Lecture 7 & 8 Negative Energy Balance and Exercise, Exercise and Pregnancy Flashcards
This is a consequence of energy imbalance due to having large amounts of exercise and inadequate food intake.
REDS (Relative Energy Deficiency In Sport
- can alter reproductive function in both males and females (More common/better recognised in males)
- REDS is most common in elite athletes
Altered menstrual cycle which has a gap of 35-90 days between menstrual cycle.
Oligomenorrhoea
No menstrual cycles for 3 consecutive months
Amenorrhea
What are short term consequences of REDS in Females?
- recurrent or multiple stress fractures
- low body mas and muscle mass
- depression
What are long term consequences of REDS in Females?
- increased risk of osteoporosis
- reduced risk of estrogen dependent cancer (not really much of a risk)
- uncertain influence on long term fertility potential
What are the treatments for Amenorrhea?
- reduce training volume 10-20%
- Increase energy intake 5-10%
- calcium supplementation 1500 mg daily
- contraceptive pill as source of oestrogen
What are some considerations for exercise during pregnancy?
- weight gain (Typically in 3rd semester 10-14kg) increased weight usually has little negative impact on joints
- Lordosis and back pain common in 50% of women late in pregnancy
- Balance problems and falling uncommon
- Respiratory changes in VE
- CV changes - progressive, increases Blood volume, HR, SV, CO, Decreases MAP 5-10mmhg mid pregnancy
- supine or prolonged standing may decrease VR (compresses vena cava)
Thermoregulation - increase in BMR, increase need for hydration monitoring
Risk to foetus
Urinary incontinence - affects 32-64% of women
What are the consequences of REDS in Males?
- decreased testosterone level to lower end of normal range
- reduced fertility potential (lower sperm count, reduced sperm motility, increase morphological abnormalities of sperm)
Who is at risk?
- men with high training volumes
- males with weight loss or energy restriction goal
(more likely to not be identified until severe)
Exercise during pregnancy, if the person has no regular exercise prior to pregnancy what must be done?
- check with the GP prior to commencing exercise
- generally recommend low-moderate intensity aerobic exercise
- 30 min daily at 3-5 METS
Note: Start gradually
Do not try to obtain substantial fitness gains
Do not use exercise for large weight loss (unless medically supervised and recommended)
If the person exercises prior to pregnancy it is…
generally ok to continue training
- aim to maintain fitness not improve
What is the physical activity guidelines for pregnant women?
- at least 150 minutes of moderate intensity exercise every week
- if not active: start gradually
- if active: keep going
- remember to listen to your body and adapt
List of activities not recommended during pregnancy
- activities with increased risk of trauma
- activities with physiological risk factors (skiing, horse riding, gymnastics)
- activities involving lying supine positions after the first trimester (sky diving)
- activities pregnant women who are not already active should avoid
Aerobic exercise recommendations for pregnant women (tap card)
- Large muscle group dynamic activity
- 30 min/day low-moderate intensity
- RPE (rating of perceived exertion) of 11-13 not recommended
- Recommended that program is not progressive
Resistance Exercise Recommendations for pregnant women (tap card)
- 1 set of 12 reps for a variety of muscle group
- avoid isometric and heavy resistance activities
- core exercises important for addressing abdominal separation
Flexibility exercise recommendations for pregnant women (tap card)
- limit activities to normal range of motion
- activities associated with supine usually excluded
What are some of the maternal benefits of exercise during pregnancy?
- controls maternal weight gain
- improve mental well being and body image
- Reduced risk of gestational diabetes
- Reduce risk of pre-eclampsia
- Reduced risk of gestational hypertension
- Reduced pelvic and lower back pain
- reduce risk of acute caesarean section
- Reduced risk of prolonged labor and instrumental delivery
- reduced risk of macrosomia
- reduced risk of preterm delivery
Information on Lactation and Exercise
- exercise does not compromise breast milk quality/quantity nor infant growth if nutrition appropriate
- exercise may slow bone loss during lactation, resulting in higher BMD levels at 1 year postpartum
Recommendation:
- breast feeding prior to exercise
less breast discomfort and less lactic acid in milk
