Energy intake and expenditure of free-living, pregnant Colombian women in an urban setting (original) (raw)
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Longitudinal assessment of energy balance in well-nourished, pregnant women
The American journal of clinical nutrition, 1999
Clinicians often recommend an additional energy intake of 1250 kJ/d to their pregnant patients. Previous studies have shown considerable variation in the metabolic response to pregnancy and thus in the additional energy required to support a pregnancy. The purpose of this study was to assess how well-nourished women meet the energy demands of pregnancy and to identify factors that predict an individual's metabolic response. Resting metabolic rate (RMR), diet-induced thermogenesis (DIT), total energy expenditure (TEE), activity energy expenditure (AEE), energy intake (EI), and body fat mass (FM) were measured longitudinally in 10 women preconception; at 8-10, 24-26, and 34-36 wk of gestation; and 4-6 wk postpartum. Compared with preconception values, individual RMRs increased from 456 to 3389 kJ/d by late pregnancy. DIT varied from -266 to 110 kJ/meal, TEE from -105 to 3421 kJ/d, AEE from -2301 to 2929 kJ/d, EI from -259 to 2176 kJ/d, and FM from a 0.6-kg loss to a 10.6-kg gain. ...
Energy requirements during pregnancy based on total energy expenditure and energy deposition
The American Journal of Clinical Nutrition, 2004
Background: Energy requirements during pregnancy remain controversial because of uncertainties regarding maternal fat deposition and reductions in physical activity. Objective: This study was designed to estimate the energy requirements of healthy underweight, normal-weight, and overweight pregnant women and to explore energetic adaptations to pregnancy. Design: The energy requirements of 63 women [17 with a low body mass index (BMI; in kg/m 2), 34 with a normal BMI, and 12 with a high BMI] were estimated at 0, 9, 22, and 36 wk of pregnancy and at 27 wk postpartum. Basal metabolic rate (BMR) was measured by calorimetry, total energy expenditure (TEE) by doubly labeled water, and activity energy expenditure (AEE) as TEE Ҁ BMR. Energy deposition was calculated from changes in body protein and fat. Energy requirements equaled the sum of TEE and energy deposition. Results: BMR increased gradually throughout pregnancy at a mean (ȀSD) rate of 10.7 Ȁ 5.4 kcal/gestational week, whereas TEE increased by 5.2 Ȁ 12.8 kcal/gestational week, which indicated a slight decrease in AEE. Energy costs of pregnancy depended on BMI group. Although total protein deposition did not differ significantly by BMI group (mean for the 3 groups: 611 g protein), FM deposition did (5.3, 4.6, and 8.4 kg FM in the low-, normal-, and high-BMI groups; P ҃ 0.02). Thus, energy costs differed significantly by BMI group (P ҃ 0.02). In the normal-BMI group, energy requirements increased negligibly in the first trimester, by 350 kcal/d in the second trimester, and by 500 kcal/d in the third trimester. Conclusion: Extra energy intake is required by healthy pregnant women to support adequate gestational weight gain and increases in BMR, which are not totally offset by reductions in AEE.
The Impact of Maternal Nutrition on the Offspring, 2005
Energy requirements as defined in the 1985 FAO/WHO/UNU report on Energy and Protein Requirements [1] should support a body size and composition and level of energy expenditure (EE) consistent with good health, and allow for economically necessary and socially desirable physical activity. In pregnancy, extra energy is needed to cover the costs of maternal and fetal tissue accretion, and the rise in EE attributable to basal metabolism and physical activity. Because of uncertainties regarding desirable gestational weight gain (GWG), maternal fat deposition, putative reductions in physical activity and energetic adaptations to pregnancy, controversy remains regarding energy requirements during pregnancy [2]. Dietary energy studies imply that the incremental needs of pregnancy are relatively low. Calorimetric studies have demonstrated energetic adaptations to pregnancy via suppression of basal metabolism and reduction in physical activity. Energy requirements during pregnancy have been based on immediate infant and maternal outcomes; the long-term consequences of inadequate and excess maternal energy intake on fetal growth and development are just now being recognized. The objectives of this chapter are to review: (1) energy requirements during pregnancy; (2) energetic adaptations to pregnancy, and (3) consequences of deviations from maternal energy requirement on fetal outcome.
2011
Women in poor rural communities often engage in heavy physical activity yet consume diets that are deficient in energy. Pregnant women in these communities do not often show an augmentation in kilocalorie intake yet they continue with heavy work. Strenuous work may alter a pregnant woman’s nutritional status, therefore increasing her risk of morbidity, mortality and low gestational weight gain; a key risk factor for low birth weight. The study investigated energy intake and levels of physical activity, and their influence on gestational weight gain among women at Rongo Sub-District Hospital in Kenya. The specific objectives of the study were to determine energy intake, physical activity energy expenditure, weight gain, and teste for significant relationships. The study adopted a longitudinal design and comprehensive sampling was used to select a sample of 100 pregnant women. Data was collected by use of structured questionnaires, observation, 24-hour recall and food weighing techniq...
Energy Requirements of Pregnancy in the Philippines
The Lancet, 1987
40 rural Philippine women were studied longitudinally from 11-16 wk pregnancy until 3 months post partum. Energy intake, body weight, fat mass, basal metabolic rate (BMR), and physical activity patterns were recorded every 6 wk. The cumulative energy cost of pregnancy over the second and third trimesters of pregnancy was 189 MJ (1130 kJ/day). There was no increase in energy intake, rather a very small reduction over the final two trimesters. Changes in physical activity provided part of the estimated energy needs (375-415 kJ/day throughout the second and third trimesters of pregnancy). These measurements leave an unexplained deficit of at least 700 kJ/day. Nevertheless, there was an adequate mean birthweight (2885 g) and a 10% incidence of low birthweight. The findings seem to suggest that pregnancy outcome can be successful despite marginal energy intake.
Energy expenditure during pregnancy: a systematic review
Nutrition Reviews, 2020
Context Contrary to nutritional guidelines, accumulating evidence shows that pregnant women’s energy intakes remain stable throughout trimesters. Although pregnant women may eat below their needs or underreport their energy intakes, it is also relevant to question how energy requirements – estimated through measurements of energy expenditure (EE) – change throughout pregnancy. Objective This review examined prospective studies that measured EE during pregnancy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources PubMed/MEDLINE, Web of Science, Embase, and CINAHL databases were searched to identify relevant publications up to November 14, 2019. Study selection All studies that measured EE prospectively and objectively during pregnancy were included in this systematic review. Two authors independently screened 4852 references. A total of 32 studies were included in the final analysis. Data extraction One author extracted data and a...
Body composition and energy metabolism in pregnancy
The Australian and New Zealand Journal of Obstetrics and Gynaecology, 2001
The objective of the study was to measure energy metabolism and body composition during pregnancy and postpartum, compared to non-pregnant women, using non-invasive techniques. A longitudinal study of eight normotensive pregnant women was carried out at 19 k 1 and 36 k 1 weeks gestation, and postpartum. A cross-sectional study was also performed comparing postpartum to 12 nonpregnant women. Indirect calorimetry was performed while fasting to measure basal metabolic rate (BMR) and postprandially to measure diet-induced thermogenesis (DIT). Body composition consists of fat mass, lean body mass (LBM), and total body water (TBW) and was measured by bio-electrical impedance. Insulin resistance was indirectly assessed by glucose and insulin concentration and DIT. Weight gain in pregnancy was predominantly fat mass (p < O.Ol), but LBM and TBW also increased (p < 0.01). Weight loss postpartum was comprised of fat mass, LBM and TBW (p < 0.01). BMR, glucose and insulin increased in pregnancy and decreased postpartum (p < 0.05), but DIT was unchanged. The BMR was not correlated with weight gain. Apart from fat mass, postpartum and non-pregnant women were similar. The insulin resistance increased insulin and glucose levels but not DIT. Fat mass was the major component of weight gain during pregnancy and there was an increase in BMR, glucose and insulin but no change in DIT. BMR decreased to normal but fat mass remained elevated 16 weeks post-partum.
Journal of Maternal and Child Health, 2019
Background: One of the nutritional problems experienced by pregnant women is chronic energy deficiency (CED). Chronic energy deficiency is a condition in which women of childbearing age experience a lack of energy and protein intake and take place continuously resulting in health problems. This study aims to analyze chronic energy deficiency factors in pregnant women in Gunungkidul Regency. Subjects and Method: This study implemented a case control design. It was conducted in 25 community health centers, Gunungkidul, Yogyakarta, from April to May 2019. A sample of 200 pregnant women was selected by fixed disease sampling. The dependent variable was chronic energy deficiency in pregnant women. The independent variables included food intake, education level, occupation, knowledge, family income, age, parity, utilization of antenatal care services (ANC), and food availability. The data were collected using the MUAC tape and questionnaire. The data were analyzed by a multilevel multiple logistic regression. Results: The risk of protein energy deficiency decreased with high energy and protein intake (b =-2.74; 95% CI =-7.74 to-1.28; p = 0.006), more education level than high school (b =-2.16; 95% CI =-4.54 up to-0.22; p = 0.030), working mothers (b =-2.75; CI 95% =-9.48 to-1.59; p = 0.006), sufficient knowledge (b =-2.32; CI 95% =-6.27 to-0.52; p = 0.020), high family income (b =-2.38; CI 95% =-6.27 to-0.60; p = 0.017), age ≥20 years to 35 years (b =-2.17; 95% CI =-5.16 to-0.26; p = 0.030), parity> 2 (b =-2.57; CI 95% =-8.42 to-1.13; p = 0.010), using high ANC services (b =-2.72; 95% CI =-9.20 to-1.49 ; p = 0.007), and food availability is fulfilled (b =-2.54; CI 95% =-7.63 to-0.98; p = 0.011). Public health centers had a large contextual influence on chronic energy shortages with an ICC of 51.25%. Conclusion: There is a significant influence between food intake, education level, occupation, knowledge, family income, age, parity, utilization of ANC services, and food availability for chronic energy shortages in pregnant women. The variations at the public health centers level show that there is a contextual influence on chronic energy shortages in pregnant women.
The American Journal of Clinical Nutrition, 1994
To investigate changes in energy metabolism during pregnancy, complete 8-d energy balances were measured before pregnancy and at 12, 23, and 34 wk gestation in I 2 healthy Dutch women. While for each individual woman experimental diets were kept constant throughout the study with average intakes of 8.76 ± 0.92 MI/d (before pregnancy), 8.72 ± 1 .08 Mit d (week 12), 8.85 ± 0.93 MItd (week 23), and 8.72 ± 1.12 MIt d (week 34), neither the digestibility nor the metabolizability of the supplied diets showed significant changes from before pregnancy (92.8% and 88.6%, respectively) throughout pregnancy (92.7% and 88.2%, respectively). Twenty-four-hour energy cxpenditure (24-h EE) increased significantly from 8.63 ± 0.80 Mit d (before pregnancy) to 8.73 ± 1. I 5, 9.08 ± I .08, and 9.94 ± 0.94 Mltd in weeks 12, 23, and 34 of gestation, to the extent predictable from changes in resting metabolic rate so that in an experimental setting with physical activity and energy intake standardized there seems little scope for other adaptive mechanisms.
Longitudinal assessment of energy expenditure in pregnancy by the doubly labeled water method
The American journal of clinical nutrition, 1993
Twelve women were studied before pregnancy and at 6-wk intervals from 6 to 36 wk gestation. Total energy expenditure (TEE) by the doubly labeled water method, basal metabolic rate (BMR), energy intake, and body composition were assessed on each occasion. There was substantial interindividual variation in the response to pregnancy. Mean total energy costs were as follows: delta BMR 112 +/- 104 MJ (range -53 to 273), delta TEE 243 +/- 279 MJ (range -61 to 869 MJ), and fat deposition 132 +/- 127 MJ (range -99 to 280 MJ). The mean total cost of pregnancy (cumulative TEE above baseline+energy deposited as fat and as products of conception) was 418 +/- 348 MJ (range 34-1192 MJ). This was much higher than current recommendations for incremental energy intakes. Self-recorded incremental intakes (208 +/- 272 MJ) seriously underestimated the additional costs. The variability in response emphasizes the problems in making prescriptive recommendations for individual women, because there is no wa...