March 15, 2012

Weight Management for Health and Fertility

Weight management is important when trying to become pregnant.  The best chance of success occurs in women of ideal body weight, which is a Body Mass Index (BMI) of 20-28.BMI is a function of height and weight which for example for a woman 5 feet 5 inches tall would be a weight between 120 to 165 pounds. Calorie consumption and expenditure is critical for weight maintenance and for gaining or losing weight.

Simplistically, to maintain your weight, approximately 15 calories per pound are required if you lead a very active life style. In older women who are active, 13 calories per pound is all that is needed, and for those who are relatively inactive, only 10 calories per pound are necessary to maintain current weight.

To lose weight, you should subtract 500 calories from your maintenance caloric level, while to gain weight, you would need to add 500 calories.  Therefore, if your maintenance caloric needs are 2,000 calories per day, you should consume no more than 1500 calories each day to lose approximately one pound per week.  If you are very inactive, have a difficult time losing weight, or are obese (Obese=BMI > 30,  which for a 5 foot 5 inch tall women would be a weight over 180 pounds), then you should consume no more than 9 calories per pound which would be no more than 1680 calories for a 5 foot 5 inch tall woman who was 180 pounds.

No diet works for everyone. Each plan must be tailored to suit the individual. A diet should not be thought as short term but rather as a healthy lifestyle choice.  Select lower glycemic index carbohydrates like whole grains, fruits, vegetables and legumes instead of rice, potatoes, white bread, and sweets.

Prepare balanced meals.  Select healthy unsaturated fats and eliminate saturated and trans fats. Include omega 3 fats found in fatty fish like salmon, canola oil, leafy green vegetables, and walnuts.  Beware, however, of very low fat diets, as these may lead to food cravings. Don’t  go overboard on fats as one tablespoon of olive oil contains 120 calories.

Aerobic exercise is an important  component of maintaining a healthy life style. Three to four 20-30 minute brisk walks every week is sufficient especially if combined with resistance training using light weights and more repetition.

Make small changes one at a time. Get adequate sleep and practice stress management. Vitamin and mineral supplements are also worthwhile and should include a standard multivitamin with at least 400 mcg of Folic Acid. Additional daily supplements of Vitamin D, 2000 IU together with 1500 mg of Calcium (equivalent to 2 Extra Strength Tums tablets) has been shown to enhance egg and embryo quality especially in women with ovulation dysfunction and endometriosis. B complex should be taken if you have PCOS and are taking Metformin.  Approximately 1-2 grams of mega 3 fatty acids should be taken if you are not eating fatty fish at least 3 times per week.

Weight management can be frustrating.  However, you can empower yourself to be healthier and thereby improve your chances for a successful pregnancy. This can be done using common sense by making a few healthy lifestyle choices.

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Joseph A. Hill, III, M.D.

Joseph A. Hill, III, M.D. Board-Certified in Reproductive Endocrinology and Infertility