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Angrish K, Khan-Poulin Y, Mangat J, Mack DE, Nagpal TS. Culturally Tailored Strategies for Prenatal Physical Activity for South Asian Women: A Scoping Review. J Immigr Minor Health 2023; 25:1463-1481. [PMID: 37193874 DOI: 10.1007/s10903-023-01486-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/20/2023] [Indexed: 05/18/2023]
Abstract
Low levels of physical activity (PA) are reported in South Asian pregnant women. This scoping review summarizes culturally tailored strategies in prenatal PA studies for South Asian women and identifies barriers and facilitators. A search strategy was developed with the keywords "Physical Activity" AND Pregnant AND "South Asian" and was carried out on Medline, SportDiscus, EMBASE, Web of Science and Proquest Theses and Dissertations. Primary research studies were included. Forty-six studies were included of which 40 were from South Asian countries. No interventions were identified outside of South Asian countries. Offering material in different languages was the most common tailoring strategy. Reported barriers were possible social norms favouring inactivity, lack of awareness on safe exercises, and physical symptoms (e.g., fatigue). Facilitators included social support and relief from physical symptoms. Future PA interventions for South Asian pregnant women should account for population-specific barriers and facilitators to increase PA initiation and maintenance.
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Affiliation(s)
- Kirina Angrish
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | | | - Jasman Mangat
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | - Diane E Mack
- Department of Kinesiology, Brock University, St. Catharine's, Canada
| | - Taniya S Nagpal
- Faculty of Kinesiology, Sport and Recreation, University of Alberta, 116 St & 85 Ave, Edmonton, AB, T6G 2R3, Canada.
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2
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Evenson KR, Scherer E, Peter KM, Cuthbertson CC, Eckman S. Historical development of accelerometry measures and methods for physical activity and sedentary behavior research worldwide: A scoping review of observational studies of adults. PLoS One 2022; 17:e0276890. [PMID: 36409738 PMCID: PMC9678297 DOI: 10.1371/journal.pone.0276890] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 10/15/2022] [Indexed: 11/22/2022] Open
Abstract
This scoping review identified observational studies of adults that utilized accelerometry to assess physical activity and sedentary behavior. Key elements on accelerometry data collection were abstracted to describe current practices and completeness of reporting. We searched three databases (PubMed, Web of Science, and SPORTDiscus) on June 1, 2021 for articles published up to that date. We included studies of non-institutionalized adults with an analytic sample size of at least 500. The search returned 5686 unique records. After reviewing 1027 full-text publications, we identified and abstracted accelerometry characteristics on 155 unique observational studies (154 cross-sectional/cohort studies and 1 case control study). The countries with the highest number of studies included the United States, the United Kingdom, and Japan. Fewer studies were identified from the continent of Africa. Five of these studies were distributed donor studies, where participants connected their devices to an application and voluntarily shared data with researchers. Data collection occurred between 1999 to 2019. Most studies used one accelerometer (94.2%), but 8 studies (5.2%) used 2 accelerometers and 1 study (0.6%) used 4 accelerometers. Accelerometers were more commonly worn on the hip (48.4%) as compared to the wrist (22.3%), thigh (5.4%), other locations (14.9%), or not reported (9.0%). Overall, 12.7% of the accelerometers collected raw accelerations and 44.6% were worn for 24 hours/day throughout the collection period. The review identified 155 observational studies of adults that collected accelerometry, utilizing a wide range of accelerometer data processing methods. Researchers inconsistently reported key aspects of the process from collection to analysis, which needs addressing to support accurate comparisons across studies.
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Affiliation(s)
- Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Elissa Scherer
- RTI International, Research Triangle Park, North Carolina, United States of America
| | - Kennedy M. Peter
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Carmen C. Cuthbertson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina–Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Stephanie Eckman
- RTI International, Research Triangle Park, North Carolina, United States of America
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3
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Garnweidner-Holme L, Henriksen L, Bjerkan K, Lium J, Lukasse M. Factors associated with the level of physical activity in a multi-ethnic pregnant population - a cross-sectional study at the time of diagnosis with gestational diabetes. BMC Pregnancy Childbirth 2022; 22:1. [PMID: 34979996 PMCID: PMC8722186 DOI: 10.1186/s12884-021-04335-x] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 12/13/2021] [Indexed: 12/14/2022] Open
Abstract
Background Regular physical activity during pregnancy can prevent several adverse health outcomes during this period of a woman’s life. Previous studies have shown that many women do not meet national recommendations for physical activity. This study aims to examine factors associated with sufficient leisure-time physical activity (LTPA) in a multicultural sample of pregnant women recently diagnosed with gestational diabetes mellitus (GDM). Methods We performed a cross-sectional study among 238 pregnant women. The women were recruited at diabetes outpatient clinics in the Oslo region of Norway from October 2015 to April 2017. The participants reported their activity levels using the Pregnancy Physical Activity Questionnaire (PPAQ). Pearson’s chi-square tests were used to assess differences in socio-demographic, health and pregnancy-related characteristics in relation to sufficient and insufficient LTPA, and logistic regression modelling was employed to predict the likelihood of insufficient LTPA. Results Less than half of the women in the sample (44.5%) had sufficient LTPA according to the minimum of ≥600 Met minutes per week. The majority of women were motivated to be physically active during pregnancy (84.9%). A low joint family income and being over 38 years of age increased the odds of not having sufficient LTPA. Women with sufficient LTPA had significantly higher scores of perceived health (p = 0.007). Conclusions The study indicates that pregnant women need to be better informed about the positive effects of physical activity on individually perceived health. To address the low levels of LTPA among pregnant women, communication strategies must be tailored towards women with low socio-economic backgrounds. Trial registration:https://clinicaltrials.gov/ct2/show/NCT02588729 Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04335-x.
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Affiliation(s)
- L Garnweidner-Holme
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.
| | - L Henriksen
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Division of General Gynaecology and Obstetrics, Oslo University Hospital, Oslo, Norway
| | - K Bjerkan
- Department for diabetes, Aker Hospital, Oslo University Hospital, Oslo, Norway
| | - J Lium
- Faculty for medicine, University of Bergen, Bergen, Norway
| | - M Lukasse
- Faculty of Health Sciences, Department of Nursing and Health Promotion, Oslo Metropolitan University, Oslo, Norway.,Faculty of Health and Social Sciences, University of South-Eastern Norway, Campus Vestfold, Notodden, Norway
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4
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Wulan SN, Raza Q, Prasmita HS, Martati E, Maligan JM, Mageshwari U, Fatima I, Plasqui G. Energy Metabolism in Relation to Diet and Physical Activity: A South Asian Perspective. Nutrients 2021; 13:nu13113776. [PMID: 34836031 PMCID: PMC8617748 DOI: 10.3390/nu13113776] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 10/14/2021] [Accepted: 10/21/2021] [Indexed: 12/11/2022] Open
Abstract
The prevalence of overweight and obesity is on the rise around the world, not only in the West, but also in Asian countries. South Asian countries in particular are experiencing a rapid increase in overweight and obesity, that coexists with the rapid increase in non-communicable diseases linked to obesity such as diabetes and cardiovascular disease than any other country in Asia. The phenomena observed in South Asian countries are due to the size of the population, the ageing of the population, the high degree of urbanization and the lifestyle changes in favor of increased energy consumption and reduced physical activity. The imbalance between energy consumption and energy expenditure results in the development of a positive energy balance that, over time, accumulates in higher body fat. South Asians were reported to have a more unfavorable body composition with a higher percentage of body fat than Caucasians with an equivalent BMI. Body composition is a major determinant of resting energy expenditure. It has been reported that South Asians have a lower resting energy expenditure than Caucasians with the same BMI. Resting energy expenditure accounts for the majority of total daily energy expenditure and, therefore, plays a crucial role in achieving the balance between energy intake and expenditure.
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Affiliation(s)
- Siti N. Wulan
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
- Correspondence: (S.N.W.); (Q.R.); Tel.: +92-30-0247-9044 (Q.R.)
| | - Qaisar Raza
- Department of Food Science and Human Nutrition, Faculty of Biosciences, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan
- Department of Health Sciences, Faculty of Earth and Life Sciences, VU University Amsterdam, 1081 HV Amsterdam, The Netherlands
- Correspondence: (S.N.W.); (Q.R.); Tel.: +92-30-0247-9044 (Q.R.)
| | - Hera S. Prasmita
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Erryana Martati
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Jaya M. Maligan
- Study Program of Food Science and Technology, Department of Agricultural Product Technology, Faculty of Agricultural Technology, Brawijaya University, Malang 65145, Indonesia; (H.S.P.); (E.M.); (J.M.M.)
| | - Uma Mageshwari
- Department of Food Service Management and Dietetics, Faculty of Home Science, Avinashilingham University, Coimbatore 641043, India;
| | - Itrat Fatima
- Department of Food Science and Technology, Faculty of Life Sciences, University of Central Punjab, Lahore 54000, Pakistan;
| | - Guy Plasqui
- Department of Nutrition and Movement Sciences, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center (MUMC+), 6229 HX Maastricht, The Netherlands;
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Fragoso-Bargas N, Opsahl JO, Kiryushchenko N, Böttcher Y, Lee-Ødegård S, Qvigstad E, Richardsen KR, Waage CW, Sletner L, Jenum AK, Prasad RB, Groop LC, Moen GH, Birkeland KI, Sommer C. Cohort profile: Epigenetics in Pregnancy (EPIPREG) - population-based sample of European and South Asian pregnant women with epigenome-wide DNA methylation (850k) in peripheral blood leukocytes. PLoS One 2021; 16:e0256158. [PMID: 34388220 PMCID: PMC8362992 DOI: 10.1371/journal.pone.0256158] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 08/01/2021] [Indexed: 11/26/2022] Open
Abstract
Pregnancy is a valuable model to study the association between DNA methylation and several cardiometabolic traits, due to its direct potential to influence mother's and child's health. Epigenetics in Pregnancy (EPIPREG) is a population-based sample with the aim to study associations between DNA-methylation in pregnancy and cardiometabolic traits in South Asian and European pregnant women and their offspring. This cohort profile paper aims to present our sample with genetic and epigenetic data and invite researchers with similar cohorts to collaborative projects, such as replication of ours or their results and meta-analysis. In EPIPREG we have quantified epigenome-wide DNA methylation in maternal peripheral blood leukocytes in gestational week 28±1 in Europeans (n = 312) and South Asians (n = 168) that participated in the population-based cohort STORK Groruddalen, in Norway. DNA methylation was measured with Infinium MethylationEPIC BeadChip (850k sites), with technical validation of four CpG sites using bisulphite pyrosequencing in a subset (n = 30). The sample is well characterized with few missing data on e.g. genotype, universal screening for gestational diabetes, objectively measured physical activity, bioelectrical impedance, anthropometrics, biochemical measurements, and a biobank with maternal serum and plasma, urine, placenta tissue. In the offspring, we have repeated ultrasounds during pregnancy, cord blood, and anthropometrics up to 4 years of age. We have quantified DNA methylation in peripheral blood leukocytes in nearly all eligible women from the STORK Groruddalen study, to minimize the risk of selection bias. Genetic principal components distinctly separated Europeans and South Asian women, which fully corresponded with the self-reported ethnicity. Technical validation of 4 CpG sites from the methylation bead chip showed good agreement with bisulfite pyrosequencing. We plan to study associations between DNA methylation and cardiometabolic traits and outcomes.
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Affiliation(s)
- Nicolas Fragoso-Bargas
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Julia O. Opsahl
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nadezhda Kiryushchenko
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Department of Bioscience, University of Oslo, Oslo, Norway
| | - Yvonne Böttcher
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway
- Helmholtz-Institute for Metabolic, Adiposity and Vascular Research, Leipzig, Germany
| | | | - Elisabeth Qvigstad
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kåre Rønn Richardsen
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Christin W. Waage
- Faculty of Health Sciences, Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Line Sletner
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Anne Karen Jenum
- Department of General Practice, General Practice Research Unit (AFE), Institute of Health and Society, University of Oslo, Oslo, Norway
| | | | | | - Gunn-Helen Moen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- The University of Queensland Diamantina Institute, The University of Queensland, Woolloongabba, QLD, Australia
- Department of Public Health and Nursing, K.G. Jebsen Center for Genetic Epidemiology, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Population Health Science, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Kåre I. Birkeland
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
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6
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Vietheer A, Kiserud T, Lie RT, Haaland ØA, Kessler J. Sleep and physical activity from before conception to the end of pregnancy in healthy women: a longitudinal actigraphy study. Sleep Med 2021; 83:89-98. [PMID: 33991895 DOI: 10.1016/j.sleep.2021.04.028] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 03/22/2021] [Accepted: 04/20/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Sleep and physical activity changes are common in pregnancy, but longitudinal data starting before conception are scarce. Our aim was to determine the changes of the daily total sleep time (TST) and physical activity duration (PAD) from before conception to end of pregnancies in respect of pregestational maternal factors. METHODS This longitudinal observational study formed part of the CONIMPREG research project and recruited healthy women planning to become pregnant. Sleep and physical activity were recorded around-the-clock for ≥4 days via actigraphy before conception and during each trimester of pregnancy. Data were adjusted according to pregestational maternal body composition, parity and age. RESULTS Among 123 women with eligible data, the unadjusted mean (95% confidence interval) TST increased from 415.3 min (405.5-425.2 min) before conception to 458.0 min (445.4-470.6 min) in the 1st trimester, remaining high through the 2nd and 3rd trimesters. Variation was substantial before conception (±2SD range: 307-523 min). The unadjusted mean PAD before conception was 363.7 min (±2SD range: 120-608 min), decreasing sharply to 262.1 min in the first trimester and more gradually thereafter. Vigorous and moderate activity decreased more than light activity. TST and PAD were significantly associated with age, parity, and pregestational body fat percentage; lean body mass was negatively correlated with TST. Results were generally unaffected by seasonal variations. CONCLUSION Marked variations were found in pregestational TST and PAD. Healthy women slept ≥30 min longer during pregnancy, while PAD decreased by ≥ 90 min in early pregnancy and continued to decrease thereafter.
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Affiliation(s)
- Alexander Vietheer
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Torvid Kiserud
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Rolv Terje Lie
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway; Norwegian Institute of Public Health, Bergen, Norway
| | | | - Jörg Kessler
- Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
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7
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Baena-García L, Acosta-Manzano P, Ocón-Hernández O, Borges-Cosic M, Romero-Gallardo L, Marín-Jiménez N, Aparicio VA. Objectively measured sedentary time and physical activity levels in Spanish pregnant women. Factors affecting the compliance with physical activity guidelines. Women Health 2020; 61:27-37. [PMID: 33143596 DOI: 10.1080/03630242.2020.1828231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aims of this cross-sectional study were to describe objectively measured sedentary time (ST) and physical activity (PA) levels in Spanish pregnant women, to analyze the degree of compliance with PA guidelines during the early second trimester of pregnancy and to explore sociodemographic and clinical factors associated with meeting these PA guidelines. One hundred and thirty-four Caucasian pregnant women were recruited between October 2015 and October 2017 to participate in this study. Triaxial accelerometers were used to analyze ST andPA levels for seven consecutive valid days. Womenspent512 ± 92.1 minutes daily in sedentary behaviors, and 85 ± 108.2 minutes in moderate-to-vigorous physical activity (MVPA) in bouts of at least 10 minutes. They walked on average 7436 ± 2410steps per day. Only 22% of the study sample complied with the PA guidelines. Having an University degree was related with threefold higher odds of compliance with the PA guidelines (95% confidence interval: 0.096-0.913, p < .05). Binary logistic regressions showed that being primiparous was associated with fivefold higher odds of compliance with the PA guidelines (95% confidence interval 1.658-18.039, respectively, p < .01). Maternal age, BMI, marital status, working status, and previous miscarriages were not associated with compliance with PA guidelines. Pregnant women spent more than a third of the day in sedentary behaviors and the compliance with PA guidelines was less than desirable. Finally, not having an university degree or having children could be factors related to lower odds of compliance with these guidelines, and therefore require special attention from healthcare professionals.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada , Granada, Spain
| | - Pedro Acosta-Manzano
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Olga Ocón-Hernández
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain
| | - Milkana Borges-Cosic
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - V A Aparicio
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain.,Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada , Granada, Spain
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8
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Psychosocial Stress, Sedentary Behavior, and Physical Activity during Pregnancy among Canadian Women: Relationships in a Diverse Cohort and a Nationwide Sample. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16245150. [PMID: 31861085 PMCID: PMC6950602 DOI: 10.3390/ijerph16245150] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 12/06/2019] [Accepted: 12/13/2019] [Indexed: 01/25/2023]
Abstract
BACKGROUND Past research shows that psychosocial stress and distress predict sedentary behavior and physical activity, but few studies focus on pregnant women. Our objective was to analyze relationships between psychosocial stress and distress with sedentary behavior and physical activity among pregnant women in Canada. METHODS We analyzed objectively-measured sedentary behavior and physical activity at 16-18, 24-26, and 32-24 weeks pregnancy in a sociodemographically diverse cohort of 70 women in Montreal, Canada. Participants completed the Perceived Stress Questionnaire and wore an accelerometer for 3 days that quantified sitting time and steps per day. We used univariate general linear models to analyze relationships between perceived stress with sedentary behavior and physical activity at each evaluation. To assess generalizability, we analyzed relationships between psychological distress with self-reported leisure-time sedentary behavior and daily energy expenditure in transportation and leisure physical activities among a sample representative of 166,095 women in the Canadian Community Health Survey. RESULTS In the Montreal cohort, we observed a positive association between perceived stress and sitting time, with small to moderate effect sizes (partial η2 = 0.08-0.16). We observed negative relationships between perceived stress and steps per day at the first two evaluations only, with small to moderate effect sizes (partial η2 = 0.08-0.11). Relationships for sedentary behavior were similar in the nationwide sample, but with smaller effect sizes (partial η2 = 0.02). There were no relationships between distress and physical activity in the nationwide sample. CONCLUSION Psychosocial stress represents one risk factor for sedentarity, with relationships evident throughout pregnancy and at the population level. Relationships with physical activity are less consistent, but stress might represent a risk factor for low physical activity in early to mid-pregnancy. Results might guide the development of more comprehensive interventions targeting stress, sedentarity, and physical activity. In particular, integrating psychosocial health into interventions to reduce sedentarity, and including concrete guidelines on sedentary behavior in psychosocial health interventions, might be prioritized.
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9
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Donaire-Gonzalez D, Curto A, Valentín A, Andrusaityte S, Basagaña X, Casas M, Chatzi L, de Bont J, de Castro M, Dedele A, Granum B, Grazuleviciene R, Kampouri M, Lyon-Caen S, Manzano-Salgado CB, Aasvang GM, McEachan R, Meinhard-Kjellstad CH, Michalaki E, Pañella P, Petraviciene I, Schwarze PE, Slama R, Robinson O, Tamayo-Uria I, Vafeiadi M, Waiblinger D, Wright J, Vrijheid M, Nieuwenhuijsen MJ. Personal assessment of the external exposome during pregnancy and childhood in Europe. ENVIRONMENTAL RESEARCH 2019; 174:95-104. [PMID: 31055170 DOI: 10.1016/j.envres.2019.04.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 05/18/2023]
Abstract
The human exposome affects child development and health later in life, but its personal external levels, variability, and correlations are largely unknown. We characterized the personal external exposome of pregnant women and children in eight European cities. Panel studies included 167 pregnant women and 183 children (aged 6-11 years). A personal exposure monitoring kit composed of smartphone, accelerometer, ultraviolet (UV) dosimeter, and two air pollution monitors were used to monitor physical activity (PA), fine particulate matter (PM2.5), black carbon, traffic-related noise, UV-B radiation, and natural outdoor environments (NOE). 77% of women performed the adult recommendation of ≥150 min/week of moderate to vigorous PA (MVPA), while only 3% of children achieved the childhood recommendation of ≥60 min/day MVPA. 11% of women and 17% of children were exposed to daily PM2.5 levels higher than recommended (≥25μg/m3). Mean exposure to noise ranged from Lden 51.1 dB in Kaunas to Lden 65.2 dB in Barcelona. 4% of women and 23% of children exceeded the recommended maximum of 2 Standard-Erythemal-Dose of UV-B at least once a week. 33% of women and 43% of children never reached the minimum NOE contact recommendation of ≥30 min/week. The variations in air and noise pollution exposure were dominated by between-city variability, while most of the variation observed for NOE contact and PA was between-participants. The correlations between all personal exposures ranged from very low to low (Rho < 0.30). The levels of personal external exposures in both pregnant women and children are above the health recommendations, and there is little correlation between the different exposures. The assessment of the personal external exposome is feasible but sampling requires from one day to more than one year depending on exposure due to high variability between and within cities and participants.
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Affiliation(s)
- David Donaire-Gonzalez
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Ariadna Curto
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Antònia Valentín
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Sandra Andrusaityte
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Xavier Basagaña
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Leda Chatzi
- Department of Preventive Medicine, University of Southern California, Los Angeles, USA; Department of Genetics & Cell Biology, Maastricht University, the Netherlands
| | - Jeroen de Bont
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Montserrat de Castro
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Audrius Dedele
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Berit Granum
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | | | | | - Sarah Lyon-Caen
- Institut National de la Santé et de la Recherche Médicale (Inserm), CNRS, Univ. Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, La Tronche, France
| | | | | | - Rosemary McEachan
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), Bradford, United Kingdom
| | | | | | - Pau Pañella
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Inga Petraviciene
- Department of Environmental Sciences, Vytautas Magnus University, Kaunas, Lithuania
| | - Per E Schwarze
- Norwegian Institute of Public Health (NIPH), Oslo, Norway
| | - Rémy Slama
- Institut National de la Santé et de la Recherche Médicale (Inserm), CNRS, Univ. Grenoble Alpes, Institute for Advanced Biosciences (IAB), U1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble, La Tronche, France
| | - Oliver Robinson
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain; MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, United Kingdom
| | - Ibon Tamayo-Uria
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain; Division of Immunology and Immunotherapy, Cima Universidad de Navarra and "Instituto de Investigación Sanitaria de Navarra (IdISNA)", Pamplona, Spain
| | | | - Dagmar Waiblinger
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), Bradford, United Kingdom
| | - John Wright
- Bradford Institute for Health Research, Bradford Teaching Hospitals NHS Foundation Trust (BTHFT), Bradford, United Kingdom
| | - Martine Vrijheid
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain
| | - Mark J Nieuwenhuijsen
- ISGlobal, Universitat Pompeu Fabra, CIBER Epidemiología y Salud Pública, Barcelona, Spain; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
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10
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Nguyen PTH, Binns CW, Nguyen CL, Van Ha AV, Chu KT, Duong DV, Do DV, Lee AH. Physical Activity During Pregnancy is Associated with Improved Breastfeeding Outcomes: A Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16101740. [PMID: 31100948 PMCID: PMC6571814 DOI: 10.3390/ijerph16101740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 05/10/2019] [Accepted: 05/14/2019] [Indexed: 11/28/2022]
Abstract
Physical activity is important for health, but little is known about associations between physical activity during pregnancy and breastfeeding. The aim of this study was to investigate any association between antenatal physical activity and breastfeeding duration. A prospective cohort of 2030 Vietnamese women, recruited between 24 and 28 week-gestation was followed up to twelve months postpartum. Physical activity was determined using the pregnancy physical activity questionnaire at baseline interview. Data was available for 1715 participants at 12 months, a 15.5% attrition rate. At 12 months 71.8% of mothers were still breastfeeding. A total of 20.9% women met physical activity targets and those mothers undertaking higher levels of physical activity had a lower risk of breastfeeding cessation by twelve months [hazard ratios HR = 0.59 (95% CI 0.47–0.74), p < 0.001, and HR = 0.74 (0.60–0.92), p = 0.006; respectively] when compared to the lowest tertile. Similarly, women with increased levels of physical activity have higher rates of breastfeeding at twelve months, compared to the lowest level [odds ratio OR = 1.71 (95% CI 1.29–2.25) and 1.38 (1.06–1.79)]. Higher levels of physical activity by pregnant women are associated with improved breastfeeding outcomes.
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Affiliation(s)
- Phung Thi Hoang Nguyen
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Colin W Binns
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Cong Luat Nguyen
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- National Institute of Hygiene and Epidemiology, Ha Noi 100000, Vietnam.
| | - Anh Vo Van Ha
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Faculty of Public Health, Pham Ngoc Thach University of Medicine, Ho Chi Minh City 700000, Vietnam.
| | - Khac Tan Chu
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
- Epidemiology Department, Hai Phong University of Medicine and Pharmacy, Hai Phong City 180000, Vietnam.
| | - Dat Van Duong
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
| | - Dung Van Do
- Faculty of Public Health, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City 700000, Vietnam.
| | - Andy H Lee
- School of Public Health, Curtin University, Perth, WA 6845, Australia.
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11
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Pathirathna ML, Sekijima K, Sadakata M, Fujiwara N, Muramatsu Y, Wimalasiri KMS. Effects of Physical Activity During Pregnancy on Neonatal Birth Weight. Sci Rep 2019; 9:6000. [PMID: 30979921 PMCID: PMC6461641 DOI: 10.1038/s41598-019-42473-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Accepted: 03/18/2019] [Indexed: 11/23/2022] Open
Abstract
We assessed the prevalence of adherence to the American College of Obstetricians and Gynecologists (ACOG) recommendations regarding physical activity during pregnancy among Sri Lankan women and explored the relationship between physical activity during pregnancy and neonatal birth weight. In total, 141 pregnant women (gestational age, 18–24 weeks) were included from October to December 2015 and followed up until delivery. A validated questionnaire regarding physical activity during pregnancy was administered in the second and third trimesters. Activities were grouped by type (household/caregiving, occupational, transportation, sports/exercise, and inactivity) and intensity {sedentary [<1.5 metabolic equivalents (METs)], light intensity [1.5–2.9 METs], moderate intensity [3.0–6.0 METs], and vigorous intensity [>6.0 METs]}. Women were categorised as active or inactive based on the ACOG recommendations. In total, 79.1% and 45.2% of women met the guidelines in the second and third trimesters, respectively. The overall time spent and total energy expenditure was significantly higher in the second trimester (p < 0.001). We found no relationship between physical activity during pregnancy and neonatal birth weight. This study indicates that a considerable reduction of time and total energy expenditure occur as pregnancy progresses. Physical activity during pregnancy does not appear to significantly affect neonatal birth weight.
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Affiliation(s)
- Malshani L Pathirathna
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, 951-8518, Japan. .,Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka.
| | - Kayoko Sekijima
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, 951-8518, Japan
| | - Mieko Sadakata
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, 951-8518, Japan
| | - Naoshi Fujiwara
- Department of Medical Technology,Graduate School of Health Sciences, Niigata University, Niigata, 951-8518, Japan
| | - Yoshiyuki Muramatsu
- Department of Nursing, Graduate School of Health Sciences, Niigata University, Niigata, 951-8518, Japan
| | - Kuruppu M S Wimalasiri
- Department of Food Science and Technology, Faculty of Agriculture, University of Peradeniya, Peradeniya, 20400, Sri Lanka
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12
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Kinnunen TI, Richardsen KR, Sletner L, Torgersen L, Sommer C, Waage CW, Mdala I, Jenum AK. Ethnic differences in body mass index trajectories from 18 years to postpartum in a population-based cohort of pregnant women in Norway. BMJ Open 2019; 9:e022640. [PMID: 30798304 PMCID: PMC6398684 DOI: 10.1136/bmjopen-2018-022640] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore ethnic differences in changes in body mass index (BMI) from the age of 18 years to 3 months postpartum. DESIGN A population-based cohort study. SETTING Child Health Clinics in Oslo, Norway. PARTICIPANTS Participants were 811 pregnant women (mean age 30 years). Ethnicity was categorised into six groups. PRIMARY OUTCOME MEASURES The outcome variable was BMI (kg/m2) measured at the age of 18 and 25 years, at prepregnancy and at 3 months postpartum. Body weight at 18 years, 25 years and prepregnancy were self-reported in early pregnancy, while body height and weight at 3 months postpartum were measured. The main statistical method was generalised estimating equations, adjusted for age. The analyses were stratified by parity due to ethnicity×time×parity interaction (p<0.001). RESULTS Primiparous South Asian women had a 1.45 (95% CI 0.39 to 2.52) kg/m² higher and Middle Eastern women had 1.43 (0.16 to 2.70) kg/m2 higher mean BMI increase from 18 years to postpartum than Western European women. Among multiparous women, the mean BMI increased 1.99 (1.02 to 2.95) kg/m2 more in South Asian women, 1.48 (0.31 to 2.64) kg/m2 more in Middle Eastern women and 2.49 (0.55 to 4.42) kg/m2 more in African women than in Western European women from 18 years to prepregnancy. From 18 years to postpartum, the mean increase was 4.40 (2.38 to 6.42) kg/m2 higher in African women and 1.94 to 2.78 kg/m2 higher in the other groups than in Western European women. CONCLUSIONS Multiparous women of ethnic minority origin seem substantially more prone to long-term weight gain than multiparous Western European women in Norway.
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Affiliation(s)
- Tarja I Kinnunen
- Unit of Health Sciences, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kåre R Richardsen
- Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - Line Sletner
- Department of Child and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Leila Torgersen
- Department of Child Development, Norwegian Institute of Public Health, Oslo, Norway
| | - Christine Sommer
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Christin W Waage
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Ibrahimu Mdala
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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13
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Nguyen CL, Pham NM, Lee AH, Nguyen PTH, Chu TK, Ha AVV, Duong DV, Duong TH, Binns CW. Physical activity during pregnancy is associated with a lower prevalence of gestational diabetes mellitus in Vietnam. Acta Diabetol 2018; 55:955-962. [PMID: 29948409 DOI: 10.1007/s00592-018-1174-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 06/04/2018] [Indexed: 12/14/2022]
Abstract
AIMS To assess the association between physical activity (PA) during pregnancy and the prevalence of gestational diabetes mellitus (GDM) accounting for sitting time. METHODS The study used data from a cohort study of 2030 pregnant women in Vietnam. Women were recruited from six hospitals in Ha Noi, Hai Phong, and Ho Chi Minh City. Baseline measurements including PA and GDM were taken at 24-28 weeks of gestation. PA was assessed during the past 3 months before the interview using the interviewer-administered Pregnancy Physical Activity Questionnaire. GDM was diagnosed at 24-28 weeks of gestation using the 2013 World Health Organization criteria. RESULTS 1987 out of 2030 pregnant women were included in the final analysis, of which 432 had GDM (21.7%). Women undertaking the highest level (upper tertile) of PA during pregnancy appeared to have a lower risk of GDM [odds ratio (OR) 0.70, 95% confidence interval (CI) 0.53-0.94, Ptrend 0.017] when compared to those at the lowest tertile of PA. Similarly, women with increased levels of moderate-intensive activity and household/caregiving activity during pregnancy were associated with reduced risks of GDM (OR 0.66, 95% CI 0.50-0.86, Ptrend 0.002 and OR 0.72, 95% CI 0.55-0.95, Ptrend 0.020, respectively). These apparent inverse associations were not attenuated by their sitting time. There were no significant associations between sitting time, light-intensity activity, vigorous-intensity activity, occupation, sports/exercise, commuting, or meeting exercise guidelines and GDM risk. CONCLUSIONS High levels of PA, particularly moderate-intensity and household/caregiving activities during pregnancy were associated with a lower prevalence of GDM independent of sitting time.
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Affiliation(s)
- C L Nguyen
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia.
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam.
| | - N M Pham
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen, Vietnam
| | - A H Lee
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
| | - P T H Nguyen
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - T K Chu
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Hai Phong University of Medicine and Pharmacy, Hai Phong, Vietnam
| | - A V V Ha
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
- Pham Ngoc Thach University of Medicine, Ho Chi Minh City, Vietnam
| | - D V Duong
- United Nations Population Fund, Hanoi, Vietnam
| | - T H Duong
- National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - C W Binns
- School of Public Health, Curtin University, Kent Street, Bentley, Perth, WA, 6102, Australia
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14
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Petherick ES, Fairley L, Parslow RC, McEachan R, Tuffnell D, Pickett KE, Leon D, Lawlor DA, Wright J. Ethnic differences in the clustering and outcomes of health behaviours during pregnancy: results from the Born in Bradford cohort. J Public Health (Oxf) 2017; 39:514-522. [PMID: 27614098 DOI: 10.1093/pubmed/fdw098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 08/16/2016] [Indexed: 11/13/2022] Open
Abstract
Background Pregnancy is a time of optimal motivation for many women to make positive behavioural changes. We aim to describe pregnant women with similar patterns of self-reported health behaviours and examine associations with birth outcomes. Methods We examined the clustering of multiple health behaviours during pregnancy in the Born in Bradford cohort, including smoking physical inactivity, vitamin d supplementation and exposure to second-hand smoke. Latent class analysis was used to identify groups of individuals with similar patterns of health behaviours separately for White British (WB) and Pakistani mothers. Multinomial regression was then used to examine the association between group membership and birth outcomes, which included preterm birth and mean birthweight. Results For WB mothers, offspring of those in the 'Unhealthiest' group had lower mean birthweight than those in the 'Mostly healthy but inactive' class, although no association was observed for preterm birth. For Pakistani mothers, group membership was not associated with birthweight differences, although the odds of preterm birth was higher in 'Inactive smokers' compared to the 'Mostly healthy but inactive' group. Conclusions The use of latent class methods provides important information about the clustering of health behaviours which can be used to target population segments requiring behaviour change interventions considering multiple risk factors. Given the dominant negative association of smoking with the birth outcomes investigated, latent class groupings of other health behaviours may not confer additional risk information for these outcomes.
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Affiliation(s)
- E S Petherick
- School of Sport, Exercise & Health Sciences, University of Loughborough, Loughborough, UK
| | - L Fairley
- Division of Epidemiology, University of Leeds, Leeds, UK
| | - R C Parslow
- Division of Epidemiology, University of Leeds, Leeds, UK
| | - R McEachan
- Born in Bradford, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - D Tuffnell
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford BD9 6RJ, UK
| | - K E Pickett
- Department of Health Sciences, University of York, Heslington, UK.,Hull York Medical School, University of York, Heslington, UK
| | - D Leon
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - D A Lawlor
- MRC Centre for Causal Analyses in Translational Epidemiology, School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - J Wright
- Born in Bradford, Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
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15
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Associations between quality of life, physical activity, worry, depression and insomnia: A cross-sectional designed study in healthy pregnant women. PLoS One 2017; 12:e0178181. [PMID: 28542529 PMCID: PMC5439948 DOI: 10.1371/journal.pone.0178181] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 05/09/2017] [Indexed: 11/20/2022] Open
Abstract
Health-related quality of life (QOL) is reported to be reduced during pregnancy. Associations between QOL, physical activity (PA), insomnia, depression and worry are insufficiently investigated among pregnant women. The aim of this study was to evaluate QOL and PA patterns among healthy pregnant women, and to examine how QOL might correlate to PA, sleep, worry and depression. This is an observational cross-sectional study, conducted among a convenient sample of 141 healthy pregnant women using five questionnaires: WHOQOL-brief (WHO quality of life questionnaire, brief version, ISI (Insomnia Severity Index), PSWQ (Penn State Worry Questionnaire), ZSRDS (Zung Self-Rating Depression Scale), and Pregnancy Physical Activity Questionnaire (PPAQ). Pre-gestational BMI was inversely correlated to overall health while education was positively correlated to psychological health, social relationships and environment domains. Smoking before and during pregnancy significantly impacted the general health and psychological health. Total and light PA were positively correlated to psychological health and social relationships. Sports/exercise showed positive correlations with several QOL domains. Insomnia and depression were significantly associated with a decrease in all domains of QOL, while worries were associated with a decrease in physical, psychological and environmental domains. There were significant negative correlations between ZSRDS scores and total activity. PA, worries, depression and insomnia affected QOL during pregnancy. Furthermore, pregnant women presenting depression had a reduced total PA. Sleep and mental health as well as encouraging PA during pregnancy are necessary to improve the quality of life of pregnant women.
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16
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Richardsen KR, Falk RS, Jenum AK, Mørkrid K, Martinsen EW, Ommundsen Y, Berntsen S. Predicting who fails to meet the physical activity guideline in pregnancy: a prospective study of objectively recorded physical activity in a population-based multi-ethnic cohort. BMC Pregnancy Childbirth 2016; 16:186. [PMID: 27460363 PMCID: PMC4962490 DOI: 10.1186/s12884-016-0985-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Accepted: 07/22/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND A low physical activity (PA) level in pregnancy is associated with several adverse health outcomes. Early identification of pregnant women at risk of physical inactivity could inform strategies to promote PA, but no studies so far have presented attempts to develop prognostic models for low PA in pregnancy. Based on moderate-to-vigorous intensity PA (MVPA) objectively recorded in mid/late pregnancy, our objectives were to describe MVPA levels and compliance with the PA guideline (≥150 MVPA minutes/week), and to develop a prognostic model for non-compliance with the PA guideline. METHODS From a multi-ethnic population-based cohort, we analysed data from 555 women with MVPA recorded in gestational week (GW) 28 with the monitor SenseWear™ Pro3 Armband. Predictor variables were collected in early pregnancy (GW 15). We organized the predictors within the domains health, culture, socioeconomic position, pregnancy, lifestyle, psychosocial factors, perceived preventive effect of PA and physical neighbourhood. The development of the prognostic model followed several steps, including univariate and multiple logistic regression analyses. RESULTS Overall, 25 % complied with the PA guideline, but the proportion was lower in South Asians (14 %) and Middle Easterners (16 %) compared with Westerners (35 %). Among South Asians and Middle Easterners, 35 and 28 %, respectively, did not accumulate any MVPA minutes/week compared with 18 % among Westerners. The predictors retained in the prognostic model for PA guideline non-compliance were ethnic minority background, multiparity, high body fat percentage, and perception of few physically active friends. The prognostic model provided fair discrimination between women who did vs. did not comply with the PA guideline. CONCLUSION Overall, the proportion who complied with the PA guideline in GW 28 was low, and women with ethnic minority background, multiparity, high body fat percentage and few physically active friends had increased probability of non-compliance. The prognostic model showed fair performance in discriminating between women who did comply and those who did not comply with the PA guideline.
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Affiliation(s)
- Kåre Rønn Richardsen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway. .,Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway.
| | - Ragnhild Sørum Falk
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway
| | - Anne Karen Jenum
- Institute of Health and Society, Department of General Practice, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kjersti Mørkrid
- Department of International Public Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Egil Wilhelm Martinsen
- Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway.,Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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17
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Richardsen KR, Mdala I, Berntsen S, Ommundsen Y, Martinsen EW, Sletner L, Jenum AK. Objectively recorded physical activity in pregnancy and postpartum in a multi-ethnic cohort: association with access to recreational areas in the neighbourhood. Int J Behav Nutr Phys Act 2016; 13:78. [PMID: 27386943 PMCID: PMC4936091 DOI: 10.1186/s12966-016-0401-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 06/15/2016] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity may reduce the risk of adverse pregnancy outcomes; however, compared to non-pregnant women, a lower proportion of pregnant women meet the physical activity guidelines. Our objectives were to explore overall changes and ethnic differences in objectively recorded moderate-to-vigorous intensity physical activity (MVPA) during pregnancy and postpartum and to investigate the associations with objective and perceived access to recreational areas. Methods We analysed 1,467 person-observations from 709 women in a multi-ethnic population-based cohort, with MVPA data recorded with the SenseWear™ Pro3 Armband in early pregnancy (mean gestational week (GW) 15), mid-pregnancy (mean GW 28) and postpartum (mean postpartum week 14). MVPA was limited to bouts ≥10 min. Women were nested within 56 neighbourhoods defined by postal code area. We derived neighbourhood-level objective access to recreational areas (good vs limited) by geographic information systems. We collected information about perceived access (high vs low perception) to recreational areas in early pregnancy. We treated ethnicity, objective and perceived access as explanatory variables in separate models based on linear mixed effects regression analyses. Results Overall, MVPA dropped between early and mid-pregnancy, followed by an increase postpartum. Western women performed more MVPA than women in other ethnic groups across time points, but the differences increased postpartum. Women residing in neighbourhoods with good objective access to recreational areas accumulated on average nine additional MVPA minutes/day (p < 0.01) compared with women in neighbourhoods with limited access. Women with perceptions of high access to recreational areas accumulated on average five additional MVPA minutes/day (p < 0.01) compared with women with perceptions of low access. After mutual adjustments, perceived and objective access to recreational areas remained significantly associated with MVPA. The association between MVPA and access to recreational areas did not differ by time point, ethnic group or socio-economic position. Conclusions In all ethnic groups, we observed a decline in MVPA between early and mid-pregnancy. However, at both time points during pregnancy, and especially three months postpartum, Western women were more physically active than ethnic minority women. In all ethnic groups, and at all three time points, both objective and perceived access to recreational areas were positively associated with MVPA levels. Electronic supplementary material The online version of this article (doi:10.1186/s12966-016-0401-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kåre Rønn Richardsen
- Norwegian National Advisory Unit on Women's Health, Oslo University Hospital, Oslo, Norway. .,Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, PB 4 St Olavs Plass, N-0130, Oslo, Norway. .,Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway.
| | - Ibrahimu Mdala
- Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Sveinung Berntsen
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Yngvar Ommundsen
- Department of Coaching and Psychology, Norwegian School of Sport Sciences, Oslo, Norway
| | - Egil Wilhelm Martinsen
- Clinic Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Line Sletner
- Department of Pediatric and Adolescents Medicine, Akershus University Hospital, Lørenskog, Norway
| | - Anne Karen Jenum
- Faculty of Medicine, Department of General Practice, Institute of Health and Society, University of Oslo, Oslo, Norway
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18
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Sattar N, Gill JMR. Type 2 diabetes in migrant south Asians: mechanisms, mitigation, and management. Lancet Diabetes Endocrinol 2015; 3:1004-16. [PMID: 26489808 DOI: 10.1016/s2213-8587(15)00326-5] [Citation(s) in RCA: 151] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Revised: 08/24/2015] [Accepted: 08/26/2015] [Indexed: 02/06/2023]
Abstract
South Asians, particularly when living in high-income countries, are at a substantially elevated risk of type 2 diabetes compared with white Europeans, and typically develop the disease 5-10 years earlier and at a lower BMI. Migrant south Asians seem to be more insulin resistant than white Europeans across the life course and potentially experience β-cell exhaustion at a younger age. Differences in adiposity (high percentage of body fat and high proportion of deep subcutaneous and visceral fat) and skeletal muscle (low percentage of lean mass and low cardiorespiratory fitness) are likely to contribute these factors. No clear evidence is available suggesting genetic factors make a major contribution to the increased risk of diabetes in south Asians, but epigenetic factors might have a role. Irrespective of future mechanistic discoveries, south Asians need to be encouraged and helped-by various culturally appropriate methods--to maintain a high physical activity level and low bodyweight across the life course to prevent diabetes. In clinical terms, cardiovascular risks have attenuated over time in migrant south Asians with diabetes but retinopathy and renal complication risks remain high because of the high levels of glycaemia and rapid glycaemic deterioration noted in this population. We review these aspects and suggest areas for future research.
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Affiliation(s)
- Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
| | - Jason M R Gill
- Institute of Cardiovascular and Medical Sciences, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK.
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19
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Skreden M, Øverby NC, Sagedal LR, Vistad I, Torstveit MK, Lohne-Seiler H, Bere E. Changes in mode of transportation to work or school from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study. Prev Med Rep 2015; 2:429-35. [PMID: 26844101 PMCID: PMC4721300 DOI: 10.1016/j.pmedr.2015.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective To describe changes in mode of transportation to work or school from pre-pregnancy to early pregnancy, to describe levels of physical activity related to mode of transportation to work or school, and to examine associations between changes in mode of transportation to work or school and educational level, body mass index (BMI) and age. Methods Between September 2009 and February 2013, 575 healthy pregnant nulliparous women were included into the Norwegian Fit for Delivery (NFFD) trial. At inclusion they reported their current and their pre-pregnancy mode of transportation to work or school. Data were analysed by multilevel mixed models with dichotomized modes of transportation as dependent variables. Results There was a significant change towards less active transportation to work or school and a decrease in level of physical activity from pre-pregnancy to early pregnancy. Pre-pregnancy, 58% used private transportation to work or school, compared to 64% in early pregnancy (p = 0.001). The percentage of women who biked (11% v. 5%, p < 0.001) decreased significantly from pre-pregnancy to early pregnancy. Conclusions In this sample of Norwegian women there was a significant change towards less active transportation to work or school and lower levels of physical activity from pre-pregnancy to early pregnancy. We examined mode of transportation to work/school among pregnant women. Private transport was the dominant mode of transportation. There was a change towards less active transportation and less physical activity in early pregnancy. Only 46% continued biking to work/school in early pregnancy. High education was associated with decreased public and increased private transportation.
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Affiliation(s)
- Marianne Skreden
- Department of Public Health, Sports and Nutrition, University of Agder, Norway
| | - Nina C Øverby
- Department of Public Health, Sports and Nutrition, University of Agder, Norway
| | - Linda R Sagedal
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway
| | - Ingvild Vistad
- Department of Obstetrics and Gynaecology, Sørlandet Hospital, Kristiansand, Norway
| | - Monica K Torstveit
- Department of Public Health, Sports and Nutrition, University of Agder, Norway
| | - Hilde Lohne-Seiler
- Department of Public Health, Sports and Nutrition, University of Agder, Norway
| | - Elling Bere
- Department of Public Health, Sports and Nutrition, University of Agder, Norway
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