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Obesity and incidence of chronic disease continue to rise in the United States. The current medical paradigm focuses on treatment of chronic disease. A shift from the management of disease to prevention of obesity and its associated co-morbidities including diabetes mellitus and cardiovascular disease is necessary to protect the health of future generations. Pregnancy is a “teachable moment” offering a time when many women are motivated to make healthier lifestyle choices to optimize the health of their unborn child. This critical stage of the life cycle offers a unique opportunity to influence the health of future generations by modifying the lifestyle of the expectant mother. An abundance of evidence exists to associate excessive gestational weight gain (GWG) with adverse maternal and infant outcomes. Prenatal physical activity (PA) has been recommended to curtail the increasing rates of excessive weight gain during pregnancy yet few pregnant women meet current PA guidelines. Furthermore, the ability to accurately assess PA during pregnancy is convoluted by many factors, most notably the uncomfortable waist-worn placement of many commonly used activity monitors. Therefore, to make considerable strides in improving the health of future generations, it is imperative that strategies are developed to increase and accurately evaluate prenatal PA and explore its potential relationship with improved maternal and infant outcomes. In order to provide possible answers to these issues, the Blossom Project at Iowa State University conducted two studies. The first study evaluated the validity of the SenseWear® Mini armband (SWA) to estimate energy expenditure (EE) in pregnant women. Multiple activities of daily living ranging in intensity from sedentary to moderate walking on a treadmill were performed while EE was measured by the SWA and indirect calorimetry. The results of the study showed significant overestimation by the SWA compared to indirect calorimetry (0.57 ±0.06 kcal·min -1 ) but average individual correlation coefficients revealed good overall agreement between methods (mean r = 0.93). Due to the convenient location worn on the upper-arm, the SWA is a plausible method to estimate EE and PA during pregnancy. Future studies should develop pregnancy-specific algorithms to further improve estimation of EE in this population.

The Blossom Project Online: Use of a behaviorally-based website to promote physical activity and prevent excessive gestational weight gain in previously sedentary pregnant women