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肥胖孕妇妊娠期间静息和步行能量消耗及步行速度的变化。

Changes in resting and walking energy expenditure and walking speed during pregnancy in obese women.

机构信息

School of Human Movement Studies, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.

出版信息

Am J Clin Nutr. 2011 Sep;94(3):819-30. doi: 10.3945/ajcn.110.009399. Epub 2011 Jul 27.

Abstract

BACKGROUND

Energy-conserving processes reported in undernourished women during pregnancy are a recognized strategy for providing the energy required to support fetal development. Women who are obese before conceiving arguably have sufficient fat stores to support the energy demands of pregnancy without the need to provoke energy-conserving mechanisms.

OBJECTIVE

We tested the hypothesis that obese women would show behavioral adaptation [ie, a decrease in self-selected walking (SSW) speed] but not metabolic compensation [ie, a decrease in resting metabolic rate (RMR) or the metabolic cost of walking] during gestation.

DESIGN

RMR, SSW speed, metabolic cost of walking, and anthropometric variables were measured in 23 women aged 31 ± 4 y with a BMI (in kg/m(2)) of 33.6 ± 2.5 (mean ± SD) at ≈15 and 30 wk of gestation. RMR was also measured in 2 cohorts of nonpregnant control subjects matched for the age, weight, and height of the pregnant cohort at 15 (n = 23) and 30 (n = 23) wk.

RESULTS

Gestational weight gain varied widely (11.3 ± 5.4 kg), and 52% of the women gained more weight than is recommended. RMR increased significantly by an average of 177 ± 176 kcal/d (11 ± 12%; P < 0.0001); however, the within-group variability was large. Both the metabolic cost of walking and SSW speed decreased significantly (P < 0.01). Whereas RMR increased in >80% of the cohort, the net oxygen cost of walking decreased in the same proportion of women.

CONCLUSION

Although the increase in RMR was greater than that explained by weight gain, evidence of both behavioral and biological compensation in the metabolic cost of walking was observed in obese women during gestation. The trial is registered with the Australian Clinical Trials Registry as ACTRN012606000271505.

摘要

背景

怀孕期间营养不足的女性会报告能量节约过程,这是为了支持胎儿发育而提供能量的一种公认策略。在怀孕前肥胖的女性,她们的脂肪储备量可能足以满足怀孕的能量需求,而无需引发能量节约机制。

目的

我们检验了这样一个假设,即肥胖女性在怀孕期间会表现出行为适应(即自我选择步行速度下降),但不会出现代谢补偿(即静息代谢率下降或步行代谢成本下降)。

设计

在 23 名年龄为 31 ± 4 岁、BMI(kg/m²)为 33.6 ± 2.5(均值 ± 标准差)的女性中,大约在妊娠 15 周和 30 周时,测量了静息代谢率(RMR)、自我选择步行速度(SSW 速度)、步行代谢成本以及人体测量学变量。在非妊娠对照组中,也有 2 个队列的对象,其年龄、体重和身高与妊娠组相匹配,在 15 周(n = 23)和 30 周(n = 23)时测量了 RMR。

结果

妊娠体重增加幅度差异很大(11.3 ± 5.4 kg),52%的女性体重增加超过推荐量。RMR 平均增加了 177 ± 176 kcal/d(11 ± 12%;P < 0.0001);然而,组内变异性较大。步行代谢成本和 SSW 速度均显著下降(P < 0.01)。尽管 RMR 在队列中超过 80%的女性增加,但相同比例的女性在步行的净耗氧量上减少。

结论

尽管 RMR 的增加大于体重增加所解释的,但在肥胖女性怀孕期间,在步行的代谢成本方面观察到了行为和生物补偿的证据。该试验在澳大利亚临床试验注册中心注册,编号为 ACTRN012606000271505。

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