Assessment of resting energy expenditure and body composition in Japanese pregnant women with diabetes

Abstract

Aims/IntroductionTo measure longitudinal changes in resting energy expenditure and body composition of Japanese pregnant women with or without diabetes.Materials and MethodsThe study population consisted of women who had delivered a live singleton neonate after 22 weeks’ gestation at Okayama University Hospital from July 2013 to June 2017. Resting energy expenditure and body composition were measured in the first trimester, second trimester, third trimester and postpartum.ResultsA total of 144 women participated in this study: 103 with normal glucose tolerance and 41 with diabetes. The resting energy expenditure (kcal/day) of pregnant women with normal glucose tolerance was significantly higher in the third trimester (1,644 ± 234) than in the first (1,461 ± 215) and second trimesters (1,491 ± 219), and postpartum (1,419 ± 254), whereas that of pregnant women with diabetes did not significantly change during all periods (1,568 ± 404, 1,710 ± 332, 1,716 ± 251, 1,567 ± 249). The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Fat‐free mass was closely correlated with resting energy expenditure.ConclusionsThe resting energy expenditure of Japanese pregnant women with normal glucose tolerance was significantly increased in the third trimester. The resting energy expenditure of women with good glycemic control was lower than that of women with poor control. Resting energy expenditure and fat‐free mass are potential indexes for medical nutrition therapy in pregnant women with diabetes.

Resting Energy Expenditure Guided Intervention for Gestational Weight Gain in Obese and Overweight Women

“…27 The magnitude of increase in energy requirements during pregnancy has been a matter of debate. 17 In clinical practice, TEE based on pre-pregnancy BMI is often used to guide the need for energy intake in pregnancy.…”

“…16 Therefore, REE could be a helpful monitoring tool to assess energy intake during pregnancy, especially for obese/overweight women. 17 Some investigators suggested that interventions could be developed to tailor recommendations for energy intake for women's needs based on REE measured in clinical setting. 18,19 We therefore tested the hypothesis that REE guided management of GWG for pregnant women with obesity/overweight may be helpful in a small-scale study.…”

Resting energy expenditure guided intervention for gestational weight gain in obese and overweight women

“…25 The magnitude of increase in energy requirements during pregnancy has been a matter of much debate. 10 In clinical practice, TEE based on to pre-pregnancy BMI is often used to guide the need for energy intake in pregnancy. Byrne et.al 26 suggested that TEE based on REE was more accurate than TEE based on pre-pregnant BMI.…”

“…9 Therefore, REE could be a helpful monitoring tool to assess energy intake during pregnancy, especially for obese/overweight women. 10 Some investigators thought that interventions could be developed to tailor recommendations for energy intake for women's needs based on REE measured in clinical setting. 11,12 Obesity and overweight have become a major public health problem worldwide.…”

Resting Energy Expenditure Relationship with Macronutrients and Gestational Weight Gain: A Pilot Study

“…This study found unique changes in REE across the participants that were not consistent with predictive equations [19]. It is apparent that REE is a highly variable measure that is impacted by numerous biological (disease status) [20,21] and behavioral (activity level [9], nutrition [10], and sleep [22]) factors. Consideration of REE in conjunction with other biological and behavioral factors may improve dietary and GWG recommendations during a critical period of growth and development.…”