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Serban DM, Ursoniu S, Moleriu RD, Banu AM, Serban CL. Mindful Eating, Nutrition Knowledge, and Weight Status among Medical Students: Implications for Health and Counseling Practices. Nutrients 2024; 16:1894. [PMID: 38931249 PMCID: PMC11206797 DOI: 10.3390/nu16121894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 06/28/2024] Open
Abstract
Academic stress and transitioning to young adulthood can lead medical students to develop inadequate eating habits, affecting both their physical and mental well-being and potentially compromising their ability to offer effective preventive counseling to future patients. The primary objective of this study is to analyze the levels of mindful eating and nutrition knowledge in Romanian medical students and their associations with various sociodemographic variables. Additionally, we explore the relationship between mindful eating and nutrition knowledge while accounting for sociodemographic factors and examine the impact of these factors on excess weight. Significant predictors of excess weight include high weight gain in the past year (OR = 15.8), the mindful eating questionnaire (MEQ) score (OR = 0.131), male gender (OR = 2.5), and being in the clinical years of medical school (OR = 2.2). While nutrition knowledge levels do not directly impact weight status, they share a 4% common variance with mindfulness in multivariate analysis. Notably, high weight gain is independent of the levels of mindful eating, but univariate testing links it to disinhibition and emotional response, components of mindfulness. Mindful eating stands out as independently associated with both nutrition knowledge and excess weight among medical students. Thus, interventions to address obesity should consider incorporating mindfulness training to enhance food intake awareness and improve weight management outcomes in Romanian medical students.
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Affiliation(s)
- Denis Mihai Serban
- Department of Obstetrics-Gynecology, Discipline of Obstetrics-Gynecology II, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Sorin Ursoniu
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (S.U.); (C.L.S.)
| | - Radu Dumitru Moleriu
- Department of Functional Sciences, Discipline of Medical Informatics and Biostatistics, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania
| | - Ancuta Mioara Banu
- Department 2, Discipline of Maxillo-Facial Surgery, Faculty of Dental Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania;
| | - Costela Lacrimioara Serban
- Department of Functional Sciences, Discipline of Public Health, Center for Translational Research and Systems Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu Square, 300041 Timisoara, Romania; (S.U.); (C.L.S.)
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Benson J, DeVries M, McLaurin-Jiang S, Garner CD. Experiences accessing nutritious foods and perceptions of nutritional support needs among pregnant and post-partum mothers with low income in the United States. MATERNAL & CHILD NUTRITION 2024:e13660. [PMID: 38812121 DOI: 10.1111/mcn.13660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 04/05/2024] [Accepted: 04/25/2024] [Indexed: 05/31/2024]
Abstract
Access to nutritious foods, a social determinant of health, contributes to disparities in maternal and infant health outcomes such as mental health, breastfeeding intensity and cardiometabolic risk. This study explored perceived nutrition access and intake among pregnant or post-partum women eligible for Medicaid. Qualitative, semistructured interviews were conducted with 18 women who were either currently pregnant (n = 4) or up to 12 months post-partum (n = 14) in 2021-2022. Mothers spoke English (n = 11) or Spanish (n = 7) and lived in the Texas Panhandle. Interviews were audio-recorded, transcribed, translated (Spanish to English) and verified. Two or more researchers coded each interview until consensus was reached using thematic analysis with ATLAS.ti software. The study revealed five drivers for nutrition access. (1) Social factors influenced nutrition; those with less support expressed limited ability to eat healthfully. (2) The Women, Infants and Children program was perceived as a helpful resource for some, while others faced challenges obtaining it. (3) Stress was bidirectionally related to unhealthy food choices, with food sometimes used as a coping mechanism. (4) Mothers prioritized their babies and others and had limited ability and time to prepare healthy meals. (5) Most participants felt they received inadequate nutrition guidance from their healthcare providers. Participants provided positive responses to a proposed nutritious home-delivered meal intervention. Low-income women may experience nutritional challenges specific to this life stage. Interventions that reduce stress and burden of household tasks (e.g. cooking) and improve education and access to nutritious foods may improve mothers' ability to consume nutritious foods.
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Affiliation(s)
- Jessie Benson
- School of Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
| | - Matthew DeVries
- School of Medicine, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
- Phoenix Children's Pediatric Residency Program Alliance, Phoenix, Arizona, USA
| | - Skye McLaurin-Jiang
- Department of Pediatrics, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
| | - Christine D Garner
- InfantRisk Center, Texas Tech University Health Sciences Center, Amarillo, Texas, USA
- Department of Obstetrics and Gynecology, Texas Tech University Health Sciences Center, Amarillo, Texas, United States
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Bazzazian S, Ozgoli G, Riazi H, Mahmoodi Z, Vafa M, Nasiri M. The relationship between social determinants of health and postpartum weight retention based on the World Health Organization model: path analysis. BMC Public Health 2023; 23:323. [PMID: 36788506 PMCID: PMC9926434 DOI: 10.1186/s12889-023-15207-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 02/03/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Postpartum weight retention (PPWR) causes obesity, chronic diseases, and occurring adverse maternal-fetal and neonatal outcomes. Given the social factors' effect on health and disease and considering the lack of information on social determinants of health (SDH) effects on PPWR, this study was conducted to survey the relationship between SDH and PPWR based on the World Health Organization (WHO) model. METHODS A cross-sectional study was performed on 400 women six months after delivery in 2020. Twelve health centers were randomly selected from the three universities of Medical Sciences in the city of Tehran, Iran. Participants were selected by convenience method and based on eligibility. Questionnaires used included: Lifestyle Profile Health Promoting II, Short Form Postpartum Quality of Life Questionnaire, Multidimensional Scale of Perceived Social Support, Postpartum Social Support, Depression Anxiety Stress Scales, and questionnaires designed by reviewing the literature about breastfeeding, sleep, contraceptive, child health, unhealthy behaviors, postpartum nutritional awareness/beliefs, body satisfaction, access to postpartum care, socioeconomic status, demographic, and obstetric questionnaire. Data analysis was performed in SPSS-23, and the relationship model was examined using the path analysis method in LISREL-8.8. RESULTS Path analysis indicated the direct effect of six intermediate factors on PPWR including: gestational weight gain (β = 0.42), access to postpartum care (β = 0.11), postpartum nutritional awareness/beliefs (β=-0.17), anxiety (β = 0.09), sleep duration (β=-0.09), pre-pregnancy body mass index (β = 0.09). Among the structural factors, woman's education and socioeconomic status had an indirect negative effect on PPWR. The model fit indices showed good fit (RMSE = 0/05, GFI = 0.92, CFI = 0.92, χ2/df = 2.17). CONCLUSION The results indicate the effect of structural and intermediate determinants of health on PPWR. It is recommended to use the proposed model as an appropriate framework in the research, design, and implementation of programs to prevent and control PPWR.
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Affiliation(s)
- Shahin Bazzazian
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Giti Ozgoli
- Midwifery and Reproductive Health Research Center, Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Vali Asr Ave., Niayesh Cross Road, Niayesh Complex, 1985717443 Tehran, Iran
| | - Hedyeh Riazi
- Department of Midwifery and Reproductive Health, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Zohreh Mahmoodi
- Social Determinants of Health Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Mohammadreza Vafa
- Nutrition Department, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Malihe Nasiri
- Department of Basic Sciences, School of Nursing and Midwifery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Mokhtari P, Jordan KC, Wilson A, Sisco-Tylor B, Metos JM. Development and Validation of a Diabetes Questionnaire for Middle School Students. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2023; 55:135-144. [PMID: 36764795 DOI: 10.1016/j.jneb.2022.11.004] [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: 10/26/2021] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To develop and validate a questionnaire to assess diabetes knowledge, attitudes, beliefs, and intent to change among middle school students. DESIGN A cross-sectional validation analysis. SETTING Students in 3 urban middle schools in Utah participated in this study. PARTICIPANTS The 25-item questionnaire was validated in independent samples of 277 and 304 students in the seventh and eighth grades. VARIABLES MEASURED The questionnaire includes the following variables: diabetes knowledge, attitudes, beliefs, and intent to change dietary and physical activity behaviors. ANALYSIS Rigorous statistical approaches, including Cronbach's α (goodness of fit) calculation, test-retest reliability, and exploratory and confirmatory factor analyses, were employed to examine the reliability and construct validity. RESULTS The Cronbach's α coefficients were 0.7 for both subscales demonstrating acceptable internal consistency. All factor loadings were > 0.4, revealing close relations between factors and items. The confirmatory factor analysis model fit was 0.9 for the comparative fit index and Tucker-Lewis Index, indicating a reasonable model-data fit. CONCLUSIONS AND IMPLICATIONS This study demonstrated the validity of a diabetes questionnaire for middle school students. Future work is needed to validate its use in a diabetes prevention program, given the growing need for diabetes education among young adolescents.
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Affiliation(s)
- Pari Mokhtari
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah.
| | - Kristine C Jordan
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah
| | - Andrew Wilson
- College of Nursing, University of Utah, Salt Lake City, Utah
| | - Brittany Sisco-Tylor
- Department of Population Health Sciences, School of Medicine, University of Utah, Salt Lake City, Utah
| | - Julie M Metos
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, Utah
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Kent-Marvick J, Cloyes KG, Meek P, Simonsen S. Racial and ethnic disparities in postpartum weight retention: A narrative review mapping the literature to the National Institute on Minority Health and Health Disparities Research Framework. WOMEN'S HEALTH (LONDON, ENGLAND) 2023; 19:17455057231166822. [PMID: 37082834 PMCID: PMC10126608 DOI: 10.1177/17455057231166822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 03/09/2023] [Accepted: 03/14/2023] [Indexed: 04/22/2023]
Abstract
PLAIN LANGUAGE SUMMARY A Review of the Literature Using the National Institutes of Health, National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to Create a Roadmap of the Studies Investigating Racial and Ethnic Disparities in Excess Weight Retained After Pregnancy. WHY WAS THIS STUDY DONE? Three out of four people who give birth retain excess weight at 1-year post-pregnancy. This is concerning, as weight that is retained following pregnancy is associated with increased risk for the development of disease. People from racial and ethnic minority groups experience weight retention more frequently post-pregnancy. Black and Hispanic/Latina/o/x birthing people are more likely to begin pregnancy overweight or obese. They are also more likely to retain excess weight following pregnancy. Investigating these risks in people from racially/ethnically diverse backgrounds may be an important way to address disparities in excess weight retained post-pregnancy. WHAT DID THE RESEARCHERS DO? This review of the literature used a tool called the National Institute on Minority Health and Health Disparities (NIMHD) Research Framework to map the literature to date on racial and ethnic disparities in excess weight retained post-pregnancy. WHAT DID THE RESEARCHERS FIND? We used the NIMHD Research Framework as a visual guide of the existing research about excess weight retained following pregnancy. Results illustrate the levels and domains at which research has been investigated. These results reveal that efforts have been focused at the individual level, with most attention given to diet and activity. Mapping the literature to the NIMHD Research Framework sheds light on gaps in the research. WHAT DO THE FINDINGS MEAN? Mapping the literature has revealed a need for investigations that make connections between the levels and domains of the Framework, so that we may understand underlying factors that contribute to health disparities.
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Affiliation(s)
| | - Kristin G Cloyes
- College of Nursing, University of Utah, Salt Lake City, UT, USA
- School of Nursing, Oregon Health & Science University, Portland, OR, USA
| | - Paula Meek
- College of Nursing, University of Utah, Salt Lake City, UT, USA
| | - Sara Simonsen
- College of Nursing, University of Utah, Salt Lake City, UT, USA
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Patel SM, Sisson SB, Stephens HA, Williams BD, Hoffman LA, Salvatore AL. Family Child Care Providers' Nutrition Practices and Policies: Happy Healthy Homes. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2021; 53:1066-1071. [PMID: 34635431 PMCID: PMC8671233 DOI: 10.1016/j.jneb.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 08/13/2021] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Determine the impact of family child care home providers' nutrition knowledge, confidence, and perceived barriers on program nutrition best practices and written nutrition policies. METHODS Cross-sectional analysis of self-reported surveys of 49 female providers in Oklahoma City analyzed with Spearman correlation, multivariate linear and logistic regression (α < 0.05). RESULTS Confidence and barriers were significantly correlated (rs(47) = -0.4, P = 0.004). Independent variables explained 36% of practices (r2 = 0.357). Nutrition knowledge (standard β = 0.442, P = 0.001) and confidence (standard β = 0.358, P = 0.008) were significantly associated with practices; barriers were not. No significant association between independent variables and written policies resulted. CONCLUSIONS AND IMPLICATIONS Provider nutrition knowledge and confidence appear to be suitable targets to improve nutrition practices. Further research can evaluate possible influences on the presence and quality of family child care home written nutrition policies and specific nutrition policy topics associated with healthier nutrition practices.
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Affiliation(s)
- Sarah M Patel
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Susan B Sisson
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK.
| | - Holly A Stephens
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Bethany D Williams
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK; Department of Nutrition and Exercise Physiology, Washington State University Health Sciences Spokane, Spokane, WA
| | - Leah A Hoffman
- Department of Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - Alicia L Salvatore
- Department of Health Promotion Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK; Institute for Research on Equity and Community Health (iREACH), Christiana Care Health System, Wilmington, DE
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Mazloomy Mahmoodabad SS, Molavi S, Nadjarzadeh A, Mardanian F, Riahi R, Ardian N, Salehi K, Goodarzi-Khoigani M. Prevention of Postpartum Weight Retention during One Year after Childbirth by Prenatal Nutrition Education: A Randomized Controlled Trial. Int J Prev Med 2021; 12:117. [PMID: 34760128 PMCID: PMC8551776 DOI: 10.4103/ijpvm.ijpvm_37_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 10/27/2020] [Indexed: 11/09/2022] Open
Abstract
Background: It seems that 14–25% of the women retain at least 5 kg weight from 6 to 12 months after delivery and gestational weight gain is the most important reason of weight retention. Thus, we assessed the effect of prenatal nutrition education program on the retained weights at 8, 26, and 52 weeks after delivery in primiparous women. Methods: This randomized controlled trial was implemented among 192 primiparous pregnant women in five hospitals, fifteen community health centers, and fifteen private offices. Self-developed questionnaire was used to collect the participants’ characteristics. A 72-hr dietary recall was applied to evaluate the food intakes before and after intervention. The pregnancy physical activity questionnaire determined the physical activity score. The participants’ weights at 8, 26, and 52 weeks after delivery were measured by a digital beam. Results: The means of postpartum weight decreased in both groups, but nutrition education was significantly effective on reducing postpartum weight in intervention group (β = -3.112, SE =. 7384, P < 0.001). Also, the women in intervention group had less retained weight compared to control during the follow-up (β = -3.35, SE = 0.75, p < 0.001). The proportion of pregnant women in intervention group who reached to their pre-gravid weight was more than control during the follow-up (OR = 2.86, 95% CI: 1.62, 5.07). Conclusions: Nutrition education considering an individualized calorie-appropriate diet for each pregnant woman and based on the national guideline is effective on postpartum weight retention and reaching to pre-gravid weight.
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Affiliation(s)
- Seyed Saeed Mazloomy Mahmoodabad
- Department of Health Education and Promotion, Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Sajedeh Molavi
- Msc in Counselling Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Azadeh Nadjarzadeh
- Nutrition and Food Security Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.,Department of Nutrition, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Farahnaz Mardanian
- Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Riahi
- Ph.D, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nahid Ardian
- Social Determinants of Health Research Center, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Kobra Salehi
- Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Science, Isfahan, Iran
| | - Masoomeh Goodarzi-Khoigani
- Ph.D, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
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Das N, Ghosh A. Psychometric Validation of a Nutrition Knowledge Questionnaire among Parents of 3-6-Year-Old Asian Indian Children in East Barddhaman District, West Bengal, India. Indian J Community Med 2020; 45:130-134. [PMID: 32905104 PMCID: PMC7467198 DOI: 10.4103/ijcm.ijcm_347_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 02/25/2020] [Indexed: 11/13/2022] Open
Abstract
Background: In India, virtually, no study was aimed to develop a psychometrically valid and reliable questionnaire to assess the nutrition knowledge and practice among parents of children aged between 3 and 6 years. Objective: The present study describes an evaluation of validity and reliability measures in a questionnaire designed for the assessment of nutrition knowledge among parents of children participating in a study finding relationship between physical growth and development and nonverbal intelligence quotient development being undertaken in a semi-urban area. Design: This was a cross-sectional school-based reliability and validity study. Setting: This study was conducted in seven primary schools within the limits of Purba (East) Barddhaman district legislation, West Bengal, India. Participants: One hundred and thirty-four parents of children aged 3–6 years were included in the study. Results: The final questionnaire consisted of 32 questions that were selected on the basis of content validity. Questions included closed-ended and multiple-choice items which could be answered correctly by 5%–95% of the target population with a difficulty index of 0.33–0.87, discrimination index of 0.12–0.44, and validity index of 0.10–0.86. Internal reliability of each item as measured by Cronbach's α of 0.87 was also significant. Conclusions: The test comprises basic psychometric criteria of a valid and reliable 32-item knowledge questionnaire which further forms an instrument for measuring current scenario and interpreting changes associated with intervention work aiming improvement of dietary and nutrition knowledge-practice in the middle-to-low socioeconomic community.
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Affiliation(s)
- Nilita Das
- Department of Anthropology, Biomedical Research Laboratory, Visva-Bharati (A Central University and an Institution of National Importance), Santiniketan, West Bengal, India
| | - Arnab Ghosh
- Department of Anthropology, Biomedical Research Laboratory, Visva-Bharati (A Central University and an Institution of National Importance), Santiniketan, West Bengal, India
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Lee A, Belski R, Radcliffe J, Newton M. What do Pregnant Women Know About the Healthy Eating Guidelines for Pregnancy? A Web-Based Questionnaire. Matern Child Health J 2017; 20:2179-88. [PMID: 27395383 DOI: 10.1007/s10995-016-2071-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Objectives This study explored nutrition knowledge of pregnant women, and how it correlated with participant characteristics, their main sources of information and changes to their diet since becoming pregnant. Methods Pregnant women residing in Australia accessing pregnancy forums on the internet were invited to complete a web-based questionnaire on general nutrition and pregnancy-specific nutrition guidelines. Results Of the 165 eligible questionnaire responses, 114 were complete and included in the analysis. Pregnancy nutrition knowledge was associated with education (r s = 0.21, p < 0.05) and income (r s = 0.21, p < 0.05). Only 2 % of pregnant women achieved nutrition knowledge scores over 80 %. Few women received nutrition advice during their pregnancy, of which most were advised by their doctor. Dietary changes adopted since becoming pregnant included consuming more fruit, vegetables, dairy and high fibre foods. Conclusions for Practice Pregnant women in this study had limited knowledge of the dietary guidelines for healthy eating during pregnancy. Furthermore, nutrition counselling in maternity care appears to be infrequent. One approach to optimising maternal diets and subsequently preventing adverse health outcomes is to enhance their knowledge of the pregnancy nutrition guidelines through the provision of nutritional counselling. Furthermore, research exploring the access and use of nutrition resources, and nutrition advice provided to pregnant women is recommended to understand how knowledge impacts on dietary behaviour.
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Affiliation(s)
- Amelia Lee
- School of Allied Health, La Trobe University, Bundoora, VIC, 3086, Australia.
- Nutrition Department, Royal Women's Hospital, Parkville, VIC, 3052, Australia.
| | - Regina Belski
- School of Allied Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Jessica Radcliffe
- School of Allied Health, La Trobe University, Bundoora, VIC, 3086, Australia
| | - Michelle Newton
- School of Nursing and Midwifery, La Trobe University, Bundoora, VIC, 3086, Australia
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Barbosa LB, Vasconcelos SML, Correia LODS, Ferreira RC. Nutrition knowledge assessment studies in adults: a systematic review. CIENCIA & SAUDE COLETIVA 2017; 21:449-62. [PMID: 26910153 DOI: 10.1590/1413-81232015212.20182014] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 05/02/2015] [Indexed: 11/22/2022] Open
Abstract
The objective of this study is to perform a systematic review of published studies that assessed nutrition knowledge in adults, focusing on the methodology and content of these studies. An article search was performed on the Medline, Lilacs, and SciELO databases. The search limits were human studies; English, Portuguese, and Spanish languages; and age (over 19). Inclusion criteria were: cross-sectional studies performed on individuals over 18 years old that assessed the general nutrition knowledge of participants. The methodological quality of the articles was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria. The initial search identified 3,623 articles. After reading the titles and the abstracts and applying the exclusion criteria, 25 articles were selected. The results showed that, in most studies, nutrition knowledge was associated with socioeconomic parameters and eating behaviour. Most studies belonged to class B (92%), meeting 50-80% of the STROBE criteria. The studies have revealed a greater tendency to assess the relationship of nutrition knowledge with sociodemographic and economic parameters.
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Affiliation(s)
- Lídia Bezerra Barbosa
- Laboratório de Nutrição em Cardiologia, Faculdade de Nutrição, Universidade Federal de Alagoa, Maceió, Alagoas, Brasil,
| | - Sandra Mary Lima Vasconcelos
- Laboratório de Nutrição em Cardiologia, Faculdade de Nutrição, Universidade Federal de Alagoa, Maceió, Alagoas, Brasil,
| | | | - Raphaela Costa Ferreira
- Laboratório de Nutrição em Cardiologia, Faculdade de Nutrição, Universidade Federal de Alagoa, Maceió, Alagoas, Brasil,
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Kay MC, Wasser H, Adair LS, Thompson AL, Siega-Riz AM, Suchindran CM, Bentley ME. Consumption of key food groups during the postpartum period in low-income, non-Hispanic black mothers. Appetite 2017; 117:161-167. [PMID: 28651972 DOI: 10.1016/j.appet.2017.06.023] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 05/14/2017] [Accepted: 06/21/2017] [Indexed: 11/18/2022]
Abstract
The postpartum period can impact diet quality and subsequently place women at greater risk for overweight or obesity. This study examined consumption of key food groups during the first 2 years postpartum among low income, non-Hispanic black, first-time mothers. Data were from the Infant Care, Feeding and Risk of Obesity Study, a cohort of 217 mother-infant dyads, followed from 3 to 18 months postpartum, collected from 2003 to 2007. At each study visit (3, 6, 9, 12, and 18 months) 24-h dietary recalls were collected. Consumption levels were compared to those recommended from the 2010 Dietary Guidelines for Americans (DGAs) for each of the following food groups: fruits, vegetables, grains, whole grains, protein foods and dairy, as well as an estimated upper limit for sugar-sweetened beverage (SSB) consumption. At each time point, mothers met recommended intake levels for grains and protein foods only. In random-intercept logistic regression models, no demographic or household characteristics were associated with a likelihood of consuming recommended levels for any of the food groups according to the DGAs. Given the low intake of fruits, vegetables, whole grains and lean protein foods and high intake of SSBs and refined grains, interventions targeting women's diet during the postpartum period are warranted.
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Affiliation(s)
- Melissa C Kay
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States.
| | - Heather Wasser
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States
| | - Linda S Adair
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States
| | - Amanda L Thompson
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States; Department of Anthropology, University of North Carolina at Chapel Hill, 209-A Alumni Bldg, 3115 Chapel Hill, NC 27599, United States.
| | - Anna Maria Siega-Riz
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States; Department of Public Health Sciences, University of Virginia, P.O. Box 800717, Charlottesville, VA 22908, United States.
| | - Chirayath M Suchindran
- Department of Biostatistics, University of North Carolina at Chapel Hill, 3103-A Mcgavran-Greenberg Hl, CB 7420, Chapel Hill, NC 27599, United States.
| | - Margaret E Bentley
- Department of Nutrition, University of North Carolina at Chapel Hill, Carolina Population Center, 137 E. Franklin St, CB 8120, Chapel Hill, NC 27516, United States
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Xu F, Wang X, Xiang D, Wang Z, Ye Q, Ware RS. Awareness of knowledge and practice regarding physical activity: A population-based prospective, observational study among students in Nanjing, China. PLoS One 2017. [PMID: 28622354 PMCID: PMC5473587 DOI: 10.1371/journal.pone.0179518] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Physical activity (PA) promotion has proven effectiveness in preventing childhood obesity. Increasing children’s health knowledge is the most frequently used approach in PA intervention programs targeting childhood obesity prevention. However, little is known about the specific association between the change in a child’s knowledge awareness and their PA practice. Methods A one-year follow-up study was conducted among primary and junior high school students in Nanjing, China. At baseline students’ knowledge of healthy behavior, and their PA levels, were assessed. Students who were unaware of the association between PA and obesity were followed for one academic year. After nine-months their knowledge and PA levels were re-measured using the same validated questionnaire. Mixed effects regression models were used to estimate the relationship between awareness of knowledge about the link between PA and obesity and PA changes. Results Of the 1899 students who were unaware of the association between PA and obesity at baseline, 1859 (follow-up rate = 97.9%) were successfully followed-up. After nine months 1318 (70.9%) participants had become aware of PA-obesity association. Compared to their counterparts who remained unaware, students who became aware of the PA-obesity association were more likely to increase both the frequency (odds ratio (OR) = 1.34, 95%CI = 1.09, 1.64) and duration (OR = 1.34, 95%CI = 1.09, 1.65) of PA, after adjusting for potentially confounding variables. Conclusion Becoming aware of the known link between PA and obesity led to positive behavior modification regarding PA in this cohort of Chinese students. This is of particular importance that knowledge disimination and health education may be a useful approach for population-based physical activity promotion aiming at childhood obesity prevention in China.
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Affiliation(s)
- Fei Xu
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
- Department of Epidemiology, Nanjing Medical University School of Public Health, Nanjing, China
- * E-mail: (FX); (RSW)
| | - Xiaorong Wang
- Nanjing Children’s Hospital Affiliated to Nanjing Medical University, Nanjing, China
| | - Dandan Xiang
- Department of Epidemiology, Nanjing Medical University School of Public Health, Nanjing, China
| | - Zhiyong Wang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Qing Ye
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, China
| | - Robert S. Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
- * E-mail: (FX); (RSW)
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Wilson PB, Madrigal LA, Burnfield JM. Weight control practices of Division I National Collegiate Athletic Association athletes. PHYSICIAN SPORTSMED 2016; 44:170-6. [PMID: 26831597 DOI: 10.1080/00913847.2016.1149420] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Altering body weight can have substantial effects on an athlete's performance and well-being. Limited information is available describing the weight control practices of Division I National Collegiate Athletic Association (NCAA) athletes. METHODS Weight control practices data from 188 (138 male and 50 female; 18-23 y) Division I NCAA athletes were analyzed as a part of this cross-sectional, retrospective study. Participants completed questionnaires on weight control practices and weight control nutrition knowledge at the end of their season and were classified into weight-sensitive and less weight-sensitive sports. RESULTS A higher proportion of females attempted to lose weight than males among less weight-sensitive sports (61% vs. 22%, chi-square = 15.8, p < 0.001). However, the prevalence of weight loss attempts was not different between females and males among weight-sensitive sports (50% vs. 60%, chi-square = 0.5, p = 0.479). The prevalence of weight gain attempts differed by gender for less weight-sensitive sports (65% vs. 4% for males and females, chi-square = 33.5, p < 0.001) but not weight-sensitive sports (24% vs. 9% for males and females, chi-square = 2.1, p = 0.146). Weight control knowledge did not differ between participants attempting versus not attempting to lose weight (Mann-Whitney U = 3340, z = -1.37, p = 0.17). Common maladaptive behaviors used to lose weight included skipping meals and exercising more than usual. CONCLUSION Weight loss attempts are common among Division I NCAA athletes, and the differences between males and females may be more pronounced among less weight-sensitive sports. Weight gain attempts are more common in select male sports.
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Affiliation(s)
- Patrick B Wilson
- a Nebraska Athletic Performance Laboratory , University of Nebraska-Lincoln , Lincoln , NE , USA.,b Department of Human Movement Sciences , Old Dominion University , Norfolk , VA , USA
| | - Leilani A Madrigal
- a Nebraska Athletic Performance Laboratory , University of Nebraska-Lincoln , Lincoln , NE , USA
| | - Judith M Burnfield
- a Nebraska Athletic Performance Laboratory , University of Nebraska-Lincoln , Lincoln , NE , USA.,c Institute for Rehabilitation Science and Engineering , Madonna Rehabilitation Hospital , Lincoln , NE , USA
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Tabbakh T, Freeland-Graves JH. The home environment: A mediator of nutrition knowledge and diet quality in adolescents. Appetite 2016; 105:46-52. [PMID: 27170447 DOI: 10.1016/j.appet.2016.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 03/31/2016] [Accepted: 05/05/2016] [Indexed: 10/21/2022]
Abstract
The objective of this research was to assess adherence to the Healthy Eating Index-2010 of mothers and their adolescents (11-14 years old) and to examine the role of the home environment as a mediator of maternal nutrition knowledge and adolescent diet quality. It is hypothesized that mothers with greater knowledge impact the diet quality of their adolescents by creation of healthier home environments. A sample of 206 mother-adolescent dyads separately completed the Multidimensional Home Environment Scale, a Food Frequency Questionnaire, and a Nutrition Knowledge Scale. Body mass index-for-age percentiles were derived from weight and height measurements obtained by researcher; diet quality was estimated via the Healthy Eating Index (HEI)-2010. Percent of maximum score on nutrition knowledge for both mothers and adolescents were poor, with lowest scores on recommendations of healthy eating and physical activity (48% and 19%, respectively). A model of maternal nutrition knowledge (independent variable) and adolescent diet quality (dependent variable) indicated that greater knowledge was associated with higher scores on total fruit (p = 0.02), whole grains (p = 0.05), seafood and plant proteins (p = 0.01), and overall diet quality (p < 0.01), as well as lower scores on empty calories (p = 0.01). Inclusion of the home environment as a mediator yielded significant estimates of the indirect effect (β = 0.61, 95% CI: 0.3-1.0). Within the home environment, psychological (β = 0.46), social (β = 0.23), and environmental (β = 0.65) variables were all significant mediators of nutrition knowledge on diet quality. These results emphasize the importance of maternal nutrition knowledge and the mediating effect of the home environment on the diet quality of adolescents.
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Affiliation(s)
- Tamara Tabbakh
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78701, USA
| | - Jean H Freeland-Graves
- Department of Nutritional Sciences, The University of Texas at Austin, Austin, TX 78701, USA.
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Kennelly MA, McAuliffe FM. Prediction and prevention of Gestational Diabetes: an update of recent literature. Eur J Obstet Gynecol Reprod Biol 2016; 202:92-8. [PMID: 27235645 DOI: 10.1016/j.ejogrb.2016.03.032] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Revised: 03/19/2016] [Accepted: 03/23/2016] [Indexed: 11/16/2022]
Abstract
A diagnosis of Gestational Diabetes (GDM) confers adverse risk to the health of the mother and fetus both in pregnancy and later life. The background rate in pregnancy varies between 2 and 14% with incidences reported to be as high as 40% in obese populations. GDM diagnoses are escalating because of rising numbers of overweight and obesity in the reproductive age group but also because of different screening and diagnostic criteria. Lifestyle modification in those diagnosed with GDM has been proven to be an effective treatment in attenuating the metabolic dysregulation associated with this and potentially avoiding the need for medical therapy with either metformin or insulin. Emerging evidence in previous years suggests lifestyle interventions (dietary±physical activity and behavior modification) either pre-pregnancy or antenatally may reduce the incidence of GDM. The first trimester is also becoming an important interrogation period for the prediction of many adverse obstetric outcomes including abnormal glucose metabolism. This review outlines the most contemporary evidence on the prediction and non-pharmacological antenatal prevention strategies used for Gestational Diabetes.
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Affiliation(s)
- M A Kennelly
- UCD Obstetrics and Gynecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland
| | - F M McAuliffe
- UCD Obstetrics and Gynecology, School of Medicine and Medical Science, University College Dublin, National Maternity Hospital, Dublin, Ireland.
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Laz TH, Rahman M, Pohlmeier AM, Berenson AB. Level of nutrition knowledge and its association with weight loss behaviors among low-income reproductive-age women. J Community Health 2016; 40:542-8. [PMID: 25394404 DOI: 10.1007/s10900-014-9969-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
To examine influence of nutrition knowledge on weight loss behaviors among low-income reproductive-age women. We conducted a self-administered cross-sectional survey of health behaviors including socio-demographic characteristics, nutrition knowledge, and weight loss behaviors of 16-40 year old women (n = 1,057) attending reproductive health clinics located in Southeast Texas between July 2010 and February 2011. Multiple linear regression and multivariable logistic regression analyses were performed to identify correlates of nutrition knowledge and examine its association with various weight loss behaviors after adjusting for confounders. The mean nutrition knowledge score was low (5.7 ± 2.8) (possible score 0-15). It was significantly lower among African American women than whites (P < .001). Obese women (P = .002), women with high school enrollment/diploma (P = .030), and some college hours/degree (P < .001) had higher nutrition knowledge scores than their counterparts. The higher score of nutrition knowledge was significantly associated with higher odds of engaging in healthy weight loss behaviors: eating less food [odds ratio (OR) 1.12, 95% confidence interval (CI) 1.06-1.18], switching to foods with fewer calories (OR 1.10, 95% CI 1.04-1.16), exercising (OR 1.10, 95% CI 1.04-1.16), eating more fruits/vegetables/salads (OR 1.11, 95% CI 1.06-1.17) and less sugar/candy/sweets (OR 1.09, 95% CI 1.04-1.15). However, it was not associated with unhealthy weight loss behaviors, such as using laxatives/diuretics or inducing vomiting. Nutrition knowledge is low among reproductive-age women. An increase in nutrition knowledge may promote healthy weight loss behaviors.
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Affiliation(s)
- Tabassum H Laz
- Department of Obstetrics and Gynecology, Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, 301 University Boulevard, Galveston, TX, 77555-0587, USA,
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Jones AM, Zidenberg-Cherr S. Exploring nutrition education resources and barriers, and nutrition knowledge in teachers in California. JOURNAL OF NUTRITION EDUCATION AND BEHAVIOR 2015; 47:162-169. [PMID: 25257845 DOI: 10.1016/j.jneb.2014.06.011] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 06/20/2014] [Accepted: 06/23/2014] [Indexed: 06/03/2023]
Abstract
OBJECTIVE To determine barriers to nutrition education, nutrition education resources used, and the relationship between nutrition knowledge and whether public school teachers in California teach nutrition in the classroom. METHODS A total of 102 teachers in California participated in a Web-based survey about nutrition education barriers, resources used to plan nutrition lessons, and factors that would encourage inclusion of nutrition. A validated questionnaire was used to assess nutrition knowledge. Analyses included ordinary least-squares regression. RESULTS Common barriers were lack of instructional time and unrelated subject. Teachers were unaware of many nutrition education resources. Nutrition knowledge was not associated with nutrition lessons but was positively associated with teaching high school (β = 5.13; P < .05) and female gender (β = 6.78; P < .05), and negatively associated with identifying as Hispanic or Latino (β = -15.50; P < .001). CONCLUSIONS AND IMPLICATIONS Barriers of time and lack of unrelated subject matter are difficult to address but lack of awareness of resources indicates that promotion of existing resources may encourage teachers to provide nutrition education. Larger studies are needed to determine whether this holds true in a broader sample.
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Affiliation(s)
- Anna Marie Jones
- Center for Nutrition in Schools, Department of Nutrition, University of California, Davis, Davis, CA
| | - Sheri Zidenberg-Cherr
- Center for Nutrition in Schools, Department of Nutrition, University of California, Davis, Davis, CA.
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Beckham AJ, Urrutia RP, Sahadeo L, Corbie-Smith G, Nicholson W. “We Know but We Don’t Really Know”: Diet, Physical Activity and Cardiovascular Disease Prevention Knowledge and Beliefs Among Underserved Pregnant Women. Matern Child Health J 2015; 19:1791-801. [DOI: 10.1007/s10995-015-1693-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jancey JM, Dos Remedios Monteiro SM, Dhaliwal SS, Howat PA, Burns S, Hills AP, Anderson AS. Dietary outcomes of a community based intervention for mothers of young children: a randomised controlled trial. Int J Behav Nutr Phys Act 2014; 11:120. [PMID: 25245213 PMCID: PMC4177414 DOI: 10.1186/s12966-014-0120-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 09/16/2014] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Unhealthy dietary behaviours are one of the key risk factors for many lifestyle-related diseases worldwide. This randomised controlled trial aimed to increase the level of fruit, vegetable and fibre intake and decrease the fat and sugar consumption of mothers with young children (0-5 years) via the playgroup setting. METHODS Playgroups located in 60 neighbourhoods in Perth, Western Australia were randomly assigned to an intervention (n = 249) or control group (n = 272). Those in the intervention group received a 6-month multi-strategy primarily home-based physical activity and nutrition program (data is only presented on dietary behaviours). Data on dietary consumption was collected via the Fat and Fibre Barometer and frequency of serves of fruit and vegetable and cups of soft drink, flavoured drink and fruit juice. The effects of the intervention on continuous outcome measures were assessed using analysis of variance (ANOVA), after adjusting for mother's age and the corresponding variables. RESULTS The outcomes of the intervention were positive with the intervention group showing statistically significant improvements, when compared to the control group in the overall consumption of fat and fibre (p < 0.0005); of fibre (p < 0.0005) - fruit and vegetables (p < 0.0005), wholegrain (p = 0.002): and fat (p = 0.005) - dairy products (p = 0.006) and lean meat and chicken (p = 0.041). There were no significant changes in the consumption of sweet drinks. CONCLUSIONS This intervention was successful in improving dietary intake in the intervention group participants. The moderate positive outcomes indicate that playgroups potentially provide quite a viable setting to recruit, engage and retain this hard to reach group of mothers of young children in programs that support the adoption of health-enhancing behaviours. This adds valuable information to this under researched area. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12609000718246.
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Affiliation(s)
- Jonine Maree Jancey
- />Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
| | | | - Satvinder S Dhaliwal
- />Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
| | - Peter A Howat
- />Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
| | - Sharyn Burns
- />Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
| | - Andrew P Hills
- />Mater Mothers Hospital and Mater Medical Research Institute- UQ, Queensland, Australia
- />Centre for Musculoskeletal Research, Griffith Health Institute, Griffith University, Queensland, Australia
| | - Annie S Anderson
- />Centre for Public Health Nutrition Research Centre for Research into Cancer Prevention and Screening, Division of Cancer Research Medical Research Institute, Level 7, Mailbox 7, University of Dundee Ninewells Hospital and Medical School, Dundee DD1 9SY, Dundee, Scotland, UK
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Ng SK, Cameron CM, Hills AP, McClure RJ, Scuffham PA. Socioeconomic disparities in prepregnancy BMI and impact on maternal and neonatal outcomes and postpartum weight retention: the EFHL longitudinal birth cohort study. BMC Pregnancy Childbirth 2014; 14:314. [PMID: 25201481 PMCID: PMC4165994 DOI: 10.1186/1471-2393-14-314] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 08/11/2014] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Long-term obesity after pregnancy is associated with obesity prior to pregnancy and retention of weight postpartum. This study aims to identify socioeconomic differences in prepregnancy body mass index, quantify the impact of prepregnancy obesity on birth outcomes, and identify determinants of postpartum weight retention. METHODS A total of 2231 pregnant women, recruited from three public hospitals in Southeast Queensland in Australia during antenatal clinic visits, completed a questionnaire to elicit information on demographics, socioeconomic and behavioural characteristics. Perinatal information was extracted from hospital records. A follow-up questionnaire was completed by each participant at 12 months after the birth to obtain the mother's postpartum weight, breastfeeding pattern, dietary and physical activity characteristics, and the child's health and development information. Multivariate logistic regression method was used to model the association between prepregnancy obesity and outcomes. RESULTS Being overweight or obese prepregnancy was strongly associated with socioeconomic status and adverse behavioural factors. Obese women (18% of the cohort) were more likely to experience gestational diabetes, preeclampsia, cesarean delivery, and their children were more likely to experience intensive- or special-care nursery admission, fetal distress, resuscitation, and macrosomia. Women were more likely to retain weight postpartum if they consumed three or fewer serves of fruit/vegetables per day, did not engage in recreational activity with their baby, spent less than once a week on walking for 30 minutes or more or spent time with friends less than once per week. Mothers who breastfed for more than 3 months had reduced likelihood of high postpartum weight retention. CONCLUSIONS Findings provide additional specificity to the increasing evidence of the predisposition of obesity prepregnancy on adverse maternal and perinatal outcomes. They may be used to target effective behavioural change interventions to address obesity in women.
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Affiliation(s)
- Shu-Kay Ng
- />School of Medicine, Griffith Health Institute, Griffith University, Brisbane, QLD 4131 Australia
| | - Cate M Cameron
- />Centre of National Research on Disability and Rehabilitation, School of Human Services and Social Work, Griffith Health Institute, Griffith University, Brisbane, QLD 4131 Australia
| | - Andrew P Hills
- />Mater Mothers’ Hospital, Mater Research Institute – University of Queensland and Centre for Musculoskeletal Research, Griffith University, Brisbane, QLD Australia
| | - Roderick J McClure
- />Injury Research Institute, Monash University, Monash, VIC 3800 Australia
| | - Paul A Scuffham
- />School of Medicine, Griffith Health Institute, Griffith University, Brisbane, QLD 4131 Australia
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Miller M, Hearn L, van der Pligt P, Wilcox J, Campbell KJ. Preventing maternal and early childhood obesity: the fetal flaw in Australian perinatal care. Aust J Prim Health 2014; 20:123-7. [PMID: 24176286 DOI: 10.1071/py13080] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 09/02/2013] [Indexed: 01/15/2023]
Abstract
Almost half of Australian women of child-bearing age are overweight or obese, with a rate of 30-50% reported in early pregnancy. Maternal adiposity is a costly challenge for Australian obstetric care, with associated serious maternal and neonatal complications. Excess gestational weight gain is an important predictor of offspring adiposity into adulthood and higher maternal weight later in life. Current public health and perinatal care approaches in Australia do not adequately address excess perinatal maternal weight or gestational weight gain. This paper argues that the failure of primary health-care providers to offer systematic advice and support regarding women's weight and related lifestyle behaviours in child-bearing years is an outstanding 'missed opportunity' for prevention of inter-generational overweight and obesity. Barriers to action could be addressed through greater attention to: clinical guidelines for maternal weight management for the perinatal period, training and support of maternal health-care providers to develop skills and confidence in raising weight issues with women, a variety of weight management programs provided by state maternal health services, and clear referral pathways to them. Attention is also required to service systems that clearly define roles in maternal weight management and ensure consistency and continuity of support across the perinatal period.
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Affiliation(s)
- Margaret Miller
- Child Health Promotion Research Centre, Edith Cowan University, 2 Bradford St, Mount Lawley, WA 6050, Australia
| | - Lydia Hearn
- Child Health Promotion Research Centre, Edith Cowan University, 2 Bradford St, Mount Lawley, WA 6050, Australia
| | - Paige van der Pligt
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia
| | - Jane Wilcox
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia
| | - Karen J Campbell
- Centre for Physical Activity and Nutrition Research, Deakin University, 221 Burwood Highway, Burwood, Vic. 3125, Australia
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Ferranti EP, Narayan KMV, Reilly CM, Foster J, McCullough M, Ziegler TR, Guo Y, Dunbar SB. Dietary self-efficacy predicts AHEI diet quality in women with previous gestational diabetes. DIABETES EDUCATOR 2014; 40:688-99. [PMID: 24942530 DOI: 10.1177/0145721714539735] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
PURPOSE The purpose of this study was to examine the association of intrapersonal influences of diet quality as defined by the Health Belief Model constructs in women with recent histories of gestational diabetes. METHODS A descriptive, correlational, cross-sectional design was used to analyze relationships between diet quality and intrapersonal variables, including perceptions of threat of type 2 diabetes mellitus development, benefits and barriers of healthy eating, and dietary self-efficacy, in a convenience sample of 75 community-dwelling women (55% minority; mean age, 35.5 years; SD, 5.5 years) with previous gestational diabetes mellitus. Diet quality was defined by the Alternative Healthy Eating Index (AHEI). Multiple regression was used to identify predictors of AHEI diet quality. RESULTS Women had moderate AHEI diet quality (mean score, 47.6; SD, 14.3). Only higher levels of education and self-efficacy significantly predicted better AHEI diet quality, controlling for other contributing variables. CONCLUSIONS There is a significant opportunity to improve diet quality in women with previous gestational diabetes mellitus. Improving self-efficacy may be an important component to include in nutrition interventions. In addition to identifying other important individual components, future studies of diet quality in women with previous gestational diabetes mellitus are needed to investigate the scope of influence beyond the individual to potential family, social, and environmental factors.
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Affiliation(s)
- Erin Poe Ferranti
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Ferranti, Dr Reilly, Dr Foster, Dr Dunbar)
| | - K M Venkat Narayan
- Rollins School of Public Health and School of Medicine, Emory University, Atlanta, Georgia (Dr Narayan, Dr Guo)
| | - Carolyn M Reilly
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Ferranti, Dr Reilly, Dr Foster, Dr Dunbar)
| | - Jennifer Foster
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Ferranti, Dr Reilly, Dr Foster, Dr Dunbar)
| | | | - Thomas R Ziegler
- School of Medicine, Emory University, Atlanta, Georgia (Dr Ziegler)
| | - Ying Guo
- Rollins School of Public Health and School of Medicine, Emory University, Atlanta, Georgia (Dr Narayan, Dr Guo)
| | - Sandra B Dunbar
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia (Dr Ferranti, Dr Reilly, Dr Foster, Dr Dunbar)
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Saarela AM, Lapveteläinen AT, Mykkänen HM, Kantanen TT, Rissanen RL. Real-life setting in data collection. The role of nutrition knowledge whilst selecting food products for weight management purposes in a supermarket environment. Appetite 2013; 71:196-208. [DOI: 10.1016/j.appet.2013.08.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Revised: 08/06/2013] [Accepted: 08/14/2013] [Indexed: 11/29/2022]
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Diet and carbohydrate food knowledge of multi-ethnic women: a comparative analysis of pregnant women with and without Gestational Diabetes Mellitus. PLoS One 2013; 8:e73486. [PMID: 24069200 PMCID: PMC3772003 DOI: 10.1371/journal.pone.0073486] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 07/21/2013] [Indexed: 12/16/2022] Open
Abstract
Background Diet therapy is the cornerstone for the management of gestational diabetes mellitus (GDM). Carbohydrate is the primary nutrient affecting postprandial blood glucose levels. Hence, knowledge of food containing carbohydrates can assist women with GDM optimize glycemic control. Despite that, there is a paucity of research on carbohydrate-related knowledge of women with GDM. The United Arab Emirates (UAE) has one of the highest prevalence of diabetes (19.2%) in the world. This study compared diet and knowledge of carbohydrate-containing foods among pregnant women with and without GDM in the UAE. Methods The sample consisted of multi-ethnic women with GDM (n = 94) and a control group of healthy pregnant women (n = 90) attending prenatal clinics in three hospitals in Al Ain, UAE. Data were collected using a questionnaire and a 24-hour recall. Knowledge of food sources of carbohydrate, dietary patterns, and nutrient intakes of the two groups were compared. Results There were no significant differences in the mean knowledge score of food sources of carbohydrate between women with GDM and that of pregnant women without GDM. Similarly, there were no significant differences in energy and nutrient intakes between the two groups with the exception of percent energy from protein. Women with GDM reported significantly lower intake of fruits and fruit juices (P = 0.012) and higher consumption of milk and yogurt (P = 0.004) compared to that of women without GDM. Twenty-two percent of women with GDM indicated they never visited a dietitian for counseling while 65% reported they visited a dietitian only once or twice during the pregnancy. Predictors of carbohydrate knowledge score were perceived knowledge of diet and GDM and parity among women with GDM and parity and educational level among those without GDM. Conclusion The results of the study highlight the urgent need to provide nutrition education for women with GDM in the UAE.
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Dressler H, Smith C. Health and Eating Behavior Differs between Lean/Normal and Overweight/Obese Low-Income Women Living in Food-Insecure Environments. Am J Health Promot 2013; 27:358-65. [DOI: 10.4278/ajhp.120119-qual-55] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Purpose. To explore differences and similarities in environmental, personal, and behavioral factors influencing eating behavior among low-income women of varying weight status. Design. Focus groups (n = 16) were used to collect qualitative data. Quantitative data collected included demographic, lifestyle, and anthropometric (heights and weights). Setting. Community centers, libraries, and homeless shelters in low-income neighborhoods. Participants. Of the 83 participants, 58% were African-American, 28% were white, and the remainder were American Indian, Hispanic, or mixed race. A total of 35% of participants were lean/normal (body mass index < 25 kg/m2) and 65% were overweight/obese (body mass index > 25 kg/m2). Method. Focus group methodology was used to collect data on 83 participants. Social Cognitive Theory (SCT) provided the theoretical basis. Transcripts were analyzed using the open-coding method and comments between lean/normal and overweight/obese women were systematically compared. Results. Focus group themes were food environment, aberrant eating behavior, health values, and beliefs. Differences in personal and behavioral factors were apparent between overweight/obese and lean/normal women, with the former group frequently discussing emotional eating, overeating, and stashing food, and the latter group communicating greater nutrition knowledge and describing regular physical activity. Both groups similarly expressed experiences with food insecurity and lived in low-income environments. Conclusion. For low-income women, personal and behavioral factors may modify the influence of their obesogenic food environment. Further research within the context of SCT should examine differences between lean/normal and overweight/obese women living in the same environment.
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Cluss PA, Ewing L, King WC, Reis EC, Dodd JL, Penner B. Nutrition knowledge of low-income parents of obese children. Transl Behav Med 2013; 3:218-25. [PMID: 24039639 PMCID: PMC3717981 DOI: 10.1007/s13142-013-0203-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Minority and low-income children are overrepresented among obese US children. Lack of basic nutrition knowledge among parents may contribute to this disparity. The purpose of this study is to measure nutrition knowledge of parents of Medicaid-insured obese children using a simple low-literacy tool. Parents, recruited from pediatric clinics, demonstrated their nutrition knowledge by placing food stickers into cells on a printed grid with food groups displayed in columns and three nutrition categories displayed in rows. In general, parents (n = 135; 74.8 % black; 79.2 % income of ≤$25,000/year) correctly identified food groups (median = 90.5 % correct). Nutritional categories were more commonly misidentified (median = 67 % correct), with parents mostly believing foods were healthier than they were. Multivariable linear regression revealed black race (p = 0.02), no college education (p = 0.02) and income of <$15,000 (p = 0.03) independently predicted misidentification of nutritional categories. Parents' understanding of food's nutritional value is variable. Black race, less education, and very low income are associated with poorer nutrition knowledge.
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Affiliation(s)
- Patricia A. Cluss
- />School of Medicine, Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213 USA
| | - Linda Ewing
- />School of Medicine, Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213 USA
- />Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor, 210 S. Bouquet Street, Pittsburgh, PA 15260 USA
- />School of Medicine, Department of Pediatrics, University of Pittsburgh, Children’s Hospital of Pittsburgh of UPMC One Children’s Hospital Drive 4401 Penn Avenue, Pittsburgh, PA 15224 USA
| | - Wendy C. King
- />Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 517 Parran Hall, Pittsburgh, PA 15261 USA
| | - Evelyn Cohen Reis
- />School of Medicine, Department of Pediatrics, University of Pittsburgh, 3414 Fifth Avenue, CHOB-3rd Floor, General Academic Pediatrics, Pittsburgh, PA 15213 USA
- />Clinical and Translational Science Institute, University of Pittsburgh, Forbes Tower, Suite 7057 Atwood and Sennott Streets, Pittsburgh, PA 15260 USA
- />CTSI Pediatric PittNet, 3414 Fifth Avenue, CHOB-3rd Floor, General Academic Pediatrics, Pittsburgh, PA 15213 USA
| | - Judith L. Dodd
- />Division of Clinical Dietetics and Nutrition, Department of Sports Medicine and Nutrition, University of Pittsburgh, 4053 Forbes Tower, Atwood and Sennott Streets, Pittsburgh, PA 15260 USA
| | - Barbara Penner
- />School of Medicine, Department of Psychiatry, University of Pittsburgh, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213 USA
- />Department of Psychology, University of Pittsburgh, Sennott Square, 3rd Floor, 210 S. Bouquet Street, Pittsburgh, PA 15260 USA
- />School of Medicine, Department of Pediatrics, University of Pittsburgh, Children’s Hospital of Pittsburgh of UPMC One Children’s Hospital Drive 4401 Penn Avenue, Pittsburgh, PA 15224 USA
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Abstract
Aim: The aim of this concept analysis is to create a clear definition and framework to guide weight self-management research and promotion of healthy weight self-management during the postpartum period. Background: A woman’s ability to manage her weight through the postpartum transition has lifelong implications for her weight status. Methods: This concept analysis was guided by Walker and Avant (2005). A broad search of sources was performed, yielding 56 articles in which postpartum weight self-management was the main focus. Results: From consideration of the attributes of postpartum weight self-management, a descriptive, situation-specific theory emerged: Postpartum weight self-management is a process by which the transition to motherhood is viewed by the woman as an opportunity to intentionally engage in healthy weight self-management behaviors by minimizing the salient inhibitors and maximizing the salient facilitators to action. Conclusion: This analysis provides a clarification of the process concept of postpartum weight self-management and its consequences, giving direction for measurement, clinical application, and further research. Future nursing interventions and research should be aimed at helping women to view the postpartum period as a normative transition in which they have the opportunity to take charge of their own health and the health of their family.
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Wiltheiss GA, Lovelady CA, West DG, Brouwer RJN, Krause KM, Østbye T. Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program. J Acad Nutr Diet 2012; 113:54-62. [PMID: 23146549 DOI: 10.1016/j.jand.2012.08.012] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 08/06/2012] [Indexed: 12/21/2022]
Abstract
BACKGROUND Postpartum weight retention is a risk factor for long-term weight gain. Encouraging new mothers to consume a healthy diet may result in weight loss. OBJECTIVE To assess predictors of diet quality during the early postpartum period; to determine whether diet quality, energy intake, and lactation status predicted weight change from 5 to 15 months postpartum; and to determine whether an intervention improved diet quality, reduced energy intake, and achieved greater weight loss compared with usual care. DESIGN Randomized clinical trial (KAN-DO: Kids and Adults Now-Defeat Obesity), a family- and home-based, 10-month, behavioral intervention to prevent childhood obesity, with secondary aims to improve diet and physical activity habits of mothers to promote postpartum weight loss. PARTICIPANTS Overweight/obese, postpartum women (n=400), recruited from 14 counties in the Piedmont region of North Carolina. INTERVENTION Eight education kits, each mailed monthly; motivational counseling; and one group class. METHODS Anthropometric measurements and 24-hour dietary recalls collected at baseline (approximately 5 months postpartum) and follow-up (approximately 10 months later). Diet quality was determined using the Healthy Eating Index-2005 (HEI-2005). STATISTICAL ANALYSES Descriptive statistics, χ(2), analysis of variance, bi- and multivariate analyses were used. RESULTS At baseline, mothers consumed a low-quality diet (HEI-2005 score=64.4 ± 11.4). Breastfeeding and income were positive, significant predictors of diet quality, whereas body mass index was a negative predictor. Diet quality did not predict weight change. However, total energy intake, not working outside of the home, and breastfeeding duration/intensity were negative predictors of weight loss. There were no significant differences in changes in diet quality, decreases in energy intake, or weight loss between the intervention (2.3 ± 5.4 kg) and control (1.5 ± 4.7 kg) arms. CONCLUSIONS The family-based intervention did not promote postpartum weight loss. Reducing energy intake, rather than improving diet quality, should be the focus of weight-loss interventions for overweight/obese postpartum women.
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Affiliation(s)
- Gina A Wiltheiss
- Department of Nutrition, The University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA
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Cahill JM, Freeland-Graves JH, Shah BS, Lu H, Pepper MR. Determinants of Weight Loss after an Intervention in Low-Income Women in Early Postpartum. J Am Coll Nutr 2012; 31:133-43. [DOI: 10.1080/07315724.2012.10720019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Psychometric validation of a knowledge questionnaire on micronutrients among adolescents and its relationship to micronutrient status of 15-19-year-old adolescent boys, Hyderabad, India. Public Health Nutr 2012; 15:1182-9. [PMID: 22321774 DOI: 10.1017/s1368980012000055] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE To develop a psychometrically valid questionnaire for testing knowledge on micronutrients and to assess the relationship between knowledge and biomarkers of micronutrient status among adolescents. DESIGN Cross-sectional, institution-based, validity and reliability study. SETTING Seven higher secondary schools were covered in the limits of Greater Hyderabad Municipal Corporation, Hyderabad, India. SUBJECTS Students aged 15-19 years, n 92 for the pre-test, n 108 for test-retest and n 109 for studying the relationship between knowledge and biomarkers of Fe, retinol, ascorbic acid, α-tocopherol, folic acid and vitamin B12 status. RESULTS From an item pool of 106, thirty-one items were selected based on content validity. Statistical tools to obtain a valid and reliable questionnaire among adolescent boys and girls resulted in eighteen items with a difficulty index of 0·11-0·86, discrimination index of 0·20-0·72 and validity index (point bi-serial correlation) of 0·10-0·62. Reliability as measured by Cronbach's α was 0·71 and the intra-class correlation coefficient was 0·80. A Bland-Altman plot showed good agreement between test and retest scores. The mean response score to the eighteen-item questionnaire was 5·2 (sd 2·68). The mean values of serum retinol were significantly different (P = 0·022) between groups below (24·8 (sd 6·64) μg/dl) and above (28·0 (sd 7·67) μg/dl) the 50th percentile of knowledge score. The relationship persisted after controlling for economic status as a covariate using analysis of covariance (P = 0·018). Other micronutrients did not show any significant relationship. CONCLUSIONS A valid and reliable eighteen-item knowledge questionnaire was constructed and found to have a significant positive relationship with plasma retinol status alone.
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Abstract
This review examines published literature to answer 2 questions: 1) Are there racial-ethnic differences in excessive or inadequate gestational weight gain (GWG) and postpartum weight retention (PPWR)? and 2) Is there evidence that approaches to promote healthy weight during and after pregnancy should vary by race-ethnicity? We identified a limited number of articles that explicitly looked at racial-ethnic differences in either GWG or PPWR after controlling for relevant covariates. These studies suggest that black and Hispanic women are more likely to gain inadequately based on the Institute of Medicine's pregnancy weight gain guidelines compared to white women. Black women are more likely to retain considerable amounts of weight postpartum compared to both Hispanic and white mothers. Studies were inconclusive as to whether Hispanic women retained more or less weight postpartum, so more research is needed. Interventions to increase GWG were few and those designed to reduce GWG and PPWR showed mixed results. Future studies should address the methodological and conceptual limitations of prior research as well as investigate biological mechanisms and behavioral risk factors to determine the reasons for the racial-ethnic differences in pregnancy-related weight outcomes. Interventions would benefit from a mixed-methods approach that specifically identifies race-relevant barriers to weight management during and after pregnancy. Attention to the greater social context in which pregnancy-related weight exists is also needed.
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Affiliation(s)
- Irene E. Headen
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Esa M. Davis
- Department of General Internal Medicine Center for Research on Health Care, University of Pittsburgh/University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Mahasin S. Mujahid
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
| | - Barbara Abrams
- Division of Epidemiology, School of Public Health, University of California, Berkeley, CA
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Monteiro SMDR, Jancey J, Howat P, Burns S, Jones C, Dhaliwal SS, McManus A, P Hills A, Anderson AS. The protocol of a randomized controlled trial for playgroup mothers: Reminder on Food, Relaxation, Exercise, and Support for Health (REFRESH) Program. BMC Public Health 2011; 11:648. [PMID: 21843366 PMCID: PMC3166931 DOI: 10.1186/1471-2458-11-648] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2011] [Accepted: 08/16/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mother's physical activity levels are relatively low, while their energy consumption is generally high resulting in 58% of Australian women over the age of 18 years being overweight or obese. This study aims to confirm if a low-cost, accessible playgroup based intervention program can improve the dietary and physical activity behaviours of mothers with young children. METHODS/DESIGN The current study is a randomized controlled trial lifestyle (nutrition and physical activity) intervention for mothers with children aged between 0 to 5 years attending playgroups in Perth, Western Australia. Nine-hundred participants will be recruited and randomly assigned to the intervention (n = 450) and control (n = 450) groups. The study is based on the Social Cognitive Theory (SCT) and the Transtheoretical Model (TTM), and the Precede-Proceed Framework incorporating goal setting, motivational interviewing, social support and self-efficacy. The six month intervention will include multiple strategies and resources to ensure the engagement and retention of participants. The main strategy is home based and will include a specially designed booklet with dietary and physical activity information, a muscle strength and flexibility exercise chart, a nutrition label reading shopping list and menu planner. The home based strategy will be supported by face-to-face dietary and physical activity workshops in the playgroup setting, posted and emailed bi-monthly newsletters, and monthly Short Message Service (SMS) reminders via mobile phones. Participants in the control group receive no intervention materials. Outcome measures will be assessed using data that will be collected at baseline, six months and 12 months from participants in the control and intervention groups. DISCUSSION This trial will add to the evidence base on the recruitment, retention and the impact of community based dietary and physical activity interventions for mothers with young children. TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry ACTRN12609000735257.
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Affiliation(s)
- Sarojini MDR Monteiro
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Australia
| | - Jonine Jancey
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Australia
| | - Peter Howat
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Australia
| | - Sharyn Burns
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
| | - Carlie Jones
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Australia
| | - Satvinder S Dhaliwal
- Western Australian Centre for Health Promotion Research, School of Public Health, Curtin University, Western Australia, Australia
- Centre for Behavioural Research in Cancer Control, Curtin University, Western Australia, Australia
| | - Alexandra McManus
- Curtin Health Innovation Research Institute, Curtin University, Western Australia, Australia
| | - Andrew P Hills
- Griffith University and Mater Medical Research Institute, Queensland, Australia
| | - Annie S Anderson
- Centre for Public Health Nutrition Research, University of Dundee, Dundee, UK
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Hughes R, Maher J, Baillie E, Shelton D. Nutrition and physical activity guidance for women in the pre- and post-natal period: a continuing education needs assessment in primary health care. Aust J Prim Health 2011; 17:135-41. [DOI: 10.1071/py10012] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Accepted: 11/08/2010] [Indexed: 11/23/2022]
Abstract
The study objective was to assess primary health care (PHC) providers’ exposure to women in the pre- and post-natal period, current nutrition and physical activity guidance practices, confidence and perceived needs for continuing education relevant to nutrition and physical activity guidance in the peri-natal period. A self-administered cross-sectional questionnaire survey amongst a purposively recruited sample of 226 local primary health care providers evenly distributed across general practice, community nursing, pharmacist and pharmacy assistant worker groups. The questionnaire contained 106 items about primary health care providers’ exposure to women in the pre- and post-natal life-stage, their current nutrition and physical activity guidance practices, confidence and perceived needs for continuing education relevant to nutrition and physical activity guidance in the peri-natal period. Results indicate that PHC providers across general practice, community nursing and pharmacy service settings are frequently accessed by women during this life-stage, and regularly and variably provide guidance on nutrition and physical activity, and report different continuing education needs. Continuing education interventions need to be tailored to match the needs of each PHC group. Pharmacy-based staff are a priority for PHC continuing education about nutrition and physical activity if the potential of the community-based pharmacy as a primary health setting is to be realised.
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Rebelo F, Castro MBT, Dutra CL, Schlussel MM, Kac G. Fatores associados à retenção de peso pós-parto em uma coorte de mulheres, 2005-2007. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2010. [DOI: 10.1590/s1519-38292010000200009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: investigar fatores associados à retenção de peso pós-parto. MÉTODOS: estudo de coorte com 104 gestantes recrutadas em uma Unidade Básica de Saúde no município do Rio de Janeiro, da 8ª a 13ª semana de gestação e acompanhadas até aproximadamente 55 dias pós-parto. As variáveis incluíram informações sócio-demográficas, econômicas, bioquímicas, antropométricas e reprodutivas. A retenção de peso pós-parto (diferença entre o peso pós-parto e o peso pré-gestacional) foi utilizada como variável dependente. RESULTADOS: a média de peso retido foi 3,2 kg ± 3,7 kg. As mulheres com ganho de peso gestacional (GPG) excessivo retiveram 5,0 kg ± 3,9 em comparação a 3,6 kg ± 3,0 em mulheres com GPG adequado e 1,4 kg ± 3,1 para as com GPG insuficiente. O GPG e o Índice de Massa corporal (IMC) pré-gestacional mantiveram associação significativa com a retenção de peso no modelo final. Observou-se que a cada quilo de peso ganho na gestação, quase 50% ficaram retidos no pós-parto (β = 0,494; p<0,001) e a cada 1,0 kg/m² a menos no IMC pré-gestacional correspondeu a uma retenção de aproximadamente 150g (β = -0,149;p<0,05). CONCLUSÃO: o GPG está positivamente e o IMC pré-gestacional inversamente associado à retenção de peso pós-parto. Orientações nutricionais sobre o controle do ganho ponderal podem ajudar a minimizar a incidência de obesidade entre mulheres no pós-parto.
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Phelan ST. Obesity in minority women: calories, commerce, and culture. Obstet Gynecol Clin North Am 2009; 36:379-92, x. [PMID: 19501320 DOI: 10.1016/j.ogc.2009.04.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Obesity is increasing at epidemic rates in all women, but especially in minority women and children. Factors that contribute to this include changes in caloric intake and expenditure (calories), cost and ease of acquiring food along with pressures from the marketplace and media (commerce) and the community response to the increasing prevalence of obesity and sedentary lifestyle (culture).
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Affiliation(s)
- Sharon T Phelan
- Department of Obstetrics and Gynecology, School of Medicine, University of New Mexico, 2211 Lomas Boulevard, NE, MSC10 5580, Albuquerque, NM 87131, USA.
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Ferraro Z, Adamo KB. Pediatric Obesity: It's Time for Prevention before Conception Can Maternal Obesity Program Pediatric Obesity? CLINICAL MEDICINE. PEDIATRICS 2008. [DOI: 10.4137/cmped.s1099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Global increases in obesity have led public health experts to declare this disease a pandemic. Although prevalent in all ages, the dire consequences associated with maternal obesity have a pronounced impact on the long-term health of their children as a result of the intergenerational effects of developmental programming. Previously, fetal under-nutrition has been linked to the predisposition to pediatric obesity explained by the adiposity rebound and ‘catch-up’ growth that occurs when a child born to a nutrient deprived mother is exposed to the obesogenic environment of present day. Given the recent increase in maternal overweight/obesity (OW/OB) our attention has shifted from nutrient restriction to overabundance and excess during pregnancy. Consideration must now be given to interventions that could mitigate pregravid body mass index (BMI), attenuate gestational weight gain (GWG) and reduce postpartum weight retention (PPWR) in an attempt to prevent the downstream signaling of pediatric obesity and halt the intergenerational cycle of weight related disease currently plaguing our world. Thus, this paper will briefly review current research that best highlights the proposed mechanisms responsible for the development of child OW/OB and related sequalae (e.g. type II diabetes (T2D) and cardiovascular disease (CVD)) resulting from maternal obesity.
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Affiliation(s)
- Zach Ferraro
- Healthy, Active, Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute
- University of Ottawa, School of Human Kinetics, Faculty of Health Sciences
| | - Kristi B. Adamo
- Healthy, Active, Living and Obesity (HALO) Research Group, Children's Hospital of Eastern Ontario Research Institute
- University of Ottawa, School of Human Kinetics, Faculty of Health Sciences
- Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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