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Simione M, Moreno-Galarraga L, Perkins M, Price SN, Luo M, Kotelchuck M, Blake-Lamb TL, Taveras EM. Effects of the First 1000 Days Program, a systems-change intervention, on obesity risk factors during pregnancy. BMC Pregnancy Childbirth 2021; 21:729. [PMID: 34706698 PMCID: PMC8549242 DOI: 10.1186/s12884-021-04210-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 10/12/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND First 1000 Days is a systems-oriented program starting in early pregnancy lasting through the first 24 months of infancy focused on preventing obesity and related risk factors among low income, mother-infant pairs. The program was developed in partnership with stakeholders to create an infrastructure for system-wide change. It includes screening for adverse health behaviors and socio-contextual factors, patient navigation and educational materials to support behavior change and social needs, and individualized health coaching for women at highest risk of obesity and has been shown to reduce excess gestational weight gain for women who were overweight at the start of their pregnancy. The purpose of this study was to examine changes from the first to third trimester for women participating in the First 1000 Days Program. METHODS We collected information through self-administered questionnaires during the first and third trimester of gestation and from electronic health records relating to obesity risk factors. Measures collected included behavior (i.e., diet, physical activity and screen time) and psychosocial (i.e., anxiety) outcomes, as well as enrollment in Women, Infant, and Children (WIC) program. We examined the extent to which participation in the program was associated with changes in behaviors and psychosocial outcomes among women during pregnancy. RESULTS Women completed surveys at their initial and third trimester prenatal visits (n = 264). Mean age (SD) was 30.2 (5.51) years and 75% had an annual household income of <$50,000. Mean pre-pregnancy body mass index (BMI) was 27.7 kg/m2 and 64% started pregnancy with a BMI ≥ 25 kg/m2. In multivariable adjusted models, we observed decreases in intake of sugary-drinks (- 0.95 servings/day; 95% CI: - 1.86, - 0.03) and in screen time (- 0.21 h/day; 95% CI: - 0.40, - 0.01), and an increase in physical activity (0.88 days/week; 95% CI: 0.52, 1.23) from the first to third trimester. We also observed a decrease in pregnancy-related anxiety score (- 1.06 units; 95% CI: - 1.32, - 0.79) and higher odds of enrollment in Women, Infant, and Children (WIC) program (OR: 2.58; 95% CI: 1.96, 3.41). CONCLUSIONS Our findings suggest that a systems-oriented prenatal intervention may be associated with improvements in behaviors and psychosocial outcomes during pregnancy among low-income mothers. TRIAL REGISTRATION ClinicalTrials.gov ( NCT03191591 ; Retrospectively registered on June 19, 2017).
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Affiliation(s)
- Meg Simione
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Laura Moreno-Galarraga
- Department of Pediatrics, Complejo Hospitalario de Navarra, IdiSNA, Pamplona, Navarre, Spain
| | - Meghan Perkins
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
| | - Sarah N Price
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
| | - Man Luo
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
| | - Milton Kotelchuck
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Tiffany L Blake-Lamb
- Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA
- Kraft Center for Community Health Leadership, Massachusetts General Hospital, Boston, MA, USA
| | - Elsie M Taveras
- Division of General Academic Pediatrics, Massachusetts General Hospital for Children, 125 Nashua Street, Suite 860, Boston, MA, 02114, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
- Kraft Center for Community Health Leadership, Massachusetts General Hospital, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Crovetto M, Valladares M, Espinoza V, Mena F, Oñate G, Fernandez M, Durán-Agüero S. Effect of healthy and unhealthy habits on obesity: a multicentric study. Nutrition 2018; 54:7-11. [PMID: 29677480 DOI: 10.1016/j.nut.2018.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [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: 08/29/2017] [Revised: 02/01/2018] [Accepted: 02/02/2018] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Our aim was to characterize and compare eating patterns of university students in Chile, by sex and body weight, body mass index, and nutritional status. METHODS This was a cross-sectional study. University students (n = 1454) of Chile were evaluated. A self-assessment survey was used to evaluate healthy eating habits using a questionnaire with values between 1 (do not consume) and 5 (consume) for a total of 9 to 45 points (higher values represent better eating habits). Unhealthy habits were assessed with six questions, including consumption of sugary soft drinks, alcohol, fried foods, fast food, and snacks and adding salt to foods without tasting first. RESULTS Obese students had a lower consumption of healthy foods (P <0.05) compared with normal weight participants. Underweight male participants had higher unhealthy food consumption (P <0.05) and obese women had the lowest score (P <0.05). Protective factors for being overweight/obese were included (odds ratio [OR] = 0.5; 95% confidence interval [CI] 0.3-0.8), consumption of ≥2 servings of vegetables (OR = 0.5; 95% CI 0.4-0.7). Risk factors included consumption (more than 1 cup a day) of sugary soft drinks (OR = 1.5; 95% CI 1.0-2.1) and male sex (OR = 1.8; 95% CI 1.3-2.4). CONCLUSION The consumption of vegetables and belonging to an undergraduate program in health sciences at a university contributed to protection against for obesity. On the other hand, male sex and consumption of sugary drinks were found to be risk factors for obesity.
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Affiliation(s)
- Mirta Crovetto
- Centro de Estudios Avanzados, Facultad de Ciencias de la Salud, Universidad Playa Ancha, Valparaíso, Chile
| | - Macarena Valladares
- Centro Integrativo de Biología y Química Aplicada (CIBQA), Universidad Bernardo O Higgins, Santiago, Chile
| | - Valentina Espinoza
- Carrera de Nutrición y Dietética, Universidad Católica de Temuco, Temuco, Chile
| | - Francisco Mena
- Universidad de Antofagasta, FACSA, Departamento de Nutrición y Dietética, Antofagasta, Chile
| | - Gloria Oñate
- Universidad Autónoma de Chile, Carrera Nutrición y Dietética, Santiago, Chile
| | - Macarena Fernandez
- Universidad Autónoma de Chile, Carrera Nutrición y Dietética, Santiago, Chile
| | - Samuel Durán-Agüero
- Facultad de Ciencias para el Cuidado de la Salud, Universidad San Sebastián, Santiago, Chile.
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Parrino C, Vinciguerra F, La Spina N, Romeo L, Tumminia A, Baratta R, Squatrito S, Vigneri R, Frittitta L. Influence of early-life and parental factors on childhood overweight and obesity. J Endocrinol Invest 2016; 39:1315-1321. [PMID: 27312861 DOI: 10.1007/s40618-016-0501-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Accepted: 06/07/2016] [Indexed: 12/15/2022]
Abstract
PURPOSE We recently reported that a high BMI and high waist circumference prevalence is present in Sicilian children and that the male gender is associated with a significant risk of obesity. Early-life and parent-related risk factors were investigated 1521 Sicilian children (752 females and 769 males, aged 9.0-14.0 years) to identify biological and environmental factors that can contribute to obesity onset. METHODS Anthropometric measurements of children, their urban vs rural area provenience, birth weight and neonatal feeding were collected. In addition, the BMI and educational level of their parents and the perception of their child weight status were investigated. RESULTS In the study cohort, the prevalence of overweight and obesity was 27.2 and 14.1 %, respectively, significantly (p < 0.05) higher in males than in females. Breastfeeding emerged as a protective factor (OR 0.64; p < 0.0005), while risk factors for developing childhood obesity were a birth weight ≥4.0 kg (OR 1.83; p < 0.05), an overweight or obese mother (OR 2.33; p < 0.0001) or father (OR 1.68; p < 0.0001) and a mother with a low/medium education level (OR 1.72; p < 0.005). CONCLUSION Understanding risk factors for pediatric obesity is a prerequisite to identify children at highly risk of being obese and to predispose early intervention strategies.
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Affiliation(s)
- C Parrino
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - F Vinciguerra
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - N La Spina
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - L Romeo
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - A Tumminia
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - R Baratta
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
- "S. Signorelli" Diabetes and Obesity Center, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - S Squatrito
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
| | - R Vigneri
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy
- Institute of Biostructures and Bioimages, National Research Council, CNR, Catania, Italy
| | - L Frittitta
- Endocrinology Unit, Garibaldi-Nesima Hospital, Department of Clinical and Experimental Medicine, University of Catania, Via Palermo 636, 95122, Catania, Italy.
- "S. Signorelli" Diabetes and Obesity Center, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
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Burger KS, Stice E. Greater striatopallidal adaptive coding during cue-reward learning and food reward habituation predict future weight gain. Neuroimage 2014; 99:122-8. [PMID: 24893320 DOI: 10.1016/j.neuroimage.2014.05.066] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 05/02/2014] [Accepted: 05/25/2014] [Indexed: 02/03/2023] Open
Abstract
Animal experiments indicate that after repeated pairings of palatable food receipt and cues that predict palatable food receipt, dopamine signaling increases in response to predictive cues, but decreases in response to food receipt. Using functional MRI and mixed effects growth curve models with 35 females (M age=15.5±0.9; M BMI=24.5±5.4) we documented an increase in BOLD response in the caudate (r=.42) during exposure to cues predicting impending milkshake receipt over repeated exposures, demonstrating a direct measure of in vivo cue-reward learning in humans. Further, we observed a simultaneous decrease in putamen (r=-.33) and ventral pallidum (r=-.45) response during milkshake receipt that occurred over repeated exposures, putatively reflecting food reward habitation. We then tested whether cue-reward learning and habituation slopes predicted future weight over 2-year follow-up. Those who exhibited the greatest escalation in ventral pallidum responsivity to cues and the greatest decrease in caudate response to milkshake receipt showed significantly larger increases in BMI (r=.39 and -.69 respectively). Interestingly, cue-reward learning propensity and food reward habituation were not correlated, implying that these factors may constitute qualitatively distinct vulnerability pathways to excess weight gain. These two individual difference factors may provide insight as to why certain people have shown obesity onset in response to the current obesogenic environment in western cultures, whereas others have not.
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