'The Harvard Medical School Guide to Healthy Eating During Pregnancy'

[APRIL 12, 2006]  ^"The Harvard Medical School Guide to Healthy Eating During Pregnancy." W. Allan Walker, M.D., with Courtney Humphries, McGraw-Hill, 2006, 211 pages.

Review by
Richard Sumrall

How important is proper nutrition to women who are pregnant? According to Dr. W. Allan Walker, "It may seem hard to believe, but recent research reveals that what a mother eats during pregnancy can affect whether her child will develop diseases such as heart disease and diabetes -- 40 to 50 years later, when that child is an adult." In his new book Walker contends that research indicates a child's health can be dependent on several factors during the mother's term of pregnancy.

Expectant mothers can improve their child's health by reaching a healthy weight before becoming pregnant, following a balanced diet before conception, avoiding extreme weight swings while pregnant, nourishing the body with a proper balance of nutrients and staying active during the pregnancy.

"How to Prepare for Pregnancy," "How Pregnancy Works" and "Why Fetal Health Lasts a Lifetime"

Women who are planning a pregnancy should make certain lifestyle changes prior to or during conception. Achieving a stable weight through proper diet and nutrition, developing a positive activity schedule, and monitoring any existing medical conditions are all part of these preparations. It is crucial that women "iron up"; since the blood volume can expand during pregnancy, the demands of the growing baby can put a woman at a high risk for iron deficiency or anemia.

The life of a pregnancy is generally measured through the three trimesters. Walker explains what a woman can expect during each of the trimesters and the corresponding role of fetal nutrition.

Since proper nutrition and a metabolic balance in the woman's heath are central to a healthy fetus, the author raises the subject of "fetal programming." According to Walker, "Your body is much more than simply a home for your baby as she develops … the overall health and conditions of a mother's body can leave a lasting impression on her baby's health."

"Eating Well for Your Baby-to-Be," "What to Avoid While Pregnant" and "Dietary Supplements"

One of the reoccurring themes in this book is the importance of good nutrition and balance of diet. During the pregnancy a balance between diet and the natural craving for certain foods must be met. According to Walker, women can reach this dietary balance by making each meal a square meal (choose items from all of the different food groups); include plenty of fruits and vegetables; change your food proportions from your normal routine; eat healthy substitutes for high-fat and high-sugar foods; and put your indulgences to work (use them to add more of the healthy food you might skimp on).

What you avoid is as important as what you eat. Always avoid the usual substances -- alcohol, tobacco, caffeine, recreational drugs -- but don't ignore the new research on other substances. For example, certain medications can interfere with fetal development. Artificial sweeteners satisfy the sugar cravings but can also harm the fetus.

Some women consider substituting or enhancing their dietary and nutritional requirements through supplements. These supplements come in the form of prenatal vitamins, fish oil for DHA and herbals. The bottom line -- choose reputable supplements as advised by your doctor; don't use supplements as replacements for nutrient-rich foods; and be wary of herbal supplements that have not passed rigorous safety tests.

"Why Weight Matters" and "How to Stay Active, Safely"

According to Walker, a mother's weight during pregnancy can influence the baby's health. Research shows that women who gain too little weight or too much weight can give birth to babies who are correspondingly smaller or larger than normal. There's also evidence that too much or too little weight gain "can cause similar metabolic problem in the child, including a higher risk of diabetes and obesity later in life." Women can achieve their target weight gain through a useful "Prepregnancy Body Mass Index" contained in the book. The chart provides guidelines on a desired weight, based on a woman's height and body mass index (the ratio of height to weight).

One way to maintain a desired weight is through exercise. Although exercise during a pregnancy is different from regular exercise, it's important that a woman exercise regularly to benefit her body and cardiovascular system. Although exercise is a necessary part of a successful pregnancy, women should always avoid activities that are intense, vigorous or apply pressure to the tummy area.

"Recipes," "Meal Planning" and "Eating Well After Pregnancy"

These final chapters contain recipes that help women apply the nutritional information presented in the book. Tips include how to eat for morning sickness and making healthy foods convenient to prepare, store and eat.

Good nutrition is also important after giving birth, particularly for those women who choose to breast-feed their baby. The author feels very strongly that mothers should breast feed-their babies; in fact, he writes, "It is almost universally agreed by health authorities all over the world that breast-feeding is the healthiest choice for mothers and their babies."

"The Harvard Medical School Guide to Healthy Eating During Pregnancy" is a valuable addition to the latest science and literature on nutrition during and after a pregnancy. As a top expert in pediatrics and nutrition, the author "draws upon the latest research and his more than two decades of clinical experience to explain, in plain English, the science of prenatal nutrition." This book is recommended to any woman who is pregnant or considering a pregnancy; fathers-to-be should also become familiar with the information and advice found in this book.

[Richard Sumrall, Lincoln Public Library District]

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