human
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To evaluate the effectiveness and safety of water aerobics during pregnancy . Methods A r and omized controlled trial carried out in 71 low-risk sedentary pregnant women , r and omly allocated to water aerobics or no physical exercise .  Maternal body composition and perinatal outcomes were evaluated . For statistical analysis Chi-square , Fisher 's or Student 's t-tests were applied . Risk ratios and their 95 % CI were estimated for main outcomes . Body composition was evaluated across time using MANOVA or Friedman multiple analysis . Results There were no significant differences between the groups regarding maternal weight gain , BMI or percentage of body fat during pregnancy . Incidence of preterm births ( RR = 0.84 ; 95%CI:0.28–2.53 ) , vaginal births ( RR = 1.24 ; 95%CI:0.73–2.09 ) , low birthweight ( RR = 1.30 ; 95%CI:0.61–2.79 ) and adequate weight for gestational age ( RR = 1.50 ; 95%CI:0.65–3.48 ) were also not significantly different between groups . There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session . Conclusion Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition , type of delivery , preterm birth rate , neonatal well-being or weight PURPOSE The present study examined the effects of exercise on physical and psychological variables in sedentary primigravidae ( PRA ) . METHODS A total of nine women r and omly assigned to an exercise ( E ) ( mean age = 31.3 + /- 3.1 yr ) and six subjects r and omly assigned to a control ( C ) group ( mean age = 27.8 + /- 3.1 yr ) fulfilled all requirements for the study . Exercise included a variety of exercise activities performed to a target heart rate of 150 - 156 beats x min(-1 ) , three times per week for 15 wk . RESULTS Results showed no significant differences between E and C groups in physical characteristics initially . A repeated measures ANOVA showed a significant group effect ( P < 0.05 ) and a significant group by time interaction ( P = 0.001 ) with the E group showing a significantly longer amount of time on the PWC150 test than the C group . There was no significant group , time , or group by time interaction for lactate accumulation . This occurred , despite the fact that the E group spent 56 % longer on the PWC150 test and the C group spent 30 % less time on the same test at the conclusion of the study . Finally , the E group in comparison to the C group showed more favorable improvements in several items related to health and well-being on the Body Cathexis Scale . There were no significant differences between E and C groups in any pregnancy outcome measures . All babies were delivered healthy  at term . CONCLUSIONS These data suggest that a vigorous exercise program can lead to significant improvements in aerobic fitness at similar lactate concentrations compared to a control group and can be well tolerated by low risk sedentary PRA without any deleterious effects occurring to herself or unborn child Pregnant women at risk for preeclampsia may benefit from the positive effects of exercise , but they may be unlikely to adhere to an exercise program . A r and omized trial was conducted with 124 sedentary pregnant women to compare the effects of walking exercise to a stretching exercise on adherence and on the preeclampsia risk factors of heart rate ( HR ) , blood pressure , and weight gain .  Walkers exercised less than stretchers both overall and as pregnancy advanced . HR and blood pressure were lower among stretchers than walkers , but weight gain did not differ between the groups . For sedentary pregnant women , a stretching exercise may be more effective than walking in mitigating the risk of preeclampsia due to higher adherence and possible cardiac-physiologic effects AIM The significant deterioration of insulin sensitivity and glucose tolerance during pregnancy can have serious health implication s for both the pregnant woman and her baby . Although it is well established that regular exercise benefits insulin sensitivity in the nonpregnant population , the effect on glucose tolerance in obese pregnant women is not known . The purpose of this study was to investigate the effect of a supervised 10-week , home-based , exercise programme , beginning at week 18 of gestation , on glucose tolerance and aerobic fitness in previously sedentary obese women . METHODS Twelve sedentary obese women were r and omized into an exercise ( EX ; n=6 ) or control ( CON ; n=6 ) group at 18 weeks of gestation . Those r and omized to EX engaged in 10 weeks of supervised home-based exercise ( three sessions a week of stationary cycling ) , while those in the CON group maintained their usual daily activity . Their glucose and insulin responses to an oral glucose tolerance test ( OGTT ) , as well as their aerobic fitness , were assessed both pre- and postintervention . RESULTS Reduced glucose tolerance in the CON , but not EX , group was indicated by a tendency postintervention towards higher blood glucose levels at 1h of the OGTT ( P=0.072 ) . Furthermore , at 2h of the postintervention OGTT , blood glucose tended to remain elevated from baseline in the CON ( P=0.077 ) . There was also a trend towards increased fitness in the EX ( P=0.064 ) , but not the CON group . CONCLUSION Regular aerobic exercise begun during pregnancy may have favourable effects on glucose tolerance and fitness in obese women , and warrants further investigation in a larger sample population PURPOSE This study aim ed to evaluate the effect of an exercise program of two different intensities , with nutritional control , on gestational weight gain ( GWG ) , infant birth weight , and maternal weight retention at 2 months postpartum ( 2 mopp ) . METHODS Pregnant women ( prepregnancy body mass index = 18.5 - 24.9 kg·m ) were r and omized at study entry ( 16 - 20 wk of gestation ) to a low-intensity ( LI , 30 % HR reserve ( HRR ) , n = 23 ) or moderate-intensity ( MI , 70 % HRR , n = 26 ) exercise program , with nutritional control . The exercise program consisted of walking sessions three to four times per week , gradually increasing exercise time from 25 to 40 min per session . Forty-five normal-weight women who did not participate in any structured exercise program during pregnancy and had singleton births were used as a historical control group .  RESULTS Total GWG was higher in the control group ( 18.3 ± 5.3 kg ) compared with the LI ( 15.3 ± 2.9 kg , P = 0.01 ) and MI ( 14.9 ± 3.8 kg , P = 0.003 ) groups . During the intervention , GWG was similar in both intervention groups , with weekly rates of weight gain of 0.49 ± 0.1 and 0.47 ± 0.1 kg·wk in the LI and MI groups , respectively . Excessive GWG during the intervention was prevented in 70 % of the women in the LI group and 77 % of those in the MI group . Excessive GWG occurred before the intervention began . At 2 mopp , 18 % and 28 % of the women in the LI and MI groups , respectively , retained ≤2.0 kg compared with only 7 % of those in the control group . Infant birth weight was not different between the groups . CONCLUSIONS Results suggest that a prenatal nutrition and exercise program regardless of exercise intensity , reduced excessive GWG and decreased weight retention at 2 mopp in women of normal weight before pregnancy Objective : We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the  newborn 's birth size . We also studied the association between  maternal body weight prior to pregnancy and newborn 's birth size .  Design : R and omised controlled trial . Subjects : We r and omly assigned 160 sedentary gravidae to either a training ( n=80 ) or a control ( n=80 ) group . The training programme focused on light resistance and toning exercises ( three times per week , 35–40 min per session ) . We recorded the Apgar score , birth weight , birth length , and head circumference of the newborn , as well as gestational age at time of delivery from hospital perinatal records . We also measured maternal weight and height before parity and gestational weight gain . Results : Maternal characteristics neither differed between groups ( all P>0.1 ) nor newborn characteristics ( all P>0.1 ) . Maternal body weight was positively and significantly associated with newborn 's birth weight and length only in the control group ( β=19.20 and 0.065 , respectively , P<0.01 ) . Conclusion : Light intensity resistance training performed over the second and third trimester of pregnancy does not have a negative impact on the newborn 's body size or overall health . Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborn 's birth size Objective : To evaluate the effects of aerobic training on submaximal cardiorespiratory capacity in overweight pregnant women . Methods : We conducted a r and omized clinical trial in a referral center prenatal clinic during the period 2000–2002 . Of 132 overweight ( body mass index 26–31 kg/m2 ) but otherwise healthy volunteers , at 20 years of age or older , with gestational age of 20 weeks or less , and without diabetes or hypertension , 92 consented to participate and were r and omized . Intervention consisted of 3 one-hour aerobic exercise sessions per week ; the control group received weekly relaxation and focus group discussion s. The main outcome measure was submaximal exercise capacity evaluated by oxygen uptake at the anaerobic ( first ventilatory ) threshold during cardiopulmonary treadmill testing 12 weeks after r and omization . Results : Oxygen uptake at the anaerobic threshold increased 18 % ( 15.9 ± 2.6 to 18.1 ± 3.1 mL · min−1 · kg−1 ) in the exercise group but decreased 16 % ( 16.9 ± 3.0 to 15.8 ± 2.6 mL · min−1 · kg−1 ) among the control group . Oxygen consumption at the anaerobic threshold , adjusted through analysis of covariance for baseline oxygen uptake , was 2.68 ( 95 % confidence interval 1.23 to 4.12 ) mL · min−1 · kg−1 greater in the exercise group . Women in the exercise group were approximately 5 times more likely than those in the control group to have regular or good cardiorespiratory capacity ( 12/38 versus 2/38 ; relative risk 5.2 , 95 % confidence interval 1.2 to 22.0 , number needed to treat 5 ) . Conclusion : Aerobic training in overweight pregnant women  substantially increases submaximal exercise capacity , overcoming the otherwise negative effects of pregnancy in this regard . Additional studies are required to evaluate its effect on major clinical outcomes . LEVEL OF EVIDENCE : OBJECTIVE To study the effect on  maternal weight gain of a supervised light- to moderate-intensity exercise-based intervention performed from the ninth week of pregnancy . PARTICIPANTS AND METHODS A total of 962 healthy pregnant women were r and omly assigned to a st and ard care or exercise intervention group conducted between September 1 , 2007 , and January 31 , 2011 . The intervention included light- to moderate-intensity aerobic and resistance exercises performed 3 days a week ( 50 - 55 minutes per session ) . Excessive gestational weight gain was calculated on the basis of the 2009 Institute of Medicine ( IOM ) recommendations . Gestational body weight gain was calculated on the basis of the weight measured at the first prenatal visit ( fifth to sixth weeks of gestation ) and weight measured at the last visit to the clinic before delivery . Women were categorized into normal weight or overweight or obese . RESULTS Women in the intervention group gained less weight ( adjusted mean difference , 1.039 kg ; 95 % CI , 0.534 - 1.545 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.625 ; 95 % CI , 0.461 - 0.847 ) compared with those in the st and ard care group . The main treatment effects according to body mass index category were that normal weight women in the intervention group gained less weight ( adjusted mean difference , 1.393 kg ; 95 % CI , 0.813 - 1.972 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.508 ; 95 % CI , 0.334 - 0.774 ) than normal weight women who received st and ard care . No significant treatment effect was observed in overweight or obese women . CONCLUSION Supervised exercise of light to moderate intensity can be used to prevent excessive gestational weight gain , especially in normal weight women . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01790347 OBJECTIVE There is controversy over whether exercise and /or exercise intensity has an effect on total caloric intake or diet composition . The purpose of this study was to test the effect of exercise intensity without dietary manipulation on body composition and /or weight loss and to determine whether exercise intensity affected total caloric intake or diet composition in normal weight 
    Output:
    
agent
***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Background To evaluate the effectiveness and safety of water aerobics during pregnancy . Methods A r and omized controlled trial carried out in 71 low-risk sedentary pregnant women , r and omly allocated to water aerobics or no physical exercise .  Maternal body composition and perinatal outcomes were evaluated . For statistical analysis Chi-square , Fisher 's or Student 's t-tests were applied . Risk ratios and their 95 % CI were estimated for main outcomes . Body composition was evaluated across time using MANOVA or Friedman multiple analysis . Results There were no significant differences between the groups regarding maternal weight gain , BMI or percentage of body fat during pregnancy . Incidence of preterm births ( RR = 0.84 ; 95%CI:0.28–2.53 ) , vaginal births ( RR = 1.24 ; 95%CI:0.73–2.09 ) , low birthweight ( RR = 1.30 ; 95%CI:0.61–2.79 ) and adequate weight for gestational age ( RR = 1.50 ; 95%CI:0.65–3.48 ) were also not significantly different between groups . There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session . Conclusion Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition , type of delivery , preterm birth rate , neonatal well-being or weight PURPOSE The present study examined the effects of exercise on physical and psychological variables in sedentary primigravidae ( PRA ) . METHODS A total of nine women r and omly assigned to an exercise ( E ) ( mean age = 31.3 + /- 3.1 yr ) and six subjects r and omly assigned to a control ( C ) group ( mean age = 27.8 + /- 3.1 yr ) fulfilled all requirements for the study . Exercise included a variety of exercise activities performed to a target heart rate of 150 - 156 beats x min(-1 ) , three times per week for 15 wk . RESULTS Results showed no significant differences between E and C groups in physical characteristics initially . A repeated measures ANOVA showed a significant group effect ( P < 0.05 ) and a significant group by time interaction ( P = 0.001 ) with the E group showing a significantly longer amount of time on the PWC150 test than the C group . There was no significant group , time , or group by time interaction for lactate accumulation . This occurred , despite the fact that the E group spent 56 % longer on the PWC150 test and the C group spent 30 % less time on the same test at the conclusion of the study . Finally , the E group in comparison to the C group showed more favorable improvements in several items related to health and well-being on the Body Cathexis Scale . There were no significant differences between E and C groups in any pregnancy outcome measures . All babies were delivered healthy  at term . CONCLUSIONS These data suggest that a vigorous exercise program can lead to significant improvements in aerobic fitness at similar lactate concentrations compared to a control group and can be well tolerated by low risk sedentary PRA without any deleterious effects occurring to herself or unborn child Pregnant women at risk for preeclampsia may benefit from the positive effects of exercise , but they may be unlikely to adhere to an exercise program . A r and omized trial was conducted with 124 sedentary pregnant women to compare the effects of walking exercise to a stretching exercise on adherence and on the preeclampsia risk factors of heart rate ( HR ) , blood pressure , and weight gain .  Walkers exercised less than stretchers both overall and as pregnancy advanced . HR and blood pressure were lower among stretchers than walkers , but weight gain did not differ between the groups . For sedentary pregnant women , a stretching exercise may be more effective than walking in mitigating the risk of preeclampsia due to higher adherence and possible cardiac-physiologic effects AIM The significant deterioration of insulin sensitivity and glucose tolerance during pregnancy can have serious health implication s for both the pregnant woman and her baby . Although it is well established that regular exercise benefits insulin sensitivity in the nonpregnant population , the effect on glucose tolerance in obese pregnant women is not known . The purpose of this study was to investigate the effect of a supervised 10-week , home-based , exercise programme , beginning at week 18 of gestation , on glucose tolerance and aerobic fitness in previously sedentary obese women . METHODS Twelve sedentary obese women were r and omized into an exercise ( EX ; n=6 ) or control ( CON ; n=6 ) group at 18 weeks of gestation . Those r and omized to EX engaged in 10 weeks of supervised home-based exercise ( three sessions a week of stationary cycling ) , while those in the CON group maintained their usual daily activity . Their glucose and insulin responses to an oral glucose tolerance test ( OGTT ) , as well as their aerobic fitness , were assessed both pre- and postintervention . RESULTS Reduced glucose tolerance in the CON , but not EX , group was indicated by a tendency postintervention towards higher blood glucose levels at 1h of the OGTT ( P=0.072 ) . Furthermore , at 2h of the postintervention OGTT , blood glucose tended to remain elevated from baseline in the CON ( P=0.077 ) . There was also a trend towards increased fitness in the EX ( P=0.064 ) , but not the CON group . CONCLUSION Regular aerobic exercise begun during pregnancy may have favourable effects on glucose tolerance and fitness in obese women , and warrants further investigation in a larger sample population PURPOSE This study aim ed to evaluate the effect of an exercise program of two different intensities , with nutritional control , on gestational weight gain ( GWG ) , infant birth weight , and maternal weight retention at 2 months postpartum ( 2 mopp ) . METHODS Pregnant women ( prepregnancy body mass index = 18.5 - 24.9 kg·m ) were r and omized at study entry ( 16 - 20 wk of gestation ) to a low-intensity ( LI , 30 % HR reserve ( HRR ) , n = 23 ) or moderate-intensity ( MI , 70 % HRR , n = 26 ) exercise program , with nutritional control . The exercise program consisted of walking sessions three to four times per week , gradually increasing exercise time from 25 to 40 min per session . Forty-five normal-weight women who did not participate in any structured exercise program during pregnancy and had singleton births were used as a historical control group .  RESULTS Total GWG was higher in the control group ( 18.3 ± 5.3 kg ) compared with the LI ( 15.3 ± 2.9 kg , P = 0.01 ) and MI ( 14.9 ± 3.8 kg , P = 0.003 ) groups . During the intervention , GWG was similar in both intervention groups , with weekly rates of weight gain of 0.49 ± 0.1 and 0.47 ± 0.1 kg·wk in the LI and MI groups , respectively . Excessive GWG during the intervention was prevented in 70 % of the women in the LI group and 77 % of those in the MI group . Excessive GWG occurred before the intervention began . At 2 mopp , 18 % and 28 % of the women in the LI and MI groups , respectively , retained ≤2.0 kg compared with only 7 % of those in the control group . Infant birth weight was not different between the groups . CONCLUSIONS Results suggest that a prenatal nutrition and exercise program regardless of exercise intensity , reduced excessive GWG and decreased weight retention at 2 mopp in women of normal weight before pregnancy Objective : We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the  newborn 's birth size . We also studied the association between  maternal body weight prior to pregnancy and newborn 's birth size .  Design : R and omised controlled trial . Subjects : We r and omly assigned 160 sedentary gravidae to either a training ( n=80 ) or a control ( n=80 ) group . The training programme focused on light resistance and toning exercises ( three times per week , 35–40 min per session ) . We recorded the Apgar score , birth weight , birth length , and head circumference of the newborn , as well as gestational age at time of delivery from hospital perinatal records . We also measured maternal weight and height before parity and gestational weight gain . Results : Maternal characteristics neither differed between groups ( all P>0.1 ) nor newborn characteristics ( all P>0.1 ) . Maternal body weight was positively and significantly associated with newborn 's birth weight and length only in the control group ( β=19.20 and 0.065 , respectively , P<0.01 ) . Conclusion : Light intensity resistance training performed over the second and third trimester of pregnancy does not have a negative impact on the newborn 's body size or overall health . Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborn 's birth size Objective : To evaluate the effects of aerobic training on submaximal cardiorespiratory capacity in overweight pregnant women . Methods : We conducted a r and omized clinical trial in a referral center prenatal clinic during the period 2000–2002 . Of 132 overweight ( body mass index 26–31 kg/m2 ) but otherwise healthy volunteers , at 20 years of age or older , with gestational age of 20 weeks or less , and without diabetes or hypertension , 92 consented to participate and were r and omized . Intervention consisted of 3 one-hour aerobic exercise sessions per week ; the control group received weekly relaxation and focus group discussion s. The main outcome measure was submaximal exercise capacity evaluated by oxygen uptake at the anaerobic ( first ventilatory ) threshold during cardiopulmonary treadmill testing 12 weeks after r and omization . Results : Oxygen uptake at the anaerobic threshold increased 18 % ( 15.9 ± 2.6 to 18.1 ± 3.1 mL · min−1 · kg−1 ) in the exercise group but decreased 16 % ( 16.9 ± 3.0 to 15.8 ± 2.6 mL · min−1 · kg−1 ) among the control group . Oxygen consumption at the anaerobic threshold , adjusted through analysis of covariance for baseline oxygen uptake , was 2.68 ( 95 % confidence interval 1.23 to 4.12 ) mL · min−1 · kg−1 greater in the exercise group . Women in the exercise group were approximately 5 times more likely than those in the control group to have regular or good cardiorespiratory capacity ( 12/38 versus 2/38 ; relative risk 5.2 , 95 % confidence interval 1.2 to 22.0 , number needed to treat 5 ) . Conclusion : Aerobic training in overweight pregnant women  substantially increases submaximal exercise capacity , overcoming the otherwise negative effects of pregnancy in this regard . Additional studies are required to evaluate its effect on major clinical outcomes . LEVEL OF EVIDENCE : OBJECTIVE To study the effect on  maternal weight gain of a supervised light- to moderate-intensity exercise-based intervention performed from the ninth week of pregnancy . PARTICIPANTS AND METHODS A total of 962 healthy pregnant women were r and omly assigned to a st and ard care or exercise intervention group conducted between September 1 , 2007 , and January 31 , 2011 . The intervention included light- to moderate-intensity aerobic and resistance exercises performed 3 days a week ( 50 - 55 minutes per session ) . Excessive gestational weight gain was calculated on the basis of the 2009 Institute of Medicine ( IOM ) recommendations . Gestational body weight gain was calculated on the basis of the weight measured at the first prenatal visit ( fifth to sixth weeks of gestation ) and weight measured at the last visit to the clinic before delivery . Women were categorized into normal weight or overweight or obese . RESULTS Women in the intervention group gained less weight ( adjusted mean difference , 1.039 kg ; 95 % CI , 0.534 - 1.545 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.625 ; 95 % CI , 0.461 - 0.847 ) compared with those in the st and ard care group . The main treatment effects according to body mass index category were that normal weight women in the intervention group gained less weight ( adjusted mean difference , 1.393 kg ; 95 % CI , 0.813 - 1.972 kg ; P<.001 ) and were less likely to gain weight above the IOM recommendations ( odds ratio , 0.508 ; 95 % CI , 0.334 - 0.774 ) than normal weight women who received st and ard care . No significant treatment effect was observed in overweight or obese women . CONCLUSION Supervised exercise of light to moderate intensity can be used to prevent excessive gestational weight gain , especially in normal weight women . TRIAL REGISTRATION clinical trials.gov Identifier : NCT01790347 OBJECTIVE There is controversy over whether exercise and /or exercise intensity has an effect on total caloric intake or diet composition . The purpose of this study was to test the effect of exercise intensity without dietary manipulation on body composition and /or weight loss and to determine whether exercise intensity affected total caloric intake or diet composition in normal weight 
    Output:
    