Pregnancy Weight and Intakes

pregweightdiagramBy: Nikki Nies

As we all know, pregnancy is an  exciting time for all those involved.  With impending baby showers and last minute gatherings for mothers to be, food related activities are inevitable.  Yet, a healthy weight gain is the aim for the mother and infant for optimal growth, development and overall health.

Weight gain recommendations: Underweight (BMI <19.1) 40-50#; normal BMI (19.25) 35-45#; overweight (26-29.9) 25-35#

Normal weight women should gain 25-35# during pregnancy. UW: 28-40#; overweight: 15-25#; obese: should still gain some weight, ~15#; excessive weight gain is discouraged with any bodyweight classification of the mother.

In the first trimester of pregnancy, normal weight pregnant women do not need to consume additional calories per day according to the National Research Council.  In the second trimester, an additional 340 calories per day is recommended and then in the third trimester, intake should increase to about 450 calories per day.  Those that are underweight may expect to increase intake by an additional 100-300 calories per day.

During pregnancy, intake of folic acid is recommended to increase  prevention of birth defects.  Fortified grains can be a good source of dietary folate, with the best sources including lentils and beans. 1/2 cup cooked black eye peas, 1 cup of raw spinach and/or 1 cup fortified corn flakes can provide more than 100 mcg of folate each.

Of course, talking to your primary care physician about your weight and health is vital during pregnancy. The above weight parameters are suggested weight gain guidelines.

Photo Credit: Baby Your Baby 


Nourish to Flourish



Calculating BMI


By: Nikki Nies

BMI is a quick, easy measurement tool any one can do with a scale and a measuring tape.   BMI is a greater indicator of health status and fat mass, but by no means be used as the end all indicator of one’s health.

Measurement Units Formula and Calculation
Kilograms or meters Formula: weight (kg) / [height (m)]With the metric system, the formula for BMI is weight in kilograms divided by height in meters squared. Since height is commonly measured in centimeters, divide height in centimeters by 100 toobtain height in meters.Example: Weight = 68 kg, Height = 165 cm (1.65 m)
Calculation: 68 ÷ (1.65)2 = 24.98
Pounds and inches Formula: weight (lb) / [height (in)]2 x703Calculate BMI by dividing weight in pounds (lbs) by height in inches (in) squared and multiplying by a conversionfactor of 703.Example: Weight = 150 lbs, Height = 5’5″ (65″)
Calculation: [150 ÷ (65)2] x 703 = 24.96

Now, you may be wondering, what does a 24.96 mean? There are 4 main brackets on BMI chart, where one can be categorized.

After a calculation has been made, one can look to a standardized chart to see where their number lies:

  • Below 18.5–>Underweight
  • 18.5-24.9–>Normal
  • 25.0-29.9–>Overweight
  • 30 and above–>obese

It’s good to remember BMI is not a diagnostic, but a screening tool used by health professionals.  To determine if one has excess weight, further assessments are needed to confirm BMI’s indications of health (i.e. skinfold thickness; evaluations of diet and physical activity and family history).


The Financial Toll of Excess Weight


By: Nikki Nies

I was recently at a neighbor’s house, perusing her Money magazine that was laying on her coffee table.  I’m always up to hear the latest tips on money, yet I wasn’t expecting to read an article on obesity in money magazine.  Yet, there it was, in Money magazine, there was an article called The Economics of Fat to Thin.  With more than 2/3 of Americans overweight or obese, of course, I had to read it.

Some scary statistics, such as:

  • According to the U.S. Center for Disease and Control and Prevention, being obese elevates the risk of coronary heart disease, diabetes, stroke and cancer
  • Annually costs the government an additional $450 billion
  • An overweight person tend to consume more calories, with added costs of an additional $90 billion a year
  • Employers and employees pay a higher life insurance premium; pay out more for  those who are overweight or obese for workers’ compensation
  • The obese spend 42% more on medical care article-2531797-1A5C3A8800000578-940_634x366
  • 77% more on medications than those with healthy weights
  • May spend 48% more on hospital stays
  • The severely obese will have an additional $3000-$10000 in medical costs
  • Obese earn up to 6% less than their thinner counterparts
  • The obese are 1.7 times more likely than leaner peers to take 7 or more sick days
  • “Plus size” and “big and tall” clothes are often more expensive since they require more fabric
  • May need to pay for an additional plane ticket for 2 seats
  • Excess weight can result in decreased fuel efficiency, every 100 lbs could lessen miles per gallon by up to 2% stated by US Energy Department
  • The morbidly obese may deduct 8-10 years from their life span
  • Those with BMI above 30 have 50-100% increased risk of premature death compared to those with healthy weigh

I liked this article because I wasn’t expecting it from  Money magazine.  Their in depth evaluation and impact of excess weight on one’s wallet is eye opening and provides an eye opening additional angle on the problems people can avoid by living a healthier life.




By: Nikki Nies

Sugar sweetened beverage (SSB) consumption is the largest contributing factor to childhood obesity.  SSB includes soda, fruit drinks, fruit juice, energy drinks, sports drinks, flavored milk and are the unnecessary consumption of added carbohydrates for flavoring.  High consumption of SSB increases risk for metabolic syndrome and chronic diseases, such as diabetes and cardiovascular disease.

Risk factors for increased consumption of SSB:

  •  Sedentary lifestyle: With increased sedentary activities such as TV watching and computer use comes mindless consumption of SSB; an increased opportunity to overeat and additional exposure to food advertisements
  •  Access at school: 68% of students consume SSB through vending machines, cafeteria and events in the classroom; Approximately 145 kcal could be saved by limiting intake of SSB at school; amount of SSB consumed is inversely related to the quality of SSB policies in schools
  •  Parental Influence:parents are “gatekeepers” of SSB consumption at home; children of lower educated mothers are 1.7 times more likely to consume SSB than those with higher educated mothers; parents are key players in the prevention and change of consumption of SSB
  • Ethic and Socioeconomic Disparities: Lower household income is independently associated with increased consumption of SSB; among children ages 6-11, Latino and black children have an increased overall consumption of SSB compared to white children of the same age

Negative Consequences:

  • Altered milk consumption: with increased consumption of SSB comes decreased consumption of milk; Kids who drink SSB instead of milk are missing out in vital nutrients such as Calcium and Vitamin D which can lead to bone disease later on; when available, two thirds of school children prefer flavored and sweetened milks instead plain low fat milk
  • Other food consumption:increased consumption of SSB leads to increased consumption of higher energy dense foods such as pizza, burgers, fried potatoes and snack foods; heavy consumers of SSB have an increased consumption of food, they also have a decreased consumption of non-sugar sweetened beverages such as milk and water

The risk factors and consequences of SSB are multifaceted.  By understanding why adults and children consume SSB in exorbitant amounts will provide great groundwork on how to best intervene and provide increased awareness on why people can’t stay away from sugar sweetened beverages.


1. Taber D, Chriqui J, Powell L, Chaloupka F. Banning all sugar-sweetened beverages in middle schools: Reduction of in-school access and purchasing but not overall consumption. Arch Pediatr Adolesc Med. 2012;166:256-262.
2. Kremers SPJ, van der Horst K, Brug J. Adolescent screen-viewing behaviour is associated with consumption of sugar-sweetened beverages: The role of habit strength and perceived parental norms. Appetite. 2007;48(3):345-350.
3. Wijtzes AI, Jansen W, Jansen PW, Jaddoe VWV, Hofman A, Raat H. Maternal educational level and preschool children’s consumption of high-calorie snacks and sugar-containing beverages: Mediation by the family food environment. Prev Med. 2013;57(5):607-612.
 4. Briefel R, Wilson A, Cabilli C, Dodd A. Reducing calories and added sugars by improving children’s beverage choices. Journal of the Academy of Nutrition and Dietetics. 2013;113(2):269-275.

5. Johnson D, Bruemmer B, Lund A, Evens C, Mar C. Impact of school district sugar-sweetened beverage policies on student beverage exposure and consumption in middle schools. Journal of Adolescent Health. 2009;45(3):S30-S37.
6. Bogart LM, Cowgill BO, Sharma AJ, et al. Parental and home environmental facilitators of sugar-sweetened beverage consumption among overweight and obese latino youth. Academic Pediatrics. 2013;13(4):348-355
7. Han E, Powell L. Consumption patterns of sugar sweetened beverages in the U.S. J Acad Nutr Die. 2013.
8. Beck AL, Patel A, Madsen K. Trends in sugar-sweetened beverage and 100% fruit juice consumption among california children. Academic Pediatrics. 2013;13(4):364-370.
9.Keller K, Kirzner J, Pietrobelli A, MP S, Faith M. Increased sweetened beverage intake is associated with reduced milk and calcium intake in 3- to 7-year-old children at multi-item laboratory lunche. J Am Diet Assoc. 2009;109(3):497-501
10. Mathias KC, Slining MM, Popkin BM. Foods and beverages associated with higher intake of sugar-sweetened beverages. Am J Prev Med. 2013;44(4):351-357.
11. Story M, Hannan P, Fulkerson J, et al. Bright start: Description and main outcomes from a group-randomized obesity prevention trial in american indian children. Obesity (Silver Spring). 2012.
12.Shapiro J, Bauer S, Hamer R, Kordy H, Ward D, Bulik C. Use of test messaging for monitoring sugar-sweetened beverages, physical activity, and screen time in children: a pilot study. J Nutr Educ Behav. 2008;40:385-391.

The Stroke Belt


By: Nikki Nies

A culmination of factors raise concern for those located in the “Stroke Belt” region. The southeast region is composed of the the Stroke Belt, which refers to higher risk of heart disease and/or hypertension.  The term Stroke Belt started in the late 1950’s by epidemiologists compiled data showing a higher-than-average death rate from strokes.

The stereotypical consumption of fatty, fried foods is not the only culprit, but genetic, socioeconomic, cultural associations, lack of access to healthy food, and lack of physical activity contribute to the higher percentage of the overweight. It’s a shame MI and TN are limited in side walks since the thought of walking around the block isn’t easily supported. It’s no coincidence southern states are also tobacco producing states as well as smoking is more common in the south.With increased weight and higher blood pressure, significantly increases one’s risk of stroke.  The elderly, Native stroke-signsAmericans, African Americans and those with lower education levels are found to be more likely to be overweight.

It should not be overlooked there are some changes that have been put into place.  As of 2007, Mississippi created nutrition standards for schools lunches, Tennessee encourages schools to buy fresh ingredients from locally grown areas and Arkansas has a school BMI program, where screening results can be sent home to inform parents.  The impact of these implemented programs will take time, but I’m glad to see such changes have been gradually introduced.

As the 4th leading cause of death in the U.S., living in the Stroke Belt, which consists of Alabama, Arkansas, Georgia, Louisiana, Mississippi, North Carolina, South Carolina and Tennessee increases one’s risk of stroke.  It’s critical to know the warning signs of stroke, such as: sudden numbness or weakness of the face, arm, or leg—especially on one side of the body; sudden confusion or trouble speaking or understanding; sudden trouble seeing in one or both eye; sudden trouble walking, dizziness, or loss of balance or coordination and/or sudden severe headache with no known cause.

Although not all factors that contribute to being overweight, like genetics or ethnicity, but lifestyle changes can make a difference.  By lowering one’s blood pressure, cholesterol and weight and avoiding use of cigarettes, can help the situation and decrease chances of stroke.


Good Measurement: Waist/Hip Ratio

Original Image by Quinn Dombrowski via Flickr
Original Image by Quinn Dombrowski via Flickr

By: Nikki Nies

The calculation of one’s BMI: BMI = ( Weight in Pounds / ( Height in inches x Height in inches ) ) x 703 or BMI = ( Weight in Kilograms / ( Height in Meters x Height in Meters ) ) has become the gold standard of evaluating one’s weight and quickly categorizes someone into underweight, normal weight, overweight, or obese.  However, critics recognize BMI is not always the best measurement as it doesn’t take into consideration muscle mass and doesn’t always reflect client’s full body composition.

Physicians and health professionals are relying more and more on measuring clients waist/hip ratio. Just like BMI, it’s a quick way to evaluate obesity and it doesn’t require anything more than a measuring tape.

When measuring hips and/or waist, use a measuring tape to measure the circumference of your hips at the widest part of butt and then measure waist at the smaller circumference of natural waist, which is usually just above the belly button.To find the ratio, one divides the waist measurement/hip measurement. After you’ve got your ratio, use the chart at the beginning of this post to see where your ratio falls.

When the stomach measurement is 90 percent or more of the hip measurement in men — and 85 percent or more of the hip measurement in women — a patient generally is thought to have a worrisome distribution of fat, said Dr. Francisco Lopez-Jimenez

There’s a correlation with abdominal fat and overall body visceral fat, signifying higher blood pressure, insulin and glucose in the blood. While BMI may help predict client’s survival without coronary disease, it doesn’t signify those affected by coronary heart disease already.

It’s suggested BMI and waist/hip ratio should be measured during assessments when possible.  Also, at home measurements of waist/hip ratio is easy for all to do, you just need to get a measuring tape.  Fluctuations from weighing oneself on a scale is not always a true indicator of weight status, but by weekly measurements of one’s waist/hip ratio can give a better indication of one’s health.