Optimising your weight; an important part of preconception care

Obesity Australia estimates that 1 in 3 Australian women are overweight or obese prior to conception which results in serious health risks to the mother and developing foetus. In the following Q&A, I explore what a healthy weight is and if you are overweight/obese what to do to reduce your weight and risk factors.

By Karen Latter, naturopath

​Q: How do I know if I am a healthy weight?
A: We find out via measuring your weight, height, Body Mass Index (BMI), waist circumference (WC) and fat percentage through Bio Impedance Analysis (BIA). A healthy range consists of a BMI 18.5 – 24.9, a waist circumference under 80cm and a fat percentage of between 21-33 per cent.
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Overweight BMI is 25-29.9 and Obese BMI 30 and above. A waist circumference of 80cm increases your risk of metabolic conditions like diabetes, and a waist circumference of over 88cm vastly increases this risk.
Q: I am in the overweight/obese range what are the risks if I fall pregnant?
A: Overweight mothers are more likely to develop gestational diabetes, preeclampsia, suffer from birthing complications, require an emergency caesarean delivery and give birth to a larger baby (>4kg). Women who develop gestational diabetes during pregnancy increase their baby’s risk of developing childhood obesity and of developing diabetes in early adulthood. Children with overweight or obese parents have a greater risk of being overweight or obese children and adults, the result of genetic, social and environmental factors.

Q: I am overweight/obese what can I do before falling pregnant?
A: Give yourself 3-4 preconception months to get healthy, your naturopathic practitioner will work with you to plan a realistic weight loss goal and also make dietary and lifestyle recommendations to help you reach this goal.
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Q: Do you have any diet tips to lose weight?
As part of the preconception diet, we recommend that you eat a Mediterranean style diet including plenty of vegetables (5+serves a day), wholegrains, lean protein including white meat and fish as well as vegetarian proteins beans and legumes, nuts and seeds. We also suggest that you lower your intake of refined carbohydrate (bread, pasta, biscuits, sugary treats) these are low in nutrition, but high in kilojoules. Instead we recommend complex carbohydrates (wholegrains such as rice, quinoa, buckwheat) these are nutritious and a slow release of energy helping to balance your blood sugar.
We recommend avoiding alcohol in the preconception phase, which lowers your kilojoules considerably because a standard measure of alcohol is 280 kilojoules.

Q: And do you have any exercise tips?
A: Increasing your daily movement, such as setting a target to reach 10,000 steps a day, participating in activities you enjoy for 30-60 minutes a day such as team sports, swimming, running and cycling. Exercise will help to build muscle, which in turn increases your metabolic rate (i.e. more muscle means you burn more energy).

Q: I am eating well, exercising and still not dropping weight – what can I do?
Disturbing factors might be limiting your weight loss, these might include:-
Sluggish thyroid gland - a healthy thyroid is vital for a healthy metabolism.
Blood sugar irregularities – elevated blood sugar can lead to insulin resistance and diabetes.
Leptin resistance - leptin is a hormone released by our fat cells that tells the brain to stop eating. Leptin resistance is when this hormone doesn’t reach its target in the brain (the receptors) or is not effective on the receptors, the result your hunger does not switch off and you keep eating.
A compromised microbiome - healthy bugs in our gut actually help keep us thin, factors such as repetitive antibiotics or eating a poor diet can affect your microbiome
Excessive stress – elevated stress hormones (e.g. cortisol) reduces our ability to lose weight as well as messes with our fertility.
Psychosocial issues – our relationship to food, and our deeply ingrained patterns and thoughts about food influence our ability to stick to a weight reduction program.
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Q How much weight can I hope to lose? 
A: Well if your target is to lose 10kg to reach a healthy BMI, it would be realistic to lose 0.5-1kg each week therefore this could be achieved over 10-20 weeks (3-5 months).

Karen is a degree qualified Naturopath, Nutritionist & Herbalist. She has been working in clinical practice for the last 12 years. She is a member of the Australian Traditional Medicine Society (ATMS) and Naturopaths & Herbalists Association of Australia (NHAA).
Karen is passionate about encouraging and guiding individuals to take control of their own health. She believes in educating people about their health conditions so they can feel truly empowered to make changes to their diet, health and lifestyle. 
www.karenlatter.com.au