In the U.S. the number of obese women entering pregnancy has more than doubled in the past 30 years. Pregravid obesity alone however is not the only cause for concern since two-thirds of obese women gain weight in excess of the 2009 IOM recommendations and attempts to manage gestational weight gain to date have failed. To improve weight management of obese pregnant women, there is a critical need to deliver specific evidence-based recommendations on energy intake and energy expenditure (physical activity);the two primary determinants of weight gain in non-pregnant individuals. As an ancillary study to LIFE-Moms (Lifestyle Interventions in Expectant Moms Study) we will evaluate energy intake and energy expenditure during pregnancy (13 to 37 weeks) and 12 months postpartum in 80 obese women randomized to receive an intensive lifestyle intervention to manage gestational weight gain. We will test the hypothesis that obese pregnant women with weight gain above the IOM guidelines, 'High Gainers', will have increased energy intake but no evidence for changes in energy expenditure after adjustment for the weight gained when compared to women with appropriate gestational weight gain, 'Normal Gainers'. The primary outcome variables are 1) energy intake during pregnancy and 12 months postpartum measured with the energy balance method and with a mathematical model of maternal energy intake 2) the free-living energy expenditure and sleeping metabolic rate (absolute and adjusted for maternal body composition and fetal size) during pregnancy. Secondary outcomes include measurement of changes in physical activity and substrate oxidation, determinants of energy intake including fasting concentrations of leptin, total ghrelin, peptide YY, cholecystokinin and determinants of energy expenditure including urinary epinephrine and norepinephrine, fasting concentrations of T3, T4 and TSH.

Public Health Relevance

Energy intake and energy expenditure are the two key determinants of weight gain in non- pregnant individuals. Successful weight management programs utilizing behavior change theory are thereby bolstered by targeting dietary intake and physical activity. The majority of obese pregnant women are exceeding the 2009 IOM guidelines for gestational weight gain. Without understanding how energy intake, energy expenditure and physical activity contribute to gestational weight gain in obese women, the IOM guidelines lack the critical evidence needed to translate the weight gain guidelines to clinical practice. Evidenced based recommendations on energy intake, energy expenditure and physical activity are needed to foster appropriate gestational weight gain in obese women.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZDK1-GRB-S (M5))
Program Officer
Evans, Mary
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Lsu Pennington Biomedical Research Center
Organized Research Units
Baton Rouge
United States
Zip Code
Broskey, Nicholas T; Wang, Peng; Li, Nan et al. (2017) Early Pregnancy Weight Gain Exerts the Strongest Effect on Birth Weight, Posing a Critical Time to Prevent Childhood Obesity. Obesity (Silver Spring) 25:1569-1576
Sutton, Elizabeth F; Cain, Loren E; Vallo, Porsha M et al. (2017) Strategies for Successful Recruitment of Pregnant Patients Into Clinical Trials. Obstet Gynecol 129:554-559
Thomas, D M; Bredlau, C; Islam, S et al. (2016) Relationships between misreported energy intake and pregnancy in the pregnancy, infection and nutrition study: new insights from a dynamic energy balance model. Obes Sci Pract 2:174-179
Shepherd, John A; Heymsfield, Steven B; Norris, Shane A et al. (2016) Measuring body composition in low-resource settings across the life course. Obesity (Silver Spring) 24:985-8
Harrison, Cheryce L; Brown, Wendy J; Hayman, Melanie et al. (2016) The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health. Semin Reprod Med 34:e28-37
Shumilov, Dmytro; Heymsfield, Steven B; Redman, Leanne M et al. (2016) New compartment model analysis of lean-mass and fat-mass growth with overfeeding. Nutrition 32:590-600
Gilmore, L Anne; Butte, Nancy F; Ravussin, Eric et al. (2016) Energy Intake and Energy Expenditure for Determining Excess Weight Gain in Pregnant Women. Obstet Gynecol 127:884-92
Gilmore, L Anne; Klempel-Donchenko, Monica; Redman, Leanne M (2015) Pregnancy as a window to future health: Excessive gestational weight gain and obesity. Semin Perinatol 39:296-303
Gilmore, L Anne; Redman, Leanne M (2015) Weight gain in pregnancy and application of the 2009 IOM guidelines: toward a uniform approach. Obesity (Silver Spring) 23:507-11
Gilmore, L Anne; Ravussin, Eric; Bray, George A et al. (2014) An objective estimate of energy intake during weight gain using the intake-balance method. Am J Clin Nutr 100:806-12

Showing the most recent 10 out of 11 publications