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Donofry SD, Jouppi RJ, Call CC, Kolko Conlon RP, Levine MD. Improvements in Maternal Cardiovascular Health Over the Perinatal Period Longitudinally Predict Lower Postpartum Psychological Distress Among Individuals Who Began Their Pregnancies With Overweight or Obesity. J Am Heart Assoc 2024; 13:e034153. [PMID: 38874183 PMCID: PMC11255758 DOI: 10.1161/jaha.123.034153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 05/15/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Adverse cardiovascular events during pregnancy (eg, preeclampsia) occur at higher rates among individuals with overweight or obesity (body mass index ≥25 kg/m2) and have been associated with postpartum depression. The present study examined whether changes in cardiovascular health (CVH) during the perinatal period, as defined by the American Heart Association's Life's Essential 8 framework, predicted postpartum psychological functioning among individuals with prepregnancy body mass index ≥25 kg/m2. METHODS AND RESULTS Pregnant individuals (N = 226; mean ± SD age = 28.43 ± 5.4 years; mean body mass index = 34.17 ± 7.15 kg/m2) were recruited at 12 to 20 weeks of gestation (mean, 15.64 ± 2.45 weeks) for a longitudinal study of health and well-being. Participants completed ratings of depression and perceived stress and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6 months postpartum. Body mass index and CVH behaviors were used to calculate a composite CVH score at both time points. Linear regression analyses were performed to examine whether change in CVH related to postpartum symptom scores. Because sleep was measured in only a subset of participants (n = 114), analyses were conducted with and without sleep. Improved CVH was associated with lower postpartum depression (β = -0.18, P<0.01) and perceived stress (β = -0.13, P=0.02) scores. However, when including sleep, these relationships were no longer significant (all P>0.4). CONCLUSIONS Improvements in CVH from early pregnancy to 6 months postpartum were associated with lower postpartum depressive symptoms and perceived stress but not when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.
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Affiliation(s)
- Shannon D. Donofry
- RANDPittsburghPA
- Department of PsychologyUniversity of PittsburghPittsburghPA
| | - Riley J. Jouppi
- Department of PsychologyUniversity of PittsburghPittsburghPA
| | - Christine C. Call
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
| | | | - Michele D. Levine
- Department of PsychologyUniversity of PittsburghPittsburghPA
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPA
- Department of Obstetrics, Gynecology, and Reproductive SciencesUniversity of PittsburghPittsburghPA
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Donofry SD, Jouppi RJ, Call CC, Conlon RPK, Levine MD. Improvements in cardiovascular health over the perinatal period predicts lower postpartum psychological distress. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.22.23300475. [PMID: 38234856 PMCID: PMC10793538 DOI: 10.1101/2023.12.22.23300475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Background Adverse cardiovascular events during pregnancy (e.g., pre-eclampsia) occur at higher rates among individuals with pre-pregnancy overweight or obesity (body mass index [BMI]≥25kg/m2) and have been associated with postpartum depression. However, it is unclear whether cardiovascular health (CVH), defined more holistically than the absence of cardiovascular conditions in pregnancy, relates to postpartum psychological functioning. The present study examined whether changes in CVH during the perinatal period predicted postpartum psychological functioning among individuals with pre-pregnancy BMI≥25kg/m2. Methods Individuals (N=226; Mage=28.43±5.4 years; MBMI=34.17±7.15kg/m2) were recruited when their pregnancies were 12-20 weeks gestation (M=15.64±2.45 weeks) for a longitudinal study of health and well-being. Participants completed the Center for Epidemiological Studies Depression Scale (CES-D) and Perceived Stress Scale (PSS) and reported on CVH behaviors (dietary intake, physical activity, nicotine exposure, and sleep) at baseline and at 6-months postpartum. BMI and CVH behaviors were coded according to the American Heart Association's Life's Essential 8 to create a CVH score at both timepoints. Linear regression analyses were performed to examine whether change in CVH related to postpartum CES-D and PSS scores. Because sleep was only measured in a subset of participants (n=114), analyses were conducted with and without sleep included. Baseline CVH, CES-D and PSS scores, and demographic factors were included as covariates in all models. Results Improved CVH was associated with lower postpartum CES-D (β=-0.18, p<0.01) and PSS (β=-0.13, p=0.02) scores when excluding sleep. Compared to those whose CVH improved by >1SD from pregnancy to 6-months postpartum, individuals whose CVH worsened by >1SD scored 6.42 points higher on the CESD (MCESD=15.25±10.92 vs. 8.52±6.90) and 6.12 points higher on the PSS (MPSS=24.45±8.29 vs. 17.83±8.70). However, when including sleep, these relationships were no longer significant (ps>0.4). Conclusions Improvements in CVH from early pregnancy to 6-months postpartum were associated with lower postpartum depressive symptoms and perceived stress. However, these relationships were no longer significant when including sleep in the CVH metric, potentially due to the large reduction in sample size. These data suggest that intervening during pregnancy to promote CVH may improve postpartum psychological functioning among high-risk individuals.
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Affiliation(s)
- Shannon D. Donofry
- RAND Corporation, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Riley J. Jouppi
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Christine C. Call
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
| | | | - Michele D. Levine
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA
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Sámano R, Martínez-Rojano H, Ortiz-Hernández L, Nájera-Medina O, Chico-Barba G, Gamboa R, Mendoza-Flores ME. Individual, Family, and Social Factors Associated with Gestational Weight Gain in Adolescents: A Scoping Review. Nutrients 2023; 15:nu15061530. [PMID: 36986260 PMCID: PMC10058126 DOI: 10.3390/nu15061530] [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] [Received: 02/12/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
About 56% to 84% of pregnant adolescents have inappropriate (insufficient or excessive) gestational weight gain (GWG); however, the factors associated with GWG in this age group have not been systematically identified. This scoping review aimed to synthesize the available scientific evidence on the association of individual, family, and social factors with inappropriate gestational weight gain in pregnant adolescents. To carry out this review, the MEDLINE, Scopus, Web of Science, and Google Scholar databases were searched for articles from recent years. The evidence was organized according to individual, family, and social factors. The analyzed studies included 1571 adolescents from six retrospective cohorts, 568 from three prospective cohorts, 165 from a case-control study, 395 from a cross-sectional study, and 78,001 from two national representative samples in the USA. At the individual level, in approximately half of the studies, the pre-pregnancy body mass index (pBMI) was positively associated with the GWG recommended by the Institute of Medicine of the USA (IOM). The evidence was insufficient for the other factors (maternal age, number of deliveries, and family support) to determine an association. According to the review, we concluded that pBMI was positively associated with the GWG. More quality studies are needed to assess the association between GWG and individual, family, and social factors.
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Affiliation(s)
- Reyna Sámano
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
| | - Hugo Martínez-Rojano
- Sección de Posgrado e Investigación de la Escuela Superior de Medicina del Instituto Politécnico Nacional, Mexico City 11340, Mexico
| | - Luis Ortiz-Hernández
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Departamento de Atención a la Salud, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Oralia Nájera-Medina
- Programa de Posgrado Doctorado en Ciencias Biológicas y de la Salud, División de Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana, Mexico City 04960, Mexico
- Departamento de Atención a la Salud, Ciencias Biológicas y de la Salud, Universidad Autónoma Metropolitana-Xochimilco, Mexico City 04960, Mexico
| | - Gabriela Chico-Barba
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
- Programa de Maestría y Doctorado en Ciencias Médicas, Odontológicas y de la Salud, Universidad Nacional Autónoma de México, Mexico City 04510, Mexico
| | - Ricardo Gamboa
- Departamento de Fisiología, Instituto Nacional de Cardiología, Mexico City 14080, Mexico
| | - María Eugenia Mendoza-Flores
- Coordinación de Nutrición y Bioprogramación, Instituto Nacional de Perinatología, Secretaría de Salud, Mexico City 11000, Mexico
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Waselewski M, Plegue M, Sonneville K, Resnicow K, Ghumman A, Ebbeling C, Mahmoudi E, Sen A, Wolfson JA, Chang T. Grocery Delivery to Support Healthy Weight Gain Among Pregnant Young Women With Low Income: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40568. [PMID: 35930351 PMCID: PMC9391971 DOI: 10.2196/40568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Excessive weight gain during pregnancy is associated with complications for both the mother and her infant including gestational diabetes, hypertensive disorders, operative delivery, and long-term obesity. A healthy diet during pregnancy promotes healthy gestational weight gain and determines fetal epigenetic programming in infants that impacts risk for future chronic disease. OBJECTIVE This project will examine the impact of grocery delivery during pregnancy on the weight, diet, and health outcomes of young pregnant women and their infants. METHODS A three-arm randomized controlled trial design will be performed. A total of 855 young pregnant women, aged 14-24 years, from across the state of Michigan will be enrolled and randomized equally into the three study arms. Participants in arm one (control) will receive usual care from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC); arm two will receive WIC plus biweekly grocery delivery; and arm three will receive WIC plus biweekly grocery and unsweetened beverage delivery. Weight will be assessed weekly during pregnancy, and total pregnancy weight gain will be categorized as above, below, or within guidelines. Additionally, dietary intake will be assessed at three time points (baseline, second trimester, and third trimester), and pregnancy outcomes will be extracted from medical records. The appropriateness of pregnancy weight gain, diet quality, and occurrence of poor outcomes will be compared between groups using standard practices for multinomial regression and confounder adjustment. RESULTS This study was funded in April 2021, data collection started in December 2021, and data collection is expected to be concluded in 2026. CONCLUSIONS This study will test whether grocery delivery of healthy foods improves weight, diet, and pregnancy outcomes of young moms with low income. The findings will inform policies and practices that promote a healthy diet during pregnancy, which has multigenerational impacts on health. TRIAL REGISTRATION ClinicalTrials.gov NCT05000645; https://clinicaltrials.gov/ct2/show/NCT05000645. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/40568.
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Affiliation(s)
- Marika Waselewski
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Melissa Plegue
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Kendrin Sonneville
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Ken Resnicow
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
| | - Aisha Ghumman
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
| | - Cara Ebbeling
- New Balance Foundation Obesity Prevention Center, Boston Children's Hospital, Boston, MA, United States
- Department of Pediatrics, Harvard Medical School, Boston, MI, United States
| | - Elham Mahmoudi
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
| | - Ananda Sen
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, United States
| | - Julia A Wolfson
- School of Public Health, University of Michigan, Ann Arbor, MI, United States
- Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, United States
| | - Tammy Chang
- Department of Family Medicine, University of Michigan, Ann Arbor, MI, United States
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, United States
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Disordered Eating Behaviors Are Associated with Gestational Weight Gain in Adolescents. Nutrients 2021; 13:nu13093186. [PMID: 34579063 PMCID: PMC8470326 DOI: 10.3390/nu13093186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 09/01/2021] [Accepted: 09/07/2021] [Indexed: 11/26/2022] Open
Abstract
Disordered eating behaviors (DEBs) and adolescent pregnancy are public health problems. Among adolescents, there is little evidence concerning the relationship of DEB with gestational weight gain (GWG) and the birth weight and length of their offspring. We aimed to determine the association between DEB with GWG and the weight and length of adolescents’ offspring. We conducted a study with 379 participants. To evaluate DEB, we applied a validated scale. We identified three factors from DEB by factorial analysis: restrictive, compensatory, and binge–purge behaviors. The main events were GWG and offspring’s birth weight and length. We performed linear regression models. We found that 50% of adolescents have at least one DEB. Excessive and insufficient GWG were 37 and 34%, respectively. The median GWG was 13 kg; adolescents with restrictive behaviors had higher GWG (13 vs. 12 kg, p = 0.023). After adjusting for pregestational body mass index and other covariables, the restrictive (β = 0.67, p = 0.039), compensatory (β = 0.65, p = 0.044), and binge–purge behaviors (β = 0.54, p = 0.013) were associated with higher GWG. We did not find an association between the birth weight and length of newborns with DEB, and suggest that DEB is associated with GWG but not with the birth weight or length of the offspring.
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Locher I, Waselewski M, Sonneville K, Resnicow K, Chang T. Grocery Delivery of Healthy Foods to Pregnant Young Women With Low Incomes: Feasibility and Acceptability Mixed Methods Study. JMIR Form Res 2020; 4:e21602. [PMID: 33361055 PMCID: PMC7790606 DOI: 10.2196/21602] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 07/31/2020] [Accepted: 10/28/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Poor maternal diets increase the risk of excess gestational weight gain which can contribute to serious intergenerational morbidity for both the mother and infant. Pregnant young women with low incomes have disproportionately high rates of inadequate fruit and vegetable consumption as well as excess weight gains during pregnancy. OBJECTIVE Our aim was to describe the feasibility and acceptability of Special Delivery, a longitudinal nutrition intervention that delivers healthy foods to pregnant youth (aged 14-24 years) with low incomes. METHODS The Special Delivery pilot study, conducted in Michigan, enrolled pregnant young women with low incomes. Study participants were sent twice-monthly grocery deliveries consisting of US $35 worth of healthy foods, primarily fruits and vegetables. Between grocery deliveries, participants received daily SMS text message prompts to confirm receipt of delivery and document diet and weight. Program feasibility was assessed by the number of grocery orders placed, delivered, and confirmed by participants. Qualitative interviews and SMS text message data were used to determine acceptability by assessing participants' perspectives on grocery delivery, participants' perspectives on dietary impact of the program, and foods consumed by participants. RESULTS A total of 27 participants were enrolled in the pilot study. The mean age was 20.3 years (SD 2.0), and 59.3% (16/27) were African American or Black. During the pilot, 263 deliveries were sent with 98.5% (259/263) successful deliveries and 89.4% (235/263) deliveries confirmed by participants. Participants reported that grocery delivery was convenient; that delivered foods were high quality; and that the program improved their diet, increased access to healthy foods, and promoted healthy habits during pregnancy. CONCLUSIONS A grocery delivery-based weight gain and nutrition intervention is both feasible and acceptable among low-income pregnant youth. Grocery deliveries were successfully completed and participants were willing and able to receive grocery deliveries, eat the healthy foods that were delivered, and communicate via SMS text message with study coordinators. The Special Delivery program warrants further evaluation for efficacy in promoting healthy weight gain for low-income youth during pregnancy.
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Affiliation(s)
- Ione Locher
- University of Michigan, Ann Arbor, MI, United States
| | | | | | - Ken Resnicow
- University of Michigan, Ann Arbor, MI, United States
| | - Tammy Chang
- University of Michigan, Ann Arbor, MI, United States
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Maternal Characteristics that Impact Postpartum Weight Retention: Results from the 2016 Los Angeles Mommy and Baby (LAMB) Follow-Up Study. Matern Child Health J 2020; 25:151-161. [PMID: 33188470 DOI: 10.1007/s10995-020-03082-3] [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] [Accepted: 11/07/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To identify maternal characteristics associated with 24-month postpartum weight retention. METHODS Data were collected from the 2016 Los Angeles Mommy and Baby (LAMB) Follow-Up Survey, a population-based prospective cohort study that assesses maternal and infant health in Los Angeles County. In 2014, LAMB initially surveyed 6035 women 6 months following a live birth. The 2016 LAMB Follow-Up reevaluated this same cohort after the index child's second birthday. 2679 women completed 2016 LAMB Follow-Up (52% adjusted response rate). The final sample size was 1524 after excluding subjects with subsequent pregnancies after the index child and missing information for postpartum weight. Eight predictors were included in this analysis: gestational weight gain, pre-pregnancy BMI, exercise, depressed mood since having child, age, race, education, and job loss during pregnancy. Chi-square tests and logistic regression analyses were performed using SAS 9.3. RESULTS Two years after delivery, women with postpartum weight retention weighed on average of 15.3 lb. more than before the index pregnancy. Women were more likely to retain postpartum weight when they exceeded gestational weight gain guidelines (AOR = 2.03, 95% CI = 1.40-2.93), did not exercise (AOR = 3.32, CI = 1.85-5.98), were between ages 20-29 (AOR = 1.54, CI = 1.01-2.36), were Hispanic (AOR = 1.51, CI = 1.02-2.24), completed high school only (AOR = 1.77, CI = 1.15-2.73), or lost a job during pregnancy (AOR = 2.62, CI = 1.39-4.93). CONCLUSIONS Modifiable risk factors and sociodemographic characteristics can impact maternal weight retention 24 months after pregnancy. Understanding postpartum weight retention is essential for guiding future public health research, programming, and policy. Tailoring appropriate public health interventions may help women sustain healthy weight during their reproductive years and beyond.
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Noh K, Min JJ. Understanding School-Aged Childhood Obesity of Body Mass Index: Application of the Social-Ecological Framework. CHILDREN (BASEL, SWITZERLAND) 2020; 7:E134. [PMID: 32933126 PMCID: PMC7552775 DOI: 10.3390/children7090134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 09/10/2020] [Accepted: 09/11/2020] [Indexed: 01/24/2023]
Abstract
In order to understand the prevalence of school-aged childhood obesity in the United States and suggest better methods to prevent and treat the public health problem, we examined it with significant and identifiable factors within the social-ecological model. To investigate the association between social-ecological factors and child obesity/overweight (BMI), we used the 5th wave of the Fragile Families and Child Wellbeing Study. The dataset included information on 9-year-old children. The sample size for our study was 2054. We utilized multiple normal distributions for missing values and the Ordinary Least Square regression analysis. Black and Hispanic children were more likely to be obese/overweight than White children; children with higher physical activity were negatively associated with higher obesity; older mothers were more likely to be associated with children's obesity; family structure was also significantly related to the likelihood of childhood obesity; finally, school environment was significantly associated with child obesity. To combat childhood obesity, more school physical activities should be implemented, such as increasing physical education opportunities as well as building more sizable playgrounds and accessible recreation facilities at school and in communities. School environments also should be pleasant and safe for children. Health practitioners need to assess home environments to intervene for children's health.
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Affiliation(s)
- Keeyoon Noh
- Department of History, Philosophy, and Social Sciences, Pittsburg State University, Pittsburg, KS 66762, USA;
| | - Jihyun Jane Min
- Thomas Jefferson Independent Day School, 3401 Newman Rd, Joplin, MO 64801, USA
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Thomas A, Janusek L. Obesity Prevention Behaviors in Asian Indian Adolescent Girls: A Pilot Study. J Pediatr Nurs 2018; 42:9-15. [PMID: 30219305 DOI: 10.1016/j.pedn.2018.05.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Revised: 05/14/2018] [Accepted: 05/15/2018] [Indexed: 12/26/2022]
Abstract
PURPOSE The purpose of this pilot study was to evaluate obesity prevention behaviors of Asian Indian adolescent females and determine the relationship of these behaviors to cardiovascular risk factors. DESIGN AND METHODS A purposive sample of twenty females, 14-18 years of age, was enrolled. Body mass index, percent body fat, waist circumference, and blood pressure were measured to assess cardiovascular risk. Measures of obesity prevention behaviors were physical activity, dietary and sleeping behaviors. To quantify engagement in physical activity, participants wore an accelerometer. The dietary intake was assessed using the web based SuperTracker. Pittsburgh Sleep Quality Index was used to assess sleep behaviors. For data analysis, descriptive statistics was used for demographic characteristics. Correlations were calculated to evaluate the relationship between cardiovascular risk factors and obesity prevention behaviors. RESULTS The majority of the adolescents did not meet recommended physical activity levels. Most reported unhealthy eating behaviors with higher saturated fat intake correlating with higher percent body fat. The cardiovascular risk measures fell below normative values. However, more time spent in sedentary behaviors was related to higher systolic blood pressure, while poor sleep quality was associated with higher diastolic blood pressure and greater BMI. CONCLUSIONS The findings support the unhealthy patterns of physical activity, dietary and sleep behaviors in Asian Adolescent girls and the need for promoting healthy behaviors in this at risk population. PRACTICE IMPLICATIONS The study findings provide a basis for education on healthy behaviors and development of culturally appropriate interventions to prevent obesity.
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Affiliation(s)
- Annie Thomas
- Marcella Niehoff School of Nursing, Loyola University Chicago, Chicago, IL, USA.
| | - Linda Janusek
- Marcella Niehoff School of Nursing, Loyola University Chicago, Maywood, IL, USA.
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Denize KM, Acharya N, Prince SA, da Silva DF, Harvey AL, Ferraro ZM, Adamo KB. Addressing cultural, racial and ethnic discrepancies in guideline discordant gestational weight gain: a systematic review and meta-analysis. PeerJ 2018; 6:e5407. [PMID: 30186674 PMCID: PMC6118200 DOI: 10.7717/peerj.5407] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To systematically review the literature and describe the discrepancies in achieving the 2009 Institute of Medicine (IOM) gestational weight gain (GWG) guidelines across cultures. METHODS Ten databases were searched from inception to April 2018. Observational cohort studies were included that examined adult women; reported on a measure of culture; compared cultural groups, and reported on GWG. Articles were broken down into papers that used the current 2009 IOM GWG guidelines and those that used others. A meta-analysis was conducted for studies using the 2009 guidelines examining the prevalence of discordant GWG across cultural groups. RESULTS The review included 86 studies. Overall, 69% of women experienced discordant GWG irrespective of culture. White women experienced excessive GWG most often, and significantly more than Asian and Hispanic women; Black women had a higher prevalence of excessive GWG than Hispanic and Asian women; however, this difference was not significant. CONCLUSIONS The majority of women experience excessive GWG, with White women experiencing this most often. Culturally diverse GWG guidelines are needed to individualize antenatal care and promote optimal maternal-fetal health outcomes across cultural groups.
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Affiliation(s)
- Kathryn M. Denize
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Nina Acharya
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | - Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Canada
| | - Danilo Fernandes da Silva
- Department of Physical Education, State University of Midwest/Parana (UNICENTRO), Guarapuava, Paraná, Brazil
| | - Alysha L.J. Harvey
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
| | | | - Kristi B. Adamo
- School of Human Kinetics, Faculty of Health Science, University of Ottawa, Ottawa, Canada
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