Changes in energy expenditure, anthropometry, and energy intake during the course of pregnancy and lactation in well-nourished Indian women

Abstract

Basal metabolic rate (BMR), thermic effect of a meal (TEM), anthropometry, and dietary intakes were measured in 18 control subjects; 18 pregnant women at 12, 24, and 34 wk gestation; and in 17 of these women at 12 and 24 wk postpartum, to uncover any metabolic economy associated with either pregnancy or lactation. Results indicated that the BMR and TEM were not associated with any energy saving either during pregnancy or lactation. Mean weight gain from 12 wk gestation to term was 11.4 +/- 3.7 kg; mean birth weight of the infants was 3.06 +/- 0.41 kg. Estimated gain in adipose tissue and fat mass were 3.1 +/- 3.6 and 2.5 +/- 2.9 kg, respectively. Energy cost of pregnancy was estimated to be 303 +/- 171 MJ. The cumulative increase in energy intake over the last two trimesters of pregnancy was 290 +/- 280 MJ, meeting a large part of the total estimated cost of pregnancy. Weight gained by infants who were exclusively breast-fed from birth to 12 wk of age was used as a proxy indicator of adequate lactational performance. The extra energy required during lactation appeared to have been met largely by increases in energy intake, rather than by any metabolic economy or increase in fat mobilization.

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

“…For this group of poor urban women increasing carbohydrate intake would be the most economical way of increasing energy intake. Piers et al, (1995) also found higher carbohydrate intakes in lactating Indian women at 3 and 6 months pp in comparison to NPNL controls. However, in a longitudinal study of lactating Swedish women Sadurskis et al, (1988) did not find any change in macronutrient composition of the lactating women's diets when compared to their pre-pregnant state.…”

“…For example, lactating women in India, 1 -6 months pp (Madhavapeddi & Rao, 1992;Piers et al, 1995), and in Bangladesh, 2 -8 months pp (Rashid & Ulijaszek 1999), as well as food supplemented women in the Gambia, 3 -9 months pp (Lawrence et al, 1986) were essentially weight stable showing changes in body weight of less than 0.7 kg. In contrast, studies of lactating women in the Philippines, 1-8 months pp (Guillermo-Tuazon et al, 1992), as well as those in Europe (Forsum, et al, 1992;Sadurkis et al, 1988;van Raaij et al, 1991) reported weight losses of 1.3 -1.4 kg in lactating women 1 -7 months pp.…”

“…Although only a limited number of studies have examined both sides of the energy balance equation, intake and expenditure, it appears that women in different populations may use different strategies to cover the cost of milk synthesis. For example, well-nourished Indian women increased food intake, but did not mobilize fat stores to any significant extent (Piers et al, 1995). In contrast, rural women in Guatemala did not increase energy intake, but met the additional costs primarily via the mobilization of body fat stores (Schutz et al, 1980).…”

Repeated measurements of energy intake, energy expenditure and energy balance in lactating Bangladeshi mothers

“…The energy intake results from the three sessions (8325 + 1504, 8148 + 1676 and 9419 + 1142 kJaday at 3.5, 10 and 13-months, respectively) are well within the range of the TEE (8554 + 1867, 8555 + 1824 and 9004 + 1818 kJaday) and within the range of energy intakes found from other lactating women living in developing countries. Piers et al (1995) found that energy intake ranged between 9090 and 9600 kJaday over 6 months postpartum for well-nourished lactating Indian women weighing 54 kg, using 5 day weighed dietary records. With a 7 day weighed record, Guillermo-Tuazon et al (1992) obtained a range of energy intake of 8670 ± 8710 kJaday between 1.5 and 7.5 months postpartum among poor rural Philippino lactating women with body weight ranging between 45.4 and 46.9 kg.…”

“…Recently, attention has focussed on lactating women and a number of studies have investigated their energy expenditure and body composition (Goldberg et al, 1991;Adair & Popkin, 1992;Forsum et al, 1992;Guillermo-Tuazon et al, 1992;Piers et al, 1995;Dewey, 1998;Butte et al, 1997Butte et al, ,1999Krebs et al, 1997;Motil et al, 1998;Spurr et al, 1998). However there have been few longitudinal studies beyond 6 months post-partum (cf Lawrence et al, 1986) and most of the subjects were well-nourished mothers (van Raaij et al, 1990;Adair & Popkin, 1992;Motil et al, 1998).…”