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Ketchum K, Jevitt CM. Evidence-Based Eating Patterns and Behavior Changes to Limit Excessive Gestational Weight Gain: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 21:15. [PMID: 38276803 PMCID: PMC10815062 DOI: 10.3390/ijerph21010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 11/02/2023] [Accepted: 12/15/2023] [Indexed: 01/27/2024]
Abstract
BACKGROUND International prenatal care guidelines set a standard for clinicians to discuss gestational weight gain with their patients along with the complications associated with prepregnancy obesity and excessive gestational weight gain. Clinicians often lack evidence-based eating, nutrition, and activity strategies to share with patients. METHODS This systematic review aimed to find eating patterns and behaviors that could be used safely during pregnancy to limit excessive gestational weight gain. PubMed, MEDLINE, and Web of Science were searched for research or systematic reviews performed in the United States or Canada and published in English from 2013 to 2023. Keyword search terms included weight, manage, behavior, strategy, strategies, gestational weight gain, and nutrition. Excluded research used pediatric or adolescent populations, restrictive diets, such as no carbohydrate or no fat diets, fasting, bariatric surgery, weight loss medications, private industry or profit-earning programs using food brands, or specific diet programs. RESULTS A total of 844 abstracts were retrieved, with 103 full-text studies reviewed. Behaviors had to be useful for maintaining a healthy gestational weight gain and had to be safe for use during pregnancy. Behaviors useful during pregnancy included meal planning, home meal preparation, portion control, using diets such as the Mediterranean diet, the low-glycemic index diet, and the Dietary Approaches to Stop Hypertension diet (DASH), regular physical activity, sleeping 6-7 h a night, mindful eating, intuitive eating, and regular seif-weighing. CONCLUSION The evidence-based strategies outlined in this review are safe for use during pregnancy and can assist patients in avoiding excessive gestational weight gain while maintaining the nutrition needed for healthy fetal growth.
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Affiliation(s)
| | - Cecilia M. Jevitt
- Midwifery Program, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada;
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Choi SK, Bauermeister J, Tingler RC, Johnson S, Macagna N, Ho K, Hoesley C, Liu A, Kayange N, Palanee-Phillips T, Chariyalertsak S, Gonzales P, Piper JM. A latent trajectory analysis of young sexual and gender minorities' adherence to three rectal microbicide placebo formulations (MTN-035; a randomized crossover trial). BMC Public Health 2023; 23:2464. [PMID: 38066471 PMCID: PMC10709877 DOI: 10.1186/s12889-023-17368-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Rectal microbicides (RM) are biomedical HIV prevention products that aim to prevent or reduce the transmission of HIV and other sexually transmitted infections (STIs). RM modalities may be beneficial for populations who have complex lifestyles, difficulties adhering to pre-exposure prophylaxis (PrEP) regimens, and/or have limited access to care. MTN-035 (DESIRE; Developing and Evaluating Short-Acting Innovations for Rectal Use), a randomized crossover trial, aimed to evaluate the safety and acceptability of, and adherence to, three placebo RM modalities (douche, insert, and suppository) prior to receptive anal intercourse. METHODS We conducted latent trajectory analysis to identify clusters of individuals who shared similar trajectories in acceptability and adherence for each product (douche, insert, and suppository) over time. We analyzed weekly short messaging service (SMS) use reports for each modality as reported by enrolled sexual and gender minority (SGM) participants. RESULTS Two trajectories for each product were identified: a "protocol compliant" trajectory (i.e., at least one product use occasion per week) and "high use" trajectory (i.e., more than three product use occasions per week). Participants with high use were more likely to lack access to PrEP and have higher intentions to utilize RM modalities compared to those who were protocol compliant. CONCLUSIONS This study highlighted high adherence to RM modalities among SGM. As research into viable HIV prevention modalities continues to evolve, tailored intervention strategies are needed to support the uptake of and adherence to alternative prevention modalities that are behaviorally congruent with targeted users. TRIAL REGISTRATION NCT03671239 (14/09/2018).
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Affiliation(s)
- Seul Ki Choi
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA.
| | - José Bauermeister
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
| | - Ryan C Tingler
- Department of Family and Community Health, School of Nursing, University of Pennsylvania, 418 Curie Blvd, Room 235L, Philadelphia, PA, 19104, USA
| | | | | | - Ken Ho
- Magee-Women's Research Institute, Pittsburgh, PA, USA
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Craig Hoesley
- University of Alabama at Birmingham, Birmingham, AL, USA
| | - Albert Liu
- San Francisco Department of Public Health, San Francisco, CA, USA
| | - Noel Kayange
- Johns Hopkins University Research Project, Blantyre, Malawi
| | - Thesla Palanee-Phillips
- Faculty of Health Sciences, School of Public Health, Wits Reproductive Health and HIV Institute, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Suwat Chariyalertsak
- Faculty of Public Health, Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand
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Zafir S, Jovanovski N. The weight of words: Discursive constructions of health in weight-neutral peer-reviewed journal articles. Body Image 2022; 40:358-369. [PMID: 35149443 DOI: 10.1016/j.bodyim.2022.01.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/21/2022] [Accepted: 01/22/2022] [Indexed: 11/30/2022]
Abstract
Weight-neutral approaches to health, like the Health at Every Size® (HAES®) approach arose in response to emerging evidence showing the negative health consequences of weight-focused approaches through the effects of stigma and marginalization in many settings, including healthcare. While the discourses of dominant 'weight-normative' approaches are well-researched and described, little is known about how language and discourse is creating certain 'truths' about weight-neutral approaches. The aim of this study was to explore how academic discourses create truths about weight-neutral approaches to health. A discourse analysis of 63 academic journal articles was conducted. We found that the language used in academic literature is creating confusing and contradictory messages about weight and weight-neutral approaches to health (like the HAES® approach) through: (i) the continued use of stigmatising and normative labels like 'overweight' and 'obese', (ii) paradoxical language like 'flexible restraint', and (iii) a focus on individual responsibility and blame for health and weight without acknowledgement of broader societal and systemic factors. More research is needed to characterize weight-neutral approaches and develop a clearer framework for researchers wishing to engage with the weight-neutral paradigm of health.
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Affiliation(s)
- Shoa Zafir
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
| | - Natalie Jovanovski
- Melbourne School of Population and Global Health, The University of Melbourne, Victoria, Australia.
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Braun TD, Unick JL, Abrantes AM, Dalrymple K, Conboy LA, Schifano E, Park CL, Lazar S. Intuitive eating buffers the link between internalized weight stigma and body mass index in stressed adults. Appetite 2022; 169:105810. [PMID: 34813916 PMCID: PMC9434977 DOI: 10.1016/j.appet.2021.105810] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 11/05/2021] [Accepted: 11/14/2021] [Indexed: 02/03/2023]
Abstract
Internalized weight stigma (IWS) is independently associated with less intuitive eating (i.e., eating based on endogenous hunger/satiety cues) and higher Body Mass Index (BMI), and intuitive eating training is commonly conceptualized as protective against the effects of IWS on poor behavioral health. The 3-way relationship between IWS, intuitive eating, and BMI has yet to be examined, and it is unclear whether the link between IWS and BMI is buffered by high intuitive eating. This secondary preliminary analysis examined baseline data of stressed adults with poor diet (N = 75, 70% female, 64.1% White, 42.7% with overweight/obesity) in a parent clinical trial that tested the effects of yoga on diet and stress. Validated self-report surveys of IWS and intuitive eating were analyzed with objectively-assessed BMI. Moderated regression analyses using the SPSS PROCESS macro tested whether intuitive eating moderated the IWS-BMI link. The analysis revealed IWS was positively associated with BMI except among people with high intuitive eating. Results extend observational findings linking intuitive eating to lower BMI, and offer preliminary support for the hypothesis that this link may hold even among those with greater IWS. It's possible that individuals with lower BMI and greater IWS may gravitate more towards intuitive eating than those with greater BMI, and/or intuitive eating may be an important target for ameliorating the adverse association of IWS with behavioral and physical health indicators linked to BMI. Continued work is warranted in larger, more generalizable samples using causal and prospective designs.
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Affiliation(s)
- Tosca D. Braun
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Storrs, CT 06269-1020,Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University,Centers for Behavioral and Preventive Medicine, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903
| | - Jessica L. Unick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University,Weight Control and Diabetes Research Center, The Miriam Hospital, 196 Richmond St., Providence, RI, 02903
| | - Ana M. Abrantes
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University,Behavioral Medicine and Addictions Research, Butler Hospital
| | - Kristy Dalrymple
- Department of Psychiatry and Human Behavior, Alpert Medical School of Medicine at Brown University,Lifespan Physician’s Group, 146 West River Street, Suite 11B, Providence, RI 02904
| | - Lisa A. Conboy
- Department of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston MA 02215,New England School of Acupuncture, Massachusetts College of Pharmacy and Health Sciences
| | - Elizabeth Schifano
- Department of Statistics, University of Connecticut, 215 Glenbrook Road U4120, Storrs, CT 06269
| | - Crystal L. Park
- Department of Psychological Sciences, University of Connecticut, 406 Babbidge Road, Storrs, CT 06269-1020
| | - Sara Lazar
- Department of Psychiatry, Massachusetts General Hospital, 55 Fruit St., Boston, MA,Department of Psychology, Harvard Medical School
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Beattie MM, Konttinen HM, Volanen SM, Hankonen NE. Latent profile analysis as a method for process evaluations: Discovering response subgroups in a mindfulness intervention. Soc Sci Med 2022; 296:114748. [DOI: 10.1016/j.socscimed.2022.114748] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 12/16/2021] [Accepted: 01/24/2022] [Indexed: 11/16/2022]
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Abstract
Internally regulated eating style, the eating style that is driven by internal bodily sensations of hunger and satiation, is a concept that has received increasing attention in the literature and health practice over the last decades. The various attempts that have been made so far to conceptualise internally regulated eating have taken place independently of one another, and each sheds light on only parts of the total picture of what defines internally regulated eating. This has resulted in a literature that is rather fragmented. More importantly, it is not yet clear which are the characteristics that comprise this eating style. In this paper, we identify and describe the full spectrum of these characteristics, namely, sensitivity to internal hunger and satiation signals, self-efficacy in using internal hunger and satiation signals, self-trusting attitude for the regulation of eating, relaxed relationship with food and tendency to savour the food while eating. With this research, we introduce a common language to the field and we present a new theoretical framework that does justice not just to the full breadth of characteristics that are necessary for the internally regulated eating style but also to the associations between them and the potential mechanisms by which they contribute to this eating style.
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