1
|
Ross MG, Kavasery MP, Cervantes MK, Han G, Horta B, Coca KP, Costa SO, Desai M. High-Fat, High-Calorie Breast Milk in Women with Overweight or Obesity and Its Association with Maternal Serum Insulin Concentration and Triglycerides Levels. CHILDREN (BASEL, SWITZERLAND) 2024; 11:141. [PMID: 38397253 PMCID: PMC10887191 DOI: 10.3390/children11020141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/25/2024]
Abstract
The childhood obesity epidemic continues to be a challenge. Maternal obesity and excessive infant weight gain are strong predictors of childhood obesity, which itself is a major risk factor for adult obesity. The primary source of nutrition during early life is breast milk, and its composition is impacted by maternal habitus and diet. We thus studied the relationship between maternal BMI, serum lipids and insulin, and breast milk fat and calorie content from foremilk to hindmilk. Women who were exclusively breastfeeding at 7-8 weeks postpartum were BMI classified as Normal (18.5-24.9, n = 9) and women with Overweight/Obese (OW/OB ≥ 25, n = 13). Maternal blood and continuous breast milk samples obtained from foremilk to hindmilk were analyzed, and infant milk intake was assessed. Women with OW/OB had significantly higher milk fat and calorie content in the first foremilk and last hindmilk sample as compared to Normal BMI women. Amongst all women, maternal serum triglycerides, insulin, and HOMA were significantly correlated with foremilk triglyceride concentration, suggesting that maternal serum triglyceride and insulin action contribute to human milk fat content. As the milk fat content of OW/OB women has caloric implications for infant growth and childhood obesity, these results suggest the potential for modulating milk fat content by a reduction in maternal serum lipids or insulin.
Collapse
Affiliation(s)
- Michael G. Ross
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
- Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA 90059, USA
| | - Manasa P. Kavasery
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - MacKenzie K. Cervantes
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Guang Han
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| | - Bernardo Horta
- School of Medicine, Universidade Federal de Pelotas, Pelotas 96010-610, Brazil;
| | - Kelly P. Coca
- Escola Paulista de Enfermagem, Universidade Federal de São Paulo, São Paulo 04023-900, Brazil;
| | - Suleyma O. Costa
- Laboratory of Metabolic Disorders, School of Applied Sciences, University of Campinas, Campinas 13083-970, Brazil;
| | - Mina Desai
- Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California Los Angeles at Harbor-UCLA, Torrance, CA 90502, USA;
- The Lundquist Institute at Harbor-UCLA Medical Center, 1124 West Carson Street, RB3 Building, Torrance, CA 90502, USA; (M.P.K.); (M.K.C.); (G.H.)
| |
Collapse
|
2
|
Bleiweiss-Sande R, Skelton K, Zaltz D, Bacardí-Gascón M, Jiménez-Cruz A, Benjamin-Neelon SE. Interventions to prevent obesity in Latinx children birth to 6 years globally: a systematic review. Public Health Nutr 2023; 26:2498-2513. [PMID: 37622420 PMCID: PMC10641617 DOI: 10.1017/s1368980023001283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 04/03/2023] [Accepted: 06/20/2023] [Indexed: 08/26/2023]
Abstract
OBJECTIVE To conduct a systematic review of obesity prevention interventions in Latinx children ages birth to 6 years published in any language from 2010-2020. DESIGN We used PubMed, ERIC, PsycINFO, Scopus, Scientific Electronic Library Online (SciELO) and Google Scholar databases to conduct a search on May 1 2020, January 1 2021 and November 1 2022. We included randomised controlled trials, quasi-experimental studies and non-randomised interventions with a control or comparison group that reported measures of adiposity. SETTING Interventions taking place in the United States, Latin America or the Caribbean. PARTICIPANTS Latinx children ages birth to 6 years. RESULTS Of 8601 unique records identified, forty manuscripts about thirty-nine unique studies describing thirty distinct interventions in the United States and nine interventions in Latin America and the Caribbean met our inclusion criteria. Interventions were primarily based in early care and education centres (n 13) or combined home settings, for example home and community (n 7). Randomised interventions taking place in community or home settings were more likely to report significant reductions in adiposity or weight-related outcomes compared to other settings. Using the Cochrane risk of bias tools for randomised and non-randomised studies, we judged thirty-eight randomised trials and nine non-randomised interventions to have a high or unclear risk of bias. CONCLUSIONS The results highlight a need for more rigorous designs and more effective intervention strategies in Latinx children at risk for having overweight and obesity. Registered with the PROSPERO database for systematic reviews under registration number CRD42020161339.
Collapse
Affiliation(s)
- Rachel Bleiweiss-Sande
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD21205, USA
| | - Kara Skelton
- Department of Health Sciences, Towson University, Towson, MD, USA
| | - Daniel Zaltz
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD21205, USA
| | | | - Arturo Jiménez-Cruz
- Universidad Autónoma de Baja California, Department of Medicine and Psychology, Tijuana, Mexico
| | - Sara E Benjamin-Neelon
- Johns Hopkins Bloomberg School of Public Health, Department of Health, Behavior and Society, 624 N Broadway, Baltimore, MD21205, USA
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
3
|
Soltero EG, Lopez C, Hernandez E, O'Connor TM, Thompson D. Technology-Based Obesity Prevention Interventions Among Hispanic Adolescents in the United States: Scoping Review. JMIR Pediatr Parent 2022; 5:e39261. [PMID: 36331547 PMCID: PMC9675012 DOI: 10.2196/39261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/05/2022] [Accepted: 08/24/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Given that today's adolescents are digital front-runners, technology-based obesity prevention strategies are age-appropriate for this population. The use of remote and wireless technologies may be suitable for extending the reach and engagement of obesity prevention efforts among high-risk Hispanic youths, as this subgroup is disproportionately affected by barriers that limit participation in traditional, in-person interventions. OBJECTIVE The purpose of this scoping review was to examine the intervention and sample characteristics of technology-based obesity prevention interventions among Hispanic adolescents. We also examined feasibility criteria to assess the acceptability and appropriateness of technology-based strategies among Hispanic youths. METHODS A comprehensive search of Embase and PubMed identified 7 studies that met the inclusion criteria. Data were extracted by 2 independent reviewers. RESULTS Of the 7 included studies, half (n=4, 57%) used a randomized control trial design, with equal implementation in school (n=3, 43%) and clinic (n=4, 57%) settings. Studies commonly targeted improvements in diet (n=4, 57%) and physical activity (n=7, 100%), with only 1 (14%) study focused on sedentary behaviors. Just 2 (29%) studies reported the use of behavioral theories or models. Studies focused primarily on youths in early (n=5, 71%) or middle (n=6, 86%) adolescence, and there was limited information reported on socioeconomic status. Only 3 (43%) study conducted formative work, and few (n=3, 43%) reported on acceptability. Only 1 (14%) study reported that materials were available in Spanish and English, and only 1 (14%) study used culturally tailored content. Additionally, 3 (43%) studies used strategies that considered social determinants of health. CONCLUSIONS To increase our understanding of the feasibility and effectiveness of technology-based obesity prevention strategies among Hispanic adolescents, there is a need for more feasibility studies that are theoretically grounded and comprehensively report on feasibility-related outcomes. Future studies should also leverage technology to simultaneously address multiple health behaviors beyond diet and physical activity. The result of this review can be used to guide the development of future technology-based obesity prevention strategies among Hispanic adolescents. TRIAL REGISTRATION CliniclaTrials.gov NCT04953442; https://clinicaltrials.gov/ct2/show/NCT04953442.
Collapse
Affiliation(s)
- Erica G Soltero
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Callie Lopez
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Edith Hernandez
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Teresia M O'Connor
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| | - Debbe Thompson
- United States Department of Agriculture/Agricultural Research Services Children's Nutrition Research Center, Department of Pediatrics, Baylor College of Medicine, Houston, TX, United States
| |
Collapse
|
4
|
MacMillan Uribe AL, Rudt HG, Leak TM. Cultural influences on infant and toddler feeding among low-income Latinx mothers. MATERNAL & CHILD NUTRITION 2022; 18:e13342. [PMID: 35702987 PMCID: PMC9480920 DOI: 10.1111/mcn.13342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
Abstract
Latinx infants and toddlers experience higher obesity rates than their black or white counterparts, increasing chronic disease risk later in life. Infant and toddler feeding (ITF) interventions are shown to improve dietary behaviours, but few studies target Latinx populations. Culturally tailoring such interventions is imperative, but cultural influences on Latinx ITF practices remain unclear. The purpose of this study was to characterize how culture influences ITF practices among Latinx mothers of low income. A brief survey and semistructured interview informed by the theory of planned behaviour (TPB) were conducted on Zoom with New York City-based Latinx mothers of children 4 to 24 months old. A directed content analysis approach was used to identify themes using TPB theoretical codes and inductive codes. Transcripts were coded independently by two researchers using NVivo 12. Survey data were analyzed using descriptive statistics in Excel. Participants (n = 19) were of Dominican, Mexican and Central and South American origin, had low acculturation scores and mean child age was 16.7 months (range: 5-24 months old). The central theme identified was that participants balanced cultural information with evidence-based health information to determine which ITF practices were most beneficial to infant/toddler health. This resulted in the adoption of evidence-based ITF recommendations, adoption of cultural practices that aligned with evidence-based recommendations and dismissal or postponement of cultural ITF practices that contradicted evidence-based recommendations. The present results can be applied to culturally relevant ITF education as follows: emphasizing the benefits of desirable ITF practices on children's health and promoting healthy cultural ITF practices.
Collapse
Affiliation(s)
- Alexandra L. MacMillan Uribe
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
- Institute for Advancing Health Through AgricultureTexas A&M AgriLife ResearchDallasTexasUnited States
| | - Hannah G. Rudt
- Division of Nutritional SciencesCornell UniversityIthacaNew YorkUSA
| | | |
Collapse
|
5
|
Lutenbacher M, Elkins T, Dietrich MS. Using Community Health Workers to Improve Health Outcomes in a Sample of Hispanic Women and Their Infants: Findings from a Randomized Controlled Trial. HISPANIC HEALTH CARE INTERNATIONAL 2022:15404153221107680. [PMID: 35702003 DOI: 10.1177/15404153221107680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Introduction: The Maternal Infant Health Outreach Worker (MIHOW) program, an early childhood home visiting program, uses community health workers (CHWs) to improve health outcomes in underserved communities. Methods: This randomized clinical trial evaluated the impact of MIHOW's use of CHWs on selected maternal/infant outcomes up to 15 months postpartum. We hypothesized outcomes would be better among Hispanic women receiving MIHOW compared to a similar group of women eligible for MIHOW who received only a minimal education intervention (MEI). The study also expanded earlier research testing MIHOW's efficacy among Hispanic families using criteria set forth by federal guidelines. Women living in middle Tennessee enrolled during pregnancy (≤26 weeks gestation) and continued through 15 months postpartum. Results: Enrolled women (N = 132) were randomly assigned, with 110 women completing the study (MEI = 53; MIHOW = 57). Positive and statistically significant (p < .01) effects of MIHOW were observed on breastfeeding duration, safe sleep practices, stress levels, depressive symptoms, emotional support, referral follow through, parental confidence, and infant stimulation in the home. Conclusions: Findings provided strong evidence of the effectiveness of MIHOW for improving health outcomes in this sample. Using trained CHWs makes programs such as MIHOW a viable option for providing services to immigrant and underserved families.
Collapse
Affiliation(s)
| | - Tonya Elkins
- 16194Vanderbilt University School of Nursing, Nashville, TN, USA
| | - Mary S Dietrich
- 16194Vanderbilt University School of Nursing, Nashville, TN, USA.,5718Vanderbilt University School of Medicine (Biostatistics, Hearing and Speech), Nashville, TN, USA
| |
Collapse
|
6
|
Soltero EG, O'Connor TM, Thompson D, Shaibi GQ. Opportunities to Address Obesity Disparities Among High-Risk Latino Children and Adolescents. Curr Obes Rep 2021; 10:332-341. [PMID: 34263434 PMCID: PMC9116051 DOI: 10.1007/s13679-021-00445-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/03/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW This review highlights obesity-related disparities among Latino children and adolescents, discusses the social determinants of health (SDoH) that drive disparities, and presents case studies of strategies for reducing disparities and promoting health equity. RECENT FINDINGS Recommended strategies for reducing obesity-related disparities include the use of culturally grounded programming, multi-sector collaborations, and technology. We present two exemplar studies that demonstrate that integrating cultural values and enhancing the overall cultural fit of prevention programs can increase engagement among high-risk Latino families. We also examine the use of multi-sector collaborations to build community capacity and address key SDoH that impact health behaviors and outcomes. Our last example study demonstrates the utility of technology for engaging youth and extending the reach of prevention strategies in vulnerable communities. To address growing obesity-related disparities, there is an urgent need to develop and test these strategies among high-risk, vulnerable populations like Latino children and adolescents.
Collapse
Affiliation(s)
- Erica G Soltero
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA.
| | - Teresia M O'Connor
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA
| | - Deborah Thompson
- Department of Pediatrics, USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, 1100 Bates Avenue, Houston, TX, 77030, USA
| | - Gabriel Q Shaibi
- Center for Health Promotion and Disease Prevention, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| |
Collapse
|
7
|
Estrada-Gutiérrez G, Zambrano E, Polo-Oteyza E, Cardona-Pérez A, Vadillo-Ortega F. Intervention during the first 1000 days in Mexico. Nutr Rev 2021; 78:80-90. [PMID: 33196088 DOI: 10.1093/nutrit/nuaa082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Health systems and society are facing the growing problem of obesity and its accompanying comorbidities. New approaches to reduce these problems must be oriented to population groups in which long-lasting effects of interventions may occur. Biological processes occurring during the first 1000 days of life, which may be modulated by environmental modifications and result in phenotypes with differential risk for noncommunicable chronic disease, constitute an opportunity for interventions. The nutritional and general health conditions of pregnant women and the fetus, as well as toddlers, can be improved with interventions during the first 1000 days, offering pregnancy care, promoting breastfeeding, instructing on the use of complementary foods, and educating on the adequacy of the family dietary patterns for children. Evidence that interventions during this period result in promotion of children's growth and development, influencing the risk for development of obesity in infancy, is available. In this article, an ongoing program in Mexico City directed to offer continuum of care during the first 1000 days is described.
Collapse
Affiliation(s)
- Guadalupe Estrada-Gutiérrez
- Dirección de Investigación, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, México City, México
| | - Elena Zambrano
- Departamento de Biología de la Reproducción, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, México City, México
| | | | - Arturo Cardona-Pérez
- Dirección General, Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, México City, México
| | - Felipe Vadillo-Ortega
- Dirección de Investigación y Unidad de Vinculación de la Facultad de Medicina, UNAM, Instituto Nacional de Medicina Genómica, México City, México
| |
Collapse
|
8
|
McEligot AJ, Mitra S, Beam W. The association between fitness and obesity in diverse multi-ethnic college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2021; 69:290-297. [PMID: 31995450 PMCID: PMC8631309 DOI: 10.1080/07448481.2019.1665054] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/21/2019] [Accepted: 09/01/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE We examined differences and associations between physical fitness and behavioral factors with obesity in a multi-ethnic student population. Participants: Study population included non-Hispanic whites (NHW, n = 1,454); Hispanics (n = 1,436) and Asians (n = 1,016) at a metropolitan university from Fall 2006 to Fall 2013. Methods: Analyses of Variance and regression analyses, utilizing cross-sectional data, measured the association between fitness, and behavior with obesity. Results: BMI differences (p < .05) were observed between NHW (23.17 ± 3.67), Hispanics (24.32 ± 3.67), and Asians (22.92 ± 4.12). Fitness parameters, relative VO2 max, % body fat, and total fitness score were significantly (p < .0001) associated with obesity. Stress was strongly significantly associated with obesity in Hispanics (p < .001) and somewhat in NHW. Conclusions: Obesity disparities persist in college. Physical fitness and stress management interventions should be targeted towards Hispanic and NHW college students, which may curb current and/or adult-onset obesity.
Collapse
Affiliation(s)
- Archana Jaiswal McEligot
- Department of Health Science/Public Health, California State University, Fullerton, California, USA
| | - Sinjini Mitra
- Department of Information Systems and Decision Sciences, California State University Fullerton, California, USA
| | - William Beam
- Department of Kinesiology, California State University Fullerton, California, USA
| |
Collapse
|