Low Resting Energy Expenditure Is Associated with High Gestational Weight Gain Only When Resting Energy Expenditure Fluctuates

Abstract Objectives Resting energy expenditure (REE) comprises 60% of total energy expenditure and variations may be associated with gestational weight gain (GWG). There is a paucity of research investigating the relationship between REE and GWG. We investigated variations in REE and dietary composition throughout the second trimester and their association with GWG. Methods In this controlled trial, pregnant women (N = 16, mean age of 29.9 ± 4.3 years) with a gestational age < 17 weeks used the Breezing™ device for 13 weeks. This device is a real-time metabolism tracker that measures REE via indirect calorimetry. Height, weight, REE, and dietary intake via 24-hr recall were assessed every 2 weeks. Rate of GWG was calculated as weight gain divided by number of study weeks. Early (EC, GA wks 14–21), late (LC, GA wks 21–28), and overall (OC, GA wks 14–28) changes in macronutrient composition, REE, and GWG were used to evaluate time-specific associations. Group differences were analyzed using a General Linear Model in SPSS Version 25. Results Among the 16 participants, 25% of women were normal weight, 50% were overweight, and 25% were obese at study start. Women had a total and rate of GWG of 8.1 ± 2.9 kg and 0.6 ± 0.2 kg/wk, respectively. REE increased 72 ± 211 kcals/d during the early period, 121 ± 294 kcals/d during the late period, and 200 ± 316 kcals/d overall (from 1544 ± 237 kcal/d to 1744 ± 384 kcal/d). Early changes in REE were significantly correlated with the late changes in total (r = 0.52, P = 0.04) and rate of weight gain (r = 0.54, P = 0.03). A correlation between overall changes in REE and total weight gain was moderate and approached significance, r = 0.44, P = 0.09. Changes in total energy, fat, carbohydrate, and protein intake were not correlated with changes in REE; however, a moderate relationship between early changes in REE and overall changes in energy intake approached significance, r = 0.46, P = 0.07. Changes in GWG and REE did not differ among normal, overweight, or obese women (EC: F(2,15) = 0.36, P = 0.70; LC: F(2,15) = 2.37, P = 0.13; OC: F(2.15) = 1.27, P = 0.31). Conclusions Early changes in REE demonstrated a moderate, positive correlation with total and rate of GWG suggesting that assessment of REE early in pregnancy may help understand changes in GWG. Future research that evaluates both REE and dietary composition throughout pregnancy may provide insight into appropriate GWG. Funding Sources Project HoneyBee, Arizona State University.

Download Full-text

Resting energy expenditure guided intervention for gestational weight gain in obese and overweight women

10.21203/rs.2.16248/v1 ◽

2019 ◽

Author(s):

Xiuling Zhao ◽

Wei Ma ◽

Caixia Zhang ◽

Pili Xu ◽

Chunmei Zhang ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Gestational Weight Gain ◽

Intervention Group ◽

Resting Energy Expenditure ◽

Control Group ◽

Overweight Women ◽

Gestational Weight ◽

Beijing China ◽

Resting Energy

Abstract Background There is sparse in the literature on resting energy expenditure guided intervention to manage gestational weight gain in obese and overweight women.Methods We conducted a prospective cohort study in Beijing, China between May 1, 2017 and April 30, 2018. Obese/overweight women who visited the Department of Obstetrics and Gynecology at LuHe hospital of Capital Medical University, a tertiary care facility in Beijing, China, for their routine prenatal care at 10-13 weeks of gestation during the study period were recruited into the study after written consent was obtained. Women whose pre-pregnant body mass index was < 25Kg/m2 or who took steroid medication or those diagnosed with thyroid disease or affected by pre-pregnant diabetes mellitus or for other reasons could not participate in the study assessments were excluded. Participants who were recruited between May 1, 2017 and December 30, 2017 were the designated control group with diet recommendation based on pre-pregnancy body mass index and ideal weight, without resting energy expenditure monitoring. Those who were recruited between November 1, 2017 and April 30, 2018 were the intervention group, with resting energy expenditure guided diet recommendation to manage gestational weight gain. Gestational weight gain and perinatal outcomes between the two study groups were then compared.Results A total of 53 eligible women (32 in intervention group and 21 in control group) were recruited and included in the final analysis. There was no difference in baseline demographic and clinical characteristics between the two groups. Gestational weight gain in the intervention group (13.45±4.16 Kg) was lower than in the control group (18.20±4.84 Kg). Rate of macrosomia in the intervention group (3.12%) was also lower than in the control group (19.05%). There was no fetal growth restriction observed in either group.

Download Full-text

Resting Energy Expenditure Relationship with Macronutrients and Gestational Weight Gain: A Pilot Study

Nutrients ◽

10.3390/nu12020450 ◽

2020 ◽

Vol 12 (2) ◽

pp. 450

Author(s):

Kiley B. Vander Wyst ◽

Matthew P. Buman ◽

Gabriel Q. Shaibi ◽

Megan E. Petrov ◽

Elizabeth Reifsnider ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Gestational Weight Gain ◽

Maternal Diet ◽

Resting Energy Expenditure ◽

Gestational Weight ◽

And Control ◽

The Impact ◽

Hispanic White ◽

Resting Energy

Resting energy expenditure (REE) comprises 60% of total energy expenditure and variations may be associated with gestational weight gain (GWG) or maternal diet. The objective of this study was to examine the impact of metabolic tracking on GWG and the association with maternal macronutrients. Pregnant women aged 29.8 ± 4.9 years (78.6% non-Hispanic, White) with gestational age (GA) < 17 week were randomized to Breezing™ (n = 16) or control (n = 12) groups for 13 weeks. REE by Breezing™ indirect calorimetry, anthropometrics and dietary intake were collected every two weeks. Early (14–21 weeks), late (21–28 weeks), and overall (14–28 weeks) changes in macronutrients and GWG were calculated. The Breezing™ group had a significantly greater rate of GWG [F (1,23) = 6.8, p = 0.02] in the latter half of the second trimester. Late (−155.3 ± 309.2 vs. 207.1 ± 416.5 kcal, p = 0.01) and overall (−143.8 ± 339.2 vs. 191.8 ± 422.2 kcal, p = 0.03) changes in energy consumption were significantly different between Breezing™ and control groups, respectively. Early changes in REE were positively correlated with overall changes in carbohydrates (r = 0.58, p = 0.02). Regular metabolism tracking alone did not have an impact on GWG. Early shifts in REE might impact GWG later in pregnancy. Investigation in a larger population from preconception through postpartum is needed.

Download Full-text

Resting Energy Expenditure Relationship with Macronutrients and Gestational Weight Gain: A Pilot Study

10.21203/rs.2.16720/v1 ◽

2019 ◽

Author(s):

Kiley B. Vander Wyst ◽

Matthew P. Buman ◽

Gabriel Q. Shaibi ◽

Megan E. Petrov ◽

Elizabeth Reifsnider ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Dietary Intake ◽

Gestational Weight Gain ◽

Resting Energy Expenditure ◽

Second Trimester ◽

Or Education ◽

Gestational Weight ◽

The Impact ◽

Resting Energy

Abstract Background: Resting energy expenditure (REE) comprises 60% of total energy expenditure and variations may be associated with gestational weight gain (GWG) or maternal diet. The objective of this study was to examine the impact of ambulatory metabolic tracking on GWG and the association with maternal macronutrient composition during mid-pregnancy. Methods: Pregnant women aged 29.8±4.9 yr (78.6% non-Hispanic, White) with gestational ages (GA) < 17 wk were randomized to Breezing™ (N=16) or control (N=12) groups for 13 wks. REE by Breezing™ indirect calorimetry, anthropometrics and dietary intake were collected every two weeks. Early (GA weeks 14-21), late (GA weeks 21-28), and overall (GA week 14-28) changes in macronutrients and GWG were calculated. Results: Overall total and rate of GWG did not differ by group but Breezing™ women had lower rate and total GWG in the beginning of the second trimester but gained significantly more weight [F(1,24)=5.29, p=0.03] in the latter half. Independent of group assignment, early increases in REE were associated with an increased rate of GWG later in pregnancy (r=0.53, p=0.05). Dietary intake did not differ by group at baseline; however, overall energy (-144±339 vs. 192±422, p=0.03) and protein (-10±24 vs. 13±31, p=0.05) intake were significantly lower for the Breezing than the control women which primarily occurred in the latter half of the second trimester. Conclusion: Regular metabolism tracking alone did not have an impact on GWG. Assessment of REE during pregnancy in conjunction with nutritional counseling or education may result in improvements in GWG.

Download Full-text

Variations in resting energy expenditure: impact on gestational weight gain

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.05.054 ◽

2017 ◽

Vol 217 (4) ◽

pp. 445.e1-445.e6 ◽

Cited By ~ 12

Author(s):

E.K. Berggren ◽

P. O’Tierney-Ginn ◽

S. Lewis ◽

L. Presley ◽

S. Hauguel De-Mouzon ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Gestational Weight Gain ◽

Resting Energy Expenditure ◽

Gestational Weight ◽

Resting Energy

Download Full-text

Resting Energy Expenditure Guided Intervention for Gestational Weight Gain in Obese and Overweight Women

10.21203/rs.3.rs-38597/v1 ◽

2020 ◽

Author(s):

Xiuling Zhao ◽

Wei Ma ◽

Caixia Zhang ◽

Pili Xu ◽

Chunmei Zhang ◽

...

Keyword(s):

Weight Gain ◽

Energy Expenditure ◽

Gestational Weight Gain ◽

Intervention Group ◽

Resting Energy Expenditure ◽

Control Group ◽

Overweight Women ◽

Gestational Weight ◽

Beijing China ◽

Resting Energy

Abstract BackgroundThere is sparse in the literature on resting energy expenditure guided intervention to manage gestational weight gain in obese and overweight women. Methods We conducted a prospective cohort study in Beijing, China between May 1, 2017 and April 30, 2018. Obese/overweight women who visited the Department of Obstetrics and Gynecology at LuHe hospital of Capital Medical University, a tertiary care facility in Beijing, China, for their routine prenatal care at 10-13 weeks of gestation during the study period were recruited into the study after written consent was obtained. Pregnant women who took steroid medication or who were diagnosed with thyroid disease or affected by pre-pregnant diabetes mellitus or for other reasons could not participate in the study assessments were excluded. Women who were recruited between May 1, 2017 and November 30, 2017 were the designated control group with diet recommendation based on pre-pregnancy body mass index and ideal weight, without resting energy expenditure monitoring. Women who were recruited between December 1, 2017 and April 30, 2018 were the intervention group, with resting energy expenditure guided diet recommendation to manage gestational weight gain. Gestational weight gain and perinatal outcomes between the two groups were compared.ResultsA total of 53 eligible women (32 in intervention group and 21 in control group) were recruited and included in the final analysis. There was no difference in baseline demographic and clinical characteristics between the two groups. Gestational weight gain (GWG) in the intervention group (13.45±4.16 Kg) was lower than in the control group (18.20±4.84 Kg). Rate of excess GWG in the intervention group (37.59%) was also lower than in the control group (66.67%). The REE in women of the intervention group with excess GWG increased faster than women with appropriate GWG during pregnancy, especially from 1st trimester to 2nd trimester. Rate of macrosomia in the intervention group (3.12%) was lower than in the control group (19.05%). There was no fetal growth restriction observed in either group. Conclusion: Resting energy expenditure guided nutrition intervention during pregnancy may lower GWG and lower incidence of macrosomia, with no apparent impact on fetal growth restriction. Future studies with larger sample size and randomized controlled trial design are needed to confirm findings from this small-scale study.

Download Full-text