Studies have demonstrated that new and expectant mothers experience increased levels of stress and anxiety during the COVID-19 pandemic. Though prenatal yoga is an effective mode of improving mental health during pregnancy, no research has evaluated its effect on mental health during times of extreme stress, such as a global pandemic. The purpose of this study was to determine the influence of a single session and a 10-week prenatal yoga intervention on the mental health of pregnant women during the COVID-19 pandemic. Women (n = 19; 28.52 ± 3.74 years; 20.94 ± 4.69 weeks gestation; BMI 29.33 ± 9.08) were randomized into a yoga or a non-yoga control group. There were no differences in demographic factors or depression/anxiety scores between groups at baseline. Baseline levels of anxiety and depression were high, with an average depression score of 8.10 ± 4.85 (scores > 8 represent possible depression) and an average anxiety score of 39.26 ± 12.99 (scores ≥ 39 represent a clinically significant anxiety). After just one session of yoga, women reported feeling less depressed (p = 0.028), tense (p < 0.001), and fatigued (p = 0.004). After 10 weeks, the yoga group had lower anxiety (p = 0.002), depression (p = 0.032), and total mood disturbance (p = 0.002) scores when compared to the control group. Yoga appears to benefit the mental health of expectant mothers, even in times of extreme stress. The findings of this study provide clinicians with valuable information regarding alternative exercise options for mental health during pregnancy during the COVID-19 pandemic.
Pregnant women with obesity are less metabolically flexible, and this is linked to maternal insulin resistance during pregnancy. It is well-known that an altered intrauterine metabolic environment contributes to the programming of neonatal outcomes; however, the relationship between maternal metabolic flexibility (i.e. the ability to switch between fat and carbohydrate oxidation in response to changes in fuel availability) and neonatal outcomes has not been studied. PURPOSE: The aim of this study was to determine the relationships between maternal metabolic flexibility and other metabolic factors during pregnancy and neonatal health outcomes. METHODS: The interventional physiology study among a cohort of pregnant women utilized indirect calorimetry to assess lipid oxidation rate before and after consumption of a high-fat meal. The percent change in lipid oxidation was calculated as the measure of 'metabolic flexibility'. Maternal insulin resistance was measured via fasted plasma insulin and glucose values. Neonatal adiposity was assessed within 48 hours of delivery by skinfold anthropometry. Additional neonatal outcomes were also assessed including cord blood biomarkers. RESULTS: A less favorable maternal metabolic profile (decreased metabolic flexibility, increased insulin resistance, increased BMI) was associated with higher neonatal adiposity. Specifically, metabolic flexibility (r = -.271, p = 0.034), maternal HOMA-IR (r = 0.280, p = 0.030), and maternal BMI (r = 0.299, p = 0.018) were correlated with subscapular skinfold. Regression analysis revealed metabolic flexibility was a significant independent predictor of neonatal subscapular skinfold thickness even when controlling for neonatal gestational age at delivery, maternal HOMA-IR, and maternal BMI (p = 0.046). CONCLUSIONS: Decreased metabolic flexibility/substrate shifting in response to a high-fat meal during pregnancy is linked to neonatal adiposity. Funding was provided by NIH NIGMS IDeA Grant 5P20GM103436 and WKU RCAP Grant 17-8011.
The purposes of this pilot study were to describe changes in breastmilk lipid content in response to an acute bout of moderate intensity exercise and to explore maternal metabolic health factors, including metabolic flexibility, which may impact this change. A cross-sectional, observational, pilot study design was performed in 14 women between 4 and 6 months postpartum. Whole body fasting lipid oxidation was assessed, a standardized high-fat breakfast was consumed, and lipid oxidation was again measured 120-minutes post-meal. Metabolic flexibility was determined by comparing the change in lipid oxidation before and after the meal. Women completed 30-minutes of moderate intensity treadmill walking 150-minutes post-meal. Breastmilk was expressed and analyzed for lipid content before and after exercise. Overall, there was no significant difference between pre- and post-exercise breastmilk lipid content (pre-exercise 59.4±36.1 g/L vs. post-exercise 52.5±20.7 g/L, p=0.26). However, five (36%) women had an increase in breastmilk lipid content in response to the exercise bout, compared to nine (64%) that had a decrease in breastmilk lipid content suggesting inter-individual variability. The change in breastmilk lipid content from pre- to post-exercise was positively correlated to metabolic flexibility (r=0.595, p=0.03). Additionally, post-exercise lipid content was positively correlated with body mass index (BMI), body composition, and postpartum weight retention. Preliminary findings from this pilot study suggest that metabolic flexibility and maternal weight status may help explain the inter-individual changes in breastmilk lipid content in response to an acute bout of moderate intensity exercise.
ABSTRACT: Americans living in rural areas often encounter health disparities, due, in part, to lack of access to healthcare. Establishing health promotion programs in rural church settings presents opportunities for nurses and other healthcare professionals to serve their communities and live out Christian faith. This article describes a health ministry program that was successfully implemented in a small, rural church using the Healthy People 2020 MAP-IT framework.
African-American (AA) women have elevated predominance of inflammatory diseases concurrent with local inflammation resulting in compromised metabolic function. The purpose of the study was 2-fold: 1) to examine the gene and protein expression of pro- and anti-inflammatory cytokine secretion by peripheral blood mononuclear cells (PBMC) obtained from AA and Caucasian-American (CA) women in response to an acute high-fat meal; and 2) to explore the influence of race (AA vs. CA) on PBMC reactivity. Ten AA and 11 CA women consumed a high-fat meal with baseline and 4 h postprandial venous blood draws. PBMCs were incubated for 3 h then messenger RNA expression and supernatant protein concentration was used to examine inflammatory profiles. All women had a postprandial increase in interleukin (IL)-8 gene expression, IL-8 protein concentration, and tumor necrosis factor alpha (TNF-α) protein concentration (P < 0.05). AA women had a postprandial increase in IL-6, IL-8, and TNF-α protein concentration (P < 0.05). AA women had higher postprandial IL-1β protein concentration and IL-8 gene expression compared with CA women (P < 0.05). Our data uncovers the specific impact of race and time on pro-inflammatory PBMC (IL-1β, IL-6, IL-8, and TNF-α) expression profiles in response to an acute high-fat meal challenge. Novelty: African Americans have higher predominance of inflammatory disease. We explored the potential race impact on peripheral blood mononuclear cell reactivity in response to a meal. A pro-inflammatory response to an acute high-fat meal with race impact was observed possibly contributing to health disparities impacting African-American women.
