EXERCISE AND THE NUTRITIONAL MANAGEMENT OF DIABETES DURING PREGNANCY

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REVIEW OF THE LITERATURE ON EXERCISE AND PREGNANCY

Intuitively, one would think that exercise would be safe for the pregnant woman. How did the human species survive if the fetus died whenever the mother fled from an enemy, worked in a field, sought out food, or contributed to the workload of her community? Perhaps, the woman would gradually decrease her level of exertion as the pregnancy exerted a greater demand on her energy, but, intermittently, she would need to shift her energy expenditure into exercise if she and the fetus were to

STUDIES OF DIETARY INTERVENTION IN WOMEN WITH GESTATIONAL DIABETES MELLITUS

Dietary strategy is the mainstay of therapy for the gestational diabetic woman. The optimal dietary prescription would be a diet that provides the caloric and nutrient needs to sustain pregnancy but that does not cause postprandial hyperglycemia. The search for an optimal diet began with the American Diabetes Association diet, which recommended 35 kcal/kg of the present pregnant weight composed of 50% to 60% carbohydrates. This diet caused not only excessive weight gain but also resulted in

STUDIES OF EXERCISE IN WOMEN WITH GESTATIONAL DIABETES MELLITUS

Taylor and coworkers46 studied dietary intake and exercise, obesity, and noncommunicable disease in rural and urban populations of three Pacific Island countries. Urban subjects were more obese than rural ones, had higher prevalence rates of diabetes and hypertension, and, generally, had higher cholesterol levels. Rural subjects were leaner, had less morbidity from diabetes and hypertension, and had greater total energy intake than urban dwellers. On the other hand, rural subjects in all three

A SIMPLE EXERCISE PRESCRIPTION

Gestational diabetic women can be taught to exercise safely in the comforts of their home, seated in a study chair with firm back support, while they watch the nightly news cast. Patients should choose from their pantries 2-pound cans of tomato sauce or a 2-pound sack of flour or sugar. The 2-pound selections, one in each hand, should be lifted above the head. Five lifts should be performed with the left arm, then five lifts with the right arm, and then both together. This sequence should be

CONCLUSION

Pregnancy is a time when serial metabolic changes in the mother are carefully regulated to provide optimum substrate to both mother and fetus. Subtle perturbations in maternal metabolism can have implications not only for the index pregnancy but also for future generations. The goal of management during the past century has generally focused on the delivery of a live infant from a live mother. This goal is generally achieved at most centers. The challenge for the twenty-first century is to

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  • Cited by (33)

    • Prenatal Exercise and Pre-gestational Diseases: A Systematic Review and Meta-analysis

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      Poor glycemic control substantially increases the risk of miscarriage, preterm delivery, stillbirth, macrosomia, preeclampsia, polyhydramnios, and premature rupture of membranes.13 In light of the possible benefits that optimizing glycemic control through low- to moderate-intensity (maximal volume of oxygen consuption) cardiovascular conditioning exercise may provide in managing overall care of pregnancies complicated by pre-gestational diabetes, further insights to provide evidence-based recommendations are of critical importance.15 Maternal diabetes also raises the lifelong risk of obesity and diabetes in the child.16

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    • Prenatal Physical Activity and Gestational Weight Gain

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    • Aerobic exercise during pregnancy influences infant heart rate variability at one month of age

      2014, Early Human Development
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      In the absence of obstetric complications, moderate exercise during pregnancy is generally considered safe and poses no known risk to the fetus [1–8]. Epidemiological data suggest that regular physical activity throughout pregnancy improves maternal cardiovascular function [3], limits weight gain and fat retention [9], improves insulin resistance and metabolic control [9–11], prevents the onset of gestational diabetes mellitus [12,13], reduces the incidence of operative delivery [14], and decreases depressive symptoms in the postnatal period [15,16]. Maternal exercise has also been shown to benefit the fetus, improving fetal stress tolerance [17], reducing neonatal fat mass [3,18–20] and advancing neurobehavioral maturation [18,19].

    • Promoting Healthy Habits in Pregnancy

      2008, Obstetrics and Gynecology Clinics of North America
      Citation Excerpt :

      The key is adequate hydration and ventilation. Studies suggest that regular exercise may help in the prevention of gestation diabetes [4,5]. Before the initiation of such an exercise program, however, the obstetric provider should help the patient determine a reasonable program with appropriate goals.

    • The Effect of Vigorous Exercise During Pregnancy

      2008, Journal of Midwifery and Women's Health
      Citation Excerpt :

      There are many benefits to exercise during pregnancy, such as a greater sense of well-being, increased energy, enhanced strength and endurance, help with weight control, improved sleep, and decreased backaches.1 Exercise may help in the prevention of gestational diabetes in morbidly obese women and in controlling blood glucose in women with gestational diabetes when optimal blood glucose values are not achieved by diet alone.2,3 It is uncertain if these effects apply to the health of the fetus.

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    Address reprint requests to Lois Jovanovic-Peterson, MD Sansum Medical Research Foundation 2219 Bath Street Santa Barbara, CA 93105

    *

    From the Sansum Medical Research Foundation, Santa Barbara, California

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