File Name: nutrition and exercise during pregnancy .zip
This clinically and practice oriented, multidisciplinary book is intended to fill the gap between evidence-based knowledge on the benefits of physical activity and exercise during pregnancy and the implementation of exercise programmes and related health promotion measures in pregnant women. It will provide medical, sports, and fitness professionals both with the knowledge needed to allay undue fears regarding the consequences of exercising during pregnancy and with the practical expertise to offer optimal guidance on exercising to pregnant exercisers and athletes. Readers will find up-to-date evidence on the psychological, social, physiological, body composition, musculoskeletal, and biomechanical changes that occur during pregnancy and their implications for physical activity and exercise.
J Am Osteopath Assoc ; 8 — Context: Obstetric providers are logical choices for conveying information about physical activity to their pregnant patients.
However, research regarding obstetric providers counseling pregnant patients about physical activity is sparse. Objectives: To investigate the association between obstetric providers discussing exercise with their pregnant patients and patients' exercise behaviors and to explore factors related to obstetric providers discussing exercise and other health behaviors tobacco use, alcohol use, and nutrition with their patients.
Methods: We received completed surveys from pregnant women and 31 obstetric providers at 12 obstetrician offices. The offices were located throughout the United States and were heterogeneous in regards to patient insurance coverage, number of patients treated per month, and percentage of patients with complications. The odds of obstetric providers discussing exercise with pregnant patients increased 7-fold OR, 7.
Conclusion: Patient discussions with obstetric providers about exercise and patient attention to eating habits are associated with exercising during pregnancy. A more multibehavioral approach by obstetric providers may improve the likelihood that patients exercise during pregnancy. Sign In. Forgot password? August Linda E. Glaros, PhD. Author Notes. Address correspondence to Richard R. E-mail: rsuminski kcumb. Article Information.
Get Citation Citation. Alerts User Alerts. You will receive an email whenever this article is corrected, updated, or cited in the literature. You can manage this and all other alerts in My Account. Women who exercise during pregnancy benefit in multiple ways, including improved cardiovascular health, less weight gain, more appropriate blood glucose levels, and decreased risk of gestational diabetes.
To achieve these benefits, pregnant women must exercise regularly throughout their pregnancy. The advice received from such sources may not accurately represent the safety and benefits of exercise during pregnancy and may not be authoritatively tailored to the specific circumstances of a woman's pregnancy.
Obstetric providers, as defined for the purposes of this study, are practicing obstetricians, nurse practitioners, and certified nurse-midwives who offer pregnancy-related health services in a systematic way to individuals, families, and communities. Most obstetric providers agree with empirical evidence supporting the benefits of exercise during normal pregnancies. Additional information on this topic is needed to better understand exercise behavior during pregnancy and the role played by obstetric providers.
Therefore, the objective of the present study was to examine the association between obstetric providers' discussions about exercise with their pregnant patients and the pregnant patients' exercise and other health behaviors. We also explored the factors associated with whether obstetric providers discussed exercise with their pregnant patients.
Using a cross-sectional, retrospective study design, we examined characteristics and behaviors of pregnant women and of obstetric providers working in obstetrician clinics located throughout the United States.
Women were included if they were aged 18 years or older, were either pregnant or had given birth in the past year, and did not have complications during their pregnancy that limited or restricted exercise. Obstetric providers who completed questionnaires were obstetricians, nurse practitioners, and certified nurse-midwives working at the clinic certified for obstetrics-gynecology clientele and whose job responsibilities required direct contact with pregnant patients.
In addition, all participants were able to read and write in English. To target obstetric providers and to maximize the response rate, we obtained the names and addresses of obstetric providers currently employed within the United States from an alumni relations office at a large midwestern university with an osteopathic medical school.
In January , we mailed packets to 52 obstetrics-gynecology clinics. Each packet contained instructions, 25 patient and 5 obstetric provider questionnaires to be completed anonymously , and 1 self-addressed return envelope for all materials.
Clinics received 3 monthly follow-up letters to encourage return of completed questionnaires. The packet instructions described our research survey process, explained how the questionnaires should be completed, and included the names and contact information of the investigators in case the survey participants had any questions.
The instruction letters attached to the surveys clearly stated that participation for both groups was voluntary. The study protocol was approved by the university's institutional review board. A item patient questionnaire and a item obstetric provider questionnaire were developed according to previous research for assessing health care behaviors of pregnant patients and obstetric providers' interactions with their pregnant patients.
In stage 1, panel members reviewed each item and proposed conceptual or grammatical revisions. During stage 2, panel members reached consensus on proposed item revisions to maximize face and content validity. Preliminary versions of the questionnaires were pilot tested with pregnant women and obstetric providers to ensure that the questions were clear and concise. The patient questionnaires were given to pregnant women as they waited for their appointments. Seven questions were used to assess patient demographics ie, age, ethnicity, education level, and insurance status and pregnancy-related information ie, number of pregnancies, week of pregnancy or weeks postpartum, and number of times the practice was visited.
In question 9, patients responded to 3 items regarding their health behaviors related to smoking tobacco, drinking alcohol, and eating healthy foods; these items were also scored as yes or no. Question 10 concerned current levels of exercise. In the obstetric provider questionnaire, 6 questions assessed demographic variables ie, age and sex, ethnicity, and profession and practice information ie, percentage of patients with private insurance, number of pregnant patients seen per month, and percentage of patients with complications.
Four questions were used to determine whether obstetric providers discussed health behaviors related to smoking, drinking alcohol, nutrition, and exercising with their pregnant patients.
For each health behavior, the responses available were 1 always, 2 very frequently, 3 frequently, 4 sometimes, 5 infrequently, 6 very infrequently, and 7 never. Patient and obstetric provider data were expressed as mean standard deviation [SD] or as percentages where appropriate. The same analytical procedures were followed to contrast select variables between obstetric providers who always, very frequently, or frequently discussed exercise with their pregnant patients and obstetric providers who sometimes, infrequently, very infrequently, or never discussed exercise with their pregnant patients.
Binary logistic regression analysis was conducted to determine if patients who exercised were more likely to have discussed exercise with their obstetric provider.
In this regression model, patient exercise status exerciser vs nonexerciser was the dependent variable, and patient demographics, the number of other health behaviors discussed with the obstetric provider, and whether exercise was discussed with the obstetric provider were the independent ie, predictor variables. Another binary logistic regression model was constructed to determine if self-reported characteristics of the obstetric providers were associated with obstetric providers' discussions about exercise with their pregnant patients.
Of the 52 clinics that received the materials, 12 A total of patients and 31 obstetric providers completed questionnaires from these 12 clinics, which were located throughout the United States. According to survey responses, the offices were heterogeneous for patient insurance coverage, number of patients seen per month, and percentage of patients with complications.
Among the obstetric providers who completed surveys, 19 Differences between the patient groups on education level, insurance status, ethnicity, age, and week of pregnancy were not statistically significant. Table 1. Exercisers were defined as those who engaged in recommended levels of moderate to vigorous aerobic exercise; all others were considered nonexercisers.
Ten exercisers and 4 nonexercisers were postpartum patients. Abbreviation: SD, standard deviation. The results of the regression analysis used to examine predictors of exercise in pregnant patients are presented in Table 2. After controlling for patient age, ethnicity, and the number of other behavior changes encouraged by the obstetric providers, obstetric provider discussion of exercise was found to be associated with patient behavior.
For instance, the probability of being an exerciser was significantly greater for patients who discussed exercise with their obstetric provider than for those who did not discuss exercise with their obstetric provider OR, 2.
We also found a statistically significant association between diet conscientiousness and exercise status during pregnancy. Table 2. Statistically significant differences were found between obstetric providers who discussed and those who did not discuss exercise with their pregnant patients Table 3.
Table 3. The results of the regression analysis used to examine factors associated with obstetric providers discussing exercise with their pregnant patients are given in Table 4. Obstetric providers were more likely to discuss exercise with pregnant patients if they discussed other health behaviors with their patients OR, 7. The probability of obstetric providers discussing exercise with their pregnant patients increased 7-fold for each additional health behavior discussed.
Although there were statistically significant differences in demographic group comparisons, regression analysis revealed that discussing exercise with pregnant patients was not associated with obstetric provider age OR, 3. Table 4. The first objective of the present study was to examine the association between obstetric providers discussing exercise with their pregnant patients and the patients' exercise behavior. We found that women whose obstetric providers discussed exercise with them were more likely to exercise during pregnancy.
The second aim of the study was to explore factors related to obstetric providers discussing exercise with their pregnant patients. The results indicate that obstetric providers who discussed exercise with their pregnant patients also discussed multiple health behaviors with their pregnant patients. Our results suggest that obstetric providers' discussion of exercise with their pregnant patients is associated with a significantly greater likelihood that the patient will engage in exercise.
These findings are similar to those reported elsewhere showing the positive impact of patient education and counseling on health behaviors during pregnancy.
Regular maternal exercise, at or above ACOG minimum recommendations, leads to augmented fetal and neonatal cardiac autonomic control, similar to the lower resting heart rate seen in an adult exercise-trained response. The results of previous studies 15 , 16 suggest that obstetric providers may not be familiar with the current guidelines for exercise during pregnancy and may not possess adequate knowledge about the outcomes associated with exercising during pregnancy.
With this in mind, obstetric providers may be reluctant to discuss exercise with their pregnant patients because the providers are not sure what is appropriate or safe. The need for obstetric providers to counsel patients about exercise has been previously recognized, and numerous effective strategies have been articulated. Obstetric providers who discussed tobacco use, alcohol use, and nutrition with their pregnant patients were more likely to discuss exercise with their pregnant patients.
Research suggests that osteopathic physicians are more cognizant of their own health habits than are allopathic physicians and may be more likely to encourage healthy lifestyle practices among their patients. Nevertheless, it seems that some obstetric providers are more aware of the holistic aspect of health and health behaviors and thus are more likely to advise patients on other health behaviors.
The present study has limitations that should be considered when interpreting the results. First, the use of questionnaires to obtain information on exercise can lead to biased data. We attempted to minimize the impact of these biases by using rigorous techniques for survey development and keeping the survey responses anonymous.
Although these steps may not have eliminated these biases, our use of survey research is consistent with that of others who obtained information on exercise from obstetric providers and pregnant women.
Second, clinics were selected for participation in the study on the basis of alumni status from an osteopathic medical school, which may limit generalizability only to clinics employing osteopathic physicians. However, generalizations are still plausible given that the questionnaires were completed by various obstetric providers in the clinic with and without osteopathic medical training.
The implications of the findings may therefore be applicable to a larger audience. Third, although our questionnaires were the first to our knowledge to explore obstetric providers' discussions of exercise with pregnant patients and pregnant patient participation in exercise, we did not investigate whether the information conveyed by the obstetric providers to their pregnant patients was consistent with the most current ACOG guidelines.
Good nutrition during pregnancy can help to keep you and your developing baby healthy. Your need for certain nutrients, such as iron, iodine and folate, increases when you are pregnant. A varied diet that includes the right amount of healthy foods from the five food groups generally provides our bodies with the vitamins and minerals it needs each day. However, pregnant women may need to take vitamin or mineral supplements during pregnancy such as folate and vitamin D. Consult your doctor before taking any supplements. They may recommend that you have a blood test or see a dietitian to review your need to take a supplement.
This sheet talks about exercise in a pregnancy and while breastfeeding. This information should not take the place of medical care and advice from your healthcare provider. The American College of Obstetricians and Gynecologists ACOG recommends that women without medical or pregnancy complications consider at least 30 minutes of moderate exercise on most days, if not all, days of the week. You may not be able to exercise while pregnant if you have experienced preterm delivery, ongoing vaginal bleeding, contractions, or other pregnancy-related complications.
Learn more about key recommendations for women during pregnancy and the postpartum period from the Physical Activity Guidelines for Americans , 2 nd edition pdf icon external icon. If you are a healthy pregnant or postpartum woman, physical activity is good for your overall health. For example, moderate-intensity physical activity, such as brisk walking, keeps your heart and lungs healthy during and after pregnancy. Physical activity also helps improve your mood throughout pregnancy and after birth. After you have your baby, exercise also helps maintain a healthy weight, and when combined with eating fewer calories, helps with weight loss.
Evidence from epidemiological and animal studies support the concept of programming fetal, neonatal, and adult health in response to in utero exposures such as maternal obesity and lifestyle variables. Maternal intake of dairy foods rich in high-quality proteins, calcium, and vitamin D may influence later bone health status. If effective, this RCT will generate high-quality evidence to refine the nutrition guidelines during pregnancy to improve the likelihood of women achieving recommended GWG.
Eating healthy food during pregnancy is important for you and your baby's health. Nutritional needs are higher when you are pregnant. Contrary to old wives' tales, you should not 'eat for two' when you are pregnant.
Read the Latest. It's a time to celebrate when you find out you're pregnant. A child is a blessing in many ways and this will be an exciting journey for you. However, there are a number of things you should know from the start — a list of do's and don'ts to ensure a healthy pregnancy for you and your baby. It is always recommended that you discuss do's and don'ts with your doctor to determine a list of suggestions specific to your pregnancy. The following resources are also available to help you learn more about what you can do to lower risks during pregnancy.
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