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O'Rourke N, Dervis S, da Silva DF, Geurts C, Haman F, Adamo KB. Heat production during exercise in pregnancy: discerning the contribution of total body weight. Pflugers Arch 2024; 476:769-778. [PMID: 38433124 DOI: 10.1007/s00424-024-02929-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 12/23/2023] [Accepted: 02/13/2024] [Indexed: 03/05/2024]
Abstract
Studies have reported enhanced thermoregulatory function as pregnancy progresses; however, it is unclear if differences in thermoregulation are attributed to weight gain or other physiological changes. This study aimed to determine if total body weight will influence thermoregulation (heat production (Hprod)), heart rate, and perceptual measurements in response to weight-bearing exercise during early to late pregnancy. A cross-sectional design of healthy pregnant women at different pregnancy time points (early, T1; middle, T2; late, T3) performed a 7-stage weight-bearing incremental exercise protocol. Measurements of Hprod, HR, and RPE were examined. Two experimental groups were studied: (1) weight matched and (2) non-weight matched, in T1, T2, and T3. During exercise, equivalent Hprod at T1 (326 ± 88 kJ), T2 (330 ± 43 kJ), and T3 (352 ± 52 kJ) (p = 0.504); HR (p = 0.830); and RPE (p = 0.195) were observed in the WM group at each time point. In the NWM group, Hprod (from stages 1-6 of the exercise) increased across pregnancy time points, T1 (291 ± 76 kJ) to T2 (347 ± 41 kJ) and T3 (385 ± 47 kJ) (p < 0.001). HR increased from T1 to T3 in the warm-up to stage 6 (p = 0.009). RPE did not change as pregnancy time point progressed (p = 0.309). Total body weight, irrespective of pregnancy time point, modulates Hprod and HR during exercise. Therefore, accounting for total body weight is crucial when comparing thermoregulatory function during exercise across pregnancy.
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Affiliation(s)
- Nicholas O'Rourke
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada
| | - Sheila Dervis
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada
| | - Danilo F da Silva
- Sports Studies Department, Faculty of Arts and Science, Bishop's University, Sherbrooke, QC, Canada
| | - Carla Geurts
- Fontys University of Applied Sciences, Venlo, Netherlands
| | - François Haman
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada
| | - Kristi Bree Adamo
- Faculty of Health Sciences, School of Human Kinetics, University of Ottawa, Lees Campus, 518E, 200 Lees Ave, Ottawa, ON, K1N 6N5, Canada.
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Silva-Jose C, Sánchez-Polán M, Barakat R, Gil-Ares J, Refoyo I. Level of Physical Activity in Pregnant Populations from Different Geographic Regions: A Systematic Review. J Clin Med 2022; 11:jcm11154638. [PMID: 35956253 PMCID: PMC9369818 DOI: 10.3390/jcm11154638] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 06/23/2022] [Accepted: 08/05/2022] [Indexed: 12/05/2022] Open
Abstract
The aim of this study was to examine the level of physical activity during pregnancy in different populations worldwide. An intensive search was carried out from February until May 2021. The inclusion criteria were original studies of healthy pregnant women, and the main study variable was the assessment of physical activity. A total of 110 out of 1451 studies were assessed for inclusion, using the Newcastle–Ottawa Scale for quality, and for the risk of bias. The 44 analyzed articles were divided into 5 tables according to the characteristics of the intervention and the validated instrument used to measure physical activity (PA). A total of 59.09% of the studies indicated that participants had a low level of physical activity during pregnancy. In addition, the median quality score of the studies was 7.12, and 77.27% of the studies were cataloged as having a high-quality score. Although international guidelines recommend that women without a contraindication engage in prenatal physical activity, the results of the present study show that the level of PA is too low for women to achieve scientifically proven maternal-fetal benefits. Failure to achieve the recommended levels of weekly physical activity could pose significant risks to maternal well-being.
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Affiliation(s)
- Cristina Silva-Jose
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Miguel Sánchez-Polán
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
- Correspondence: ; Tel.: +34-913364120
| | - Rubén Barakat
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Javier Gil-Ares
- AFIPE Research Group, Faculty of Physical Activity and Sport Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
| | - Ignacio Refoyo
- Sports Department, Faculty of Physical Activity and Sports Sciences-INEF, Universidad Politécnica de Madrid, 28040 Madrid, Spain
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3
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Rodríguez-Martínez C, Leirós-Rodríguez R. The Influence of Practising Physical Activity on the Prevention and Treatment of Gestational Diabetes: A Systematic Review. Curr Diabetes Rev 2022; 18:e200821195742. [PMID: 34420508 DOI: 10.2174/1573399817666210820110941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 06/21/2021] [Accepted: 07/24/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND During pregnancy, maintaining an inadequate lifestyle (bad eating habits, stress, consumption of toxic substances, etc.) generates complications such as pre-eclampsia, overweight, lumbar pain and Gestational Diabetes. OBJECTIVE This review was carried out with the objective to determine the influence of practising physical activity on the prevention and treatment of Gestational Diabetes; and to evaluate the efficacy of interventions based on therapeutic exercise in the management of such diseases. METHOD A systematic review of the publications of the last five years in Medline, Pubmed, Web of Science and Cinahl databases was conducting with the terms Exercise and Gestational Diabetes. RESULTS 25 articles were found, 9 were observational studies that analysed physical activity habits through questionnaires, and other 16 applied an intervention. With respect to the frequency of the sessions, most of these studies applied their interventions three times per week, with all of them obtaining positive results. Regarding intensity, all the studies that referred to it concluded that it must be at least moderate, highlighting that, at all times, the limitations of pregnant women must be taken into account. CONCLUSION Both for the prevention and treatment of this disease, the physical activity must be performed for a minimum of three times per week, at least in moderate intensity, and must be based on aerobic, resistance and strength exercises.
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Affiliation(s)
- Carla Rodríguez-Martínez
- Functional Biology and Health Sciences Department, Faculty of Physiotherapy, University of Vigo, Pontevedra, Spain
| | - Raquel Leirós-Rodríguez
- SALBIS Research Group, Nursing and Physical Therapy Department, Faculty of Health Sciences Universidad de León, Ponferrada, Spain
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Paulo MS, Abdo NM, Bettencourt-Silva R, Al-Rifai RH. Gestational Diabetes Mellitus in Europe: A Systematic Review and Meta-Analysis of Prevalence Studies. Front Endocrinol (Lausanne) 2021; 12:691033. [PMID: 34956073 PMCID: PMC8698118 DOI: 10.3389/fendo.2021.691033] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 11/17/2021] [Indexed: 01/14/2023] Open
Abstract
Background Gestational Diabetes Mellitus (GDM) is defined as the type of hyperglycemia diagnosed for the first-time during pregnancy, presenting with intermediate glucose levels between normal levels for pregnancy and glucose levels diagnostic of diabetes in the non-pregnant state. We aimed to systematically review and meta-analyze studies of prevalence of GDM in European countries at regional and sub-regional levels, according to age, trimester, body weight, and GDM diagnostic criteria. Methods Systematic search was conducted in five databases to retrieve studies from 2014 to 2019 reporting the prevalence of GDM in Europe. Two authors have independently screened titles and abstracts and full text according to eligibility using Covidence software. A random-effects model was used to quantify weighted GDM prevalence estimates. The National Heart, Lung, and Blood Institute criteria was used to assess the risk of bias. Results From the searched databases, 133 research reports were deemed eligible and included in the meta-analysis. The research reports yielded 254 GDM-prevalence studies that tested 15,572,847 pregnant women between 2014 and 2019. The 133 research reports were from 24 countries in Northern Europe (44.4%), Southern Europe (27.1%), Western Europe (24.1%), and Eastern Europe (4.5%). The overall weighted GDM prevalence in the 24 European countries was estimated at 10.9% (95% CI: 10.0-11.8, I2 : 100%). The weighted GDM prevalence was highest in the Eastern Europe (31.5%, 95% CI: 19.8-44.6, I2 : 98.9%), followed by in Southern Europe (12.3%, 95% CI: 10.9-13.9, I2 : 99.6%), Western Europe (10.7%, 95% CI: 9.5-12.0, I2 : 99.9%), and Northern Europe (8.9%, 95% CI: 7.9-10.0, I2 : 100). GDM prevalence was 2.14-fold increased in pregnant women with maternal age ≥30 years (versus 15-29 years old), 1.47-fold if the diagnosis was made in the third trimester (versus second trimester), and 6.79- fold in obese and 2.29-fold in overweight women (versus normal weight). Conclusions In Europe, GDM is significant in pregnant women, around 11%, with the highest prevalence in pregnant women of Eastern European countries (31.5%). Findings have implications to guide vigilant public health awareness campaigns about the risk factors associated with developing GDM. Systematic Review Registration PROSPERO [https://www.crd.york.ac.uk/PROSPERO/], identifier CRD42020161857.
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Affiliation(s)
- Marília Silva Paulo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Noor Motea Abdo
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Rita Bettencourt-Silva
- Department of Endocrinology and Nutrition, Unidade Local de Saúde do Alto Minho, Viana do Castelo, Portugal
- Department of Endocrinology, Hospital Lusíadas Porto, Porto, Portugal
| | - Rami H. Al-Rifai
- Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Xiang M, Zhang J, Liang H, Zhang Z, Konishi M, Hu H, Nishimaki M, Kim HK, Tabata H, Shimizu H, Arao T, Sakamoto S. Physical activity and dietary intake among Chinese pregnant women: an observational study. BMC Pregnancy Childbirth 2019; 19:295. [PMID: 31412799 PMCID: PMC6693271 DOI: 10.1186/s12884-019-2452-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 08/07/2019] [Indexed: 02/01/2023] Open
Abstract
Background Physical activity (PA) and dietary intake are important modifiable factors associated with health outcomes. However, Chinese pregnant women’s PA and dietary intake are only vaguely understood. The aim of this study was to reveal the characteristics of PA and dietary intake of Chinese women in different trimesters as well as the associations between PA and dietary intake. Methods This is a cross-sectional observational study. PA, dietary intake, and demographics of 1077 Chinese pregnant women were measured. The Chi-square test, Kruskal-Wallis test, multiple logistic regression, and multiple linear regression were used for data analysis. Results About 57.1% of the participants met the international guideline for PA. Household activity and occupational activity contributed the most to the total PA, while sports/exercise contributed little. The mean energy intake of the participants was 2008 ± 748.0 kcal. Most participants had normal energy intake, but they obtained excessive energy from fat (mean = 41.7 ± 8.7%). PA was not found to be significantly associated with dietary intake. Further, the participants who were unemployed during pregnancy (OR = 0.72, 95% CI: 0.55–0.95; p < 0.05) or had no exercise habits before pregnancy (OR = 0.62, 95% CI: 0.47–0.80; p < 0.01) were less likely to meet the PA guideline. The participants in the third trimester (OR = 1.43, 95% CI: 1.03–1.99; p < 0.05) were more likely to meet the PA guideline compared to those in the first trimester. The older participants (> 30 years) showed higher dietary intake than the younger (< 25 years) participants (p < 0.01). Conclusions The total PA of Chinese women during pregnancy mostly consists of household and occupational activities, but little sports/exercise. Starting exercise before pregnancy may help women achieve adequate PA during pregnancy. Moreover, these women consumed an excessive amount of fat and their diet intake varies by age.
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Affiliation(s)
- Mi Xiang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Huigang Liang
- Department of Business Information & Technology, Fogelman College of Business & Economics, University of Memphis, Memphis, USA.
| | - Zhiruo Zhang
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China.
| | | | - Huanhuan Hu
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Mio Nishimaki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Hyeon-Ki Kim
- Faculty of Sport Sciences, Waseda University, Saitama, Japan.,Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hiroki Tabata
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan.,Research Fellow of the Japan Society for the Promotion of Science, Tokyo, Japan
| | - Hisao Shimizu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takashi Arao
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
| | - Shizuo Sakamoto
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Most J, Dervis S, Haman F, Adamo KB, Redman LM. Energy Intake Requirements in Pregnancy. Nutrients 2019; 11:nu11081812. [PMID: 31390778 PMCID: PMC6723706 DOI: 10.3390/nu11081812] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 04/02/2019] [Accepted: 04/08/2019] [Indexed: 12/21/2022] Open
Abstract
Energy intake requirements in pregnancy match the demands of resting metabolism, physical activity, and tissue growth. Energy balance in pregnancy is, therefore, defined as energy intake equal to energy expenditure plus energy storage. A detailed understanding of these components and their changes throughout gestation can inform energy intake recommendations for minimizing the risk of poor pregnancy outcomes. Energy expenditure is the sum of resting and physical activity-related expenditure. Resting metabolic rate increases during pregnancy as a result of increased body mass, pregnancy-associated physiological changes, i.e., cardiac output, and the growing fetus. Physical activity is extremely variable between women and may change over the course of pregnancy. The requirement for energy storage depends on maternal pregravid body size. For optimal pregnancy outcomes, women with low body weight require more fat mass accumulation than women with obesity, who do not require to accumulate fat mass at all. Given the high energy density of fat mass, these differences affect energy intake requirements for a healthy pregnancy greatly. In contrast, the energy stored in fetal and placental tissues is comparable between all women and have small impact on energy requirements. Different prediction equations have been developed to quantify energy intake requirements and we provide a brief review of the strengths and weaknesses and discuss their application for healthy management of weight gain in pregnant women.
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Affiliation(s)
- Jasper Most
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA
| | - Sheila Dervis
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Francois Haman
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Kristi B Adamo
- School of Human Kinetics, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Leanne M Redman
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA.
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Liu B, Song L, Zhang L, Wang L, Wu M, Xu S, Cao Z, Wang Y. Higher Numbers of Pregnancies Associated With an Increased Prevalence of Gestational Diabetes Mellitus: Results From the Healthy Baby Cohort Study. J Epidemiol 2019; 30:208-212. [PMID: 31006717 PMCID: PMC7153959 DOI: 10.2188/jea.je20180245] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Pregnancy leads to substantial maternal metabolic and lifestyle alterations. However, it is still unclear whether repeated exposure to these changes will influence the development of gestational diabetes mellitus (GDM). In the present study, we aimed to investigate the association between the number of pregnancies and GDM among Chinese women. Methods A total of 7,008 subjects from the Healthy Baby Cohort study were included in this study. The number of pregnancies was classified into three categories: 1, 2, or ≥3 pregnancies. GDM was diagnosed using International Association of Diabetes and Pregnancy Study Groups criteria. Multivariate logistic regression models were used. Results In the fully adjusted model, women with ≥3 pregnancies had a 1.27-fold (95% confidence interval [CI], 1.05–1.54) higher risk of GDM. Among women ≥30 years old, 2 and ≥3 pregnancies were associated with a higher risk of GDM (odds ratio [OR] 1.32; 95% CI, 1.01–1.73 and OR 1.54; 95% CI, 1.17–2.01, respectively). Among women with a pre-pregnancy BMI <24 kg/m2, ≥3 pregnancies were associated with a 1.35-fold (95% CI, 1.09–1.67) higher risk of GDM. Conclusions Our findings suggested that higher numbers of pregnancies is an independent risk factor of GDM. The association between number of pregnancies and GDM was more prominent among women who were ≥30 years old or with a pre-pregnancy BMI <24 kg/m2.
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Affiliation(s)
- Bingqing Liu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Lina Zhang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Lulin Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Mingyang Wu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
| | - Zhongqiang Cao
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology
| | - Youjie Wang
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology.,Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology
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Affiliation(s)
- Joanna D Holbrook
- NIHR Southampton Biomedical Research Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.,Singapore Institute for Clinical Sciences (SICS), A*STAR, Brenner Centre for Molecular Medicine, 30 Medical Drive, 117609, Singapore
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