Advertisement

Nutritional Requirements for the Pregnant Exerciser and Athlete

  • Maria-Raquel G. SilvaEmail author
  • Belén Rodriguez Doñate
  • Karen Nathaly Che Carballo
Chapter

Abstract

The purpose of this chapter is to identify special groups of pregnant exercisers and pregnant athletes such as (1) athletes practicing aesthetic sports, weight competing sports, and sports of long duration, (2) pregnant exerciser women who restrict or prohibit certain dietary practices or the consumption of important sources of energy and nutrients, (3) adolescent pregnant exercisers, and (4) other pregnant exerciser women in high-risk categories. In addition, risk factors as eating disorders or low energy availability related to their energy and nutritional requirements are also included. Micronutrients’ needs increase much more than for macronutrients. Even prior to conception, an increased average intake of folate, iodine, and iron is recommended. However, only in the beginning of the second trimester, a marked increase in vitamins and minerals is observed. A pregnant exerciser or athlete who continues to train during pregnancy may have total energy expenditure quite high; this will depend on the type, intensity, frequency, and duration of the activities performed. Therefore, dietary intakes before, during, and after physical exercise are crucial for the maintenance of adequate energy availability. In addition, some unhealthy behaviors such as the consumption of alcohol, smoking, caffeine, and/or non-nutritive sweeteners and the lack of sleep should be avoided.

Keywords

Pregnancy Energy needs Nutritional intakes Athletes Exercisers Eating disorders Sleep 

References

  1. 1.
    Tompkins WT, Wiehl DG. Nutritional deficiencies as a casual factor in toxemia and premature labor. Am J Obstet Gynecol. 1951;62:898–919.PubMedCrossRefGoogle Scholar
  2. 2.
    Venkatachalam PS. Maternal nutritional status and its effect on the newborn. Bull World Health Organ. 1962;26:193–201.PubMedPubMedCentralGoogle Scholar
  3. 3.
    Dodd JM, Grivell RM, Nguyen AM, et al. Maternal and perinatal health outcomes by body mass index category. Aust N Z J Obstet Gynaecol. 2011;51:136–40.PubMedCrossRefGoogle Scholar
  4. 4.
    Guelinckx I, Devlieger R, Beckers K, et al. Maternal obesity: pregnancy complications, gestational weight gain and nutrition. Obes Rev. 2008;9:140–50.PubMedCrossRefGoogle Scholar
  5. 5.
    Blumfield ML, Hure AJ, Macdonald-Wicks L, et al. A systematic review and meta-analysis of micronutrient intakes during pregnancy in developed countries. Nutr Rev. 2013;71:118–32.PubMedCrossRefGoogle Scholar
  6. 6.
    Grieger JA, Clifton VL. A review of the impact of dietary intakes in human pregnancy on infant birthweight. Nutrients. 2014;7(1):153–78.PubMedCrossRefGoogle Scholar
  7. 7.
    Perng W, Stuart J, Rifas-Shiman SL, et al. Preterm birth and long-term maternal cardiovascular health. Ann Epidemiol. 2015;25(1):40–5.PubMedCrossRefGoogle Scholar
  8. 8.
    Gillman MW, Rifas-Shiman SL, Kleinman K, et al. Developmental origins of childhood overweight: potential public health impact. Obesity (Silver Spring). 2008;16:1651–6.CrossRefGoogle Scholar
  9. 9.
    Callaway LK, Prins JB, Chang AM, et al. The prevalence and impact of overweight and obesity in an australian obstetric population. Med J Aust. 2006;184:56–9.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Ehrenberg HM, Mercer BM, Catalano PM. The influence of obesity and diabetes on the prevalence of macrosomia. Am J Obstet Gynecol. 2004;191:964–8.PubMedCrossRefGoogle Scholar
  11. 11.
    WHO. Energy and protein requirements. Report of a Joint FAO/WHO/UNU expert consultation. Technical report series no. 724. Geneva: World Health Organization; 1985.Google Scholar
  12. 12.
    Hytten FE. Nutrition. In: Hytten FE, Chamberlain G, editors. Clinical physiology in obstetrics. Oxford: Blackwell Scientific Publications; 1980. p. 163–92.Google Scholar
  13. 13.
    Butte NF, King JC. Energy requirements during pregnancy and lactation. Public Health Nutr. 2005;8(7a):1010–27.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Butte N, Caballero B. Energy needs: assessment and requirements. In: Shils M, Shike M, Ross A, Caballero B, Cousins R, editors. Modern nutrition in health and disease. 10th ed. Baltimore/Philadelphia: Lippincott Williams & Wilkins; 2006. p. 136–48.Google Scholar
  15. 15.
    Artal R, O'toole M. Guidelines of the American College of Obstetricians and Gynecologists for exercise during pregnancy and the postpartum period. Br J Sports Med. 2003;37(1):6–12.PubMedCrossRefGoogle Scholar
  16. 16.
    Silva M-RG, Bellotto ML. Nutritional requirements for maternal and newborn health. Curr Womens Health Rev. 2015;11:41–50.Google Scholar
  17. 17.
    Silva M-RG, Paiva T. Low energy availability and low body fat of female gymnasts before an international competition. Eur J Sport Sci. 2015;15(7):591–9.PubMedCrossRefGoogle Scholar
  18. 18.
    Loucks AB, Kiens B, Wright HH. Energy availability in athletes. J Sport Sci. 2011;29:S7–15.CrossRefGoogle Scholar
  19. 19.
    Rodriguez NR, DiMarco NM, Langley S, et al. Position of the American Dietetic Association, Dietitians of Canada and the American College of Sports Medicine: nutrition and athletic performance. J Am Diet Assoc. 2009;109:509–27.PubMedCrossRefGoogle Scholar
  20. 20.
    Forsum E, Löf M. Energy metabolism during human pregnancy. Annu Rev Nutr. 2007;27:277–92.PubMedCrossRefGoogle Scholar
  21. 21.
    Hoch AZ, Pajewski NM, Moraski L, et al. Prevalence of the female athlete triad in high school athletes and sedentary students. Clin J Sport Med. 2009;19(5):421–8.PubMedCrossRefGoogle Scholar
  22. 22.
    Institute of Medicine and National Research Council of the National Academies. Weight gain during pregnancy: reexamining the guidelines. Washington, DC: Institute of Medicine and National Research Council of the National Academies; 2009.Google Scholar
  23. 23.
    Bø K, Artal R, Barakat R, et al. Exercise and pregnancy in recreational and elite athletes: 2016 evidence summary from the IOC expert group meeting, Lausanne. Part 1-exercise in women planning pregnancy and those who are pregnant. Br J Sports Med. 2016;50(10):571–89.PubMedCrossRefGoogle Scholar
  24. 24.
    Sundgot-Borgen J, Torstveit MK. Prevalence of eating disorders in elite athletes is higher than in the general population. Clin J Sport Med. 2004;14:25–32.PubMedCrossRefGoogle Scholar
  25. 25.
    Sundgot-Borgen J, Torstveit MK. Aspects of disordered eating continuum in elite high-intensity sports. Scand J Med Sci Sports. 2010;20(Suppl 2):112–21.PubMedCrossRefGoogle Scholar
  26. 26.
    Currie A. Sport and eating disorders—understanding and managing the risks. Asian J Sports Med. 2010;1:63–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Czech-Szczapa B, Szczapa T, Merritt TA, et al. Disordered eating attitudes during pregnancy in mothers of newborns requiring Neonatal Intensive Care Unit admission: a case control study. J Matern Fetal Neonatal Med. 2015;28:1711–5.PubMedCrossRefGoogle Scholar
  28. 28.
    Silva M-RG, Paiva T. Sleep, nutrition, circadian rhythm, jet lag and athletic performance [in Portuguese]. Lisbon: Portuguese Federation of Gymnastics/Portuguese Institute of Sport and Youthood I.P; 2015.Google Scholar
  29. 29.
    Silva M-RG. Nutritional evaluation and body composition [in Portuguese]. 3rd ed. Porto: University Fernando Pessoa Press; 2015.Google Scholar
  30. 30.
    Nielsen S, Moller-Madsen S, Isager T, et al. Standardized mortality in eating disorders—a quantitative summary of previously published and new evidence. J Psychosom Res. 1998;44:413–34.PubMedCrossRefGoogle Scholar
  31. 31.
    Cardwell MS. Eating disorders during pregnancy. Obstet Gynecol Surv. 2013;68:312–23.PubMedCrossRefGoogle Scholar
  32. 32.
    Franko DL, Spurrell EB. Detection and management of eating disorders during pregnancy. Obstet Gynecol. 2000;95(Pt 1):942–6.PubMedPubMedCentralGoogle Scholar
  33. 33.
    Mazzeo SE, Slof-Op’t Landt MC, Jones I, et al. Associations among postpartum depression, eating disorders, and perfectionism in a population-based sample of adult women. Int J Eat Disord. 2006;39:202–11.PubMedCrossRefGoogle Scholar
  34. 34.
    Koubaa S, Hallstrom T, Lindholm C, et al. Pregnancy and neonatal outcomes in women with eating disorders. Obstet Gynecol. 2005;105:255–60.PubMedCrossRefGoogle Scholar
  35. 35.
    Park RJ, Senior R, Stein A. The offspring of mothers with eating disorders. Eur Child Adolesc Psychiatry. 2003;12(Suppl 1):I110–9.PubMedGoogle Scholar
  36. 36.
    Patel P, Wheatcroft R, Park RJ, et al. The children of mothers with eating disorders. Clin Child Fam Psychol Rev. 2002;5:1–19.PubMedCrossRefGoogle Scholar
  37. 37.
    James DC. Eating disorders, fertility, and pregnancy: relationships and complications. J Perinat Neonatal Nurs. 2001;15:36–48.PubMedCrossRefGoogle Scholar
  38. 38.
    Brahmbhatt H, Kågesten A, Emerson M, et al. Prevalence and determinants of adolescent pregnancy in urban disadvantaged settings across five cities. J Adolesc Health. 2014;55:S48–57.PubMedCrossRefGoogle Scholar
  39. 39.
    van Baaren GJ, Peelen MJ, Schuit E, et al. Preterm birth in singleton and multiple pregnancies: evaluation of costs and perinatal outcomes. Eur J Obstet Gynecol Reprod Biol. 2015;3:34–41.CrossRefGoogle Scholar
  40. 40.
    Kaiser LL, Allen L. Position of the American Dietetic Association: nutrition and lifestyle for a healthy pregnancy outcome. J Am Diet Assoc. 2002;102:1479–90.PubMedCrossRefGoogle Scholar
  41. 41.
    Food and Nutrition Board/Institute of Medicine (2005) Dietary reference intakes for energy, carbohydrate, fiber, fat, fatty acids, cholesterol, protein and amino acids. Washington, DC: National Academies Press. http://www.nap.edu/catalog.php?record_id=10490.
  42. 42.
    Koletzko B, Bauer CP, Bung P, et al. German national consensus recommendations on nutrition and lifestyle in pregnancy by the 'Healthy Start - Young Family Network'. Ann Nutr Metab. 2013;63(4):311–22.PubMedCrossRefGoogle Scholar
  43. 43.
    Food and Nutrition Board/Institute of Medicine (2001) Dietary reference intakes for vitamin A, vitamin K, arsenic, boron, chromium, copper, iodine, iron, manganese, molybdenum, nickel, silicon, vanadium, and zinc. Washington, DC: National Academies Press. http://www.nap.edu/catalog/10026.html.
  44. 44.
    Food and Nutrition Board/Institute of Medicine (1999) Dietary reference intakes for thiamin, riboflavin, niacin, vitamin B6, folate, vitamin B12, pantothenic acid, biotin, and choline. Washington, DC: National Academies Press. http://www.nap.edu/catalog.php?record_id=6015.
  45. 45.
    Food and Nutrition Board/Institute of Medicine. Dietary reference intakes for vitamin C, vitamin E, selenium, and carotenoids. Washington, DC: National Academies Press; 2000. http://www.nap.edu/catalog.php?record_id=9810.Google Scholar
  46. 46.
    Food and Nutrition Board/Institute of Medicine. Dietary reference intakes for calcium and vitamin D. Washington, DC: National Academies Press; 2011. http://www.nap.edu/catalog.php?record_id=13050.Google Scholar
  47. 47.
    Food and Nutrition Board/Institute of Medicine. Dietary reference intakes for water, potassium, sodium, chloride, and sulfate. Washington, DC: National Academies Press; 2005. http://www.nap.edu/catalog/10925.html.Google Scholar
  48. 48.
    Buford TW, Kreider RB, Stout JR, et al. International Society of Sports Nutrition position stand: creatine supplementation and exercise. J Int Soc Sports Nutr. 2007;4(1):6.PubMedCrossRefGoogle Scholar
  49. 49.
    Kerksick C, Harvey T, Stout J, et al. International Society of Sports Nutrition position stand: nutrient timing. J Int Soc Sports Nutr. 2008;5:17.PubMedCrossRefGoogle Scholar
  50. 50.
    Thomas DT, Erdman KA, Burke LM. Position of the Academy of Nutrition and Dietetics, Dietitians of Canada, and the American College of Sports Medicine: nutrition and athletic performance. J Acad Nutr Diet. 2016;116(3):501–28.PubMedCrossRefGoogle Scholar
  51. 51.
    Jeukendrup AE, Jentjens RLPG, Moseley L. Nutritional considerations in triathlon. Sports Med. 2005;35(2):163–81.PubMedCrossRefGoogle Scholar
  52. 52.
    Jentjens RL, Wagenmakers AJ, Jeukendrup AE. Heat stress increases muscle glycogen use but reduces the oxidation of ingested carbohydrates during exercise. J Appl Physiol. 2002;92(4):1562–72.PubMedCrossRefGoogle Scholar
  53. 53.
    Polańska K, Jurewicz J, Hanke W. Smoking and alcohol drinking during pregnancy as the risk factors for poor child neurodevelopment—a review of epidemiological studies. Int J Occup Med Environ Health. 2015;28(3):419–43.PubMedCrossRefGoogle Scholar
  54. 54.
    Bakker R, Steegers EAP, Obradov A, Raat H, Hofman A, Jaddoe VWV. Maternal caffeine intake from coffee and tea, fetal growth, and the risks of adverse birth outcomes: the Generation R Study. Am J Clin Nutr. 2010;91(6):1691–8.PubMedCrossRefGoogle Scholar
  55. 55.
    Rhee J, Kim R, Kim Y, et al. Maternal caffeine consumption during pregnancy and risk of low birth weight: a dose-response meta-analysis of observational studies. PLoS One. 2015;10(7):e0132334.PubMedCrossRefGoogle Scholar
  56. 56.
    American College of Obstetricians and Gynecologists. Committee opinion: moderate caffeine consumption during pregnancy. Obstet Gynecol. 2010;116(462):467–8.Google Scholar
  57. 57.
    Araujo JR, Martel F, Keating E. Exposure to non-nutritive sweeteners during pregnancy and lactation: impact in programming of metabolic diseases in the progeny later in life. Reprod Toxicol. 2014;49:196–201.PubMedCrossRefGoogle Scholar
  58. 58.
    Hedman C, Pohjasvaara T, Tolonen U, Suhonen-Malm AS, Myllyla VV. Effects of pregnancy on mothers’ sleep. Sleep Med. 2002;3(1):37–42.PubMedCrossRefGoogle Scholar
  59. 59.
    Mindell JA, Jacobson BJ. Sleep disturbances during pregnancy. J Obstet Gynecol Neonatal Nurs. 2000;29(6):590–7.PubMedCrossRefGoogle Scholar
  60. 60.
    Lee KA, Gay CL. Sleep in late pregnancy predicts length of labor and type of delivery. Am J Obstet Gynecol. 2004;191(6):2041–6.PubMedCrossRefGoogle Scholar
  61. 61.
    Lee KA, Zaffke ME, McEnany G. Parity and sleep patterns during and after pregnancy. Obstet Gynecol. 2000;95(1):14–8.PubMedPubMedCentralGoogle Scholar
  62. 62.
    Le Bon O, Staner L, Hoffmann G, et al. The first-night effect may last more than one night. J Psychiatr Res. 2001;35(3):165–72.PubMedCrossRefGoogle Scholar
  63. 63.
    Silva M-RG, Paiva T. Poor precompetitive sleep habits, nutrients' deficiencies, inappropriate body composition and athletic performance in elite gymnasts. Eur J Sport Sci. 2016;16(6):726–35.PubMedCrossRefGoogle Scholar
  64. 64.
    Silva M-RG, Paiva T. Sleep during pregnancy: neurophysiology, disturbances and sleep hygiene [in Portuguese]. In: Santos-Rocha R, Branco M, editors. Active pregnancy—physiological and biomechanical adaptations during pregnancy and postpartum [Portuguese]. CIPER-FMH-UTL/ESDRM-IPS/FCT, Ed ESDRM, 2016.Google Scholar
  65. 65.
    Centers for Disease Control and Prevention. National sleep awareness week. MMWR Morb Mortal Wkly Rep. 2011;60(8):233.Google Scholar
  66. 66.
    Picchietti DL, Hensley JG, Bainbridge JL, et al. Consensus clinical practice guidelines for the diagnosis and treatment of restless legs syndrome/Willis-Ekbom disease during pregnancy and lactation. Sleep Med Rev. 2014;22:64–77.PubMedCrossRefGoogle Scholar
  67. 67.
    Chang JJ, Pien GW, Duntley SP, et al. Sleep deprivation during pregnancy and maternal and fetal outcomes: is there a relationship? Sleep Med Rev. 2010;14:107–14.PubMedCrossRefGoogle Scholar
  68. 68.
    Nodine PM, Matthews EE. Common sleep disorders: management strategies and pregnancy outcomes. J Midwifery Womens Health. 2013;58:368–77.PubMedCrossRefGoogle Scholar
  69. 69.
    Okun ML, Schetter CD, Glynn LM. Poor sleep quality is associated with preterm birth. Sleep. 2011;34:1493–8.PubMedCrossRefGoogle Scholar
  70. 70.
    Ramirez JO, Cabrera SA, Hidalgo H, et al. Is preeclampsia associated with restless legs syndrome? Sleep Med. 2013;14:894–6.PubMedCrossRefGoogle Scholar
  71. 71.
    Vahdat M, Sariri E, Miri S, et al. Prevalence and associated features of restless legs syndrome in a population of Iranian women during pregnancy. Int J Gynecol Obstet. 2013;123:46–9.CrossRefGoogle Scholar
  72. 72.
    Wesstrom J, Skalkidou A, Manconi M, et al. Prepregnancy restless legs syndrome (Willis-Ekbom disease) is associated with perinatal depression. J Clin Sleep Med. 2014;10:527–33.PubMedPubMedCentralGoogle Scholar
  73. 73.
    Ismailogullari S, Ozturk A, Mazicioglu MM, et al. Restless legs syndrome and pregnancy in Kayseri, Turkey: a hospital based survey. Sleep Biol Rhythms. 2010;8:137–43.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Maria-Raquel G. Silva
    • 1
    • 2
    Email author
  • Belén Rodriguez Doñate
    • 3
  • Karen Nathaly Che Carballo
    • 3
  1. 1.Faculty of Health SciencesUniversity Fernando PessoaPortoPortugal
  2. 2.Research Centre for Anthropology and HealthUniversity of CoimbraCoimbraPortugal
  3. 3.Tu Gestor de Salud for Nutrition and SportMadridSpain

Personalised recommendations