Self-selected recreational exercise has no impact on early postpartum lactation-induced bone loss

Little, Kathleen D.; Clapp, James F.

doi:10.1097/00005768-199806000-00009

Cited by 26 publications

(18 citation statements)

References 19 publications

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“…In particular, the correlation between exercises and birth weight has been studied using various methods. In a recent study, no significant associations with birth weight was seen in a large cohort undergoing moderate to heavy physical activity in the second and early third trimester [22]. However, the mean activity level of the women in this study was around 3–4 h per week, while the activity level in the cohort in our study was significantly higher.…”

Section: Discussioncontrasting

confidence: 84%

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Wong

2012

Arch Gynecol Obstet

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ObjectiveTo evaluate whether bone mineral density (BMD) changes in women engaged in active exercises during pregnancy would be different from non-exercising women.MethodsConsecutive patients with singleton pregnancies who were engaged in active exercise training during pregnancy were prospectively recruited over a period of 6 months. Quantitative USG measurements of the os calcis BMD were performed at 14–20 weeks and at 36–38 weeks. These patients were compared to a control cohort of non-exercising low-risk women.ResultsA total of 24 physically active women undergoing active physical training of over 10 h per week at 20 weeks gestation and beyond (mean 13.1 h, SD 3.3) were compared to 94 non-exercising low-risk women. A marginal fall in BMD of 0.015 g/cm2 (SD 0.034) was demonstrable from early to late gestation in the exercising women, which was significantly lower than that of non-exercising women (0.041 g/cm2; SD 0.042; p = 0.005). Logistic regression models confirmed that active exercises in pregnancy were significantly associated with the absence of or less BMD loss in pregnancy.ConclusionIn women actively engaged in physical training during pregnancy, the physiological fall in BMD during pregnancy was apparently less compared to those who did not regularly exercise.

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Section: Discussioncontrasting

confidence: 84%

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Wong

2012

Arch Gynecol Obstet

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“…However, a subsequent study by the same investigators found no beneficial effect of exercise on any skeletal site (193). A cohort study comparing exercising to sedentary women also showed no impact of exercise on lactational BMD losses (560).…”

Section: Human Datamentioning

confidence: 93%

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Kovacs

2016

Physiological Reviews

372

524

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During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ϳ30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.

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“…Two were RCTs, 19,20 one was a followup study of these two studies, 21 and the last was a retrospective cohort study. 22 All studies were conducted in the United States, with a total of 67 participants ( Table 1).…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

“…The included studies contained a diverse range of exercise programs, including resistance and weightbearing aerobic exercise, 19 walking plus stretching 20 and regular self-selected recreational exercise 22 (Table 1). Three of the studies involved moderate-intensity exercise, [19][20][21] and the other involved self-selected, recreational exercise that met criteria for regular exercise.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

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Effect of exercise on slowing breastfeeding‐induced bone loss: A meta‐analysis and trial sequential analysis

Lee

Huang

Lai

et al. 2020

J of Obstet and Gynaecol

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Aim This study systematically reviewed evidence regarding the effectiveness of exercise in slowing breastfeeding‐induced bone loss. Methods The evidence‐based approach of a systematic review (PROSPERO registration No. CRD42019111623) was adopted. The inclusion criteria were randomized controlled trials or observational studies. Study samples were breastfeeding women, the intervention was any form of exercise, and bone mineral density (BMD) of the total body, lumbar spine and hip/femur neck before 6 months and at 1 year were the outcome measures. Meta‐analyses were performed using a random effect model, and calculations of mean differences of BMD change and 95% confidence intervals (CIs) were carried out. Studies were further evaluated through trial sequential meta‐analysis (TSA), and the ‘Grading of Recommendations Assessment, Development and Evaluation’ methodology was used to assess the certainty of evidence (CoE). Results A total of 1049 studies were screened, and 4 met the inclusion criteria. Weight‐bearing aerobic exercise and resistance training before the 6‐month evaluation slowed breastfeeding‐induced bone loss in the lumbar spine (1.62% BMD change [95% CI = 0.53–2.71]; I2 = 8%). The TSA Z‐curve revealed crossing of the TSA boundary and line of information size, indicating sufficient sampling and significance. The CoE of exercise benefit in the lumbar spine at 6 months was low, whereas the CoE for other areas ranged from low to very low. Conclusion This first systematic review and meta‐analysis provided some evidence of the advantages of exercise for slowing breastfeeding‐induced bone loss. However, additional randomized controlled trials are warranted to generate more conclusive evidence.

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Self-selected recreational exercise has no impact on early postpartum lactation-induced bone loss

Abstract: These results suggest that regular, self-selected, recreational E has no impact on early postpartum lactation-induced BMD loss.

Cited by 26 publications

References 19 publications

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Bone mineral density changes during pregnancy in actively exercising women as measured by quantitative ultrasound

Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery

Effect of exercise on slowing breastfeeding‐induced bone loss: A meta‐analysis and trial sequential analysis

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