Pregnancy: The Window to Future Health

1,000 Days advisor Dr. Leanne Redman answers questions about weight gain, fitness (physical and mental), and mom’s role as a nutritional gatekeeper. Read on to learn more about the essential role of nutrition in women’s health from Dr. Redman, an Associate Professor at Pennington Biomedical Research Center within the Louisiana State University System.


As your research is focused on women’s health and weight management, particularly during the 1,000-day window, what trends are you seeing with respect to nutrition during, and even before, pregnancy?

Dr. Redman:  Not only is the weight and health status of a mother at the time of conception important, but the amount of weight gain during pregnancy is also now known to have consequences for the infant. For example, too little weight gain is associated with babies being born small for gestational age and, many times, preterm. Moms with too much weight gain in pregnancy are more likely to develop metabolic issues like gestational diabetes or blood pressure problems, and the babies are often born large for gestational age. In both cases – under- and over- nutrition in pregnancy has been shown to translate to weight and obesity in childhood and adult life.

There is an abundance of solid scientific evidence that suggests that mothers entering pregnancy heavier than their ‘ideal’ weight or body mass index (BMI) have an increased risk of maternal complications during the pregnancy. More alarming is the data showing increased risks for the unborn infant during gestation, injury and complications at the time of birth, as well as increased risk for future weight gain, and even obesity and diabetes later during childhood and in adult life.

Pregnancy in many cultures is viewed as the time to let go and to eat for two. While that might have been a good idea 50 plus years ago when the quality of food was more nutritious and less likely to be high in saturated fat and sugar, eating for two in today’s obesogenic environment leads to excess weight being gained in pregnancy. Women should know the consequences of weight gain in pregnancy and the amount of weight it is recommended they gain on the basis of where they start. The Institute of Medicine put out guidelines in 2009 for women in the United States.

The phrase ‘Fertility Fitness’ seems to pop up in your work. What does it mean, and why is it so important?

Dr. Redman:  The U.S. Institute of Medicine strongly advocates that women contemplating pregnancy tackle barriers interfering with a healthy lifestyle prior to pregnancy, and attempt to conceive once maintaining a healthy weight and lifestyle. Many women are united in a common goal for pregnancy, that is to deliver a healthy baby – however many newly pregnant women (and men) do not realize the importance of their pre-pregnancy health on the future potential outcomes of their unborn child. Being physically and mentally ‘fit’ for pregnancy will help to ensure the most optimal pregnancy outcomes for mom and child; and, the whole family will enjoy the newly learned habits needed to maintain a healthy lifestyle for years to come.

So you’ve said ‘pregnancy is the window to future health’ – what do you mean by this?

Dr. Redman: Pregnancy is a time in a woman’s life when she is more likely than any other time to adopt new health behaviors to give her unborn child the best start in life. For instance, women will quit smoking, avoid caffeine or soda, increase fruits and vegetables, and take a vitamin. There is no better time in fact to adopt new behaviors that support a healthy lifestyle that will hopefully be carried forward with her in her life for many years after the birth of her baby.

Mothers have been described as the nutritional gatekeepers of the home – making most of the decisions regarding foods, meals, meal preparation and shopping. Since we now understand how critical pregnancy is on the future and long-term health of both the mother and her child, pregnancy can be thought of as a window of opportunity to foster changes for healthy nutrition. Unfortunately, pregnancy can also be a window to poor health outcomes for mom and baby. Optimizing health and nutrition for pregnancy and beyond needs to be at the forefront of thinking for moms from day one!