Michelle Mottola was her own first guinea pig. Her pregnancy with her youngest daughter was the first test in the R. Samuel McLaughlin Foundation Exercise and Pregnancy Lab, that has since led to national guidelines on exercise and pregnancy.
Recently, the Kinesiology professor celebrated a research milestone – 20 years for her lab and more than 400 women and babies delivering life-changing research results. On May 8 (Mother’s Day), the lab welcomed back its past research participants and their babies for family-friendly activities and to learn about new and historic findings from its research studies.
“Back then, we didn’t really know if exercise during pregnancy was safe for the fetus,” Mottola said. “Nobody really knew what happens to the fetus when the mother is being physically active. The guidelines didn’t know what to suggest and many myths developed back then, such as pregnant women shouldn’t do anything but put their feet up and eat for two.
“We didn’t know that what the mother does during pregnancy has a huge impact on chronic disease risk of her child.”
As an embryologist, having completed her PhD dissertation in anatomy and cell biology, and with a master’s degree in exercise and physiology and physical education, Mottola’s expertise allowed her to tackle this research gap.
She was working in the field of exercise and pregnancy prior to moving into the lab, including participating in research during the pregnancy with her eldest daughter two years earlier. There is nothing that she will ask her research participants to do that she hasn’t already tried herself, she noted.
“The idea was to identify mechanisms with regards to metabolic changes with exercise,” she said. “We found that intensity of exercise is important; a mild exercise program was just as good as a moderate intensity program with regards to metabolic changes. That was important for us because with overweight and obese pregnant program, if a walking program was just as good as a moderate intensity program to help control blood sugars, that was really important because these women were at risk for gestational diabetes.”
As a result of this work, the Nutrition and Exercise Lifestyle Intervention Program (NELIP) was developed and has since been selected for the Canadian Best Practice Portal by the Public Health Agency of Canada.
Eating healthy, meaning eating twice as healthy instead of ‘eating for two,’ and exercising during pregnancy was found to prevent excessive pregnancy weight gain, gestational diabetes mellitus (GDM) and hypertension in the mother.
Mottola’s research also found walking during pregnancy, combined with controlling carbohydrate intake, helps prevent GDM, especially in First Nations women, and minimizes insulin therapy in women already diagnosed with GDM.
Additionally, preventing excessive weight gain during pregnancy prevents childhood obesity, she explained.
“We also looked at babies at delivery and we found that in our overweight women, we saw a decline or decrease in the incidences of very large babies,” she said. “What this area of research is examining is the fetal environment and how the fetal environment can influence the health risks of the developing baby.”
Mottola is involved in updating the Canadian guidelines for Exercise During Pregnancy (PARmed-X for Pregnancy), and the current (2015) guidelines are based on her evidence-based work involving women from London, Ont.
“We are the only lab in North America that has been investigating exercise during pregnancy and post-delivery,” she said.
Karyn Koopman didn’t want a repeat of the weight gain from her first pregnancy, so her midwife recommended she contact Mottola to see if she qualified as a research participant for a study.
“With my first pregnancy, I gained a lot of weight and he was a big baby,” she said. “Everybody says you need to rest, sit down and put your feet up. In my mind I thought I could eat whatever I wanted because whether I gained weight or not, it was all hidden. I don’t think I realized my belly didn’t need to get as big as it did and I didn’t need to put so much strain on my body.”
Koopman joined the NELIP study in 2007, which included a regular walking routine four days a week and a nutrition program. During her first pregnancy, she gained 50 pounds and her baby was born at 10 pounds 15 ounces. After completing the study, she gained half the amount of weight of her first pregnancy and gave birth to a 9-pound-10-ounce child. As a result of the lower weight gain, within a short period of time she returned to her pre-pregnancy weight.
The lessons she learned during the research study carried her through three more pregnancies and has continued to be incorporated into her healthy lifestyle.
“With my first pregnancy I didn’t know anything about being healthy,” she said. “You want to have a healthy baby and I think there is a link between that and you taking care of your body and how that affects your labour and delivery, and the birth weight of your baby.
“Childbirth is such a short time in your life, and I think you should treat it as a continuation of you taking care of your body and your health because you want to develop these habits. I didn’t have them before I was pregnant, but now I have them,” she added.