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Herman A, Hand LK, Gajewski B, Krase K, Sullivan DK, Goetz J, Hull HR. A high fiber diet intervention during pregnancy: The SPROUT (Single goal in PRegnancy to optimize OUTcomes) protocol paper. Contemp Clin Trials 2024; 137:107420. [PMID: 38145714 DOI: 10.1016/j.cct.2023.107420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/19/2023] [Accepted: 12/20/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Interventions to prevent excessive gestational weight gain (GWG) have had a limited impact on maternal and infant outcomes. Dietary fiber is a nutrient with benefits that counters many of the metabolic and inflammatory changes that occur during pregnancy. We will determine if a high dietary fiber (HFib) intervention provides benefit to maternal and infant outcomes. METHODS AND DESIGN Pregnant women will be enrolled in an 18-week intervention and randomized in groups of 6-10 women/group into the intervention or control group. Weekly lessons will include information on high-dietary fiber foods and behavior change strategies. Women in the intervention group will be given daily snacks high in dietary fiber (10-12 g/day) to facilitate increasing dietary fiber intake. The primary aim will assess between-group differences for the change in maternal weight, dietary fiber intake, dietary quality, and body composition during pregnancy and up to two months post-partum. The secondary aim will assess between-group differences for the change in maternal weight, dietary fiber intake, and dietary quality from two months to one year post-partum and infant body composition from birth to one-year-old. DISCUSSION Effective and simple intervention strategies to improve maternal and offspring outcomes are lacking. Changes during the perinatal period are related to the risk of disease development in the mother and offspring. However, it is unknown which changes can be successfully targeted to have a meaningful impact. We will test the effect of an intervention designed to counter many of the metabolic and inflammatory changes that occur during pregnancy. ETHICS AND DISSEMINATION The University of Kansas Medical Center Institutional Review Board (IRB) approved the study protocol (STUDY00145397). The results of the trial will be disseminated at conferences and in peer reviewed publications. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT04868110.
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Affiliation(s)
- Amy Herman
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Lauren K Hand
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Byron Gajewski
- Department of Biostatistics, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Kelli Krase
- Department of Obstetrics and Gynecology, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Debra K Sullivan
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Jeannine Goetz
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States of America
| | - Holly R Hull
- Department of Dietetics and Nutrition, University of Kansas Medical Center, Kansas City, KS, United States of America.
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2
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Mattson R, Barger MK. Feasibility of Telehealth and Innovative Technologies to Limit Excessive Gestational Weight Gain. Nurs Womens Health 2024; 28:30-40. [PMID: 37989496 DOI: 10.1016/j.nwh.2023.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 08/03/2023] [Accepted: 10/19/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE To test the feasibility of using telehealth to deliver nutritional counseling by tracking gestational weight gain remotely using Bluetooth weight scales. DESIGN Quasi-experimental feasibility study. SETTING One-on-one nutritional counseling was conducted remotely via a telehealth platform using a registered dietitian. PARTICIPANTS Twenty-nine pregnant individuals ages 18 years or older, between 12 and 27 weeks' gestation, with a prepregnancy body mass index of ≥30 kg/m2, singleton fetus, and English proficiency were recruited for the study. Among the 29 potential participants, 20 completed the initial survey and met the criteria; 11 completed the study. METHODS This study tested the feasibility of using telehealth to deliver nutritional counseling for 30 minutes, once a week, for 6 weeks. Self-weighing was tracked through a preconfigured Bluetooth scale given to study participants that enabled weight data to be automatically uploaded each time the scale was used. RESULTS Among the 11 study participants receiving Bluetooth scales, adherence to self-weighing was high (81%). All five participants randomized to nutritional counseling found that telehealth visits with a registered dietitian were easy to use and helpful. Although participants who received nutritional counseling gained 2.5 lb less than those who did not receive nutritional counseling (p = .523), there was no significant difference between the intervention group and historical control individuals (p = .716). CONCLUSION Incorporating telehealth for nutrition counseling and accurate remote weight data collection may be part of a comprehensive strategy to address gestational weight gain in high-risk pregnant populations. Further research with larger samples is needed.
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O'Reilly SL, McAuliffe FM, Geraghty AA, Burden C, Davies A. Implementing weight management during and after pregnancy to reduce diabetes and CVD risk in maternal and child populations. Proc Nutr Soc 2023:1-12. [PMID: 38037711 DOI: 10.1017/s0029665123004883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
Maintaining a healthy weight during pregnancy is critical for both women's and children's health. Excessive gestational weight gain (GWG) can lead to complications such as gestational diabetes, hypertension and caesarean delivery. Insufficient GWG can cause fetal growth restriction and increase infant mortality risk. Additionally, postpartum weight retention raises risk of obesity, type 2 diabetes and other chronic diseases for both mother and child. This review seeks to identify current obstacles in weight management research during and after pregnancy and explore evidence-based strategies to overcome them. Pregnancy offers a window of opportunity for health behaviour changes as women are more receptive to education and have regular contact with health services. Staying within Institute of Medicine's recommended GWG ranges is associated with better maternal and fetal outcomes. Systematic review evidence supports structured diet and physical activity pregnancy interventions, leading to reduced GWG and fewer complications. Health economic evaluation indicates significant returns from implementation, surpassing investment costs due to decreased perinatal morbidity and adverse events. However, the most effective way to implement interventions within routine antenatal care remains unclear. Challenges increase in the postpartum period due to competing demands on women physically, mentally and socially, hindering intervention reach and retention. Flexible, technology-supported interventions are needed, requiring frameworks such as penetration-implementation-participation-effectiveness and template-for-intervention-description-and-replication for successful implementation. Greater research efforts are necessary to inform practice and investigate fidelity aspects through pragmatic implementation trials during the pregnancy and postpartum periods. Understanding the best ways to deliver interventions will empower women to maintain a healthy weight during their reproductive years.
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Affiliation(s)
- Sharleen L O'Reilly
- School of Agriculture and Food Science, University College Dublin College of Health Sciences, Dublin, Ireland
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin School of Medicine, Dublin 2, Ireland
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin School of Medicine, Dublin 2, Ireland
| | - Aisling A Geraghty
- School of Agriculture and Food Science, University College Dublin College of Health Sciences, Dublin, Ireland
- UCD Perinatal Research Centre, National Maternity Hospital, University College Dublin School of Medicine, Dublin 2, Ireland
| | - Christy Burden
- Academic Women's Health Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Anna Davies
- Academic Women's Health Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
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4
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Jacobson LT, Wolfe M, Zackula R, Okut H, Hampton FE, Grainger DA, Griebel-Thompson AK, Ling Kong K, Befort C. Electronic Monitoring Of Mom's Schedule (eMOMS TM): Recruitment of pregnant populations with elevated BMI in a feasibility randomized controlled trial. Prev Med Rep 2023; 34:102254. [PMID: 37292426 PMCID: PMC10244679 DOI: 10.1016/j.pmedr.2023.102254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/27/2023] [Accepted: 05/19/2023] [Indexed: 06/10/2023] Open
Abstract
Underrepresentation of pregnant populations in randomized controlled trials of lifestyle change interventions is concerning due to high attrition and providers' limited clinical time. The purpose of this evaluative study was to assess intervention uptake of pregnant individuals enrolled in a three-arm feasibility randomized controlled trial, electronic Monitoring Of Mom's Schedule (eMOMSTM), examining lifestyle changes and lactation support alone, and in combination. Measures included: (1) participation and completion rates, and characteristics of intervention completers versus other eligible participants; and (2) provider experiences with screening and enrolling pregnant participants. Pregnant people with a pre-pregnancy body mass index ≥ 25 and < 35 kg/m2 were enrolled into the eMOMSTM trial between September 2019 - December 2020. Of the 44 consented participants, 35 were randomized, at a participation rate of 35%, and 26 completed the intervention, resulting in a completion rate of 74%. Intervention completers were slightly older and entered the study earlier in pregnancy compared to non-completers. Completers were more likely to be first-time mothers, resided in urban areas, had higher educational attainment, and were slightly more racially and ethnically diverse. A majority of providers reported willingness to participate, believed the study aligned with their organization's mission, and were satisfied with using iPads for screening. Lessons learned to guide recruitment success include use of: (1) designated research staff in combination with physician support; and (2) user-friendly technology to help mitigate time burden on physicians and their staff. Future work should focus on successful strategies to recruit/retain pregnant populations in clinical trials.
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Affiliation(s)
- Lisette T. Jacobson
- University of Kansas School of Medicine-Wichita, Department of Population Health, 1010 North Kansas, Wichita, KS 67214, USA
- University of Kansas School of Medicine-Wichita, Department of Obstetrics and Gynecology, 1010 North Kansas, Wichita, KS 67214, USA
| | - Michael Wolfe
- Ascension Via Christi Hospitals Wichita, Inc., Ascension Via Christi Maternal Fetal Medicine Clinic, 1515 South Clifton Avenue, Suite 130, Wichita, KS 67218, USA
| | - Rosey Zackula
- University of Kansas School of Medicine-Wichita, Office of Research, 1010 North Kansas, Wichita, KS 67214, USA
| | - Hayrettin Okut
- University of Kansas School of Medicine-Wichita, Department of Population Health, 1010 North Kansas, Wichita, KS 67214, USA
- University of Kansas School of Medicine-Wichita, Office of Research, 1010 North Kansas, Wichita, KS 67214, USA
| | - Faith E. Hampton
- University of Kansas School of Medicine-Wichita, Department of Population Health, 1010 North Kansas, Wichita, KS 67214, USA
| | - David A. Grainger
- University of Kansas School of Medicine-Wichita, Department of Obstetrics and Gynecology, 1010 North Kansas, Wichita, KS 67214, USA
| | - Adrianne K. Griebel-Thompson
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Kai Ling Kong
- Baby Health Behavior Lab, Division of Health Services and Outcomes Research, Children’s Mercy Research Institute, Children’s Mercy Hospital, Kansas City, MO 64108, USA
| | - Christie Befort
- University of Kansas School of Medicine-Kansas City, Department of Population Health, 3901 Rainbow Boulevard, Mailstop 1003, Kansas City, KS 66160, USA
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Lewandowski S, Neale E, D'Arcy E, Hodge AM, Schoenaker DAJM. Quality of low-carbohydrate diets among Australian post-partum women: Cross-sectional analysis of a national population-based cohort study. MATERNAL & CHILD NUTRITION 2023:e13502. [PMID: 36938942 DOI: 10.1111/mcn.13502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Revised: 02/17/2023] [Accepted: 03/01/2023] [Indexed: 03/21/2023]
Abstract
Low-carbohydrate diets (LCDs) are popular among people attempting weight loss and recommended for pregnant women with gestational diabetes (GDM), but they may increase health risks if nutritionally inadequate. We aimed to describe the dietary intake of post-partum women according to their relative carbohydrate intake, overall, and among women attempting weight loss or diagnosed with GDM in their recent pregnancy. This cross-sectional population-based cohort study included 2093 post-partum women aged 25-36 years who participated in the Australian Longitudinal Study on Women's Health. Dietary intake was assessed using a validated food frequency questionnaire. Relative carbohydrate intake was determined using a previously developed LCD score. Data were weighted to account for oversampling of women from rural/remote areas. More than half of women (n[weighted] = 1362, 66.3%) were trying to lose weight, and 4.6% (n[weighted]=88) had GDM in their recent pregnancy. Women with the lowest relative carbohydrate intake (LCD score quartile 4) consumed 36.8% of total energy intake from carbohydrates, and had a lower intake of refined grains, whole grains, fruit and fruit juice, and a higher intake of red and processed meat, compared with women with the highest relative carbohydrate intake (quartile 1). Different food groups, both healthy and unhealthy, were restricted depending on whether women were attempting weight loss and had recent GDM. These findings may reflect a lack of knowledge among post-partum women on carbohydrates and dietary guidelines. Health professionals may have an important role in providing advice and support for post-partum women who wish to restrict their carbohydrate intake, to ensure optimal diet quality.
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Affiliation(s)
- Sophie Lewandowski
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Elizabeth Neale
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Ellie D'Arcy
- Integrated Care, Western New South Wales Local Health District, New South Wales, Dubbo, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Danielle A J M Schoenaker
- School of Medical, Indigenous and Health Sciences, University of Wollongong, Wollongong, New South Wales, Australia.,School of Primary Care, Population Sciences and Medical Education, University of Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
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Affiliation(s)
- Edoardo Aromataris
- JBI, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
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Chen F, Wang P, Wang J, Liao Z, Zong X, Chen Y, Lai J, Zhang T, Liu G, Xie X. Analysis and Comparison of Early Childhood Nutritional Outcomes Among Offspring of Chinese Women Under the Chinese 2021 and US 2009 Gestational Weight Gain Guidelines. JAMA Netw Open 2022; 5:e2233250. [PMID: 36149650 PMCID: PMC9508653 DOI: 10.1001/jamanetworkopen.2022.33250] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IMPORTANCE In 2009, the US National Academy of Medicine (NAM) released revised gestational weight gain (GWG) guidelines, which were established primarily for White North American women and may be unsuitable for Asian women. In 2021, the Chinese Nutrition Society (CNS) released its GWG guidelines, but their applicability requires re-examination. OBJECTIVE To compare the differences between the CNS and NAM recommendations for GWG in association with health outcomes in the offspring of Chinese women. DESIGN, SETTING, AND PARTICIPANTS In this bidirectional cohort study, children in China were recruited at age 3 years from 2017 to 2018, with 2 follow-up visits over the next 2 years (between September 2017 and September 2020). Information during pregnancy was retrieved from medical records. Data analysis was performed from October 2021 to January 2022. MAIN OUTCOMES AND MEASURES GWG was classified as insufficient, appropriate, or excessive according to the CNS and NAM guidelines separately. Children's height, weight, fat mass, fat-free mass, and percentage of body fat were measured at each visit. Body mass index, fat mass index, fat-free mass index, weighted κ score, risk ratio values, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. RESULTS A total of 3822 children (1996 boys and 1826 girls; mean [SD] age, 3.79 [0.30] years) were enrolled; after exclusions, 3170 term singleton children were recruited and were followed at 4 and 5 years of age. According to the CNS guidelines, the prevalence rates were 14.1% for insufficient GWG, 48.1% for appropriate GWG, and 37.9% for excessive GWG, whereas the rates according to NAM guidelines were 39.7% for insufficient GWG, 37.2% for appropriate GWG, and 23.1% for excessive GWG. The weighted κ value for the classification agreement between the 2 guidelines was 0.530 (95% CI, 0.510-0.550). For the appropriate GWG group, the rates for low nutritional levels did not differ between the 2 guidelines, but the rates for high nutritional levels were significantly lower under CNS guidelines than under NAM guidelines. When the sensitivity, specificity, PPV, and NPV with respect to the mothers who maintained appropriate GWG were used to estimate the nonhigh nutritional status of their offspring, generally higher values based on the CNS guidelines were found compared with those based on the NAM recommendations. CONCLUSIONS AND RELEVANCE These findings suggest that the GWG recommendations promulgated by the NAM are higher than the CNS guidelines, with the latter more suitable for Chinese women.
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Affiliation(s)
| | - Peng Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Jing Wang
- Tianjin Women’s and Children’s Health Center, Tianjin, China
| | - Zijun Liao
- Capital Institute of Pediatrics, Beijing, China
| | - Xinnan Zong
- Capital Institute of Pediatrics, Beijing, China
| | - Yiren Chen
- Capital Institute of Pediatrics, Beijing, China
| | - Jianqiang Lai
- National Institute of Nutrition and Health, Chinese Centre for Disease Control and Prevention, Beijing, China
| | - Ting Zhang
- Capital Institute of Pediatrics, Beijing, China
| | - Gongshu Liu
- Tianjin Women’s and Children’s Health Center, Tianjin, China
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8
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Liu J, Wilcox S, Hutto B, Turner‐McGrievy G, Wingard E. Effects of a lifestyle intervention on postpartum weight retention among women with elevated weight. Obesity (Silver Spring) 2022; 30:1370-1379. [PMID: 35722816 PMCID: PMC9307422 DOI: 10.1002/oby.23449] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 03/22/2022] [Accepted: 03/24/2022] [Indexed: 12/22/2022]
Abstract
OBJECTIVE The effectiveness of a pregnancy and postpartum behavioral lifestyle intervention on postpartum weight retention was examined. METHODS Pregnant women with overweight and obesity in South Carolina were recruited into a theory-based randomized controlled trial (n = 112 intervention, n = 107 standard care), which was designed to reduce gestational weight gain and postpartum weight retention. RESULTS Participants (44% African American, 56% White) had a mean prepregnancy BMI of 32.3 kg/m2 and were at 12.6 weeks' gestation at baseline. From prepregnancy to 6 months post partum, intervention participants retained less weight than standard care women (mean difference: -3.6 kg, 95% CI: -5.5 to -1.8). The intervention effect was maintained at 12 months post partum (mean difference: -2.4 kg, 95% CI: -4.3 to -0.5). Intervention women had 2.3 times higher odds of having no weight retention at 6 months post partum versus standard care women (95% CI: 1.2 to 4.4). Intervention participants also had lower odds of retaining ≥5% of their prepregnancy weight after delivery (adjusted odds ratio: 0.3, 95% CI: 0.1 to 0.5 at 6 months; adjusted odds ratio: 0.3, 95% CI: 0.2 to 0.6 at 12 months). CONCLUSION This theory-based lifestyle intervention resulted in significantly less weight retention at 6 and 12 months after delivery among pregnant women with overweight and obesity.
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Affiliation(s)
- Jihong Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Sara Wilcox
- Prevention Research Center, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
- Department of Exercise Science, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Brent Hutto
- Prevention Research Center, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Gabrielle Turner‐McGrievy
- Department of Health Promotion, Education, and Behavior, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
| | - Ellen Wingard
- Prevention Research Center, Arnold School of Public HealthUniversity of South CarolinaColumbiaSouth CarolinaUSA
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"There's a Lot of Like, Contradicting Stuff"-Views on Healthy Living during Pregnancy and Postpartum. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19105849. [PMID: 35627385 PMCID: PMC9140655 DOI: 10.3390/ijerph19105849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 11/17/2022]
Abstract
The transition from pregnancy through early postpartum can be a particularly vulnerable time for women as they adjust to the changes of motherhood. This study aimed to provide a detailed account of additional health challenges that mothers are facing throughout motherhood during the pandemic. Data obtained can be utilized to create tailored interventions to aid women during their reproductive years. A sequential approach was utilized, collecting health-related information via survey and subsequent focus groups or interviews to further examine health experiences during pregnancy or postpartum. Fifty-seven participants completed the online survey, 73.5% were postpartum. The healthy eating index of the cohort was low, 50.5 ± 10.3%. Prior to pregnancy, 54.5% were classified as overweight/obese. Following pregnancy, 71.1% were classified as overweight or obese. Emergent qualitative themes from focus groups (n = 3) and interviews (n = 6) included (1) value and desire for healthy eating, (2) desire to make well-informed health-based decisions, and (3) role of social networks during pregnancy and postpartum. Pregnant/postpartum women desire to lead a healthy lifestyle but experience barriers to accomplishing intended goals. Upstream resources and policies that promote healthy living for pregnant/postpartum women can reduce chronic disease throughout the lifespan following childbirth.
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Chen Y, Qin Y, Zhang Z, Huang S, Jiao C, Zhang Z, Bao W, Mao L. Association of the low-carbohydrate dietary pattern with postpartum weight retention in women. Food Funct 2021; 12:10764-10772. [PMID: 34609398 DOI: 10.1039/d1fo00935d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Low-carbohydrate diets (LCD) have been considered a popular dietary strategy for weight loss. However, the association of the low-carbohydrate dietary pattern with postpartum weight retention (PPWR) in women remains unknown. The present study involved 426 women from a prospective mother-infant cohort study. Overall, animal or plant LCD scores, which represent adherence to different low-carbohydrate dietary patterns, were calculated using diet intake information assessed by three consecutive 24 h dietary surveys. PPWR was assessed by the difference of weight at 1 year postpartum minus the pre-pregnancy weight. After adjusting for potential confounding variables, women in higher quartiles of total and animal-based LCD scores had a significantly lower body weight and weight retention at 1 year postpartum (P < 0.05). The multivariable-adjusted ORs of substantial PPWR (≥5 kg), comparing the highest with the lowest quartile, were 0.47 (95% confidence interval 0.23-0.96) for the total LCD score (P = 0.021 for trend) and 0.38 (95% confidence interval 0.19-0.77) for the animal-based LCD score (P = 0.019 for trend), while this association was significantly attenuated by rice, glycemic load, fish, poultry, animal fat and animal protein (P for trend <0.05). A high score for plant-based LCD was not significantly associated with the risk of PPWR (P > 0.05). The findings suggested that a low-carbohydrate dietary pattern, particularly with high protein and fat intake from animal-source foods, is associated with a decreased risk of weight retention at 1 year postpartum. This association was mainly due to low intake of glycemic load and high intake of fish and poultry.
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Affiliation(s)
- Ying Chen
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
| | - Yuting Qin
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
| | - Zhiwei Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
| | - Shaoming Huang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
| | - Changya Jiao
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
| | - Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
| | - Wei Bao
- Department of Epidemiology, College of Public Health, University of Iowa, 145 North Riverside Drive, Room S431 CPHB, Iowa City, IA 52242, USA
| | - Limei Mao
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, Guangdong, P. R. China.
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11
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Fealy S, Leigh L, Hazelton M, Attia J, Foureur M, Oldmeadow C, Collins CE, Smith R, Hure AJ. Translation of the Weight-Related Behaviours Questionnaire into a Short-Form Psychosocial Assessment Tool for the Detection of Women at Risk of Excessive Gestational Weight Gain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189522. [PMID: 34574447 PMCID: PMC8472452 DOI: 10.3390/ijerph18189522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 11/16/2022]
Abstract
The identification and measurement of psychosocial factors that are specific to pregnancy and relevant to gestational weight gain is a challenging task. Given the general lack of availability of pregnancy-specific psychosocial assessment instruments, the aim of this study was to develop a short-form psychosocial assessment tool for the detection of women at risk of excessive gestational weight gain with research and clinical practice applications. A staged scale reduction analysis of the weight-related behaviours questionnaire was conducted amongst a sample of 159 Australian pregnant women participating in the Women and Their Children’s Health (WATCH) pregnancy cohort study. Exploratory factor analysis, univariate logistic regression, and item response theory techniques were used to derive the minimum and most predictive questions for inclusion in the short-form assessment tool. Of the total 49 questionnaire items, 11 items, all 4 body image items, n = 4 attitudes towards weight gain, and n = 3 self-efficacy items, were retained as the strongest predictors of excessive gestational weight gain. These within-scale items were highly correlated, exhibiting high item information function value statistics, and were observed to have high probability (p < 0.05) for excessive gestational weight gain, in the univariate analysis. The short-form questionnaire may assist with the development of tailored health promotion interventions to support women psychologically and physiologically to optimise their pregnancy weight gain. Confirmatory factor analysis is now required.
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Affiliation(s)
- Shanna Fealy
- School of Nursing, Paramedicine, and Healthcare Sciences, Faculty of Science and Health, Charles Sturt University, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia;
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.A.); (R.S.); (A.J.H.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- Correspondence:
| | - Lucy Leigh
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
| | - Michael Hazelton
- School of Nursing, Paramedicine, and Healthcare Sciences, Faculty of Science and Health, Charles Sturt University, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia;
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- School of Nursing and Midwifery, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
| | - John Attia
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.A.); (R.S.); (A.J.H.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
| | - Maralyn Foureur
- School of Nursing and Midwifery, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia;
- Hunter New England Health Nursing and Midwifery Research Centre, Newcastle, NSW 2300, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
| | - Clare E. Collins
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- School of Health Sciences, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Roger Smith
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.A.); (R.S.); (A.J.H.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
- Department of Endocrinology, John Hunter Hospital, Newcastle, NSW 2305, Australia
| | - Alexis J. Hure
- School of Medicine and Public Health, College of Health and Wellbeing, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; (J.A.); (R.S.); (A.J.H.)
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; (L.L.); (C.O.); (C.E.C.)
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12
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Adherence to the Mediterranean diet during pregnancy is associated with lower odds of excessive gestational weight gain and postpartum weight retention: results of the Mother-Infant Study Cohort. Br J Nutr 2021; 128:1401-1412. [PMID: 34294166 DOI: 10.1017/s0007114521002762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
During the first 1000 d of life, gestational weight gain (GWG) and postpartum weight retention (PPWR) are considered critical determinants of nutritional status. This study examined the effect of adherence to the Mediterranean diet (MD) during pregnancy on GWG and PPWR at 2 and 6 months among women in the United Arab Emirates (UAE), using data from the Mother-Infant Study Cohort. The latter is a prospective study, for which pregnant women were recruited (n 243) during their third trimester and were followed up for 18 months. Data on socio-demographic characteristics and anthropometric measurements were obtained. An eighty-six-item FFQ was used to examine dietary intake during pregnancy. Adherence to the MD was assessed using the alternate MD (aMED) and the Lebanese MD (LMD). Adherence to the MD, PPWR2 (2 months) and PPWR6 (6 months) were considered high if participants belonged to the third tertile of the respective measures. Results indicated that 57·5 % of participants had excessive GWG while 50·7 % and 45 % retained ≥ 5 kg at 2 and 6 months postpartum, respectively. After adjustment, adherence to both MD scores was associated with lower odds of excessive GWG (aMED, OR:0·41, 95 % CI:0·18, 0·93; LMD, OR:0·40, 95 % CI: 0·16, 0·98). Adherence to MD was also associated with PPWR2 (aMED: OR: 0·23, 95 % CI: 0·06, 0·88) and PPWR6 (aMED OR:0·26; 95 % CI:0·08-0·86; LMD, OR:0·32; 95 % CI: 0·1, 0·98). The findings of this study showed that adherence to the MD may reduce GWG and PPWR and, hence, underscored the importance of promoting the MD for better health of the mother and infant.
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Adaptive, behavioral intervention impact on weight gain, physical activity, energy intake, and motivational determinants: results of a feasibility trial in pregnant women with overweight/obesity. J Behav Med 2021; 44:605-621. [PMID: 33954853 DOI: 10.1007/s10865-021-00227-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
Interventions have modest impact on reducing excessive gestational weight gain (GWG) in pregnant women with overweight/obesity. This two-arm feasibility randomized control trial tested delivery of and compliance with an intervention using adapted dosages to regulate GWG, and examined pre-post change in GWG and secondary outcomes (physical activity: PA, energy intake: EI, theories of planned behavior/self-regulation constructs) compared to a usual care group. Pregnant women with overweight/obesity (N = 31) were randomized to a usual care control group or usual care + intervention group from 8 to 2 weeks gestation and completed the intervention through 36 weeks gestation. Intervention women received weekly evidence-based education/counseling (e.g., GWG, PA, EI) delivered by a registered dietitian in a 60-min face-to-face session. GWG was monitored weekly; women within weight goals continued with education while women exceeding goals received more intensive dosages (e.g., additional hands-on EI/PA sessions). All participants used mHealth tools to complete daily measures of weight (Wi-Fi scale) and PA (activity monitor), weekly evaluation of diet quality (MyFitnessPal app), and weekly/monthly online surveys of motivational determinants/self-regulation. Daily EI was estimated with a validated back-calculation method as a function of maternal weight, PA, and resting metabolic rate. Sixty-five percent of eligible women were randomized; study completion was 87%; 10% partially completed the study and drop-out was 3%. Compliance with using the mHealth tools for intensive data collection ranged from 77 to 97%; intervention women attended > 90% education/counseling sessions, and 68-93% dosage step-up sessions. The intervention group (6.9 kg) had 21% lower GWG than controls (8.8 kg) although this difference was not significant. Exploratory analyses also showed the intervention group had significantly lower EI kcals at post-intervention than controls. A theoretical, adaptive intervention with varied dosages to regulate GWG is feasible to deliver to pregnant women with overweight/obesity.
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Makama M, Skouteris H, Moran LJ, Lim S. Reducing Postpartum Weight Retention: A Review of the Implementation Challenges of Postpartum Lifestyle Interventions. J Clin Med 2021; 10:1891. [PMID: 33925502 PMCID: PMC8123857 DOI: 10.3390/jcm10091891] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/15/2021] [Accepted: 04/23/2021] [Indexed: 02/07/2023] Open
Abstract
Postpartum weight retention (PPWR) is a strong predictor of obesity in later life with long term health consequences in women. Suboptimal lifestyle behaviours (e.g., diet and physical activity) contribute to PPWR. Postpartum lifestyle interventions are known to be efficacious in reducing PPWR; however, there are challenges to their successful implementation. To inform implementation, this narrative review provides an overview of the factors that contribute to PPWR, the efficacy of existing postpartum lifestyle interventions and key determinants of effective implementation using the Consolidated Framework for Implementation Research (CFIR) across intervention characteristics, implementation process, individual characteristics and outer and inner setting. We then suggest strategies to improve the translation of evidence into large-scale interventions that deliver on health impact in postpartum women. We have identified gaps that need to be addressed to advance postpartum lifestyle research, including the involvement of postpartum women and community members as key stakeholders for optimal reach and engagement, more complete reporting of intervention characteristics to optimize translation of evidence into practice, capacity building of health professionals and guidelines for postpartum lifestyle management.
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Affiliation(s)
- Maureen Makama
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
| | - Helen Skouteris
- Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
| | - Lisa J. Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
| | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC 3168, Australia;
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The Effectiveness of Smoking Cessation, Alcohol Reduction, Diet and Physical Activity Interventions in Improving Maternal and Infant Health Outcomes: A Systematic Review of Meta-Analyses. Nutrients 2021; 13:nu13031036. [PMID: 33806997 PMCID: PMC8005204 DOI: 10.3390/nu13031036] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/15/2021] [Accepted: 03/19/2021] [Indexed: 12/30/2022] Open
Abstract
Diet, physical activity, smoking and alcohol behaviour-change interventions delivered in pregnancy aim to prevent adverse pregnancy outcomes. This review reports a synthesis of evidence from meta-analyses on the effectiveness of interventions at reducing risk of adverse health outcomes. Sixty-five systematic reviews (63 diet and physical activity; 2 smoking) reporting 602 meta-analyses, published since 2011, were identified; no data were identified for alcohol interventions. A wide range of outcomes were reported, including gestational weight gain, hypertensive disorders, gestational diabetes (GDM) and fetal growth. There was consistent evidence from diet and physical activity interventions for a significantly reduced mean gestational weight gain (ranging from -0.21 kg (95% confidence interval -0.34, -0.08) to -5.77 kg (95% CI -9.34, -2.21). There was evidence from larger diet and physical activity meta-analyses for a significant reduction in postnatal weight retention, caesarean delivery, preeclampsia, hypertension, GDM and preterm delivery, and for smoking interventions to significantly increase birth weight. There was no statistically significant evidence of interventions having an effect on low or high birthweight, neonatal intensive care unit admission, Apgar score or mortality outcomes. Priority areas for future research to capitalise on pregnancy as an opportunity to improve the lifelong wellbeing of women and their children are highlighted.
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A Revalidation of the Weight Related Behaviours Questionnaire within an Australian Pregnancy Cohort. Midwifery 2021; 97:102951. [PMID: 33677171 DOI: 10.1016/j.midw.2021.102951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 07/17/2020] [Accepted: 02/10/2021] [Indexed: 11/23/2022]
Abstract
PROBLEM Studies investigating the direct and indirect relationships between psychosocial factors (i.e. attitudes, beliefs and values), health related behaviour (diet and physical activity) and gestational weight gain are increasing. To date heterogeneity of psychosocial measurement tools has limited research progress in this area, preventing measurement of effects by meta-analysis techniques. AIM To conduct a revalidation analysis of a Weight Related Behaviours Questionnaire, originally developed by Kendall, Olson and Frangelico within the United States of America and assess its performance for use within the Australian context. METHODS A revalidation study using Exploratory Factor Analysis was undertaken to assess the factor structure and internal consistency of the six psychosocial scales of the Weight Related Behaviours Questionnaire, within the Woman and Their Children's Health (WATCH), pregnancy cohort. The questionnaire was self-completed between 18 - 20 weeks gestation. Psychosocial factors included; Weight locus of control; Self-efficacy; Attitudes towards weight gain; Body image, Feelings about the motherhood role; and Career orientation. FINDINGS Weight locus of control, Self-efficacy and Body image, retained the same factor structure as the original analysis. The remaining psychosocial factors observed a different factor structure in terms of loadings or number of factors. Deleted items modelling suggests the questionnaire could be strengthened and shortened. CONCLUSION Weight Locus of control, Self-efficacy and Body image were observed as consistent, valid and reliable psychosocial measures for use within the Australian context. Further research is needed to confirm the model and investigate the potential for combining these scales into a shorter psychosocial measurement tool.
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Fealy S, Attia J, Leigh L, Oldmeadow C, Hazelton M, Foureur M, Collins CE, Smith R, Hure A. Demographic and social-cognitive factors associated with gestational weight gain in an Australian pregnancy cohort. Eat Behav 2020; 39:101430. [PMID: 32942238 DOI: 10.1016/j.eatbeh.2020.101430] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 08/19/2020] [Accepted: 09/01/2020] [Indexed: 01/01/2023]
Abstract
AIM To identify and describe the demographic and social-cognitive factors associated with excessive gestational weight gain using the Weight-Related Behaviours Questionnaire, within an Australian pregnancy cohort. BACKGROUND Supporting women to achieve optimal weight gain in pregnancy is complex. Social-cognitive factors are recognised antecedents to, and mediators of, weight related behaviour change. Less is known about their role during pregnancy. METHODS 159 women enrolled in a pregnancy cohort study completed the Weight-Related Behaviours Questionnaire (WRBQ) at approximately 19 weeks gestation, and total gestational weight gain was later measured at 36 weeks. Summary scores were reported descriptively. Multivariable logistic regression was used to test demographic (maternal age, pre pregnancy body mass index, parity, smoking status, marital status, education) and social-cognitive factors (weight locus of control, self- efficacy, attitudes towards weight gain, body image, feelings about motherhood, career orientation) as predictors of excessive gestational weight gain. FINDINGS Maternal age was the sole demographic factor predictive of excessive gestational weight gain. Older participants (34-41 yrs) were less likely to gain excessive weight when compare to younger participants (18-24 yrs): Odds Ratio 0.20, 95% Confidence Interval 0.05, 0.82. Body image (measured as personal satisfaction and perception of own weight) was the sole social-cognitive factor associated with excessive gestational weight gain. For every one unit improvement in body image score, there was a 33% decreased odds of excessive gestational weight gain (OR 0.67, 95% CI 0.53, 0.85). CONCLUSION This study suggests that younger maternal age and lower perceived body image are predictive of excessive gestational weight gain.
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Affiliation(s)
- Shanna Fealy
- Charles Sturt University, Faculty of Science, School of Nursing, Midwifery and Indigenous Health, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia; University of Newcastle, Faculty of Health and Medicine, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia; University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia.
| | - John Attia
- University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Lucy Leigh
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
| | - Michael Hazelton
- Charles Sturt University, Faculty of Science, School of Nursing, Midwifery and Indigenous Health, 7 Major Innes Road, Port Macquarie, NSW 2444, Australia; University of Newcastle, Faculty of Health and Medicine, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; Priority Research Centre for Brain and Mental Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia
| | - Maralyn Foureur
- University of Newcastle, Faculty of Health and Medicine, School of Nursing and Midwifery, University Drive, Callaghan, NSW 2308, Australia; Hunter New England Health Nursing and Midwifery Research Centre, Australia
| | - Clare E Collins
- University of Newcastle, Faculty of Health and Medicine, School of Health Sciences, University Drive, Callaghan, NSW 2308, Australia; Priority Research Centre in Physical Activity and Nutrition, University of Newcastle, Ring Road, Callaghan, NSW 2308, Australia
| | - Roger Smith
- University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia; University of Newcastle Priority Research Centre for Reproductive Science, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia; Department of Endocrinology, John Hunter Hospital, Newcastle, NSW, Australia
| | - Alexis Hure
- University of Newcastle, Faculty of Health and Medicine, School of Medicine and Public Health, University Drive, Callaghan, NSW 2308, Australia; Hunter Medical Research Institute, Lot 1 Kookaburra Circuit, New Lambton Heights, NSW 2305, Australia
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Hutchesson MJ, Taylor R, Shrewsbury VA, Vincze L, Campbell LE, Callister R, Park F, Schumacher TL, Collins CE. Be Health e for Your Heart: A Pilot Randomized Controlled Trial Evaluating a Web-Based Behavioral Intervention to Improve the Cardiovascular Health of Women with a History of Preeclampsia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165779. [PMID: 32785044 PMCID: PMC7459885 DOI: 10.3390/ijerph17165779] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 08/06/2020] [Accepted: 08/07/2020] [Indexed: 01/07/2023]
Abstract
This pilot randomized controlled trial (RCT) aimed to determine the acceptability and preliminary efficacy of a web-based cardiovascular disease (CVD) prevention intervention for women following preeclampsia. Australian women with a recent history (≤4 years post diagnosis) of preeclampsia were randomized into two study arms: (1) Be Healthe for your Heart, a web-based behavioral intervention or; (2) Control, access to the National Heart Foundation website. Assessments were conducted at baseline, and after three months. Intervention acceptability and impact on absolute CVD 30-year risk score, CVD risk markers and health behaviors were assessed. Twenty-four of 31 (77.4%) women completed the three-month assessment. Eleven out of 13 intervention participants (84.6%) agreed/strongly agreed they were satisfied with the program, with a mean score of 4.2 ± 0.9 (maximum of five). There were no significant between or within group differences in absolute CVD risk, CVD risk markers or health behaviors from baseline to three months. Women with a history of preeclampsia were successfully recruited and retained and they reported high levels of acceptability with the Be Healthe for your Heart program. Further research is therefore needed from powered trials to determine the impact of web-based lifestyle interventions on CVD risk in this at-risk group.
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Affiliation(s)
- Melinda J. Hutchesson
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.T.); (V.A.S.); (T.L.S.); (C.E.C.)
- Correspondence:
| | - Rachael Taylor
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.T.); (V.A.S.); (T.L.S.); (C.E.C.)
| | - Vanessa A. Shrewsbury
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.T.); (V.A.S.); (T.L.S.); (C.E.C.)
| | - Lisa Vincze
- School of Allied Health Sciences & Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD 4222, Australia;
| | - Linda E. Campbell
- School of Psychology, Faculty of Science, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Robin Callister
- Priority Research Centre for Physical Activity and Nutrition, School of Biomedical Sciences and Pharmacy, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia;
| | - Felicity Park
- Department of Maternal Foetal Medicine, John Hunter Hospital, Newcastle, NSW 2305, Australia;
| | - Tracy L. Schumacher
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.T.); (V.A.S.); (T.L.S.); (C.E.C.)
- Priority Research Centre for Health Behaviours, Department of Rural Health, Faculty of Health and Medicine, University of Newcastle, Tamworth, NSW 2340, Australia
| | - Clare E. Collins
- Priority Research Centre for Physical Activity and Nutrition, School of Health Sciences, Faculty of Health and Medicine, The University of Newcastle, Callaghan, NSW 2308, Australia; (R.T.); (V.A.S.); (T.L.S.); (C.E.C.)
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19
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Li N, Su X, Liu T, Sun J, Zhu Y, Dai Z, Zhang Y, Pan L, Jiang W, Zhu W. Dietary patterns of Chinese puerperal women and their association with postpartum weight retention: Results from the mother-infant cohort study. MATERNAL AND CHILD NUTRITION 2020; 17:e13061. [PMID: 33135839 PMCID: PMC7729653 DOI: 10.1111/mcn.13061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 06/05/2020] [Accepted: 06/17/2020] [Indexed: 12/12/2022]
Abstract
Dietary intake may affect maternal health, but it remains unclear about puerperal dietary intake and its association with maternal health. This study investigated the dietary patterns and their related factors and association with postpartum weight retention (PPWR) in Chinese puerperal women. Participants were from the mother-infant cohort study, in which both mothers and infants were followed up from childbirth to the next 2 years, in seven cities around China. Maternal puerperal dietary patterns were derived by a food frequency questionnaire and principal component analysis (PCA) within 1 month postpartum. PPWR was assessed by the difference of weight at 42 days and 6 months postpartum minus the pre-pregnancy weight. Of 503 postpartum women, four dietary patterns were identified, including 'plant food' pattern (rice and vegetables as dominant foods), 'diverse' pattern (starchy roots, fruit, livestock meat and aquatic products), 'traditional northern' pattern (poultry, eggs and soup) and 'marine-flour' pattern (flour, coarse food grains and marine fish). The diverse pattern was associated with professional puerperal family care and counselling service (p < .05). PPWRs at 42 days and 6 months postpartum were 6.37 and 4.70 kg averagely. The plant food dietary pattern tended to be associated with higher 42-day PPWR (β = .105, p < .05), and diverse pattern was associated with lower 6-months PPWR (β = -.137, p < .05). Conclusively, this study presented four dominant dietary patterns in Chinese postpartum women and showed a lower PPWR in adherence to diverse dietary pattern. The results would provide evidence to furtherly guide dietary practice and improve maternal health.
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Affiliation(s)
- Niuniu Li
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Xiao Su
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Tan Liu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Jing Sun
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Yimin Zhu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
| | - Zhiyong Dai
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Yanchun Zhang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Lina Pan
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Wei Jiang
- Peking-Ausnutria Maternal and Infant Nutrition Research Center, Peking University, Beijing, China
| | - Wenli Zhu
- Department of Nutrition and Food Hygiene, Peking University School of Public Health, Beijing, China.,National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China
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20
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Hutchesson MJ, de Jonge Mulock Houwer M, Brown HM, Lim S, Moran LJ, Vincze L, Rollo ME, Hollis JL. Supporting women of childbearing age in the prevention and treatment of overweight and obesity: a scoping review of randomized control trials of behavioral interventions. BMC Womens Health 2020; 20:14. [PMID: 31973716 PMCID: PMC6979060 DOI: 10.1186/s12905-020-0882-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 01/10/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity. METHODS Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15-44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes. RESULTS Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain (n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention (n = 18 RCTs) or a combination of the two (n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors (n = 84) and were delivered in-person (n = 85). CONCLUSIONS This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.
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Affiliation(s)
- Melinda J Hutchesson
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, New South Wales, Australia.
| | - Mette de Jonge Mulock Houwer
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Division of Human Nutrition and Health, Wageningen University, Wageningen, The Netherlands
| | - Hannah M Brown
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Siew Lim
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Lisa J Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, Victoria, Australia
| | - Lisa Vincze
- School of Allied Health Science, Griffith University, Gold Coast, Queensland, Australia
| | - Megan E Rollo
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
| | - Jenna L Hollis
- School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, University of Newcastle, University Drive, Callaghan, New South Wales, Australia
- Hunter New England Population Health, Longworth Avenue, Wallsend, Australia
- School of Medicine and Public Health, The University of Newcastle, Callaghan, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, New South Wales, Australia
- Hunter Medical Research Institute, New Lambton Heights, NSW, Australia
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21
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Schünemann HJ, Santesso N, Brozek JL. Interactive Summary of Findings tables. ACTA ACUST UNITED AC 2019; 17:259-260. [DOI: 10.11124/jbisrir-d-19-00059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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