The risks of having a raised BMI in pregnancy

Why have we invited you to this group?

Having a raised BMI carries increased risks in pregnancy but, most of you will have healthy pregnancies. However we want to make you aware of these risks and give you advice regarding steps you can take to reduce the risks.

Risks for mother include

Developing diabetes Big/small babies Premature births High blood pressure Blood clots in the legs Caesarean section Long-term heart disease Uncomfortable pregnancies Complications in labour

Risks for baby include

Baby can have obesity in childhood/later life Low blood sugars at birth Shoulder dystocia Asthma Diabetes

Information supporting appropriate activity during pregnancy

NHS Choices website: “The more active and fit you are during pregnancy, the easier it will be for you to adapt to your changing shape and weight gain. It will also help you to cope with labour and get back into shape after the birth. Keep up your normal daily physical activity or exercise (sport, running, yoga, dancing, or even walking to the shops and back) for as long as you feel comfortable. Exercise is not dangerous for your baby – there is some evidence that active women are less likely to experience problems in later pregnancy and labour”.

The average person takes 3,000-4,000 steps daily, 10,000 is recommended. Aim for 150 minutes exercise a week, which can be broken down into 10 minute segments. Build up slowly, any increase is beneficial. Begin every walk with a warm up and finish with a cool down, faster than a stroll if possible”.

Pregnancy specific benefits

Control weight gain Decrease chance of diabetes Decrease chance of raised blood pressure and pre-eclampsia Decrease in anxiety and depression Decrease in constipation problems Increase in positive moods Improves sleep quality By maintaining movement, you will have less aches and pains

Why walk?

It is free, can be done anywhere, no specific equipment required, safe, can build up gradually, fun and sociable.

Walking tips

Begin slowly/build up gradually Wear comfortable clothing Walk most days Start short then increase to get a feeling of warmth, be slightly out of puff Take the stairs Leave the car and walk to work or walk at lunch time Get family and friends involved Join a walking group Download a walking app Get off a bus a stop earlier and walk Don’t over heat, drink plenty of water Be able to hold a conversation while exercising

Other safe recommended activities

Swimming Yoga Aqua-aerobics

Always tell an instructor that you are pregnant.

Avoid - This is due to risk of falls and injuries.

Scuba diving Horse riding

The Eatwell Guide

The Eatwell Guide is designed to help you get a balance of healthier food, It shows how much of what you eat overall comes from each food group

Key messages -

Green section – Fruits and vegetables (provide vitamins, minerals and fibre)

Have at least 5 portions of fruit and vegetables every a day. Eat a wide variety of different colours of fruit and vegetables

(Eat a rainbow) Tinned, dried and frozen fruit and vegetables still count as a

portion of fruit and vegetables. Tinned fruit and vegetables have to be in natural juices NOT in syrup or brine.

Dried fruit: try not to eat too much (30g max) and best eaten at meal times due to the sugar content and possible damage to your teeth.

A portion of fruit and vegetables is what fits in your hand (80g)

150ml glass of fruit juice or smoothie (counts as a maximum of one portion a day)

Yellow section – Carbohydrates slow releasing Energy foods.

We need carbohydrates to give our body slow releasing energy. Limit the amount of high fats and sugars you add to carbohydrates

(butter, jam etc) Balance your carbohydrates with the amount of energy you are

using Wholegrain or higher fibre options are better (choose brown rice or

pasta or simple leave skin on potatoes) This helps us to feel fuller for longer

Purple section – Oils and spreads

Try and limit the amount of spreads (thin layer) and oils you use Use non stick pans or fry light when cooking Try and pick unsaturated oils

Blue section –Dairy foods contain calcium: good for bones and teeth, protein and vitamins

Choose low fat cheese

Try to pick low fat & low sugar yoghurt. Look at your labels-some yoghurts that say they are low in fat add more sugar. High protein yoghurts are sometimes healthier

Skimmed and semi-skimmed milk are healthier options.

Pink section – Protein

Meat, fish, plain peanuts, beans, pulses, lentils all count as protein

Cut off any visible fat. Its healthier to grill or oven cook, Try not to deep fry or fry as this will add more fat to the food..

Try and eat at least 2 portions of fish a week (one being oily) Eat less processed meat Eat less than 70g per day of red or processed meat

Food high in Fat, Sugar and Salt

These foods are not on the Guide, and are placed to the side as they are not needed in the diet

If consumed these foods should only be eaten infrequently and in small amounts

Limit the amount of high fat, high sugar and high salt foods you eat.

Fluids

Drink between 6-8 glasses of fluids daily. Can be water, low fat milk, sugar free squashes, tea and coffee Only 150ml of fresh fruit juice daily Limit the amount of smoothies.

Suggested ideas

Print off the Eatwell guide - guidance accessed at https://www.gov.uk/government/publications/the-eatwell-guide

Sugar -Key messages

Eating too much sugar can make you gain weight and cause tooth decay. The type of sugars most adults and children in the UK eat too much of are “free sugars”: any sugar that is added to foods such as sweets, fizzy juice, cakes etc.

Limit the amount of free sugars (added) you have Honey, syrups (including maple, agave and golden), smoothies, fresh fruit and

vegetable juices still count as free sugars (added) S ugars occur naturally in fruit, vegetables and milk but we don’t need to cut

down on these types of sugars We should not be having any more than 30g of free sugars (added) daily,

roughly 7 sugar cubes. There may be traffic light labelling on the front of food packaging however this is not always the case, looking at the back of the pack will give you sugar per 100g.

a low amount of sugar is 5g or less per 100g a medium amount of sugar is 6-22gs per 100g a high amount of sugar is more than 22.5g per 100g Sugar can be described using different words including sucrose, glucose,

fructose, maltose, fruit juice, molasses , hydrolysed starch, invert sugar, words ending in OSE can relate to sugar

Sugar has designed to give you a quick short release of energy that does not last long

One teaspoon equals 5gs of sugar If you drink fizzy/sugary drinks or fresh fruit juice you are better to drink them

at meal time and with a straw to help protect your teeth.

Suggested ideas

Sugar quiz with foods that appear healthy however have high sugar content. For this you need various packaging, sugar, see through plastic cups and teaspoons.

The Be Food Smart app (https://www.nhs.uk/change4life-beta/be-food-smart) from Change4Life can help you make healthier choices.

Fats

Current UK government guidelines advise cutting down on all fats and replacing saturated fat with unsaturated fat. A small amount of fat is an essential part of healthy balanced diet. Fat helps the body absorb vitamins A,D,E , these vitamins are fat-soluble meaning they can only be absorbed with the help of fats.

Any fat not used by your body is converted into body fat.

There are two main types of fat; saturated and unsaturated Most saturated fats come from animal sources such as meat and dairy

products, as well as some plant foods such as palm and coconut oil It is recommended that women have no more than 70g of fat in total per day Women shouldn't have more than 20g of saturated fat a day, children should

have much less Examples of foods high in saturated fats; fatty cuts of meat, meat products

including sausages and pies, butter, cheese, cream and ice cream, savoury snacks including crisps and crackers, chocolate, biscuit, cakes.

Unsaturated fats can be found in oils, avocados, nuts, oily fish such as salmon and trout

Tips

Cut off any visible fat Try not to fry; use the oven or grill instead If you choose to fry do not add any extra oil, use a non stick pan or fry-light Try and cut down on high fat foods such as pastries, biscuits and crisps Look out for labels that suggest low fat as they may have increased the

amount of sugar

Suggested options

Consider using relevant resources to visually demonstrate the fat content in foods for example use packaging of foods high in fat; pizza, crisps, biscuits to create and deliver a fat quiz.

Reading food labels

Nutrition (food) labels can help you choose between products and keep a check on the amount of foods you are eating that are high in fat, salt and added sugars.

There may be traffic light labelling on the front of food packaging however this is not always the case, looking at the back of the pack will give you nutritional information per 100g and sometimes per portion of the food.

labels can also give information on how a particular food or drinks fits in to your daily recommended diet

some front of pack labels use the traffic light system (red, amber, green colour coding)

Use this system above to see at a glance if the food has high, medium or low amounts of fat, saturated fat, sugars and salt to help make a healthy choice

The more green on the label, the healthier the choice. If you buy a food that has all or mostly green on the label then you know straight away that it’s a healthier choice

Amber means neither high nor low, so you can eat foods with all or mostly amber on the label most of the time

Any red on the label means high in fat, saturated fat, salt or sugars, these are the foods we should cut down on; try to eat these foods less often and in small amounts

Suggested options Order the leaflets on label reading with the above detachable decoder at https://www.bhf.org.uk/publications/healthy-eating-and-drinking/this-label-could-change-your-life

REGISTRATION FORM

Name _______________________________________________________________

Address ______________________________________________________________

_______________________________________________________________

Postcode_____________________

Telephone number___________________________________

email address________________________________________

Emergency Contact

Name: ___________________________________ Number: _______________________

Do you have any allergies/dietary requirements? Please specify

Do you any medical, physical, learning or social needs that we should be aware of? Please specify

Baby Steps includes gentle activity sessions and cooking in the kitchen. I agree to take full responsibility for my personal safety.

Sign…………………………………………………………………………………… Date……………………………………………

Important information

GDPR (General Data Protection Regulation) Data that you provide to us will only be accessed by the NHSG staff who deliver the course and Public Health Staff who host the data base and questionnaires, no third party will have access to your information. Your data will be stored in a secure database and any identifying information will be destroyed after 2 years.

During your attendance on the course the leaders will have a registration form containing your information in the event they need your emergency contact. After the course is completed this paper copy will be destroyed.

We collect data about your learning and experiences throughout the course, this data is used to improve and learn from each course delivery. You will not be identifiable from this data if used in reports.

Once you have completed the course you will be invited to attend a 6 month catch up with the Baby Steps group.

Your feedback will help us develop Baby Steps in the future, please can you complete this questionnaire as honestly as possible to give us a genuine insight into what you thought about Baby Steps. Thank you

Can you tell us why you came along to Baby Steps?

Was it what you expected? (If not, why not?)

What did you enjoy about Baby Steps?

Is there anything we could do to improve Baby Steps?

Would you come along to a weekly walking group? YES NO If yes: what time would suit you best? 10am /6pm

Baby Steps ran for 8 weeks, do you think this was:Just the right length not enough sessions too many sessions

What changes (if any) have you made to your daily activities since joining Baby Steps?

What changes have you made (if any) to your diet or the way you prepare meals since attending Baby Steps?

Have you any other comments?

THANK YOU!