Body composition and energy metabolism in pregnancy (original) (raw)
Related papers
Maternal Adiposity and Energy Balance After Normotensive and Preeclamptic Pregnancies
The Journal of Clinical Endocrinology and Metabolism, 2021
Background: Preeclampsia is a major pregnancy complication associated with longterm maternal cardiometabolic disease. Research generally is focused on metabolic and pathophysiological changes during pregnancy; however, there is much less focus on the early postpartum period in subjects who suffered preeclampsia. The aim of this study was to (1) characterize energy intake and expenditure 6 months following normotensive and preeclamptic pregnancies and (2) examine associations between energy balance, body composition, insulin resistance measures (HOMA-IR), and clinical characteristics. Design: A cross-sectional study 6 months following normotensive (n = 75) and preeclamptic (n = 22) pregnancies was performed. Metabolic measurements included anthropometrics measures, body composition via bioelectrical impedance analysis, 24-h energy expenditure via SenseWear Armbands, energy intake via a 3-day food diary, and serum metabolic parameters. Results: Six months following preeclampsia, women had a significantly higher weight (77.3 ± 20.9 kg vs 64.5 ± 11.4 kg, P = 0.01), fat mass percentage (FM%; 40.7 ± 7.4% vs 34.9 ± 8.1%, P = 0.004), and insulin resistance (HOMA-IR 2.2 ± 1.5 vs 1.0 ± 0.7, P = 0.003), as well as reduced HDL levels (1.
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. ...
Adjustments in energy expenditure and substrate utilization during late pregnancy and lactation
The American journal of clinical nutrition, 1999
Metabolic adjustments occur during pregnancy and lactation to support fetal growth and milk synthesis; however, the effect of body composition and hormonal milieu on these changes is poorly understood. We hypothesized that energy metabolism changes during pregnancy and lactation to support fetal growth and milk synthesis, and that body composition and hormonal milieu influence these alterations. We measured energy expenditure, body composition, and hormone, metabolite, and catecholamine concentrations in 76 women (40 lactating, 36 nonlactating) at 37 wk gestation and 3 and 6 mo postpartum. Total energy expenditure (TEE), basal metabolic rate (BMR), sleeping metabolic rate (SMR), and minimal SMR (MSMR) were measured with room calorimetry. Fat-free mass (FFM) and fat mass were estimated with a 4-component model. TEE, BMR, SMR, and MSMR were 15-26% higher during pregnancy than postpartum after being adjusted for FFM, fat mass, and energy balance. TEE, SMR, and MSMR were higher in lacta...
The influence of energy metabolism on postpartum weight retention
The American Journal of Clinical Nutrition, 2018
Background: Profiling postpartum energy metabolism may assist in optimizing weight management following childbirth. Objectives: The aims of this study were to profile total energy expenditure (TEE), resting energy expenditure (REE), exercise energy expenditure, sleep energy expenditure, and respiratory quotient in women at 3 and 9 mo postpartum (3M-PP, 9M-PP, respectively), and to examine the association between energy metabolism and postpartum weight retention (PPWR). Methods: In this cohort study, 1-h REE (measured in a whole body calorimetry unit, WBCU) and body composition (BC, measured by dual-energy X-ray absorptiometry) were measured at 3M-PP and 9M-PP (n = 49). Cardiorespiratory fitness [measured by the predicted maximal volume of oxygen consumption (pV O 2 max), n = 47] and 24-h TEE (WBCU, n = 43) were assessed only at 9M-PP. Women were stratified as high (>4.8 kg) or low (≤ 4.8 kg) weight retainers. Two-way mixed repeated-measures ANOVA and longitudinal regression models were applied. Linear regression was used to generate an equation at 3M-PP from the BC data, to predict the REE at 9M-PP.
Prepregnancy Body Mass Index and Resting Metabolic Rate during Pregnancy
Annals of Nutrition and Metabolism, 2010
The RMR is significantly increased in the third trimester of pregnancy. The absolute gestational RMR is higher in women with high prepregnancy BMI due to increased body weight. The scaled metabolic rate (RMR/kilograms 0.73 ) is similar among the BMI groups of pregnant women.
Nutrition, 2011
Objective: There is conflicting evidence as to whether anthropometric parameters are related to resting energy expenditure (REE) during pregnancy. The aim of this prospective longitudinal study was to precisely assess a major anthropometric determinant of REE for pregnant and non-pregnant women with verification of its use as a possible predictor. Methods: One hundred fifty-two randomly recruited, healthy, pregnant Czech women were divided into groups G1 and G2. G1 (n ¼ 31) was used for determination of the association between anthropometric parameters and REE. G2 (n ¼ 121) and a group of non-pregnant women (G0; n ¼ 24) were used for verification that observed relations were suitable for the prediction of REE during pregnancy. The women in the study groups were measured during four periods of pregnancy for REE by indirect calorimetry and anthropometric parameters after 12 h of fasting. Results: Associations were found in all groups between measured REE by indirect calorimetry and anthropometric parameters such as weight, fat mass, fat-free mass (FFM), body surface area, and body mass index (P < 0.0001). The best derived predictor, REE/FFM (29.5 kcal/kg, r ¼ 0.70, P < 0.0001), in group G1 was statistically verified in group G2 and compared with G0. Conclusion: Anthropometrically measured FFM with its metabolically active components is an essential determinant of REE in pregnancy. REE/FFM can be used for the prediction of REE in pregnant and non-pregnant woman.
The American journal of clinical nutrition, 1989
Body weight, fat mass, and basal metabolic rate were measured longitudinally from early pregnancy until 2 mo postpartum in 57 healthy Dutch women; 23 of whom were also studied before pregnancy. Weight gain over pregnancy was 11.8 +/- 3.7 kg and weight gain from 12 wk gestation to delivery was 10.3 +/- 3.8 kg. Birth weights and placental weights were 3458 +/- 527 and 657 +/- 114 g, respectively. Gain in maternal fat stores over pregnancy was 2.0 +/- 2.6 kg and difference in fat mass from 12 wk gestation to 5 wk postpartum was 1.2 +/- 2.2 kg. The energy equivalent of the gain in fat stores, including costs of synthesizing, can be estimated as 22,000 kcal. The cumulative increment in basal metabolism over pregnancy was 34,350 +/- 30,000 kcal. When the energy equivalent of the gain in tissue other than fat stores is assumed to be approximately 11,750 kcal, total energy cost of pregnancy is at 68,100 +/- 38,560 kcal.
2015
Introduction: Obesity and excessive gestational weight gain (GWG) have been associated with higher occurrence of large for gestational age (LGA) babies, and several interventions have been proposed to limit GWG, which, however, does not reflect adequately the subtle changes in body composition that happens during pregnancy. The aim of this study is to evaluate if the variations of body composition, induced by a lifestyle program intended to limit GWG and measured through bioelectrical impedence analysis (BIA), could affect the newborns’ weight in overweight/obese women. Methods: One hundred and thirty-nine women with BMI ≥ 25 kg/m 2 were enrolled between 9 th -12 th week and a lifestyle program, consisting of low glycemic diet with caloric restriction and physical activity, was prescribed to them. BIA was performed at enrolment and at 35 th -36 th week. Data regarding the newborns’ weight were collected from clinical charts after delivery. Results: Women who exceeded recommended ran...
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.
Journal of Obesity & Weight Loss Therapy, 2016
Introduction: we evaluated the utility of bioimpedance analysis and the SenseWear armband for monitoring gestational weight gain (GWG) in overweight/obese pregnant women. Materials and methods: Sixty overweight/obese pregnant women were recruited and advised to follow a physical activity (PA) program (sessions gradually increasing to 30 minutes of mild physical activity intensity per day at least 4-5 days a week) with caloric restriction (1500 kcal/day + 200 kcal/day for obese and 300 kcal/day for overweight women). Weight, GWG and body composition were measured at enrollment (within the 12 th week of gestation), at the 16 th , 20 th , 32 nd , and 36 th week, at delivery and 12 weeks after delivery using BIA. The patients were also instructed to wear the SWA, for 5 consecutive days, at enrollment, and at the 20 th and 36 th weeks of gestation. Results: GWG at delivery was 12.6 ± 5.4 kg for overweight, 9.0 ± 8.0 kg for obese women and 3.3 ± 5.3 kg for morbidly obese women. Nine overweight (60.0%), 22 obese (66.7%) and 10 morbidly obese (90.9%) women remained within the Institute of Medicine recommended ranges at delivery. Overall percentual body composition changed significantly throughout pregnancy, (fat-free mass: 53.4 ± 6.1 to 56.9 ± 6.5; FM = 40.9 ± 12.8 to 44.1 ± 11.8, p < 0.05). Logistic regression analysis showed that women who adhered to the prescribed diet achieved a lower GWG (CI 95% =-1.65-0.54; r =-1.10, p = 0.001). Conclusion: The efficacy of the intervention depends directly on the adherence to the prescribed diet and PA program.