scholarly journals Increased Energy Intake After Pregnancy Determines Postpartum Weight Retention in Women With Obesity

2020 ◽  
Vol 105 (4) ◽  
pp. e1601-e1611 ◽  
Author(s):  
Jasper Most ◽  
Abby D Altazan ◽  
Marshall St. Amant ◽  
Robbie A Beyl ◽  
Eric Ravussin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Body Composition ◽  
Energy Expenditure ◽  
Energy Intake ◽  
Postpartum Period ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Postpartum Weight ◽  
Metabolic Biomarkers

Abstract Context This study was designed to understand causes and critical periods for postpartum weight retention by characterizing changes in body composition, energy intake, energy expenditure and physical activity in women with obesity during pregnancy and postpartum. Design In this prospective, observational cohort study, body composition (plethysmography), energy expenditure (doubly labeled water, whole-body room calorimetry), physical activity (accelerometry), metabolic biomarkers, and eating behaviors were measured. Energy intake was calculated by the intake-balance method for pregnancy, and for 2 postpartum periods (0 to 6 months and 6 to 12 months). Results During the 18-month observation period, weight loss occurred in 16 (43%) women (mean ± SEM, −4.9 ± 1.6 kg) and weight retention occurred in 21 (57%) women (+8.6 ± 1.4 kg). Comparing women with postpartum weight loss and weight retention, changes in body weight were not different during pregnancy (6.9 ± 1.0 vs 9.5 ± 0.9 kg, P = 0.06). After pregnancy, women with postpartum weight loss lost −3.6 ± 1.8 kg fat mass whereas women with weight retention gained 6.2 ± 1.7 kg fat mass (P < 0.001). Women with postpartum weight loss reduced energy intake during the postpartum period (compared with during pregnancy) by 300 kcal/d (1255 kJ/d), while women with weight retention increased energy intake by 250 kcal/d (1046 kJ/d, P < 0.005). There were no differences in the duration of breastfeeding, eating behavior, or metabolic biomarkers. Conclusions Postpartum weight gain was the result of increased energy intake after pregnancy rather than decreased energy expenditure. Dietary intake recommendations are needed for women with obesity during the postpartum period, and women should be educated on the risk of overeating after pregnancy.

The influence of sleep quality on weight retention in the postpartum period

2021 ◽  
Vol 46 (1) ◽  
pp. 77-85
Author(s):  
Brittany A. Matenchuk ◽  
Margie H. Davenport
Keyword(s):  
Physical Activity ◽  
Sleep Quality ◽  
Postpartum Period ◽  
Vigorous Physical Activity ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Light Activity ◽  
Postpartum Weight

Poor sleep in the postpartum is often treated as an unavoidable consequence of childbirth. This study aims to compare objective and subjective measures of sleep, explore the relationship between sleep and postpartum weight retention (PPWR), and investigate factors that may contribute to sleep quality in the postpartum period. In this cross-sectional cohort, PPWR, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), and objective sleep and physical activity (accelerometry) were assessed in 109 women 0–52 weeks postpartum. Anthropometric and demographic data were collected. Gestational weight gain (GWG) was classified as inadequate, appropriate, or excessive according to Institute of Medicine guidelines. Average GWG (33.7 lbs) and PPWR (5.39 lbs) were not different between “good” (PSQI < 6) and “bad” (PSQI ≥ 6) sleepers. Following adjustment, mothers with excessive GWG who were “bad” sleepers had 5.26 higher odds of PPWR ≥ 10 lbs compared with all other combinations of GWG and PSQI. PSQI was not correlated with total sleep time (accelerometer-derived). Light activity and moderate-to-vigorous physical activity (MVPA) were associated with reduced odds of being a “bad” sleeper. The influence of GWG on PPWR was modified by postpartum sleep quality. Both light activity and meeting the MVPA guidelines in the postpartum were associated with higher sleep quality. Novelty Subjectively rated poor sleep may represent the number of awakenings and wake after sleep onset in postpartum women. Poor postpartum sleep quality increases excessive postpartum weight retention in women with excessive GWG. Women doing light-to-vigorous physical activity in the postpartum are less likely to experience poor sleep quality.

Modeling the Impact of Prepregnancy BMI, Physical Activity, and Energy Intake on Gestational Weight Gain, Infant Birth Weight, and Postpartum Weight Retention

2012 ◽  
Vol 9 (7) ◽  
pp. 1020-1029 ◽  
Author(s):  
Amy E. Montpetit ◽  
Hugues Plourde ◽  
Tamara R. Cohen ◽  
Kristine G. Koski
Keyword(s):  
Physical Activity ◽  
Energy Intake ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Gestational Weight ◽  
Prepregnancy Bmi ◽  
Prepregnancy Weight ◽  
Postpartum Weight ◽  
Infant Birth ◽  
The Impact

Background:A “fit pregnancy” requires balancing energy expenditure with energy intake (EI) to achieve appropriate gestational weight gains (GWG), healthy infant birth weights (IBW), and minimal postpartum weight retention (PPWR). Our objective was to develop an integrated conceptual framework to assess the contribution of prepregnancy weight (PP-BMI), EI, and physical activity (PA) as determinants of GWG, IBW, and PPWR.Methods:Pregnant women (n = 59) were recruited from prenatal classes. Energy intake was estimated using 3 24-hr diet recalls and PA using a validated PA questionnaire and a pedometer. Telephone interviews at 6-weeks postpartum assessed self-reported GWG, IBW, and PPWR. Hierarchical multiple regression analyses were used to explore the potential predictors of GWG, IBW, and PPWR.Results:Prepregnancy BMI was associated with GWG, and EI was associated with IBW; each model captured only 6%–18% of the variability. In contrast, PPWR was predicted by PP-BMI, GWG, and EI, which together explained 61% of its variability, whereas GWG alone explained 51% of the variability in PPWR.Conclusions:Modeling the relationship using hierarchical models suggests that PP-BMI, prepartum PA, and EI differentially impact GWG, IBW, and PPWR.

scholarly journals Session 3 (Joint with the British Dietetic Association): Management of obesity Weight-loss interventions in the treatment of obesity

2009 ◽  
Vol 69 (1) ◽  
pp. 34-38 ◽  
Author(s):  
C. R. Hankey
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Energy Expenditure ◽  
Energy Intake ◽  
Weight Maintenance ◽  
Dietary Advice ◽  
Excess Body Weight ◽  
Lifestyle Interventions ◽  
Post Intervention ◽  
Weight Losses

Treatments to induce weight loss for the obese patient centre on the achievement of negative energy balance. This objective can theoretically be attained by interventions designed to achieve a reduction in energy intake and/or an increase in energy expenditure. Such ‘lifestyle interventions’ usually comprise one or more of the following strategies: dietary modification; behaviour change; increases in physical activity. These interventions are advocated as first treatment steps in algorithms recommended by current clinical obesity guidelines. Medication and surgical treatments are potentially available to those unable to implement ‘lifestyle interventions’ effectively by achieving losses of between 5 kg and 10 kg. It is accepted that the minimum of 5% weight loss is required to achieve clinically-meaningful benefits. Dietary treatments differ widely. Successful weight loss is most often associated with quantification of energy intake rather than macronutrient composition. Most dietary intervention studies secure a weight loss of between 5 kg and 10 kg after intervention for 6 months, with gradual weight regain at 1 year where weight changes are 3–4 kg below the starting weight. Some dietary interventions when evaluated at 2 and 4 years post intervention report the effects of weight maintenance rather than weight loss. Specific anti-obesity medications are effective adjuncts to weight loss, in most cases doubling the weight loss of those given dietary advice only. Greater physical activity alone increases energy expenditure by insufficient amounts to facilitate clinically-important weight losses, but is useful for weight maintenance. Weight losses of between half and three-quarters of excess body weight are seen at 10 years post intervention with bariatric surgery, making this arguably the most effective weight-loss treatment.

scholarly journals Associations Among Leisure-Time Physical Activity, Gestational Weight Gain, and Postpartum Weight Retention With Varying Estimates of Prepregnancy Weight

2016 ◽  
Vol 11 (6) ◽  
pp. 501-510
Author(s):  
Rebecca A. Schlaff ◽  
Claudia Holzman ◽  
Kimberly S. Maier ◽  
Karin A. Pfieffer ◽  
James M. Pivarnik
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Leisure Time ◽  
Leisure Time Physical Activity ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Gestational Weight ◽  
Prepregnancy Weight ◽  
Pregnancy And Postpartum ◽  
Postpartum Weight

Prospective studies examining postpartum weight retention (PPWR) in relation to the appropriateness of gestational weight gain (GWG) and leisure-time physical activity (LTPA) during pregnancy and postpartum are lacking. While utilizing varying estimates of prepregnancy weight, we sought to prospectively examine associations among the aforementioned variables. Our sample consisted of a subset of women from the Archive for Research on Child Health Study (n = 68). Prepregnancy weight was obtained via questionnaire and birth certificates. GWG (2 estimates) was calculated by subtracting prepregnancy weight estimates from weight at delivery and classified as “excess” or “not excess.” Pregnancy and postpartum LTPA were self-reported and dichotomized at recommended levels. Prepregnancy weight estimates were subtracted from self-reported postpartum weight to calculate 2 estimates of PPWR at 6 months. Linear regression was used to examine relationships among GWG and LTPA, and PPWR. Estimates of excess GWG were associated with increased PPWR (mean difference = 3.3-8.9 kg), even after adjustment for prepregnancy body mass index and breastfeeding. Meeting pregnancy and postpartum LTPA recommendations did not significantly predict PPWR. Our findings highlight the importance of encouraging appropriate GWG and provide insight into the impact varying estimates of prepregnancy weight may have when exploring associations among these variables.

scholarly journals Maternal adiposity and energy balance after normotensive and preeclamptic pregnancies

2021 ◽  
Author(s):  
Sarah L McLennan ◽  
Amanda Henry ◽  
Lynne M Roberts ◽  
Sai S Siritharan ◽  
Melissa Ojurovic ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Body Composition ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Energy Intake ◽  
Postpartum Period ◽  
Food Diary ◽  
Lifestyle Behaviour ◽  
Cross Sectional

Abstract Background Preeclampsia is a major pregnancy complication associated with long-term maternal cardiometabolic disease. Research generally is focused on metabolic and pathophysiological changes during pregnancy, however, there is much less focus on the early postpartum period in subjects who suffered preeclampsia. The aim of this study was to (a) characterise energy intake and expenditure six months following normotensive and preeclamptic pregnancies, and (b) examine associations between energy balance, body composition, insulin resistance measures (HOMA-IR), and clinical characteristics. Design A cross-sectional study six months following normotensive (n=75) and preeclamptic (n=22) pregnancies was performed. Metabolic measurements included: anthropometrics measures, body composition via bioelectrical impedance analysis, 24-hour energy expenditure via SenseWear Armbands, energy intake via a three-day food diary, and serum metabolic parameters. Results Six months following preeclampsia, women had a significantly higher weight (77.3±20.9kg versus 64.5±11.4kg, p=0.01), fat mass percentage (FM%) (40.7±7.4% versus 34.9±8.1%, p=0.004), and insulin resistance (HOMA-IR 2.2±1.5 versus 1.0±0.7, p=0.003), as well as reduced HDL levels (1.5±0.4 mmol/L versus 1.8±0.4 mmol/L, p=0.01) compared to normotensive women. Women post-preeclampsia had lower activity-related energy expenditure (p=0.02) but a decreased total energy intake (p=0.02), leading to a more negative energy balance compared to their normotensive counterparts (-1,942 kJ/24-hours versus -480 kJ/24-hours; p=0.02). Conclusion Increases in insulin resistance and FM%, reduced HDL, and more sedentary lifestyles characterise the postpartum period following preeclamptic compared with normotensive pregnancies. Early post-preeclampsia interventions, such as lifestyle behaviour change, should be implemented and assessed to determine whether they reduce long-term cardiometabolic risk in women who experienced preeclampsia during pregnancy.

Relationship of Past-Pregnancy Physical Activity and Self-efficacy With Current Physical Activity and Postpartum Weight Retention

2013 ◽  
Vol 8 (1) ◽  
pp. 68-73 ◽  
Author(s):  
Patricia W. Bauer ◽  
James M. Pivarnik ◽  
Deborah L. Feltz ◽  
Nigel Paneth ◽  
Christopher J. Womack
Keyword(s):  
Physical Activity ◽  
Self Efficacy ◽  
Postpartum Weight Retention ◽  
Weight Retention ◽  
Postpartum Weight ◽  
Relationship Of

scholarly journals Energy intake, physical activity and body weight: a simulation model

1995 ◽  
Vol 73 (3) ◽  
pp. 337-347 ◽  
Author(s):  
Klaas R. Westerterp ◽  
Jeroen H. H. L. M. Donkers ◽  
Elisabeth W. H. M. Fredrix ◽  
Piet oekhoudt
Keyword(s):  
Physical Activity ◽  
Body Composition ◽  
Body Weight ◽  
Energy Balance ◽  
Energy Expenditure ◽  
Dietary Intake ◽  
Energy Intake ◽  
Relative Size ◽  
The Body ◽  
Fat Free Mass

In adults, body mass (BM) and its components fat-free mass (FFM) and fat mass (FM) are normally regulated at a constant level. Changes in FM and FFM are dependent on energy intake (EI) and energy expenditure (EE). The body defends itself against an imbalance between EI and EE by adjusting, within limits, the one to the other. When, at a given EI or EE, energy balance cannot be reached, FM and FFM will change, eventually resulting in an energy balance at a new value. A model is described which simulates changes in FM and FFM using EI and physical activity (PA) as input variables. EI can be set at a chosen value or calculated from dietary intake with a database on the net energy of foods. PA can be set at a chosen multiple of basal metabolic rate (BMR) or calculated from the activity budget with a database on the energy cost of activities in multiples of BMR. BMR is calculated from FFM and FM and, if necessary, FFM is calculated from BM, height, sex and age, using empirical equations. The model uses existing knowledge on the adaptation of energy expenditure (EE) to an imbalance between EI and EE, and to resulting changes in FM and FFM. Mobilization and storage of energy as FM and FFM are functions of the relative size of the deficit (EI/EE) and of the body composition. The model was validated with three recent studies measuring EE at a fixed EI during an interval with energy restriction, overfeeding and exercise training respectively. Discrepancies between observed and simulated changes in energy stores were within the measurement precision of EI, EE and body composition. Thus the consequences of a change in dietary intake or a change in physical activity on body weight and body composition can be simulated.

scholarly journals Effect of physical activity on weight loss, energy expenditure, and energy intake during diet induced weight loss

Obesity ◽  
2013 ◽  
Vol 22 (2) ◽  
pp. 363-370 ◽  
Author(s):  
James P. DeLany ◽  
David E. Kelley ◽  
Kazanna C. Hames ◽  
John M. Jakicic ◽  
Bret H. Goodpaster
Keyword(s):  
Physical Activity ◽  
Weight Loss ◽  
Energy Expenditure ◽  
Energy Intake

scholarly journals Evolution of Postpartum Weight and Body Composition after Excessive Gestational Weight Gain: The Role of Lifestyle Behaviors—Data from the INTER-ACT Control Group

2021 ◽  
Vol 18 (12) ◽  
pp. 6344
Author(s):  
Margriet Bijlholt ◽  
Lieveke Ameye ◽  
Hanne van Uytsel ◽  
Roland Devlieger ◽  
Annick Bogaerts
Keyword(s):  
Body Composition ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Postpartum Weight Retention ◽  
Lifestyle Behaviors ◽  
Weight Retention ◽  
Fat Percentage ◽  
Gestational Weight ◽  
Excessive Gestational Weight Gain ◽  
Postpartum Weight

Women with excessive gestational weight gain are at increased risk of postpartum weight retention and potentially also unfavorable body composition. Insight into the lifestyle behaviors that play a role in the evolution of postpartum weight and body composition among these women could aid identification of those at highest risk of long-term adverse outcomes. This secondary analysis of the INTER-ACT randomized controlled trial investigates control group data only (n = 524). The evolution of weight retention, percentage loss of gestational weight gain, fat percentage, waist circumference, and associated lifestyle behaviors between 6 weeks and 12 months postpartum were assessed using mixed model analyses. At six weeks postpartum, every sedentary hour was associated with 0.1% higher fat percentage (P = 0.01), and a higher emotional eating score was associated with 0.2% higher fat percentage (P < 0.001) and 0.3 cm higher waist circumference (P < 0.001). Increase in emotional eating score between 6 weeks and 6 months postpartum was associated with a 0.4 kg (P = 0.003) increase in postpartum weight retention from six months onwards. Among women with overweight, an increase in the uncontrolled eating score between 6 weeks and 6 months postpartum was associated with a 0.3 kg higher postpartum weight retention (P = 0.04), and 0.3% higher fat percentage (P = 0.006) from six months onwards. In conclusion, sedentary and eating behaviors play important roles in postpartum weight and body composition of women with excessive gestational weight gain and should therefore be incorporated as focal points in lifestyle interventions for this population.

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