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[HEALTHTRACK]

Your Pregnancy: Expect the Benefits of Exercise

HEALTHTRACK - JULY 96
A SUPPLEMENT TO THE PHYSICIAN AND SPORTSMEDICINE FOR THE WAITING ROOM


Your body will undergo many changes during your pregnancy. But there are steps you can take to ease the transition and keep you (and your baby) healthy. If you are pregnant, read on to understand the roles of nutrition and exercise, and what you can expect if you develop gestational diabetes.


Why Exercise for Two?

If you're pregnant and already active, you're well acquainted with the positive effects of exercise. If you're not currently active, exercise may be the next logical step toward your pregnancy health goals. But it's important to know your limits and exercise wisely at this time.

The main benefits of exercising while pregnant are the same as those for people who are not pregnant: heart and lung conditioning, weight control, stress release, and a hedge against depression.

Some extras for pregnant women also make exercise worthwhile: It can also prevent or control gestational diabetes. (See "Understanding Gestational Diabetes")

And, though exercise doesn't guarantee a problem-free pregnancy or an easy labor, it can help you prepare for labor by increasing your strength, flexibility, endurance, and stamina.

Already Active...

If you exercise regularly, your pregnancy may require a change of perspective—and flexibility in attitude.

For most women, pregnancy is not a time to improve performance in strenuous sports. But you can take heart in the fact that pregnancy, in itself, produces a training effect: You don't have to go all out to get a good workout. As your exercise focus shifts from performance to health benefits, you should alter your routines if fatigue or nausea are a problem. Also, ligament laxity during pregnancy can increase the chance of injury or reinjury if you've ever had a sports injury.

... Or Considering Exercise?

Many experts advise women who are pregnant and new to the workout world to wait until the start of the second trimester to begin an exercise routine. Experiencing nausea and fatigue (common in the first trimester) during exercise doesn't bode well for adopting this healthy lifestyle change. Low-intensity activities such as walking, stationary biking, or swimming are recommended for pregnant women who have not regularly exercised. Taking a 20- to 30-minute walk a few times a week can help you feel like you're not losing control of your body during pregnancy.

Do It for You

The upcoming months will be a time of great transition, whether you're a first-time mom or one who's experienced. Chances are, it'll be easier to take those changes in stride when you've nurtured yourself with the benefits of exercise: increased energy, a positive body image, and a feeling of well-being.

Safety Tips

It is important to check with your doctor before continuing or starting an exercise program during pregnancy. Your doctor will base his or her recommendation on your general health and current fitness level. And you'll learn about the following safety guidelines:

  • Stay cool. Overheating during the first trimester can impair development of the baby's central nervous system. Don't exercise in hot, humid weather or when you have a fever, and forego saunas and hot tubs, too.
  • Keep a moderate pace. Prolonged exercise can divert oxygen in the blood away from the baby. Use the "talk test" to monitor your exertion level: Work out at a pace that allows you to converse without feeling too out of breath.
  • Drink plenty of fluids. Have beverages before, during, and after exercise. An easy way to monitor your fluid intake is to check the color of your urine: if it's clear, you're fluid level is fine.
  • Go easy. Because your ligaments are more lax during pregnancy, sports injuries are a real concern. Avoid jumping and jarring motions, along with activities that require rapid changes in direction. Make sure your footwear fits properly and provides good traction. Use slow, gentle movements when you stretch. Also, your center of balance will change. Avoid activities that put you at risk for falls, such as biking and downhill skiing.
  • Modify exercises you do lying on your back. After the fourth month, uterine weight can impede blood flow when a woman is on her back, causing dizziness and other serious problems.

Prepared by Lisa Schnirring


Eating for Two

Feeding a Healthy Pregnancy

What does eating for two mean? There's more to it than eating a little more than usual to sustain your tiny companion. It also means eating the right foods to nurture growth and replenish your increasing energy and protein needs.

You'll need extra nutrients for a growing baby, a healthy placenta, and a body that's preparing itself for breast-feeding. Nutritionists advise an extra 10 g of protein and 300 extra calories per day. If you have been getting enough protein before pregnancy, adding just 1 cup of skim milk, one slice of whole grain bread, and one piece of fruit will meet this recommendation. Improving your folic acid intake, especially before pregnancy and during the first 3 months, can lower the risk of certain birth defects (see "Folic Acid Facts").

Folic Acid Facts

  • The US Public Health Service recommends that all women of childbearing age consume 0.4 mg (400 mcg) of folic acid, a nutrient that has been shown to prevent neural tube birth defects such as spina bifida.

  • Women can meet the folic acid requirement by eating a diet rich in leafy, dark green vegetables, citrus fruits and juices, and lentils. Dietary supplements are another good option. One cup of cooked lentils provides 360 mcg of folic acid; a salad containing 2 cups of raw spinach provides 260 mcg.

  • Starting January 192021, it'll be even easier for women to get enough folic acid when US food manufacturers begin fortifying enriched breads, flours, corn meals, pastas, rice, and other grain products with folic acid.

Food safety during pregnancy doesn't have to be complicated. Just don't ingest anything that you wouldn't serve your baby: alcohol, caffeine, artificial sweeteners, and contaminants from pollution or bacteria.

The best way to avoid pollution contaminants is to avoid eating large ocean fish (such as swordfish, marlin, and shark), limit your intake of tuna to 1/2 pound a week, stick with low-fat fish, and trim the fat off the fish you eat. Call your local health department about recommended limits on consumption of fresh water fish for pregnant women.

Wash all produce thoroughly to remove chemical residue. To steer clear of bacterial contaminants, avoid soft cheeses, and foods that contain raw eggs. When in foreign countries, avoid raw food and food from street vendors.


Gestational Diabetes

Understanding Gestational Diabetes

(Back up to article)

Pregnancy is a time of many profound changes in the body's makeup. For 3% to 6% of pregnant Americans, some of these changes can lead to gestational diabetes.

What Is Gestational Diabetes?

Gestational diabetes occurs when pregnancy alters the way a woman's body uses sugar. Usually the hormone insulin helps move blood sugar (glucose) into muscles and organs. In gestational diabetes, insulin levels are too low, so the amount of glucose in the blood rises to dangerous levels while muscles and organs don't get enough.

The condition usually disappears with the birth of the baby, but it can be a sign that the mother may develop diabetes in later life.

How Will I Know I Have It?

The condition is most often detected in the second half of pregnancy. Doctors routinely screen for gestational diabetes between 24 and 28 weeks by administering the glucose tolerance test. However, doctors also monitor a woman's general glucose status at each prenatal visit by observing the results of the urine test and measuring abdominal growth. (A bigger-than-normal fetus can be a sign of gestational diabetes.)

What Are My Treatment Options?

If you have gestational diabetes, your doctor will more closely monitor your urine and blood glucose levels. Traditional care involves a diet that limits carbohydrate intake and, if necessary, may also include insulin therapy.

Some doctors are urging patients to add exercise as part of the treatment plan. They're finding that, for nonpregnant and pregnant diabetics alike, moderate exercise can aid the body's uptake of glucose. At the moderate level, exercise is described as "somewhat hard," but easy enough that you can talk during activity. Exercise can reduce or even eliminate the need for insulin therapy.

If you'd like to start an exercise routine, first check with your doctor. He or she will take into account your risk factors, changes to your body, and risk to the fetus. You'll be given specific instructions on how to safely exercise that involve checking your glucose level, monitoring the frequency of the baby's movements before and after exercise, and timing exercise to follow meals.


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