Preventing long-term risk of obesity for two generations: Prenatal physical activity is part of the puzzle

Background. The period surrounding pregnancy has been identified as a risk period for overweight/obesity in both mother and child because of excessive gestational weight gain (GWG). The promotion of a healthy GWG is therefore of paramount importance in the context of the prevention of obesity in the current and next generations. Objective. To provide a comprehensive overview of the effect of prenatal physical activity interventions, alone or in combination with nutritional counselling, on GWG and to address whether preventing excessive GWG decreases the incidence of infant high birth weight and/or postpartum weight retention. Method. A search of the PubMed database was conducted to identify all relevant studies. Nineteen studies were included in this review: 13 interventions combining physical activity, nutrition, and GWG counselling and 6 interventions including physical activity alone. Results. Prenatal lifestyle interventions promoting healthy eating and physical activity habits appear to be the most effective approach to prevent excessive GWG. Achievement of appropriate GWG may also decrease the incidence of high infant birth weight and postpartum weight retention. Conclusion. Healthy eating habits during pregnancy, combined with an active lifestyle, may be important elements in the prevention of long-term risk of obesity for two generations. © 2012 Stephanie-May Ruchat and Michelle F. Mottola

Physical activity throughout pregnancy is key to preventing chronic disease

According to The Developmental Origins of Health and Disease theory, the intrauterine environment of the developing fetus may impact later life physiology, including susceptibility to chronic disease conditions. Maternal exposures during pregnancy can affect the intrauterine environment and result in fetal programming for chronic diseases through changes in the structure or function of specific organs. Negative maternal exposures, such as poor nutrition intake, have been shown to increase the risk for later life chronic diseases. On the contrary, healthful behaviors, such as physical activity, may have a positive and protective effect against chronic disease risk. This narrative review summarizes literature to discuss the potential preventative role prenatal physical activity may have on prevalent chronic diseases: obesity, type 2 diabetes, and cardiovascular disease. We describe the natural physiological response to pregnancy that may increase the risk for complications and consequently later life disease for both mother and baby. We then present evidence highlighting the role prenatal exercise may have in preventing pregnancy complications and downstream chronic disease development, as well as proposing potential mechanisms that may explain the protective maternal and fetal physiological response to exercise. As the prevalence of these non-communicable diseases increase globally, intervening during pregnancy with an effective exercise intervention may be the key to preventing chronic disease risk in more than one generation

How Did Participating In a Prenatal Nutrition and Exercise Program Influence Postpartum Experiences During COVID-19?

International Journal of Exercise Science 16(3): 1-11, 2023. Lifestyle interventions focusing on prenatal physical activity (PA) and healthy nutritional habits can carry forward into the postpartum period. As many health resources, like PA facilities and postpartum support groups, were inaccessible due to the Coronavirus-19 (COVID-19) pandemic restrictions, it may be plausible that individuals who participated in a prenatal lifestyle intervention continued engaging in positive health behaviours on their own. This study explored experiences of postpartum individuals during the pandemic who had engaged in a prenatal PA and nutrition program prior to COVID-19. Semi-structured interviews were completed with postpartum individuals following a qualitative description approach. The study objectives were to identify and summarize the impact of the COVID-19 pandemic on PA and nutritional behaviours postpartum, and the role of previous participation in a prenatal lifestyle intervention, pre-pandemic, on PA and nutritional habits during postpartum quarantine restrictions. Thirteen participants completed interviews and reported that overall, PA levels stayed the same however, there was a change in PA type, as walking became the prominent choice of PA. Diet became more limited and involved a great deal of meal planning. Participation in a prenatal lifestyle intervention prior to the pandemic positively impacted PA and nutritional habits postpartum during COVID-19 restrictions. Specifically, it enabled individuals to implement walking as a daily PA habit and encouraged important concepts such as mindful eating and meal planning. Prenatal lifestyle interventions can be beneficial in establishing healthy postpartum habits, even during pandemic restrictions

Exercise is associated with a reduction in gestational diabetes mellitus

Purpose The objective of this study is to assess the effectiveness of a maternal exercise program (land/aquatic activities, both aerobic and muscular conditioning) in preventing gestational diabetes mellitus (GDM). Methods Three hundred and forty-two pregnant women from Spain (age, 33.24 ± 4.3 yr) without obstetric contraindications were recruited for a clinical randomized controlled trial. The intervention group (IG, n = 101) exercised for 60 and 50 min on land and in water, respectively, three times per week. The control group (n = 156) received usual standard care. Results The prevalence of GDM was reduced in the IG group (IG, 1%, n = 1, vs control group, 8.8%, n = 13 (χ21 = 6.84, P = 0.009)) with a significant risk estimate (odds ratio = 0.103; 95% confidence interval, 0.013-0.803). Conclusion The exercise program performed during pregnancy reduced the prevalence of GDM by preserving glucose tolerance

The ‘new normal’ includes online prenatal exercise: exploring pregnant women’s experiences during the pandemic and the role of virtual group fitness on maternal mental health

Background: Prenatal anxiety and depressive symptoms have significantly increased since the onset of the coronavirus (COVID-19) pandemic In addition, home confinement regulations have caused a drastic increase in time spent sedentary. Online group fitness classes may be an effective strategy that can increase maternal physical activity levels and improve mental health outcomes by providing an opportunity for social connectedness. The present study explores the experiences of pregnant women who participated in an online group exercise program during the pandemic and identifies relationships with maternal mental health and well-being. In addition, we present person-informed recommendations on how to improve the delivery of future online prenatal exercise programs. Methods: Semi-structured interviews were conducted with pregnant women (8-39 weeks of pregnancy) who participated in an online group exercise program, from March to October 2020 in Spain. A phenomenological approach was taken, and open-ended questions were asked to understand women’s experiences throughout the pandemic and the role the online exercise classes may have had on their physical activity levels, mental health, and other health behaviours such as diet. A thematic analysis was performed to evaluate data. In addition, women completed the State-Trait Anxiety Inventory and these data supplemented qualitative findings. Results: Twenty-four women were interviewed, and the anxiety scores were on average 32.23 ± 9.31, ranging from low to moderate levels. Thematic analysis revealed that women felt safe exercising from home, an increased availability of time to schedule a structured exercise class, and consequently an improvement in their adherence to the program and other behaviours (i.e., healthier diet). Women emphasized feeling connected to other pregnant women when they exercised online together, and overall, this had a positive effect on their mental well-being. Women suggested that future online exercise programs should include flexible options, detailed instructions and facilitation by a qualified exercise professional. Conclusion: Pregnant women are receptive to online group exercise classes and expressed that they are an accessible option to accommodating physical activity during the pandemic. In addition, the online group environment provides an important sense of connectivity among pregnant women exercising together and this may mitigate the detrimental effect of COVID-19 on maternal mental health

Capacity-building and participatory research development of a community-based Nutrition and Exercise Lifestyle Intervention Program (NELIP) for pregnant and postpartum Aboriginal women: Information gathered from talking circles

Objectives were to gather information from Talking Circles of Aboriginal women who participated in a maternal Nutrition and Exercise Lifestyle Intervention Program (NELIP) to identify strategies to bring NELIP into the community. Twelve First Nations women participated. Several main themes were identified regarding health: balance, knowledge/education and time management. Benefits of the NELIP were improvement in health, stamina, stress, and a healthy baby, no gestational diabetes and a successful home birth, with social support as an important contributing factor for success. Suggestions for improvement for the NELIP included group walking, and incorporating more traditional foods into the meal plan. The information gathered is the first step in determining strategies using participatory research and capacity-building to develop a community-based NELIP for pregnant Aboriginal women

Prenatal and postpartum maternal mental health and neonatal motor outcomes during the COVID-19 pandemic

Background: Rates of prenatal and postpartum stress and depression in pregnant individuals have increased during the COVID-19 pandemic. Perinatal maternal mental health has been linked to worse motor development in offspring, with motor deficits appearing in infancy and early childhood. We aimed to evaluate the relationship between prenatal and postpartum stress and depression and motor outcome in infants born during the COVID-19 pandemic. Methods: One hundred and seventeen participants completed an online prospective survey study at two timepoints: during pregnancy and within 2 months postpartum. Depression was self-reported using the Edinburgh Perinatal/Postpartum Depression Scale (EPDS), and stress via the Perceived Stress Scale (PSS). Mothers reported total infant motor ability (fine and gross) using the interRAI 0–3 Developmental Domains questionnaire. Results: Prenatal (EPDS median=10.0, interquartile range[IQR]=6.0 – 14.0, B=-0.035, 95%CI=-0.062 to -0.007, p = 0.014) and postpartum maternal depression outcomes (median=7, IQR=4–12, B=-0.037, 95%CI= -0.066 to -0.008, p = 0.012) were significantlynegatively associated with total infant motor ability. Neither pregnancy nor postpartum perceived stress was associated with infant motor function. A cluster analysis revealed that preterm and low-birth weight infants whose mothers reported elevated depressive symptoms during pregnancy and in the postpartum period had the poorest motor outcomes. Conclusions: Prenatal and postpartum depression, but not stress, was associated with early infant motor abilities. Preterm and low-birth weight infants whose mothers reported elevated depressive symptoms maybe at-risk of experiencing poor motor outcomes. These results highlight the importance of identifying pre- and postnatal maternal mental health issues, especially during the ongoing COVID-19 pandemic