Energy requirements during pregnancy and lactation

USDA/ARS Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, Texas 77030, USA.
Public Health Nutrition (Impact Factor: 2.68). 11/2005; 8(7A):1010-27. DOI: 10.1079/PHN2005793
Source: PubMed


To estimate the energy requirements of pregnant and lactating women consistent with optimal pregnancy outcome and adequate milk production.
Total energy cost of pregnancy was estimated using the factorial approach from pregnancy-induced increments in basal metabolic rate measured by respiratory calorimetry or from increments in total energy expenditure measured by the doubly labelled water method, plus energy deposition attributed to protein and fat accretion during pregnancy.
Database on changes in basal metabolic rate and total energy expenditure during pregnancy, and increments in protein based on measurements of total body potassium, and fat derived from multi-compartment body composition models was compiled. Energy requirements during lactation were derived from rates of milk production, energy density of human milk, and energy mobilisation from tissues.
Healthy pregnant and lactating women.
The estimated total cost of pregnancy for women with a mean gestational weight gain of 12.0 kg, was 321 or 325 MJ, distributed as 375, 1200, 1950 kJ day(-1), for the first, second and third trimesters, respectively. For exclusive breastfeeding, the energy cost of lactation was 2.62 MJ day(-1) based on a mean milk production of 749 g day(-1), energy density of milk of 2.8 kJ g(-1), and energetic efficiency of 0.80. In well-nourished women, this may be subsidised by energy mobilisation from tissues on the order of 0.72 MJ day(-1), resulting in a net increment of 1.9 MJ day(-1) over non-pregnant, non-lactating energy requirements.
Recommendations for energy intake of pregnant and lactating women should be updated based on recently available data.

Download full-text


Available from: Janet King, Aug 17, 2015
    • "In low-resource settings, GWG is strongly dependent on pre-pregnancy nutritional status and nutrient supply during gestation. When the nutrient requirements of the mother, placenta and fetus are not met, fetal growth may be reduced and adverse pregnancy outcomes, such as LBW, may ensue (Abrams & Selvin 1995; Carmichael et al. 1997; Butte & King 2005; Mola et al. 2011). The impact of sulphadoxine-pyrimethamine/ azithromycin-based intermittent preventive treatment (SPAZ-IPTp) on GWG is unknown, but it is conceivable that SPAZ-IPTp partly achieves its effect on birthweight by improving GWG. "
    [Show abstract] [Hide abstract]
    ABSTRACT: In Papua New Guinea, intermittent preventive treatment with sulphadoxine-pyrimethamine and azithromycin (SPAZ-IPTp) increased birthweight despite limited impact on malaria and sexually transmitted infections. To explore possible nutrition-related mechanisms, we evaluated associations between gestational weight gain (GWG), enrolment body mass index (BMI) and mid-upper arm circumference (MUAC), and birthweight. We investigated whether the increase in birthweight associated with SPAZ-IPTp may partly be driven by a treatment effect on GWG. The mean GWG rate was 393 g/week (SD 250; n = 948). A 100 g/week increase in GWG was associated with a 14 g (95% CI 2.6, 25.4) increase in birthweight (P = 0.016). Enrolment BMI and MUAC also positively correlated with birthweight. SPAZ-IPTp was associated with increased GWG [58 g/week (26, 900), P < 0.001, n = 948] and with increased birthweight [48 g, 95% CI (8, 880), P = 0.019] when all eligible women were considered (n = 1947). Inclusion of GWG reduced the birthweight coefficient associated with SPAZ-IPTp by 18% from 44 to 36 g (n = 948), although SPAZ-IPTp was not significantly associated with birthweight among women for whom GWG data were available (P = 0.13, n = 948). One month post-partum, fewer women who had received SPAZ-IPTp had a low post-partum BMI (<18.5 kg m−2) [adjusted risk ratio: 0.55 (95% CI 0.36, 0.82), P = 0.004] and their babies had a reduced risk of wasting [risk ratio 0.39 (95% CI 0.21, 0.72), P = 0.003]. SPAZ-IPTp increased GWG, which could explain its impact on birthweight and maternal post-partum BMI. Future trials of SPAZ-IPTp must incorporate detailed anthropometric evaluations to investigate mechanisms of effects on maternal and child health.
    Maternal and Child Nutrition 10/2015; DOI:10.1111/mcn.12215 · 3.06 Impact Factor
  • Source
    • "In our study, crude analyses indicated that both short (≤11 mo) and long (≥60 mo) intervals were associated with elevated OR for LBW in comparison to the interval equal to 18-23 months, but after adjustment for maternal and infant characteristics these associations did not reach the level of statistical significance. It should be noted that IPI is not the best measure of whether a mother has had a chance to recover from the pregnancy, in terms of replenishing her nutritional status, because nutritional burden on the mother between pregnancies depends on the extent of breastfeeding (Butte and King, 2005; Dufour and Sauther, 2002; Jasienska, 2013). It was suggested that the " recuperative interval " (duration of the non-pregnant, non-lactating interval) instead, would be a more sensitive measure of maternal ability to recover from the previous reproductive event (Dewey and Cohen, 2007). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Short interpregnancy intervals (IPI) and high parity may be synergistically associated with the risk of unfavorable pregnancy outcomes. This study tests if the effect of short IPI on the odds ratio for low birth weight (LBW, <2,500 g) differs across parity status. The study was carried out on the birth registry sample of almost 40,000 singleton, live-born infants who were delivered between the years 1995 and 2009 to multiparous mothers whose residence at the time of infant's birth was the city of Krakow. Multiple logistic regression analyses were used for testing the effect of IPI on the odds ratio (OR) for LBW, after controlling for employment, educational and marital status, parity, sex of the child, maternal and gestational age. Stratified analyses (according to parity) and tests for interaction were performed. Very short IPI (0-5 months) was associated with an increased OR for LBW, but only among high parity mothers with three or more births (OR = 2.64; 95% CI 1.45-4.80). The test for interaction between very short IPI and parity on the OR for LBW was statistically significant after adjustment for multiple comparisons (P = 0.04). Among low parity mothers (two births) no statistically significant associations were found between IPI and LBW after standardization. Parity may modify the association between short birth spacing and LBW. Women with very short IPI and high parity may have a higher risk of having LBW infants than those with very short IPI but low parity. Am. J. Hum. Biol., 2015. © 2015 Wiley Periodicals, Inc. © 2015 Wiley Periodicals, Inc.
    American Journal of Human Biology 03/2015; in press(5). DOI:10.1002/ajhb.22708 · 1.70 Impact Factor
  • Source
    • "Evidence showed that child-bearing during adolescence hinder growth and nutritional status of the adolescent girls (Rah et al., 2008). Nutrition in pregnancy demands extra care due to the growing foetus, placing a high demand on the mother's energy, protein and micronutrients (Butte and King, 2005). Good nutrition is the best way to prevent anaemia during pregnancy but young still-growing women are highly disadvantaged due to competition for nutrients between the mother and the foetus (Scholl et al., 1994). "

    Acta Tropica 12/2014; 144. DOI:10.1016/j.actatropica.2014.12.009 · 2.27 Impact Factor
Show more