Exercise in pregnancy improves health of obese mothers by restoring their tissues
August 29, 2019
Science Daily/University of Cambridge
Exercise immediately prior to and during pregnancy restores key tissues in the body, making them better able to manage blood sugar levels and lowering the risk of long term health problems, suggests new research carried out in mice.
Researchers at the University of Cambridge, who led the study published today in the journal Physiological Reports, say the findings reinforce the importance of an active lifestyle when planning pregnancy.
In the UK, more than a half of all women of reproductive age and almost a third of pregnant women are overweight or obese. This is particularly concerning, as being overweight or obese during pregnancy increases the risk of complications in the mother, such as gestational diabetes, and predisposes both her and her infant to develop metabolic diseases such as type 2 diabetes in the years after pregnancy.
Exercise is known to improve how the body manages blood sugar levels and thereby reduce the risk of type-2 diabetes and metabolic syndrome in non-pregnant women. It also has positive effects prior to and during pregnancy, with beneficial outcomes for both mother and her child, preventing excessive gestational weight gain and the development of gestational diabetes, and the need for insulin use in women who have already developed gestational diabetes. However, little is known about the changes that exercise causes to the tissues of obese pregnant mother.
To answer this questions, researchers at the University of Cambridge fed mice a sugary, high fat diet such that they become obese and then the obese mice were exercised. The mice exercised on a treadmill for 20 minutes a day for at least a week before their pregnancy and then for 12.5 minutes a day until day 17 of the pregnancy (pregnancy lasts for around 20 days in mice).
Mice are a useful model for studying human disease as their biology and physiology have a number of important characteristics in common with those of humans, including showing metabolic changes with obesity/obesity-causing diets and in the female body during pregnancy.
The researchers found that the beneficial effects on metabolic health in obese mothers related to changes in how molecules and cells communicate in maternal tissues during pregnancy.
"A moderate level of exercise immediately before and then during pregnancy leads to important changes in different tissues of the obese mother, effectively making the tissues more like those seen in non-obese mothers," says Dr Amanda Sferruzzi-Perri, a Royal Society Dorothy Hodgkin Research Fellow from the Centre for Trophoblast Research in the Department of Physiology, Development and Neuroscience at the University of Cambridge, who co-led the study.
"We believe these changes may explain how exercise improves the metabolism of the obese mother during pregnancy and, in turn, may prevent her babies from developing early signs of type 2 diabetes after birth."
The key organs of the mother that were affected by exercise were:
· white adipose tissue -- the fatty tissue that stores lipids and can be found in different parts around the body, including beneath the skin and around internal organs;
· skeletal muscle -- muscle tissue that uses glucose and fats for contraction and movement;
· the liver -- the organ that stores, as well as syntheses lipids and glucose.
Exercise affected key signalling pathways -- the ways that molecules and cells within tissue communicate -- involved in responding to insulin (the hormone that stimulates glucose uptake by white adipose tissue and skeletal muscle), in storage and breakdown of lipids (fats found in the blood and tissue) and in growth and the synthesis of proteins.
White adipose tissue showed the greatest number of changes in response to exercise in the obese pregnant mouse, being restored to a state similar to that seen in the tissue of non-obese mothers. This suggests that insulin resistance of the mother's white adipose tissue may be the cause of poor glucose-insulin handling in obese pregnancies. The findings are different to that seen in non-pregnant animals, whereby exercise typically affects insulin signalling in the skeletal muscle.
In addition, the team's previous work showed that exercise improves sensitivity to insulin and glucose handling throughout the whole body in the obese mother. It also prevents the development of insulin resistance in the offspring of obese mothers after birth. Low insulin sensitivity/insulin resistance requires larger amounts of insulin to control blood glucose levels.
"Our findings reinforce the importance of having an active lifestyle and eating a healthy balanced diet when planning pregnancy and throughout for both the mother and her developing child," says co-lead Professor Susan Ozanne from the Wellcome Trust-Medical Research Council Institute of Metabolic Science at the University of Cambridge.
"This is can be important in helping to reduce the risk of adverse health problems in the mother and of later health problems for her child."
https://www.sciencedaily.com/releases/2019/08/190829214754.htm
Being teased about weight linked to more weight gain among children
May 30, 2019
Science Daily/NIH/Eunice Kennedy Shriver National Institute of Child Health and Human Development
Youth who said they were teased or ridiculed about their weight increased their body mass by 33 percent more each year, compared to a similar group who had not been teased, according to researchers at the National Institutes of Health. The findings appear to contradict the belief that such teasing might motivate youth to change their behavior and attempt to lose weight. The study was conducted by Natasha A. Schvey, Ph.D., of the Uniformed Services University of the Health Sciences in Bethesda, MD, and colleagues at NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institute of Diabetes and Digestive and Kidney Diseases. It appears in Pediatric Obesity.
The study involved 110 youth who were an average of 11.8 years of age when they enrolled. The participants were either overweight (defined as a body mass index above the 85th percentile) when they began the study or had two parents who were overweight or obese. At enrollment, they completed a six-item questionnaire on whether they had been teased about their weight. They then participated in annual followup visits for the next 15 years.
The researchers found that youth experiencing high levels of teasing gained an average of .20 kg (.44 lbs) per year more than those who did not. The authors theorize that weight-associated stigma may have made youths more likely to engage in unhealthy behaviors, such as binge eating and avoiding exercise. Another possible explanation is that the stress of being teased could stimulate the release of the hormone cortisol, which may lead to weight gain.
https://www.sciencedaily.com/releases/2019/05/190530101213.htm
Maternal Obesity Puts Infants at Risk of Iron Deficiency
May 1, 2011
Science Daily/American Academy of Pediatrics
Babies born to obese mothers are at risk for iron deficiency, which could affect infant brain development, according to a study presented on April 30 at the Pediatric Academic Societies (PAS) annual meeting in Denver.
In nonpregnant adults, obesity-related inflammation hinders the transport of iron through the intestine, increasing the risk of iron deficiency anemia. When a woman is pregnant, iron is transferred through the intestine to the placenta, but it is not known how maternal obesity affects newborn iron status. Fetal iron status is important because 50 percent of the iron needed for infant growth is obtained before birth.
In this study, researchers studied 281 mother/newborn pairs. The women's body mass index was calculated before delivery, and a score of 30 or above was defined as obese. Investigators also determined infants' iron level by analyzing umbilical cord blood.
Results showed evidence of impaired iron status in newborns of women who were obese.
"These findings are important because iron deficiency in infancy is associated with impaired brain development, and we should understand all risk factors for iron deficiency in infancy," said Pamela J. Kling, MD, FAAP, principal investigator and associate professor of pediatrics/neonatology at the University of Wisconsin-Madison.
The researchers are investigating why obesity during pregnancy is a risk factor for poorer iron status at birth, Dr. Kling said.
"In nonpregnant adults, obesity has been linked to poorer dietary iron absorption and to diabetes, so both factors may contribute," she said. "Additionally, the link may be due to larger fetuses, because obesity during pregnancy results in larger fetuses, and iron needs are proportional to fetal size."
The study results also have important implications because the prevalence of obesity in women of childbearing age is increasing.
http://www.sciencedaily.com/releases/2011/04/110430133125.htm
Depression in early pregnancy linked to gestational diabetes
September 19, 2016
Science Daily/National Institutes of Health
A two-way link between depression and gestational diabetes has been uncovered by researchers. Women who reported feeling depressed during the first two trimesters of pregnancy were nearly twice as likely to develop gestational diabetes, according to an analysis of pregnancy records. Conversely, a separate analysis found that women who developed gestational diabetes were more likely to report postpartum depression six weeks after giving birth, compared to a similar group of women who did not develop gestational diabetes.
https://images.sciencedaily.com/2016/09/160919094450_1_540x360.jpg
Pregnant woman having her blood sugar/ glucose checked.
Credit: © Mediteraneo / Fotolia
Gestational diabetes is a form of diabetes (high blood sugar level) occurring only in pregnancy, which if untreated may cause serious health problems for mother and infant.
"Our data suggest that depression and gestational diabetes may occur together," said the study's first author, Stefanie Hinkle, Ph.D., staff scientist in the Division of Intramural Population Health Research at the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "Until we learn more, physicians may want to consider observing pregnant women with depressive symptoms for signs of gestational diabetes. They also may want to monitor women who have had gestational diabetes for signs of postpartum depression."
Although obesity is known to increase the risk for gestational diabetes, the likelihood of gestational diabetes was higher for non-obese women reporting depression than for obese women with depression.
The researchers analyzed pregnancy records from the NICHD Fetal Growth Studies-Singleton Cohort, which tracked the progress of thousands of pregnancies, to understand the patterns of fetal growth. The study enrolled 2,334 non-obese and 468 obese women in weeks eight to 13 of pregnancy. The women responded to questionnaires on symptoms of depression when they enrolled in the study, again between the 16th and 22nd week of pregnancy, and then six weeks after giving birth. The researchers also reviewed the women's records to identify who had developed gestational diabetes.
"Of particular note, persistent depression from the first to second trimester set women at even greater risk for gestational diabetes" said the study's senior author, Cuilin Zhang, M.D., Ph.D, in the Division of Intramural Population Health Research at NICHD. Women who had the highest scores for depression in the first and second trimesters -- about 17 percent -- had nearly triple the risk for gestational diabetes when compared to women who had lower depression scores.
"Our results suggest it would be a good idea for clinicians to pay particular attention to women with high depression scores when evaluating the risk of gestational diabetes," Dr. Zhang added.
Although obesity increases the risk for gestational diabetes, non-obese women with high depression scores had nearly triple the risk for gestational diabetes than the other women in the study. Depression did not appear to increase the risk for gestational diabetes among obese women.
Currently, the American College of Obstetricians and Gynecologists recommends (link is external) that physicians screen patients at least once for depression during the perinatal period (link is external) (22 weeks of pregnancy through 7 days after birth.)
The researchers also found a higher risk for postpartum depression among the women who had gestational diabetes. Of the women who developed gestational diabetes, nearly 15 percent experienced depressive symptoms after birth, which was more than four times that of women who had not had gestational diabetes.
Dr. Hinkle stressed that the study was not able to prove a cause and effect relationship between symptoms of depression and gestational diabetes. The researchers added that earlier studies have shown that depression is associated with impaired glucose metabolism that may lead to higher blood sugar levels. Similarly, high blood sugar levels may lead to inflammation, hormonal, and other changes that could lead to symptoms of depression.Gestational diabetes is a form of diabetes (high blood sugar level) occurring only in pregnancy, which if untreated may cause serious health problems for mother and infant.
"Our data suggest that depression and gestational diabetes may occur together," said the study's first author, Stefanie Hinkle, Ph.D., staff scientist in the Division of Intramural Population Health Research at the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). "Until we learn more, physicians may want to consider observing pregnant women with depressive symptoms for signs of gestational diabetes. They also may want to monitor women who have had gestational diabetes for signs of postpartum depression."
Although obesity is known to increase the risk for gestational diabetes, the likelihood of gestational diabetes was higher for non-obese women reporting depression than for obese women with depression.
The researchers analyzed pregnancy records from the NICHD Fetal Growth Studies-Singleton Cohort, which tracked the progress of thousands of pregnancies, to understand the patterns of fetal growth. The study enrolled 2,334 non-obese and 468 obese women in weeks eight to 13 of pregnancy. The women responded to questionnaires on symptoms of depression when they enrolled in the study, again between the 16th and 22nd week of pregnancy, and then six weeks after giving birth. The researchers also reviewed the women's records to identify who had developed gestational diabetes.
"Of particular note, persistent depression from the first to second trimester set women at even greater risk for gestational diabetes" said the study's senior author, Cuilin Zhang, M.D., Ph.D, in the Division of Intramural Population Health Research at NICHD. Women who had the highest scores for depression in the first and second trimesters -- about 17 percent -- had nearly triple the risk for gestational diabetes when compared to women who had lower depression scores.
"Our results suggest it would be a good idea for clinicians to pay particular attention to women with high depression scores when evaluating the risk of gestational diabetes," Dr. Zhang added.
Although obesity increases the risk for gestational diabetes, non-obese women with high depression scores had nearly triple the risk for gestational diabetes than the other women in the study. Depression did not appear to increase the risk for gestational diabetes among obese women.
Currently, the American College of Obstetricians and Gynecologists recommends (link is external) that physicians screen patients at least once for depression during the perinatal period (link is external) (22 weeks of pregnancy through 7 days after birth.)
The researchers also found a higher risk for postpartum depression among the women who had gestational diabetes. Of the women who developed gestational diabetes, nearly 15 percent experienced depressive symptoms after birth, which was more than four times that of women who had not had gestational diabetes.
Dr. Hinkle stressed that the study was not able to prove a cause and effect relationship between symptoms of depression and gestational diabetes. The researchers added that earlier studies have shown that depression is associated with impaired glucose metabolism that may lead to higher blood sugar levels. Similarly, high blood sugar levels may lead to inflammation, hormonal, and other changes that could lead to symptoms of depression.
Science Daily/SOURCE :https://www.sciencedaily.com/releases/2016/09/160919094450.htm