Effective Physical Activity and Diet to Avoid Weight Gain during Pregnancy - Literature review Example

? Effective Physical Activity and Diet to Avoid Weight Gain during Pregnancy October 15, Introduction Scientific studies and research are important in determining the role that physical activity along with diet and diet modifications play in many physiological conditions, including pregnancy. At one time, it was advised that woman reduce activity during pregnancy though studies in the last twenty years have shown benefit to moderate physical activity barring adverse conditions (Schlussel, Souza, Reichenheim, & Kac, 2008, p531). This paper will be a narrative review of literature summarizing current known information and highlighting research with significance on the effects of physical activity and diet on pregnancy. Literature Review Incidence of obesity and an excessive amount of weight gain during pregnancy have been shown to be a major factor in adverse effects for both delivering mothers and newborn infants. Other variables impacting pregnancy weight gain were found to be those common behaviors that affect weight status such as nutrition, physical activity and smoking cigarettes (Weisman, Hilliemeier, Chuang, & Dyer.2010, p 127). Healthier behaviors found to be associated with weight gain that falls within the Institute of Medicine’s guidelines were increased physical activity, the inclusion of more vegetables in the expectant mothers’ diet and non smoking. One study concluded that energy intake was comparable during pregnancy to that of other populations. Overweight pregnant women were shown to have a higher energy intake from fats and a lower energy intake from carbohydrates. Pregnant woman consuming 3 or more serving of vegetables or fruits per day gained 0.8 kg’s less than those whose dietary intake did not include these amounts (Guelinckx, Devlieger, Mullie,, & Vansant, 2010). Lifestyle interventions in these groups of woman reduced the occurrence of gestational diabetes mellitus and included dietary changes and increases in physical activity. To determine the reduction in obstetric and neonatal complications, a larger study group would have been needed than that was used in this research study, ‘Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial, (Guelinckx,et al, 2010, p 379). Intervention groups receiving initial dietary counseling which recommended a diet of 40% carbohydrates, 30% protein and 30% fat and who were also advised to participate in moderate intensity exercise at least three times weekly showed that those in the counseling group did gain less weight though the major difference between the intervention group receiving the dietary counseling and that of the control group was the rates of adherence to the Institute of Medicine’s guidelines, once again as demonstrated in prior studies (Asbee, et al, 2009, p 307). A successful study protocol to prevent excessive gestational weight gain could be integrated into the routine functions of primary health care across all pregnant populations though adherence or lack thereof requires more study into behavioral intervention methods that are effective in increasing that adherence to recommended guidelines (Kinnunen, et al, 2008, p7), such as the recommendations of the Institute of Medicine guidelines, which are used across each population. Comparison of dietary changes plus lifestyle changes analyzed against diet versus usual care indicates that diet interventions during pregnancy showed a significant effect on reducing long term post-partum weight gain which has further implications of following pregnancy’s (Tanentsapf, Heitman, & Adegboye, 2011, p 11). A similar study reported that decreased physical activity during pregnancy showed an association with approximately 2.7 lbs. more of gestational weight gain when measured against those who maintained or increased physical activity. Lifestyle changes including increasing physical activity are closely connected to dietary modifications as well (Jiang, et al, 2012, p 5). Individualized nutrition intervention programs and individualized exercise programs which included structured programs of exercise consisting only of the inclusion of 40 minutes daily of structured walking demonstrated an 80% success rate in preventing excess weight gain (Mottola, et al, 2010, p 6). Though this study was completed by a variety of agencies and departments, it is the only one known to quantify a program consisting of structured walking along with nutritional control. Other effective physical activities shown to avoid or reduce weight gain during pregnancy are light intensity resistance training, weight bearing exercises (Thangaratinam, 2012, p 3), exercise class attendance, and supervised class attendance to classes that included muscular and endurance training (Kinnunen, 2008, p6). Most nutrition topics focused on several topics: the establishment of a regular meal pattern which includes breakfast, consuming a minimum of five portions daily of fruits, vegetables, and berries, maintaining an intake of high fiber bread, and reducing your intake of high sugar snacks to less than one portion daily. Those participating in this study were women who were younger, less educated, more frequent smokers and had higher pre-pregnancy weights before the study (Kinnunen, Pasanen, Aittasalo, Fogelholm, Hilakivi, Weiderpass, & Luoto, 2007, p 887). Interventions in this group showed no effects of significance on weight change at any of the points that were used for measurement; actually, a larger percentage of these women exceeded the weight gain recommendations though the statistics were not significant. These findings are indicative that demographics such as education level, age, race, lifestyle factors, motivation, and factors such as the number of pregnancy’s all play important roles in defining which intervention will be more likely to succeed in different populations. This also demonstrates that findings are many times population specific and cannot represent the larger population of pregnant women as a whole. More controlled trials would be needed to determine if gestational weight gain can be controlled through diet and exercise across the continuum (Ronnberg, and Nilsson, 2010, p 1332). Results of intervention trials published, though good indicators for practitioner’s, are insufficient to allow many evidenced based recommendation’s beyond those defined generalities that are appropriate for all groups though many of these studied interventions may be prescribed they cannot be considered evidenced based. Many factors limiting these studies are the sampling size, demographics representing only a portion of the pregnant population and statistics that are too closely matched to the control group to be considered definitive. Public studies in primary health must each account for selection bias, allocation bias, confounders, blinding of outcome assessors, data collection methods, and withdrawals and dropouts (Liu, Mirza, & Thomas, 2005, p 10). These ratings assess the quality of the research study and the dependence on its reliability in your particular pregnant client. References Asbee, S., Jenkins, T., Butler, J., White, J., Elliot, M., & Rutledge, A. (2009). Preventing Excessive Weight Gain During Pregnancy Through Dietary and Lifestyle Counseling. Obstetrics and Gynecology, 113(2), 305-312. Gardner, B., Wardle, J., Poston, L., & Croker, H. (2011). Changing diet and physical activity to reduce gestational weight gain: A meta-analysis. Obesity Reviews, 12, E602-E620. Guelinckx, I., Devlieger, R., Mullie, P., & Vansant, G. (2010). Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: A randomized controlled trial. American Journal of Clinical Nutrition, 91(2), 373-380. doi: 10.3945/ajcn.2009.28166 Jiang, H., Qian, X., Li, M., Lynn, H., Fan, Y., Jiang, H., He, G. (2012). Can physical activity reduce excessive gestational weight gain? Findings from a Chinese urban pregnant women cohort study. Journal of Behavioral Nutrition, 9, 12. Kinnunen, T. I., Aittasalo, M., Koponen, P., Ojala, K., Mansikkamaki, K., Weiderpass, E., ... Luoto, R. (2008). Feasibility of a controlled trial aiming to prevent excessive pregnancy-related weight gain in primary health care. BMC Pregnancy and Childbirth, 8(37), 37. doi: 10.1186/1471-2393-8-37 Kinnunen, T. I., Pasanen, M., Aittasalo, M., Fogelholm, M., Hilakivi-Clarke, L., Weiderpass, E., & Luoto, R. (2007). Preventing excessive weight gain during pregnancy – a controlled trial in primary health care. European Journal of Clinical Nutrition, 61(7), 884-891. doi: 10.1038/sj.ejcn.1602602 Liu, L., Mirza, M., & Thomas, H. (2005). Effectiveness of Interventions to Prevent Excessive Weight Gain During Pregnancy. Effective Public Health Practice Project (EPHPP) Epidemiology and Evaluation City of Hamilton, Public Health Services, 1-31 Mottola, M. F., Giroux, I., Gratton, R., Hammond, J., Hanley, A., Harris, S., Sopper, M. M. (2010). Nutrition and Exercise Prevent Excess Weight Gain in Overweight Pregnant Women. Medicine & Science in Sports & Exercise, 42(2), 265-272. doi: 10.1249/MSS.0b013e3181b5419a Ronnberg, A., & Nilsson, K. (2010). Interventions during pregnancy to reduce excessive gestational weight gain: A systematic review assessing current clinical evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. BJOG: An International Journal of Obstetrics & Gynaecology, 117(11), 1327-1334. doi: 10.1111/j.1471-0528.2010.02619.x Schlussel, M. M., Souza, E. D., Reichenheim, M. E., & Kac, G. (2008). Physical activity during pregnancy and maternal-child health outcomes: A systematic literature review. Cadernos De Saude Publica, 24, S531-S544. doi: 10.1590/S0102-311X2008001600006 Tanentsapf, I., Heitmann, B., & Adegboye, A. (2011). Systematic review of clinical trials on dietary interventions to prevent excessive weight gain during pregnancy among normal weight, overweight and obese women. BMC Pregnancy and Childbirth, 11, 81. Thangaratinam, S., Rogozinska, E., Jolly, K., Glinkowski, S., Roseboom, T., Tomlinson, J., .Kahn, K. (2012). Effects of interventions in pregnancy on maternal weight and obstetric outcomes: Meta-analysis of randomised evidence. BMJ, 344, 1-15. Weisman, C., Hilliemeier, M., Downs, D., Chuang, C., & Dyer, A. (2010). PRECONCEPTION PREDICTORS OF WEIGHT GAIN DURING PREGNANCY Prospective Findings from the Central Pennsylvania Women’s Health Study. Womans Helath Issues, 20, 126-132. doi: doi:10.1016/j.whi.2009.12.002 Read More