Skip to main content
Top
Published in: BMC Pregnancy and Childbirth 1/2012

Open Access 01-12-2012 | Research article

Level and intensity of objectively assessed physical activity among pregnant women from urban Ethiopia

Authors: Mads F Hjorth, Stine Kloster, Tsinuel Girma, Daniel Faurholt-Jepsen, Gregers Andersen, Pernille Kæstel, Søren Brage, Henrik Friis

Published in: BMC Pregnancy and Childbirth | Issue 1/2012

Login to get access

Abstract

Background

Women in low-income countries are generally considered to have a high physical workload which is sustained during pregnancy. Although most previous studies have been based on questionnaires a recent meta-analysis of doubly labeled water data has raised questions about the actual amount of physical activity performed. In this study we report objectively assessed levels of physical activity, cardiorespiratory fitness and muscular fitness among pregnant urban Ethiopian women, and their association with demographic characteristics and anthropometric measures.

Methods

Physical activity was measured for seven consecutive days in 304 women using a combined uniaxial accelerometer and heart rate sensor. Activity energy expenditure was determined using a group calibration in a branched equation model framework. Type and duration of activities were reported using a 24-hour physical activity recall and grip strength was assessed using a dynamometer.

Results

Median (interquartile-range, IQR) activity energy expenditure was 31.1 (23.7-42.0) kJ/kg/day corresponding to a median (IQR) physical activity level of 1.46 (1.39-1.58). Median (IQR) time in sedentary, light, and moderate-to-vigorous intensity was 1100 (999–1175), 303 (223–374) and 40 (22–69) min/day, respectively. Mean (standard deviation) sleeping heart rate was 73.6 (8.0) beats/min and grip strength was 21.6 (4.5) kg. Activity energy expenditure was 14% higher for every 10 cm2 difference in arm muscle area and 10% lower for every 10 cm2 difference in arm fat area and 10-week difference in gestational age.

Conclusion

The level and intensity of physical activity among pregnant women from urban Ethiopia is low compared to non-pregnant women from other low income countries as well as pregnant European women from high-income countries.
Appendix
Available only for authorised users
Literature
1.
go back to reference Benefice E, Cames C: Physical activity patterns of rural Senegalese adolescent girls during the dry and rainy seasons measured by movement registration and direct observation methods. Eur J Clin Nutr. 1999, 53: 636-643. 10.1038/sj.ejcn.1600826.CrossRefPubMed Benefice E, Cames C: Physical activity patterns of rural Senegalese adolescent girls during the dry and rainy seasons measured by movement registration and direct observation methods. Eur J Clin Nutr. 1999, 53: 636-643. 10.1038/sj.ejcn.1600826.CrossRefPubMed
2.
go back to reference Roberts SB, Paul AA, Cole TJ, Whitehead RG: Seasonal changes in activity, birth weight and lactational performance in rural Gambian women. Trans R Soc Trop Med Hyg. 1982, 76: 668-678. 10.1016/0035-9203(82)90239-5.CrossRefPubMed Roberts SB, Paul AA, Cole TJ, Whitehead RG: Seasonal changes in activity, birth weight and lactational performance in rural Gambian women. Trans R Soc Trop Med Hyg. 1982, 76: 668-678. 10.1016/0035-9203(82)90239-5.CrossRefPubMed
3.
go back to reference Spurr GB, Dufour DL, Reina JC: Energy expenditure of urban Colombian women: a comparison of patterns and total daily expenditure by the heart rate and factorial methods. Am J Clin Nutr. 1996, 63: 870-878.PubMed Spurr GB, Dufour DL, Reina JC: Energy expenditure of urban Colombian women: a comparison of patterns and total daily expenditure by the heart rate and factorial methods. Am J Clin Nutr. 1996, 63: 870-878.PubMed
4.
go back to reference Lawrence M, Whitehead RG: Physical activity and total energy expenditure of child-bearing Gambian village women. Eur J Clin Nutr. 1988, 42: 145-160.PubMed Lawrence M, Whitehead RG: Physical activity and total energy expenditure of child-bearing Gambian village women. Eur J Clin Nutr. 1988, 42: 145-160.PubMed
5.
go back to reference Rao S, Kanade A, Margetts BM, Yajnik CS, Lubree H, Rege S, et al: Maternal activity in relation to birth size in rural India. The Pune Maternal Nutrition Study. Eur J Clin Nutr. 2003, 57: 531-542. 10.1038/sj.ejcn.1601582.CrossRefPubMed Rao S, Kanade A, Margetts BM, Yajnik CS, Lubree H, Rege S, et al: Maternal activity in relation to birth size in rural India. The Pune Maternal Nutrition Study. Eur J Clin Nutr. 2003, 57: 531-542. 10.1038/sj.ejcn.1601582.CrossRefPubMed
6.
go back to reference Dwarkanath P, Muthayya S, Vaz M, Thomas T, Mhaskar A, Mhaskar R, et al: The relationship between maternal physical activity during pregnancy and birth weight. Asia Pac J Clin Nutr. 2007, 16: 704-710.PubMed Dwarkanath P, Muthayya S, Vaz M, Thomas T, Mhaskar A, Mhaskar R, et al: The relationship between maternal physical activity during pregnancy and birth weight. Asia Pac J Clin Nutr. 2007, 16: 704-710.PubMed
7.
go back to reference Tafari N, Naeye RL, Gobezie A: Effects of maternal undernutrition and heavy physical work during pregnancy on birth weight. Br J Obstet Gynecol. 1980, 87: 222-226. 10.1111/j.1471-0528.1980.tb04523.x.CrossRef Tafari N, Naeye RL, Gobezie A: Effects of maternal undernutrition and heavy physical work during pregnancy on birth weight. Br J Obstet Gynecol. 1980, 87: 222-226. 10.1111/j.1471-0528.1980.tb04523.x.CrossRef
8.
go back to reference Dugas LR, Harders R, Merrill S, Ebersole K, Shoham DA, Rush EC, et al: Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies. Am J Clin Nutr. 2011, 93: 427-441. 10.3945/ajcn.110.007278.CrossRefPubMed Dugas LR, Harders R, Merrill S, Ebersole K, Shoham DA, Rush EC, et al: Energy expenditure in adults living in developing compared with industrialized countries: a meta-analysis of doubly labeled water studies. Am J Clin Nutr. 2011, 93: 427-441. 10.3945/ajcn.110.007278.CrossRefPubMed
9.
go back to reference Assah FK, Ekelund U, Brage S, Wright A, Mbanya JC, Wareham NJ: Accuracy and validity of a combined heart rate and motion sensor for the measurement of free-living physical activity energy expenditure in adults in Cameroon. Int J Epidemiol. 2011, 40: 112-120. 10.1093/ije/dyq098.CrossRefPubMed Assah FK, Ekelund U, Brage S, Wright A, Mbanya JC, Wareham NJ: Accuracy and validity of a combined heart rate and motion sensor for the measurement of free-living physical activity energy expenditure in adults in Cameroon. Int J Epidemiol. 2011, 40: 112-120. 10.1093/ije/dyq098.CrossRefPubMed
10.
go back to reference Gradmark A, Pomeroy J, Renstrom F, Steiginga S, Persson M, Wright A, et al: Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women. BMC Pregnancy Childbirth. 2011, 11: 44-51. 10.1186/1471-2393-11-44.CrossRefPubMedPubMedCentral Gradmark A, Pomeroy J, Renstrom F, Steiginga S, Persson M, Wright A, et al: Physical activity, sedentary behaviors, and estimated insulin sensitivity and secretion in pregnant and non-pregnant women. BMC Pregnancy Childbirth. 2011, 11: 44-51. 10.1186/1471-2393-11-44.CrossRefPubMedPubMedCentral
11.
go back to reference Melzer K, Schutz Y, Soehnchen N, Othenin-Girard V, Martinez De Tejada B, Irion O, et al: Effects of recommended levels of physical activity on pregnancy outcomes. Obstet Gynecol. 2010, 202 (266): e1-e6. Melzer K, Schutz Y, Soehnchen N, Othenin-Girard V, Martinez De Tejada B, Irion O, et al: Effects of recommended levels of physical activity on pregnancy outcomes. Obstet Gynecol. 2010, 202 (266): e1-e6.
12.
go back to reference Central Statistical Agency: Summary and Statistical Report of the 2007 Population and Housing Census. 2008, Addis Ababa: United Nations Population Fund (UNFPA) Central Statistical Agency: Summary and Statistical Report of the 2007 Population and Housing Census. 2008, Addis Ababa: United Nations Population Fund (UNFPA)
13.
go back to reference Brage S, Brage N, Ekelund U, Luan J, Franks PW, Froberg K, et al: Effect of combined movement and heart rate monitor placement on physical activity estimates during treadmill locomotion and free-living. Eur J Appl Physiol. 2006, 96: 517-524. 10.1007/s00421-005-0112-6.CrossRefPubMed Brage S, Brage N, Ekelund U, Luan J, Franks PW, Froberg K, et al: Effect of combined movement and heart rate monitor placement on physical activity estimates during treadmill locomotion and free-living. Eur J Appl Physiol. 2006, 96: 517-524. 10.1007/s00421-005-0112-6.CrossRefPubMed
14.
go back to reference Stegle O, Fallert SV, MacKay D, Brage S: Gaussian process robust regression for noisy heart rate data. IEEE Trans Biomed Eng. 2008, 55: 2143-2151.CrossRefPubMed Stegle O, Fallert SV, MacKay D, Brage S: Gaussian process robust regression for noisy heart rate data. IEEE Trans Biomed Eng. 2008, 55: 2143-2151.CrossRefPubMed
15.
go back to reference Brage S, Ekelund U, Brage N, Hennings MA, Froberg K, Franks PW, et al: Hierarchy of individual calibration levels for heart rate and accelerometry to measure physical activity. J Appl Physiol. 2007, 103: 682-692. 10.1152/japplphysiol.00092.2006.CrossRefPubMed Brage S, Ekelund U, Brage N, Hennings MA, Froberg K, Franks PW, et al: Hierarchy of individual calibration levels for heart rate and accelerometry to measure physical activity. J Appl Physiol. 2007, 103: 682-692. 10.1152/japplphysiol.00092.2006.CrossRefPubMed
16.
go back to reference Christensen DL, Faurholt-Jepsen D, Boit MK, Mwaniki DL, Kilonzo B, Tetens I, et al: Cardiorespiratory fitness and physical activity in Luo, Kamba, and Maasai of rural Kenya. Am J Hum Biol. 2012, 24: 723-729. 10.1002/ajhb.22303.CrossRefPubMedPubMedCentral Christensen DL, Faurholt-Jepsen D, Boit MK, Mwaniki DL, Kilonzo B, Tetens I, et al: Cardiorespiratory fitness and physical activity in Luo, Kamba, and Maasai of rural Kenya. Am J Hum Biol. 2012, 24: 723-729. 10.1002/ajhb.22303.CrossRefPubMedPubMedCentral
17.
go back to reference Brage S, Brage N, Franks PW, Ekelund U, Wong MY, Andersen LB, et al: Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol. 2004, 96: 343-351.CrossRefPubMed Brage S, Brage N, Franks PW, Ekelund U, Wong MY, Andersen LB, et al: Branched equation modeling of simultaneous accelerometry and heart rate monitoring improves estimate of directly measured physical activity energy expenditure. J Appl Physiol. 2004, 96: 343-351.CrossRefPubMed
18.
go back to reference Henry CJK: Basal metabolic rate studies in humans: measurement and development of new equations. Public Health Nutr. 2005, 8: 1133-1152.CrossRefPubMed Henry CJK: Basal metabolic rate studies in humans: measurement and development of new equations. Public Health Nutr. 2005, 8: 1133-1152.CrossRefPubMed
19.
go back to reference Frisancho AR: New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981, 34: 2540-2545.PubMed Frisancho AR: New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981, 34: 2540-2545.PubMed
21.
go back to reference Thompson D, Batterham AM, Bock S, Robson C, Stokes K: Assessment of low-to-moderate intensity physical activity thermogenesis in young adults using synchronized heart rate and accelerometry with branched-equation modeling. J Nutr. 2006, 136: 1037-1042.PubMed Thompson D, Batterham AM, Bock S, Robson C, Stokes K: Assessment of low-to-moderate intensity physical activity thermogenesis in young adults using synchronized heart rate and accelerometry with branched-equation modeling. J Nutr. 2006, 136: 1037-1042.PubMed
22.
go back to reference Crouter SE, Churilla JR, Bassett DR: Accuracy of the Actiheart for the assessment of energy expenditure in adults. Eur J Clin Nutr. 2008, 62: 704-711. 10.1038/sj.ejcn.1602766.CrossRefPubMed Crouter SE, Churilla JR, Bassett DR: Accuracy of the Actiheart for the assessment of energy expenditure in adults. Eur J Clin Nutr. 2008, 62: 704-711. 10.1038/sj.ejcn.1602766.CrossRefPubMed
23.
go back to reference Pivarnik JM, Stein AD, Rivera JM: Effect of pregnancy on heart rate/oxygen consumption calibration curves. Med Sci Sports Exerc. 2002, 34: 750-755. 10.1097/00005768-200205000-00004.CrossRefPubMed Pivarnik JM, Stein AD, Rivera JM: Effect of pregnancy on heart rate/oxygen consumption calibration curves. Med Sci Sports Exerc. 2002, 34: 750-755. 10.1097/00005768-200205000-00004.CrossRefPubMed
24.
go back to reference Butte NF, Wong WW, Treuth MS, Ellis KJ, O’Brian Smith E: Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr. 2004, 79: 1078-1087.PubMed Butte NF, Wong WW, Treuth MS, Ellis KJ, O’Brian Smith E: Energy requirements during pregnancy based on total energy expenditure and energy deposition. Am J Clin Nutr. 2004, 79: 1078-1087.PubMed
25.
go back to reference Gallagher D, Albu J, He Q, Heshka S, Boxt L, Krasnow N, et al: Small organs with a high metabolic rate explain lower resting energy expenditure in African American than in white adults. Am J Clin Nutr. 2006, 83: 1062-1067.PubMedPubMedCentral Gallagher D, Albu J, He Q, Heshka S, Boxt L, Krasnow N, et al: Small organs with a high metabolic rate explain lower resting energy expenditure in African American than in white adults. Am J Clin Nutr. 2006, 83: 1062-1067.PubMedPubMedCentral
26.
go back to reference Alemu T, Lindtjorn B: Physical activity, illness and nutritional status among adults in a rural Ethiopian community. Int J Epidemiol. 1995, 24: 977-983. 10.1093/ije/24.5.977.CrossRefPubMed Alemu T, Lindtjorn B: Physical activity, illness and nutritional status among adults in a rural Ethiopian community. Int J Epidemiol. 1995, 24: 977-983. 10.1093/ije/24.5.977.CrossRefPubMed
27.
go back to reference Assah FK, Ekelund U, Brage S, Mbanya JC, Wareham NJ: Urbanization, Physical Activity, and Metabolic Health in Sub-Saharan Africa. Diabetes Care. 2011, 34: 491-496. 10.2337/dc10-0990.CrossRefPubMedPubMedCentral Assah FK, Ekelund U, Brage S, Mbanya JC, Wareham NJ: Urbanization, Physical Activity, and Metabolic Health in Sub-Saharan Africa. Diabetes Care. 2011, 34: 491-496. 10.2337/dc10-0990.CrossRefPubMedPubMedCentral
28.
go back to reference Schmidt MD, Pekow P, Freedson PS, Markenson G, Chasan-Taber L: Physical activity patterns during pregnancy in a diverse population of women. J Womens Health. 2006, 15: 909-918. 10.1089/jwh.2006.15.909.CrossRef Schmidt MD, Pekow P, Freedson PS, Markenson G, Chasan-Taber L: Physical activity patterns during pregnancy in a diverse population of women. J Womens Health. 2006, 15: 909-918. 10.1089/jwh.2006.15.909.CrossRef
29.
go back to reference Lawrence M, Coward WA, Lawrence F, Cole TJ, Whitehead RG: Energy requirements of pregnancy in the Gambia. Lancet. 1987, 330: 1072-1076. 10.1016/S0140-6736(87)91492-9.CrossRef Lawrence M, Coward WA, Lawrence F, Cole TJ, Whitehead RG: Energy requirements of pregnancy in the Gambia. Lancet. 1987, 330: 1072-1076. 10.1016/S0140-6736(87)91492-9.CrossRef
30.
go back to reference Forsum E, Löf M: Energy metabolism during human pregnancy. Annu Rev Nutr. 2007, 27: 277-292. 10.1146/annurev.nutr.27.061406.093543.CrossRefPubMed Forsum E, Löf M: Energy metabolism during human pregnancy. Annu Rev Nutr. 2007, 27: 277-292. 10.1146/annurev.nutr.27.061406.093543.CrossRefPubMed
31.
go back to reference Avery ND, Wolfe LA, Amara CE, Davies GAL, McGrath MJ: Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold. J Appl Physiol. 2001, 90: 321-328.PubMed Avery ND, Wolfe LA, Amara CE, Davies GAL, McGrath MJ: Effects of human pregnancy on cardiac autonomic function above and below the ventilatory threshold. J Appl Physiol. 2001, 90: 321-328.PubMed
32.
go back to reference Assah FK, Ekelund U, Brage S, Mbanya JC, Wareham NJ: Free-living physical activity energy expenditure is strongly related to glucose intolerance in Cameroonian adults independently of obesity. Diabetes Care. 2009, 32: 367-369.CrossRefPubMedPubMedCentral Assah FK, Ekelund U, Brage S, Mbanya JC, Wareham NJ: Free-living physical activity energy expenditure is strongly related to glucose intolerance in Cameroonian adults independently of obesity. Diabetes Care. 2009, 32: 367-369.CrossRefPubMedPubMedCentral
33.
go back to reference Dempsey JC, Sorensen TK, Williams MA, Lee I, Miller RS, Dashow EE, et al: Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol. 2004, 159: 663-670. 10.1093/aje/kwh091.CrossRefPubMed Dempsey JC, Sorensen TK, Williams MA, Lee I, Miller RS, Dashow EE, et al: Prospective study of gestational diabetes mellitus risk in relation to maternal recreational physical activity before and during pregnancy. Am J Epidemiol. 2004, 159: 663-670. 10.1093/aje/kwh091.CrossRefPubMed
34.
go back to reference Sorensen TK, Williams MA, Lee I, Dashow EE, Thompson ML, Luthy DA: Recreational physical activity during pregnancy and risk of preeclampsia. Hypertension. 2003, 41: 1273-1280. 10.1161/01.HYP.0000072270.82815.91.CrossRefPubMed Sorensen TK, Williams MA, Lee I, Dashow EE, Thompson ML, Luthy DA: Recreational physical activity during pregnancy and risk of preeclampsia. Hypertension. 2003, 41: 1273-1280. 10.1161/01.HYP.0000072270.82815.91.CrossRefPubMed
35.
go back to reference Hegaard HK, Pedersen BK, Nielsen BB, Damm P: Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: a review. Acta Obstet Gynecol Scand. 2007, 86: 1290-1296. 10.1080/00016340701647341.CrossRefPubMed Hegaard HK, Pedersen BK, Nielsen BB, Damm P: Leisure time physical activity during pregnancy and impact on gestational diabetes mellitus, pre-eclampsia, preterm delivery and birth weight: a review. Acta Obstet Gynecol Scand. 2007, 86: 1290-1296. 10.1080/00016340701647341.CrossRefPubMed
Metadata
Title
Level and intensity of objectively assessed physical activity among pregnant women from urban Ethiopia
Authors
Mads F Hjorth
Stine Kloster
Tsinuel Girma
Daniel Faurholt-Jepsen
Gregers Andersen
Pernille Kæstel
Søren Brage
Henrik Friis
Publication date
01-12-2012
Publisher
BioMed Central
Published in
BMC Pregnancy and Childbirth / Issue 1/2012
Electronic ISSN: 1471-2393
DOI
https://doi.org/10.1186/1471-2393-12-154

Other articles of this Issue 1/2012

BMC Pregnancy and Childbirth 1/2012 Go to the issue