Physical activity pattern and activity energy expenditure in healthy pregnant and non-pregnant Swedish women

Division of nutrition, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.
European journal of clinical nutrition (Impact Factor: 2.71). 07/2011; 65(12):1295-301. DOI: 10.1038/ejcn.2011.129
Source: PubMed


Energy costs of pregnancy approximate 320  MJ in well-nourished women, but whether or not these costs may be partly covered by modifications in activity behavior is incompletely known. In healthy Swedish women: (1) to evaluate the potential of the Intelligent Device for Energy Expenditure and Physical Activity (IDEEA) to assess energy expenditure during free-living conditions, (2) to assess activity pattern, walking pace and energy metabolism in pregnant women and non-pregnant controls, and (3) to assess the effect on energy expenditure caused by changes in physical activity induced by pregnancy.
Activity pattern was assessed using the IDEEA in 18 women in gestational week 32 and in 21 non-pregnant women. Activity energy expenditure (AEE) was assessed using IDEEA, as well as using the doubly labelled water method and indirect calorimetry.
AEE using the IDEEA was correlated with reference estimates in both groups (r=0.4-0.5; P<0.05). Reference AEE was 0.9 MJ/24 h lower in pregnant than in non-pregnant women. Pregnant women spent 92 min/24 h more on sitting, lying, reclining and sleeping (P=0.020), 73 min/24 h less on standing (P=0.037) and 21 min/24 h less on walking and using stairs (P=0.049), and walked at a slower pace (1.1 ± 0.1 m/s versus 1.2±0.1 m/s; P=0.014) than did non-pregnant controls. The selection of less demanding activities and slower walking pace decreased energy costs by 720 kJ/24 h and 80 kJ/24 h, respectively.
Healthy moderately active Swedish women compensated for the increased energy costs of pregnancy by 0.9 MJ/24 h. The compensation was mainly achieved by selecting less demanding activities.

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    • "This compares favorably with a recent English study conducted in obese and overweight nondiabetic pregnant women, which found that only 2 h out of a total 12.4 daytime hours (16%) was spent in light intensity activities, with 9.7 h (81%) spent sedentary, although an equivalent of 33 min were spent in moderate intensity exercise (23). Studies of healthy pregnancy from Switzerland (24) and Sweden (25) also reported lesser amounts of light intensity exercise (5.3 and 4.1 h, respectively), although the women in those studies spent rather more time in moderate to vigorous intensity exercise (57 and 63 min, respectively). "
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    ABSTRACT: OBJECTIVE To describe activity patterns in pregnant women with type 1 diabetes and evaluate the impact of increased structured physical activity on glucose control.RESEARCH DESIGN AND METHODS Physical activity energy expenditure (PAEE) and glucose levels (continuous glucose monitoring) were measured in 10 pregnant women with type 1 diabetes (age 33.2 years, gestation 20 weeks, BMI 27.9 kg/m(2), diabetes duration 16.6 years, HbA(1c) 6.5% [48 mmol/mol], insulin pump duration 2.4 years) during a day at home (free-living) and during a 24-h visit incorporating controlled diet and structured physical activity with light intensity activity (three 20-min self-paced walks) and moderate intensity activity (two 50-min sessions of brisk treadmill walking). PAEE was evaluated through individually calibrated combined heart rate and movement sensing.RESULTSFree-living PAEE was comparable to that under controlled study conditions (3.8 and 5.1 kcal/kg/day, P = 0.241), with women achieving near to the recommended 30 min of moderate physical activity (median 27 min [interquartile range 14-68]). During the free-living period, more time was spent in light activity (10.3 vs. 7.2 h, P = 0.005), with less sedentary time (13.0 vs. 14.9 h, P = 0.047) and less moderate activity (27 vs. 121 min, P = 0.022). The free-living 24-h mean glucose levels by continuous glucose monitoring were significantly higher (7.7 vs. 6.0 mmol/L, P = 0.028). The effect of controlled diet and exercise persisted overnight, with significantly less time spent hyperglycemic (19% vs. 0%, P = 0.028) and less glucose variability (glucose SD 1.3 vs. 0.7 mmol/L, P = 0.022).CONCLUSIONSA controlled diet and structured physical activity program may assist women with type 1 diabetes in achieving optimal glucose control during pregnancy.
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