foods in smaller serving vessels might help us take more or less of certain foods.

Many of us have a natural tendency to fill a plate, regardless of the size.  Consider your own habits and behaviors to assess whether the smaller plate strategy is one for you to employ in your own home.  But, if you are trying to eat more veggies, maybe your large plate will help, just make sure to fill ½ of it with veggies!

“‘Do’ is stronger than ‘Don’t’.” — Slim By Design

For years ‘healthy living’ has carried a stigma of restriction…  

Don’t eat ‘this’.  

Avoid ‘this’ restaurant.  

Don’t buy processed foods.  

Stay away from ___.

Eliminate sugar.

But maybe there is more power in the ‘doing.’  Focusing on what we can do to make healthy eating easier on a daily basis removes the decision-making- it just happens, naturally.

Enough with convincing yourself to “make better choices.”  Stop shaming your lack of self-discipline.  

Begin with setting up your environment to win!  You will still have to make choices and food decisions during the day.  And you will still have to decide whether to grab the handful of M&M’s when you walk into your co-workers office, but some decisions will be a bit easier.  

You will be “working smarter, not harder.”  And that is a powerful place to be!

 

TRUTH: If any of you lacks wisdom, you should ask God, who gives generously to all without finding fault, and it will be given to you.  –James 1:5 (NIV)

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Health
An Honest Conversation About Varicose Veins During Pregnancy, Part 2

“A woman’s body is stunning and awe-inspiring.  She can nurture a baby in the most intimate, loving way, birthing new life.  You don’t have to live with the embarrassment or stigma from changes that occur to your body during pregnancy.”  —Jennifer Hunt, RDN, LD

No 30-something woman wants to be told she has varicose veins.  There are moments when it feels like you are wearing a “scarlet letter” that everyone is whispering about as you walk by.  Hiding might feel instinctive, but it is not the solution.  In fact, there are many interventions for varicose veins that can empower you to regain your confidence and love your legs!  

Throughout the process of dealing with my own insecurities related to varicose veins popping up during pregnancy in Part 1, I learned that my confidence is my own.  I can either claim it or give it away.

(My varicose veins- left leg; spider around the knee and down the interior portion of leg)

We can wait and long for others to admire our beautifully complex body OR, we can decide that what God made is GOOD.  Truth.

But living life confidently and proud of our perfectly imperfect body doesn’t mean we can’t (or shouldn’t) take advantage of options to care for our bodies.  If varicose veins are a reality for you, solutions are available.

FIRST, if you have not been evaluated by a physician, make an appointment with a vein specialist or at least your primary care physician so that your specific situation can be assessed and proper diagnosis can be delivered.  No referral was needed for me to set up an appointment at GHS Center for Venous and Lymphatic Medicine, so a simple call to your local vein center will let you know how you can proceed.  

Depending on your specific diagnosis, different treatment options will be available.  If you are currently pregnant, it is recommended that you wait 3-12 months post-delivery to allow your body to recover from pregnancy and lose weight gained.  This also allows for natural fading to occur, which is likely due to the reduction in blood volume and less pressure from your shrinking uterus.  

There are several proactive measures you can take during pregnancy to halt or minimize varicose veins from getting worse.  Many of them were discussed in An Honest Conversation About Varicose Veins During Pregnancy, Part 1, and today I am going to share more information about methods I put into action in my own life.  Then, therapies and treatments post-pregnancy will be discussed to inform you of additional actions you can take if those pesky ugly guys hang around.

 

DURING PREGNANCY

Varicose veins and similar vein issues tend to get worse as the baby gets larger during pregnancy.  Therefore, the goal during at this time is to support the body in every way possible to slow the progression of the issue.  

Women can be quite proactive by exercising regularly, not sitting or standing for long periods, eating a diet rich in fiber and antioxidants as well as minimizing high sodium and processed foods.  Even swimming in cool water can help relieve the pressure and discomfort!  But there are 2 specific tools I used in addition to these diet and lifestyle behaviors/interventions to support my body and feel better during pregnancy.

 

Compression Hose

These are not sexy, BUT, they work!  If you want some attractive legs after you and your spouse decide your nest is “full” then these are worth wearing for a few months as baby is growing.  Compression hose prevent or manage swelling and edema in your legs and feet along with:

  • Improve circulation
  • Reduce pain and discomfort of varicose veins

What You Should Know

  • They come in a variety of shades, styles, lengths, and sizes.  
  • There are different levels of compression.  Your healthcare provider can help you determine what level you need based on your diagnosis.
  • Compression hose DO take time to put on.  They are snug for a reason- that’s why they work!  You will think that you ordered 2 sizes too small.

My Experience

Medi USA sent me 2 different types of compression hose to test out:

  1. Mediven Comfort, Open Toe, Thigh Lace, Level 2 Compression, Color Sandstone
  2. Mediven Comfort, Closed Toe, Maternity Panty Hose, Level 2 Compression, Color Sandstone

(Thigh High Compression Hose)

(Maternity Compression Panty Hose)

The first time you put them on it will feel like you are battling a pack of wolves, destined to be consumed.  The second time you put them on it will feel like the longest uphill battle you have ever fought.  But, by the 6th or 7th time, it will feel like you are trying to fit into pants that are 2 sizes too small.

Gradually it will get a bit easier and you will get a bit quicker.  I can now put the thigh high compression hose on in about 4 minutes (yes, I timed myself).  

These videos guide you step-by-step how to put compression hose on and take off:

The reason I put these on almost every single day is because my legs immediately feel better as soon as they are in place.  They feel lighter and I don’t experience discomfort from the varicose veins.  I put them on before I get dressed in the morning and usually take them off around 6-7pm.  In the beginning I was horrified and embarrassed at the thought of wearing them, but I got over it because I care about my health and my legs.  

Do I wear them out of the house?  YES!  If you have encountered me at any time in the last few months, chances are I am wearing them.  I have worn them with shorts and tennis shoes, jeans, under dresses and skirts.  The open toe option allows you to wear almost any pair of shoes without feeling like you are in ‘granny panties.’  

 

Maternity Belts, Pelvic & Back Support Bands

There are a variety of maternity support options to wear underneath your clothing to lift the abdomen, relieve pressure and promote beneficial circulation.  The brand, It’s You Babe, has 9 different band options to allow you to find the most useful one to support your body.  The discussion can begin with your Midwife or OBGYN, but a vein specialist may also discuss these options with you as well.  Whether you are experiencing back pain, varicose veins, sciatica or simply want to provide yourself with better pelvic floor support, this is an option to pursue.

(PF PRESS FRONT)

(PF PRESS BACK; velcro to adjust)

My Experience

It’s You Babe sent me the PF Press to try out for pelvic floor therapy and vulvar varicosities.  Varicose veins can also show up in the vulvar area, often producing a feeling a fullness or pressure in your genitalia.  This particular product helps lift and relieve the pressure to promote appropriate blood flow.

The PF Press can easily be worn under any pants, skirt or dress (over your underwear).  It worked very well for me.  Once the belt arrived in the mail, I wore it daily, with the exception of cleaning it.  I highly doubt anyone would know it is being worn, so this tool can certainly be hidden well under clothing.

 

AFTER PREGNANCY

According to the American Pregnancy Association, it can take 3-12 months for varicose veins to “diminish” after delivery.  While most women I know wouldn’t be excited to wait that long to “see” if they go away, it is necessary to give your body time to lose pregnancy weight and extra blood volume and fluid.  A Vascular Medicine Physician will likely schedule for you to come in for assessment during that 3-12 month window to evaluate your next steps.  If you are finished having children, these are some potential options you can discuss with your vein specialist:

 

Laser Surgery

A laser light is focused on the varicose vein which causes it to fade away.  It is used to treat small varicose veins.  No cutting, injections or medications/chemicals are used.

 

Endovenous Laser Treatment (EVLT)

A thin laser fiber is inserted into the vein and uses heat to close off the vein.  This same day procedure occurs while the patient is awake, with area numbed.  Advantages include minimal scarring and individual can quickly return to everyday activities.

 

Sclerotherapy

Often used to treat smaller varicose and spider veins, this procedure is done in-office by injecting a solution into the unhealthy vein to cause it to shrink, turn to scar tissue and fade away.  Depending on the vein’s size, it can require 3-6 treatments to close off the vein, typically scheduled every 4-6 weeks.  It is recommended to wear compression hose following the procedure for 2 weeks to support legs.

 

Micro-incisional OR Ambulatory Phlebectomy

Using local anesthesia and usually performed in the doctor’s office, the physician makes small cuts to remove the varicose vein.  Unlike “vein stripping” this approach is less invasive, minimizing cuts and incision size.

 

Vein Stripping & Ligation

The most invasive of vein procedures and only used for severe cases of varicose veins, this surgery ties down and cuts parts of the ill-functioning vein to remove them.  The patient is usually sedated under general anesthesia in the hospital.  It can require 1-4 weeks for recovery time.   

Each vein specialty center may have slightly different variations of procedures offered to patients. Physicians should educate patients on all options available at their center but recommend the one that will best address the health issue with the least risk, side effects and recovery time.  

Definitely make sure to thoroughly discuss options with your physician, understanding the length of the procedure and potential side effects. Ask questions about scarring, pain, whether consecutive appointments will be necessary and best practices to help prevent future varicose vein issues.

Make sure you feel informed, comfortable and secure as you make the best decision with your healthcare provider.

Rest assured… According to the National Heart, Lung and Blood Institute, “removing or closing varicose veins usually doesn’t cause problems with blood flow because the blood starts moving through other veins.”

Varicose veins are unattractive, but they are also a sign of venous insufficiency.  That means that they are not working or functioning as designed.  Addressing this particular issue with a specialist is not just about having attractive legs, but maintaining or improving the health of your circulatory system.  

It’s not vanity- it’s your health, vitality, mobility, and confidence.

YOU ARE WORTH IT!

TRUTH: Prepare plans by consultation.  –Proverbs 20:18a (NASB)

 

NOTE: This is NOT a sponsored post.  Thank you to Medi and It’s You Babe for allowing me to test out the products provided.  All opinions are my own.

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Health Recipes
No-Bake Carrot Cake Snack Balls

This dietitian adores carrot cake.  Adores with a capital “A.” Growing up, each person in my family got to choose what type of cake we wanted to enjoy on our birthday and every year, there was no need to even have a discussion with me- carrot cake with cream cheese icing.  I was a little bit predictable.

Through the years I have attempted making healthier versions of my beloved treat…some good and others an epic fail.  But the combination of warm spices, chewy raisins, crunchy bits of carrot and moist cinnamon spiced cake make my mouth water just thinking about it!  

My most recent birthday…9.18.17

While working at Rex Surgical Specialists a few years ago, I shared this Carrot Cake Oatmeal with our cooking class.  This was a recipe I have been making for years with many of the flavors and textures I love about carrot cake.  Recently I decided to attempt my own version of carrot cake balls for an energizing and delicious snack to enjoy mid-afternoon or as my after dinner treat.

Carrots have received a bad reputation from the “high glycemic/low sugar gurus.”  Actually, their glycemic index for 1 serving of raw, diced carrots is 35 (under 55 is considered “low”).  You can read about whether we should be making food choices based on the glycemic index in my published article for the online magazine, TJM.  But if you want my plain and simple nutrition advice, if it grows in the ground or on a tree, we should be free to eat it!  

Carrots are a sweet vegetable which makes them a great option to introduced to kids in a variety of ways!  Just a 1/2 cup portion provides 184% of your daily needs for vitamin A!  Immune function, reproduction, vision, and cell communication are just a few of the roles Vitamin A plays in keeping your body healthy and functioning well.  Carrots also may be of benefit in warding off cardiovascular disease.  According to this study published in the British Journal of Nutrition in 2011, consuming an average of ¼ cup of carrots daily were associated with a 32% reduction in the risk of developing coronary heart disease.

These Carrot Cake Snack Balls are so easy to make and filled with good-for-you foods.  Use your favorite protein or “green” powder to make them- I used vanilla flavored.  At, first it might look like you need more liquids but just keep mixing and you will find that a crumbly dough forms.

Enjoy!!

Carrot Cake Snack Balls

Jennifer Hunt, RDN, LD
Print Recipe
Servings 20

Ingredients
  

  • 1/2 cup raisins packed
  • 1 tbsp water
  • 1 very large carrot about 1 cup grated
  • ¼ tsp kosher salt
  • ½ cup almond flour
  • 2 servings vanilla whey protein powder about 60-65 grams total
  • 1 ½ tsp ground cinnamon
  • 1 cup old-fashioned rolled oats
  • 1 tsp vanilla extract
  • 2 tbsp coconut oil melted
  • ½ cup walnuts chopped

Instructions
 

  • Place raisins in a small bowl with 1 tbsp water and microwave for 20 seconds. In a food processor, blend raisins in liquid until mostly pureed. Shred carrots into raisins using the grate attachment on your food processor.  
  • In a medium bowl combine oats, cinnamon, salt, almond flour and protein powder.. Stir in carrot and raisins mixture, melted coconut oil, and vanilla. Combine well until the mixture is moist and comes together when pressed. Refrigerate for at least 30 minutes to allow to set.  
  • Finely chop walnuts. Roll mixture into heaping tablespoon size balls and then roll in walnuts to coat. Place balls in air-tight container and keep refrigerated.

Notes

  • When stirring up wet and dry ingredients, it might not look wet enough initially.  Keep stirring because it will be!
  • Refrigerating the mixture before rolling into balls will make it less sticky and easier to handle.  But, if it feels too “tacky,” freeze the mixture for a few minutes to harden and make it easier to form balls.
Nutrition per Ball
Calories 89; Total Fat 5g; Saturated Fat 2g; Cholesterol 6mg; Sodium 37mg; Carbohydrate 8g; Dietary Fiber 2g; Sugar 3g (Added Sugars 0g*); Protein 4g
*Added sugars depends on your choice of protein powder.  Check out the label and ingredient list to determine how it is sweetened.

Find more than 15 additional snack ideas to pack in your lunch box (or your kids!) in my article The Art of Snacking Well.

You really can have your cake, and eat it too!

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Health
An Honest Conversation About Varicose Veins During Pregnancy, Part 1

Mortified.  Day by day I watched purple veins pop to the surface of the inside of my left knee and spread down my calf like a spider web.  It looked awful.  I tried to ignore it, pretend it wasn’t there, but as the weeks of pregnancy passed by I realized this was something that was not going away.

At first, it was just like an ugly scar that wouldn’t vanish, but then it became uncomfortable.  When I would get up in the morning and step out of the bed, I would feel a worrisome throbbing or pulsing sensation travel down my leg that would take 30-60 seconds to go away.  Usually moving around (literally jogging in place with sleep still in my eyes) would help it subside a bit faster.  

Finally, one day I asked my husband to take a look.  While he works in prosthetics and orthotics, he has a wide knowledge of vein issues.  He confirmed my dreaded suspicions.  I was horrified.  Would my leg really look like this the rest of my life?  To be honest, I was completely naive and thought that varicose veins only occurred when you were a great-grandmother and no longer went to the beach, put on shorts or wore a skirt above your knees.  

My pride made me bitter.

Of course, my husband tried to comfort and reassure me in all the ways a loving husband would, but I was just plain mad.  I had always been in charge of my health.  If I didn’t like something I could change it.  But this was something I couldn’t change.  The cleanest diet, best workout plan, appropriate sleep and smart stress management couldn’t make those expanding, vivid purple lines go away.  

Only about 10 weeks into pregnancy when these appalling veins began to show themselves, I was determined to keep them hidden, even as we approached warmer weather months.

It took a couple of weeks for me to eat my pride, accept the reality, humble myself and seek out a professional opinion.  Thankful for my husband’s connections in the healthcare arena, I soon had an appointment with an amazing physician at GHS Center for Venous and Lymphatic Medicine.

Pulling up my long maxi skirt to reveal the secret I had been hiding was a bit emotional for me.  Dr. Darby was so sweet with a kind bedside manner and warm eyes.  After a quick ultrasound to verify there were no clots, she stated,

“I have good news and bad news… The bad news is that varicose veins usually get worse during pregnancy and with consecutive pregnancies.”  Then she said confidently, “The good news is that after pregnancy, I can fix it.”

It was a dose of encouragement and discouragement all in one pill, but I was certainly relieved that maybe one day, I would go to the beach or wear shorts again.  

She made several recommendations about what I could do proactively during pregnancy to halt or minimize these ugly guys from getting worse.  Considering the hot summer months ahead during pregnancy, Dr. Darby encouraged long, flowy palazzo pants and maxi dresses and skirts to keep cool.

Without any prompting, she pulled up her palazzo pants leg and showed off her candy pink knee high compression hose.  You would have never known she was wearing them if she hadn’t shared, but she was actually proud to display that she practices what she preaches.  Even though her varicose veins that popped up in her own pregnancy have been “fixed,” she continues to promote circulatory health by becoming an advocate and model to her patients.

This particular health issue was nothing I had asked for, deserved or a result of my own health behaviors.  But it was mine to own.  Decidedly, I began my own personal research on this unspoken topic of varicose veins during pregnancy.  There is a stigma, an idea that after pregnancy within a few weeks everything should just ‘pop’ back into place.  

Women talk about a lot of issues during pregnancy but varicose veins aren’t one of them.  It feels hush-hush.  But, I decided if I was going to bear those glory scars to have another healthy baby, I would also educate and champion other women who were also wondering if they could ever feel sexy again.

Let’s begin with the basics…

What are varicose veins?

These are twisted, enlarged veins near the surface of the skin.  They develop most often in the legs and ankles, but during pregnancy, can also occur in the groin, vagina, and buttocks.  Hemorrhoids are another type of varicose vein that occurs in the areas of the rectum or anus.

When veins are functioning well, the valves open and blood volume is pushed back from the legs to towards the heart.  But when an upward flow is prevented, blood pools in the veins causing excessive pressure which can lead to swelling of the veins and discomfort.

According to the Department of Health and Human Services, 50-55% of women and 40-45% of men in the United States suffer from some type of vein problem.  The Journal of Circulation claims that 23% of Americans have varicose veins in an article published in 2014.

 

Why do they occur during pregnancy for some women?

During pregnancy, blood volume increases while the rate at which your blood flows from your legs to your pelvis decreases.  This puts pressure on your veins.  Other reasons include:

  • Hormonal changes
  • Pressure on the inferior vena cava from the growing uterus
  • Genetics- if you mom had them, you might too

 

Will they go away or fade?

The very good news is that according to the American Pregnancy Association and at the advisement of my physician, varicose veins usually fade or go away within 3-12 months following delivery.  This gives your body time to regulate hormones, lose pregnancy weight and allow blood volume to normalize.

However, it is wise to schedule an appointment with a vein specialist before and after you deliver to ensure that your circulatory system is working well, no blood clots are present, and no further damage is occurring to your legs.  

By meeting with a physician, they are able to assess and advise on treatment options that can relieve pressure to prevent the issue from getting worse.  During my appointment, they also took photos of my legs (not the loveliest pictures!) to provide visual evidence to insurance.  If additional treatment or interventions are necessary post-delivery, it is smart to have documentation and photos of the pregnancy varicose veins.

 

What are the long-term consequences of varicose veins?  

If vein issues are left untreated, varicose veins can eventually lead to ulcers, bleeding, painful inflammation and blood clots.  A healthy circulatory system is part of a healthy body!

In addition to being quite unattractive, they are also quite uncomfortable!  Some common complaints about varicose veins:

  • Aching
  • Feeling of heaviness or fatigue in legs
  • Tenderness
  • Pain
  • Itching

Personally, I experienced a lot of tenderness (felt like a bruise that wouldn’t go away), heavy feeling legs, and occasional itching.  In addition, when getting up from bed each morning, there was a throbbing sensation pulsing through my legs that could last up to 30-60 seconds.  

 

What can you do during pregnancy to help?

Taking a proactive approach is key to feeling good and not allowing this issue to ruin your self-esteem.  You can maintain your pregnancy glow even if you have purple spider veins tattooed on your legs!

Maintaining healthy circulation is essential throughout pregnancy.  These are some you can do:

  • Exercise regularly– Your heart pumps blood to all your limbs and exercise helps keep circulation working properly.
  • Gain weight at a healthy rate– All women need to gain weight during pregnancy for a healthy baby.  Talk with your physician, dietitian, or midwife about how much weight is appropriate for you.  However, gaining at a steady, gradual pace is very important to prevent excessive pressure at any one time.
  • Avoid sitting or standing for long periods of time-  Get up and stretch if you have been sitting a while.  Take a short break and sit down if you stand a lot.  
  • Avoid wearing high-heeled shoes-  Flats or low-heel shoes work your calf muscles more, helping push blood back up into your legs.
  • Avoid crossing your legs while sitting
  • Elevate your legs when you are able- This allows gravity to help get blood flowing back towards your heart.
  • Sleep on your left side to reduce pressure on your inferior vena cava.
  • Wear compression hose (like these) to help stimulate blood flow up the legs and towards your heart.

Other options pregnant women can consider include a Prenatal Cradle.  This flexible device helps hold up the growing abdomen and is worn under clothing.  It relieves pressure on the pelvis and back which can help blood flow improve during pregnancy.

There is also a similar device specifically created to relieve pressure in the vagina.  These can be helpful for women who have vulvar varicosities (varicose veins occurring in the vaginal area).

The primary purpose of all of these techniques and tools is to help relieve pressure so that your body and circulatory system can function properly pushing blood back up your legs towards your heart.

Most physicians would recommend following most if not all of these methods to prevent further dysfunction of your veins during pregnancy, although some of the specific devices may or may not be applicable to your diagnosis.

 

Can I do anything nutritionally to help improve varicose veins?

  1. Avoid foods high in sodium to maintain a healthy blood pressure.  Eating a diet rich in fruits, vegetables, low-fat dairy and whole grains boosts your body’s intake of magnesium, potassium, and calcium,- all nutrients which help regulate blood pressure (DASH eating pattern).  Remember that most fast food, processed foods, and restaurant foods are extremely high in sodium.  
  2. Consume adequate fiber and water.  Straining to have a bowel movement puts more pressure on your veins and can cause a hemorrhoid to form.  But especially if you are already experiencing hemorrhoids, this is one recommendation worth following!  You can help maintain a healthy gastrointestinal tract and avoid additional pain and discomfort by choosing foods naturally high in fiber including whole grains, beans, peas & legumes, whole fruit, and vegetables, as well as nuts and seeds.
  3. Eat a diet rich in antioxidants & flavonoids.  These plant super-heroes help practically every part of the body, including your veins!  All the more reason to load up half your plate with veggies and fruit.  

NOTE: During my appointment with Dr. Darby, we discussed a specialized supplement with high concentrations of bioflavonoids that is on the market and specifically designed to treat venous insufficiency.  It is advertised as a tool to include along with proactive measures like weight loss, compression hose, exercise, etc.  Dr. Darby advised me that she is still learning more about the research and supplement as to whether she will regularly advise patients to use this product.

If you feel plagued with varicose veins now (during pregnancy) or have them to show from previous pregnancies, you are not alone!  I completely understand the frustration, self-esteem issues, and feeling of helplessness.  BUT, there are many options for you to pursue (along with me!) that can dramatically help!

Don’t miss my follow-up post next week that will provide an in-depth look at treatment and intervention options during pregnancy AND post-delivery for varicose veins.  I will share some of my own real-life pregnancy experiences testing out Medi compression hose and the PF Press (for vulvar varicosities).  You will also find out exactly what you need to know about options you can discuss with a physician post-delivery to reclaim your beautiful legs and regain your confidence.

“You are altogether beautiful, my darling; there is no flaw in you.”  –Song of Songs 4:7 (NIV)

A woman’s body is stunning and awe-inspiring.  She can nurture a baby in the most intimate, loving way, birthing new life.  We don’t have to live with the embarrassment or stigma from changes that occur to your body during pregnancy.  

Educate yourself.

Be proactive.

Make choices that promote confidence.

And, celebrate your beautiful and amazing body!

 

TRUTH: Her children arise and call her blessed; her husband also, and he praises her: “Many women do noble things, but you surpass them all.”  Charm is deceptive, and beauty is fleeting, but a woman who fears the Lord is to be praised.  Honor her for all that her hands have done, and let her works bring her praise at the city gate.  –Proverbs 31:28-31

 

NOTE: This is NOT a sponsored post.  Thank you to Medi and It’s You Babe for allowing me to test out the products provided.  All opinions are my own.

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Health
Faster Weeknight Dinners- Strategies That Really Work!

Years ago, Rachael Ray had a tv show on the Food Network called Week in a Day.  In the course of 60 (tv) minutes, she would show you how to make 5 different meals for your family and how to reheat and serve them each night.  The idea of having a yummy home-cooked meal on the table for your family each night is quite appealing and beneficial.  And this may compel you, even more, to sit down at the dinner table as a family.

But, I remember watching it several times and thinking that the concept was completely impractical.  I mean, who really wants (or has time!) to spend half a day (or more!) in the kitchen cooking meals for the entire week!?

Through the course of her career, Rachael Ray has had some brilliant time-saving ideas, some that I have even employed in my own kitchen.  However,  I just don’t think that the average mom or dad plans to spend that much time in the kitchen each weekend on a regular basis.  Home improvement list, anyone?  Yard work?  Soccer games?

While a day of cooking may not ever make it on your to-do list, I do think there is something to doing a little extra prep on the weekends to make your weeknight meals a little bit (or A LOT bit!) easier.  There are several strategies I use each week to help our weeknight meals come together in a flash.

When my husband gets home from work, he likes to spend some time playing with our daughter and I love to go for a walk.  But, in order for this to happen, dinner can’t take long to come together.  

To be completely honest, I don’t follow all of these strategies every single week, but we do employ them most of the time.  They are simple actions that truly get dinner on the table faster and easier during the workweek.  It’s not rocket science.  It’s just intentional living.  And, YOU can do this too!

Each weekend when I am cooking dinner or preparing a lunch, I do a couple extra things since I am already in the kitchen…

 

Start a Slow Cooker Meal

This is one of the best tools in the entire kitchen!  Your slow cooker tends to your food so you don’t have to and it comes out delicious and tender every time! But, some slow cooker meals don’t take a full 8-9 hours (a typical workday).  Cooking these recipes on the weekend (or your day off), means you can then cool it and pop it into your fridge for the night you want to eat it.  Simply reheat and serve!

And, let’s also applaud most slow cooker recipes that make more than enough for 1 family meal.  That means the leftovers are perfect for another dinner or to package up into containers for ready-to-go lunches.

Seriously, if your slow cooker is dusty in a corner of your kitchen, this is a solution waiting to be discovered!

These are a few of our favorite slow cooker meals!

 

Wash & Chop Veggies

This might not be a new or clever sounding strategy, but it really works!!  If you need an onion chopped for 2 separate recipes, why not do it all at once!?  By batching washing and chopping, you can save yourself valuable time and energy each weeknight.  While there are a few veggies (like tomatoes) that just aren’t as good chopped in advance, many veggies work well with this strategy!

  • Wash lettuce and place in container or plastic bags with a damp paper towel
  • Chop onions, bell peppers, carrots- store in containers or plastic bags
  • Rinse and chop squash, zucchini, broccoli, and cauliflower

 

Bake Potatoes

A staple meal we have every single week is grilled chicken salads with sweet potatoes.  Every. Single. Week.  Do you have a meal like that too?  But, potatoes, sweet or white, take about 1 hour to cook in the oven.  To save time during the week, we cook them on the weekends and wrap them up to be reheated on salad night.  Of course, you could mash them for sweet/white potato mash as well.  This one is a no-brainer- it only takes a minute to wash them, throw them into the oven and set a timer.  This means we don’t end up moving to “plan B” during the week if it’s too late to wait on potatoes to bake.

 

Cook 1 Type of Whole Grain

Whether your family likes wild/brown rice, quinoa, farro or any other type of whole grain, it is so simple to cook this up on the weekend and have ready to reheat with a splash of water, vegetable or chicken broth before serving during the week.  You can season or keep plain so that it is versatile.  

Making extra means that you can then use your whole grain in different dishes you might want to throw together, like this Quinoa Edamame Salad with Citrus Vinaigrette.  When ingredients are already cooked and prepped, it takes absolutely no time to make recipes like these!

 

Grill or Pan-Sear Extra Chicken

Chicken is one of the most popular proteins, especially among families.  It is a great lean source of protein and well received by most kids and adults alike.  But, if you are like me, too many times I have forgotten to take the chicken out of the freezer to defrost and have ready to cook by that evening.  This quickly makes us turn to plan B or C!  

Instead of that pressure, save yourself and go ahead and cook extra on the weekends.  You can grill it, pan-sear it, or even bake extra chicken so that you can use it in at least 1 other recipe during the week.  It can easily be sliced and reheated in a pan with a bit of low sodium chicken broth (or even its own juices) in a matter of a couple of minutes.  

Here is what we do with leftover, reheated chicken:

  • Add atop salads
  • Shred and make chicken tacos or even enchiladas
  • Add to a stir fry with quick sauteed veggies and a whole grain
  • Slice and top with marinara sauce over pasta with broccoli and parmesan

 

Weeknights are already hectic enough!  But, it is not impossible to get a healthy meal on the dinner table.  Choose a strategy or 2 to try out this week and see if it makes a difference.  For our family, we like to get our daughter in the kitchen 1 or 2 nights to “help” us put together dinner.  However, if the meal takes too long to prep and cook, she loses interest and gets restless.  By having many of these ingredients prepped and cooked in advance, time is saved, frustration is avoided and dinner is served!  

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