Women who were physically-fit before becoming pregnant were 21% less likely to develop gestational diabetes than women at low levels of fitness, according to a recent University of Iowa study published online in the journal Medicine & Science in Sports & Exercise.
“The main point for women is, it’s important to get into better shape before you get pregnant,” lead researcher Kara Whitaker, PhD, MPH, assistant professor of Health and Human Physiology at the University of Iowa, told On Track Diabetes.
Gestational diabetes is high blood sugar that develops during pregnancy. It increases risk for dangerous high blood pressure for pregnant women (pre-eclampsia), preterm birth, a high birth-weight baby and complications during labor. It raises a baby’s risk for obesity and type 2 diabetes later in life.
And while gestational diabetes usually resolves itself at birth, it boosts a woman’s risk for developing type 2 diabetes in the next five to ten years seven-fold. Currently, up to 14% of women have gestational diabetes during pregnancy. Obesity is the leading cause, according to the Centers for Disease Control and Prevention, but a family history of diabetes, having multiple pregnancies and being an older mom also raise your risk.
The study looked at 1,333 women in their 20s and 30s who became pregnant while participating in a National Institutes of Health-sponsored study called Coronary Artery Risk Development in Young Adults (CARDIA). The women did not have diabetes at the start. Their health was tracked for 25 years and they had a fitness exam at the start of the study—walking on a treadmill at a faster and faster pace and on steeper and steeper inclines. During the study, 164 developed gestational diabetes.
Women with higher fitness scores were at lowest risk. The good news: The benefit wasn’t just for athletes. Moderately-fit and extremely-fit women both got protection against high blood sugar during their pregnancies.
“If you increase your fitness from a fair to a good level, you can lower your risk,” Dr. Whitaker says. “It’s hard to say how much exercise that would take, but getting 30 minutes of brisk walking at least five days a week could be enough. Doing that for about six months before you start trying to conceive can help protect you during pregnancy. At the same time, work to bring your body weight down into a healthy range with a healthy diet that’s low in saturated fat and full of fruit and vegetables.”
Getting fit may help guard against gestational diabetes in several ways. “Physical activity helps regulate blood glucose levels. It takes glucose out of the bloodstream and into muscles,” she says. “People who engage in moderate to vigorous physical activity regularly also tend to be at a healthier weight and to gain less during pregnancy, which lowers risk. Physical activity may also mean more muscle mass, which burns more calories and helps control weight, too.”
Women can check their exercise intensity and fitness improvements with two simple tests, Dr. Whitaker says. “Use the talk test. During moderate-intensity exercise, your heart rate is elevated and your breathing is faster. You should still be able to talk but holding a full conversation would be difficult,” she says. “To check your fitness, time yourself as you walk briskly around a loop course in your neighborhood, such as around the block. Six weeks later, time yourself again. If you’re faster, you’re becoming more fit.”
“This is really exciting,” says certified diabetes educator and On Track Diabetes advisor Amy Hess-Fischl , MS, RD, LDN, BC-ADM, CDE, of the Kovler Diabetes Center in Chicago. “We KNOW if someone gets gestational diabetes, they WILL get T2D in the future. So if we can prevent that now, it’s a game changer.
We also know that for pregnant women, staying healthy after delivery is just as important for avoiding type 2 diabetes. Staying healthy before and during your pregnancy will also help with recovery, with the actual delivery and may improve your stamina for the long nights and work of raising an infant. Seeing a dietitian for an individualized meal plan, staying active and seeing a personal trainer for tips and motivations before pregnancy are great ideas.”