[Anthropometric methods used in the evaluation of the postpartum weight retention: a systematic review]

Post-partum weight retention in Northeastern Brazilian women: a prospective NISAMI cohort study

BACKGROUND

Weight retention during the post-partum period is associated with excessive weight gain.

OBJECTIVES

To investigate factors associated with maternal weight retention at six months post-partum (PPWR).

DESIGN AND SETTING

A prospective cohort study was conducted with 127 women monitored using prenatal services.

METHODS

The outcome variable was represented by post-partum maternal weight retention and calculated as the difference between the mother's weight at sixth month post-partum and her pregestational weight.

RESULTS

The mean age of the pregnant women was 26.7 ± 5.25 years old, and the post-partum maternal weight retention was 46.5%. The proximal determinants showed a direct association with PPWR after adjusting for the distal and intermediate variables: excessive gestational weight gain (odds ratio [OR]:3.34; confidence interval [CI]:1.16-9.59), greater adhesion to dietary intake pattern 2 (composed of red meats and derivatives, eggs, industrialized foods, and coffee) (OR:2.70; CI:1.16-6.32), and the absence of exclusive maternal breastfeeding in the first month (OR:3.40; CI:1.27-9.12), as well as primiparity (OR:2.36; CI:1.00-5.55), an intermediate determinant. Insufficient weight gain in pregnancy was inversely associated with the outcome (OR:0.35; CI:0.31-0.93).

CONCLUSIONS

Among the hierarchical determinants, proximal factors were interrelated with maternal weight retention, indicating that excessive total weight gain, an inadequate dietary intake pattern, and the absence of exclusive maternal breastfeeding in the first month of life work as dampeners of the return to pre-gestational weight. Prepartum and post-partum care interventions can contribute to reducing excess weight in women.

Overweight and associated factors in Basic Education teachers during the Covid-19 pandemic: gender differentials

ABSTRACT Objective To estimate the prevalence of overweight among teachers in Minas Gerais during the Covid-19 pandemic and to review relevant gender associated factors. Methods Cross-sectional and analytical study, websurvey type, carried out with 15,641 teachers of public Basic Education in Minas Gerais, Brazil. Data collection took place from August to September 2020 with the use of a digital form. The dependent variable was overweight, calculated by the body mass index using the teachers’ self-reported weight and height. Poisson regression was used, with robust variance. Results Among the participating teachers, 52.4% were overweight. When stratified by gender, 51.1% women and 58.2% men were considered overweight, with a significant difference between them (p<0.001). There was a higher prevalence of overweight among women in the age group of 30 to 59 years (PR=1.39) and in women 60 years or older (PR=1.45) living in the metropolitan region of the state (PR=1.06) who had children (PR=1.19), who were not exercising (PR=1.09) and with a worse dietary pattern during the pandemic (PR=1.12), much afraid of Covid-19 (PR=1.04) and with anxiety and/or depression during the pandemic (PR=1.14). Among men, there was a higher prevalence of overweight among those individuals aged 30 to 59 years (PR=1.19), who lived with a spouse (PR=1.15) working more than 40 hours per week (PR=1.12) and those with the worst dietary pattern during the pandemic (PR=1.10). Conclusion The results showed a 52.4% prevalence of overweight teachers and different associated factors between the genders.

Prevalence, temporal trend and associated factors with excess body weight in mothers of children under five years

ABSTRACT Objective This study aims to evaluate the prevalence, temporal trends and associated factors with excess weight in mothers of children under five years of age. Methods This is a time-series study using data from two household surveys conducted in 2005 and 2015. A total of 1,436 mothers were evaluated in 2005, and 690 were evaluated in 2015. The dependent variables were excess body weight (Body Mass Index [BMI] ≥25.0kg/m2), high percentage of Body Fat (%BF ≥33%) and abdominal obesity (waist circumference >80cm). The independent variables were the socioeconomic and demographic factors. The changes that occurred between the two surveys were expressed in percentages, and the measure of association was the Prevalence Ratio, calculated by Poisson regression, in both the crude and multivariate analyses. Results There were increases of 33.2%, 59.2% and 31.0%, respectively, for the prevalence of excess weight (PR=1.33, 95% Confidence Interval [CI]:1.21-1.46), abdominal obesity (PR=1.59, 95% CI:1.43-1.77) and high %BF (PR=1.31, 95% CI:1.07-1.60). The factors independently associated with excess weight and abdominal obesity were the highest age group (>30 years), menarche ≤12 years and higher parity (>2 children). The same was observed for high %BF, except for the loss of significance in the adjusted analysis for the variable menarche ≤12 years. Conclusion The prevalence of high body adiposity is a problem of relevant importance in the studied population and has presented an upward trend in the last 10 years. Women over 30 years and with more than two children should be given priority in prevention and control.

[Nutritional and sociodemographic characteristics of nursing mothers: a systematic review]

A systematic review of nutritional and sociodemographic characteristics of nursing mothers, using the published literature from 2004 to 2014 in the Biblioteca Virtual de Saúde and Medline databases. Using the following key words, 561 articles were identified: "Human Milk" and "Milk Banks"; keywords: "Profile," "Nutritional," "Milk Donor," "Nursing Mother" and "Nursing Mothers"; available abstracts; date and language. From these, 84.1% were excluded for not dealing with the established subject, 1.8% for being a review and 7.5% for the unavailability of abstracts for study. Thirty-seven articles were selected, of which 18.9% analyzed the profile of the HM donor. Of the total, 89.2% reported age, the majority between 20 and 30 years of age. The level of schooling was mentioned in 32.4% ranging from elementary school and higher education. With respect to income, a higher prevalence of low socioeconomic status was observed. About the nutritional status, 45.9% of the studies measured the body mass index and 29.4% reported the predominance of excess weight. There were deficiencies, particularly of vitamin A, with frequencies between 9% and 26%. A majority of young adult mothers, varied schooling, low income and nutritional deficiencies were noted, demanding interventions to improve health and increase HM donations.

Energy expenditure in the immediate postpartum period: Indirect calorimetry versus predictive equations

OBJECTIVE

The aim of this study was to evaluate the resting energy expenditure (REE) of postpartum women by indirect calorimetry and to provide the most appropriate predictive equations to estimate it.

METHODS

This was a cross-sectional study with 79 women in the maternity unit of a Brazilian city hospital. Information regarding age, income, gestational age, and breastfeeding was collected. Height, weight, and body composition were measured. We measured REE by indirect calorimetry and predicted REE using eight equations. Analysis of comparison, correlation, agreement, and accuracy was performed.

RESULTS

The median of measured REE was 1224 kcal (95% confidence interval [CI], 1157.4-1330), and the predicted REE ranged from 1213.8 (95% CI, 1207.3-1261.9) to 1553.1 kcal (95% CI, 1430.8-1488.5). No difference was found in REE between mothers who breastfed and those who did not (P = 0.994); however, there was a positive correlation with lean mass (r = 0.336; P = 0.003) and weight (r = 0.237; P = 0.036). The best predictor of REE was the Harris Benedict equation, with lower difference (P = 0.876), better median of adequacy (99.8%), and better interclass correlation coefficient (0.289). The Schofield equation was next, with greater percentage of accuracy (33.3%) and lower opposite agreement (7.6%).

CONCLUSIONS

All predictive equations showed low agreement and accuracy, and, in most cases, the results were overestimated. These findings indicate the need for continued studies to propose more suitable methods to determine the energy requirements for this population.

Low Nourishment of Vitamin C Induces Glutathione Depletion and Oxidative Stress in Healthy Young Adults

The present study was conducted to assess the status of vitamin C among healthy young adults in relation to serum antioxidant parameters [glutathione (GSH), thiols, and total antioxidant capacity, (TAC)], and oxidative stress markers [malondialdehyde (MDA), and nitrites plus nitrates (NN)]. A prospective study included 200 young adults, and their dietary intake was assessed by using food diaries. Fasting plasma vitamin C, serum levels of GSH, thiols, TAC, MDA, and NN were measured using biochemical assays. It was observed that 38% of the enrolled subjects, n=76, had an adequate dietary intake of vitamin C (ADI group). Meanwhile, 62%, n=124, had a low dietary intake of vitamin C (LDI group) as compared to the recommended dietary allowances. The fasting plasma level of vitamin C was significantly higher in the ADI group as compared to the LDI group. Oxidative stress in the sera of the LDI group was evidenced by depletion of GSH, low thiols levels, impairment of TAC, an elevation of MDA, and increased NN. In the ADI group, positive correlations were found between plasma vitamin C and serum antioxidant parameters (GSH, thiols, and TAC). Meanwhile, the plasma vitamin C was negatively correlated with serum MDA and NN levels. This study reveals a significant increase of oxidative stress status and reduced antioxidant capacity in sera from healthy young adults with low intake of the dietary antioxidant, vitamin C.