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Flor-Alemany M, Sandborg J, Migueles JH, Söderström E, Henström M, Marín-Jiménez N, Baena-García L, Aparicio VA, Löf M. Mediterranean Diet Adherence and Health-Related Quality of Life during Pregnancy: Is the Mediterranean Diet Beneficial in Non-Mediterranean Countries? Nutrients 2024; 16:718. [PMID: 38474846 DOI: 10.3390/nu16050718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 02/25/2024] [Accepted: 02/28/2024] [Indexed: 03/14/2024] Open
Abstract
This study aimed to examine the association of Mediterranean diet (MD) adherence and MD components with health-related quality of life (HRQoL) in pregnant women from Spain and Sweden. A total of 138 pregnant women from Spain (age: 32.9 ± 4.6 years old) and 302 pregnant women from Sweden (age: 31.3 ± 4.1 years old) were included. MD adherence was assessed with the Mediterranean food pattern (i.e., a MD index) at the 14-16th gestational weeks. HRQoL was assessed with the Spanish and Swedish versions of the 36-item Short-Form Health Survey (SF-36 and RAND-36, respectively) at the 14-16th and 34-37th gestational weeks. A greater MD adherence was associated with better physical functioning, bodily pain, vitality, emotional role, and mental health in cross-sectional associations (2nd trimester) in the Spanish sample (all p < 0.05). Furthermore, a greater MD adherence was associated with lower bodily pain in both Spanish and Swedish samples (both p < 0.05) in the 3rd trimester. The associations of MD adherence with pain seem to be explained by a greater intake of fiber, fish, fruits, nuts, and legumes (all p < 0.05). A greater MD adherence, driven by a higher intake of fiber, fish, fruits, nuts, and legumes, was associated with lower pain throughout pregnancy in both Mediterranean and non-Mediterranean populations.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Johanna Sandborg
- Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Huddinge, Sweden
| | - Jairo H Migueles
- PROFITH "Promoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Emmie Söderström
- Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden
| | - Maria Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Huddinge, Sweden
| | - Nuria Marín-Jiménez
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cadiz, Spain
| | - Laura Baena-García
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain
- Instituto de Investigación Biosanitaria (IBS), 18012 Granada, Spain
| | - Virginia A Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Huddinge, Sweden
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Flor-Alemany M, Acosta-Manzano P, Migueles JH, Henriksson P, Löf M, Aparicio VA. Impact of Exercise Intervention Combined with Optimal Mediterranean Diet Adherence during Pregnancy on Postpartum Body Composition: A Quasi-Experimental Study-The GESTAFIT Project. Nutrients 2023; 15:4413. [PMID: 37892487 PMCID: PMC10609918 DOI: 10.3390/nu15204413] [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: 09/22/2023] [Revised: 10/08/2023] [Accepted: 10/16/2023] [Indexed: 10/29/2023] Open
Abstract
This study aimed to investigate whether the effects of an exercise program during pregnancy on postpartum body composition are moderated by following a healthy dietary pattern (i.e., Mediterranean diet (MD)). Eighty-three pregnant women (control n = 40, exercise n = 43) were included in the present quasi-experimental study. The exercise intervention consisted of a 60 min, 3 day/week throughout pregnancy from gestational week 17, supervised concurrent (aerobic + resistance) exercise program. A food frequency questionnaire and the MD Score (min-max: 0-50) were employed to assess dietary habits and the MD adherence during pregnancy, respectively. Postpartum body composition was measured with dual-energy X-ray absorptiometry, 6 weeks postpartum. The body mass index and the gynecoid fat mass at postpartum were lower in the exercise compared to the control group (p = 0.018 and p = 0.047, respectively). There was an interaction showing that the MD adherence during pregnancy positively moderated the effects of the exercise intervention on postpartum lean mass (p = 0.024), fat mass percentage (p = 0.092), android fat mass (p = 0.076), and android-to-gynecoid fat mass (p = 0.019). The Johnson-Neyman technique revealed that the effects of exercise were enhanced at a MD score of ~31 for lean mass, ~25 for fat mass, ~23 for android fat mass and ~29 for android-to-gynecoid fat mass. Our results suggest that a concurrent-exercise training plus an optimal MD adherence during pregnancy might be a useful strategy to promote a healthier body composition at the postpartum period.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
| | - Pedro Acosta-Manzano
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
- Institute of Human Movement Science, Sport and Health, University of Graz, 8010 Graz, Austria
| | - Jairo H. Migueles
- PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, 58183 Linköping, Sweden;
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, 14152 Huddinge, Sweden;
| | - Virginia A. Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Biomedical Research Centre (CIBM), Institute of Nutrition and Food Technology (INYTA), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain;
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Aparicio VA, Baena-García L, Sánchez-González C, Acosta-Manzano P, Varela-López A, Quiles JL. Influence of a concurrent exercise training program during pregnancy on the placenta mitochondrial DNA integrity and content of minerals with enzymatic relevance. The GESTAFIT project. Placenta 2023; 139:19-24. [PMID: 37295054 DOI: 10.1016/j.placenta.2023.05.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Revised: 05/19/2023] [Accepted: 05/31/2023] [Indexed: 06/12/2023]
Abstract
INTRODUCTION We aimed i) to investigate the effects of a concurrent (aerobic plus strength) exercise intervention during pregnancy on placental mtDNA copy number, proportion of deleted mtDNA, and on the content of some trace and ultra-trace minerals with coenzymatic relevance; ii) to explore the association of such mitochondrial markers with the concentration of these minerals. METHODS For the present study specific aims, 47 placentas were randomly selected from women that participated in the GESTAFIT project into exercise (n = 24) or control (n = 23) groups. The exercise group followed a concurrent aerobic and strength training program, three 60-min sessions/week, from the 17th gestational week until birth. Placenta tissue was collected and processed for minerals determination by the inductively coupled plasma mass spectrometry technique. RT-PCR was used to determine placentas mtDNA copy number and ND1/ND4 deletion. RESULTS After adjusting for potential confounders, the mothers who participated in the exercise program had placentas with greater mtDNA copy number (p = 0.04) and lower mtDNA deletion (p = 0.003). Placentas from mothers in the exercise group presented higher manganese content than those from the controls (0.26 ± 0.03 mg/dL vs. 0.13 ± 0.03 mg/dL, p = 0.003). Placenta manganese content was significantly associated with lower mtDNA deletions (r = -0.382) and greater mtDNA copy number (r = 0.513). Iron content was associated with higher mtDNA copy number (r = 0.393). Selenium content was associated with lower mtDNA deletion (r = -0.377) and greater mtDNA copy number (r = 0.442). Finally, zinc and magnesium content were associated with higher mtDNA copy number (r = 0.447 and r = 0.453, respectively). DISCUSSION This concurrent exercise training program induced a better placental status, which might be mediated through an improvement of mitochondrial bioenergetics and antioxidative capacity.
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Affiliation(s)
- Virginia A Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology "José Mataix Verdú", Biomedical Research Centre, University of Granada, Spain; Sport and Health University Research Centre (iMUDS), University of Granada, Spain; Glzartea, Kirola eta Ariketa Fisikoa Ikerkuntza Taldea (GIKAFIT), Society Sports and Exercise Research Group, Department of Physical Education and Sport, Faculty of Education and Sport-Physical Activity and Sport Sciences Section, University of Basque Country (UPV/EHU), Vitoria-Gasteiz, Araba/Álava, Basque Country, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain; The Institute of Biomedicine Research (Instituto de Investigación Biosanitaria, ibs), Spain.
| | - Cristina Sánchez-González
- Department of Physiology, Institute of Nutrition and Food Technology "José Mataix Verdú", Biomedical Research Centre, University of Granada, Spain
| | - Pedro Acosta-Manzano
- Sport and Health University Research Centre (iMUDS), University of Granada, Spain; Institute of Human Movement Science, Sport and Health, University of Graz, Austria
| | - Alfonso Varela-López
- Department of Physiology, Institute of Nutrition and Food Technology "José Mataix Verdú", Biomedical Research Centre, University of Granada, Spain
| | - Jose L Quiles
- Department of Physiology, Institute of Nutrition and Food Technology "José Mataix Verdú", Biomedical Research Centre, University of Granada, Spain
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Flor-Alemany M, Acosta-Manzano P, Migueles JH, Varela-López A, Baena-García L, Quiles JL, Aparicio VA. Influence of an exercise intervention plus an optimal Mediterranean diet adherence during pregnancy on the telomere length of the placenta. The GESTAFIT project. Placenta 2023; 136:42-45. [PMID: 37031574 DOI: 10.1016/j.placenta.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 03/13/2023] [Accepted: 04/03/2023] [Indexed: 04/11/2023]
Abstract
We aimed to investigate whether the effects of exercise on placental relative telomere length (RTL) after delivery are modulated by the Mediterranean diet [MD] adherence in 65 pregnant women (control n = 34, exercise n = 31). No differences were found in placental RTL between the exercise and the control groups (p = 0.557). The interaction-term between exercise and MD adherence with placental RTL was significant (p = 0.001). Specifically, women in the exercise group showed longer placental RTL after birth compared to controls (referent group), only for those women with a high MD adherence (mean difference = 0.467, p=0.010). A concurrent-exercise training plus an optimal MD adherence during pregnancy might prevent the placental RTL shortening.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain; Sport and Health University Research Centre, University of Granada, Spain.
| | - Pedro Acosta-Manzano
- Sport and Health University Research Centre, University of Granada, Spain; Physical Activity for Health Promotion, CTS-1018 Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain; Institute of Human Movement Science, Sport and Health, University of Graz, Austria
| | - Jairo H Migueles
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden; PROFITH "Promoting FITness and Health Through Physical Activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Alfonso Varela-López
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Spain; Instituto de Investigación Biosanitaria, IBS, Granada, Spain
| | - José L Quiles
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain; Sport and Health University Research Centre, University of Granada, Spain
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Baena-García L, de la Flor-Alemany M, Coll-Risco I, Reoyo OR, Aranda P, Aparicio VA. A concurrent prenatal exercise program increases neonatal and placental weight and shortens labor: The GESTAFIT project. Scand J Med Sci Sports 2023; 33:465-474. [PMID: 36578199 DOI: 10.1111/sms.14298] [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: 01/18/2022] [Revised: 11/14/2022] [Accepted: 11/18/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To explore the influence of a supervised concurrent exercise-training program during pregnancy on maternal and neonatal birth-related outcomes and type of birth. METHODS One hundred and fifty-nine Caucasian pregnant women from the GESTAFIT project participated in this quasi-experimental study and were allocated into control [(n = 86), (age 33.1 ± 4.8 years old, BMI 24.8 ± 4.1 kg/m2 )] or exercise group [(n = 50) (age 33.1 ± 4.1 years old, BMI: 24.7 ± 4.1 kg/m2 )]. The exercise group followed a 60-min 3 days/week concurrent (aerobic and strength) training program from the 17th gestational week until birth. Maternal and neonatal birth-related outcomes (i.e., gestational age at birth, duration of labor, placental and neonatal weight and type of birth) were collected from obstetric medical records. Umbilical arterial and venous blood gas analysis were assessed after birth. RESULTS The exercise group increased average duration of the first stage of labor [between-group differences (B): 80.8 min, 95% confidence interval (CI), 4.18, 157.31, p = 0.03] and decreased duration of the second stage of labor [between-group differences (B): 29.8 min, 95% CI: -55.5, -4.17, p = 0.02] compared to the control group. The exercise group showed greater placental [between-group differences (B): 53.3 g (95% CI: 9.99, 96.7, p = 0.01)] and neonatal [between-group differences (B): 161.8 g (95% CI: 9.81, 313.8, p = 0.033)] weight compared to the control group. No differences between groups were found regarding type of birth (p > 0.05). CONCLUSIONS A concurrent and supervised physical exercise program during pregnancy is safe and could promote better maternal and neonatal birth-related outcomes. More studies are needed to clarify the mechanisms by which physical exercise increases neonatal and placenta weight.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Marta de la Flor-Alemany
- Sport and Health University Research Institute (iMUDS), Granada, Spain.,Department of Physiology, University of Granada, Granada, Spain.,Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Olga Roldán Reoyo
- Department of Sport Sciences, Faculty of Science and Engineering, Swansea University, Swansea, UK
| | - Pilar Aranda
- Department of Physiology, University of Granada, Granada, Spain.,Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), Granada, Spain.,Department of Physiology, University of Granada, Granada, Spain.,Institute of Nutrition and Food Technology, Biomedical Research Centre, University of Granada, Granada, Spain
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Flor‐Alemany M, Acosta‐Manzano P, Migueles JH, Baena‐García L, Aranda P, Aparicio VA. Association of Mediterranean diet adherence during pregnancy with maternal and neonatal lipid, glycemic and inflammatory markers: The GESTAFIT project. MATERNAL & CHILD NUTRITION 2023; 19:e13454. [PMID: 36437523 PMCID: PMC10019045 DOI: 10.1111/mcn.13454] [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: 06/23/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022]
Abstract
To examine the association of Mediterranean diet (MD) adherence during pregnancy with maternal and neonatal lipid, glycemic, and inflammatory markers. This study included 152 women from the GESTAFIT trial and a subsample of 35 newborns. The Mediterranean Diet Score, derived from food frequency questionnaires, was employed to assess MD adherence. Total cholesterol, high-density lipoprotein-cholesterol (HDL-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides, and glucose were assessed in the mother (at the 16th and 34th gestational weeks [g.w.]) and in cord arterial and venous serum with standard procedures using an autoanalyzer. Pro-inflammatory and anti-inflammatory cytokines (interleukin [IL]-6, IL-8, IL-10, IL-1beta, interferon gamma, and tumour necrosis factor alpha [TNF-α]) were measured with Luminex xMAP technology. A greater MD adherence was associated with higher HDL-C and lower LDL-C, LDL-C/HDL-C ratio, triglycerides, triglycerides/HDL-C ratio, and TNF-α in the mother at the 16th and the 34th g.w. (|β|: 0.191-0.388, p < 0.05). A higher intake of whole grain cereals, fruits, vegetables and fish and a lower intake of sweets were associated with higher HDL-C and lower LDL-C, LDL-C/HDL-C ratio, triglycerides, triglycerides/HDL-C ratio, and TNF-α at the 16th and 34th g.w. (|β|: 0.188-0.334, p < 0.05). No associations were found with the cord arterial and venous serum markers (p > 0.05). A greater MD adherence during pregnancy, driven by a higher intake of whole grain cereals, fruits, vegetables and fish, and a lower intake of sweets, was positively associated with the maternal lipid and inflammatory serum markers throughout gestation. MD adherence during pregnancy was not associated with cord serum markers.
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Affiliation(s)
- Marta Flor‐Alemany
- Department of PhysiologyUniversity of GranadaGranadaSpain
- Institute of Nutrition and Food TechnologyUniversity of GranadaGranadaSpain
- Sport and Health University Research Institute (iMUDS)GranadaSpain
| | - Pedro Acosta‐Manzano
- Sport and Health University Research Institute (iMUDS)GranadaSpain
- Department of Physical Education and Sports, Phsical Activity for Health Promotion, CTS‐1018 Research Group, Faculty of Sport SciencesUniversity of GranadaGranadaSpain
- Institute of Human Movement Science, Sport and HealthUniversity of GrazGrazAustria
| | - Jairo H. Migueles
- Department of Biosciences and NutritionKarolinska InstitutetHuddingeSweden
- Department of Physical Education and Sports, PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Faculty of Sport SciencesUniversity of GranadaGranadaSpain
| | - Laura Baena‐García
- Department of Nursing, Faculty of Health SciencesUniversity of GranadaCeutaSpain
- Instituto de investigación biosanitaria, ibs GranadaGranadaSpain
| | - Pilar Aranda
- Department of PhysiologyUniversity of GranadaGranadaSpain
| | - Virginia A. Aparicio
- Department of PhysiologyUniversity of GranadaGranadaSpain
- Institute of Nutrition and Food TechnologyUniversity of GranadaGranadaSpain
- Sport and Health University Research Institute (iMUDS)GranadaSpain
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Assessing the Mediterranean diet adherence during pregnancy: Practical considerations based on the associations with cardiometabolic risk. Pregnancy Hypertens 2023; 31:17-24. [PMID: 36446188 DOI: 10.1016/j.preghy.2022.11.007] [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: 02/14/2022] [Revised: 06/05/2022] [Accepted: 11/20/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The aim of the present study was to provide practical considerations for assessing MD adherence during pregnancy based on the association with cardiometabolic risk. STUDY DESIGN Longitudinal study. MAIN OUTCOME MEASURES A food frequency questionnaire was fulfilled by 152 pregnant women at the 16th gestational week (g.w.). We calculated the Mediterranean Food Pattern (MFP), the MD Scale (MDScale), the Short MD questionnaire (SMDQ), the MD Score (MedDietScore), and the MD scale for pregnant women (MDS-P). The cardiometabolic risk score consisted of pre-pregnancy body mass index, blood pressure, glucose, triglycerides, and high-density lipoprotein-cholesterol (at 16th and 34th g.w.). RESULTS Multiple linear regression models showed that the MFP, the MedDietScore, and the SMDQ were associated with lower cardiometabolic risk at the 16th and 34th g.w. (β's: -0.193 to -0.415, all p < 0.05); and the MDS-P at the 34th g.w. (β = -0.349, p < 0.01). A comparison of these models with the J test showed that the MFP and the MedDietScore outperformed the SMDQ at the 16th g.w. (p's < 0.05); while the MedDietScore outperformed the SMDQ, MFP, and MDS-P (p's < 0.05) at the 34th g.w. Receiver-Operating-Characteristic-derived thresholds for the MFP, MedDietScore and MDS-P indices were 21, 30, and 6 points, respectively, to identify women with high cardiometabolic risk. CONCLUSION The MFP and MedDietScore are recommended to assess MD adherence during pregnancy, as these showed the strongest associations with cardiometabolic risk. Our validated thresholds might assist in the detection of poor dietary patterns during pregnancy.
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Flor-Alemany M, Migueles JH, Alemany-Arrebola I, Aparicio VA, Baena-García L. Exercise, Mediterranean Diet Adherence or Both during Pregnancy to Prevent Postpartum Depression-GESTAFIT Trial Secondary Analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14450. [PMID: 36361335 PMCID: PMC9657805 DOI: 10.3390/ijerph192114450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 06/16/2023]
Abstract
Targeting lifestyle behaviors during pregnancy is crucial to prevent the highly prevalent postpartum depression and its consequences. In these secondary analyses of an intervention trial to investigate the effects of concurrent exercise training on postpartum depression, we aimed to investigate the potential role of Mediterranean diet (MD) adherence on the exercise effects. A total of 85 pregnant women met the per-protocol criteria (exercise n = 46, control n = 39). The exercise program was delivered in 60 min sessions, 3 days/week, from the 17th gestational week until birth. Women's dietary habits were assessed with a food frequency questionnaire. The Mediterranean Food Pattern (an MD index) was derived from it to assess MD adherence. We used the Edinburgh Postnatal Depression Scale to assess postpartum depression. The postpartum depression score was not statistically different between control and exercise groups (p > 0.05). A higher consumption of fruits (β = -0.242, p = 0.022), lower intake of red meat and subproducts (β = 0.244, p = 0.020), and a greater MD adherence (β = -0.236, p = 0.027) were associated with lower levels of postpartum depression. Greater adherence to the MD during pregnancy was associated with fewer depressive symptoms and a lower risk of postpartum depression. Postnatal depression was not reduced by prenatal exercise. Promoting fruit consumption while controlling the intake of red meat during pregnancy might prevent postnatal depression.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Jairo H. Migueles
- Department of Biosciences and Nutrition, Karolinska Institutet, 141 52 Huddinge, Sweden
- PROFITH “Promoting FITness and Health through Physical Activity” Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Inmaculada Alemany-Arrebola
- Department of Developmental and Educational Psychology, Faculty of Education and Sports Sciences, University of Granada, 52005 Melilla, Spain
| | - Virginia A. Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
| | - Laura Baena-García
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain
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Marín-Jiménez N, Flor-Alemany M, Baena-García L, Coll-Risco I, Castro-Piñero J, Aparicio VA. Physical fitness and maternal body composition indices during pregnancy and postpartum: the GESTAFIT project. Eur J Sport Sci 2022:1-11. [PMID: 35986555 DOI: 10.1080/17461391.2022.2115405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
We explored the association of physical fitness (PF) during pregnancy with maternal body composition indices along pregnancy and postpartum period. The study comprised 159 pregnant women (32.9 ± 4.7 years old). Assessments were carried out at the 16th and 34th gestational weeks (g.w.) and six weeks postpartum. Cardiorespiratory fitness (CRF), muscular strength (absolute and relative values) and flexibility were measured. Body composition indices were obtained by using dual-energy X-ray absorptiometry at postpartum. The results, after adjusting for potential covariates at the 16th g.w., indicated that greater CRF was associated with lower postpartum indices total fat mass, android and gynoid fat mass (all, p < 0.05). Greater absolute upper-body muscular strength was associated with greater pre-pregnancy body mass index (BMI), gestational weight gain (GWG); and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, gynoid fat mass, T-score and Z-score bone mineral density (BMD) (all, p < 0.05). Greater upper-body flexibility was associated with lower pre-pregnancy BMI; and postpartum indices body weight, BMI, lean mass, fat free mass, fat mass, android fat mass and gynoid fat mass, and with greater GWG (all, p < 0.05). At the 34th g.w., greater CRF was additionally associated with greater postpartum T-score and Z-score BMD (both, p < 0.05). In conclusion, this study reveals that greater PF levels, especially during early pregnancy, may promote a better body composition in the postpartum period. Therefore, clinicians and health promoters should encourage women to maintain or improve PF levels from early pregnancy.
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Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sports, Faculty of Sport Sciences. University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Marta Flor-Alemany
- Sport and Health University Research Institute (iMUDS), Granada, Spain
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Instituto de investigación biosanitaria, ibs, Granada, Spain
| | - Irene Coll-Risco
- Sport and Health University Research Institute (iMUDS), Granada, Spain
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education. Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) research unit, Cádiz, Spain
| | - Virginia A. Aparicio
- Sport and Health University Research Institute (iMUDS), Granada, Spain
- Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain
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The Influence of Exercise, Lifestyle Behavior Components, and Physical Fitness on Maternal Weight Gain, Postpartum Weight Retention, and Excessive Gestational Weight Gain. Int J Sport Nutr Exerc Metab 2022; 32:425-438. [PMID: 35894919 DOI: 10.1123/ijsnem.2021-0201] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 04/04/2022] [Accepted: 05/16/2022] [Indexed: 12/28/2022]
Abstract
This study examines (a) the influence of exercise, lifestyle behavior components (sedentary time, physical activity, and sleep and dietary patterns), and physical fitness on maternal weight gain, postpartum weight retention, and excessive gestational weight gain and (b) whether exercise protects against the adverse effects of impaired metabolism and nonoptimal body composition related to excessive gestational weight gain. Subjects were assigned to either a supervised concurrent (aerobic + resistance) exercise program followed 3 days/week (n = 47) or a control group (n = 54). Sedentary time, physical activity, sleep and dietary patterns (assessed by accelerometry and questionnaires), muscle strength (handgrip test), and cardiorespiratory fitness (Bruce test) were determined at gestational Weeks 16 and 33 (early-middle and late pregnancy, respectively), and at 6 weeks postpartum. Weight gain and weight retention were calculated using recorded weights at prepregnancy, early-middle, and late pregnancy, and at 6 weeks postpartum. Birth complications, maternal postpartum body composition, cardiometabolic, and inflammatory markers in maternal and umbilical cord arterial and venous blood, and in colostrum, and mature milk were also recorded. The exercise intervention reduced late weight gain (B = -2.7, SE = 0.83, p = .003) and weight retention (B = -2.85, SE = 1.3, p = .03), independent of any lifestyle behavior component or physical fitness, but did not prevent excessive weight gain. Increasing cardiorespiratory fitness, muscle strength, and sleep duration were associated with a smaller mean weight gain and lower excessive weight gain values (p < .05). Among the participants who experienced excessive weight gain, those who were exercisers had a lower body mass index and systemic tumor necrosis factor-alpha concentration, lower umbilical cord venous tumor necrosis factor-alpha and arterial interferon gamma levels, higher cord arterial interleukin-10 levels, and improved placental function compared with controls (p < .05). In summary, exercise may help optimize gestational weight gain and weight retention, and may attenuate the impaired phenotype related to excessive weight gain. Increasing cardiorespiratory fitness, muscle strength, and sleep duration might help to prevent excessive weight gain during pregnancy.
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Flor-Alemany M, Nestares T, Jiménez NM, Baena-García L, Aparicio VA. Associations between Sociodemographic Factors, Lifestyle Behaviors, Pregnancy-Related Determinants, and Mediterranean Diet Adherence among Pregnant Women: The GESTAFIT Project. Nutrients 2022; 14:nu14071348. [PMID: 35405961 PMCID: PMC9003033 DOI: 10.3390/nu14071348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 02/05/2023] Open
Abstract
We examined sociodemographic factors, lifestyle behaviors, and pregnancy-related determinants associated with adherence to the Mediterranean diet (MD) during pregnancy. A total of 152 Caucasian pregnant women were included in this cross-sectional study. Dietary habits and MD adherence were assessed with a food frequency questionnaire. Physical activity (PA) levels and physical fitness (PF) components (cardiorespiratory fitness, relative muscle strength, and flexibility) were objectively measured. A clustered overall PF index was calculated. Participants with a high MD adherence were older, had a lower body mass index (BMI), spent more time in moderate−vigorous PA, had a greater overall PF, cardiorespiratory fitness, and relative muscle strength compared to participants with low MD adherence (all, p < 0.05). When we explored factors associated with improved MD adherence with logistic regression analysis, we found that the following factors: lower pre-pregnancy BMI (OR = 2.337; p = 0.026), meeting PA recommendations (OR = 2.377; p = 0.045), higher relative muscle strength (OR = 2.265; p = 0.016), and higher overall PF (OR = 5.202; p = 0.004) increased the chances to adhere to the MD. Older age, lower BMI, greater PF, and meeting PA recommendations were associated with higher MD adherence. These factors should be considered for a better design of educational programs and guidelines focused on improving materno−fetal health status during pregnancy.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), Health Sciences Technology Park, 18007 Granada, Spain;
| | - Teresa Nestares
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Correspondence:
| | - Nuria Marín Jiménez
- Sport and Health University Research Institute (IMUDS), Health Sciences Technology Park, 18007 Granada, Spain;
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11003 Cádiz, Spain
- Biomedical Research and Innovation Institute of the Province of Cadiz (INiBICA), 11009 Cádiz, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain;
| | - Virginia A. Aparicio
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), Health Sciences Technology Park, 18007 Granada, Spain;
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12
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Flor-Alemany M, Baena-García L, Migueles JH, Henriksson P, Löf M, Aparicio VA. Associations of Mediterranean diet with psychological ill-being and well-being throughout the pregnancy course: The GESTAFIT project. Qual Life Res 2022; 31:2705-2716. [PMID: 35297499 PMCID: PMC9356938 DOI: 10.1007/s11136-022-03121-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2022] [Indexed: 01/16/2023]
Abstract
Purpose The relation between diet and maternal mental health during pregnancy might be relevant to prevent adverse materno-foetal outcomes. This study examined the association of Mediterranean diet (MD) adherence and MD components with mental health during pregnancy. Methods This secondary analysis of the GESTAFIT trial included longitudinal data from 152 pregnant women. Dietary habits were assessed with a food frequency questionnaire, and MD adherence was derived from it using the Mediterranean Food pattern. Psychological ill-being (i.e., negative affect, anxiety, and depression) and well-being (i.e., emotional intelligence, resilience, positive affect) were assessed with the Spanish version of well-established self-reported questionnaires. Cross-sectional (16th gestational week [g.w.]) and longitudinal associations (34th g.w.) between MD and mental health were studied using linear regression models. Results A greater MD adherence was inversely associated with negative affect and anxiety; and positively associated with emotional regulation, resilience and positive affect at the 16th and 34th g.w. (|β| ranging from 0.179 to 0.325, all p < 0.05). Additionally, a higher intake of whole grain cereals, fruits, vegetables, fish, olive oil and nuts, and a lower intake of red meat and subproducts and sweets were associated with lower negative affect, anxiety, depression and higher emotional regulation, resilience and positive affect throughout gestation (|β| ranging from 0.168 to 0.415, all p < 0.05). Conclusion A higher intake of whole grain cereals, fruits, vegetables, fish, olive oil and nuts, together with a lower intake of red meat and sweets, resulted in a higher MD adherence, which was associated with a better mental health during pregnancy. Supplementary Information The online version contains supplementary material available at 10.1007/s11136-022-03121-2.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, School of Pharmacy, University of Granada, Granada, Spain. .,Institute of Nutrition and Food Technology, University of Granada, Granada, Spain. .,Sport and Health University Research Institute (iMUDS), Granada, Spain.
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Ceuta, Spain
| | - Jairo H Migueles
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,PROFITH "Promoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Pontus Henriksson
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Marie Löf
- Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.,Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Virginia A Aparicio
- Department of Physiology, School of Pharmacy, University of Granada, Granada, Spain.,Institute of Nutrition and Food Technology, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain
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13
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The Protective Role of Physical Fitness on Cardiometabolic Risk During Pregnancy: The GESTAtion and FITness Project. Int J Sport Nutr Exerc Metab 2022; 32:163-176. [PMID: 35240580 DOI: 10.1123/ijsnem.2021-0274] [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: 09/28/2021] [Revised: 12/21/2021] [Accepted: 01/01/2022] [Indexed: 11/18/2022]
Abstract
Physical fitness (PF) is a cornerstone of metabolic health. However, its role in maternal-fetal metabolism during pregnancy is poorly understood. The present work investigates: (i) the association of PF with maternal and fetal cardiometabolic markers, and with clustered cardiometabolic risk during pregnancy, and (ii) whether being fit counteracts cardiometabolic abnormalities associated with overweight/obesity. Several PF components (flexibility, lower and upper body strength, and cardiorespiratory fitness [CRF]) were objectively assessed in 151 pregnant women at gestational weeks 16 and 33, and an overall PF cluster score calculated. At the same times, maternal glycemic and lipid markers, cortisol, and C-reactive protein were assessed with standard biochemical methods, along with blood pressure and a proxy for insulin resistance, and a cardiometabolic risk cluster score determined. These analytes were also measured in maternal and umbilical cord arterial and venous blood collected at delivery. PF was found to be associated with several maternal and a small number of fetal cardiometabolic markers (p < .05). Lower and upper body muscle strength, CRF, overall PF (week 16), and CRF changes (weeks 16-33) were inversely associated with clustered cardiometabolic risk (p < .05). Normal weight fit women had lower values for insulin level, insulin resistance, triglycerides, low-density lipoprotein cholesterol, C-reactive protein, and diastolic blood pressure than did overweight/obese unfit women at week 16 (p < .05). In conclusion, greater PF, especially muscle strength and CRF in early-middle pregnancy, appears to be associated with a better metabolic phenotype, and may protect against maternal cardiometabolic risk. "Keep yourself fit and normal weight before and during early pregnancy" should be a key public health message.
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Hanley SJ, Sibbick E, Varley I, Sale C, Elliott‐Sale KJ. Exercise Interventions for Weight Management During Pregnancy and up to 1 year Postpartum Among Normal Weight Women and Women with Overweight and Obesity: An Updated Systematic Review. Obes Sci Pract 2022; 8:531-544. [PMID: 36238219 PMCID: PMC9535668 DOI: 10.1002/osp4.597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/20/2022] [Accepted: 01/30/2022] [Indexed: 11/06/2022] Open
Abstract
Background Given the increased occurrence of pre‐gravid obesity in recent years, and the implications of maternal obesity for maternal and offspring health, it is evident that there is a continued need to investigate antenatal and postnatal weight management strategies and to provide evidence‐based advice for exercise‐based interventions. Given the small number of studies (n = 5) included in an original systematic review by our group in 2015, it was important to add to the dataset by assessing data published since 2015, in order to provide a more in‐depth view of current knowledge. Objective To provide an updated systematic review on studies employing exercise interventions for weight management in pregnant and postpartum women. Methods A systematic review of randomised controlled trials evaluating the effects of an exercise intervention on gestational weight gain and postpartum weight management in normal weight women, and women with overweight and obesity was conducted. PubMed, Scopus, Central Register of Controlled Trials and Web of Science were searched for studies published between September 2013 and June 2021. No restrictions were set on type, intensity, duration, or frequency of exercise intervention. Only studies that targeted body weight or mass as a primary outcome were included. Results Thirteen studies were included in this review: 11 during and two following pregnancy. Exercise significantly reduced gestational weight gain in five of the pregnancy studies and induced significant weight loss in one of the postpartum studies. Across studies, there were large disparities in exercise modality, frequency, and duration, although moderate intensity exercise was consistently employed. Conclusions Some studies showed positive effects of exercise on weight management during and following pregnancy. While there is still no consensus on effective exercise intervention approaches, it is crucial that physical activity, of any safe form, is recommended to encourage healthy weight management during this time.
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Affiliation(s)
- Stephanie J. Hanley
- Sport Health and Performance Enhancement Research Centre Nottingham Trent University School of Science and Technology Clifton Campus Clifton LaneNottingham NG11 8NS
| | - Elise Sibbick
- Sport Health and Performance Enhancement Research Centre Nottingham Trent University School of Science and Technology Clifton Campus Clifton LaneNottingham NG11 8NS
| | - Ian Varley
- Sport Health and Performance Enhancement Research Centre Nottingham Trent University School of Science and Technology Clifton Campus Clifton LaneNottingham NG11 8NS
| | - Craig Sale
- Sport Health and Performance Enhancement Research Centre Nottingham Trent University School of Science and Technology Clifton Campus Clifton LaneNottingham NG11 8NS
| | - Kirsty J. Elliott‐Sale
- Sport Health and Performance Enhancement Research Centre Nottingham Trent University School of Science and Technology Clifton Campus Clifton LaneNottingham NG11 8NS
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15
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Aparicio VA, Baena-García L, Flor-Alemany M, Martínez-González LJ, Varela-López A, Sánchez C, Quiles JL. Differences in maternal and neonatal cardiometabolic markers and placenta status by foetal sex. The GESTAFIT project. WOMEN'S HEALTH 2022; 18:17455057221117976. [PMID: 35989614 PMCID: PMC9393354 DOI: 10.1177/17455057221117976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Aims: To explore the differences in some maternal-neonatal metabolic markers and
placenta status by foetal sex. Methods: One hundred thirty-nine Caucasian pregnant women from the GESTAFIT project
and their new-borns were included in the present cross-sectional study.
Serum cardiometabolic markers (i.e. lipid and glycaemic profile and uric
acid) were analysed at late pregnancy and at birth. In placenta, telomeres
length, proportion of deleted mitochondrial-DNA and mitochondrial-DNA
density, some minerals and interleukin 8, epidermal growth factor,
fibroblast growth factor-2 and vascular endothelial growth factor were
measured. The study was run between November 2015 and April 2018. Results: Mothers carrying a male showed higher serum triglycerides than mothers
carrying a female at late pregnancy (p < .05). Serum
total and low-density lipoprotein cholesterol were greater in males’
umbilical cord blood artery compared to females’ new-borns (both,
p < .05). Mothers of males and male new-borns
presented higher uric acid than mothers of females and female new-borns at
birth (p < .05). Female’s placentas presented greater
placental-newborn weight ratio, manganese content and fibroblast growth
factor-2 (all, p ⩽ .05), and evidence of statistical
significance in telomeres length, which were 17% longer
(p = .076). Conclusion: Our findings show weak differences in some cardiometabolic and placental
status markers by foetal sex. Notwithstanding, we observed a slightly more
proatherogenic profile in both, mothers carrying males’ foetuses and male
new-borns. We also found lower serum uric acid and better placenta status in
mothers carrying a female. These findings indicate that foetal sex might
need to be considered for a more personalized follow-up of pregnancies.
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Affiliation(s)
- Virginia A Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
- Sport and Health University Research Centre, University of Granada, Granada, Spain
| | - Laura Baena-García
- Sport and Health University Research Centre, University of Granada, Granada, Spain
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
- Institute of Biosanitary Research (IBS), Granada, Spain
| | - Marta Flor-Alemany
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
- Sport and Health University Research Centre, University of Granada, Granada, Spain
| | - Luis J Martínez-González
- GENYO: Centre for Genomics and Oncological Research: Pfizer/University of Granada/Andalusian Regional Government, Granada, Spain
| | - Alfonso Varela-López
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
| | - Cristina Sánchez
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
- Sport and Health University Research Centre, University of Granada, Granada, Spain
| | - José L Quiles
- Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada, Granada, Spain
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Marín-Jiménez N, Castro-Piñero J, Rodríguez-Ayllón M, Marchán-Rubio A, Delgado-Fernández M, Aparicio VA. The favourable association of self-reported physical fitness with depression and anxiety during pregnancy. The GESTAFIT project. Eur J Sport Sci 2021; 22:1932-1940. [PMID: 34559596 DOI: 10.1080/17461391.2021.1986141] [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: 10/20/2022]
Abstract
We explored the association of self-reported physical fitness with depressive symptoms and anxiety levels during pregnancy. One hundred fifty-five pregnant women (32.9 ± 4.7 years old) participated in the study. Self-reported physical fitness was assessed with the International Fitness Scale, depressive symptoms and state anxiety levels with the Center for Epidemiological Studies-Depression Scale and the State Trait Anxiety Index, respectively, at the 16 and 34 weeks of gestation. In model 1 (adjusted for age and gestational weight gain), greater overall self-reported physical fitness was associated with fewer depressive symptoms at the 16 weeks (p = .004). Greater self-reported cardiorespiratory fitness and muscular strength were associated with lower anxiety levels at the 16 weeks (all, p > .05). Greater overall self-reported physical fitness, cardiorespiratory fitness and speed-agility were associated with lower anxiety levels at the 34 weeks (all, p > .05). These results were also confirmed in model 2 (additionally adjusted for the exercise intervention, sleep quality, educational level, working status and cohabitating), except for cardiorespiratory fitness and anxiety levels at the 16 weeks (p = .09). Greater self-reported physical fitness was associated with lower psychological ill-being during pregnancy. Specifically, at the 16 weeks, greater self-reported overall physical fitness was associated with fewer depressive symptoms, greater self-reported muscular strength with lower anxiety levels; greater self-reported overall physical fitness and speed-agility with lower anxiety levels at the 34 weeks and greater self-reported cardiorespiratory fitness with lower anxiety levels during the pregnancy. Screening of physical fitness may reduce the risk of depression and anxiety and generally improve pregnancy mental health-related quality of life.HighlightsMaternal depression and anxiety have prevalence rates between 8 and 36%.Physical fitness enhancement during pregnancy results in less depression and anxiety.Greater physical fitness may provide benefits for the mother mental health.Self-reported physical fitness screening during pregnancy may be useful in clinical settings.
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Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain.,GALENO Research Group, Department of Physical Education. Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education. Faculty of Education Sciences, University of Cádiz, Puerto Real, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Cádiz, Spain
| | - María Rodríguez-Ayllón
- Department of Physical Education and Sports, Faculty of Sport Sciences, PROFITH "PROmoting FITness and Health Through Physical Activity" Research Group, Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Alba Marchán-Rubio
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Manuel Delgado-Fernández
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), Granada, Spain.,Department of Physiology, Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM) and Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
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17
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Baena-García L, Marín-Jiménez N, Romero-Gallardo L, Borges-Cosic M, Ocón-Hernández O, Flor-Alemany M, Aparicio VA. Association of Self-Reported Physical Fitness during Late Pregnancy with Birth Outcomes and Oxytocin Administration during Labour-The GESTAFIT Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18158201. [PMID: 34360494 PMCID: PMC8346096 DOI: 10.3390/ijerph18158201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 07/26/2021] [Accepted: 07/30/2021] [Indexed: 11/16/2022]
Abstract
We explored (a) the associations between self-reported maternal physical fitness and birth outcomes; (b) whether self-reported maternal physical fitness (PF) is related to the administration of oxytocin to induce or stimulate labour. Pregnant women from the GESTAFIT project randomized controlled trial (n = 117) participated in this prospective longitudinal study. Maternal physical fitness was assessed through the International Fitness Scale at the 34th gestational week. Maternal and neonatal birth outcomes and oxytocin administration were collected from the obstetric medical records. Umbilical arterial and venous cord blood gas were analysed immediately after birth. Self-reported overall fitness, cardiorespiratory fitness, muscular strength and flexibility were not related to any maternal and neonatal birth outcomes (all p > 0.05). Greater speed-agility was associated with a more alkaline arterial (p = 0.04) and venous (p = 0.02) pH in the umbilical cord blood. Women who were administered oxytocin to induce or stimulate labour reported lower cardiorespiratory fitness (p = 0.013, Cohen's d = 0.55; 95% confidence interval (CI): 0.14, 0.93) and flexibility (p = 0.040, Cohen´s d = 0.51; 95% CI: 0.09, 0.89) compared to women who were not administered oxytocin. Greater maternal physical fitness during pregnancy could be associated with better neonatal birth outcomes and lower risk of needing oxytocin administration.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, 51001 Ceuta, Spain;
| | - Nuria Marín-Jiménez
- Sport and Health University Research Institute (iMUDS), 18007 Granada, Spain; (L.R.-G.); (M.B.-C.); (M.F.-A.)
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
- Correspondence:
| | - Lidia Romero-Gallardo
- Sport and Health University Research Institute (iMUDS), 18007 Granada, Spain; (L.R.-G.); (M.B.-C.); (M.F.-A.)
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Milkana Borges-Cosic
- Sport and Health University Research Institute (iMUDS), 18007 Granada, Spain; (L.R.-G.); (M.B.-C.); (M.F.-A.)
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Olga Ocón-Hernández
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, 18016 Granada, Spain;
| | - Marta Flor-Alemany
- Sport and Health University Research Institute (iMUDS), 18007 Granada, Spain; (L.R.-G.); (M.B.-C.); (M.F.-A.)
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain;
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
| | - Virginia A. Aparicio
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain;
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
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18
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Flor-Alemany M, Acosta P, Marín-Jiménez N, Baena-García L, Aranda P, Aparicio VA. Influence of the degree of adherence to the mediterranean diet and its components on cardiometabolic risk during pregnancy. The GESTAFIT project. Nutr Metab Cardiovasc Dis 2021; 31:2311-2318. [PMID: 34112581 DOI: 10.1016/j.numecd.2021.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/07/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND AIMS Studies regarding dietary patterns and cardiometabolic risk markers during pregnancy are scarce. The aim of the present study was to analyse whether different degrees of adherence to the Mediterranean diet (MD) and the MD components were associated with cardiometabolic markers and a clustered cardiometabolic risk during pregnancy. METHODS AND RESULTS This study comprised 119 pregnant women from the GEStation and FITness (GESTAFIT) project. Dietary habits were assessed with a food frequency questionnaire at the 16th and 34th gestational weeks (g.w.). The Mediterranean Diet Score was employed to assess MD adherence. The following cardiometabolic markers were assessed: pre-pregnancy body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting glucose, triglycerides and high-density lipoprotein cholesterol (HDL-C). A greater MD adherence was associated with a better cardiometabolic status in cross-sectional (16th g.w. and 34th g.w.) and prospective analyses (MD adherence at the 16th g.w. and cardiometabolic markers at the 34th g.w.; SBP, DBP and HDL-C; all, p < 0.05). Participants with the highest MD adherence (Tertile 3) had a lower clustered cardiometabolic risk than those with the lowest MD adherence (Tertile 1) at the 16th and 34th g.w. (both, p < 0.05). A higher intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts were associated with a lower cardiometabolic risk during pregnancy (all, p < 0.05). CONCLUSION A higher MD adherence, a greater intake of fruits, vegetables and fish and a lower intake of refined cereals and red meat and subproducts showed a cardioprotective effect throughout gestation.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, Spain; Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain.
| | - Pedro Acosta
- Sport and Health University Research Institute (iMUDS), Granada, Spain; Physical Activity for Health Promotion, CTS-1018 research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health University Research Institute (iMUDS), Granada, Spain; Physical Activity for Health Promotion, CTS-1018 research group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Pilar Aranda
- Department of Physiology, University of Granada, Spain; Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
| | - Virginia A Aparicio
- Department of Physiology, University of Granada, Spain; Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, Spain; Sport and Health University Research Institute (iMUDS), Granada, Spain
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Rodriguez-Ayllon M, Acosta-Manzano P, Coll-Risco I, Romero-Gallardo L, Borges-Cosic M, Estévez-López F, Aparicio VA. Associations of physical activity, sedentary time, and physical fitness with mental health during pregnancy: The GESTAFIT project. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:379-386. [PMID: 34024352 PMCID: PMC8167327 DOI: 10.1016/j.jshs.2019.04.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 02/13/2019] [Accepted: 03/11/2019] [Indexed: 05/21/2023]
Abstract
PURPOSE This study was aimed to analyze the associations of objectively measured physical activity (PA), sedentary time, and physical fitness with mental health in the early second trimester (16 ± 2 gestational weeks) of pregnancy. METHODS From 229 women initially contacted, 124 pregnant women participated in the present cross-sectional study. Data were collected between November 2015 and March 2017. The participants wore Actigraph GT3X+ Triaxial accelerometers for 9 consecutive days to objectively measure their PA levels and sedentary time. A performance-based test battery was used to measure physical fitness. Self-report questionnaires assessed psychological ill-being (i.e., negative affect, anxiety, and depression), and psychological well-being (i.e., emotional intelligence, resilience, and positive affect). Linear regression analyses were adjusted for age, educational level, accelerometer wear time, miscarriages, and low back pain. RESULTS Moderate-to-vigorous PA was negatively associated with depression (β = -0.222, adjusted R2 = 0.050, p = 0.041). Higher levels of sedentary time were negatively associated with positive affect (β = -0.260, adjusted R2 = 0.085, p = 0.017). Greater upper-body flexibility was positively associated with better emotional regulation (β = 0.195, adjusted R2= 0.030, p = 0.047). The remaining associations were not significant (all p > 0.05). CONCLUSION An active lifestyle characterized by higher levels of moderate-to-vigorous PA and lower levels of sedentary time during pregnancy might modestly improve the mental health of pregnant women. Although previous research has focused on the benefits of cardiorespiratory exercise, the present study shows that only upper-body flexibility is related to emotional regulation in early pregnant women. If the present findings are corroborated in further experimental research, physical exercise programs should focus on enhancing flexibility to promote improvements in emotional regulation during early second-trimester of pregnancy.
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Affiliation(s)
- María Rodriguez-Ayllon
- PROFITH "PROmoting FITness and Health through physical activity" Research Group, Sport and Health University Research Institute (iMUDS), Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain.
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Irene Coll-Risco
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Lidia Romero-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada 18071, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain
| | - Fernando Estévez-López
- Department of Psychology, Faculty of Social and Behavioral Sciences, Utrecht University, CS Utrecht 3584, the Netherlands
| | - Virginia A Aparicio
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18007, Spain; Department of Physiology, Faculty of Pharmacy and Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain
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Marín-Jiménez N, Borges-Cosic M, Ocón-Hernández O, Coll-Risco I, Flor-Alemany M, Baena-García L, Castro-Piñero J, Aparicio VA. Association of Self-Reported Physical Fitness with Pregnancy Related Symptoms the GESTAFIT Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:3345. [PMID: 33804923 PMCID: PMC8036338 DOI: 10.3390/ijerph18073345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/09/2021] [Accepted: 03/17/2021] [Indexed: 12/16/2022]
Abstract
We explored the association of physical fitness (PF) with pregnancy-related symptoms, at the 16th and 34th gestational weeks (g.w.). The International Fitness Scale and the Pregnancy Symptoms Inventory were employed to assess self-reported PF and pregnancy-related symptoms, respectively. At the 16th g.w. greater self-reported overall PF was associated with lower incidence of urinary frequency (p = 0.020); greater overall PF, cardiorespiratory fitness (CRF), muscular strength and speed-agility were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater overall PF and speed-agility were associated with lower incidence of poor sleep (both, p < 0.05); greater CRF and flexibility were associated with lower limitations by tiredness-fatigue (both, p < 0.05); and greater flexibility was associated with lower limitations by poor sleep (p = 0.021). At the 34th g.w. greater self-reported overall PF, CRF and muscular strength were associated with lower incidence of tiredness-fatigue (all, p < 0.05); greater CRF was associated with lower incidence of poor sleep (p = 0.019); and, greater flexibility was associated with lower incidence of increased vaginal discharge (p = 0.023). Adequate levels of PF, especially CRF, may help women to cope with the most endorsed pregnancy-related symptoms and its limitations, especially tiredness-fatigue and poor sleep.
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Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (N.M.-J.); (M.B.-C.)
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (I.C.-R.); (V.A.A.)
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain;
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11009 Cádiz, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain; (N.M.-J.); (M.B.-C.)
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (I.C.-R.); (V.A.A.)
| | - Olga Ocón-Hernández
- Biohealth Research Institute in Granada (ibs.GRANADA), 18012 Granada, Spain;
- Gynaecology and Obstetrics Unit, ‘San Cecilio’ University Hospital, 18016 Granada, Spain
| | - Irene Coll-Risco
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (I.C.-R.); (V.A.A.)
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
| | - Marta Flor-Alemany
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (I.C.-R.); (V.A.A.)
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, 18016 Granada, Spain;
| | - José Castro-Piñero
- GALENO Research Group, Department of Physical Education, Faculty of Education Sciences, University of Cádiz, 11519 Cádiz, Spain;
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, 11009 Cádiz, Spain
| | - Virginia A. Aparicio
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (I.C.-R.); (V.A.A.)
- Department of Physiology, Faculty of Pharmacy, University of Granada, 18011 Granada, Spain
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
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21
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Flor-Alemany M, Nestares T, Alemany-Arrebola I, Marín-Jiménez N, Borges-Cosic M, Aparicio VA. Influence of Dietary Habits and Mediterranean Diet Adherence on Sleep Quality during Pregnancy. The GESTAFIT Project. Nutrients 2020; 12:E3569. [PMID: 33233842 PMCID: PMC7699965 DOI: 10.3390/nu12113569] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/13/2020] [Accepted: 11/17/2020] [Indexed: 12/22/2022] Open
Abstract
We examined the association of the dietary habits and the Mediterranean diet (MD) adherence with sleep quality during pregnancy. A food frequency questionnaire and the Mediterranean Food Pattern were employed to assess dietary habits and MD adherence, respectively. Sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI) global score (n = 150; mean age 32.9 ± 4.6 years). A higher consumption of fruits was associated with better sleep quality at the 16th gestational week (g.w.; p < 0.05). A greater olive oil consumption and a higher MD adherence were associated with better sleep quality at the 16th and 34th g.w. (all, p < 0.05). Contrarily, a higher red meat and subproducts consumption was associated with worse sleep quality at the 34th g.w. (p < 0.05). The group with the highest adherence to the MD (Tertile 3) showed better sleep quality than the group with the lowest adherence (Tertile 1) at the 16th and 34th g.w. (both, p < 0.05). A higher adherence to the MD, a greater intake of fruits and olive oil and a lower intake of red meat and subproducts were associated with better sleep quality along the pregnancy course, especially among sedentary women.
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Affiliation(s)
- Marta Flor-Alemany
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (N.M.-J.); (M.B.-C.)
| | - Teresa Nestares
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Institute of Nutrition and Food Technology (INYTA), Biomedical Research Centre (CIBM), University of Granada, 18016 Granada, Spain
| | - Inmaculada Alemany-Arrebola
- Department of Developmental and Educational Psychology, Faculty of Education and Sports Sciences, University of Granada, 52005 Melilla, Spain;
| | - Nuria Marín-Jiménez
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (N.M.-J.); (M.B.-C.)
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Milkana Borges-Cosic
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (N.M.-J.); (M.B.-C.)
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, 18071 Granada, Spain
| | - Virginia A. Aparicio
- Department of Physiology, University of Granada, 18071 Granada, Spain; (M.F.-A.); (V.A.A.)
- Sport and Health University Research Institute (IMUDS), 18007 Granada, Spain; (N.M.-J.); (M.B.-C.)
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22
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Baena-García L, Acosta-Manzano P, Ocón-Hernández O, Borges-Cosic M, Romero-Gallardo L, Marín-Jiménez N, Aparicio VA. Objectively measured sedentary time and physical activity levels in Spanish pregnant women. Factors affecting the compliance with physical activity guidelines. Women Health 2020; 61:27-37. [PMID: 33143596 DOI: 10.1080/03630242.2020.1828231] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
The aims of this cross-sectional study were to describe objectively measured sedentary time (ST) and physical activity (PA) levels in Spanish pregnant women, to analyze the degree of compliance with PA guidelines during the early second trimester of pregnancy and to explore sociodemographic and clinical factors associated with meeting these PA guidelines. One hundred and thirty-four Caucasian pregnant women were recruited between October 2015 and October 2017 to participate in this study. Triaxial accelerometers were used to analyze ST andPA levels for seven consecutive valid days. Womenspent512 ± 92.1 minutes daily in sedentary behaviors, and 85 ± 108.2 minutes in moderate-to-vigorous physical activity (MVPA) in bouts of at least 10 minutes. They walked on average 7436 ± 2410steps per day. Only 22% of the study sample complied with the PA guidelines. Having an University degree was related with threefold higher odds of compliance with the PA guidelines (95% confidence interval: 0.096-0.913, p < .05). Binary logistic regressions showed that being primiparous was associated with fivefold higher odds of compliance with the PA guidelines (95% confidence interval 1.658-18.039, respectively, p < .01). Maternal age, BMI, marital status, working status, and previous miscarriages were not associated with compliance with PA guidelines. Pregnant women spent more than a third of the day in sedentary behaviors and the compliance with PA guidelines was less than desirable. Finally, not having an university degree or having children could be factors related to lower odds of compliance with these guidelines, and therefore require special attention from healthcare professionals.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada , Granada, Spain
| | - Pedro Acosta-Manzano
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Olga Ocón-Hernández
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain
| | - Milkana Borges-Cosic
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - Nuria Marín-Jiménez
- Sport and Health Research Centre, University of Granada , Spain.,Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada, Spain
| | - V A Aparicio
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital , Granada, Spain.,Department of Physiology, Institute of Nutrition and Food Technology and Biomedical Research Centre, University of Granada , Granada, Spain
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23
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McDonald SM, Strom C, Remchak MM, Chaves A, Broskey NT, Isler C, Haven K, Newton E, DeVente J, Acosta-Manzano P, Aparicio VA, May LE. The effects of aerobic exercise on markers of maternal metabolism during pregnancy. Birth Defects Res 2020; 113:227-237. [PMID: 32803871 DOI: 10.1002/bdr2.1780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 07/11/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Optimal maternal metabolism during pregnancy is essential for healthy fetal growth and development. Chronic exercise is shown to positively affect metabolism, predominantly demonstrated in nonpregnant populations. OBJECTIVE To determine the effects of aerobic exercise on maternal metabolic biomarkers during pregnancy, with expected lower levels of glucose, insulin, and lipids among exercise-trained pregnant women. METHODS Secondary data analyses were performed using data from two, longitudinal prenatal exercise intervention studies (ENHANCED by MOM and GESTAFIT). Exercisers completed 150 min of weekly moderate-intensity exercise during pregnancy (24+ weeks) while nonexercisers attended stretching sessions. Pregnant women were 31-33 years of age, predominantly non-Hispanic white, and "normal weight" body mass index. At 16 and 36 weeks of gestation, fasting blood samples were collected via fingerstick and venipuncture. Maternal glucose, insulin, insulin resistance (HOMA-IR), total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoproteins (HDL), and triglycerides (TG) were analyzed. ANCOVA analyses were performed to evaluate the effects of aerobic exercise on markers of maternal metabolism in late pregnancy, controlling for baseline levels. RESULTS Our sample included 12 aerobic exercisers and 54 nonexercising control groups. Significant between-groups differences at 16 weeks of gestation were found for TG (92.3 vs. 121.2 mg/dl, p = .04), TC (186.8 vs. 219.6 mg/dl, p = .002), and LDL (104.1 vs. 128.8 mg/dl, p = .002). Aerobic-trained pregnant women exhibited lower insulin levels in late pregnancy (β = -2.6 μIU/ml, 95% CI:-4.2, -0.95, p = .002) and a reduced increase in insulin levels from 16 to 36 week of gestation (β = -2.3 μIU/ml, 95% CI: -4.4, -0.2, p = .034) compared with nonexercising pregnant women. No statistically significant effects were observed for maternal HOMA-IR, TC, LDL, HDL, TC:HDL, and TG in late pregnancy. CONCLUSIONS The observations of this study demonstrate that prenatal exercise may positively affect maternal insulin, with aerobic-trained pregnant women exhibiting lower insulin levels in late pregnancy. Additionally, we found no appreciable effects of prenatal exercise on maternal lipids in late pregnancy.
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Affiliation(s)
- Samantha M McDonald
- School of Dental Medicine, Department of Foundational Sciences and Research, East Carolina University (ECU), Greenville, North Carolina, USA
| | - Cody Strom
- College of Health and Human Performance, Department of Kinesiology, ECU, Greenville, North Carolina, USA
| | - Mary-Margaret Remchak
- College of Health and Human Performance, Department of Kinesiology, ECU, Greenville, North Carolina, USA
| | - Alec Chaves
- College of Health and Human Performance, Department of Kinesiology, ECU, Greenville, North Carolina, USA
| | - Nicholas T Broskey
- College of Health and Human Performance, Department of Kinesiology, ECU, Greenville, North Carolina, USA
| | - Christy Isler
- Department of Obstetrics and Gynecology, Brody School of Medicine, ECU, Greenville, North Carolina, USA
| | - Kelley Haven
- Department of Obstetrics and Gynecology, Brody School of Medicine, ECU, Greenville, North Carolina, USA
| | - Edward Newton
- Department of Obstetrics and Gynecology, Brody School of Medicine, ECU, Greenville, North Carolina, USA
| | - James DeVente
- Department of Obstetrics and Gynecology, Brody School of Medicine, ECU, Greenville, North Carolina, USA
| | - Pedro Acosta-Manzano
- Department of Physiology, Institute of Nutrition and Food Technology, Biomedical Research Center, Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology, Biomedical Research Center, Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Linda E May
- School of Dental Medicine, Department of Foundational Sciences and Research, East Carolina University (ECU), Greenville, North Carolina, USA
- College of Health and Human Performance, Department of Kinesiology, ECU, Greenville, North Carolina, USA
- Department of Obstetrics and Gynecology, Brody School of Medicine, ECU, Greenville, North Carolina, USA
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24
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Baena-García L, Coll-Risco I, Ocón-Hernández O, Romero-Gallardo L, Acosta-Manzano P, May L, Aparicio VA. Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project. PLoS One 2020; 15:e0229079. [PMID: 32069319 PMCID: PMC7028270 DOI: 10.1371/journal.pone.0229079] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 01/29/2020] [Indexed: 12/13/2022] Open
Abstract
Aim To analyse i) the association of physical fitness during early second trimester and late pregnancy with maternal and neonatal outcomes; and ii) to investigate whether physical fitness is associated with the type of birth (vaginal or caesarean section). Methods Pregnant women from the GESTAFIT Project (n = 159) participated in this longitudinal study. Maternal physical fitness including upper- and lower-body strength, cardiorespiratory fitness (CRF) and flexibility were measured through objective physical fitness tests at the 16th and 34th gestational weeks. Maternal and neonatal outcomes were collected from obstetric medical records. Umbilical arterial and venous blood gas pH and partial pressure of carbon dioxide (PCO2) and oxygen (PO2), were assessed. Results At the 16th week, greater upper-body muscle strength was associated with greater neonatal birth weight (r = 0.191, p<0.05). Maternal flexibility was associated with a more alkaline arterial pH (r = 0.220, p<0.05), higher arterial PO2 (r = 0.237, p<0.05) and lower arterial PCO2 (r = -0.331, p<0.01) in umbilical cord blood. Maternal CRF at the 16th gestational week was related to higher arterial umbilical cord PO2 (r = 0.267, p<0.05). The women who had caesarean sections had lower CRF (p<0.001) at the 16th gestational week and worse clustered overall physical fitness, both at the 16th (-0.227, p = 0.003, confidence interval (CI): -0.376, -0.078) and 34th gestational week (-0.223; p = 0.018; CI: -0.432, -0.015) compared with the women who had vaginal births. Conclusion Increasing physical fitness during pregnancy may promote better neonatal outcomes and is associated with a decrease in the risk of caesarean section. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Department of Physiology, "José Mataix Verdú" Institute of Nutrition and Food Technology (INYTA) and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- * E-mail:
| | - Olga Ocón-Hernández
- UGC of Gynaecology and Obstetrics, “San Cecilio” University Hospital, Granada, Spain
| | - Lidia Romero-Gallardo
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- UGC of Gynaecology and Obstetrics, “San Cecilio” University Hospital, Granada, Spain
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
- UGC of Gynaecology and Obstetrics, “San Cecilio” University Hospital, Granada, Spain
- Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Linda May
- Department of Foundational Science and Research, School of Dental Medicine, East Carolina University, Greenville, NC, United States of America
| | - Virginia A. Aparicio
- Department of Physiology, "José Mataix Verdú" Institute of Nutrition and Food Technology (INYTA) and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
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25
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Liu D, Hu WL. SLK Triple Therapy Improves Maternal and Fetal Status and Promotes Postpartum Pelvic Floor Function in Chinese Primiparous Women. Med Sci Monit 2019; 25:8913-8919. [PMID: 31760401 PMCID: PMC6886325 DOI: 10.12659/msm.917330] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background During pregnancy, appropriate physical activity plays critical roles in maternal and fetal health. This study investigated the effects of Sophrology childbirth-Kegel-Lamaze respiratory training (SLK triple therapy) on maternal and newborn health, pelvic floor function, and quality of life. Material/Methods Single-pregnant primiparous women involved in this study were divided into the control group (n=120) and the SLK triple therapy group (n=120). SLK triple therapy was taught to and practiced by the women in the SLK triple therapy group. Data on delivery mode (natural delivery or cesarean section), postpartum complications (postpartum urinary incontinence, postpartum hemorrhage), and birth process were recorded. Apgar scores and body weight of newborns were evaluated. Pelvic floor function, postpartum emotion, and sexual functions were assessed. Results Women in the SLK triple therapy group had significantly better natural delivery rate compared to the control group (p<0.05). SLK triple therapy significantly decreased the postpartum urinary incontinence rate and reduced the postpartum hemorrhage rate compared to the control group (p<0.05). Birth process and postpartum hemorrhage volume in the SLK triple therapy group were also significantly lower compared to the control group (p<0.05). Apgar scores were significantly lower and body weights were significantly higher in the SLK triple therapy group compared to the control group (p<0.05). SLK triple therapy significantly improved pelvic floor function compared to the control group (p<0.05). SLK triple therapy significantly decreased SDS scores and enhanced FSFI scores compared to the control group (p<0.05). Conclusions SLK triple therapy improved maternal and fetal health by improving pregnancy outcomes, promoting postpartum pelvic floor function, reducing the incidence of depression, and enhancing sexual function. Therefore, SLK triple therapy has great utility in treating primiparous women.
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Affiliation(s)
- Dan Liu
- Medical College of Jinggangshan University, Ji'an, Jiangxi, China (mainland)
| | - Wan-Liang Hu
- Jinggangshan University, Ji'an, Jiangxi, China (mainland)
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26
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Romero-Gallardo L, Soriano-Maldonado A, Ocón-Hernández O, Acosta-Manzano P, Coll-Risco I, Borges-Cosic M, Ortega FB, Aparicio VA. International Fitness Scale-IFIS: Validity and association with health-related quality of life in pregnant women. Scand J Med Sci Sports 2019; 30:505-514. [PMID: 31650582 DOI: 10.1111/sms.13584] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 10/18/2019] [Accepted: 10/21/2019] [Indexed: 12/26/2022]
Abstract
This study aimed (a) to examine the construct validity of the International Fitness Scale (IFIS) to discriminate between different objectively measured physical fitness levels in pregnant women and (b) to assess the extent to which IFIS is able to discriminate between pregnant women with different levels of health-related quality of life (HRQoL). A total of 159 pregnant women were involved in the GESTAtion and FITness project: 106 pregnant women (mean age 32.7, SD 4.4 years) were included. Self-reported physical fitness-that is, cardiorespiratory fitness, muscular strength, flexibility, and overall fitness-was assessed with the IFIS. Physical fitness was objectively measured using the Bruce test, the handgrip strength test and the back-scratch test. The HRQoL was assessed with the 36-item Short Form Health Survey (SF-36). Higher self-reported physical fitness measured with IFIS was associated with higher objectively measured physical fitness (P < .05). There was a linear association so that higher self-reported physical fitness (ie, IFIS; regardless of the fitness component) was related to greater General Health dimension scores (P < .05). Moreover, higher self-reported physical fitness (all components except muscular strength) was associated with better Physical Functioning, lower Bodily Pain and higher Vitality scores (ie, SF-36 components). This linear trend was not seen for objectively measured physical fitness. The results of this study suggest that IFIS might be a useful tool for identifying pregnant women with low or very low physical fitness and with low quality of life health-related. Further research should elucidate whether IFIS can identify women with pregnancy complications before it can be implemented in clinical practice.
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Affiliation(s)
- Lidia Romero-Gallardo
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Alberto Soriano-Maldonado
- Department of Education, Faculty of Education Sciences, University of Almería, Almería, Spain.,SPORT Research Group (CTS-1024), CERNEP Research Center, University of Almería, Almería, Spain
| | - Olga Ocón-Hernández
- Service of Gynaeocology and Obstetrics, "San Cecilio" University Hospital, Granada, Spain
| | - Pedro Acosta-Manzano
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Department of Physiology, "José Mataix Verdú" Institute of Nutrition and Food Technology (INYTA) and Biomedical Research Centre (CIBM), University of Granada, Spain
| | - Milkana Borges-Cosic
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research Group, Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - Francisco B Ortega
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,PROFITH "PROmoting FITness and Health through physical activity" Research Group, Department of Physical Education and Sports, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Virginia Ariadna Aparicio
- Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.,Department of Physiology, "José Mataix Verdú" Institute of Nutrition and Food Technology (INYTA) and Biomedical Research Centre (CIBM), University of Granada, Spain
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27
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Acosta-Manzano P, Coll-Risco I, Van Poppel MNM, Segura-Jiménez V, Femia P, Romero-Gallardo L, Borges-Cosic M, Díaz-Castro J, Moreno-Fernández J, Ochoa-Herrera JJ, Aparicio VA. Influence of a Concurrent Exercise Training Intervention during Pregnancy on Maternal and Arterial and Venous Cord Serum Cytokines: The GESTAFIT Project. J Clin Med 2019; 8:jcm8111862. [PMID: 31684183 PMCID: PMC6912691 DOI: 10.3390/jcm8111862] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 10/29/2019] [Accepted: 10/31/2019] [Indexed: 12/11/2022] Open
Abstract
The aim of the present study was to analyze the influence of a supervised concurrent exercise-training program, from the 17th gestational week until delivery, on cytokines in maternal (at 17th and 35th gestational week, and at delivery) and arterial and venous cord serum. Fifty-eight Caucasian pregnant women (age: 33.5 ± 4.7 years old, body mass index: 23.6 ± 4.1kg/m2) from the GESTAFIT Project (exercise (n = 37) and control (n = 21) groups) participated in this quasi-experimental study (per-protocol basis). The exercise group followed a 60-min 3 days/week concurrent (aerobic-resistance) exercise-training from the 17th gestational week to delivery. Maternal and arterial and venous cord serum cytokines (fractalkine, interleukin (IL)-1β, IL-6, IL-8, IL-10, interferon (IFN)-γ, and tumor necrosis factor (TNF)-α) were assessed using Luminex xMAP technology. In maternal serum (after adjusting for the baseline values of cytokines), the exercise group decreased TNF-α (from baseline to 35th week, p = 0.02), and increased less IL-1β (from baseline to delivery, p = 0.03) concentrations than controls. When adjusting for other potential confounders, these differences became non-significant. In cord blood, the exercise group showed reduced arterial IL-6 and venous TNF-α (p = 0.03 and p = 0.001, respectively) and higher concentrations of arterial IL-1β (p = 0.03) compared to controls. The application of concurrent exercise-training programs could be a strategy to modulate immune responses in pregnant women and their fetuses. However, future research is needed to better understand the origin and clearance of these cytokines, their role in the maternal-placental-fetus crosstalk, and the influence of exercise interventions on them.
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Affiliation(s)
- Pedro Acosta-Manzano
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research group, Department of Physical Education and Sport, Faculty of Sport Sciences. University of Granada, Granada 18011, Spain.
- Sport and Health Research Centre, University of Granada, Granada 18007, Spain.
| | - Irene Coll-Risco
- Sport and Health Research Centre, University of Granada, Granada 18007, Spain.
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain.
| | | | - Víctor Segura-Jiménez
- Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz 11519, Spain.
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital University of Cádiz, Cádiz 11009, Spain.
| | - Pedro Femia
- Unit of Biostatistics, Department of Statistics, Faculty of Medicine, University of Granada, Granada 18016, Spain.
| | - Lidia Romero-Gallardo
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research group, Department of Physical Education and Sport, Faculty of Sport Sciences. University of Granada, Granada 18011, Spain.
- Sport and Health Research Centre, University of Granada, Granada 18007, Spain.
| | - Milkana Borges-Cosic
- PA-HELP "Physical Activity for Health Promotion, CTS-1018" Research group, Department of Physical Education and Sport, Faculty of Sport Sciences. University of Granada, Granada 18011, Spain.
- Sport and Health Research Centre, University of Granada, Granada 18007, Spain.
| | - Javier Díaz-Castro
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain.
| | - Jorge Moreno-Fernández
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain.
| | - Julio J Ochoa-Herrera
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain.
| | - Virginia A Aparicio
- Sport and Health Research Centre, University of Granada, Granada 18007, Spain.
- Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada 18011, Spain.
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28
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Acosta‐Manzano P, Acosta FM, Femia P, Coll‐Risco I, Segura‐Jiménez V, Díaz‐Castro J, Ochoa‐Herrera JJ, Van Poppel MNM, Aparicio VA. Association of sedentary time and physical activity levels with immunometabolic markers in early pregnancy: The GESTAFIT project. Scand J Med Sci Sports 2019; 30:148-158. [DOI: 10.1111/sms.13547] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 08/20/2019] [Accepted: 08/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Pedro Acosta‐Manzano
- Department of Physical Education and Sports Faculty of Sport Sciences PA‐HELP “Physical Activity for Health Promotion CTS‐1018” Research group University of Granada Granada Spain
- Sport and Health University Research Institute (IMUDS) University of Granada Granada Spain
| | - Francisco M. Acosta
- Sport and Health University Research Institute (IMUDS) University of Granada Granada Spain
- Department of Physical Education and Sports Faculty of Sport Sciences PROFITH “PROmoting FITness and Health through Physical Activity” research group University of Granada Granada Spain
| | - Pedro Femia
- Unit of Biostatistics Department of Statistics and OR Faculty of Medicine University of Granada Granada Spain
| | - Irene Coll‐Risco
- Sport and Health University Research Institute (IMUDS) University of Granada Granada Spain
- Department of Physiology Faculty of Pharmacy Institute of Nutrition and Food Technology University of Granada Granada Spain
| | - Víctor Segura‐Jiménez
- Department of Physical Education Faculty of Education Sciences University of Cádiz Cádiz Spain
- Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit Puerta del Mar University Hospital University of Cádiz Cádiz Spain
| | - Javier Díaz‐Castro
- Department of Physiology Faculty of Pharmacy Institute of Nutrition and Food Technology University of Granada Granada Spain
| | - Julio J. Ochoa‐Herrera
- Department of Physiology Faculty of Pharmacy Institute of Nutrition and Food Technology University of Granada Granada Spain
| | | | - Virginia A. Aparicio
- Sport and Health University Research Institute (IMUDS) University of Granada Granada Spain
- Department of Physiology Faculty of Pharmacy Institute of Nutrition and Food Technology University of Granada Granada Spain
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29
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Marín-Jiménez N, Acosta-Manzano P, Borges-Cosic M, Baena-García L, Coll-Risco I, Romero-Gallardo L, Aparicio VA. Association of self-reported physical fitness with pain during pregnancy: The GESTAFIT Project. Scand J Med Sci Sports 2019; 29:1022-1030. [PMID: 30933387 DOI: 10.1111/sms.13426] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 03/15/2019] [Accepted: 03/27/2019] [Indexed: 01/22/2023]
Abstract
AIMS To explore the association of self-reported physical fitness with bodily, lumbar and sciatic pain, and pain disability during pregnancy. METHODS The present study sample comprised 159 pregnant women (32.9 ± 4.7 years old). Self-reported physical fitness was assessed with the International Fitness Scale (IFIS), where higher scores indicate greater physical fitness. Bodily pain was assessed with the 36-Item Short Form Health Survey (SF-36), where higher scores indicate lower pain. Lumbar and sciatic pain were measured with a visual analogue scale (VAS). The Oswestry Disability Index (ODI) questionnaire was employed to assess the disability resulting from pain. Measures were assessed at 16th and 34th gestational weeks (g. w.). RESULTS Pregnant women showed low-moderate pain during pregnancy course. Most of them showed medium self-reported overall physical fitness. At 16th g. w., greater self-reported overall physical fitness and cardiorespiratory fitness were associated with less bodily and lumbar pain, and pain disability (all, P < 0.05). Greater muscular strength was associated with less bodily pain and pain disability (both, P < 0.05). Greater speed-agility was associated with less bodily pain (P < 0.01) and less pain disability (P < 0.05). Self-reported flexibility was not associated with any outcome (P > 0.05). At 34th g. w., greater overall physical fitness and its components were associated with less bodily and sciatic pain (all, P < 0.05). CONCLUSION Greater self-reported overall physical fitness and its components are associated with less bodily, lumbar and sciatic pain, and reduced pain disability during pregnancy. Future studies are needed to explore whether increasing physical fitness before and during pregnancy could decrease pain in this relevant stage.
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Affiliation(s)
- Nuria Marín-Jiménez
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Sport and Health Research Centre, University of Granada, Granada, Spain.,Department of Physiology, Biomedical Research Centre and Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain.,Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Sport and Health Research Centre, University of Granada, Granada, Spain.,Department of Physiology, Biomedical Research Centre and Sport and Health Research Centre, University of Granada, Granada, Spain
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30
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Henriksson P, Sandborg J, Blomberg M, Alexandrou C, Maddison R, Silfvernagel K, Henriksson H, Leppänen MH, Migueles JH, Widman L, Thomas K, Trolle Lagerros Y, Löf M. A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2019; 8:e13011. [PMID: 30821695 PMCID: PMC6418485 DOI: 10.2196/13011] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 01/16/2019] [Accepted: 01/18/2019] [Indexed: 01/20/2023] Open
Abstract
Background Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. Objective The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. Methods HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. Results Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. Conclusions This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy. International Registered Report Identifier (IRRID) DERR1-10.2196/13011
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Affiliation(s)
- Pontus Henriksson
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Johanna Sandborg
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marie Blomberg
- Department of Obstetrics and Gynecology, Linköping University, Linköping, Sweden.,Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Christina Alexandrou
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Burwood, Australia
| | - Kristin Silfvernagel
- Division of Psychology, Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Hanna Henriksson
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Marja H Leppänen
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Jairo H Migueles
- Department of Physical and Sports Education, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Linnea Widman
- Department of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Kristin Thomas
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
| | - Ylva Trolle Lagerros
- Clinical Epidemiology Unit, Department of Medicine, Karolinska Institutet, Solna, Sweden.,Obesity Center, Academic Specialist Center, Stockholm Health Services, Stockholm, Sweden
| | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden.,Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
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31
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Mohsenzadeh-Ledari F, Taghizadeh Z, Motaghi Z, Keramat A, Moosazadeh M, Najafi A. Appropriate Interventions for Pregnant Women with Indicators of Metabolic Syndrome on Pregnancy Outcomes: A Systematic Review. Int J Prev Med 2019; 10:2. [PMID: 30774836 PMCID: PMC6360852 DOI: 10.4103/ijpvm.ijpvm_46_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 10/07/2018] [Indexed: 11/04/2022] Open
Abstract
Metabolic syndrome (MetS), a series of symptoms, including abdominal obesity, impaired glucose tolerance and insulin metabolism, hypertension, and dyslipidemia, is considered as the risk of developing cardiovascular disease and diabetes that can predispose a pregnant women to serious health problem, women in the developed as well as the developing countries. This study was aimed to investigate the effects of appropriate interventions on pregnant women with indicators of MetS to further improve the outcome of pregnancy. This systematic review was performed to extract articles of randomized controlled trials (RCT) on pregnant women with indicators of (MetS) and focusing on physical activity, dietary or lifestyle interventions on maternal health or perinatal outcomes, with searching in the Web of Science, PubMed, CDSR, Scopus, and Google Scholar were investigated. Two researchers independently evaluated the quality of the studies, being presented in all the articles and ranked the studies as high/low quality; the level of evidence was based on the number of high-quality studies and the coordination of the obtained results. Then, 17 articles, which met the inclusion criteria, were selected; among these, 7 articles studied the physical activity, 3 articles reviewed diets, 6 probed the lifestyle interventions, and 1 article was on counseling. In general, evidence suggested how the physical activity and proper diet impacts on proper weight gain during pregnancy, prevents maternal complications, and improves the outcome of pregnancy. According to the results of this systematic review, proper interventions during pregnancy can have a positive effect on maternal weight gain and the general health condition of pregnant women with indicators of MetS.
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Affiliation(s)
- Farideh Mohsenzadeh-Ledari
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Ziba Taghizadeh
- Faculty Member of Nursing and Midwifery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Motaghi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Afsaneh Keramat
- Reproductive Studies and Women's Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ali Najafi
- Shahroud University of Medical Sciences, Shahroud, Iran
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32
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Baena-García L, Ocón-Hernández O, Acosta-Manzano P, Coll-Risco I, Borges-Cosic M, Romero-Gallardo L, de la Flor-Alemany M, Aparicio VA. Association of sedentary time and physical activity during pregnancy with maternal and neonatal birth outcomes. The GESTAFIT Project. Scand J Med Sci Sports 2018; 29:407-414. [PMID: 30450596 DOI: 10.1111/sms.13337] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 10/29/2018] [Accepted: 11/12/2018] [Indexed: 01/09/2023]
Abstract
AIM (a) To analyse the association of objectively measured sedentary time (ST) and physical activity (PA) during early second trimester of pregnancy with maternal and neonatal birth outcomes; (b) to explore if ST and PA differ between women with vaginal or caesarean section deliveries. METHODS Ninety-four Caucasian pregnant women (32.9 ± 4.6 years old) participated in this prospective longitudinal study. Triaxial accelerometers were used to assess ST and PA intensity levels for seven consecutive days during second trimester of pregnancy. Birth data were collected from the obstetric medical records. Umbilical cord arterial and venous blood gas (pH, partial pressure of carbon dioxide and oxygen, and oxygen saturation) were analysed after birth. RESULTS After adjusting for potential confounders, greater ST was associated with higher arterial and venous cord blood partial pressure of carbon dioxide and more acidic arterial and venous pH (all, P < 0.01). Moderate PA, moderate-to-vigorous PA (MVPA), total PA and steps per day were positively associated with arterial cord blood oxygen saturation (all P < 0.05). Steps per day were inversely associated with gestational age at birth (P < 0.01), and duration of first stage of labor (P < 0.05). Total and light PA were associated with a more alkaline pH in umbilical vein (all, P < 0.01). Vigorous PA was inversely associated with the Apgar score (P < 0.01). No significant differences were observed in ST and PA levels between women with vaginal and women with caesarean section deliveries (all, P > 0.10). CONCLUSION Increasing PA and decreasing ST during pregnancy might promote better maternal and neonatal birth markers.
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Affiliation(s)
- Laura Baena-García
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada, Spain
| | - Olga Ocón-Hernández
- UGC of Gynaecology and Obstetrics, San Cecilio-Campus University Hospital, Granada, Spain
| | - Pedro Acosta-Manzano
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- Department of Physiology, Institute of Nutrition and Food Technology Biomedical Research Center and Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Milkana Borges-Cosic
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Lidia Romero-Gallardo
- Department of Physical Education and Sport, Faculty of Sport Sciences, University of Granada, Granada, Spain
| | - Marta de la Flor-Alemany
- Department of Physiology, Institute of Nutrition and Food Technology Biomedical Research Center and Sport and Health Research Centre, University of Granada, Granada, Spain
| | - Virginia A Aparicio
- Department of Physiology, Institute of Nutrition and Food Technology Biomedical Research Center and Sport and Health Research Centre, University of Granada, Granada, Spain
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33
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Aparicio VA, Ocón O, Diaz-Castro J, Acosta-Manzano P, Coll-Risco I, Borges-Cósic M, Romero-Gallardo L, Moreno-Fernández J, Ochoa-Herrera JJ. Influence of a Concurrent Exercise Training Program During Pregnancy on Colostrum and Mature Human Milk Inflammatory Markers: Findings From the GESTAFIT Project. J Hum Lact 2018; 34:789-798. [PMID: 29601268 DOI: 10.1177/0890334418759261] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although exercise reduces systemic inflammation, information regarding its influence on human milk is scarce or inexistent. Research Aim: The aim of this study was to investigate the influence of an exercise intervention during pregnancy on colostrum and mature human milk inflammatory markers. METHODS The authors conducted a pseudorandomized controlled trial. The exercise group followed a concurrent aerobic and strength training, three 60-minutes sessions per week, from the 17th gestational week until delivery. For the specific aims of this study, only women able to produce enough milk were included for data analyses, resulting in 24 exercise and 23 control women. Colostrum and mature human milk proinflammatory and anti-inflammatory cytokines (fractalkine, interleukin [IL]-1β, IL-6, IL-8, IL-10, interferon [IFN]-γ, and tumor necrosis factor [TNF]-α) were measured using Luminex xMAP technology. RESULTS The mothers who followed the exercise program had 36% lower IL-8 and 27% lower TNF-α concentrations in their colostrum than those in the control group ( p < .05 and p < .01, respectively). The colostrum from mothers who followed the exercise program also presented borderline significant 22% lower IL-6 ( p < .100). The mature milk from mothers who followed the exercise program had 30% greater fractalkine ( p = .05) and borderline significant 20% higher IL-10 ( p = .100). The exercise intervention did not affect IFN-γ concentrations. CONCLUSIONS This concurrent exercise program promoted a less proinflammatory profile in human milk, especially in colostrum. Moreover, it might increase mature human milk fractalkine, which could induce a greater neurodevelopment and neuroprotection in the newborn. This trial was registered at ClinicalTrials.gov (NCT02582567) on October 20, 2015.
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Affiliation(s)
- Virginia A Aparicio
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Olga Ocón
- 2 Department and UGC of Gynaecology and Obstetrics, Virgen de las Nieves University Hospital, Granada, Spain
| | - Javier Diaz-Castro
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Pedro Acosta-Manzano
- 3 Department of Physical Education and Sport, University of Granada, Granada, Spain
| | - Irene Coll-Risco
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Milkana Borges-Cósic
- 3 Department of Physical Education and Sport, University of Granada, Granada, Spain
| | | | - Jorge Moreno-Fernández
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
| | - Julio J Ochoa-Herrera
- 1 Department of Physiology, Faculty of Pharmacy, Institute of Nutrition and Food Technology, University of Granada, Granada, Spain
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34
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Coll-Risco I, Camiletti-Moirón D, Acosta-Manzano P, Aparicio VA. Translation and cross-cultural adaptation of the Pregnancy Physical Activity Questionnaire (PPAQ) into Spanish. J Matern Fetal Neonatal Med 2018; 32:3954-3961. [PMID: 29779431 DOI: 10.1080/14767058.2018.1479849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Aim: The objective of this study was to translate and transculturally adapt into Spanish the Pregnancy Physical Activity Questionnaire. Methods: The translation procedure included a forward step (translation and synthesis) and a quantitative and qualitative control of the usefulness of the Pregnancy Physical Activity Questionnaire. Afterwards, a prefinal version of the Spanish adapted questionnaire was pretested on 58 pregnant women from Granada (south of Spain). The content, semantic, technical, conceptual, and experiential equivalents of cultural adaptation were discussed by the research members at each step. Results: After the pre-test, two items of the original Pregnancy Physical Activity Questionnaire were replaced by new items that the team considered more culturally appropriate for Spanish pregnant women. Also, some rewording into the European metric system. The response time ranged from 5 to 15 minutes. These changes were well understood and worked properly in the final version. A final version of the Pregnancy Physical Activity Questionnaire was agreed on after a discussion among the research members about the results obtained in the prefinal version. Conclusion: The final Spanish version of the Pregnancy Physical Activity Questionnaire has showed cross-cultural equivalence with the original English version.
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Affiliation(s)
- Irene Coll-Risco
- Department of Physiology, Faculty of Pharmacy, and Institute of Nutrition and Food Technology, University of Granada , Granada , Spain
| | - Daniel Camiletti-Moirón
- Department of Physical Education, Faculty of Educational Sciences, University of Cádiz , Puerto Real , Spain
| | - Pedro Acosta-Manzano
- Department of Physical and Sports Education, Faculty of Sports Science, University of Granada , Granada , Spain
| | - Virginia A Aparicio
- Department of Physiology, Faculty of Pharmacy, and Institute of Nutrition and Food Technology, University of Granada , Granada , Spain
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