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Siritharan SS, Henry A, Gow ML, Roberts LM, Yao A, Ojurovic M, O'Sullivan AJ. Maternal macro- and micronutrient intake six months after hypertensive versus normotensive pregnancy: is poor diet quality contributing to future cardiometabolic disease risk? Pregnancy Hypertens 2021; 23:196-204. [PMID: 33515976 DOI: 10.1016/j.preghy.2020.11.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 10/28/2020] [Accepted: 11/09/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hypertensive pregnancy is associated with increased long-term cardiometabolic disease risk. Assessing dietary intake patterns after hypertensive (HP) versus normotensive pregnancy (NP) may provide insights into the mechanism of this risk. METHODS This study was a prospective sub-study of the P4 (Postpartum, Physiology, Psychology and Paediatrics) cohort. Women were studied six months after NP versus HP (preeclampsia or gestational hypertension). Dietary energy, macronutrient and micronutrient intake were measured using a three-day food diary (FoodWorks™) and assessed against Australian and New Zealand Nutrient Reference Values to determine nutritional adequacy. Comparisons between breastfeeding and non-breastfeeding women were assessed, and linear regression modelling (using hypertensive status, breastfeeding status, and demographic/pregnancy variables) performed to assess predictors of energy intake. RESULTS Seventy-four women (60 NP, 14 HP) were included. HP women had higher mean body mass index (p = 0.02) and lower breastfeeding rates (29% HP versus 83% NP, p < 0.001) compared to NP women. Twenty-four-hour energy intake and total fat intake were 17% and 20% lower after HP respectively. Nutrient deficiencies were prevalent across all participants, however more HP women had inadequate magnesium, calcium and phosphorus intake. Breastfeeding women had significantly increased energy (17%), carbohydrate (15%) and total fat intake (21%), and increased vitamin A, vitamin E, riboflavin, magnesium and iron intake compared to non-breastfeeding women. HP and breastfeeding status were independent predictors of energy intake. CONCLUSIONS HP women had lower micronutrient intake and greater prevalence of nutritional inadequacy compared to NP women, reflecting poorer diet quality and potentially contributing to future increased cardiometabolic disease risk.
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Affiliation(s)
- S S Siritharan
- School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia.
| | - A Henry
- School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia; Department of Women's and Children's Health, St George Hospital - Prichard Wing Level 1, Gray Street, Kogarah, NSW 2217, Australia; Global Women's Health Program, The George Institute for Global Health, Level 5/1 King Street, Newtown, NSW 2042, Australia
| | - M L Gow
- The University of Sydney Children's Hospital Westmead Clinical School, Corner Hawkesbury Road and Hainsworth Street, Westmead, NSW 2145, Australia
| | - L M Roberts
- Department of Women's and Children's Health, St George Hospital - Prichard Wing Level 1, Gray Street, Kogarah, NSW 2217, Australia; St George and Sutherland Clinical School, Short Street, St George Hospital, Kogarah, NSW 2217, Australia; Faculty of Health - University of Technology Sydney, 235 Jones Street, Ultimo, NSW 2007, Australia
| | - A Yao
- School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia; Department of Endocrinology, St George Hospital, Kogarah, NSW 2217, Australia
| | - M Ojurovic
- School of Women's and Children's Health, UNSW Medicine, Level 1 Royal Hospital for Women, Barker Street, NSW 2031, Australia
| | - A J O'Sullivan
- St George and Sutherland Clinical School, Short Street, St George Hospital, Kogarah, NSW 2217, Australia; Department of Endocrinology, St George Hospital, Kogarah, NSW 2217, Australia
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Abstract
This study was designed to investigate the apparent contradiction between recent reports of physiological and interpersonal research on stuttering that claim or imply high agreement levels, and studies of stuttering judgment agreement itself that report much lower agreement levels. Four experienced stuttering researchers in one university department used laser videodisks of spontaneous speech, from persons whose stuttering could be described as mild to severe, to locate the precise onset and offset of individual stuttering events. Results showed a series of interjudge disagreements that raise serious questions about the reliability and validity of stuttering event onset and offset judgments. These results highlight the potentially poor reliability of a measurement procedure that is currently widespread in stuttering research. At the same time, they have isolated some few highly agreed stuttering events that might serve as the basis for the further development of either event-based or interval-based judgment procedures.
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Affiliation(s)
- R J Ingham
- University of California, Santa Barbara, USA
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Abstract
This paper reports the results of two experiments that investigated interval-by-interval inter- and intrajudge agreement for stuttered and nonstuttered speech intervals (4.0 sec). The first experiment demonstrated that interval-by-interval interjudge agreement could be significantly improved, and to satisfactory levels, by training judges to discriminate between experimenter-agreed intervals of stuttered and nonstuttered speech. The findings also showed that, independent of training, judges with relatively high intrajudge agreement also showed relatively higher interjudge agreement. The second experiment showed that interval-by-interval interjudge agreement was not significantly different if judges rated 4-sec speech intervals from different samples under three conditions: in random order, separated by 5-sec recording intervals; in correct order, also separated by 5-sec recording intervals; or after brief judgment signals that occurred every 4 sec during continuous samples. The implications of these findings for stuttering measurement are discussed.
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