Exercise May Not Limit Weight Gain by Pregnant Moms

Exercise and weight gain unrelated

Exercising during pregnancy was safe for both moms and babies in a new study of heavy women in Brazil, but fitness classes and at-home exercises didn’t keep moms-to-be from gaining too much weight.

The finding is “not surprising,” according to Dr. Patrick Catalano, a maternal-fetal medicine researcher from Case Western Reserve University School of Medicine in Cleveland.

“Lots of studies have not shown any benefits relative to weight gain in pregnancy using either diet or exercise,” said Catalano, who didn’t participate in the new research.

The U.S.-based Institute of Medicine recommends that overweight women should gain between 15 and 25 pounds during pregnancy, and obese women 11 to 20 — less than the amount recommended for normal-weight women.

Being overweight or obese while pregnant, or gaining too much weight during pregnancy, increases the chance of having a large baby and needing a Cesarean section. It also ups the risk that babies will have birth defects or grow up to be obese, researchers said.

Plus, women who gain a lot of weight during pregnancy tend to keep in on afterwards, Catalano told Reuters Health.

He said that starting an exercise or diet program mid-way through pregnancy probably isn’t as useful as intervening very early in pregnancy — or better yet, before.

‘MODERATE EXERCISE IS VERY GOOD’

In the current study, researchers led by Simony Nascimento from UNICAMP Medical School in Campinas recruited 82 heavy women who were already between three and five and a half months into their pregnancies.

They split those women into two groups. Half went to weekly exercise classes and got counseled on nutrition, weight gain and home exercises or walking they could do daily. The other women received standard prenatal care advice, but no extra information on exercise.

Regardless of whether they were assigned to do group and at-home exercise, about half of the women gained more weight than recommended upper limits.

On average, obese women gained 23 to 24 pounds in both groups. Overweight women gained an average of 22 pounds when they exercised and 36 when they didn’t, but the researchers caution that those findings were based on a small group of only 14 women.

The majority of all babies were born by c-section, but there was no difference in their health at birth based on whether or not moms exercised, Nascimento and colleagues report in BJOG: An International Journal of Obstetrics and Gynecology.

Catalano said the findings don’t take away from the fact that, “moderate exercise is very good, no question about it.” But he said that the farther women get into pregnancy, the harder it is for them to stick to an exercise program. That’s why starting with exercising and diet improvement early is so important.

One of the problems is that historically, women have been given the wrong message about eating and physical activity in pregnancy, said Dr. Raul Artal, head of obstetrics, gynecology and women’s health at Saint Louis University School of Medicine.

“Pregnancy is not a state of confinement and indulgence. It’s an ideal time for behavioral modification for the benefit of both mother and the baby,” Artal, who wasn’t involved in the new research, told Reuters Health.

He considers pregnancy an opportunity to address unhealthy behaviors in patients. “In general women are more prone to adopt healthy lifestyles in pregnancy because of the concern for the unborn child.”

Nascimento’s team also pointed out that women typically have more contact with health providers when they’re pregnant.

But, Artal added, “The sad thing is that as a society we have become more sedentary and more overweight and obese. This is not confined to pregnant women.”

In an email to Reuters Health, the researchers recommended 30 minutes of moderate exercise each day for overweight and obese pregnant women, along with stretching and nutrition counseling.

Source: Reuters Health

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Africa: 2011 Closes UN’s Roll Back Malaria Decade

Angolan Press

Luanda — The commemoration of the World Malaria Day this year marks the end of the UN’s roll back malaria decade and offers an opportunity for renewed commitment on the pandemic.

This was said Sunday by the World Health Organisation (WHO) regional director for Africa, Luis Gomes Sambo.

According to him, this affords us an opportunity to renew our common vision and commitment as we look forward and aim at attaining the Millennium Development Goals (MDGs) by 2015.

Malaria, by its complexity involving health as well as environmental and socioeconomic determinants and consequences, relates virtually to all the MDGs, the official also stated, adding that “as it is well known, our part of the world is home to an estimated 795 million people exposed to malaria. Close to 90% of deaths due to malaria worldwide occur in Africa.

Gomes Sambo went on to say that the poor, children, pregnant women, people living with HIV/AIDS, victims of unrest and disasters and non-immune travellers are particularly vulnerable. Therefore, progress in the fight against malaria in Africa is critical to reaching the ambitious targets set in the UN Secretary General’s call for Universal Access to essential interventions, the AU Abuja Declaration and Plan of Action, Resolutions of WHO Governing Bodies and the Roll Back Malaria (RBM) Global Malaria Action Plan (GMAP).

In this regard, he added, it is encouraging to note that malaria control alliances are being strengthened throughout Africa. For example, the African Leaders Malaria Alliance (ALMA) has committed to support elimination of preventable malaria deaths by 2015. The African Union and Regional Economic Communities have also kept malaria high on their health and development agenda.

Countries and partners are making commendable efforts to accelerate and sustain progress in malaria prevention and control in our Region. For example, endemic countries have reflected malaria control in their poverty reduction strategies, the official stated.

Programme reviews are ongoing and strategic plans are being updated to take into account funding and capacity gaps to reach universal access. The success rate for malaria proposals for the Global Fund (GFATM) reached 80% in Round 10. Consequently, effective interventions including protection from the mosquito vector through the use of Insecticide Treated Nets (ITNs) and Indoor Residual Spaying (IRS), prompt treatment of malaria cases using Artemisinin-based combination therapy (ACT), intermittent preventive treatment of malaria in pregnant women (IPTp) and infants (IPTi) are being adapted and scaled up, the WHO regional director also stated.

According to him, cross-border initiatives are catalyzing efforts to accelerate and sustain control and, where possible, to prepare for the transition to pre-elimination. The Affordable Medicines Facility for Malaria (AMFm) has been launched in Ghana, Kenya, Madagascar, Niger, Nigeria, United Republic of Tanzania and Uganda to ensure access to quality ACTs in private sector facilities. Malaria vaccine trials are ongoing in Burkina Faso, Ghana, Gabon, Malawi, Mozambique, Tanzania and Kenya.

As he went on to say, by the end of 2010, a total of 11 countries (Algeria, Botswana, Cape Verde, Eritrea, Madagascar, Namibia, Rwanda, Sao Tome and Principe, South Africa, Swaziland, Zambia and Zanzibar, United Republic of Tanzania) had registered more than 50% reduction in malaria cases and deaths; the proportion of households owning at least one insecticide treated net (ITN) was 42% and 35% of children under five years of age slept under an ITN; 27 countries had reported implementation of Indoor Residual Spraying (IRS) so that 73 million people accounting for about 10% of the population at risk of malaria in the Region were protected by IRS; 33 countries had adopted a policy of parasitological testing of all suspected malaria cases and 35% of malaria cases in the Region were confirmed by a diagnostic test.

In his opinion, in order to consolidate the gains achieved so far, “we need to ensure: rigorous governance to strengthen performance and accountability; mobilization of additional resources; linking disease programme development and health systems strengthening; better coordination of stakeholders and partners under national stewardship; and effective involvement of every exposed individual and community.”

Among the critical challenges that countries need to address are: weak surveillance, monitoring and evaluation capacity; inadequate operational research platforms; lack of implementation of regulatory measures such as the ban on oral Artemisinin-based monotherapies and inadequate monitoring of parasite resistance to antimalarial medications and mosquito resistance to insecticides, he stated.

Gomes Sambo pledged that WHO will continue to work with Member States and partners to mainstream malaria control in health and development policies and plans; mobilize domestic and external funding; foster public private partnerships, support alignment of stakeholders around country priorities and provide guidance and assistance to ensure efficient use of resources for performance and impact. We shall also continue to support initiatives for the removal of taxes and tariffs on malaria commodities, and a ban on the marketing of oral artemisinin monotherapies.

On the other hand, he called upon Governments, parliamentarians, Nongovernmental Organizations, the private sector, civil society groups, faith-based organizations and all exposed communities to take stock of our common achievements and mobilize financial and human resources in a decisive push to further accelerate malaria prevention and control for the socioeconomic progress of countries of the African Region.

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In Africa, 10% of Pregnancies Experience Pre-eclampsia, But New Findings Bring Hope

In African, pre-eclampsia occurs in 10% of pregnancies

Scientists say they have identified genetic errors that appear to increase a pregnant woman’s chance of getting the condition called pre-eclampsia.

Pre-eclampsia is an abnormal state of pregnancy characterized by hypertension, fluid retention and albuminuria. If not detected and managed early it can be potentially life-threatening.

Approximately four in every 100 women develops this problem of high blood pressure and leaky kidneys during pregnancy. Black women are more likely to get high blood pressure and preeclampsia than white women. In African, pre-eclampsia occurs in 10% of pregnancies, which is significantly higher than the global average of approximately 4%.

Now researchers have found a faulty DNA which may be blamed in some cases. The report is presented in the journal PLoS Medicine. It is a discovery that could lead the way to identify and treat women at risk before it becomes life-threatening.

The US researchers from the Washington University School of Medicine in St. Louis analyzed DNA from over 300 pregnant women.

Sixty of these were healthy women but were hospitalized because they developed severe pre-eclampsia. The remaining 240 were women were under surveillance for other health complications. Forty of these also went on to develop pre-eclampsia.

Researchers analyzed the DNA from the subjects and found that some genetic errors were shared by five of the 60 healthy women and seven of the 40 “higher-risk pregnancy” women who developed pre-eclampsia.

The faulty DNA were located on genes that play a role in regulating immune response, confirming the suspicion that scientists had that pre-eclampsia could be provoked by hitches in the immune response. Generally, women with autoimmune diseases such as lupus have an increased risk of pre-eclampsia

The researchers plan to study more pregnant women and other genes to further their understanding.

Currently, the best way to stop the progress of pre-eclampsia is to deliver the baby. This contributes to the statistics of pre-mature babies who are at increased risks of several complications.

Further studies into these faulty genes may help to establish a protocol to identify women at increased risk of pre-eclampsia and put them on increased surveillance as early as possible in their pregnancy.

In communities where access to medical services is limited or unaffordable such as common in most African countries, these findings reveal promising potential for women in their pregnancies.

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Canadians Make Malaria Breakthrough

Mother and daughter sleep under mosquito net to prevent bites from the parasite carrying mosquito

Lana Haight, Postmedia News

SASKATOON — Scientists in Saskatoon have developed an inexpensive malaria treatment that will help the million people who die every year from the infection.

“This is the most important drug in the treatment of malaria today. The World Health Organization says it should be the first line of defence,” said Patrick Covello, a senior research officer at the National Research Council in Saskatoon.

Covello and his team figured out a way to produce a difficult-to-cultivate chemical needed to build effective malaria drugs.

The breakthrough was announced Friday at the National Research Council Plant Biotechnology Institute.

The best drugs available to fight malaria are made with artemisinin, a compound derived from the sweet wormwood plant found in parts of Asia and Africa. But cultivating and harvesting the plant and then extracting artemisinin is time-consuming and labour intensive, says Covello. And the supply of the natural compound is also dependent on weather and growing conditions.

In 2003, Covello began work to identify the genes in the wormwood plant that produce the protein that leads to artemisinin.

“We identified four genes in what we call the pathway to artemisinin in the plant,” he said in an interview.

Meanwhile, University of California at Berkley researchers found they could develop a precusor to artemisinin by introducing chemicals into yeast.

Covello contacted Amyris Technologies, a spinoff company from the Berkeley research group, to suggest it use the genes his group had identified in the wormwood plant. When two of the genes identified in Saskatoon were introduced to the yeast compound developed at Berkeley, the production of artemisinin doubled.

The Institute for OneWorld Health, the American-based organization that has led the project to develop the semi-synthetic artemisinin, and pharmaceutical company Sanofi-aventis jointly announced on Friday that the drug company is preparing to ramp up production using the genes identified in Saskatoon.

The Bill & Melinda Gates Foundation, which has already contributed $42.6 million toward the American research, is also supporting the production of the drug to ensure it will be available on a not-for-profit basis for the developing world.

“The idea is to provide the developing world with antimalarial drugs at the lowest possible cost and, in addition, to provide a very stable supply because this yeast-fermentation process is shorter term and more reliable than growing the plants themselves,” said Covello.

Covello understands that Sanofi-aventis will begin commercial-scale production in 2012.

The federal government has spent $869,000 over eight years to support the Saskatoon research.

“Our government is committed to improving the health of women and children in developing countries,” said Gary Goodyear, minister of state for science and technology, in a government news release.

“This new development in the production of a malaria treatment represents a major development in the fight against the disease. It will strengthen Canada’s position as a world leader in health research and provide a reliable and affordable solution.”

The Vancouver Sun
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African Leaders Pledge to End Malaria by 2015

Ted Purlain

The United Nations envoy tasked with coordinating efforts against malaria has reported that African leaders are at the forefront of a landmark initiative to end unnecessary deaths from the disease by 2015.

The African Leaders Malarial Alliance was recently formed and tasked with ensuring that more than 240 million insecticide-treated bed nets were distributed, according to PressTrust.com.

Malaria is believed to kill almost one million Africans every year and to affect over 200 million more. Most of those that succumb are pregnant women and children under the age of five. At least $12 billion of costs through lost development and opportunity are thought to be lost annually.

Launched at United Nations Headquarters in New York, ALMA is a high-level forum set up to oversee the efficient procurement and utilization of malaria control measures.

“Malaria is borderless,” Ray Chambers, the secretary-general’s special envoy for malaria, said, according to PressTrust.com. “Therefore, we need an organization that transcends borders. This is ALMA.”

Chambers said that the actions of ALMA can go a long way towards saving one million lives every year as it works to end deaths, enhance health infrastructures and grow economies.

U.N. Secretary-General Ban Ki-moon sent a message to the launch that supported the mutual engagement of Africa’s heads of state and government, as well as the support of the international community.

Last year, the international community spent $3 billion on the overall campaign against malaria.

World Health Organization Director-General Margaret Chan called the launch of ALMA a critical step in the fight against malaria in Africa, PressTrust.com reports.

Ted Purlain Vaccine NewsDaily
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Protection of Pregnant Women Against Malaria Remains Inadequate

Methods to protect pregnant women from malaria are still underutilised in sub-Saharan Africa, according to a study published today in ‘Lancet Infectious Diseases’.

A review of national control strategies by a team of international researchers, led by the Malaria in Pregnancy Consortium and funded by the Consortium and the Wellcome Trust, has concluded that despite major efforts, coverage is still inadequate in many areas and needs to be scaled up.

Malaria infection in pregnancy can lead to devastating consequences for both mother and child. The World Health Organization’s recommended policy for malaria prevention and control is a package of intermittent preventive treatment – therapeutic doses of a drug at defined intervals to provide protection in young children and pregnant women – and insecticide-treated bednets. These interventions have the potential to substantially reduce the disease burden and adverse outcomes of malaria in pregnancy.

The Roll Back Malaria initiative aimed to ensure that all pregnant women could receive the drugs and that at least four out of five people at risk from malaria were using the nets in areas of high transmission by 2010.

Researchers from the Malaria in Pregnancy Consortium examined specific strategies for malaria control in pregnant women from national malaria policies and calculated the number of protected pregnancies using the most recent national household cluster sample surveys. They were able to compare this to levels of malaria risk by comparing them to maps generated by the Malaria Atlas Project.

The study found that 45 of 47 countries in sub-Saharan Africa had an bednet policy for pregnant women and that estimated coverage was 17 per cent among the nearly 28 million pregnancies at risk of malaria in the 32 countries for which information was available. Among 39 countries with a policy on intermittent preventive treatment, just one in four pregnant women had received some treatment, despite more than three-quarters visiting an antenatal clinic.

Professor Feiko ter Kuile, leader of the Malaria in Pregnancy Consortium and co-author of the study, said: “Ten years after the Abuja declaration, it is encouraging that the majority of malaria endemic countries in sub-Saharan Africa have now adopted insecticide-treated nets and intermittent preventive treatment and the number of countries with nationally representative coverage data has increased to 40 out of 47.

“However, very few countries have reached either the Abuja targets or their own policy ambition, and countries are even further away from the more recent Roll Back Malaria targets set for 2010. In addition, coverage was lowest in areas with high malaria transmission, where the need is greatest.

“Whilst most countries have adopted national policies aimed at reducing and controlling malaria in pregnancy, it is clear that, with some notable exceptions, not enough progress has been made towards the new Roll Back Malaria goals or the policy ambitions of each country.

“Greater effort to fully understand the reasons why coverage is so low and to develop strategies to combat this is urgently needed to protect the tens of millions of pregnancies in sub-Saharan Africa threatened by malaria every year.”

(The Wellcome Trust)

Reference
Van Eijk, AM. Mapping coverage of malaria protection among pregnant women in sub-Saharan Africa: a synthesis and analysis of national surveys. Lancet Infectious Diseases; e-pub 26 Jan 2011.
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