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RadioMD Presents:HER Radio | Original Air Date: June 18, 2015
Host: Michelle King Robson and Pam Peeke, MD

RadioMD. RadioMD.com. Dr. Pam Peeke, founder of the Peeke Performance Center and Michelle King Robson, founder of EmpowHER.com cut through the confusion to discuss all things Her. This is HerRadio on RadioMD.

DR. PAM: Michelle, how much weight did you gain when you got pregnant?

MICHELLE: How rude.

DR. PAM: No, man, we're talking weight here, you little skinny person, you. Now, come on, tell me.

MICHELLE: I weighed in at 187 and a half when I gave birth to Amanda. She was nine pounds, six ounces, but I gained 67 pounds.

DR. PAM: Okay. This brings up the whole issue of what you're supposed to do about eating during pregnancy and even links to obesity and all the rest of it. I mean, this is huge. We are hearing so much conflicting data out there. Our "go to" person is Dr. Nicole Avena. We've had her on before. She has written a fabulous book, Why Diets Fail, that we've talked about in the past.

Now, we are going to be talking about her new book, which is What To Eat When You Are Pregnant: A Week By Week Guide To Support Your Health And Your Baby's Development. Dr. Avena is a research psychologist and neuroscientist who is an expert in the field of nutrition and diet.

Dr. Avena, welcome back to HerRadio.

DR. AVENA: Thanks so much. I'm happy to be back.

DR. PAM: What is this book really about? There are a million pregnancy books out there. Why is yours so unique?

DR. AVENA: Right. I think what is really unique about this new book is that it focuses on the positive. We spend a lot of time during pregnancy worrying about, "Oh, are we going to be good moms? Are we doing the right things? Is the baby going to be okay?" A lot of the diet advice out there is really very negative. What foods to avoid and how you should not gain a lot of weight. I really wanted to do something for women that was more positive and give them some real information they can use on what foods they should eat during each phase of the pregnancy that will help them grow healthy babies and help them not gain too much weight.

MICHELLE: I love it. I love it because I was one of them. So, one of the questions I have for you--because I know I had horrible cravings when I was pregnant. How do women deal with their cravings?

DR. AVENA: I address that in the book because, as you say, pregnancy is a very unique time when it comes to cravings. Very much like the cravings that we all face every day, but times a million. We are facing all these hormonal changes and lots of different things going on with our bodies.

I suggest that you acknowledge the cravings and really just work to make sure that it just actually is a craving where you need to give into it or if it is something that is going to pass much like you would do if you were having a craving for a donut and you were maybe on a diet and trying to avoid donuts.

It's a lot like the types of ways we deal with cravings when we are not pregnant but really just addressing the fact that they are a natural part of being pregnant and being in our society these days and it's okay to have them. We just want to make sure we don't give into them too much.

MICHELLE: Right.

DR. PAM: Sometimes it is hard, though, Nicole, because a lot of women are already overweight when they get pregnant. They already have a lot of addictive-like eating behaviors. They already have funky cravings to start with. Now they're pregnant. How do you differentiate once you're pregnant?

DR. AVENA: I think the big thing to keep in mind is that most of the cravings we have – if you are eating a healthy diet, meaning eating calories each day – the cravings that you are going to get are most likely hedonic cravings. They are not cravings that you need to give into. It's not the baby telling you that you need to eat cookies or not your body's way of telling you that you need to have some potato chips.

These are just cravings that are driven by society; by cues; by our emotions. It is important to keep in mind that while it is okay to indulge once in a while, if we're doing it every time we get the feeling for eating some of these different types of food items, that's not the best way to go. We have to keep that in mind that a lot of this we need to distract ourselves and wait for the craving to pass so that we can make that healthier food choice later on.

MICHELLE: With me, one of the things that I experienced is I didn't feel good. My stomach was upset all the time.

DR. AVENA: That is a good point. I address that in the beginning of the book because during the first trimester – and even throughout the pregnancy sometimes -- people will suffer morning sickness. I always say the people who coined the term "morning sickness", obviously, was never pregnant because you -

MICHELLE: Amen. Must have been a man.

DR. PAM: It was another guy.

DR. AVENA: Exactly. Because you have it nonstop. One of the things that I suggest in the beginning of the pregnancy, especially when morning sickness is making you feel really sluggish and not so great, is to try to focus on foods that are kind of bland. If you do have those cravings where you feel like the only thing that is going to get you through the day is eating a loaf of bread then there are other things you can do.

You can try to eat some eggs or try to eat some of these low odor type foods that will still give you that energy, but not leave you in a state where you are just giving into any sugar craving that you might have because you need the energy because you are just not eating correctly because you feel exhausted the rest of the day.

DR. PAM: Nicole, let's just say that you're somewhat out of control during your whole pregnancy.

MICHELLE: Like me.

DR. PAM: You're eating sugary stuff and the all rest of it. What does research now show about what happens to your child?

DR. AVENA: It's important to note that if you are out of control, if you are just starting to hear about all of this research now, it doesn't mean that your child is going to grow up to have all of these problems. But it is a sign that you may want to rethink your eating habits because there is research coming out that is really profound. It suggests that what we eat when we are pregnant can have dramatic effects on the offspring.

We're talking about changes in the brain that program what the baby is going to want to eat later on. There are also some links to obesity and even links to addiction to other types of things – not just food, but to drugs and alcohol. Again, it doesn't mean that just because you have been overdoing it during this pregnancy that your child is going to grow up to have all of these problems but it could mean that they might be at a higher risk and you might want to really think about what you are eating because it can affect the offspring in many different ways that we are now just beginning to understand and study.

MICHELLE: So, Nicole, what if you've gained too much weight - which happened to me too – and you're only midway through your pregnancy? What do you do then?

DR. AVENA: Again, this happens to a lot of women. Every woman is different. Every pregnancy is different. I had two pregnancies. I actually just had a baby last week.

DR. PAM: Congratulations.

MICHELLE: What did you have?

DR. AVENA: I had a girl. I have the pleasure of now having two girls. But again, I had two completely different pregnancies that were spaced seven years apart. I can say that during my second pregnancy that I just had, I gained the majority of the weight in the beginning of the pregnancy.

MICHELLE: That's what I did.

DR. AVENA: It was a little scary. What I can say is that everybody is different. If you are on track to gaining too much weight, what I suggest is people really talk to their doctor and consider maybe even meeting with a nutritionist to find out, "Is this is something I am eating or is it maybe the fact that this is just my body and the way that the baby is growing?" because you don't want to put yourself on a diet and start restricting yourself but it's also important to remember that during the first trimester we actually don't need any extra calories when we are pregnant. So, you really don't need to change your eating habits at all. If you find out you're pregnant and then all the sudden, you start eating for two, well then you are going to be in trouble midway through your pregnancy.

DR. PAM: I think this is really important to emphasize. I was curious, Nicole, did you stick with the 25 pound weight gain rule for yourself?

DR. AVENA: I didn't. I focused on eating well. Because, again, even when I am talking to people who aren't pregnant I always say, stay away from the numbers because if you focus on a number it can be really difficult. It can really mess with your mind. I gained 40 pounds this last time. But, again, a lot of it was water weight. I ended up losing 30 of it right away. Other things besides what we eat contribute to weight gain during pregnancy. I think that is for everyone to remember. Not to beat yourself up if you are a couple of pounds ahead. It is more important to be mindful of the types of food that you are eating and why you are eating them.

DR. PAM: This is wonderful. Everyone – we are talking to Dr. Nicole Avena. She is the author of What To Eat When You Are Pregnant: A Week By Week Guide To Support Your Health And Your Baby's Development. She has really helped us understand how to deal with cravings. You've got to run out there and get this book. Also, a week by week guide. What else do you want? Good grief, there is so much confusion out there. Dr. Avena, once again, has been the "go to" person to help us understand all things good science and nutrition. Thanks, Dr. Avena, for being on HerRadio. I'm Dr. Pam Peeke with Michelle King Robson.

MICHELLE: Go to Dr. Nicole Avena's site and learn more. You're listening to HER Radio on RadioMD. Follow us on Twitter. Like us on Facebook. Stay well.