Dietary intake, capillary blood glucose, and activity level of activity-restricted, hospitalized, pregnant women in the third trimester: a pilot study

Abstract

Activity restriction in hospital is commonly prescribed by care providers to decrease the incidence of maternal or fetal morbidity in high-risk pregnancies. The purpose of this pilot descriptive study was to collect preliminary data on dietary intake, capillary blood glucose concentrations, and activity level in high-risk, activity-restricted, pregnant women in the third trimester of pregnancy. Dietary food intake records, capillary blood glucose, and daily pedometer step totals were investigated in 20 activity-restricted women over 7 consecutive days in hospital. Subjects were asked to collect hospital meal tickets, as well as record any additional items not provided by the hospital in a dietary log each day. Capillary blood glucose was collected every morning (fasting) as well as 1 h after breakfast (post-prandial) using a glucometer. Subjects wore a pedometer 24 h/d, and recorded step totals 4 times daily in a pedometer log. In the analysis, average energy and macronutrient intakes met dietary reference intake (DRI) recommendations, as did average intakes of all micronutrients, including maternal supplementation. Without supplementation, vitamin E and iron intakes were lower (p<0.05) than the DRI recommendations. Average fasting (4.6+/-0.5 mmol/L) and post-prandial (7.1+/-1.0 mmol/L) blood glucose concentrations in subjects without gestational diabetes (GDM) did not exceed Canadian Diabetes Association cut-off values for screening of GDM. The mean daily step total of 1579+/-936 was lower than ambulatory third-trimester women (6495+/-2282 steps; p<0.001). Results from this pilot study suggest that with maternal supplementation, these activity-restricted, hospitalized, pregnant women were meeting dietary recommendations, and did not have elevated capillary blood glucose. However, given the severity of activity restriction, these women may be at risk for consequences of extreme inactivity.

Bone Status in Activity-Restricted Pregnant Women Assessed Using Calcaneal Quantitative Ultrasound

“…During pregnancy (before hospitalization in the AR women), both groups reported a similar physical activity pattern in METÁhr/week. However, during hospitalization and AR, the mean daily total step count was only 1,503.5 + 1,377.4 steps/day, similar to the mean step count reported in our previous study for 16 AR pregnant women in the third trimester (1,579 + 936 steps/day; Tomkins et al, 2007) and significantly less than the step count reported for 19 AM women of the same gestational age (6,495 + 2,282 steps/day). After reviewing the evidence related to public health issues, Tudor-Locke and Bassett (2004) proposed classifications for pedometer-determined physical activity in healthy adults, suggesting <5,000 steps/day as an index for a sedentary lifestyle.…”

“…We have used pedometer assessment previously and have found step counts to be a reliable measure of physical activity in this population (Tomkins, Mottola, & Giroux, 2007). Participants reset the pedometer to 0 upon awaking in the morning and recorded total daily steps at the end of each day.…”

“…We did not obtain step counts for the AM group in the present study. However, we previously analyzed step counts in AM pregnant women in the third trimester and reported an average of 6,495 + 2,282 steps/day (N ¼ 19; Tomkins et al, 2007).…”

“…We analyzed the 3-day dietary intake records using the Food Processor 1 structured query language (SQL) version 9.8.1 (ESHA Research 2006, Professional Nutrition Analysis Software). We have previously used this methodology in AR women (Tomkins et al, 2007), and 3-day dietary intake records have been shown to accurately represent the usual intake for each subject (Kolar et al, 2005). We did not conduct 3-day dietary intake analyses in the AM group because we met participants in this group only once.…”

“…Hospitalized women wore a pedometer (Accusplit, Eagle™ 120 Activity Pedometer) secured to a waistband for 7 consecutive days to define the current restriction of bed rest. We have used pedometer assessment previously and have found step counts to be a reliable measure of physical activity in this population (Tomkins, Mottola, & Giroux, 2007). Participants reset the pedometer to 0 upon awaking in the morning and recorded total daily steps at the end of each day.…”