The Pregnancy Reset: How Pregnancy Heals The Metabolism

Most women view pregnancy as a time when their metabolism abandons them in favor of their growing little one. They almost resign themselves to a ruined post-partum metabolism, and start strategizing how to deal with this situation after they give birth.

In reality, pregnancy is one of the best things that can happen to a female’s metabolism. That is, if you do it right.

What happens at pregnancy?

After ovulation, the follicle that released the egg becomes the corpus luteum and the source of progesterone. It is a little known fact, but prior to ovulation, progesterone levels in men and women are similar. If the egg is not fertilized and implanted, progesterone and estrogen levels fall and the uterine lining is shed. The cycle then starts over once more.

If fertilization and implantation occurs, HCG levels will rise and keep the corpus luteum around long enough for the placenta to take over progesterone production. HCG is the first hormone of pregnancy, and therefore, is what is used clinically to diagnose pregnancy. After about 8-weeks the corpus luteum degrades and HCG levels fall off as the placenta takes on fulltime duties of keeping estrogen and progesterone around.

Pregnancy is a unique time since it is one of the few times in a woman’s life she remains progesterone dominant. This has many implications, one of which is to increase glucose intolerance and promote insulin resistance.

This sounds bad, but remember an insulin resistant and glucose intolerant mother’s metabolism means more food for the growing baby.

Of course, many doctors and health coaches completely get this wrong. The old and VERY STUPID advice of telling women to “eat for two,” is not smart advice here. There is no need at all, in fact if you want to heal your metabolism, and be better off after pregnancy than before, you will not follow this bad advice.

Your body is intelligent and will increase your hunger as needed without your conscious effort. By consciously going into pregnancy thinking you now have a license to eat as much, and whatever you want, turns a great metabolic opportunity into a disaster.

It is estimated that a growing baby only requires about an extra 300 (2nd trimester) to 500 (third trimester) calories per day. There is not an extra calorie requirement for the first trimester.

There is really no need to count these calories at all, as your body will naturally, and gently, increase its HEC (hunger, energy and craving) signals allowing you to adjust your intake without much thought.

Studies show that more than half of pregnant moms gain more weight than is required for their pregnancy, and subject themselves to metabolic issues like gestational diabetes along the way. Most expert resources give the following guidelines related to pregnancy weight gain:

Underweight pre-pregnancy - BMI of less than 18.5 should gain 28-40 pounds

Normal weight pre-pregnancy - BMI of 18.5-24.9 should gain 25-35 pounds

Overweight pre-pregnancy - BMI of more than 25 should gain 15-25 pounds

The idea is to let the baby gain most of the weight while the mother increases enough fat and resources to sustain long-term breastfeeding. It is the combination of enough, but not too much fat gain, and breastfeeding that is such a powerful metabolic reset for women.

Every woman will be different, but my clinical experience has been that women following an ELEL based exercise approach (adjusting food intake up as their HEC dictates), do wonderful during and after pregnancy.

Remember, the ELEL approach is one where walking is done daily to tolerable levels, and weight training is done 2-3 times per week. Pregnancy is not the time to start exercising like crazy if you have not been, but it is also not the time to stop if you have been. It is imperative you talk to your physician about your particular case.

Most new research on pregnancy and exercise shows we may have gotten a little too carried away with telling women to “take it easy,” especially when that message is combined with “eat for two.”

The real message should be: listen to your body, keep yourself healthy/happy and support your growing baby. Focus on body composition goals after you give birth. Doing things intelligently during pregnancy allows for an easier process.

Breastfeeding:

Assuming you stayed active during pregnancy and ate sensibly to supply your baby all it required, your metabolism will be primed for a metabolic reset.

It is important to understand two points here. First, this metabolic reset is contingent on breast-feeding for at least six months, but longer is probably better (i.e. 9-24 months). Next, it is important to understand that breastfeeding will slow weight loss in the short-term but significantly accelerate fat loss later.

Research tells us that women who choose to bottle-feed lose weight a little faster than their breastfeeding counterparts, but after about three months, are quickly surpassed by breastfeeding moms. Most importantly, breast-feeders are shown to have leaner bodies, especially bellies and thighs, at all time points after roughly six months and these changes last.

The change a woman's body goes through when she first starts breastfeeding is part of the reason these “after” body changes happen. Lactation requires a higher calorie intake, and your HEC responses (hunger, energy and cravings) will naturally dictate this.

During this time, the insulin resistance and glucose intolerance sustained during pregnancy reduces, but prolactin levels rise, and this hormone can slow fat release a bit while lactating. All of this is beneficial and healing to the metabolism, if you give it time and patience.

Easing out of an ELEL based lifestyle to a more EMEM approach 3-6 months postpartum, and then cycling the two approaches thereafter works incredibly well.

RESOURCES:

The Reset Hypothesis: Lactation and Maternal Metabolism. Am J Perinatol. 2009 Jan;26(1):81-8

The role of lactation in GDM women. Clin Obstet Gynecol. 2013 Dec;56(4):844-52.