Wednesday, June 30, 2010

Benefits of Exercise

Here are just a few benefits to exercise. Whenever you’re thinking about skipping a session, remember some of these!


Prevents bone loss and osteoporosis.

Prevents Type II Diabetes.

Improves energy.

Boosts mood.

Helps to prevent dementia.

Prevents some types of cancers.

Prevents muscle loss that is inevitable with age if strength training isn’t performed.

Helps with weight maintenance.

Prevents heart disease.

Improves blood pressure.

Improves sleep.

Monday, June 28, 2010

The Division of Responsibility: Feeding Your Children

As a dietitian, my specialized area is not in pediatric nutrition; however, when I became pregnant for the first time, I knew I needed to start learning more. I bought a book called Child of Mine: Feeding with Love and Good Sense by Ellyn Satter, MS, RD, CICSW, BCD. This book was a great investment and has been a great source of knowledge for me. Today I am going to talk about one of Ellyn’s philosophies, which is the division of responsibility.

The division of responsibility simply states that parents are responsible for the WHAT, WHEN, and WHERE their children will eat. Children are responsible for HOW MUCH and WHETHER they will eat at all. In a lot of ways it really takes the pressure off of the parents when you practice this philosphy. If you’re anything like me, you have probably worried from time to time if your child was getting enough of what he/she needs nutritionally speaking. It is time to go back the basics and trust children to know when they are hungry. Know that children are just like us in that they are sometimes ravenously hungry, and other times they just aren’t that hungry at all. This is normal!

Although we do have to trust our children more, we also need to remember that new foods are “weird” to children. It takes them time to adjust and explore the new food. Going back to the division of responsibility, there is no need to pressure a child to eat a new food or make a big deal out of how they “don’t know what their missing”. (By the way, don’t feel bad if you have done this! I think most of us have, but it takes time to remember to refrain from these types of phrases.) Remember that you may have to offer a particular food more than a dozen times before it becomes an accepted food, so don’t give up.

Here are a few tips to help you make this work:

Relax! Mealtime should be fun and relaxing. If you have provided the food, you have done your job.

Offer snacks and meals on a regular basis. If your little one decides to go on strike at a meal, you don’t have to worry that he/she will starve because you know more food is coming in a few hours.

Always serve at least one familiar and accepted food at each meal and snack. This way you know that your child has something to eat and his/her plate won’t look so foreign.

Remember that not everyone can have his or her favorite dish at every meal.

Know that you will be tested. My son screamed through lunch a few weeks ago because he wanted cheerios instead of what I served him. I’m pretty sure most children have these episodes!

Don’t give up. Keep bringing back foods whether your child accepted them or not. It takes time for children to explore and accept new flavors and textures.

Don’t make a big deal out of your child not eating a particular food or any food. This is counterproductive.

Motivational Monday

I exercise because it can help to prevent dementia! I want a strong mind to go with my strong body as I age!

Friday, June 25, 2010

Guest Blog Post: Snacks for your Plane Trip

For today's post, please check out Fly Gracefully! I am honored and thankful that Grace allowed me to submit a guest blog post to her very informative site!

Wednesday, June 23, 2010

Getting Started With a Running Routine

There are many right ways to start a running routine and many wrong ways! This post will just give you some suggestions of possible ways to get started. Also, you may want to read about getting started with an exercise routine if you don’t already have one.

Set one or more long-term goals. My suggestion would be to sign up for a 5K. Don’t wait around to see if you can run far enough by the time the 5K arrives, just sign up. By doing this, you’ll commit yourself to training. If after the 5K you decide that running isn’t for you, move on to something else. If you are already fit, but not a runner, 3 months should be plenty of time to train. If you are not regularly exercising already, you’ll need more time. You may want to start a walking routine and engage in other activities as well. After you feel good enough to add in some running, then you can plan to do a 5K run in 3 months.

Set short-term goals. Decide what you would like to accomplish in the coming week. Each week you will want to come up with new goals. Make sure that they are challenging, yet attainable.

Now that you know what you’re goals are, it is time to begin! If you have not been exercising regularly, start slow with brisk walking or other activities you feel comfortable with. If you have already been active, here is an example of how you can get started!

Here is an example of how you might start to sprinkle jogging/running into your routine slowly to avoid injuries.

Day 1:
Brisk walking 5 minutes
Jog 1 min
Brisk walking 3 min
Jog 1.5 min
Brisk walking 3 min
Jog 2 min
Brisk walking 3 min
Jog 2 min
Brisk walking 5 min
Jog 2 min
Walking 3 min

Day 2:
Weight training

Day 3: Repeat Day 1

Day 4: REST!

Day 5: Weight training

Day 6: Cross-train (bike, walk, elliptical, swim, etc)

Day 7: Repeat Day 1

On subsequent weeks, follow this schedule, but increase your running time. Here is an example:

Brisk walking 5 min
Jog 1 min
Brisk walking 2 min
Jog 1.5 min
Brisk walking 2 min
Jog 2 min
Brisk walking 2 min
Jog 2.5 min
Brisk walking 2 min
Jog 2.5 min
Brisk walking 5 min
Jog 2.5 min
Walk 3-5 min

Each week, lengthen the jogging intervals and even add in some short, fast, running intervals. As you progress, also add in some jogging/running intervals where you just run as long as you can before walking. This is my very simple guide to starting a running routine. I feel that the walk-run technique really helps to ease you into a routine and eventually you will get to point where you can run the entire time.

If you are running outdoors, you will want to clock your run to see how far it is. That way you can be sure that you are covering enough distance to train for your 5K. If you are running on a treadmill, be sure to set your incline at 1% to simulate a flat road outdoors. You may even want to vary your incline for a more realistic “outdoor run”. Do not hold on to the handlebars unless you fear falling off, and in that case I question if you should be on the treadmill. Holding on to the handlebars significantly decreases your effort.

Monday, June 21, 2010

New Milk Recommendations for Children 12 to 24 months

The American Academy of Pediatrics (AAP) recommended whole milk for children starting at the age of 12 months and continuing until 24 months. This all changed after research was evaluated and discussed among the AAP.

In July 2008, the AAP changed its stance to recommend that some children should start with 2% milk at the age of 12 months. However, of course those children still receiving breast milk should continue as long as mommy is up for it! Children who are candidates for this new recommendation are those who have a family history of:


Dyslipidemia (elevated cholesterol, LDL-cholesterol, low HDL-cholesterol, or elevated triglycerides)


Cardiovascular Disease

Don’t children need fat for brain development?

Absolutely! However, research found no difference in the growth and development of children who drank low fat milk versus children who drank whole milk.

How can I supplement fat so that I know my child is getting enough?

Cook with olive oil, serve avocado, and serve hummus dip with whole grain crackers. Look for foods high in unsaturated fats.

Why do experts keep changing their minds?

Research, research, research! Every topic imaginable has not been studied so some recommendations are based on speculation or inferences from other research. As research develops and we get more detailed in our techniques, we learn more and more. Recommendations and position statements change based on evolving research. If recommendations never changed, I would wonder why we fund research.

So what should I do?

First, take a look at your child’s family history. Does your child have obesity, dyslipidemia, or cardiovascular disease in his/her family history? If so, discuss options with your pediatrician.

Motivational Monday
I exercise so that when I’m older, I’ll have the strength to take care of myself!

Friday, June 18, 2010

Slash Your Diaper Spending in Half!

Okay, so this doesn’t have anything to do with fitness or nutrition. However, if you think about it, saving so much money on diapers allows more money for fresh produce, lean meats, a gym membership, or piece of exercise gear/equipment. I have just been horrified with the cost of diapers and how much I used to spend on them. I have always clipped coupons and have never bought any diapers without a coupon; however, little did I know I was NOT getting the best deals. Even if you don’t have a baby or grandchild, think about all of the cheap diapers you can buy for baby showers! Again, I have to credit for teaching me all of this valuable information!!

I buy my diapers at CVS. That’s right! I know you are all gasping at the thought of buying diapers at a drugstore where everything is marked up. Well, keep reading if I have sparked your interest. Although I’ll be discussing CVS, Walgreens and other drugstores have similar rewards programs that you can utilize.

Here is how it works. First, you must get a CVS card. This card will allow you to take advantage of sales and earn Extra Care Bucks (ECBs). ECBs are credits that you earn in the store and are tied to your CVS card. They work like real money at CVS allowing you to buy anything in the store. For all prescriptions, you earn 1 ECB, and for everything else in the store you earn 2% of your total spent. At the end of each quarter, you will get these ECBs back so that you can use them at CVS.

The next thing you need to know is that every time you walk into the store, you need to head straight to the computer that checks prices for you. Scan your CVS card and watch coupons pop out. Sometimes these coupons are totally useless to me, and other times they are awesome!

Here is where you really need to pay attention! Each week CVS features certain items that are not only on sale, but have extra ECBs tied to them. So, for instance, there may be a deal on pampers. A jumbo pack (around 36 diapers) is marked down to $8.49 and you automatically get a printout of 3 ECBs at the register! These deals do not add up over the quarter, you get them back immediately. So, let’s say you have a store coupon for $1 off pampers and a manufacturer’s coupon for $2 off pampers. That brings your price down to $5.49 and you get 3 ECBs to use on your next purchase. Let’s say that this deal allows 2 per customer. So after you make your first purchase, you decide to start another transaction. You have another $1 off manufacturer’s coupon and you use the 3 ECBs that you just earned. That brings your price to $4.49 for your 36 diapers! That is 12 cents per diaper; whereas, at Wal-Mart, if you bought a box of pampers, you would pay almost 20 cents per diaper.

Here are the morals of my story:

1.Don’t buy your diapers at Wal-Mart anymore!

2.Use store coupons + manufacturer coupons whenever you can!

3.Get started with your ECBs and NEVER pay more than 12 cents per diaper. My goal is to pay 10 cents or less, but I will NEVER pay more than 12 cents!

4.Buying diapers in bulk (the big boxes) is definitely not always the cheapest way to go!

4.Always calculate how much your paying PER DIAPER because prices and so-called “sales” may not actually be a deal at all!

5.Try to stick with items at CVS (or another drug store) that offer the ECBs (or other incentive) so that you’re always earning store credit for your next purchase.

Does anyone else have any tips or suggestions? I’d love to hear them! Also note that this ECB idea can be used on many other items such as contact solution, peanut butter, paper towels, and many more products. Go ahead, save some money and use it to buy that produce that you feel is too expensive!

Wednesday, June 16, 2010

Benefits of Exercise for the Pregnant Woman

(Be sure to obtain clearance from your physician first! While exercise is healthy for most pregnant women, it is not appropriate for all!)

1. Less fat deposition during pregnancy and less fat retention post-partum (3).

2. Women who exercise during pregnancy experience less discomfort throughout their pregnancy (3, 29).

3. Studies have found that exercising during pregnancy leads to better moods, more energy, less fatigue, and a better body image (3, 29).

4. Labor is often shorter in women who exercise (3, 40, 41).

5. Lower risk of complications, including cesarean delivery in first-time mothers (43).

6. Faster emotional and physical recovery after pregnancy when exercise is continued post-partum (3, 29).

7. Quicker return to normal urinary control post-partum (3, 29).

8. It is speculated, but not studied, that pregnant women who exercise experience a lower incidence of colds, flu, sinusitis, and bronchitis (3).

9. The risk of gestational diabetes is reduced with exercise throughout pregnancy (29, 44).

10.Decreased risk of pregnancy-induced high blood pressure (preeclampsia) (27, 28, 29).

11. Maximum aerobic capacity has been found to increase between 5 to 10% during the year following birth; whereas those who do not exercise during pregnancy experience a decline of 10% (3, 20).

Monday, June 14, 2010

Examples of Recipe Reconstruction

Here are two examples of how I reconstructed recipes and the results were crowd pleasers! Please note that these recipes aren't necessarily the healthiest recipes; however, it allows you to have a little indulgence with less saturated fat, calories, and sugar.

Original Chocolate Ice Cream Recipe

3 eggs
1 cup sugar
1 quart half/half
1 pint whipping cream
1 cup chocolate syrup
1 T vanilla extract
3 cups milk

Beat eggs with electric mixer at medium speed until frothy. Gradually add sugar, beating until thick. Add next 4 ingredients; mix well. Pour mixture into freezer can of a 1-gallon hand-turned or electric freezer.
Add enough milk to fill can about three-fourths full, or up to the line on inside of freezer container. Freeze according to manufacturer’s instructions. Let ripen at least 1 hour in freezer.
Yield: About 1 gallon

Chocolate Ice Cream Made-Over

¾ cup egg substitute
1 cup splenda
½ Q fat free half/half
½ Q reg half/half
1 pt whipping cream
1 Cup chocolate syrup
1 T vanilla extract
3 cups skim milk

Mexican Chicken

6 chicken breasts
1 can cream of chicken soup
1 can cream of mushroom
½ cup chicken broth
1 small onion chopped
½ cup shredded cheddar
1 sm bag of doritos crushed
1 can tomatoes diced

Boil chicken breast and debone. Combine all ingredients except chicken, cheese and chips. Layer chips in bottom of greased casserole dish, put chicken in next, then sauce, and top with shredded cheese, Bake at 350 degrees for 30 min. Goes well with rice.

Mexican Chicken Made-Over

Remove fat and skin from chicken
2 cans healthy request cream of chicken
½ cup reduced sodium chicken broth
Cheddar cheese made with 2% milk
Baked doritos
Use nonstick spray
Use whole grain rice

Motivational Monday
I exercise because I want my clothes to fit!

Friday, June 11, 2010

Tips for Staying on Track During Your Summer Vacation

You may have a nice little vacation planned for this summer, but how will you be sure to come back from your vacation the same size you left? Here are a few tips for enjoying your time, but not blowing your hard work!

Indulge, but not for every meal. Bring along plenty of fruits and vegetables, if possible, for easy snacks. Savor the flavors of all of the delicious summer produce. If you feel like splurging at dinnertime, don’t be afraid. However, know your limits and plan on not cleaning your plate. Focus on savoring each bite, not on scarfing down every crumb.

Be cautious about alcohol. Drinking a lot of alcoholic beverages on each day of your trip will surely add a lot of calories. Pace yourself, drink water between alcoholic drinks, and choose low calorie drinks.

Do something active that is also fun! Think about walks on the beach, beach volleyball, jumping the waves, chasing your children, etc. The more you are on your feet, the more calories you will burn, but make it fun!

If it’s not worth the calories, skip it. Have you ever eaten a piece of cake that really wasn’t that great? I know I have. Then, I wondered, why did I eat that? If you are the average person on a vacation, you’ll surely take in more calories than typical. So, if you encounter food at a restaurant, party, or other event that isn’t that great, don’t eat it! Find something that does taste good and put those taste buds to good use!

Know your plan for getting back on course when you return home. It is okay to splurge a little here and there, within reason. The best way to make sure a vacation doesn’t totally derail you is to have a plan for eating better and exercising when you return. Stick to it! You’ll be glad you did!

Happy vacationing!

Wednesday, June 9, 2010

Borg's Rate of Perceived Exertion (RPE)

This scale was created to help people gauge their level of exertion and to use it in exercise testing when heart rates are unreliable or unable to be obtained. You may have seen a copy of the category-ratio scale in your local gym or favorite fitness magazine. This is most widely used in fitness classes and the like to help participants figure out how hard they should be working. As mentioned in the article about exercise and pregnancy, the RPE scale is a great tool for gauging exertion level as heart rate has not been shown to be the best indicator. Here are the two scales.

Monday, June 7, 2010

Reconstruct Your Recipes

If you have a few family favorites in your recipe box that aren’t as healthy as you would like them, but still want to be able to serve them from time to time, this blog is for you! Many very high calorie/high fat/high sugar recipes can be transformed into healthier versions without losing all of the taste. From experience, I will tell you that you can alter many recipes without your family or guests even having a clue; however, this won’t always be the case. Some recipes will have to be altered more than once before you strike a good balance of improved nutritional quality and superb taste. The following list will give you some ideas of how to alter recipes. Give some or all of them a try!

1. Flour: Use whole wheat instead of white or use half whole wheat and half white for a comporomise.

2. Butter: Will olive or canola oil work? If so, use it! If not, try using a variety such as Smart Balance that is very low in trans fat and low in saturated fat. Also consider reducing the amount of butter used in the recipe.

3. Sugar: Reduce the amount being used, use half splenda and half sugar, or use all splenda.

4. Eggs: Throw out all but one yolk when cooking with eggs, or use egg substitute.

5. Cheeses: Use cheese made with part-skim or 2% milk. When cream cheese is called for, many recipes work well with fat free or reduced fat.

6. Dairy: Most recipes work well with skim milk and low fat/fat free sour cream or yogurt.

A few extra thoughts:

Use fresh herbs to flavor foods instead of butter and salt.
Add vegetables to stir-fries and casseroles for extra fiber and nutrients.

Stay tuned next week for a few examples of recipes that I have reconstructed!
Motivational Monday!
Eating healthy sets a great example for my children!

Friday, June 4, 2010

Meal Planning

Everyone’s lives are busy, whether you have a demanding job, young children, other major commitments, or all of the above! The key to having a healthy, delicious dinner on the table each night is simple…plan ahead. It is definitely okay to have a left-over night or sandwich night here and there too. You don’t need to feel like every night has to be “gourmet”! Here are some tips to decrease the times you’ll say “what are we going to have for dinner tonight?? Pizza??”

1. Sit down once each week to plan your meals. Yes, this will take some time, but not as much as you think. By doing this, you’ll never be scrounging at the last minute to figure out what to cook and trying to see if you have the ingredients. In fact, the first person to return home can start cooking the meal if you post your plan on the refrigerator. The other plus is that you’re more likely to have balanced and healthy meals because you took the time to plan them when you weren’t rushed and hungry.

2. Make your grocery list after planning your meals and go to the store only once each week. If you are a sale shopper like me, you may do this a little differently. I make most of my meals center around the foods I already have and what is on sale. The main idea here is that if you plan your meals and make your grocery list, you will save several trips to the store each week. If you are crunched for time, the time you spend planning will actually save time.

3. Make a game plan to fit your busy schedule. I can’t tell you exactly how to get your dinner on the table in a timely fashion because everyone’s schedule is different. I’ll give you an example of how I manage. I take the meat out of the freezer that I plan to cook and place it in the refrigerator the night before. To my surprise, after being a working mom for a while, I realized that getting dinner on the table is just as hard when you’re a stay-at-home-mom! To cope, I do a lot of preparation while my son naps. The idea is that when its time to start cooking, I can just bake it, sauté it, grill it, etc. Sometimes I even make a marinade or do some preparation the night before after my son goes to bed. This really makes my life easier at dinner time.

4. Enlist other family members in this process. If your children are old enough, have them each choose a recipe to cook each week. Your spouse is certainly old enough, so he or she can take a night too! With each person planning and cooking one night of the week, the burden can be lifted off of one person and everyone does less work overall.

5. Just remember to plan, plan, plan! If you are not resistant to thinking ahead, your life will really be easier and you will spend less time stressing over what to feed your family when everyone is hungry and tired from the day.

What special strategies do you and your family have in order to get a healthy dinner on your table each night? Please share your ideas!

Wednesday, June 2, 2010

Quick Tips for Pregnant Women Who Wish to Exercise

Get your doctor's approval. While it is absolutely safe for the majority of pregnant women to exercise throughout their pregnancies, there are some situations in which the opposite is true.

Do not get overheated. Be smart about this! You know when you are uncomfortably hot, so take appropriate measures right away when you feel that you are approaching this state. Drink plenty of cold fluids, exercise indoors when it is hot and humid, use a fan, and do not over exert yourself. (30, 31, 32, 33, 34, 35, 36, 37, 38)

Avoid isometric exercises. Isometric exercises have a large effect on blood pressure, more so than other strength moves. (3, 39)

Avoid very heavy weights when strength training. Focus more on endurance by lifting weights light enough that you are able to complete at least 12 repetitions. (3, 39)

Avoid exercises completed in the supine position. This puts pressure on the vena cava restricting blood flow. (39)

Be aware of joint pain. While scientific evidence shows no concerns with pregnant women engaging in high impact activities, you may notice more stress on your joints as weight gain progresses. If this becomes a problem, switch to activities such as stationary cycling, swimming, and others that have less impact. (3, 39, 64, 65, 66)

Avoid activities that could result in falling. This includes riding a bike that is not stationary, horse back riding, and gymnastics. (39)

As long as your doctor has approved you for exercise, guidelines are exactly the same for pregnant women as they are for everyone else. These recommendations are five days of moderate activity for 30 minutes or three days of vigorous activity for 20 minutes.
Also, at least 2 days of strength training. (3, 67, 68)

Judge your appropriate intensity level based on how you feel. If you are familiar with Borg’s Rate of Perceived Exertion (RPE) (look for a future blog on this), you can aim for a rating of 12 to 14. If you are not familiar, the best thing to do is to be sensible. You shouldn’t work so hard that you are completely breathless and at the point of exhaustion. Aim for an intensity that allows you to speak in sentences and feel good throughout your activity. Unfortunately, there is absolutely no conclusion on a safe heart rate zone. No heart rate has actually been found to have a negative impact on mom or baby. If your doctor tells you that you should keep your heart rate below 140 bpm, ask another doctor’s opinion. That advice is completely arbitrary and has zero scientific evidence. In fact, one of the leading physicians in prenatal exercise research, Raul Artal, M.D., has written articles cautioning doctors about giving this advice to their patients. (3, 15, 39, 68)

For more information, stay tuned for other articles on this subject. Also, these books are easy reads written by leading researchers/physicians in prenatal exercise that give a lot of great information. Although both books are great, the first is a little older and doesn’t include some of the more recent research.

Artal, R. & Subak-Sharpe, G.J. Pregnancy & Exercise. New York, New York: Delacorte Press: 1992.

Clapp, J.F. Exercising through your pregnancy. Omaha, Nebraska: Addicus: 2002.

Tuesday, June 1, 2010

References for all blogs about Exercise and Pregnancy

1. American College of Sports Medicine. Guidelines for exercise testing and prescription, 5th edition. Baltimore: Williams & Wilkins: 2006.

2.Clapp, J.F. The effects of maternal exercise on early pregnancy outcome. Am J Obstet Gynecol, 1989; 161: 1453-7.

3.Clapp, J.F. Exercising through your pregnancy. Omaha, Nebraska: Addicus: 2002.

4.Cohen, G.C., Prior, J.C., Vigna, Y., & Pride, S.M. Intense exercise during the first two trimesters of unapparent pregnancy. The Physician and Sportsmedicine, 1989; 17: 87-94.

5.Jarrett, J.C. & Spellacy, W.N. Jogging during pregnancy: an improved outcome? Obstetrics and Gynecology, 1984; 61: 705-709.

6.Hjollund, N.I., Jensen, T.K., Bonde, J.E., Henriksen, T.B., Anderson, A.M., Kolstad, H.A., et al. Spontaneous abortion and physical strain around implantation: a follow-up study of first-pregnancy planners. Epidemiology, 2000; 11: 15-23.

7.Fenster, L., Hubbard, A.E., Windham, G.C., Waller, K.O., & Swan, S.H. A prospective study of work-related physical exertion and spontaneous abortion. Epidemiology, 1997; 8: 66-74.

8.Naeye, R.L. & Peters, E.C. Working during pregnancy: effects on fetus. Pediatrics, 1982; 69: 724-727.

9.Clapp, J.F., Little, K.D., Appleby-Wineberg, S.K., & Widness, J.A. The effect of regular maternal exercise on erythropoietin in cord blood and amniotic fluid. Am J Obstet Gynecol, 1995; 172: 1445-1450.

10.Clapp, J.F., Little, K.D., & Widness, J.A. Effect of maternal exercise and fetoplacental growth rate on serum erythropoietin concentrations. Am J Obstet Gynecol, 2003; 188: 1021-1025.

11.Clapp, J.F., Stepanchak, W., Tomaselli, J., Kortan, M., & Faneslow, S. Portal vein blood flow-effects of pregnancy, gravity, and exercise. Am J Obstet Gynecol, 2000; 183: 162-172.

12.Kennelly, M.M., Geary, M., McCaffrey, N., McLoughlin, P., Staines, A., & McKenna, P. Exercise-related changes in umbilical and uterine artery waveforms as assessed by Doppler ultrasound scans. Am J Obstet Gynecol, 2002; 187: 661-666.

13.Hatch, M., Ji, B., Shu, X., & Susser, M. Do standing, lifting, climbing, or long hours of working during pregnancy have an effect on fetal growth? Epidemiology, 1997; 8: 530-536.

14.Campbell, M.K. & Mottola, M.F. Recreational exercise and occupational activity during pregnancy and birth weight: a case-control study. Am J Obstet Gynecol, 2001; 184: 403-408.

15.Artal, R. & Subak-Sharpe, G.J. Pregnancy & Exercise. New York, New York: Delacorte Press: 1992.

16.Kardell, K.R., & Kase, T. Training in pregnant women: effects on fetal development and birth. Am J Obstet Gynecol, 1998; 178: 280-286.

17.Clapp, J.F. & Capless, E.L. Neonatal morphometrics after endurance exercise during pregnancy. Am J Obstet Gynecol, 1990; 163: 1805-1811.

18.Magann, E.F., Evans, S.F., Weitz, B., & Newnham, J. Antepartum, intrapartum, and neonatal significance of exercise on healthy low-risk pregnant working women. Obstetrics and Gynecology, 2002; 99: 466-472.

19.Clapp, J.F., Kim, H., Burciu, B., Schmidt, S., Petry, K., & Lopez, B. Continuing regular exercise during pregnancy: effect of exercise volume and fetoplacental growth. Am J Obstet Gynecol, 2002; 186: 142-147.

20.Collings, C.A., Curet, L.B., & Mullin, J.P. Maternal and fetal responses to a maternal aerobic exercise program. Am J Obstet Gynecol, 1983; 145: 702-707.

21.Clapp, J.F., Kim, H., Burciu, B., & Lopez, B. Beginning regular exercise in early pregnancy: effect on fetoplacental growth. Am J Obstet Gynecol, 2000; 183: 1484-1488.

22.Ahlborg, G., Bodint, L., & Hogstedt, C. Heavy lifting during pregnancy – a hazard to the fetus? a prospective study. International Journal of Epidemiology, 1990; 19: 90-97.

23.Evenson, K.R., Siega-Riz, A.M., Savitz, D.A., Leiferman, J.A., & Thorp, J.M. Vigorous leisure activity and pregnancy outcomes. Epidemiology, 2002; 13: 653-659.

24.Hegaard, H.K., Hedegaard, M., Damm, P., Ottesen, B., Petersson, K., & Henriksen, T.B. Leisure time physical activity is associated with a reduced risk of preterm delivery. Am J Obstet Gynecol, 2008; 198: 180.e1-180.e5.

25.Madsen, M., Jorgensen, T., Jensen, M.L., Juhl, M., Olsen, J., Anderson, P.K., et al. Leisure time physical exercise during pregnancy and the risk of miscarriage: a study within the Danish National Birth Cohort. BJOG, 2007; 114: 1419-1426.

26.Saftlas, A.F., Logsden-Sackett, N., Wang, W. Woolson, R., & Bracken, M.B. Work, leisure-time, physical activity and risk of preeclampsia and gestational hypertension. Am J Epidmiol, 2004; 160: 758-765.

27.Sorenson, T.K., Williams, M.A., Lee, I., Dashow, E.E., Thompson, M., & Luthy, D.A. Recreational physical activity during pregnancy and risk of preeclampsia. Hypertension, 2003; 41: 1273-1280.

28.Rafla, N.M. The effect of maternal exercise on umbilical artery blood flow in pregnancy-induced hypertension. Journal of Obstetrics and Gynaecology, 2000; 20: 19-23.

29.American College of Sports Medicine. American College of Sports Medicine (ACSM) offers guidance on physical activity during pregnancy and the postpartum period. 2006.

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