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Gia-Gina Across the Pond

So I've decided to follow my husband to his native Italy. Follow our adventures as we eat, drink, travel, adapt to and explore this remarkable country. Part food blog, part photo blog but mostly my rants and raves. After our two years in Italy, we relocated across the Atlantic "pond" and are back in the States.

Wednesday, September 13, 2006

A Pregnancy Diet???

I am upset, as a matter a fact I am fuming right now. Today I went to the dietician, on the recommendation of my gynecologist. He was concerned about me gaining too much weight during my pregnancy. (So far, at 32 weeks, I have gained 12 kilos or 26 pounds.)

Most pregnant women in Italy will tell you that their gynecologists recommend they gain 10 kilos, 22 pounds throughout their pregnancy, regardless of body size, height and bone structure. (I am 170 cm or 5’7”.) This is a major difference from what pregnant women are told in America. If you are of an average weight when you begin your pregnancy, then gaining 25-35 pounds is the norm.

I told her that I had a mild case of gestational diabetes and with a home monitor; I have my blood sugar under excellent control. Sparing you the details of the visit today I will summarized the highlights:

She recommended: (and I WAS comfortable with)

-more fish
-less salt
-less sweets
-less fried foods
-less bivalves
-no dried fruits
-no white bread or pasta, whole wheat only
-no cured meats, salami, proscuitto etc…
-no extra sugar, I should use aspartame instead of real sugar
-only 2 servings of fruit a day

What I was NOT comfortable with was the following:

-no cheese
-no milk or yogurt whatsoever, but soy and rice milk were okay and then she recommend a calcium pill in lieu of the milk.
-no nuts, I know nuts have good oils in them
-no oil or butter at all

I understand that controlling my blood sugar is a necessity and that is not a problem for me. What was a problem was that fact she insinuated I was obese.

When the visit began, she looked at my wrists and held them in her hands. She then told me I had very delicate bone structure and for my height, I should weight between 58-60 kilos, 127 and 132 pounds. (I have to mention that in the 8th grade, I weighed 118 pounds and as a senior in high school, I weighed 135 pounds. I was a skinny and lanky.) About my delicate bone structure, I neglected to tell her that a favorite past time of mine as a kid was jumping off the roof of my house with an umbrella or large plastic garbage bag as a parachute.

The worst thing of all was that she asked me to come back in 4 weeks and by that time; I should have lost 5 kilos or 10 pounds. I left the office shocked.

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At 1:57 PM, Anonymous Ambra Celeste said...

Dear Gia,
I haven't written to you before because I just recently found expats in italy and then your blog. I too live in Torino and I would love to meet you. But what I want to say to you right now is... take a deep breath... relax. Millions of pregnant women in the US who gain 25 to 30 pounds during pregnancy can't be wrong no matter what this particular dietician says. Can you get a second opinion? I feel you are right to be upset with her judgment, and I find it strange that she suggests you should actually lose weight during pregnancy! It sounds like you are already eating all the right foods that have a low glycemic index, and so I can't at all understand why she would ask you to cut out butter, oils and nuts, These foods have an almost negligible effect upon blood sugar. It sounds like you are already doing a great job tracking your blood sugar. Trust yourself. Congratulations on your pregnancy!

At 2:05 PM, Anonymous Meredith G said...

Wow...I'd be shocked too. I've never been pregnant before, but telling you to lose 10 lbs, nearly half of your pregnancy weight, seems VERY extreme. Please get a second opinion and don't freak out!

At 2:21 PM, Blogger Yael said...

I'm going to write here as well because I know how you feel. I left my doctors office crying on more than one occasion, normally because he said I was too fat.
The calicum thing is way out of line though, you must not cut down on diary unless you want your teeth and bones to crumble!
I really feel for you Gia, I know what it's like to be pregnant here and get all this advice which conflicts with the norms at home. I also see lots of Italian women who have that basketball pregnancy thing going on and if you have to starve to be that way then it's wrong.

I agree with Ambra, Trust yourself.

At 2:22 PM, Blogger Yael said...

Sorry I meant to say that aspartame is not recomended for pregnant women, better sticking with sugar.

At 2:52 PM, Blogger Paulie said...

My wife had gestational diabetes during her pregnancy, and it was probably more severe, because she had to take insulin, but we did learn a few things.

While keeping your blood sugar in a reasonable range is important, the amount of weight gain is also very important because children of diabetic mothers tend to grow rather large. This can cause complications during delivery or even premature birth. So you definately want to be on a diet. That being said, any diet that would actually make you lose weight is just irresponsible. That is basically starving your baby. Even if you could use to lose a few pounds you don't do it while pregnant.

My wife followed a program called "Sweet Success." perhaps you could find out more about it on Google. Basically it specifies portions of protein and carbohydrates and spreads them evenly throughout the day. You also want to limit fats because you do need to control the overall calories. No sugar. If you don't want artifical sweetener then no sweetener. I would also be careful with the type of fish you eat since overconsumption of certain types of fish and seafood can lead to mercury poisoning and even birth defects. Basically avoid large predator ocean fish like Swordfish, Tuna or Salmon. Have freshwater fish or smaller ocean fish instead or limit the large fish to once a week.

BTW, you really can't tell if you are a reasonable weight from looking at one's wrists. You need to have a body fat composition analysis done. If you could stand to lose a few pounds, it would be good to do because women who have gestational diabetes are very likely to develop regular adult onset diabetes. That happened with my wife. Her diabetes never went away. But it is under control by eating right and losing weight.

At 3:12 PM, Blogger Gia-Gina said...

Ambra, email me.

Thanks for all the support guys. My diabetes is under control and the baby is at 50% of normal right now for skull, abdomen diameter and femur length.

No one has ever told me I was obese, she says I am 25 pounds or more over weight and that is a lot. I will go to my gyno tomorrow and tell him that I do not want to see her again.

At 4:54 PM, Anonymous Roberta WA said...

Making long story short: Absurd and you should be mad with this doctors appointment.

At 5:20 PM, Anonymous PoeticaL said...

I would not recommend aspartame. And I would recommend that you hug yourself and take a deep breath. That woman was absurd. The advice is far and wide, and I would not speak up safe for the fact that you asked. My advise is...love yourself, love your baby...relax...drink plenty of water, eat well, move about as much as you can without over doing it. And...please please please enjoy your pregnancy...it's a miracle happening....a joy.

At 9:27 PM, Anonymous annamaria said...

I agree with much of the above. Forget the aspartame. The recommendation to try to lose 10 lbs during pregnancy sounds strange to me, but modifying your diet so you do not gain excessively does make sense.
I agree with several comments above, to get a second opinion.

At 12:43 AM, Anonymous Judith in Umbria said...

Gia! No responsible person would have you lose weight during pregnancy! Stop gaining, yes, but lose, no.
If you really have a problem not eating sugar, would you like to try Splenda? I will send you some if so. It is altered sugar that does not affect blood sugar or provide calories.
We are fortunately right at the height of vegetable season and that should help you.
There is a sentiment here in recent decades for frail looking women and girls. In 1973 the girls were curvaceous, and now they are narrow and thin. It is wrong wrong wrong to apply this prejudice to a pregnant woman. This dietician sounds like a quack. I had one tell me once, "No grapes because it is too hard to establish what comprises a serving." Quack! No cheese? What if you were vegetarian? No milk? No yoghurt? Just pills? Quack! This is pseudo-science gone mad.
Just say no. Switch to skimmed everything, eat 10 times as much vegetable as any other form of carb, be super picky about what comprises your 100 gram protein serving. Find an Arabic butcher and you will probably find Kaffir under a different name. Your health means everything to your baby.

At 1:24 AM, Anonymous Anonymous said...

WHAT?!!! Gia, I really feel for you, the diet the dietician reccomended doesnt sound healthy at all.Thats absolutely shocking advice....
I am 24 weeks along and just did my glucose screening test, came out ok, but have been told to repeat it after a month, being Asian puts me in the 'high risk' category, am just praying that I dont need to see a dietician here in Pavia.
Hope u get a second opinion.In the end your common sense and instinct will guide you much better than any quack!

At 2:42 AM, Anonymous Shilpa said...

Dear Gia, I too am an (Asian) American living in Torino with an Italian husband, and our baby boy is six months old. I was in the US for the first trimester and in Italy for the second and third trimesters of pregnancy. I too was puzzled and upset when my ob/gyn (who is generally fabulous and the head of Sant'Anna) told me to go on a diet because I had gained too much weight - I was still well within the normal parameters in the US. As upsetting as it is, just take everything with a grain of salt (or not as you are supposed to cut down!), and remember that there are different standards here for almost everything, but especially when it comes to women and their bodies. Keep doing what you are doing and don't go to see that dietician ever again. On a brighter note, it would be fun to meet up sometime - especially with our babies! Do you live in the center? Best, Shilpa

At 2:59 AM, Blogger Gia-Gina said...

Email me and we can exchange number, I live in the Crochetta.

See my profile for my email address.

At 3:12 AM, Anonymous sonyaustraliana said...

I think what you have been told is ridiculous! By the sound of things you are doing your utmost to have a safe pregnancy! I think the doctor's advice is influenced by the absolute mania Italians have for not putting on weight and being as thin as possible. From my personal experience, Italians generally have a poor understanding of how to maintain good nutrition when you are trying to lose weight. Italy is obsessed with image and I think women are placed under far too much pressure to conform to the ideal of 'snella and bella' (slim and beautiful). It is an unhealthy and extremely superficial attitude. I love Italy and the Italians but this is one aspect of the culture that I cannot tolerate!!! Far too many times I have heard Italians make a value judgement based solely on the appearance of a person. Yes I know all cultures are guilty of this but I feel it is something ingrained in the Italian psyche.

Do not feel demoralized and do not feel under pressure. You are experiencing one of life's most awesome miracles - do not let anyone steal your joy!!!

Can't wait to read the post announcing the arrival of your bubs!

At 6:08 AM, Anonymous J.Do said...

That doctor actually recommended that you take aspartame? She told you to cut out nuts? and milk? What kind of doctor is this? I hope you get a second opinion. The advice that she is giving you is crazy.From your pictures you don't look obese at all for a pregnant woman. You look very healthy. The previous commenters are right, and if you do actually go on a diet, it will be the baby that suffers most.

At 9:11 AM, Blogger Ebony and Ivory said...

Hi Gia,

I have been reading your blog for sometime now and I have to say, I love it! It took me a while to read it all but now that I finally have I figured it was time to show myself. Anyhow, I just wanted to comment on this post. My husband and I are going to be attempting IVF in a few weeks here and I wanted to lose some weight before actually doing it and my doctor advised me against it. I'm not even pregnant and she is telling me that this is not the time to diet!! My husband is a physician and he says before and during a pregnancy it's important not to make drastic changes to your body. I think the problem is that Italians are obsessed with "La Bella Figura". I mean look at Gwenyth Paltrow (the queen of the macro diet!) and Kate Hudson! These women gained 70 lbs during their pregnancies! Yikes! You're doing great just by controlling your intake of sugars, salts and starches. Forget what they say and just stick to your diabetes diet and you will be fine. Congratulations! <3 Liz

At 10:01 AM, Blogger em said...

okay...I know you've gotten a ton of posts! I jsut wanted to day "Hi!" from a fellow prego. I'll be 32 weeks Saturday...yay! DH are moving to Florence in May. Anyway I just wanted to repeat all of the above sentiments, but also to tell you that salmon is not considered a high-mercury fish...so get you some! and also I've read a lot of negative things about ANY artificial sweetners...including Splenda which has had NO studies involving pregnancy, so stay away from regular use.

if you are checking your sugars everyday, and they are fine, I don't see any reason why you can't have nuts and fat-free milk, etc....in fact soy milk is NOT great b/c it can encourage soy allergies in baby! OF course it's always a good idea to eat lots of fruits and veggies and fish, but I would imagine just increasing those and limiting the bad stuff (which I'm sure you're doing) is the best you can do. If you ever want to preggers chat, drop me a line! eclancy@mac.com

At 3:36 PM, Blogger Tina said...

Hey there - eh, forget that dietician, it's your body and your baby - and I have a feeling that you'll do really well if you follow your instincts. Just keep checking your blood sugar like you do and do what makes YOU feel best inside and outside...
And I'm sorry that she wants you to eat aspartame - that's dangerous stuff. Have you thought of trying stevia? It's an herbal sweetener, really good all-natural sugar substitute. :-)

At 5:48 PM, Blogger Junamay said...

Hi! I came across your blog when I was researching about dietary "restrictions" for Italians or those who live in Italy. That is so interesting that you were told to take aspartame instead. I was wondering if you could help me out... What other practices do pregnant women in Italy have to follow? Like activities and what are the taboos? Grazie mille!

At 3:02 AM, Blogger jabroon piece said...

ivf process

I was wondering if you could help me out...Thanks for all the assistance people. My diabetic issues is under management and the child is at 50% of regular right now for mind, belly size and femur size.


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