Fat Deposition

The increase in maternal fat stores is by far the largest contributor to the energy cost of tissue deposition. It is also the most variable. Although the average increase for a well-nourished woman who has an uncomplicated pregnancy and healthy infant is approximately 3 kg, a large number of studies have reported ranges of —2 to 8 kg and standard deviations of 2-4 kg. There is also a wide range in fat deposition between different populations, particularly when those from developed and developing countries are compared. Fat is very energy dense and therefore changes in body fat stores have a large impact on the energy costs of pregnancy. A loss of 2 kg saves approximately 78 MJ (18 600 kcal), whilst a gain of 8 kg costs approximately 312 MJ (74 600 kcal). Women most likely to need an energy reserve to help meet the costs of lactation are often those who are least able to deposit spare energy as fat in pregnancy. Conversely, women who store large amounts of fat during pregnancy are least likely to need to use it during lactation. They are often able to increase food intake and/or decrease physical activity instead.

Table 3 Examples of current recommendations for energy intakes during pregnancy

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