Gestational Diabetes energy requirement can be calculated based on your age, body weight & height, and your level of physical activity.
Gestational Diabetes Energy Calculation
Caloric intake must take into account;
- the maternal height,
- pre-pregnancy weight,
- maternal age,
- gestational age,
- physical activity, and
- smoking.
The calorie level recommended for GDM varies widely.
Thumb rule guideline, 30 kcal/kg ideal body weight (pre-pregnant weight), 36 kcal/kg ideal body weight in the second trimester, and 38 kcal/kg ideal body weight in the third trimester may use as a starting point.
The individualized energy requirement for gestational diabetes
Everyone is different and what works for some women might not work for you.
Energy planning for gestational diabetes should be individualized by accurately appraise the pregnant woman’s nutritional status. This assessment involves her pre-pregnancy Body Mass Index (BMI) and optimal weight gain pattern during pregnancy.
First-trimester energy requirement does increase only in the case of underweight women and not for others. However, energy requirement rises during the second and third trimester for all pregnant women's. An average weight gain of 10 to 12 Kg is recommendable during the second and third trimester; this requires an additional 350 K.cal/day above the adult requirement.
Calorie restriction in obese gestational diabetes can result in ketonemia and ketonuria. However, moderate caloric restriction (by 30% of total energy needs) reduces weight gain in obese women with gestational diabetes improves glycemic control without ketonemia.
Equations to calculate energy requirement are as follows:
Energy requirement (K.cal/d) = Basal metabolic rate (BMR) × Physical activity level (PAL)
For age 18-30 years: Basal metabolic rate (BMR in K.cal/d) = 14 × Body weight (in Kg) + 471
For age 30-60 years: Basal metabolic rate (BMR in K.cal/d) = 8.3 × Body weight (in Kg) + 788
Physical activity level (PAL) values are as follows:
- Sedentary (low activity): PAL value 1.53
- Moderate activity: PAL value 1.80
- Heavy activity: PAL value 2.30
Total energy requirement during pregnancy = Total energy requirement of adult+350 Kcal/d
Example calculation
How to determine the calorie requirement of a 30 years sedentary lifestyle pregnant woman in the second trimester with a height of 155 cm, current weight is 60 Kg, and pre-pregnancy weight is 55 Kg.
1. First, calculate Body mass index (BMI)
BMI in kg/m2 = weight in Kg / height in meter square
= 55/1.55*1.55
= 22.9 Kg/m2 (BMI is in the normal range)
2. Calculate Basal metabolic rate (BMR)
BMR in K.cal/d = 14 × Bodyweight in Kg + 471
= 14 × 55 +471
= 1241 K.cal
3. Identify Physical activity level (PAL)
PAL value for sedentary lifestyle is 1.53
4. Adult’s total energy requirement = BMR × PAL
= 1241×1.53
= 1899 K.cal
5. Total energy requirement in pregnancy = Adult’s total energy requirement + 350 Kcal/d
= 1899 + 350 = 2249 kcal per day
Adequate weight gain during pregnancy determines whether total energy requirement if fulfilled to support proper fetal growth. Pre-pregnancy body mass index (BMI) is the basis for weight gain during pregnancy.
Pre-pregnancy weight | BMI in kg/m2 | Total weight gain range in kg |
Underweight | Less than 18.5 | 11.5 to 16 kg |
Normal weight | 18.5 to 24.9 | 12.5 to 18 kg |
Overweight | 25 to 29.9 | 7 to 11.5 kg |
Obese | More than 29.9 | 5 to 9 kg |