39fuel utilization in exercise and pregnancy
Measurements by indirect calorimetry reveal preferential use of carbohydrates during exercise in pregnancy 53 . The respiratory exchange ratio RER reflects the ratio between CO2 output and oxygen uptake VO2 . The RER provides information on the proportion of substrate derived from various macronutrients. For carbohydrate to be completely oxidized to CO2 and H2O, one volume of CO2 is produced for each volume of O2 consumed. An RER of 1 indicates carbohydrates are being utilized, while an RER of...
536 Macrosomia Shoulder Dystocia and Fetal Death
Several large US population-based cohort studies have shown a significant relationship between progestational BMI and macrosomia, which is defined as a birth weight gt 4,000 g or above the 90th percentile 40, 44-46 . Risk for having a macrosomic infant appears to increase in mothers with degree of excess weight. For example, in the multicenter study by Weiss et al. 31 , the incidence of macrosomia was 8.3 in nonobese women, 13.3 in obese women, and 14.6 in morbidly obese women. In the study by...
Optimal Weight Gain
Grace A. Falciglia and Kristin H. Coppage Summary Optimal birth weight and outcome are influenced by maternal weight gain. Low gestational weight gain is associated with poor fetal growth and risk of preterm delivery. Excessive weight gain affects infant growth, body fatness in childhood, and the potential for postpartum weight retention and future obesity. Guidelines from the Institute of Medicine recommend that a woman with a normal body mass index BMI of 19.8 to 26 should gain 11.5-16 kg 25...
14 development of a food pattern meeting nutrient recommendations
The key recommendations in the 2005 Dietary Guidelines regarding nutrient adequacy emphasize the importance of consuming a variety of nutrient-dense foods and beverages within and among the five basic food groups. The 2005 Dietary Guidelines Advisory Committee recognized, however, that the general public would benefit from guidance on specific food patterns that meet the DRIs. The Dietary Guidelines' key recommendations emphasize the types of foods to select, but lack the specificity needed by...
references Ouq
1. American College of Obstetricians and Gynecologists 2002 Exercise during pregnancy and the postpartum period ACOG Committee Opinion No. 267. Obstet Gynecol 99 171-173 2. Blair SN, Kohl HW, Paffernberges RS, Clark DG, Cooper KH, Gibbons LW 1989 Physical fitness and all-cause mortality a prospective study of healthy men and women. J Am Med Assoc 262 2395-23401 3. Bouchard C, Shephard RL, Stephens RL, Stephens T eds 1994 Physical activity fitness and health international proceeding and...
41 introduction
The traditional wisdom of many cultures relates that what women eat while they are pregnant or lactating can have long-lasting effects on their children. Many of these food traditions evolved to protect and provide strength to both mother and child because of the high mortality that was typically associated with pregnancy and the early postpartum period 1 . Although there is little science-based evidence to support their efficacy, these practices, which revolve around a cuisine that combines...
22 gestational weight gain recommendations
Although the need for appropriate weight gain during pregnancy has long been recognized, recommendations for weight gain have changed over the years as new data have become available. The changes in recommended ranges for gestational weight gain are summarized in Table 2.1. Prior to 1970, it was standard obstetric practice to restrict gestational weight gain to between 18 and 20 lb 8-9 kg 2 . Overeating was believed to cause large babies and, as a consequence, more difficult deliveries. In...
Sarah C Couch and Richard J Deckelbaum
Summary Obesity in pregnancy is associated with numerous maternal and neonatal complications including difficulty conceiving, increased risk of miscarriage, fetal anomalies and mortality, higher rates of gestational hypertension, gestational diabetes and preeclampsia, and an increased risk of cesarean section and delivery related complications. Nevertheless, more women are entering pregnancy with excessive weight and are gaining weight above the Institute of Medicine IOM recommendations during...
Preface
Handbook of Nutrition and Pregnancy is written for the clinician and other healthcare professionals who treat and counsel pregnant women and women of childbearing age. Thus, physicians, physicians' assistants, nurses, and dietitians, in particular, as well as dietetic students and graduate and medical students, will find this book a useful resource. In addition to the historical perspective and background to support recommendations that are provided in each chapter, important for the...
1 Nutrient Recommendations and Dietary Guidelines for Pregnant Women
Lorrene D. Ritchie and Janet C. King Summary The requirements for selected nutrients increase appreciably during pregnancy. The recommended intakes for the following nutrients are gt 25 higher than are the amounts recommended for nonpregnant women protein, a-linolenic acid, iodine, iron, zinc, folate, niacin, riboflavin, thiamin, and vitamin B6. The needs for protein, iron, folate, and vitamin B6 are about 50 higher. Good food sources of these nutrients are grains, dark green or orange...
Contributors
Raul Artal, md Department of Obstetrics, Gynecology, and Women's Health, Saint Louis University, School of Medicine, St. Louis, MO Lynn B. Bailey, phd Food Science and Human Nutrition, University of Florida, Gainesville, FL John Beard, phd Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA Cheryl Tatano Beck, dnsc, cnm, faan School of Nursing, University of Connecticut, Storrs, CT Linda Bloom, cnm, nd Department of OB GYN, Cleveland Clinic, Macedonia, OH...