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Pregnant-woman-at-gym

Pregnancy and Childbirth During Unprecedented Times

Being pregnant and having a baby is stressful on its own. Now imagine being pregnant and delivering a baby during a global pandemic. Being a mother myself and treating pregnant women and new mothers, I recognize this population struggles with support, proper healthcare (especially postpartum), isolation and they may have limited resources at their disposal. It is important to understand that for many of these women the unexpected turn of events, has left them disappointed and it has affected the entire pregnancy and postpartum experience affecting both their mental and physical health. 

pregnancy-fitness

Risks Associated With the Development of Gestational Diabetes

Gestational diabetes mellitus (GDM) appears to be on the rise in the US, with the CDC suggesting that the prevalence of GDM may be as high as 9.2%. The disease is defined as the onset of impaired glucose intolerance during pregnancy as diagnosed from a glucose screening test (also called a glucose challenge test or GCT) between 24 and 28 weeks. Pregnant women who develop GDM are at higher risk of complications during pregnancy and delivery, and the fetus may develop macrosomia, and neonatal hypoglycemia. In addition, women who develop GDM have a greater than 7-fold increased risk of developing type 2 diabetes later in life. There’s some suggestion that babies born to mothers with GDM have a greater risk of developing impaired glucose tolerance.

Debra-TedX-Screengrab

Truth About Women’s Fitness in Menopause | My TEDx Talk

Women’s fitness in menopause is a hot topic. This is what I shared in a recent post when I began to spread the word about my TEDx talk:

I think I just threw up a little bit.

That’s how I titled my post. Here’s why.

My TEDx Talk Story

Let me tell you what happens when you get accepted to do a TEDx talk… and have less than 4 weeks to prepare it.

While you’re training for an Ironman happening two weeks after. And the weekend before you’re at a Thursday-Sunday conference knocking out a huge block of time you needed to prepare.

Then you do the talk and walk off stage feeling like you just had an out-of-body experience. You have no idea if you even said all the important things that made you do this, on your own dime and time.

Then you wait, and wait, and wait… for 7 months to it to be published (almost unheard of). And it risks getting banned because it’s controversial and in spite of a dozen+ research studies quoted and the basis of it: it flies against tradition.

It’s released… exactly what you wanted… except then you have to watch yourself and your midget mindset says, “what will people think?” You wonder if you’ve done the women whose stories you told justice. You wonder how many fitness pros will hate it because, well, they’d rather keep doing what they’re doing than accept we might be wrong.

(and of course, I’m human… I think while watching… I definitely look like I had gained that 10 lbs in 2019 I hinted at – ugh!) Keep reading beyond the video to learn more.

Well, hence the original subject line. I opened with. My TEDx talk is wayyyyyy harder to share than I anticipated.

I’ve been talking about women’s fitness for 3 1/2 decades. I’ve been diving deep into the research and protocols on exclusively women’s fitness in menopause for 10-14 hours a day for eight years. And still…

The Resistance

Somehow in my head it went different, you know? It was going to be a huge celebration and something I couldn’t wait to share.

So if I tell you when it all goes peachy and smooth, I have to tell you when it’s a sh#* storm for me.

That’s just personal doubt coming up. And I have it too. So it is fair for me to tell you, when you think maybe something won’t work for you or you can’t do this, these feelings are going to come up.

This resistance is harder than any weight you will ever lift.

So, I’ve got to say to you and to I both… lift the damn thing anyway.

We have to honor what’s happening for us at the moment we’re in no matter what that includes.

Now, a humble ask.

Will you watch my TEDx talk? 

It may help you know you’re not doing anything wrong. It may help you realize you’re doing more than you need to right now. Fitness in menopause is tricky.

Will you share it if it will benefit a friend or a health coach or trainer? 

We need to have some change in the way we think about women’s fitness in menopause order to change women’s fitness and health for the better. You deserve energy and vitality and you’re not going to get there by starving or exercise that causes extreme fatigue.

You can share the link from my website, flippingfifty.com/tedx (scroll below the video and see share buttons to put it directly on your favorite social media site) or from the TED YouTube channel directly.

And know, I appreciate it so much.

Here’s News I Haven’t Shared

Literally, the day after my TEDx talk went live, while I was still pulling up my big girl panties to share it and stop second-thoughts, I got my body fat tested. Here are the results.

Pretty amazing for a woman in post menopause at 56. From walking…. And 2 20-minute interval sessions (start to end) and 2 strength training sessions (about 30 minutes each) AT HOME during COVID19.

Now, if I changed that sentence:

Pretty amazing for a woman in post menopause at 56. From walking…. And 2 20-minute interval sessions (start to end) and 2 strength training sessions (about 30 minutes each) AT HOME during COVID19

Still true.

If I change it again:

Pretty amazing for a woman in post menopause at 56. From walking…. And 2 20-minute interval sessions (start to end) and 2 strength training sessions (about 30 minutes each) AT HOME during COVID19

Still true. (even at gym where you might think it’s easier)

So…You Need to Know

Listen, girlfriend. Please do not let that nasty, second-thought voice inside your head say you’re too old, you can’t get results, or it takes time and effort you don’t have or don’t want to put in.

Women’s fitness in menopause, and let’s get personal, your fitness in menopause may come from far less exercise than you’ve been led to believe.

Had you seen the BEFORE numbers… back in December of 2018 when I tested before beginning Ironman training … I was at 127, 24% body fat. So now… the negative impact of a year full of cortisol elevating stressors – including endurance training – become much more apparent. At my highest weight just before the Ironman I saw 139 on the scale. A number I’ve only ever seen before this when I was when pregnant. On a 5’4” frame that’s not healthy, and it’s mysterious given the exercise I was doing and high quality diet I have. Or so you might think!

Endurance exercise… causes a spike in cortisol.

You add that with many more major life stressors (I clearly got in the wrong line at some point in 2019) and you will GAIN weight. Add hitting menopause mid-year and you’ve got a perfect storm.

And no, many blessings to those who said, oh it’s muscle. Honey, um no. A girl knows. Muscle is more compact, not bulky. You can see the increase in body fat percent… 27% is not bad… just not something that makes sense with my lifestyle.

You Don’t Have to Go That Far (Please Don’t!)

I did an experiment in extremes here. You don’t have to be doing Ironman triathlon training to gain weight with too much exercise.

Please check your default thought pattern that more exercise is better.

Better exercise is better. Like walking…. Walking … for a woman used to running 3 hours, biking 4 and 5 hours… swimming for 1-1.5 hours … could also make you lose weight if it is the right Exercise is Medicine dose for you right now.

There will be a time when I can do some more of the endurance I love again. We have to listen to our bodies, adjust the exercise, as you would medication if your status changed.

 


 

Reprinted from flipping50.com with permission from Debra Atkinson.

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She is an international fitness presenter, author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

pregnancy-heart

The Increasing Need For Trained Maternal Fitness Instructors

The need for trained maternal fitness professionals has greatly increased as a result of the number of fit women who desire to continue with their exercise routine once they become pregnant. The past several decades has provided a large body of evidence that supports the benefit and safety of prenatal exercise in uncomplicated pregnancies, and ACOG and other fitness and medical health organizations recognize the importance of fitness in a healthy pregnancy. Studies have shown that women who continue or even start an exercise program during pregnancy gain less fat weight, have fewer complications during labor and delivery, and return to their pre-pregnancy weight faster than women who didn’t exercise while pregnant.

Knowing what the current evidence based guidelines are for pregnant and postpartum women and being able to work with this population will open up opportunities to create a specialized program that fits their unique needs. Fitness professionals who have training in this field offer skilled support and guidance to pregnant and postpartum women and help them confidently include exercise as part of their lifestyle. Pregnant women are unsure of what exercises and activities they can continue throughout pregnancy and need guidance on how to monitor their routine for safety. As pregnancy progresses, women need strategies for modifying their exercise program as their body changes to maintain a comfortable and safe routine.

For more information on prenatal and postpartum exercise and our CE correspondence course, “Prenatal and Postpartum Exercise Design” please visit, www.ppfconsulting.com

Article reprinted from Catherine’s Maternal Fitness blog with permission.


Catherine Cram, MS, is the owner of Comprehensive Fitness Consulting, a company that provides pre- and postnatal fitness certifications and information to hospitals, health & wellness organizations and the military.

Feet on bathroom scale

The Dreaded Menopod – Menopausal Belly Fat

The most common concern I hear from women in their 40’s and 50’s is increased belly fat. It isn’t weight gain that they are mostly upset about but where it’s deposited…right around the belly button.

Even women that don’t gain weight, see changes in where the fat is deposited. Is it an evil magic trick? I’ve heard it being called the belly bagel, spare tire, jelly center, and my favorite the menopod. Regardless of its name, it’s unwanted and you want to know how to get rid of it. Can you get rid of it or are you doomed to everlasting belly fat increases? Well, let’s break down why it happens and I’ll give you some ideas on what you can do.

Aging 

As we age, it is normal to see some weight gain. This is not something unique to women but women do see a larger increase in abdominal fat. In fact,  the prevalence of abdominal obesity in women in 2008 was 65.5% for women aged 40-59 years. So you’re not alone in this experience. Many different factors play a role in this. Changing hormone levels, loss in muscle mass, decreased activity level, and increased caloric intake, are just a few.

Estrogen

This is the queen bee of all hormones and sadly, this is the one that you’re being robbed off during menopause. Why is this such a big deal? Because she controls everything!! Estrogen plays a role in endocrine, immune, and neurologic systems. That’s why when it’s taken away, many women feel symptoms ranging from hot flashes to forgetfulness, depression and insomnia. One of the biggest connections of estrogen on increased belly fat is its relationship to cortisol. Ahhh, there it is, one of the biggest baddest buzz words in the health industry right now.

If you believe what you read in headlines, this is the one to blame for everything. If it’s out of control, you lose, but to control it seems impossible. Is it? How is estrogen related to it and how does it play a role in belly fat?

Cortisol deserves an entire article by itself (which will come soon) so here is the condensed version on why cortisol is so important to your menopod.

Cortisol is:

“Cortisol regulates energy by selecting the right type and amount of substrate (carbohydrate, fat or protein) that is needed by the body to meet the physiological demands that is placed upon it.” (5)

  • Energy production, exercising, eating, and under stress.
  • This chronic stress can cause excess fat storage deep in the abdomen (visceral fat).
  • Deep abdominal fat has greater blood flow and four times more cortisol receptors. That’s why when there is too much cortisol in your body, it goes right to your belly.
  • It naturally is higher in the morning when you wake up and tapers down as the day goes on.
  • When the body remains under constant stress, cortisol levels remain high regardless of time of day.

Estrogen – Cortisol Connection 

Estrogen has anti-cortisol properties, which helps the body counteract some of the negative effects of cortisol. So as estrogen starts disappearing, so do its cortisol-fighting superpowers. This means that if your body was able to handle some of the excess day-to-day stress before, it may not be able to handle it quite as well now, which translates into excess belly fat.

What can you do?

Chill out!!

  • This is the most important thing you can do
  • Eliminate little, unimportant things that drive you crazy. This is unnecessary stress.
    • In my case, every time I feel like getting stressed out over some inconsiderate driver on the road, I say to myself “menopod alert, menopod alert…not worth it!!” It helps 🙂
    • Stress will always be a part of life. Learning how to cope with it, is essential to controlling weight gain, belly fat, and overall health and well-being.

Resistance training

  • Don’t wait!
    • It is easier to maintain than to try and lose weight during menopause
    • Nobody knows exactly when menopause starts. It can be as early as mid-30’s to late 50’s.
    • Being active before midlife has advantages as it can contribute to entering menopause with lower BMI, higher bone density, lower fat mass, higher lean body mass.

Muscle mass decreases with age for every person, not just women. However, this decrease is accelerated in women as they transition through menopause.

Mindful exercises such as yoga, Tai Chi, meditation.

  • It can help with stress reduction as well as other psychological symptoms, such as anxiety and depression

Eat healthy and adjust your caloric intake to your energy output.

  • If you’re not working out as much as you did before, you can’t eat like you did

As we age, we are faced with many physical changes that affect us not only physically but also psychologically and emotionally. As women, those changes are exacerbated during menopause. Understanding these changes is a key factor in being able to overcome these challenges and transition happily through menopause. In regards to increased belly fat, you must remember that weight gain doesn’t happen overnight and it doesn’t start with menopause.

Don’t wait until you’re unhappy with your body… live healthy now!

Exercise, eat well, find a good balance between work and personal life, and enjoy the smaller things in life. Most importantly, don’t let inconsiderate drivers give you a menopod! 🙂

Have a comment or question? Tweet me @doctorluque

Republished with permission from doctorluque.com


Dr. Maria Luque is a health educator and fitness expert that specializes in helping women take charge of their own wellness. A native of Germany, she pursued a career driven by a passion for health and fitness. Dr. Luque currently teaches at the College of Health Sciences at Trident University International, in addition to conducting workshops, group/personal training, and writing. She’s an IDEA Fitness Expert and has been published in the IDEA Fitness Journal as well as appeared as a guest at local news channel to talk about quality of life and menopause. Visit her website, doctorluque.com

References

  1. Davis, et al. (2012) Understanding weight gain at menopause. Climacteric 15;419-429. doi: 10.3109/13697137.2012.707385
  2. Sammel, et al (2003). Weight gain among women in the late reproductive years. Family Practice, 20: 401-409. doi: 10.1093/fampra/cmg411
  3. Lovejoy, J. C., Champagne, C. M., De Jonge, L., Xie, H., & Smith, S. R. (2008). Increased visceral fat and decreased energy expenditure during the menopausal transition. International Journal of Obesity, 32(6), 949-58. doi:http://dx.doi.org/10.1038/ijo.2008.25
  4. Epel, E. S. (1997). Can stress shape your body? stress and cortisol reactivity among women with central body fat distribution. (Order No. 9930948, Yale University). ProQuest Dissertations and Theses, , 96-96 p. Retrieved from http://search.proquest.com/docview/304388219?accountid=28844. (304388219).
  5. Maglione-Graves, C., Kravitz, L., Schneider, S. (no date). Cortisol Connection: Tips on Managing Stress and Weight. http://www.unm.edu/~lkravitz/Article%20folder/stresscortisol.html

Hormone Balancing Fitness for Women in Midlife

Before hormone balance can be a goal you need a clear definition of what it or hormone imbalance looks like! It’s never just hormones though is it? For the majority of women in midlife and beyond, there’s also a special condition, a joint issue, or a crazy schedule that also needs to be addressed.

If any of these describe you:

  • You’re putting on weight lately no matter what you do
  • You have belly fat even though you’re weight is OK
  • You have cellulite on your thighs, belly, bum, or on your upper arms
  • You can’t seem to develop any muscle tone in your legs
  • You’ve got a saggy bum in spite of so many lunges and squats you can’t sit down
  • You’ve turned up the exercise and eat carefully but still no results
  • You’ve got saggy chest and neck skin

Plus:

  • You have touchy joints from prior or current injuries
  • You have had breast cancer surgeries
  • You’ve had other invasive surgery or joint replacement
  • You have a chronic condition

And potentially:

  • You can’t sleep well
  • Even if you do sleep you don’t wake up refreshed
  • You have high levels of stress right now
  • You’ve tested your hormones and you’re “normal” but don’t feel it
  • You still don’t have any idea how to exercise “normal” or not
  • You have depression or anxiety
  • You’re taking medications for the above or other things with side effects
  • Your digestion is off (even if you thought that was “just me”): You don’t poo every day at least once (more is better); You have rabbits or pudding instead of snakes, You have gas or bloating you just tolerate

And finally:

What you used to do doesn’t work any more.

Then this is definitely for you… if you want to change. Changing is the obstacle for a significant percent of women that express interest in change. If you aren’t willing to change habits, change beliefs, change what you eat and when, change how you exercise and when, then this will just be another blog. No set of exercises, videos, menu plans will ever help until you decide you are 100% in.

Throw Away the Textbook

Exercise for hormone balance is not your textbook exercise. “I’ve never heard that before,” is not a good excuse to dismiss something as true. How many research studies did you read last week about menopause, hormones, and exercise? They’re at anyone’s fingertips in today’s world. So holding onto old ideas without researching for yourself or finding a voice you trust instead of going by an outdated text is irresponsible. A published textbook is outdated by the time it goes to print. Research in this area is accelerating. Get help and get up to speed on research on hormone balance.

Approximately 6000 women a day go into menopause right now. That’s 2 million a year. Yet, 39% of all sports medicine and exercise research features females at all. It’s safe to say a small slice of that focuses on women in perimenopause, menopause, and post menopause and the hormones that influence and are influenced by her exercise.

It’s time to change the way we prescribe exercise during the change. If a woman begins perimenopause in her mid 40s and lives to her mid 80s she spends 40 years in menopause. Shouldn’t we be optimizing exercise for this large population of currently 38 baby boomer women, 25 million Gen X women and coming soon, an even larger number of millennial women? Fitness is either going to open a new level of health for women, who ultimately influence 80% of household decisions including health, or fail miserably. Conventional exercise prescriptions contribute to hormone imbalance.

Your hormone balance exercise

Start lifting weights focused on major muscle groups. Even if you swear by functional movement patterns, insulin, cortisol, and the half dozen more hormones that influence her fat and health are key for reducing risk of disease. Even if you want to tone those arms, you want to start with major muscle groups. Even if you want a flat belly, start with major muscle groups. Stop long slow exercise sessions and long endurance activity.

Increase your protein at every meal and eat regularly. Get to bed early and make sure you control your environment. If you love your wine or nightcap, you’ll want to stop that. All of these things kill testosterone, a key hormone for building lean tissue and libido. Testosterone gives you a kick of confidence too also important for libido.

These are but a few scenarios of exercise changes you can make for more hormone balance. Each woman has a unique set of health history, physical status, signs and symptoms that make her unique.


Excerpt from the original blog post by Debra Atkinson for Flipping 50

Debra Atkinson is the #youstillgotitgirl who is flipping 50 and changing the way thousands of women think about their second half. She’s the host of the Flipping 50 TV Show and the Flipping 50 podcast. As a master personal trainer, strength and wellness coach with over 30 years fitness industry experience, she works with women who are pro-aging with vitality and energy. She is an international fitness presenter, author of hundreds of articles and multiple books. Visit her website, flippingfifty.com

Meta Slider - HTML Overlay - Pregnant woman holding fitness dumbbells

Prenatal Exercise: Training for the Main Event

Say good-bye to the myth of the “delicate” condition and hello to pregnancy in the 21st Century!

Current research continues to show that women can safely exercise and maintain their fitness level during the perinatal period.  The mom who laces up her sneakers instead of heading to the couch will be rewarded with a healthier pregnancy and a healthier baby.

Pregnant woman doing yoga with a personal trainerPregnancy is a time of excitement, uncertainties, fears, and many profound physical and emotional changes. This “season in life” affords mom a wonderful opportunity to adopt a healthier lifestyle.  Starting an exercise program during pregnancy is a great way to begin and continue this healthier lifestyle for herself and subsequently for her child.  With obesity on the rise in the US, it is important for everyone to increase their current level of physical activity.  This is especially important for pregnant women as the results of obesity and excessive weight gain have been shown to be detrimental to both mom and baby long term.

A Historical Perspective on Prenatal Exercise Guidelines

Moms today are inundated with information regarding pregnancy and exercise. Unfortunately, a great deal of this information is outdated.   It is important for women to have a working knowledge of the most current guidelines so that they can make intelligent choices regarding their exercise programs. For many years, pregnant women were advised to “take it easy” during pregnancy.  Mom was advised to rest and gain weight in order to ensure a healthy pregnancy.  In the 1950’s women were “allowed” to walk a mile a day for exercise and this mile was preferably “broken up” into smaller segments. The American Congress of Obstetrics and Gynecology (ACOG) issued the first formal guidelines for perinatal exercise in 1985 (1).  These guidelines were highly restrictive as they were not based on extensive research and were designed for the majority of pregnant women without regard to pre-pregnancy fitness levels. Four of the original guidelines are highlighted below:

  • Mom should exercise at a heart rate <140 bpm.
  • Strenuous exercise should not exceed 15 minutes
  • Maternal core temperature should not exceed 38 degrees C
  • No supine exercise after the first trimester

A great deal of research involving both sedentary and trained subjects was published

after the release of the 1985 guidelines. This prompted ACOG to publish a revision of the original guidelines in 1994 which lifted specific limitations for prenatal exercise (2).  ACOG said, “There are no data in humans to indicate that pregnant women should limit   exercise intensity and lower target heart rate because of adverse effects.”   In this revision, there was no mention of the 140 bpm maximal heart rate or an exercise limit of fifteen minutes. Women were advised to use the “talk test” and “perceived exertion” as ways to measure exercise intensity. We were making progress!    Although the 1994 guidelines were a refreshing change in the right direction for ACOG, they still did not address the pregnant athlete. In 2002, ACOG published “Exercise During Pregnancy and the Postpartum Period: ACOG Committee Opinion 267” (3). In this publication, which was reaffirmed in 2009, ACOG recognized that “in the absence of contraindications, pregnant women should be encouraged to engage in regular, moderate intensity physical activity to continue to derive health benefits during their pregnancy as they did prior to pregnancy.” This revision focused more on the athlete as well and was the first formal recommendation by an American physician group to include prenatal exercise. The major points of the 2002 update include:

  • Previously sedentary women and those with any medical or obstetrical problems should obtain medical clearance before embarking on an exercise program; NO PRENATAL CLEARANCE, NO EXERCISE, NO EXCEPTION.
  • Thirty minutes or more of moderate exercise daily, or on most days of the week is recommended. This brought the exercise guideline for pregnancy more in line with the ACSM guidelines for the general population.
  • Competitive and recreational athletes with routine pregnancies can remain active, “listen to their bodies” and modify their exercise routines if medical necessity arises.
  • Physically active women with a history of or risk for preterm labor or fetal growth restriction should reduce their activity in the second and third trimesters.

In 2006, the “ACSM Roundtable Consensus Statement: Impact of Physical Activity During Pregnancy and Postpartum on Chronic Disease Risk” was published (4). This report, based on an analysis of the most current research by a panel of scientific and clinical experts, supported the safety and long term benefits of prenatal and postpartum exercise for both mom and baby. Some of the benefits highlighted in this report and other studies show that exercise:

  • Reduces the risk of preeclampsia (a condition marked by high blood pressure, protein in the urine and marked fluid retention in the mom which can lead to serious maternal and fetal complications).
  • Treats or prevents gestational diabetes, the diabetes of pregnancy. For some women exercise alone may stabilize blood sugar. Moms with gestational diabetes are more prone to Type II diabetes later in life.
  • Helps manage or alleviate pregnancy related musculoskeletal issues. Exercise may help with low back pain, urinary incontinence, abdominal muscle and joint and muscle issues.
  • Links breastfeeding and postpartum weight loss. Weight loss can occur with moderate exercise and caloric restriction without affecting the quantity and quality of breast milk or infant growth.
  • Positively impacts mood and mental health. Exercise is a “mood elevator.”  It reduces stress, fatigue, anxiety and improves self-image.
  • Baby’s health and development: The panel advised that beginning or continuing a prenatal exercise program had both short and long term positive effects.

Beautiful pregnant woman thinking of her babyThe most recent guidelines for prenatal exercise were included in the 2008 US Dept. of Health and Human Services Physical Activity Guidelines (5).  Women who are not currently active should strive for at least 150 minutes of moderate intensity cardiovascular activity per week.  This translates to 30 minutes of exercise 5 days a week, very similar to the ACOG guideline.  They recommend that those women who are currently active may continue their normal routine providing there is an open line of communication with their healthcare providers

The latest research continues to showcase the benefits of prenatal exercise. A 2013 review of the international evidence reinforced the fact that women who engage in prenatal exercise have a decreased risk of developing gestational diabetes and other hypertensive disorders during their pregnancies.  They are also less likely to deliver big babies (> 9 pounds).  Other studies suggest that babies born to active moms are lighter and leaner at 1 and 5 years of age (6). Additional research has supported these findings and has extended the benefits to older children (8-10 year olds) (7).  This is quite significant considering the fact that childhood obesity is on the rise. We now have exciting evidence that the in utero environment of exercising mothers may provide long term effects for their offspring with regards to bodyweight and body fat.  Prenatal exercise may also boost babies’ brain activity.  Canadian research has shown that babies of exercising moms had greater brain activity 8 – 12 days after they were born, as evidenced by an increased ability to process repeated sounds (8).  This was the first study to link prenatal exercise with babies’ brain development.

In 2015, ACOG released two new publications, “Obesity in Pregnancy,” Bulletin Number 156 (9) and “Physical Activity and Exercise During Pregnancy and the Postpartum Period,” Committee Opinion Number 650 (10).   Both publications emphasize the need for regular exercise to prevent or combat excess weight gain and /or obesity in the perinatal population.   Greater than half of the women of childbearing age in the US are overweight or obese. Obesity in pregnancy is associated with significant risks for both mother and baby.  Bulletin 156 authors wrote, “Optimal control of obesity begins before conception.  Weight loss before pregnancy, achieved by surgical or nonsurgical methods, has been shown to the most effective intervention to  improve other health problems.”  The updated Bulletin 156 recommendations include:

  • Behavioral interventions that utilize both diet and exercise can improve postpartum weight loss better than exercise alone
  • BMI should be calculated at the first prenatal visit and used to counsel women on diet and exercise utilizing the Institute of Medicine Guidelines for prenatal weight gain
  • Small preconception weight losses in obese patients can improve pregnancy outcome
  • Losing weight between pregnancies in obese patients may decrease the risk for a large-for-gestational-age baby in a subsequent pregnancy

Pregnant women doing squatting exercise.Pregnancy is an ideal time for maintaining or adopting a healthy lifestyle. Recommendations from ACOG Committee Opinion Number 650, “Physical Activity and Exercise During Pregnancy and the Postpartum Period” include:

  • Physical activity in pregnancy has minimal risks and has been shown to benefit most women, although some modification to exercise routines may be necessary because of normal anatomic and physiologic changes and fetal requirements.
  • A thorough clinical evaluation should be conducted before recommending an exercise program to ensure that a patient does not have a medical reason to avoid exercise.
  • Women with uncomplicated pregnancies should be encouraged to engage in aerobic and strength-conditioning exercises before, during, and after pregnancy.
  • OB-GYN’s and other obstetric care providers should carefully evaluate women with medical or obstetric complications before making recommendations on physical activity participation during pregnancy. Although frequently prescribed, bed rest is only rarely indicated and, in most cases, allowing ambulation should be considered.
  • Regular physical activity during pregnancy improves or maintains physical fitness, helps with weight management, reduces the risk of gestational diabetes in obese women, and enhances psychological well-being.
  • 20-30 minutes of moderate intensity exercise per day, on most or all days, is recommended.
  • Exercise intensity should be monitored by RPE and the “talk test.” Suggested RPE is 13-14 on a 6-20 scale.
  • Women are encouraged to stay well hydrated, avoid long periods of lying supine and cease exercise if they have any warning signs (see below).
  • Women who were sedentary before pregnancy should gradually progress their exercise programming
  • Women who were regular exercisers prior to pregnancy and who have uncomplicated, healthy pregnancies should be able to engage in high-intensity exercise programs, such as jogging and aerobics, with no adverse effects. High-intensity or prolonged exercise in excess of 45 minutes can lead to hypoglycemia; therefore, adequate caloric intake before exercise, or limiting the exercise session, is essential to minimize any risk.\Contact sports, activities with a high risk of falling, scuba diving, sky diving and “hot yoga” are not recommended

Warning Signs and Symptoms to Discontinue Exercise (11)

If a woman experiences any of the following, she should cease exercise and contact her health care provider as soon as possible:

  • Vaginal bleeding or fluid leakage
  • Shortness of breath prior to exertion
  • Pelvic pressure or cramps
  • Dizziness
  • Headache or any vision problem
  • Pain of any kind
  • Uterine contractions
  • Muscle weakness
  • Calf pain or swelling
  • Preterm labor
  • Decreased fetal movement
  • Chest pain
  • Temperature extremes (hot or cold; clammy)
  • Nausea / Vomiting

As a result of almost 30 years of research showing the benefits of prenatal exercise, we have seen a substantial increase in the number of motivated personal trainers who are certified to work with this very special population.  No two pregnancies are the same and no two prenatal fitness programs should be the same.  Trainers certified in perinatal fitness and wellness possess the knowledge and skills to design and implement individualized programs to help mom prepare for the “marathon of labor” and the “tasks of mothering” after the baby is born.

Join Sheila for her upcoming webinar:

 


Sheila Watkins is a perinatal fitness specialist with over 25 years of experience training 2500+ pregnant and new moms, and educating hundreds of fitness instructors, health professionals, and childbirth educators on the rapidly changing field of perinatal fitness. She is the creator of Healthy Moms® Fitness Programs to provide safe and effective group exercise classes and personal training for new and expectant moms, as well as education and training in the field of perinatal exercise for fitness professionals, childbirth educators and other health professionals.

References

  1. ACOG. The ACOG Guidelines for Exercise During Pregnancy and Postpartum; Home Exercise Programs, 1985.
  2. ACOG. Exercise During Pregnancy and the Postpartum Period. ACOG Technical Bulletin, No.189, February 1994.
  3. ACOG. Exercise During Pregnancy and the Postpartum Period, ACOG Committee Opinion, No. 267, Washington, DC: ACOG, January 2002 (reaffirmed in 2009).
  4. Pivarnik, J. et al. American College of Sports Medicine Roundtable Consensus Statement, June 2006.
  5. http://www.cdc.gov/physicalactivity/everyone/guidelines/pregnancy.html
  6. Mudd LM, Owe KM, Mottola MF, Pivarnik JM. Health benefits of physical activity during pregnancy: an International Perspective Med Sci Sports Exerc. 2013 Feb;45(2):268-77.
  7. Pivarnik. J. and Kuffel, E. ACSM Sports Medicine Bulletin; Active Voice: More Maternal Physical Activity May Lead to Leaner Pre-Adolescent Children; June 20, 2010.
  8. http://www.nouvelles.umontreal.ca/udem-news/news/2013-exercise-during-pregnancy-gives-newborn-brain-development-a-head-start.html
  9. ACOG. Obesity in Pregnancy. ACOG Practice Bulletin, No.156, December, 2015.
  10. ACOG. Exercise During Pregnancy and the Postpartum Period, ACOG Committee Opinion, No. 650, December 2015
  11. Watkins, Sheila S. “Healthy Moms@ Perinatal Fitness Instructor Training Manual.” 2013.
fdn-pregnancy-article

Pregnancy, Hormones and Mood Swings

Why are women hormonal when they are pregnant?  And are there different types of food that can help alleviate the symptoms?

By “hormonal”, we are referring to the severe mood swings that many women experience during pregnancy. Mood swings are also a common symptom of PMS, and in both cases, hormone imbalance is a likely cause. Unfortunately, hormone imbalance is quite common and is often a result of the unhealthy habits that our modern lifestyles promote. While there are many health factors that can cause moodiness, female hormone imbalance will be the focus of this discussion.

Female Hormone Imbalance

Estrogen and progesterone are the primary hormones involved in menstruation and pregnancy. In general, estrogen promotes tissue growth and progesterone regulates it. As such, when an imbalance between these hormones develops, serious problems can result.

Low progesterone is the most common form of female hormone imbalance and typically results in a condition called “estrogen dominance.” Even if estrogen levels are normal, they’ll still be high in relation to the low level of progesterone. This can cause mood swings, breast soreness, migraines, irregular menstruation, water retention, weight gain and much more. If left untreated, some of the major problems it can lead to include fibroids, infertility, endometriosis, cancer, heart disease and stroke.

Although the production of both estrogen and progesterone are dramatically increased during pregnancy, the severity of estrogen dominance can increase if the body is not able to meet the increased demand of progesterone. In extreme situations, this can even result in miscarriage.

What Causes the Imbalance?

The two primary factors that contribute to progesterone deficiency have to do with how it’s made and its involvement with stress.

Progesterone is synthesized from another hormone named pregnenolone which is created from cholesterol. Because we’ve been programmed to fear dietary cholesterol, many people follow a low fat and low cholesterol diet. This deprives them of the materials needed to synthesize important hormones such as progesterone. Furthermore, because cholesterol is important to the function of the brain and nervous system, the body will always sacrifice hormone production in favor of these more important areas.

Another dietary factor that contributes to estrogen dominance is the consumption of xenoestrogens and phytoestrogens. Respectively, these are chemical and plant based substances that mimic estrogen in the human body. Xenoestrogens are commonly found in plastics, pesticides, and other agricultural chemicals while soy products are notorious for containing phytoestrogens. This is just one of many reasons why it’s important to eat organic food, avoid storing your food or water in plastic, and minimize your consumption of soy products.

The Contribution of Stress

Finally, stress is a major contributor to progesterone deficiency. Cortisol, the body’s primary stress and anti inflammatory hormone, is derived from progesterone. As such, chronic exposure to stress will greatly reduce the availability of progesterone for other purposes. Furthermore, common sources of chronic inflammation such as infection and food sensitivities will do the same.

Many of us live with excessive stress, eliminate saturated fat and cholesterol from our diets, eat conventionally farmed foods that are laced with chemicals, and unknowingly eat foods that we’re sensitive to. In fact, this typically occurs on a daily basis. Each of these factors can cause estrogen dominance and modern society promotes all of them!

Adrenal fatigue is another example of how modern living promotes hormone imbalance and poor health. And it plays a role in estrogen dominance as well.

Regaining Balance

The question asked assumes that eating specific foods can resolve all of this. While diet is part of the solution, it’s far from being the complete solution. Searching for a particular food or supplement to resolve a specific problem is nothing more than a natural form of chasing symptoms. As always, the solution to all health problems begins with living a lifestyle that incorporates the 7 foundational factors of optimal health.

Because cholesterol is a precursor to many essential hormones, it’s important to get past the fear that dietary cholesterol and saturated fat cause heart disease. For further information about the fallacies of this belief, read The Cholesterol Myths by Uffe Ravnskov MD, PhD.

A few good sources of saturated fat and cholesterol include beef, pork, butter, ghee, and eggs. Be sure to get these foods from quality sources, and consider following the Metabolic Typing Diet to understand what quantities of these foods would be best for you.

In chronic cases of hormone imbalance where progesterone is used excessively to produce the cortisol needed to handle frequent stress and inflammation, the body’s preferred pathways of hormone synthesis can become altered indefinitely. In such cases, lifestyle improvements are still necessary, but often not enough.

Supplementation of bio-identical hormones is often needed to re-establish the proper pathways. However, for this to happen, any existing food sensitivities or chronic infections must be addressed as well. For this type of treatment to be effective, and also safe, proper testing is absolutely essential.

Hormone Balance is Just One Part of Functional Nutrition. 

Integrate Functional Nutrition Into Your Services. Functional Diagnostic Nutrition (FDN) offers a certification for professionals with a passion for helping others and who is willing to walk-the-talk. Helping others to regain health, regardless of their starting point, requires only the proper training and leadership. Click here to learn more about the FDN Certification course.


Originally printed on the Functional Diagnostic Nutrition blog. Reprinted with permission.

The mission of Functional Diagnostic Nutrition is to educate as many people as possible about how to get well and stay well naturally, so that they may, in turn, educate others. FDN founder Reed Davis is a Certified Nutritional Therapist and Founder of the Functional Diagnostic Nutrition® (FDN) Certification Course. Reed is known as one of the most successful and experienced clinicians in the world today, having provided functional assessments to over 10,000 clients for hormone levels, bone density testing, adrenal function, digestive problems, immune system and detoxification issues as well as testing for pathogens, food sensitivities and many related health problems.

probiotics

Probiotics & Menopause

Probiotic, Prebiotic, Synbiotic, Antibiotic, Psychobiotic?

If you think this is the title to a new Sci-Fi flick, you’re not alone. How confusing can things get? We hear about them in the news and on ads but does anyone ever really explain what they mean and why you should care to know? Well, I’m breaking it all down for you into small digestible bites. 

Menopause is marked by a plethora of symptoms ranging from hot flashes, weight gain, and memory loss, to depression and anxiety, just to name a few. With probiotics being the new hot topic on the supplement market with its adds promising infinite health benefits, the question arises if they can be beneficial with menopausal symptoms as well. Is there truth to any of those claims? What are probiotics? Would you benefit from consuming them? The last question is one you will have to answer for yourself but after reading this blog you’ll be well-equipped to make an informed decision:

Probiotics:

Probiotics come from the Greek word “pro bios” which means “for life”. The internationally endorsed definition of probiotics is “live microorganisms that, when administered in adequate amounts, confer a health benefit on the host.” The key word here is “live”.

Prebiotics:

Dietary substances that nurture a selected group of microorganisms living in the gut. Example: Polyphenols in chocolate act as prebiotics, enhancing beneficial bacteria that are already in the gut. They favor the growth of beneficial bacteria over that of harmful ones. (1)

Synbiotics:

Appropriate combinations of prebiotics and probiotics.

Antibiotics:

A substance that inhibits the growth of or destroys microorganisms.

Psychobiotics:

Probiotics that have a specific health benefit in regards to mental health. This is not a scientific term but rather a term coined by a scientist that was researching the mental health benefits of probiotics. (2) It’s very catchy so I thought I’d share 🙂

There are over 100 trillion bacteria, most of them in the intestines. These bacteria are our own intestinal medicine cabinet, which is capable of protecting us from damaging organisms.

They produce neurotransmitters that relay messages from the intestines to the brain via the vagus nerve, which causes the body to react in many different ways:

Gut bacteria work in the body through different modes of action supporting essential functions:

  • Digestion
  • Immunity
  • Metabolism
  • Mental Health
  • Nervous system

And helping with a variety of diseases. A few are mentioned below:

  • Lactose intolerance
  • Stress
  • Hypertension
  • Cholesterol reduction
  • Irritable bowel syndrome
  • Crohn’s disease

A lot of the now marketed probiotics don’t have any benefits as they don’t make it passed the stomach acid. There are however, some that have great benefits:

Warning: No legal definition of probiotics currently exists, which allows companies to label their products “probiotic” even if they don’t meet the scientific definition of the term. No probiotic has of yet been approved for therapeutic purposes by the FDA. So when purchasing probiotic supplements, do your research. As with any other nutrient, always try to get as much in your daily fresh food (yogurt, kefir, fermented foods, sauerkraut, kimchi) instead of supplementing with pills or powders.

Due to their specific benefit, some of the strains of bacteria that may be beneficial for menopausal symptoms are listed below:

Combination of Lactobacillus helveticus & Bifidobacterium longum 

  • Reduced cortisol and inflammation
  • Cortisol is a big player in menopausal belly fat
  • Inflammation is a big player in musculoskeletal pain

Lactobacillus and Bifodobacterium

  • Secrete GABA, a neurotransmitter, who’s deficiency has been linked to depression. Polyphenols in dark chocolate act as prebiotics increasing both bacterial families

Lactobacillus rhamnosus

  • Reduces anxiety and depression by increasing GABA receptors in the brain

Bifidobacterium 

  • Alters levels of serotonin (similar to Prozac)

Lactobacillus reuteri 

  • Improves mood, appearance, and general health by increasing levels of the feel-good-hormone oxytocin

Lactobacillus acidophilus 

    • Influences canabinoid receptors, which are critical to regulating pain

B. infantis, L. reuteri 

    • Decrease inflammation

Active agents in yogurt 

    • Reduce anxiety and fear

Note: I was not able to find any specific studies that evaluated the benefit of probiotics for menopausal symptoms. This article, although based on information from peer-reviewed sources, is my own opinion on the possible benefits that probiotics can have on menopausal symptoms. It is intended to provide you with information but should not be taken as medical advice. Each situation is different. Contact your health care provider if you have other health conditions and are interested in exploring probiotics, as there may be interactions with medications that were not explored in this article.

Have a comment or question? Tweet me @doctorluque

Republished with permission from doctorluque.com


Dr. Maria Luque is a health educator and fitness expert that specializes in helping women take charge of their own wellness. A native of Germany, she pursued a career driven by a passion for health and fitness. Dr. Luque currently teaches at the College of Health Sciences at Trident University International, in addition to conducting workshops, group/personal training, and writing. She’s an IDEA Fitness Expert and has been published in the IDEA Fitness Journal as well as appeared as a guest at local news channel to talk about quality of life and menopause. Visit her website, doctorluque.com

References:

(1) Jain, D. & Chaudhary, H.S. (2014). Clinical significance of probiotics in human. International Journal of Nutrition, Pharmacology, Neurological Diseases, 4(1), 11-22.

(2) Davidson, J. (2014). The Psychobiotic Revolution. Psychology Today March/April, 40-41.

(3) Sanders, M.E. (2008). Probiotics: Definition, Sources, Selection, and Uses. Clinical Infectious Diseases, 46:S58-61.