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Energy Expenditure in Pregnant Women with Obesity Does Not Support Energy Intake Recommendations
Author(s) -
Most Jasper,
Vallo Porsha M.,
Gilmore L. Anne,
St. Amant Marshall,
Hsia Daniel S.,
Altazan Abby D.,
Beyl Robbie A.,
Ravussin Eric,
Redman Leanne M.
Publication year - 2018
Publication title -
obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.438
H-Index - 199
eISSN - 1930-739X
pISSN - 1930-7381
DOI - 10.1002/oby.22194
Subject(s) - medicine , endocrinology , obesity , basal metabolic rate , pregnancy , triiodothyronine , gestation , energy expenditure , weight gain , insulin resistance , hormone , body weight , biology , genetics
Objective This study aimed to identify factors that may predispose women to excess gestational weight gain (GWG). Methods Seventy‐two healthy women with obesity (30 class I, 24 class II, 18 class III) expecting a singleton pregnancy were studied at 13 to 16 weeks gestation. Energy expenditure (EE) was measured during sleep (SleepEE, average EE from 0200‐0500 hours) in a whole‐room calorimeter, and total daily EE (TDEE) over 7 days using doubly labeled water. Glucose, insulin, thyroid hormones, and catecholamines were measured. Results Body composition explained 70% variability in SleepEE, and SleepEE accounted for 67% to 73% of TDEE. Though there was no evidence of consistent low metabolism, there was considerable variability. Low SleepEE was associated with insulin resistance and low triiodothyronine concentrations (both P = 0.01). Physical activity level was 1.47 ± 0.02. For women with SleepEE within 100 kcal/d of their predicted EE, TDEE was significantly less than the estimate (2,530 ± 91 vs. 2,939 kcal/d; P < 0.001) provided from the most recent gestational energy requirement model. Conclusions Pregnant women with obesity are inactive, possibly predisposing them to excess GWG. Current energy requirement models overestimate activity and may promote excess GWG in women with obesity. Furthermore, the observed large interindividual variability in basal metabolism may be important to consider when assessing the risk for excess GWG.