Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes

Abstract

Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical activity reported shortly after the GDM diagnosis and prepregnancy weight and post-diagnosis GWG obtained from electronic medical records (n= 1,055). Multinomial logistic regression models in the full cohort and stratified by prepregnancy overweight/obesity estimated associations of moderate and vigorous intensity exercise with GWG below and above the Institute of Medicine’s (IOM) prepregnancy BMI-specific recommended ranges for weekly rate of GWG in the second and third trimesters. Results In the full cohort, any participation in vigorous intensity exercise was associated with decreased odds of GWG above recommended ranges as compared to no participation [Odds Ratio (95% Confidence Interval): 0.63 (0.40, 0.99)], with a significant trend for decreasing odds of excess GWG with increasing level of vigorous intensity exercise. Upon stratification by prepregnancy overweight/obesity, significant associations were only observed for BMI ≥ 25.0 kg/m2: any vigorous intensity exercise, as compared to none, was associated with 54% decreased odds of excess GWG [0.46 (0.27, 0.79)] and significant trends were detected for decreasing odds of GWG both below and above the IOM’s recommended ranges with increasing level of vigorous exercise (both P ≤ 0.03). No associations were observed for moderate intensity exercise. Conclusions In women with GDM, particularly overweight and obese women, vigorous intensity exercise during pregnancy may reduce the odds of excess GWG.

Physical activity level in women with gestational diabetes mellitus: Lifestyle INtervention for Diabetes prevention After pregnancy (LINDA‐Brasil) study

“…However, more than half of women do not receive counseling about physical activity during the prenatal service before GDM diagnosis, and more than 60% do not receive counseling after the diagnosis. In addition, for those with GDM, light walking for 25 to 40 minutes, three or four times a week, resulted in a decrease in the need for insulin, and there are suggestions that the best results may be achieved with vigorous intensity exercises . Resistance training for muscular endurance has also been reported to reduce the need for insulin, as well as insulin doses, in women with GDM and in women with GDM who are overweight, including when performed with moderate to vigorous intensity exercise, 20 to 30 min/session, 3 to 4 d/wk .…”

“…In addition, for those with GDM, light walking for 25 to 40 minutes, three or four times a week, resulted in a decrease in the need for insulin, 35 and there are suggestions that the best results may be achieved with vigorous intensity exercises. 11,36 Resistance training for muscular endurance has also been reported to reduce the need for insulin, as well as insulin doses, in women with GDM 37 and in women with GDM who are overweight, 38 including when performed with moderate to vigorous intensity exercise, 20 to 30 min/session, 3 to 4 d/wk. 9 However, our findings indicated that less than half the participants received counseling for physical activity practice before or after the diagnosis of GDM, behavior that could help in the management of GDM.…”

“…7 Prevention and management of GDM involves behavioral changes, including undertaking physical activity. 1 Physical activity improves glycemic control, 8,9 insulin resistance, 10 and weight gain, 11,12 important elements for the management of GDM and prevention of T2D. 1 Despite the recognized benefits of physical activity, a lack of time is the most frequently reported barrier to undertaking physical activity worldwide.…”

Physical Activity/Exercise and Diabetes: A Position Statement of the American Diabetes Association

“…Once gestational diabetes mellitus is diagnosed, either aerobic or resistance training can improve insulin action and glycemic control (129). In women with gestational diabetes mellitus, particularly those who are overweight and obese, vigorousintensity exercise during pregnancy may reduce the odds of excess gestational weight gain (130). Ideally, the best time to start physical activity is prior to pregnancy to reduce gestational diabetes mellitus risk (131), but it is safe to initiate during pregnancy with very few contraindications (126).…”

Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes

“…The baseline GEM survey included a self-administered Pregnancy Physical Activity Questionnaire [17, 21, 22] that assessed key components of physical activity (i.e., type, frequency, duration and intensity) and is recommended for use in pregnancy and the postpartum [23]. The GEM Pregnancy Physical Activity Questionnaire asked women to report time spent in 36 population-appropriate activities over the past three months (questions on yoga/Pilates, use of cardiovascular exercise machines, aerobic exercise classes, weight lifting/resistance exercises and team sports were added to the original Pregnancy Physical Activity Questionnaire).…”