Health News | 'Eating for Two'? Doctors Warn Myth May Increase Risk of Gestational Diabetes During Pregnancy

By Divya Malhotra

New Delhi [India], March 11 (ANI): For generations, pregnant women have been told, "You're eating for two now." It is often repeated lovingly by family members and friends, accompanied by extra servings at the dinner table and encouragement to indulge cravings.

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However, modern medical science warns that this well-intentioned advice may be one of the most persistent myths surrounding pregnancy nutrition.

Health experts warn that interpreting the advice literally can lead to excessive calorie intake, unhealthy weight gain and a higher risk of Gestational Diabetes Mellitus (GDM), a condition that affects blood sugar levels during pregnancy.

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In reality, specialists say pregnancy requires better nutrition, not more food.

"The idea of 'eating for two' is misleading," said Dr. Tripti Raheja, Director of Obstetrics and Gynaecology at the CK Birla Hospital in Delhi, while speaking to ANI.

"In the first trimester, there is no significant increase in calorie requirements. Most women do not need additional calories at this stage. In the second and third trimesters, an extra 300 to 450 kilocalories per day is sufficient, roughly equal to one healthy snack, not double meals," she added.

Nutrition experts note that calorie requirements increase only gradually as the pregnancy progresses.

According to Garima Chaudhary, dietitian and nutritionist at Cloudnine Group of Hospitals, energy needs typically remain unchanged during the first trimester, when the developing fetus is still very small.

"Calorie needs increase gradually, not dramatically," Chaudhary explained, adding, "For women with a normal body mass index, there is usually no need for additional calories in the first trimester. In the second trimester, around 340 extra calories per day may be required, and in the third trimester, about 450. The key is nutrient-dense foods, not larger portions."

These requirements can vary depending on factors such as pre-pregnancy weight, activity levels, and whether the pregnancy involves twins. However, the overarching principle remains the same: the focus should be on nutrient-dense foods rather than larger portions.

"Most Indian women already consume over 2,000 calories per day," Dr. Tripti Raheja further said.

"So the focus should be on improving the quality of food, more protein and fibre, fewer refined carbohydrates, rather than increasing quantity," she added.

The concern with excessive eating during pregnancy, especially early on, lies in its link to gestational diabetes.

The condition develops when pregnancy hormones interfere with the body's ability to use insulin effectively, causing blood sugar levels to rise.

Dr. Raheja explained that hormones such as human placental lactogen, progesterone and cortisol naturally increase insulin resistance during pregnancy.

When excessive calorie intake, particularly from refined carbohydrates and sugary foods, occurs alongside this hormonal shift, the body's metabolic balance can be disrupted.

"If a woman gains weight rapidly in early pregnancy, especially central fat, insulin resistance worsens further," Dr. Raheja said.

"This puts stress on the pancreas, which must produce higher levels of insulin to keep blood sugar under control," she added.

On the other hand, Chaudhary noted that excess fat tissue increases inflammatory signals in the body, compounding the problem. "More fat tissue leads to more insulin resistance. If the pancreas cannot compensate adequately, blood sugar levels begin to rise," she said.

Research and clinical observation suggest that rapid weight gain before 20 weeks of pregnancy can increase the risk of gestational diabetes by as much as 20 to 50 per cent. It may also raise the likelihood of having a larger-than-average baby, a condition known as macrosomia, which can complicate delivery and increase the chances of cesarean section (C-section).

Another challenge is that gestational diabetes often develops quietly. Many women do not experience noticeable symptoms, making early detection dependent on medical screening and careful observation of diet and weight patterns.

"Gestational diabetes is frequently silent," said Dr. Swati Kanodia, consultant pediatric endocrinologist at Rainbow Children's Hospital.

"However, certain red flags should prompt earlier glucose testing rather than waiting until the routine screening at 24 to 28 weeks," she added.

Doctors commonly look for warning signs such as rapid weight gain in the first trimester, particularly more than two to three kilograms, high intake of sugary foods and refined carbohydrates, frequent consumption of fruit juices or processed snacks, low protein intake, and a sedentary lifestyle.

Medical history also plays an important role. Women with polycystic ovary syndrome (PCOS), previous gestational diabetes, obesity, or a family history of Type 2 diabetes may require earlier monitoring.

"In India especially, baseline insulin resistance rates are already high, so early screening becomes particularly important," Dr. Raheja said.

Although gestational diabetes often resolves after childbirth, its implications can extend far beyond pregnancy. Doctors stress that it should be viewed as a warning sign of future metabolic risk rather than a temporary condition.

"Women who experience gestational diabetes have a seven to ten times higher lifetime risk of developing Type 2 diabetes," Dr. Kanodia said, adding, "The risk can persist for years, which is why postpartum monitoring and lifestyle changes are essential."

Chaudhary added that nearly half of these women may develop Type 2 diabetes within five to ten years if preventive steps are not taken.

The effects may also extend to the next generation. Exposure to high blood sugar levels in the womb can influence how a child's metabolism develops, increasing the likelihood of obesity, insulin resistance and Type 2 diabetes later in life.

"This phenomenon is known as fetal metabolic programming," explained Dr. Sushma Dikhit, senior consultant gynaecologist at Cloudnine Group of Hospitals in East Delhi.

"Gestational diabetes isn't just a pregnancy condition; it has long-term metabolic consequences for both mother and child," she added, in a conversation with ANI.

For this reason, doctors emphasise balanced nutrition rather than larger portions during pregnancy.

Experts often recommend a simple "plate model" for daily meals: half the plate filled with fibre-rich vegetables, one quarter with protein sources such as dal, paneer, eggs, fish or chicken, and the remaining quarter with complex carbohydrates like multigrain roti, brown rice, oats or millets. Small portions of healthy fats such as nuts, seeds or ghee can also support satiety and nutrient absorption.

"Combining carbohydrates with protein and healthy fats slows glucose absorption and helps maintain stable blood sugar levels," Chaudhary said, adding that refined sugars, sugary beverages and fruit juices should be limited.

Meals spaced throughout the day, rather than large, heavy servings, can also help maintain steady energy levels during pregnancy.

Still, navigating cultural expectations around pregnancy and eating habits can be challenging.

In many Indian households, women are strongly encouraged to eat more "for the baby," making portion control difficult.

Experts suggest addressing these pressures through education and communication.

"A helpful approach is to explain that the doctor has advised focusing on nutritious, balanced meals rather than eating double," Dr. Raheja said, adding, "Families are usually more receptive when this message is framed as medical advice."

Chaudhary agrees, noting that the emphasis should be placed on quality rather than quantity. "The baby needs nutrients, not excess sugar," she said.

Meanwhile, Dr. Dikhit added that involving family members in prenatal consultations can help dispel myths and reduce guilt around eating less than expected.

"When families understand that overeating can increase the risk of gestational diabetes, a very large baby, difficult delivery or future diabetes risk, they often become supportive of healthier eating habits," she said.

Pregnancy, doctors say, is a period of remarkable physiological change, but also an opportunity to build a foundation for lifelong health.

"Pregnancy is a state of controlled metabolic stress," Dr. Dikhit said, adding, "The goal is not maximum weight gain but optimal metabolic health."

In that sense, the message for expectant mothers may be simple but powerful: pregnancy is not about eating twice as much, it is about "eating twice as wisely". (ANI)

(The above story is verified and authored by ANI staff, ANI is South Asia's leading multimedia news agency with over 100 bureaus in India, South Asia and across the globe. ANI brings the latest news on Politics and Current Affairs in India & around the World, Sports, Health, Fitness, Entertainment, & News. The views appearing in the above post do not reflect the opinions of LatestLY)