Limiting Excess Weight Gain in Healthy Pregnant Women: Importance of Energy Intakes, Physical Activity, and Adherence to Gestational Weight Gain Guidelines

Abstract

Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed >300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting “recommended weight gain advice” were 3 times more likely to meet total GWG recommendations (OR: 3.2, P < 0.05); women who complied with weekly GWG goals minimized PPWR (OR: 4.2, P < 0.02). In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs.

Factors associated with knowledge of personal gestational weight gain recommendations

“…Healthcare provider advice about GWG has influenced patient GWG goals [ 16 , 20 , 33 ] and total GWG [ 20 , 33 – 36 ], but more recent studies have not found any association between physician advice and GWG [ 9 , 14 ]. This may be the first study to find healthcare provider advice about GWG was not related to knowledge of GWG recommendations even though doctors were the most frequently reported source of health information during pregnancy.…”

“…Personal GWG goals have been associated with total GWG [ 14 , 15 ]. Moreover, when personal GWG goals are congruent with IOM GWG recommendations, adherence to IOM recommendations is more likely [ 16 , 17 ]. Studies have shown 30–79% of pregnant women know how much weight they should gain during pregnancy [ 18 – 22 ].…”

Efecto De Una Dieta Personalizada en Mujeres Embarazadas Con Sobrepeso U Obesidad

“…Con la implementación de la dieta personalizada durante tres meses acompañada de una orientación alimentaria previa, hubo un impacto positivo en los patrones de alimentación, en este estudio se encontró un incremento de 30.2% en la adecuación de energía recomendada de 90-110%, similar a lo reportado por Lee y colaboradores en Australia donde el porcentaje de mejora fue 28% (19). Al finalizar el estudio ninguna paciente sobrepasó los niveles de adecuación de energía, contrario a los reportes de Cohen y colaboradores en Canadá donde 54% de las mujeres con un plan de alimentación individualizado excedieron su ingesta diaria de calorías correspondiente (20).…”

“…Debido a que no hubo una adherencia del 100% al plan de alimentación otorgado, no se logró alcanzar el peso ideal en las pacientes de acuerdo a las semanas de gestación, sin embargo, se logró controlar este peso, reflejado en que no sobrepasó el peso real al peso proyectado. Un estudio en Canadá en mujeres con sobrepeso u obesidad con un plan de alimentación individualizado reportó un promedio de aumento de peso de 0.7 kg por semana (20), en comparación con 1.8 kg en promedio de ganancia de peso en nuestras pacientes en un mes.…”

Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy

“…In contrast to the minimal data available on women’s knowledge and perception of the effects that diet and exercise may have on pregnancy weight gain, there is documented evidence supporting the overall effects of energy intake and expenditure on weight gain and loss during pregnancy [17]. For example, Health Canada’s Healthy Weights Report states that healthy eating and physical activity (PA) practices are important for both weight management and general health [18], and other studies provide evidence to demonstrate that physical activity (PA) during pregnancy is beneficial for both mom and the baby [19,20].…”