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Evenson KR, Brown WJ, Brinson AK, Budzynski-Seymour E, Hayman M. A review of public health guidelines for postpartum physical activity and sedentary behavior from around the world. JOURNAL OF SPORT AND HEALTH SCIENCE 2024; 13:472-483. [PMID: 38158180 PMCID: PMC11184298 DOI: 10.1016/j.jshs.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Revised: 11/29/2023] [Accepted: 12/05/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND The period following pregnancy is a critical time window when future habits with respect to physical activity (PA) and sedentary behavior (SB) are established; therefore, it warrants guidance. The purpose of this scoping review was to summarize public health-oriented country-specific postpartum PA and SB guidelines worldwide. METHODS To identify guidelines published since 2010, we performed a (a) systematic search of 4 databases (CINAHL, Global Health, PubMed, and SPORTDiscus), (b) structured repeatable web-based search separately for 194 countries, and (c) separate web-based search. Only the most recent guideline was included for each country. RESULTS We identified 22 countries with public health-oriented postpartum guidelines for PA and 11 countries with SB guidelines. The continents with guidelines included Europe (n = 12), Asia (n = 5), Oceania (n = 2), Africa (n = 1), North America (n = 1), and South America (n = 1). The most common benefits recorded for PA included weight control/management (n = 10), reducing the risk of postpartum depression or depressive symptoms (n = 9), and improving mood/well-being (n = 8). Postpartum guidelines specified exercises to engage in, including pelvic floor exercises (n = 17); muscle strengthening, weight training, or resistance exercises (n = 13); aerobics/general aerobic activity (n = 13); walking (n = 11); cycling (n = 9); and swimming (n = 9). Eleven guidelines remarked on the interaction between PA and breastfeeding; several guidelines stated that PA did not impact breast milk quantity (n = 7), breast milk quality (n = 6), or infant growth (n = 3). For SB, suggestions included limiting long-term sitting and interrupting sitting with PA. CONCLUSION Country-specific postpartum guidelines for PA and SB can help promote healthy behaviors using a culturally appropriate context while providing specific guidance to public health practitioners.
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8050, USA.
| | - Wendy J Brown
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, QLD 4226, Australia; School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, QLD 4072, Australia
| | - Alison K Brinson
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-3115, USA; Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-8120, USA
| | | | - Melanie Hayman
- Appleton Institute, School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton, QLD 4701, Australia
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Moholdt T, Sujan MAJ, Ashby ER, Beetham K. Interval training and cardiometabolic health in reproductive-aged females. Appl Physiol Nutr Metab 2024; 49:993-1001. [PMID: 38478956 DOI: 10.1139/apnm-2023-0498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2024]
Abstract
Physical activity and exercise training are especially important for reproductive-aged females as exercise-induced health benefits can also affect their infants. However, levels of physical inactivity remain high among females in this age group, before, during, and after pregnancy. There is a great need for practical and feasible exercise modes to increase adherence to exercise in this population, and interval training may be a time-efficient training modality. Interval training is a form of exercise involving intermittent bouts of intense effort interspersed with recovery periods of rest or lower-intensity exercise. A substantial amount of research indicates that interval training induces superior cardiometabolic health benefits compared with iso-energetic moderate-intensity continuous exercise. This review provides a comprehensive overview of research on interval training interventions in reproductive-aged females across various life stages, focusing on the cardiometabolic health benefits. We discuss the potential role of interval training in premenopausal females with overweight/obesity, polycystic ovary syndrome, and subfertility, as well as the potential influence of oral contraceptives on cardiometabolic adaptations to interval training. Furthermore, this review also highlights recent findings supporting the beneficial role of high-intensity interval training for cardiometabolic health outcomes during pregnancy. In summary, the existing evidence suggests that interval training can improve several cardiometabolic and reproductive outcomes in females spanning different life stages. However, more research is needed to further strengthen the evidence-base for physical activity recommendations for females in their reproductive years of life.
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Affiliation(s)
- T Moholdt
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women's Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - M A J Sujan
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Women's Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - E R Ashby
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - K Beetham
- School of Behavioural and Health Sciences, Australian Catholic University, Brisbane, QLD, Australia
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Bucciarelli V, Moscucci F, Dei Cas A, Coppi F, Angeli F, Pizzi C, Renda G, Nodari S, Maffei S, Montisci R, Pedrinelli R, Sciomer S, Perrone Filardi P, Mattioli AV, Gallina S. Maternal-fetal dyad beyond the phenomenology of pregnancy: from primordial cardiovascular prevention on out, do not miss this boat! Curr Probl Cardiol 2024; 49:102695. [PMID: 38852910 DOI: 10.1016/j.cpcardiol.2024.102695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/11/2024]
Abstract
Pregnancy represents a stress test for every woman's cardiovascular (CV) system, and a pre-existing maternal unfavorable cardio-metabolic phenotype can uncover both adverse pregnancy outcomes and the subsequent development of cardiovascular disease (CVD) risk factors during and after pregnancy. Moreover, the maternal cardiac and extracardiac environment can affect offspring's cardiovascular health through a complex mechanism called developmental programming, in which fetal growth can be influenced by maternal conditions. This interaction continues later in life, as adverse developmental programming, along with lifestyle risk factors and genetic predisposition, can exacerbate and accelerate the development of CV risk factors and CVD in childhood and adolescence. The aim of this narrative review is to summarize the latest evidences regarding maternal-fetal dyad and its role on primordial, primary and secondary CV prevention.
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Affiliation(s)
- Valentina Bucciarelli
- Cardiovascular Sciences Department, Azienda Ospedaliero-Universitaria delle Marche, Ancona, Italy
| | - Federica Moscucci
- Department of Internal Medicine and Medical Specialties, Policlinico Umberto I, Viale del Policlinico n. 155, Rome 00161, Italy
| | - Alessandra Dei Cas
- Department of Medicine and Surgery, Università di Parma, Parma, Italy; Division of Endocrinology and Metabolic Diseases, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy
| | - Francesca Coppi
- Department of Medical and Surgical Sciences for Children and Adults, University of Modena and Reggio Emilia, Modena 41121, Italy
| | - Francesco Angeli
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, Bologna 40138, Italy
| | - Carmine Pizzi
- Cardiology Unit, Cardiac Thoracic and Vascular Department, IRCCS Azienda, Ospedaliero-Universitaria di Bologna, Bologna, Italy; Department of Medical and Surgical Sciences- DIMEC, University of Bologna, Via Giuseppe Massarenti 9, Bologna 40138, Italy
| | - Giulia Renda
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
| | - Savina Nodari
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia 25123, Italy
| | - Silvia Maffei
- Department of Cardiovascular Endocrinology and Metabolism, Gynaecological and Cardiovascular Endocrinology and Osteoporosis Unit, "Gabriele Monasterio" Foundation and Italian National Research Council (CNR) Pisa, Pisa 56124 Italy
| | - Roberta Montisci
- Clinical Cardiology, AOU Cagliari, Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Susanna Sciomer
- Dipartimento di Scienze Cliniche, Internistiche, Anestesiologiche e Cardiovascolari, 'Sapienza', Rome University, Viale dell'Università, 37, Rome 00185, Italy
| | | | - Anna Vittoria Mattioli
- Department of Quality of Life Sciences, University of Bologna-Alma Mater Studiorum, Bologna 40126, Italy.
| | - Sabina Gallina
- Department of Neuroscience, Imaging and Clinical Sciences, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy
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Bueno SV, Nielsen RO, Kallestrup P, Ryom K, Morgan K, Elsborg P, Petersen CB, Jacobsen JS. Parous women perform less moderate to vigorous physical activity than their nulliparous peers: a population-based study in Denmark. Public Health 2024; 231:47-54. [PMID: 38626671 DOI: 10.1016/j.puhe.2024.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/05/2024] [Accepted: 03/08/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVES The World Health Organization (WHO) highlights parous women as a key population for monitoring trends of physical activity (PA). We aimed to estimate the proportion of Danish women non-adhering to WHO PA guidelines in parous women compared with nulliparous women and to describe leisure-time PA intensity in each of these groups. STUDY DESIGN Cross-sectional study. METHODS This population-based study builds on a sample of 27,668 women aged 16-40 years from the Danish National Health Survey 2021. These data were linked with childbirth data from the Danish National Birth Registry. The primary outcome was self-reported weekly hours of moderate to vigorous leisure-time PA (MVPA) dichotomized into: (i) adhering to WHO guidelines for MVPA or (ii) not adhering to WHO guidelines for MVPA. Binomial regression analysis was used to calculate prevalence proportions (PP) and prevalence proportion ratios (PPR). RESULTS Of the 27,668 women, a total of 20,022 were included; 9338 (46.6%) parous women and 10,684 (53.4%) nulliparous women. The PP of women non-adhering to WHO PA guidelines was 63.8% (95% CI 62.9-64.8) for parous and 51.3% (95% CI 50.4-52.3) for nulliparous women, corresponding to a PPR of 1.24 (95% CI 1.21; 1.27). CONCLUSIONS The proportion of parous women who did not adhere to WHO PA guidelines for MVPA was 24% higher than that of nulliparous women. This highlights parous women as a subgroup of the adult population at increased risk of non-adherence to WHO PA guidelines. These findings call for future research to inform new strategies aiming to promote PA in parous women.
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Affiliation(s)
- S V Bueno
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark.
| | - R O Nielsen
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - P Kallestrup
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - K Ryom
- Department of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C 8000, Denmark
| | - K Morgan
- Centre for Development, Evaluation, Complexity and Implementation in Public Health Improvement (DECIPHer), Cardiff University, Spark, Maindy Road, Cardiff CF24 4HQ, United Kingdom
| | - P Elsborg
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Capital Region of Denmark, Copenhagen, Denmark
| | - C B Petersen
- National Institute of Public Health, Faculty of Health Science, University of Southern Denmark, Copenhagen, Denmark
| | - J S Jacobsen
- Research Unit for General Practice, Bartholins Allé 2, Aarhus C 8000, Denmark; Research Centre for Health and Welfare Technology, VIA University College, Aarhus, Denmark
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Nicklas JM, Pyle L, Soares A, Leiferman JA, Bull SS, Tong S, Caldwell AE, Santoro N, Barbour LA. The Fit After Baby randomized controlled trial: An mHealth postpartum lifestyle intervention for women with elevated cardiometabolic risk. PLoS One 2024; 19:e0296244. [PMID: 38194421 PMCID: PMC10775990 DOI: 10.1371/journal.pone.0296244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 12/03/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Postpartum women with overweight/obesity and a history of adverse pregnancy outcomes are at elevated risk for cardiometabolic disease. Postpartum weight loss and lifestyle changes can decrease these risks, yet traditional face-to-face interventions often fail. We adapted the Diabetes Prevention Program into a theory-based mobile health (mHealth) program called Fit After Baby (FAB) and tested FAB in a randomized controlled trial. METHODS The FAB program provided 12 weeks of daily evidence-based content, facilitated tracking of weight, diet, and activity, and included weekly coaching and gamification with points and rewards. We randomized women at 6 weeks postpartum 2:1 to FAB or to the publicly available Text4baby (T4B) app (active control). We measured weight and administered behavioral questionnaires at 6 weeks, and 6 and 12 months postpartum, and collected app user data. RESULTS 81 eligible women participated (77% White, 2% Asian, 15% Black, with 23% Hispanic), mean baseline BMI 32±5 kg/m2 and age 31±5 years. FAB participants logged into the app a median of 51/84 (IQR 25,71) days, wore activity trackers 66/84 (IQR 43,84) days, logged weight 17 times (IQR 11,24), and did coach check-ins 5.5/12 (IQR 4,9) weeks. The COVID-19 pandemic interrupted data collection for the primary 12-month endpoint, and impacted diet, physical activity, and body weight for many participants. At 12 months postpartum women in the FAB group lost 2.8 kg [95% CI -4.2,-1.4] from baseline compared to a loss of 1.8 kg [95% CI -3.8,+0.3] in the T4B group (p = 0.42 for the difference between groups). In 60 women who reached 12 months postpartum before the onset of the COVID-19 pandemic, women randomized to FAB lost 4.3 kg [95% CI -6.0,-2.6] compared to loss in the control group of 1.3 kg [95% CI -3.7,+1.1] (p = 0.0451 for the difference between groups). CONCLUSIONS There were no significant differences between groups for postpartum weight loss for the entire study population. Among those unaffected by the COVID pandemic, women randomized to the FAB program lost significantly more weight than those randomized to the T4B program. The mHealth FAB program demonstrated a substantial level of engagement. Given the scalability and potential public health impact of the FAB program, the efficacy for decreasing cardiometabolic risk by increasing postpartum weight loss should be tested in a larger trial.
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Affiliation(s)
- Jacinda M. Nicklas
- Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Laura Pyle
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Andrey Soares
- Department of Medicine, Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Jennifer A. Leiferman
- Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Sheana S. Bull
- Department of Community and Behavioral Health, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Suhong Tong
- Department of Biostatistics and Informatics, University of Colorado School of Public Health, Aurora, Colorado, United States of America
| | - Ann E. Caldwell
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Nanette Santoro
- Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility & Reproductive Sciences, University of Colorado School of Medicine, Aurora, Colorado, United States of America
| | - Linda A. Barbour
- Department of Medicine, Division of Endocrinology, Metabolism, and Diabetes, University of Colorado School of Medicine, Aurora, Colorado, United States of America
- Department of Obstetrics and Gynecology, Division of Maternal-Fetal Medicine, University of Colorado School of Medicine, Aurora, Colorado, United States of America
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Schulz JM, Marmura H, Hewitt CM, Parkinson LJ, Thornton JS. Navigating the 'new normal': what guidelines exist for postpartum return to physical activity and sport? A scoping review. Br J Sports Med 2023; 57:1573-1578. [PMID: 37898507 DOI: 10.1136/bjsports-2023-107166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE Women are often advised to return to activity (RTA) as early as 6 weeks postpartum, despite undergoing significant physical, physiological and psychological changes. Our objective was to examine existing evidence and clinical practice guidelines to navigate a safe and successful RTA or return to sport (RTS) postpartum. METHODS We searched CINAHL, Embase, Medline, PsycINFO and SPORTDiscus and included any secondary studies with recommendations or guidelines for RTA or RTS postpartum. Grey literature and primary sources were excluded. Four reviewers independently screened titles and abstracts, followed by full-text review for eligibility, with conflicts resolved by a third-party reviewer. One reviewer extracted data, which was cross-referenced by another reviewer. RESULTS 5851 studies were screened, and 33 were included in this scoping review. Most studies stated that RTS postpartum can begin once 'medically safe', around 6 weeks postpartum, but this term was generally left undefined. In addition, most studies recommended engaging in 150 min of moderate-vigorous physical activity per week after 6 weeks postpartum, but the type of exercise recommended was often non-specific. CONCLUSION A lack of consistent, evidence-based guidelines exist for RTA or RTS postpartum. Multiple evidence gaps require additional research to inform patient and activity specific guidelines for a safe and successful RTA or RTS postpartum.
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Affiliation(s)
- Jenna M Schulz
- Department of Family Medicine, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Fowler-Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
- Bone & Joint Institute, Western University, London, Ontario, Canada
| | - Hana Marmura
- Fowler-Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
- Bone & Joint Institute, Western University, London, Ontario, Canada
- Department of Physical Therapy, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Chloe M Hewitt
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Laura J Parkinson
- Department of Kinesiology, Faculty of Health Sciences, Western University, London, Ontario, Canada
| | - Jane S Thornton
- Fowler-Kennedy Sport Medicine Clinic, Western University, London, Ontario, Canada
- Bone & Joint Institute, Western University, London, Ontario, Canada
- Department of Family Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Lee N, Bae YH, Fong SSM, Lee WH. Effects of Pilates on inter-recti distance, thickness of rectus abdominis, waist circumference and abdominal muscle endurance in primiparous women. BMC Womens Health 2023; 23:626. [PMID: 38008749 PMCID: PMC10680311 DOI: 10.1186/s12905-023-02775-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Pilates is expected to have a positive effect on women with weakened abdominal muscles after childbirth. Pilates may have a beneficial effect on the structure and function of the abdominal muscles in pregnant women. Therefore, the objective of this study was to investigate the effects of Pilates on inter-recti distance, thickness of the rectus abdominis, waist circumference, and abdominal muscle endurance in primiparous women. METHODS Thirty-five primiparous postpartum women were assigned to either the Pilates exercise group (n = 20) or the control group (n = 15). Pilates was undertaken by the exercise group for 50 min/day, 5 days/week, for 4 weeks. The control group maintained their daily activities without any intervention. The inter-recti distance was measured at three locations along the linea alba, and the thickness of the rectus abdominis was measured using ultrasound. Abdominal muscle endurance was measured using a repeated 1-min curl-up test. Waist circumference was also measured. RESULTS The exercise group showed significant improvements from baseline in inter-recti distance, waist circumference, and abdominal muscle endurance (p < 0.05). The control group showed no significant improvement in these variables. Compared with the control group, the exercise group showed significantly improved performance in terms of inter-recti distance, waist circumference, and abdominal muscle endurance (p < 0.05). CONCLUSIONS The results of this study demonstrate that Pilates was effective in reducing inter-recti distance and waist circumference and improving abdominal muscle endurance in primiparous postpartum women. Pilates is considered an effective exercise for improving muscle structure and function in primiparous postpartum women, helping in the recovery from, and preventing, diastasis rectus abdominis.
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Affiliation(s)
- Namee Lee
- Department of Physical Therapy, Graduate School, Sahmyook University, Seoul, Republic of Korea
| | - Young-Hyeon Bae
- Department of Healthcare and Public Health, National Rehabilitation Center, Seoul, South Korea
| | - Shirley S M Fong
- Department of Health and Physical Education, Education University of Hong Kong, Hong Kong, Hong Kong, Special Administrative Region of China
| | - Wan-Hee Lee
- Department of Physical Therapy, Sahmyook University College of Health Science, Seoul, Republic of Korea.
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N Fotso M, Gonzalez NA, Sanivarapu RR, Osman U, Latha Kumar A, Sadagopan A, Mahmoud A, Begg M, Tarhuni M, Khan S. Association of Physical Activity with the Prevention and Treatment of Depression During the Postpartum Period: A Narrative Review. Cureus 2023; 15:e44453. [PMID: 37791151 PMCID: PMC10544133 DOI: 10.7759/cureus.44453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 08/31/2023] [Indexed: 10/05/2023] Open
Abstract
The benefits of physical activity during pregnancy or postpartum are auspicious, especially in preventing and treating postpartum depression. This review aimed to examine the relationship between exercise and postpartum depression in terms of prevention and treatment. The goals were to determine if exercise alone is sufficient for this purpose and to attract attention to the kind, intensity, and duration needed to achieve this purpose. A literature review was conducted in PubMed, PubMed Central, MEDLINE, and Cochrane libraries. The search terms were "physical activity," "postpartum depression," "postnatal depression," and "exercise." Physical activity can be a preventative measure and a treatment aid for pregnant or postpartum women with depressive disorders. However, the exercise protocol should include a support/wellness program to achieve better and more remarkable results.
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Affiliation(s)
- Monique N Fotso
- Obstetrics and Gynecology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Natalie A Gonzalez
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Raghavendra R Sanivarapu
- Pulmonary and Critical Care Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Usama Osman
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Abishek Latha Kumar
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Aishwarya Sadagopan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Anas Mahmoud
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maha Begg
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Mawada Tarhuni
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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Zhang X, Zuo X, Matheï C, Aertgeerts B, Afnan M, Li T, Buntinx F, Vermandere M. Impact of a postpartum care rehabilitation program to prevent postpartum depression at a secondary municipal hospital in Qingdao China: a cross-sectional study. BMC Pregnancy Childbirth 2023; 23:239. [PMID: 37041524 PMCID: PMC10088113 DOI: 10.1186/s12884-023-05547-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 03/25/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The emerging postpartum rehabilitation (PPR) program in Chinese hospitals characterized by applying ongoing medical care through traditional cultural practices shows a protective effect in early puerperium in China. This study explores the benefit of PPR program practices to postpartum depression (PPD) and the influencing factors for PPD among Chinese women during the first postnatal six weeks. METHODS The cross-sectional study included 403 participants and was conducted in a Secondary Municipal Hospital in Qingdao, China, from 01 to 2018 to 31 December 2021. Information on this PPR program was collected during the six-weeks postpartum consultation, including the Edinburgh postnatal depression scale (EPDS) scores, the measurement results for diastasis recti abdominis, and the international physical activity questionnaire (long form) (IPAQ-L) scores. Logistic regression models were used to examine the effect of the PPR program on PPD among the local population. The secondary aim of this study was to investigate possible influencing factors for PPD, such as coronavirus disease 2019 (COVID-19), physical exercises, etc. RESULTS: PPR program has shown a positive effect in preventing PPD (p < 0.001) and diastasis recti prevalence (p < 0.001) during the six-weeks postnatal control in Qingdao, China. Better post-pregnancy weight reduction (p = 0.04) and higher metabolic equivalent of task (MET) value (p < 0.001) were noticed in the non-PPR group. Furthermore, lower PPD risk was associated with factors such as longer relationship duration years (2-5 years) (p = 0.04) and exercising one to three times a week (p = 0.01). A higher PPD risk was related to factors such as urinary incontinence during the postpartum period (p = 0.04) and subjective insomnia (p < 0.001). No significant effect was shown between COVID-19 and the EPDS score in this study (p = 0.50). CONCLUSION Our results suggested that the PPR program provided protection against PPD and diastasis recti during the first six weeks after delivery. Urinary incontinence and subjective insomnia were the main risk factors for PPD, while longer relationship duration years and exercising one to three times a week gave protective effects to PPD. This study emphasized that a comprehensive ongoing medical care program, such as the PPR program, effectively improves women's mental and physical health in the early postpartum in China.
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Affiliation(s)
- Xiaoqian Zhang
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium.
- Qingdao United Family Hospital, Qingdao, China.
| | - Xiaoli Zuo
- Qingdao United Family Hospital, Qingdao, China
| | - Catharina Matheï
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Bert Aertgeerts
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | | | - Tang Li
- Qingdao University Medical College, Qingdao, China
| | - Frank Buntinx
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
| | - Mieke Vermandere
- Academic Center for General Practice, Department of Public Health and Primary Care, Leuven, KU, Belgium
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Makama M, Brown WJ, Lim S, Skouteris H, Harrison CL, Joham AE, Mishra GD, Teede H, Moran LJ. Levels of physical activity and sitting time in women with infants, toddlers and preschoolers: a population-based cross-sectional study. Public Health 2023; 214:1-9. [PMID: 36417813 DOI: 10.1016/j.puhe.2022.10.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 09/29/2022] [Accepted: 10/14/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Insufficient physical activity (PA) and prolonged sitting time (ST) increase the risk of chronic disease and mortality. Caring for young children can potentially impact maternal PA and sedentary behaviours. The aims of this study were to explore the levels of PA and ST in women with young children (infants, toddlers and preschoolers) and sociodemographic and behavioural factors associated with these. STUDY DESIGN This was a population-based cross-sectional study. METHODS Survey 5 data collected in 2009 (n = 4290) of the 1973-1978 birth cohort of the Australian Longitudinal Study on Women's Health were used. Multiple linear and logistic regression models were used to examine associations. RESULTS In adjusted models, compared with women with preschoolers, women whose youngest child was an infant aged 0-6 months, aged >6-12 months or toddler had lower PA (-321.3 MET.min/week [95% confidence interval (CI) -416.2, -226.4], -147.9 MET.min/week [95% CI -237.6, -58.1] and -106.4 MET.min/week [95% CI -172.3, -40.5]). ST was higher in women whose youngest child was an infant aged 0-6 months (0.48 h/day; 95% CI 0.19, 0.77) but lower with infants aged >6-12 months (-0.33 h/day; 95% CI -0.60, -0.05) and toddlers (-0.40 h/day; 95% CI -0.60, -0.20) than in those with preschoolers. The findings were similar in the logistic model. Sociodemographic and behavioural factors such as occupation and marital status also influenced PA and ST. CONCLUSIONS Women with infants and toddlers have lower PA than women with preschoolers. Women are more likely to sit more in the first 6 months after childbirth. These findings can inform resources and intervention development to improve activity levels in women with young children through consideration of the age of the youngest child, sociodemographic and behavioural factors.
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Affiliation(s)
- M Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - W J Brown
- School of Human Movement and Nutrition Sciences, University of Queensland, St Lucia, Queensland, Australia; Faculty of Health Science and Medicine, Bond University, Gold Coast, Australia
| | - S Lim
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Box Hill, Victoria, Australia
| | - H Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Warwick Business School, Warwick University, Coventry, United Kingdom
| | - C L Harrison
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - A E Joham
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - G D Mishra
- Centre for Longitudinal and Life Course Research, University of Queensland, Brisbane, Queensland, Australia
| | - H Teede
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia; Warwick Business School, Warwick University, Coventry, United Kingdom; Department of Endocrinology and Diabetes, Monash Health, Clayton, Victoria, Australia
| | - L J Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia.
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Garr Barry V, Martin SL, Chandler-Laney P, Carter EB, Worthington CS. A Comparison of Bioimpedance Analysis vs. Dual X-ray Absorptiometry for Body Composition Assessment in Postpartum Women and Non-Postpartum Controls. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13636. [PMID: 36294216 PMCID: PMC9602548 DOI: 10.3390/ijerph192013636] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/28/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
Postpartum fat mass (FM) and fat-free mass (FFM) may be informative predictors of future disease risk among women; hence, there is growing use of bioelectrical impedance analysis (BIA) to quantify FFM and FM among postpartum women due to the quick, non-invasive, and inexpensive nature of BIA. Despite this, very few studies have examined BIA's performance, and it remains unclear as to whether specific BIA equations are needed for postpartum women. To explore these questions, we measured total body FFM and FM with a multi-frequency, segmental BIA, and dual-X-ray absorptiometry (DXA) in (1) women at one and four months postpartum (n = 21); and (2) height- and weight-matched non-postpartum women (controls, n = 21). BIA was compared to DXA using Deming regression models, paired t-tests, and Bland-Altman plots. Between-group comparisons were performed using an analysis of variance models. The mean difference between DXA and BIA was 1.2 ± 1.7 kg FFM (p < 0.01) and -1.0 ± 1.7 kg FM (p < 0.05) in postpartum women at both time points. The measurements of longitudinal changes in FFM and FM were not significantly different between BIA and DXA. Furthermore, there was no significant difference in BIA's performance in postpartum vs. non-postpartum women (p = 0.29), which suggests that population-specific equations are not needed for postpartum women. The results of this study suggest that BIA is a suitable method to assess postpartum body composition among women at one and four months postpartum, using existing age-, race-, and sex-adjusted equations.
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Affiliation(s)
- Valene Garr Barry
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Samantha L. Martin
- Department of Obstetrics and Gynecology, The University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Paula Chandler-Laney
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ebony B. Carter
- Department of Obstetrics and Gynecology, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, USA
| | - Camille S. Worthington
- Department of Nutrition Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
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Maternal training during lactation modifies breast milk fatty acid composition and male offspring glucose homeostasis in rat. Biochim Biophys Acta Mol Cell Biol Lipids 2022; 1867:159223. [PMID: 35987325 DOI: 10.1016/j.bbalip.2022.159223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Revised: 08/11/2022] [Accepted: 08/15/2022] [Indexed: 11/23/2022]
Abstract
The perinatal exposome can modify offspring metabolism and health later in life. Within this concept, maternal exercise during gestation has been reported modifying offspring glucose sensing and homeostasis, while the impact of such exercise during lactation is little-known. We thus aimed at evaluating short- and long-term effects of it on offspring pancreatic function, assuming a link with changes in breast milk composition. Fifteen-week-old primiparous female Wistar rats exercised during lactation at a constant submaximal intensity (TR) or remained sedentary (CT). Male offspring were studied at weaning and at 7 months of age for growth, pancreas weight, glycemia and insulin responses. Milk protein content was determined by the bicinchoninic acid assay (BCA colorimetric method), and lipid content and fatty acid composition by gas chromatography. Mature milk from TR rats contained significantly less saturated (-7 %) and more monounsaturated (+18 %) and polyunsaturated (PUFA +12 %) fatty acids compared to CT rats, with no difference in total lipid and protein concentrations. In offspring from TR vs CT mothers, fasting glycemia was lower, pancreas weight was higher with a lower insulin content (-37 %) at weaning. Such outcomes were correlated with milk PUFA levels and indices of desaturase or elongase activities. These effects were no longer present at 7 months, whereas a more efficient muscle insulin sensitivity was observed. Maternal training during lactation led to a specific milk phenotype that was associated with a short-term impact on glucose homeostasis and pancreatic function of the male offspring.
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13
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The Profiling of Diet and Physical Activity in Reproductive Age Women and Their Association with Body Mass Index. Nutrients 2022; 14:nu14132607. [PMID: 35807789 PMCID: PMC9268133 DOI: 10.3390/nu14132607] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/17/2022] [Accepted: 06/21/2022] [Indexed: 12/25/2022] Open
Abstract
Pre-pregnancy, pregnancy and postpartum are critical life stages associated with higher weight gain and obesity risk. Among these women, the sociodemographic groups at highest risk for suboptimal lifestyle behaviours and core lifestyle components associated with excess adiposity are unclear. This study sought to identify subgroups of women meeting diet/physical activity (PA) recommendations in relation to sociodemographics and assess diet/PA components associated with body mass index (BMI) across these life stages. Cross-sectional data (Australian National Nutrition and Physical Activity Survey 2011–2012) were analysed for pre-pregnancy, pregnant and postpartum women. The majority (63–95%) of women did not meet dietary or PA recommendations at all life stages. Core and discretionary food intake differed by sociodemographic factors. In pre-pregnant women, BMI was inversely associated with higher whole grain intake (β = −1.58, 95% CI −2.96, −0.21; p = 0.025) and energy from alcohol (β = −0.08, −0.14, −0.005; p = 0.035). In postpartum women, BMI was inversely associated with increased fibre (β = −0.06, 95% CI −0.11, −0.004; p = 0.034) and PA (β = −0.002, 95% CI −0.004, −0.001; p = 0.013). This highlights the need for targeting whole grains, fibre and PA to prevent obesity across life stages, addressing those most socioeconomically disadvantaged.
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Li Y, de Bakker CMJ, Lai X, Zhao H, Parajuli A, Tseng WJ, Pei S, Meng T, Chung R, Wang L, Liu XS. Maternal bone adaptation to mechanical loading during pregnancy, lactation, and post-weaning recovery. Bone 2021; 151:116031. [PMID: 34098162 PMCID: PMC8504362 DOI: 10.1016/j.bone.2021.116031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 04/25/2021] [Accepted: 06/01/2021] [Indexed: 12/16/2022]
Abstract
The maternal skeleton undergoes dramatic bone loss during pregnancy and lactation, and substantial bone recovery post-weaning. The structural adaptations of maternal bone during reproduction and lactation exert a better protection of the mechanical integrity at the critical load-bearing sites, suggesting the importance of physiological load-bearing in regulating reproduction-induced skeletal alterations. Although it is suggested that physical exercise during pregnancy and breastfeeding improves women's physical and psychological well-being, its effects on maternal bone health remain unclear. Therefore, the objective of this study was to investigate the maternal bone adaptations to external mechanical loading during pregnancy, lactation, and post-weaning recovery. By utilizing an in vivo dynamic tibial loading protocol in a rat model, we demonstrated improved maternal cortical bone structure in response to dynamic loading at tibial midshaft, regardless of reproductive status. Notably, despite the minimal loading responses detected in the trabecular bone in virgins, rat bone during lactation experienced enhanced mechano-responsiveness in both trabecular and cortical bone compartments when compared to rats at other reproductive stages or age-matched virgins. Furthermore, our study showed that the lactation-induced elevation in osteocyte peri-lacunar/canalicular remodeling (PLR) activities led to enlarged osteocyte lacunae. This may result in alterations in interstitial fluid flow-mediated mechanical stimulation on osteocytes and an elevation in solute transport through the lacunar-canalicular system (LCS) during high-frequency dynamic loading, thus enhancing mechano-responsiveness of maternal bone during lactation. Taken together, findings from this study provide important insights into the relationship between reproduction- and lactation-induced skeletal changes and external mechanical loading, emphasizing the importance of weight-bearing exercise on maternal bone health during reproduction and postpartum.
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Affiliation(s)
- Yihan Li
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Chantal M J de Bakker
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada
| | - Xiaohan Lai
- Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, China
| | - Hongbo Zhao
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Ashutosh Parajuli
- Center for Biomechanical Research, Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Wei-Ju Tseng
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Shaopeng Pei
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Center for Biomechanical Research, Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - Tan Meng
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Rebecca Chung
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Liyun Wang
- Center for Biomechanical Research, Department of Mechanical Engineering, University of Delaware, Newark, DE, USA
| | - X Sherry Liu
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Qian J, Sun S, Liu L, Yu X. Effectiveness of nonpharmacological interventions for reducing postpartum fatigue: a meta-analysis. BMC Pregnancy Childbirth 2021; 21:622. [PMID: 34521386 PMCID: PMC8442348 DOI: 10.1186/s12884-021-04096-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/31/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Postpartum fatigue is the most common issue among postnatal women and it could not only seriously affect the health of mothers but also bring about adverse impacts on their offspring. This meta-analysis aims to synthesize nonpharmacological evidence and evaluate the effectiveness of interventions for reducing postpartum fatigue among puerperae. METHODS The Cochrane Library, PubMed, Embase, Web of Science, PsycINFO, CINAHL and ProQuest databases were searched for papers published from inception until June 2021. Grey literature was searched using OpenGrey. Randomized controlled trials (RCTs) or controlled clinical trials (CCTs) evaluating nonpharmacological interventions conducted during 0 ~ 78 weeks postpartum for fatigue reduction were eligible for inclusion. The methodological quality of the included studies was independently assessed by two reviewers using the Cochrane risk-of-bias tool and the risk of bias in nonrandomized studies of interventions. Cohen's kappa coefficient was used to measure inter-rater agreement. The meta-analysis was conducted using Review Manager 5.3. RESULTS Seventeen published clinical trials matched the eligibility criteria and ten studies involving 1194 participants were included in this meta-analysis. The intervention start time varied from immediately postpartum care to 1 year after delivery, and duration ranged from 1 day to 3 months. The results revealed that exercise (SMD = - 1.74, 95% CI = -2.61 to - 0.88) and drinking tea (MD = - 3.12, 95% CI = -5.44 to - 0.80) resulted in significant improvements in women's postpartum fatigue at postintervention. Drinking tea may have beneficial effects on depression (MD = - 2.89, 95% CI = -4.30 to - 1.49). Positive effects of psychoeducational interventions on postpartum fatigue or depression were not observed. Physical therapies including mother-infant skin-to-skin contact, taking warm showers and breathing lavender oil aroma were used for reducing postpartum fatigue. No significant risk of publication bias was found. Small number of included studies and sample sizes, not time-matched conditions of control groups, high heterogeneity and the risk of bias within the included studies were the main limitations of our review. CONCLUSIONS This review provides evidence that exercise and drinking tea may be effective nonpharmacological interventions for relieving postpartum fatigue. More effective and targeted exercise programs need to be further studied. Rigorous RCTs of drinking tea are needed. Caution is required when interpreting the findings due to the limitations of our study. Further studies are still needed to validate our findings and increase confidence in the results.
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Affiliation(s)
- Jialu Qian
- Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Shiwen Sun
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Lu Liu
- Zhejiang University School of Medicine, Zhejiang, Hangzhou, China
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China
| | - Xiaoyan Yu
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine, Zhejiang University, 1st Xueshi Road, Hangzhou, 310006, Zhejiang Province, China.
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Kullman SM, Semenchuk BN, Schellenberg BJI, Ceccarelli L, Strachan SM. Adjusting Identities When Times Change: The Role of Self-Compassion. JOURNAL OF SPORT & EXERCISE PSYCHOLOGY 2021; 43:410-418. [PMID: 34480010 DOI: 10.1123/jsep.2020-0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 05/06/2021] [Accepted: 05/13/2021] [Indexed: 06/13/2023]
Abstract
Adjusting identity standards may be preferable to relentless pursuit or abandonment of an identity when facing an identity-challenging life transition. Self-compassion (SC) can help people adjust to challenges. The authors examined whether SC was associated with identity adjustment, exercise, and the moderating effect of identity-behavior discrepancy in 279 women exercisers who reported reduced exercise in motherhood. Participants completed the Self-Compassion Scale and reported the extent of and reflected on their identity discrepant behavior (reduced exercise). Reactions to discrepancy (acceptance, shame, guilt, and rumination), correlates of identity adjustment (subjective well-being, autonomous motivation, controlled motivation, and role conflict), and exercise behavior were assessed. SC associated positively with acceptance, correlates of successful identity adjustment, and exercise behavior. SC associated negatively with shame, rumination, and correlates of unsuccessful adjustment. SC may help exercise-identifying women who exercise less after becoming mothers adaptively cope with this identity challenge and continue exercising.
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Makama M, Skouteris H, Moran LJ, Lim S. Reducing Postpartum Weight Retention: A Review of the Implementation Challenges of Postpartum Lifestyle Interventions. J Clin Med 2021; 10:1891. [PMID: 33925502 PMCID: PMC8123857 DOI: 10.3390/jcm10091891] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/15/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
Postpartum weight retention (PPWR) is a strong predictor of obesity in later life with long term health consequences in women. Suboptimal lifestyle behaviours (e.g., diet and physical activity) contribute to PPWR. Postpartum lifestyle interventions are known to be efficacious in reducing PPWR; however, there are challenges to their successful implementation. To inform implementation, this narrative review provides an overview of the factors that contribute to PPWR, the efficacy of existing postpartum lifestyle interventions and key determinants of effective implementation using the Consolidated Framework for Implementation Research (CFIR) across intervention characteristics, implementation process, individual characteristics and outer and inner setting. We then suggest strategies to improve the translation of evidence into large-scale interventions that deliver on health impact in postpartum women. We have identified gaps that need to be addressed to advance postpartum lifestyle research, including the involvement of postpartum women and community members as key stakeholders for optimal reach and engagement, more complete reporting of intervention characteristics to optimize translation of evidence into practice, capacity building of health professionals and guidelines for postpartum lifestyle management.
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Affiliation(s)
- Maureen Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
| | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
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Geyer K, Spies M, Günther J, Hoffmann J, Raab R, Meyer D, Rauh K, Hauner H. Effects of a Prenatal Lifestyle Intervention in Routine Care on Maternal Health Behaviour in the First Year Postpartum-Secondary Findings of the Cluster-Randomised GeliS Trial. Nutrients 2021; 13:1310. [PMID: 33921063 PMCID: PMC8071441 DOI: 10.3390/nu13041310] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/08/2021] [Accepted: 04/13/2021] [Indexed: 12/16/2022] Open
Abstract
Lifestyle interventions during pregnancy were shown to beneficially influence maternal dietary behaviour and physical activity, but their effect on health behaviour after delivery is unclear. The objective of this secondary analysis was to investigate the sustained effect of a lifestyle intervention in routine care on maternal health behaviour during the first year postpartum. The cluster-randomised controlled "Healthy living in pregnancy" (GeliS) study included 2286 pregnant women. Data on maternal health behaviour were collected at 6-8 weeks (T1pp) and one year postpartum (T2pp) using validated questionnaires. The intervention group showed a lower mean intake of fast food (T1pp: p = 0.016; T2pp: p < 0.001) and soft drinks (T1pp: p < 0.001), a higher mean intake of vegetables (T2pp: p = 0.015) and was more likely to use healthy oils for meal preparation than the control group. Dietary quality rated by a healthy eating index was higher in the intervention group (T1pp: p = 0.093; T2pp: p = 0.043). There were minor trends towards an intervention effect on physical activity behaviour. The proportion of smokers was lower in the intervention group (p < 0.001, both time points). The lifestyle intervention within routine care modestly improved maternal postpartum dietary and smoking behaviours.
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Affiliation(s)
- Kristina Geyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Monika Spies
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Julia Günther
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Julia Hoffmann
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Roxana Raab
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Dorothy Meyer
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
| | - Kathrin Rauh
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
- Competence Centre for Nutrition (KErn), Am Gereuth 4, 85354 Freising, Germany
| | - Hans Hauner
- Else Kröner-Fresenius-Centre for Nutritional Medicine, Institute of Nutritional Medicine, School of Medicine, Technical University of Munich, Georg-Brauchle-Ring 62, 80992 Munich, Germany; (K.G.); (M.S.); (J.G.); (J.H.); (R.R.); (D.M.); (K.R.)
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Phelan S, Jelalian E, Coustan D, Caughey AB, Castorino K, Hagobian T, Muñoz-Christian K, Schaffner A, Shields L, Heaney C, McHugh A, Wing RR. Protocol for a randomized controlled trial of pre-pregnancy lifestyle intervention to reduce recurrence of gestational diabetes: Gestational Diabetes Prevention/Prevención de la Diabetes Gestacional. Trials 2021; 22:256. [PMID: 33827659 PMCID: PMC8024941 DOI: 10.1186/s13063-021-05204-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Gestational diabetes mellitus (GDM) is associated with several maternal complications in pregnancy, including preeclampsia, preterm labor, need for induction of labor, and cesarean delivery as well as increased long-term risks of type 2 diabetes, metabolic syndrome, and cardiovascular disease. Intrauterine exposure to GDM raises the risk for complications in offspring as well, including stillbirth, macrosomia, and birth trauma, and long-term risk of metabolic disease. One of the strongest risk factors for GDM is the occurrence of GDM in a prior pregnancy. Preliminary data from epidemiologic and bariatric surgery studies suggest that reducing body weight before pregnancy can prevent the development of GDM, but no adequately powered trial has tested the effects of a maternal lifestyle intervention before pregnancy to reduce body weight and prevent GDM recurrence. METHODS The principal aim of the Gestational Diabetes Prevention/Prevención de la Diabetes Gestacional is to determine whether a lifestyle intervention to reduce body weight before pregnancy can reduce GDM recurrence. This two-site trial targets recruitment of 252 women with overweight and obesity who have previous histories of GDM and who plan to have another pregnancy in the next 1-3 years. Women are randomized within site to a comprehensive pre-pregnancy lifestyle intervention to promote weight loss with ongoing treatment until conception or an educational control group. Participants are assessed preconceptionally (at study entry, after 4 months, and at brief quarterly visits until conception), during pregnancy (at 26 weeks' gestation), and at 6 weeks postpartum. The primary outcome is GDM recurrence, and secondary outcomes include fasting glucose, biomarkers of cardiometabolic disease, prenatal and perinatal complications, and changes over time in weight, diet, physical activity, and psychosocial measures. DISCUSSION The Gestational Diabetes Prevention /Prevención de la Diabetes Gestacional is the first randomized controlled trial to evaluate the effects of a lifestyle intervention delivered before pregnancy to prevent GDM recurrence. If found effective, the proposed lifestyle intervention could lay the groundwork for shifting current treatment practices towards the interconception period and provide evidence-based preconception counseling to optimize reproductive outcomes and prevent GDM and associated health risks. TRIAL REGISTRATION ClinicalTrials.gov NCT02763150 . Registered on May 5, 2016.
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Affiliation(s)
- Suzanne Phelan
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA USA
| | - Elissa Jelalian
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI USA
| | - Donald Coustan
- Department of Obstetrics and Gynecology, Alpert Medical School of Brown University, Providence, RI USA
| | - Aaron B. Caughey
- Department of Obstetrics and Gynecology, Oregon Health & Science University, Portland, OR, USA
| | | | - Todd Hagobian
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA USA
| | - Karen Muñoz-Christian
- Department of World Languages and Cultures, California Polytechnic State University, San Luis Obispo, CA USA
| | - Andrew Schaffner
- Statistics Department, California Polytechnic State University, San Luis Obispo, CA USA
| | - Laurence Shields
- Dignity Health, Marian Regional Medical Center, Santa Maria, CA USA
| | - Casey Heaney
- Department of Kinesiology & Public Health, Center for Health Research, California Polytechnic State University, San Luis Obispo, CA USA
| | - Angelica McHugh
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, USA
| | - Rena R. Wing
- Weight Control and Diabetes Research Center, The Miriam Hospital, Providence, USA
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, USA
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20
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Physical Activity Based on the BASNEF Model Constructs in Women with a Child Less Than Two Years of Age. Asian J Sports Med 2021. [DOI: 10.5812/asjsm.107700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Lack of physical activity plays an important role in increasing blood pressure, diabetes, elevated lipids, and obesity. Postpartum women are at risk for low physical activity. Objectives: The aim of this study was to determine the status of physical activity based on beliefs, attitudes, subjective norms, and enabling factors (BASNEF) model constructs at the postpartum period in women attending the centers of comprehensive health services. Methods: This cross-sectional study was performed on 217 randomly selected mothers who had a child less than 2 years of age in Sanandaj, Kurdistan Province, northwest of Iran. A researcher-made questionnaire including demographic information and BASNEF model components was used to collect the data. Data were analyzed in SPSS software version 22 and using Pearson’s correlation coefficient, multiple linear regression, and logistic regression. Results: Results showed that 89% of mothers had low or no physical activity. According to the findings, despite the fact that all three components of knowledge, attitude, and subjective norms somewhat predicted the intention to engage in physical activity, the predictive ability of the subjective norms with a correlation coefficient of 0.34 was statistically significant (P < 0.001) in predicting the mother’s physical activity. Conclusions: The results of this study showed that the level of physical activity of studied women after childbirth was undesirable. Designing and implementing interventions by health managers and providers to change women’s behavior and encouraging them to do physical activity is necessary.
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Divine A, Blanchard C, Naylor PJ, Benoit C, Symons Downs D, Rhodes RE. Effect of housework on physical activity during transitions to parenthood. Women Health 2020; 61:50-65. [PMID: 33190626 DOI: 10.1080/03630242.2020.1844357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The transition to parenthood is associated with declines in moderate to vigorous physical activity (MVPA) and increases in light PA (LPA). One potential mechanism for this change in PA that occur at the onset of parenthood is housework. We examined housework load and PA levels of three cohorts of couples across 12 months recruited from Victoria, British Columbia, Canada between January 2007 and December 2011. Participants (N = 314; 102 not expecting a child, 136 expecting first-child, 76 expecting second child) completed baseline demographics and 7-day accelerometry, followed by assessments at 6 and 12 months. Hierarchical linear regression assessed the association between PA, housework, and perceptions of partner's workload. New fathers' but not new mothers' housework was positively related to their LPA at 12 months. Perceptions of partners' workload were positively related to new mothers LPA, and negatively related to new fathers MVPA at 12 months. Mediation analysis determined if perceived behavioral control accounts for the relationship between the discrepancy in housework between partners' PA. Results suggest that if a woman perceives their partner to do more housework their own PA increases, whereas for men their PA decreases. These findings highlight the importance of the division of housework on PA for both mothers and fathers.
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Affiliation(s)
- Alison Divine
- Department of Sport and Exercise Science, University of Leeds , Leeds, UK
| | - Chris Blanchard
- Department of Medicine, Dalhousie University , Halifax, Canada
| | - Patti-Jean Naylor
- Exercise Science, Physical & Health Education, University of Victoria , Victoria, Canada
| | - Cecilia Benoit
- Exercise Science, Physical & Health Education, University of Victoria , Victoria, Canada
| | | | - Ryan E Rhodes
- Exercise Science, Physical & Health Education, University of Victoria , Victoria, Canada
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22
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Özkan SA, Kücükkelepce DS, Korkmaz B, Yılmaz G, Bozkurt MA. The effectiveness of an exercise intervention in reducing the severity of postpartum depression: A randomized controlled trial. Perspect Psychiatr Care 2020; 56:844-850. [PMID: 32187390 DOI: 10.1111/ppc.12500] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Revised: 03/02/2020] [Accepted: 03/08/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE This study aims to identify the effectiveness of an exercise program in reducing the severity of postnatal depression in women who had a spontaneous vaginal delivery. DESIGN AND METHODS This randomized control trial was conducted with 65 postpartum women residing in a city located in south-eastern Turkey. In the first postpartum month, following random assignment of subjects, the experimental group (n = 40) performed exercises for 4 weeks, and the control group (n = 40) received standard care. The participating women were administered the Edinburgh postpartum depression scale. FINDINGS The average age of the participants was 28.90 ± 4.83 (min:19, max:40). Pretest mean depression scores of the exercises (16.41 ± 1.61) and control group (15.74 ± 2.35) were found to be similar, and there were no statistically significant differences (P > .05). After the 4-week exercise program, a statistically significant difference was found between the posttest mean scores of the exercises (7.29 ± 1.67) and control (12.54 ± 2.65) group participants. Pretest mean scores were found to be similar, and there were no statistically significant differences (Z = -6.501, P = .001). CONCLUSION The 4-week exercise program was found to be an effective method in decreasing the severity of depressive symptoms experienced in the postpartum period. Nurses and midwives providing care in the postpartum period are recommended to provide women in this period with exercise training. PRACTICE IMPLICATIONS Postpartum depression is a specific psychological disorder in which preventive interventions might lead to dramatic benefits. Exercises done in the postpartum period are reported to enable psychosocial well-being, less anxiety, and depression.
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Affiliation(s)
- Semiha Aydın Özkan
- Midwifery Department, Adiyaman University Faculty of Health, Adiyaman, Turkey
| | | | - Busra Korkmaz
- Midwifery Department, Adiyaman University Faculty of Health, Adiyaman, Turkey
| | - Gizem Yılmaz
- Midwifery Department, Adiyaman University Faculty of Health, Adiyaman, Turkey
| | - Merve Ayse Bozkurt
- Midwifery Department, Adiyaman University Faculty of Health, Adiyaman, Turkey
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23
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Snyder K, Pelster AK, Dinkel D. Healthy eating and physical activity among breastfeeding women: the role of misinformation. BMC Pregnancy Childbirth 2020; 20:470. [PMID: 32807126 PMCID: PMC7433096 DOI: 10.1186/s12884-020-03153-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 08/04/2020] [Indexed: 12/04/2022] Open
Abstract
Background Eating healthy, being physically active and breastfeeding can greatly support a new mother’s physiological and psychological health. However, within the United States, only 8.5% of women are meeting fruit and vegetable recommendations and only 35% of women are maintaining their pre-pregnancy physical activity after childbirth. Preliminary investigations suggest barriers such as lack of time and knowledge hinder a breastfeeding woman’s ability to eat well and be physically active. The purpose of this study was to explore women’s perceptions of healthy eating and physical activity while breastfeeding. Methods This qualitative study utilized a 33-question semi-structured interview guide developed using the constructs of Self-Determination Theory. Data were analyzed via the process of immersion/crystallization. Results A total of 24 breastfeeding women completed a roughly 40-min telephone interview. The mean age of the mother was 32 ± .88 and the mean age of the child being breastfed was 8.5 ± 1.4 months old. Findings demonstrate mothers see value in engaging in physical activity primarily for reasons related to self-care. In addition, breastfeeding women have a lack of information and support regarding healthy eating and physical activity while breastfeeding and many are receiving misinformation through resources such as Facebook support groups. Finally, mothers want more resources available that focus specifically on healthy behaviors while breastfeeding. Conclusion Women need greater access to education and resources regarding healthy eating and physical activity while breastfeeding. Ideally, information and resources would come from an educated health professional such as their healthcare provider rather than an internet source.
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Affiliation(s)
- Kailey Snyder
- School of Pharmacy and Health Sciences, Creighton University, 2500 California Plaza, Omaha, NE, 68178, USA.
| | - Aja Kneip Pelster
- Health Behavior, School of Health & Kinesiology, University of Nebraska at Omaha, 6001, Dodge Street, Omaha, NE, 68182, USA
| | - Danae Dinkel
- Physical Activity in Health Promotion, School of Health & Kinesiology, University of Nebraska at Omaha, 6001Dodge Street, Omaha, NE, 68182, USA
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24
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Loewen B, Collum C, Ryan GA. Exercise Benefits and Recommendations for the 6-Week Postpartum Period. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Lee LL, Huang SF, Lai PC, Huang YT. Effect of exercise on slowing breastfeeding-induced bone loss: A meta-analysis and trial sequential analysis. J Obstet Gynaecol Res 2020; 46:1790-1800. [PMID: 32643316 DOI: 10.1111/jog.14346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 05/19/2020] [Indexed: 11/28/2022]
Abstract
AIM This study systematically reviewed evidence regarding the effectiveness of exercise in slowing breastfeeding-induced bone loss. METHODS The evidence-based approach of a systematic review (PROSPERO registration No. CRD42019111623) was adopted. The inclusion criteria were randomized controlled trials or observational studies. Study samples were breastfeeding women, the intervention was any form of exercise, and bone mineral density (BMD) of the total body, lumbar spine and hip/femur neck before 6 months and at 1 year were the outcome measures. Meta-analyses were performed using a random effect model, and calculations of mean differences of BMD change and 95% confidence intervals (CIs) were carried out. Studies were further evaluated through trial sequential meta-analysis (TSA), and the 'Grading of Recommendations Assessment, Development and Evaluation' methodology was used to assess the certainty of evidence (CoE). RESULTS A total of 1049 studies were screened, and 4 met the inclusion criteria. Weight-bearing aerobic exercise and resistance training before the 6-month evaluation slowed breastfeeding-induced bone loss in the lumbar spine (1.62% BMD change [95% CI = 0.53-2.71]; I2 = 8%). The TSA Z-curve revealed crossing of the TSA boundary and line of information size, indicating sufficient sampling and significance. The CoE of exercise benefit in the lumbar spine at 6 months was low, whereas the CoE for other areas ranged from low to very low. CONCLUSION This first systematic review and meta-analysis provided some evidence of the advantages of exercise for slowing breastfeeding-induced bone loss. However, additional randomized controlled trials are warranted to generate more conclusive evidence.
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Affiliation(s)
- Ling-Ling Lee
- Department of Nursing, College of Nursing, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Sen-Fang Huang
- Center for Physical Education Teaching, College of Education and Communication, Tzu Chi University, Hualien, Taiwan
| | - Pei-Chun Lai
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Pediatrics, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,Evidence-based Medicine Center, Department of Medical Education, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Yen-Ta Huang
- Division of Experimental Surgery, Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan
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26
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Be'er M, Mandel D, Yelak A, Gal DL, Mangel L, Lubetzky R. The Effect of Physical Activity on Human Milk Macronutrient Content and Its Volume. Breastfeed Med 2020; 15:357-361. [PMID: 32267727 DOI: 10.1089/bfm.2019.0292] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Objective: There are multiple health benefits associated with both breastfeeding and practicing physical activity (PA). Therefore, it is likely that many women might want to engage in both. We designed the current randomized clinical trial to examine the effect of moderate- to high-intensity PA on human milk (HM) volume and macronutrient contents. Methods and Study Design: In this prospective, randomized, crossover clinical trial, we recruited 31 healthy mothers who had been exclusively breastfeeding their infants. Mothers expressed HM twice each day on 2 consecutive days-a day with PA (1-hour before and 1-hour after PA) and a control day without PA (at the exact same hours of the day). The order of days (with/without PA) was determined randomly. Macronutrients and energy contents of HM were analyzed using the Human Milk Analyzer (Miris AB, Uppsala, Sweden). PA was graded according to the Borg Rating of Perceived Exertion scale (RPE scale). Results: A total 124 HM samples from 31 mothers were analyzed. Moderate- to high-intensity PA affected neither macronutrients (fat, carbohydrates, protein) nor energy content. Milk volume remained unaffected by PA as well. Conclusions: Maternal PA does not affect HM volume or its macronutrient contents. Lactating mothers can be reassured regarding their breast milk volume and composition while practicing PA of moderate to high intensity.
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Affiliation(s)
- Moria Be'er
- Department of Pediatrics and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dror Mandel
- Department of Neonatology, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Alexander Yelak
- Department of Pediatrics and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Dana Lihi Gal
- Department of Pediatrics and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Laurence Mangel
- Department of Neonatology, Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Ronit Lubetzky
- Department of Pediatrics and Dana Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ford EL, Underwood MA, German JB. Helping Mom Help Baby: Nutrition-Based Support for the Mother-Infant Dyad During Lactation. Front Nutr 2020; 7:54. [PMID: 32373623 PMCID: PMC7186439 DOI: 10.3389/fnut.2020.00054] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 03/31/2020] [Indexed: 12/13/2022] Open
Abstract
Lactation and breastfeeding support the short- and long-term health of both mother and infant, yet the success of these processes depend upon individual and combined factors of the pair. Complications during pregnancy and delivery greatly affect the likelihood that a mother will be capable of breastfeeding for at least the recommended 6 months. Guidelines for women regarding postpartum diet and lifestyle management also fail to reflect the diversity of mother-infant pairs and their circumstances. In our analysis of the literature, we have identified a categorical deficit in modern scientific discourse regarding human lactation; namely, that postpartum involves full-body contribution of resources and thus requires the application of nutrition from a systemic perspective.
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Affiliation(s)
- Erin L Ford
- Department of Food Science and Technology, Foods for Health Institute, University of California, Davis, Davis, CA, United States
| | | | - J Bruce German
- Department of Food Science and Technology, Foods for Health Institute, University of California, Davis, Davis, CA, United States.,Foods for Health Institute, University of California, Davis, Davis, CA, United States
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28
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Dinkel DM, Hein N, Snyder K, Siahpush M, Maloney S, Smith L, Farazi PA, Hanson C. The impact of body mass index and sociodemographic factors on moderate-to-vigorous physical activity and sedentary behaviors of women with young children: A cross-sectional examination. ACTA ACUST UNITED AC 2020; 16:1745506519897826. [PMID: 31971094 PMCID: PMC6984422 DOI: 10.1177/1745506519897826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Objectives: Moderate-to-vigorous physical activity provides multiple benefits to women after childbirth. To achieve these benefits, the recommendation that adults obtain, 150 min of moderate-to-vigorous physical activity per week and reduce sedentary behaviors, also applies to women in the post-partum phase of the life span. However, research examining the moderate-to-vigorous physical activity and sedentary behaviors of women with young children (0–2 years) is limited. A greater understanding of these behaviors from a nationally representative sample is needed. Therefore, the primary objective of this study was to determine the levels of moderate-to-vigorous physical activity and sedentary behaviors of a nationally representative sample of women with young children within the United States. A secondary objective was to examine the influence of body mass index and sociodemographic factors on these behaviors. Methods: Cross-sectional data from four cycles of the National Health and Nutrition Examination Survey (2007–2008, 2009–2010, 2011–2012, and 2013–2014) were used for analysis. Descriptive statistics were calculated and a generalized linear model was used to investigate associations between mean minutes of moderate-to-vigorous physical activity, sedentary activity, body mass index, and sociodemographic variables. Discussion: Women with young children (n = 477) obtained 634 min in moderate-to-vigorous physical activity per week and this was positively associated with having a higher income (p < 0.001) and the number of children in the home (p < 0.001). In total, 62% of women were meeting the World Health Organization guidelines for aerobic activity. Lower odds of achieving guidelines was associated with being Black (p = 0.004), Mexican American (p = 0.009), or married (p = 0.042) compared with being White or not married. Finally, women accumulated ~5 h of sedentary activity per day, with higher levels associated with race (p = 0.005), education (p = 0.022), and number of children within the home (p < 0.001). Research efforts should continue to focus on strategies to help non-adhering women with young children achieve the physical activity recommendations and reduce time spent in sedentary behaviors.
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Affiliation(s)
- Danae M Dinkel
- School of Health and Kinesiology, College of Education, University of Nebraska Omaha, Omaha, NE, USA
| | - Nicholas Hein
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kailey Snyder
- DDepartment of Physical Therapy, College of Pharmacy and Health Professions, Creighton University, Omaha, NE
| | - Mohammad Siahpush
- Department of Health Services Research and Administration, College of Public Health, University of Nebraska Medical Center, Omaha, NE
| | - Shannon Maloney
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Lynette Smith
- Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Paraskevi A Farazi
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Corrine Hanson
- Medical Nutrition Education Division, University of Nebraska Medical Center, Omaha, Nebraska, USA
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29
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Burton C, Doyle E, Humber K, Rouxel C, Worner S, Colman R, Palmer S. The biopsychosocial barriers and enablers to being physically active following childbirth: a systematic literature review. PHYSICAL THERAPY REVIEWS 2019. [DOI: 10.1080/10833196.2019.1632049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Catherine Burton
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Emily Doyle
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Kariss Humber
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Camille Rouxel
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Steffany Worner
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | | | - Shea Palmer
- Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
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Abstract
The aim of this study was to characterise changes in lean soft tissue (LST) and examine the contributions of energy intake, physical activity and breast-feeding practices to LST changes at 3 and 9 months postpartum. We examined current weight, LST (via dual-energy X-ray absorptiometry), dietary intake (3-d food diary), physical activity (Baecke questionnaire) and breast-feeding practices (3-d breast-feeding diary) in forty-nine women aged 32·9 (sd 3·8) years. Changes in LST varied from -2·51 to +2·50 kg with twenty-nine women gaining LST (1·1 (sd 0·7) kg, P<0·001) and twenty women losing LST (-0·9 (sd 0·8) kg, P<0·001). Energy intake (133 (SD 42) v. 109 (SD 33) kJ/kg, P=0·019) and % kJ from fat at 3 months postpartum was higher in women who gained LST at 9 months postpartum (gained LST=34 (sd 5) % kJ; lost LST=29 (sd 4) % kJ, P=0·002). Women who gained LST reported breast-feeding their infants more frequently (gained LST=8 (sd 3) feeds/d; lost LST=5 (sd 1) feeds/d, P=0·014) and for more time per d (gained LST=115 (sd 78) min/d; lost LST=59 (sd 34) min/d, P=0·016) at 9 months postpartum. Energy intake and % kJ from fat at 3 months were significant predictors of LST gain (β=0·08 (se 0·04) and 0·24 (se 0·09), respectively). This suggests that gain in LST may be associated with more frequent and longer episodes of breast-feeding at 9 months postpartum as well as dietary intake early in the postpartum period.
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31
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Kamp Dush CM, Yavorsky JE, Schoppe-Sullivan SJ. What Are Men Doing While Women Perform Extra Unpaid Labor? Leisure and Specialization at the Transition to Parenthood. SEX ROLES 2017; 78:715-730. [PMID: 30013287 DOI: 10.1007/s11199-017-0841-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Marriage has significantly changed since Becker proposed his specialization model yet some scholars maintain that specialization characterizes modern couples. Specialization occurs when one partner, traditionally the man, concentrates on market work while the other partner, traditionally the woman, focuses on nonmarket work such as housework or childcare. Using innovative time diary data from primarily highly-educated, White, dual-earner U.S. couples, we examine how couples manage their time in market and household work and leisure across a momentous, gendered life course turning point-the transition to parenthood. We find little evidence of specialization, but stronger evidence of nonspecialization where both partners concurrently engaged in market work or leisure. Yet gender still mattered. Men enjoyed more leisure time, particularly on nonworkdays, whereas their partners performed more nonmarket work. Our study is the first known to uncover exactly what men were doing while women performed additional minutes of housework and childcare. On nonworkdays, fathers engaged in leisure 47% and 35% of the time during which mothers performed childcare and routine housework, respectively. Mothers engaged in leisure only about 16% to 19% of the time that fathers performed childcare and routine housework. In sum, although our study challenges economic theories of specialization by showing that nonspecialization is the norm for new parents' time among highly-educated, dual-earner couples, persistent gender inequalities continue to characterize family work and leisure time.
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Affiliation(s)
- Claire M Kamp Dush
- Department of Human Sciences, The Ohio State University, ORICID: 0000-0003-4307-6825
| | - Jill E Yavorsky
- Department of Sociology, University of North Carolina at Charlotte
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Yang CL, Chen CH. Effectiveness of aerobic gymnastic exercise on stress, fatigue, and sleep quality during postpartum: A pilot randomized controlled trial. Int J Nurs Stud 2017; 77:1-7. [PMID: 28950158 DOI: 10.1016/j.ijnurstu.2017.09.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Gymnastics is a preferable safe exercise for postnatal women performing regularly. OBJECTIVE The aim of this pilot randomized controlled trial was to determine whether the aerobic gymnastic exercise improves stress, fatigue, sleep quality and depression in postpartum women. DESIGN Single-blinded, randomized controlled trial held from December 2014 until September 2015. SETTING Postnatal clinic of a medical center in southern Taiwan. PARTICIPANTS 140 eligible postnatal women were systematically assigned, with a random start to experimental (n=70) or a control (n=70) group. INTERVENTIONS Engage in aerobic gymnastic exercise at least three times (15min per section) a week for three months using compact disc in the home. OUTCOME MEASURES Perceived Stress Scale, Postpartum Fatigue Scale, Postpartum Sleep Quality Scale, and Edinburgh Postnatal Depression Scale. RESULTS In a two-way ANOVA with repeated measures, the aerobic gymnastic exercise group showed significant decrease in fatigue after practicing exercise 4 weeks and the positive effects extended to the 12-week posttests. Paired t-tests revealed that aerobic gymnastic exercise participants had improved significantly in perceived stress and fatigue after 4 weeks gymnastic exercise; these positive effects extended to the 12-week posttests. In addition, the changes in physical symptoms-related sleep inefficiency after 12 weeks gymnastic exercise were significantly decreased in the experimental group compared with the control group. RELEVANCE TO CLINICAL PRACTICE The findings can be used to encourage postnatal women to perform moderate-intensity gymnastic exercise in their daily life to reduce their stress, fatigue and improve sleep quality.
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Affiliation(s)
- Chiu-Ling Yang
- Department of Nursing, Fooyin University, No. 151, Jinxue Road, Daliao Dis., Kaohsiung 83102, Taiwan.
| | - Chung-Hey Chen
- Institute of Allied Health Sciences & Department of Nursing, National Cheng Kung University, 1 University Road, Tainan 70101, Taiwan.
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33
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Falivene MA, Orden AB. Maternal behavioral factors influencing postpartum weight retention. Clinical and metabolic implications. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2017. [DOI: 10.1590/1806-93042017000200003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Objectives: to describe some factors of maternal behavior such as breastfeeding, diet, physical activity, sleep and clinical-metabolic disorders associated with retention and/or weight gain during postpartum. Methods: specific articles on the subject were searched in LILACS, MEDLINE/PubMed and SciELO databases. Results: the literature review suggests that breastfeeding or physical activity alone are not enough to return to the pre-pregnancy weight, if they are not combined with restrictions of energy intake. Reduced sleep affects both eating habits and activity patterns resulting in lower energy expenditure, in addition to altering the glycemic metabolism. Conclusions: maternal obesity increases the risk of metabolic syndrome. Interventions during postpartum are critical for maternal health and could be the key in reducing the risk of transgenerational maternal/childhood obesity.
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Affiliation(s)
| | - Alicia B. Orden
- Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina
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34
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Mailey EL, Hsu WW. Is a general or specific exercise recommendation more effective for promoting physical activity among postpartum mothers? J Health Psychol 2017; 24:964-978. [PMID: 28810385 DOI: 10.1177/1359105316687627] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This comparative effectiveness trial examined the effects of a behavior change intervention supplemented by a general or specific exercise recommendation on physical activity among postpartum mothers. Participants ( N = 49) attended three workshop sessions that provided the exercise recommendation and taught self-regulatory skills. Physical activity, self-efficacy, planning, and barriers were assessed at baseline, post-intervention, and 6-month follow-up. Self-reported physical activity increased significantly in both groups ( p < .001), but the increase was larger in the general condition ( p = .03). Both groups reported increased planning and decreased barriers. Postpartum mothers may benefit from interventions that teach strategies for overcoming barriers while allowing them to choose preferred activities.
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Abstract
Many women who are breastfeeding also want to participate in exercise, but have concerns about the safety of their newborn. The following chapter reviews issues related to postpartum exercise and lactation. The goals of the chapter are to help clinicians understand the benefits of exercise, examine the impact of postpartum exercise on breastfeeding, and provide practical recommendations for exercise during the postpartum period in women who are breastfeeding.
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Affiliation(s)
- Susan M Bane
- Department of Allied Health and Sport Studies, Barton College, Wilson, North Carolina
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Larson-Meyer DE, Schueler J, Kyle E, Austin KJ, Hart AM, Alexander BM. Do Lactation-Induced Changes in Ghrelin, Glucagon-Like Peptide-1, and Peptide YY Influence Appetite and Body Weight Regulation during the First Postpartum Year? J Obes 2016; 2016:7532926. [PMID: 27313876 PMCID: PMC4893568 DOI: 10.1155/2016/7532926] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 12/14/2022] Open
Abstract
To determine whether fasting and meal-induced appetite-regulating hormones are altered during lactation and associated with body weight retention after childbearing, we studied 24 exclusively breastfeeding women (BMI = 25.2 ± 3.6 kg/m(2)) at 4-5 weeks postpartum and 20 never-pregnant controls (BMI = 24.0 ± 3.1 kg/m(2)). Ghrelin, PYY, GLP-1, and appetite ratings were measured before/and 150 minutes after a standardized breakfast and 60 minutes after an ad libitum lunch. Body weight/composition were measured at 6 and 12 months. Fasting and area under-the-curve responses for appetite-regulating hormones did not differ between lactating and control groups; ghrelinacyl, however, tended to track higher after the standardized breakfast in lactating women and was higher (p < 0.05) after the ad libitum lunch despite a 24% higher energy intake (p < 0.05). By 12 months, lactating women lost 5.3 ± 2.2 kg (n = 18), whereas control women (n = 15) remained weight stable (p = 0.019); fifteen of the lactating women returned to within ±2.0 kg of prepregnancy weight but three retained >6.0 kg. The retainers had greater (p < 0.05) postmeal ghrelin rebound responses following breakfast. Overall these studies do not support the hypothesis that appetite-regulating hormones are altered during lactation and associated with postpartum weight retention. Altered ghrelin responses, however, deserve further exploration.
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Affiliation(s)
- D. Enette Larson-Meyer
- Department of Family and Consumer Sciences (Human Nutrition), University of Wyoming, Laramie, WY 82071, USA
- *D. Enette Larson-Meyer:
| | - Jessica Schueler
- Department of Family and Consumer Sciences (Human Nutrition), University of Wyoming, Laramie, WY 82071, USA
- St. Charles Medical Center, Bend, OR 97701, USA
| | - Erin Kyle
- Department of Family and Consumer Sciences (Human Nutrition), University of Wyoming, Laramie, WY 82071, USA
- Department of Campus Recreation, University of Wyoming, Laramie, WY 82071, USA
| | - Kathleen J. Austin
- Department of Animal Science, University of Wyoming, Laramie, WY 82071, USA
| | - Ann Marie Hart
- School of Nursing, University of Wyoming, Laramie, WY 82071, USA
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Vladutiu CJ, Evenson KR, Jukic AM, Herring AH. Correlates of Self-Reported Physical Activity at 3 and 12 Months Postpartum. J Phys Act Health 2015; 12:814-22. [PMID: 25157810 PMCID: PMC4564345 DOI: 10.1123/jpah.2014-0147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Postpartum women are encouraged to participate in ≥ 150 min/week of moderate-intensity aerobic activity, but few women achieve this recommendation. This study sought to identify factors associated with participation in physical activity after pregnancy. METHODS We examined correlates of any self-reported moderate-to-vigorous physical activity (MVPA) (≥ 10 min/week across all modes) and any recreational MVPA (≥ 10 min/week) among women enrolled in the Pregnancy, Infection, and Nutrition Postpartum study at 3 months postpartum (n = 667) and at 12 months postpartum (n = 530). Potential correlates were identified according to the socioecological framework. RESULTS At 3 and 12 months postpartum, lower odds of participation in any MVPA were associated with lower education, breastfeeding, and minimal emotional support. Low exercise self-efficacy, receipt of advice about physical activity, and warmer seasons were associated with higher odds of any MVPA. For recreational MVPA, lower odds of participation were associated with unmarried status, lower education, employment, low income, preeclampsia, and minimal emotional support. Involvement in child/adult care activities, transportation MVPA, and warmer seasons were associated with higher odds of recreational MVPA. CONCLUSION These findings suggest that several modifiable intrapersonal and interpersonal factors are associated with postpartum MVPA and should be considered when developing interventions to help women maintain or increase MVPA after pregnancy.
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Affiliation(s)
- Catherine J. Vladutiu
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Anne Marie Jukic
- National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina
| | - Amy H. Herring
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
- Carolina Population Center, University of North Carolina, Chapel Hill, North Carolina
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Phelan S, Brannen A, Erickson K, Diamond M, Schaffner A, Muñoz-Christian K, Stewart A, Sanchez T, Rodriguez VC, Ramos DI, McClure L, Stinson C, Tate DF. 'Fit Moms/Mamás Activas' internet-based weight control program with group support to reduce postpartum weight retention in low-income women: study protocol for a randomized controlled trial. Trials 2015; 16:59. [PMID: 25887964 PMCID: PMC4347547 DOI: 10.1186/s13063-015-0573-9] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Accepted: 01/07/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High postpartum weight retention is a strong independent risk factor for lifetime obesity, cardiovascular disease, and type 2 diabetes in women. Interventions to promote postpartum weight loss have met with some success but have been limited by high attrition. Internet-based treatment has the potential to overcome this barrier and reduce postpartum weight retention, but no study has evaluated the effects of an internet-based program to prevent high postpartum weight retention in women. METHODS/DESIGN Fit Moms/Mamás Activas targets recruitment of 12 Women, Infants and Children (WIC) Supplemental Nutrition Program clinics with a total of 408 adult (>18 years), postpartum (<1 year) women with 14.5 kg or more weight retention or a body mass index of 25.0 kg/m(2) or higher. Clinics are matched on size and randomly assigned within county to either a 12-month standard WIC intervention or to a 12-month WIC enhanced plus internet-based weight loss intervention. The intervention includes: monthly face-to-face group sessions; access to a website with weekly lessons, a web diary, instructional videos, and computer-tailored feedback; four weekly text messages; and brief reinforcement from WIC counselors. Participants are assessed at baseline, six months, and 12 months. The primary outcome is weight loss over six and 12 months; secondary outcomes include diet and physical activity behaviors, and psychosocial measures. DISCUSSION Fit Moms/Mamás Activas is the first study to empirically examine the effects of an internet-based treatment program, coupled with monthly group contact at the WIC program, designed to prevent sustained postpartum weight retention in low-income women at high risk for weight gain, obesity, and related comorbidities. TRIAL REGISTRATION This trial was registered with Clinicaltrials.gov (identifier: NCT01408147 ) on 29 July 2011.
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Affiliation(s)
- Suzanne Phelan
- Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Anna Brannen
- Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Karen Erickson
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, 318 Rosenau Hall, Campus Box 7400, Chapel Hill, NC, 27599-7440, USA.
| | - Molly Diamond
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, 318 Rosenau Hall, Campus Box 7400, Chapel Hill, NC, 27599-7440, USA.
| | - Andrew Schaffner
- Statistics Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Karen Muñoz-Christian
- Department of Modern Languages, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Ana Stewart
- Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Teresa Sanchez
- Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Vanessa C Rodriguez
- Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Dalila I Ramos
- Kinesiology Department, California Polytechnic State University, 1 Grand Avenue, San Luis Obispo, CA, 93407, USA.
| | - Linda McClure
- San Luis Obispo County Women, Infants, and Children Supplemental Nutrition Program, 2191 Johnson Ave, San Luis Obispo, CA, 93401, USA.
| | - Caro Stinson
- Santa Barbara County Women, Infants, and Children Supplemental Nutrition Program, 315 Camino del Remedio, Santa Barbara, CA, 93110, USA.
| | - Deborah F Tate
- Department of Health Behavior, University of North Carolina Gillings School of Global Public Health, 318 Rosenau Hall, Campus Box 7400, Chapel Hill, NC, 27599-7440, USA.
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Usability testing and piloting of the Mums Step It Up program--a team-based social networking physical activity intervention for women with young children. PLoS One 2014; 9:e108842. [PMID: 25272039 PMCID: PMC4182756 DOI: 10.1371/journal.pone.0108842] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 09/04/2014] [Indexed: 11/19/2022] Open
Abstract
Background Women’s physical activity levels decline during their transition to parenthood. Facebook is widely used by Australian mothers and provides the opportunity to target social networks in order to maintain and increase physical activity. Method This mixed method study aimed to pilot and assess the usability of the Mums Step It Up Facebook app, a new team-based physical activity intervention for mothers with young children. A purposive sample of five “Captain” women with young children, were recruited through personal contacts. These women used the app to recruit 3–7 Facebook friends (with children under 5) to join their respective teams (total n = 25). The app encourages women to take 10,000 steps a day measured by a pedometer. Women used the app for 28 days to log steps, interact with team mates and monitor progress. Physical activity was assessed at two time points (baseline and final week) using the Active Australia Survey. Usability testing with the five “Captain” women took place over two one hour face-to-face sessions. A questionnaire seeking feedback on the app was completed at time point two. Results Participants’ total physical activity increased by an average of 177 minutes per week (p = 0.01). The complexity of the team forming process and issues using the Facebook environment, where a variety of devices and software platforms are used, was highlighted. Discussion A team-based Facebook app shows considerable promise for the recruitment and retention of participants to a social network-based physical activity intervention. A randomised controlled trial to further evaluate the effectiveness of the intervention is warranted.
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Zourladani A, Zafrakas M, Chatzigiannis B, Papasozomenou P, Vavilis D, Matziari C. The effect of physical exercise on postpartum fitness, hormone and lipid levels: a randomized controlled trial in primiparous, lactating women. Arch Gynecol Obstet 2014; 291:525-30. [PMID: 25138123 DOI: 10.1007/s00404-014-3418-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2014] [Accepted: 08/08/2014] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the effect of an exercise training program combining low-impact dance aerobic, resistance and stretching exercise on physical fitness, hormone and lipid levels of postpartum, primiparous, lactating women. METHODS Thirty seven primiparous, lactating women were randomly assigned at 4-6 weeks postpartum to either follow an exercise training program of 50-60 min aerobic, strengthening and stretching exercise, 3 days a week, for 12 weeks (interventional group; n = 20) or no training program at all (control group; n = 17). The following parameters were measured at baseline and 12 weeks later: (1) for evaluation of physical fitness: VO2max, muscular endurance, joint mobility and body fat; (2) for evaluation of the lipidemic profile: triglyceride, total cholesterol, HDL and LDL levels, and (3) levels of hormones associated with lactation: prolactin, estradiol, cortisol, TSH, fT3 and fT4. RESULTS After completion of the exercise training program, comparisons between the interventional and the control group showed statistically significant mean changes in VO2max (p = 0.003), muscular endurance of the upper extremities (p < 0.001), and the abdomen (p < 0.001), flexibility (p = 0.042), and body fat (p = 0.007). There were no significant differences between the two groups in mean changes of lipid and hormone levels. CONCLUSION Implementation of a low-impact exercise training program appears to improve physical fitness of postpartum women, while it does not seem to affect lipid levels and lactation-associated hormone levels. Hence, implementation of an exercise training program combining low-impact dance aerobic, resistance and stretching exercise is feasible in postpartum, primiparous, lactating women.
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Affiliation(s)
- A Zourladani
- School of Physical Education and Sport Science, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Hoppu U, Isolauri E, Koskinen P, Laitinen K. Maternal dietary counseling reduces total and LDL cholesterol postpartum. Nutrition 2013; 30:159-64. [PMID: 24176529 DOI: 10.1016/j.nut.2013.07.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 05/27/2013] [Accepted: 07/04/2013] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the effects of dietary counseling on blood lipid concentrations during and after pregnancy. METHODS Partcipants (N = 256) were randomized into three study groups: dietary counseling with probiotics or placebo and a control group at first trimester of pregnancy. Diet quality was evaluated from food records by an index of healthy eating and total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, triglycerides, apolipoproteins A-I and B, and lipoprotein (a) were measured at the first and third trimesters of pregnancy and 1, 6, and 12 mo postpartum. RESULTS During pregnancy, no differences in lipid values were noted among the groups, but postpartum TC and LDL-C were lower in both dietary counseling groups compared with controls (P = 0.027 and P = 0.012, respectively). Higher points on the healthy eating index, normal weight, and regular exercise were associated with a more favorable lipid profile at 12 mo after delivery. CONCLUSION Maternal dietary counseling may lower maternal TC and LDL-C levels postpartum. A healthy lifestyle during pregnancy and postpartum may benefit women's cardiovascular health.
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Affiliation(s)
- Ulla Hoppu
- Functional Foods Forum, University of Turku, Turku, Finland
| | - Erika Isolauri
- Department of Pediatrics, University of Turku and Turku University Central Hospital, Turku, Finland
| | - Pertti Koskinen
- TYKSLAB Laboratory, Hospital District of Southwest Finland, Turku, Finland
| | - Kirsi Laitinen
- Functional Foods Forum, University of Turku, Turku, Finland; Institute of Biomedicine, University of Turku, Turku, Finland.
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The effect of physical exercise strategies on weight loss in postpartum women: a systematic review and meta-analysis. Int J Obes (Lond) 2013; 38:626-35. [PMID: 24048142 DOI: 10.1038/ijo.2013.183] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 09/04/2013] [Accepted: 09/10/2013] [Indexed: 12/24/2022]
Abstract
For women of reproductive age, excessive gestational weight gain and/or postpartum weight retention can increase the risk of obesity. This systematic review evaluates the effectiveness of lifestyle modification control trials that utilize exercise interventions, with or without dietary intervention, on weight loss among postpartum women. A search of randomized clinical trials (RCT) was performed using the follow databases and the bibliography of candidate studies: MEDLINE, Web of Science, EMBASE, CENTRAL/Cochrane and Physiotherapy Evidence Database. English language RCT papers published up to 31 October 2012, which present changes on maternal body weight from baseline to the end of exercise intervention were included. The primary meta-analysis examined the effects of exercise interventions, with or without complementary dietary intervention, on weight loss during the postpartum period compared with usual standard of care. Five subgroup analyses were performed to examine differences in study interventions and exercise modalities: duration of intervention, quality of study methodology, supervision of exercise intervention, exercise intervention goals used and the type of dietary intervention. In total 11 studies met eligibility criteria with 769 participants, 409 under intervention and 360 in the control group. The primary meta-analysis included all 11 studies and found a mean difference (MD) on weight loss of -2.57 kg (95% CI -3.66 to -1.47). The subgroup analysis demonstrated that the most effective interventions in reducing weight in postpartum women were exercise programs with objectively defined goals, such as the use of heart rate monitors or pedometer (MD of -4.09 kg-95% CI -4.94 to -3.25, I(2)=0%) and exercise combined with intensive dietary intervention (MD of -4.34 kg-95% CI -5.15 to -3.52, I(2)=0%). Thus, there is benefit from overall lifestyle interventions on weight loss in postpartum women and exercise plus intensive diet and objective targets are the most effective intervention strategies.
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Bauer PW, Pivarnik JM, Feltz DL, Paneth N, Womack CJ. Relationship of Past-Pregnancy Physical Activity and Self-efficacy With Current Physical Activity and Postpartum Weight Retention. Am J Lifestyle Med 2013. [DOI: 10.1177/1559827613498061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Life events unique to the perinatal period may place a woman at greater risk for decreased physical activity and increased postpartum weight retention (PPWR). Study purposes were to determine a) the relationship between women’s postpartum self-efficacy (SE) to overcome perceived barriers to exercise with current and past pregnancy leisure-time physical activity (LTPA), and b) the relationship between LTPA and PPWR. A Modifiable Activity Questionnaire was used to assess current and past pregnancy LTPA (Met*h/wk) at 20 and 32 weeks gestation and 12 weeks postpartum. Current barriers to LTPA and SE were assessed via the Perceived Barriers Efficacy Questionnaire. Top three barrier values were averaged to obtain an overall SE score for participants (N=30). Pearson correlations were run between LTPA, PPWR and SE scores. ANOVA was used to compare PPWR between women who did and did not meet LTPA guidelines of 7.5 MET*h/wk. The top three barriers to LTPA were time, motivation, and childcare. Positive correlations (p≤0.01) were found between SE levels and LTPA at all time periods of interest. LTPA was inversely related to PPWR. Relationships between SE, LTPA, and PPWR helped validate the need to promote perinatal PA, to aid long term weight management.
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Affiliation(s)
- Patricia W. Bauer
- Naples, Florida (PWB)
- Department of Kinesiology, Michigan State University, East Lansing, Michigan (JMP, DLF)
- Departments of Epidemiology and Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan (NP)
- Department of Kinesiology, James Madison University, Harrisonburg, Virginia (CJW)
| | - James M. Pivarnik
- Naples, Florida (PWB)
- Department of Kinesiology, Michigan State University, East Lansing, Michigan (JMP, DLF)
- Departments of Epidemiology and Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan (NP)
- Department of Kinesiology, James Madison University, Harrisonburg, Virginia (CJW)
| | - Deborah L. Feltz
- Naples, Florida (PWB)
- Department of Kinesiology, Michigan State University, East Lansing, Michigan (JMP, DLF)
- Departments of Epidemiology and Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan (NP)
- Department of Kinesiology, James Madison University, Harrisonburg, Virginia (CJW)
| | - Nigel Paneth
- Naples, Florida (PWB)
- Department of Kinesiology, Michigan State University, East Lansing, Michigan (JMP, DLF)
- Departments of Epidemiology and Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan (NP)
- Department of Kinesiology, James Madison University, Harrisonburg, Virginia (CJW)
| | - Christopher J. Womack
- Naples, Florida (PWB)
- Department of Kinesiology, Michigan State University, East Lansing, Michigan (JMP, DLF)
- Departments of Epidemiology and Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, Michigan (NP)
- Department of Kinesiology, James Madison University, Harrisonburg, Virginia (CJW)
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Evenson KR, Brouwer RJN, Østbye T. Changes in physical activity among postpartum overweight and obese women: results from the KAN-DO Study. Women Health 2013; 53:317-34. [PMID: 23705761 DOI: 10.1080/03630242.2013.769482] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Few studies have assessed physical activity at multiple time points in the postpartum period or used both self-reported and objective measures of assessment. The purpose of this study was to describe physical activity and sedentary behavior at two time points in a cohort of overweight or obese postpartum women using both self-reported and objective measures. In total, 132 women completed physical activity assessments at a median of 24 weeks postpartum and again approximately 10 months later. At both time points, women wore an Actical accelerometer for one week and completed the Kaiser Physical Activity Survey. Adjusted Poisson regression models were used to determine whether physical activity changed over time for the cohort. Overall counts per minute and moderate to vigorous physical activity increased from baseline to 10 months later, although the absolute levels were modest (median 6.9 to 8.8 minutes/day). A median of 64%-71% at baseline and 63%-67% at follow-up of their monitored times were sedentary. More intensive interventions are needed to help postpartum women integrate physical activity and reduce sedentary behavior. [Supplementary material is available for this article. Go to the publisher's online edition of Women & Health for the following resource: three figures that show the distribution of physical activity and sedentary behavior by study periods among control participants].
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Affiliation(s)
- Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina 27514, USA.
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Roozbahani N, Ghofranipour F, Eftekhar Ardabili H, Hajizadeh E. Factors influencing physical activity among postpartum Iranian women. HEALTH EDUCATION JOURNAL 2013. [DOI: 10.1177/0017896913490511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background: Postpartum women are a population at risk for sedentary living. Physical activity (PA) prior to pregnancy may be effective in predicting similar behaviour in the postpartum period. Objective: To test a composite version of the extended transtheoretical model (TTM) by adding ‘past behaviour’ in order to predict PA behaviour among postpartum Iranian women. Methods: Participants were 300 primiparous postpartum women from health clinics in Arak, Iran who completed the Iranian versions of the TTM, past behaviour and PA behaviour questionnaires. The mean age of the participants was 24.85 years ( SD = 4.4, range = 15–41). Data were analysed using bivariate correlation and path analysis. Results: The first revised model accounted for 43% of the variance in current PA and represented a good data fit (χ2 = 7.45, df = 4, p = 0.114). There were significant direct pathways between PA and stage of change (β = 0.51), pros (β = 0.30), and cons (β = −0.31), and significant indirect effects of self-efficacy (β = .39) and processes of change (β = 0.34). The final model, which included the direct effects of past behaviour (β = 0.28), explained 50% of the variance in PA and represented a good data fit (χ2 = 8.30, df = 5, p = 0.14). Additionally, in this model pros (β = 0.25) and cons (β = −0.26) are directly related to PA, and self-efficacy (β = 0.39) and processes of change (β = 0.34) are indirectly related to PA. Conclusion: The findings of this study support the application of TTM to PA behaviour change among Iranian postpartum women. However, adding past behaviour to the model increases our understanding of the population’s PA and may help the planning of more efficient interventions for promoting PA.
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Affiliation(s)
- Nasrin Roozbahani
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Iran
| | - Fazlollah Ghofranipour
- Department of Health Education, Faculty of Medical Sciences, Tarbiat Modares University, Iran
| | | | - Ebrahim Hajizadeh
- Department of Biostatistics, Faculty of Medical Sciences, Tarbiat Modares University, Iran
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Postpartum Exercise among Nigerian Women: Issues Relating to Exercise Performance and Self-Efficacy. ISRN OBSTETRICS AND GYNECOLOGY 2013; 2013:294518. [PMID: 23844290 PMCID: PMC3697309 DOI: 10.1155/2013/294518] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Accepted: 06/04/2013] [Indexed: 11/18/2022]
Abstract
Physical exercise during postpartum period is beneficial to mothers, and the health gains are abundantly reported. This study characterises the postpartum exercise profile of a group of Nigerian women and reports how their exercise self-efficacies are influenced by sociodemographic characteristics. Participants were women attending the two largest postnatal clinics in Ibadan, south-western Nigeria. A self-developed questionnaire assessed the socio-demographic and exercise profile of participants, while the Exercise Self-Efficacy Scale assessed their exercise self-efficacy. About two-third (61.0%) of the participants were not aware that they could undertake physical exercise to enhance postpartum health, and 109 (47.8%) were not engaged in any exercise. Those who exercised did so for less than three days/week, and 89% of the women did not belong to any exercise support group. Exercise self-efficacy was significantly (P < 0.05) associated with being in an exercise programme, age, employment, work hours/week, monthly income, and number of pregnancies. Most of the women were not aware they could engage in postpartum exercise, and about half were not undertaking it. More women with high compared to moderate exercise self-efficacy undertook the exercise. Efforts at increasing awareness, improving exercise self-efficacy and adoption of postpartum exercise are desirable among the Nigerian women.
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Kernot J, Olds T, Lewis LK, Maher C. Effectiveness of a facebook-delivered physical activity intervention for post-partum women: a randomized controlled trial protocol. BMC Public Health 2013; 13:518. [PMID: 23714411 PMCID: PMC3674954 DOI: 10.1186/1471-2458-13-518] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Accepted: 05/20/2013] [Indexed: 11/23/2022] Open
Abstract
Background Physical activity is reduced during the post-partum period. Facebook is frequently used by Australian mothers, and offers flexibility, high levels of engagement and the ability to disseminate information and advice via social contacts. The Mums Step it Up Program is a newly developed 50 day team-based physical activity intervention delivered via a Facebook app. The program involves post-partum women working in teams of 4–8 friends aiming to achieve 10,000 steps per day measured by a pedometer. Women are encouraged to use the app to log their daily steps and undertake social and supportive interactions with their friends and other participants. This study aims to determine the effectiveness of the Mums Step it Up Program. Method/design A sample of 126 women up to 12 months post-partum will be recruited through community-based health and family services. Participants will be randomly allocated into one of three groups: control, pedometer only and the Mums Step it Up Program. Assessments will be completed at baseline, 6 weeks and 6 months. The primary outcome (objective physical activity) and the secondary outcomes (sleep quality and quantity, depressive symptoms, weight and quality of life) will be used to determine the effectiveness of the Mums Step it Up Program compared with the control and pedometer only groups. Analyses will be undertaken on an intention-to-treat-basis using random effects mixed modeling. The effect of theorized mediators (physical activity attitudes, subjective norms and perceived behavioral control) will also be examined. Discussion This study will provide information about the potential of a Facebook app for the delivery of health behavior interventions. If this intervention proves to be effective it will be released on a mass scale and promoted to the general public. Trial registration Australia and New Zealand Clinical Trials Register: ACTRN12613000069752
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Affiliation(s)
- Jocelyn Kernot
- Health and Use of Time (HUT) group, Sansom Institute of Health Research, School of Health Sciences, University of South Australia, Adelaide, Australia
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Ferrari RM, Siega-Riz AM, Evenson KR, Moos MK, Melvin CL, Herring AH. Provider advice about weight loss and physical activity in the postpartum period. J Womens Health (Larchmt) 2013; 19:397-406. [PMID: 20156083 DOI: 10.1089/jwh.2008.1332] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To explore the association between healthcare provider advice about weight loss and physical activity in the postpartum period and weight retention and activity levels in women assessed at 3 months postpartum. METHODS Using data from a prospective cohort study, we explored the association of advice with postpartum weight retention and activity levels in 688 women at 3 months postpartum. Data from home visits included anthropometric measurements and information collected from sociodemographic, health behavior, and psychosocial questionnaires. Weight retention was calculated as weight at 3 months postpartum minus prepregnancy weight; activity levels and advice were based on maternal self-report. Linear regression and Poisson regression were used to explore associations. RESULTS The majority of the population was white (76%), had a greater than high school education (83%), and had an income >185% of the federal poverty level (81%). Women ranged in age from 17 to 48 years. Most women reported receiving no weight loss (89.1%) and no physical activity advice (77.4%) from a healthcare provider during the 3-month postpartum period. After adjustment, we found no association between provider advice and weight retention. When compared with those who reported no advice, following provider advice showed an association with recreational activity above the median (RR 1.50, 95% confidence interval [CI] 1.24, 1.80). CONCLUSIONS Provider advice may influence physical activity but may not be enough to help postpartum women lose pregnancy weight. Instead, women may benefit more from individualized counseling and follow-up beyond the usual 6-week postpartum visit.
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Affiliation(s)
- Renée M Ferrari
- Department of Maternal and Child Health, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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LeCheminant JD, Hinman T, Pratt KB, Earl N, Bailey BW, Thackeray R, Tucker LA. Effect of resistance training on body composition, self-efficacy, depression, and activity in postpartum women. Scand J Med Sci Sports 2012; 24:414-21. [DOI: 10.1111/j.1600-0838.2012.01490.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2012] [Indexed: 11/29/2022]
Affiliation(s)
| | - T. Hinman
- Brigham Young University; Provo Utah USA
| | | | - N. Earl
- Brigham Young University; Provo Utah USA
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Scarpa SC, Kurashima CH, Takito MY. Impacto da orientação para a prática regular de atividade física dois anos após o parto. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2012. [DOI: 10.1590/s1519-38292012000200006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: avaliar as modificações na prática de atividade física (AF) e as barreiras para adoção de um estilo de vida saudável em mulheres que receberam orientações nutricionais e de AF durante a gestação e no primeiro ano após o parto. MÉTODOS: estudo de coorte com 57 mulheres (Grupo Controle = 29 e Grupo Intervenção = 28), e idade média igual a 28 (±6) anos. As informações foram obtidas através de entrevistas em visita domiciliar (durante a intervenção) e inquérito telefônico (um ano após o término da intervenção), utilizou-se questionário de AF. Para análise das barreiras foi realizada uma entrevista semiestruturada com questões abertas, as quais foram codificadas e agrupadas para análise dos dados. Foram realizados testes de qui-quadrado, Mann-Whitney U e Friedman. RESULTADOS: aos seis meses, apenas 30% das mulheres do grupo Intervenção realizavam AF no lazer pelo menos 120 minutos por semana, contra 10% do grupo Controle, reduzindo para 18% e 4%, respectivamente, dois anos após o parto. As principais barreiras à prática de AF regular foram: falta de tempo (44%), cuidado com os filhos (37%), trabalho (21%), afazeres domésticos (21%) e comodismo (26%). CONCLUSÕES: futuros programas devem priorizar a aquisição de conhecimento, visando à adoção de um estilo de vida ativo no pós-parto, considerando as barreiras maternas.
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