Maternal dietary intake and physical activity habits during the postpartum period: associations with clinician advice in a sample of Australian first time mothers

Background Numerous health benefits are associated with achieving optimal diet and physical activity behaviours during and after pregnancy. Understanding predictors of these behaviours is an important public health consideration, yet little is known regarding associations between clinician advice and diet and physical activity behaviours in postpartum women. The aims of this study were to compare the frequency of dietary and physical activity advice provided by clinicians during and after pregnancy and assess if this advice is associated with postpartum diet and physical activity behaviours. Methods First time mothers (n = 448) enrolled in the Melbourne InFANT Extend trial completed the Cancer Council of Australia’s Food Frequency Questionnaire when they were three to four months postpartum, which assessed usual fruit and vegetable intake (serves/day). Total physical activity time, time spent walking and time in both moderate and vigorous activity for the previous week (min/week) were assessed using the Active Australia Survey. Advice received during and following pregnancy were assessed by separate survey items, which asked whether a healthcare practitioner had discussed eating a healthy diet and being physically active. Linear and logistic regression assessed associations of advice with dietary intake and physical activity. Results In total, 8.6 % of women met guidelines for combined fruit and vegetable intake. Overall, mean total physical activity time was 350.9 ± 281.1 min/week. Time spent walking (251.97 ± 196.78 min/week), was greater than time spent in moderate (36.68 ± 88.58 min/week) or vigorous activity (61.74 ± 109.96 min/week) and 63.2 % of women were meeting physical activity recommendations. The majority of women reported they received advice regarding healthy eating (87.1 %) and physical activity (82.8 %) during pregnancy. Fewer women reported receiving healthy eating (47.5 %) and physical activity (51.9 %) advice by three months postpartum. There was no significant association found between provision of dietary and/or physical activity advice, and mother’s dietary intakes or physical activity levels. Conclusions Healthy diet and physical activity advice was received less after pregnancy than during pregnancy yet no association between receipt of advice and behaviour was observed. More intensive approaches than provision of advice may be required to promote healthy diet and physical activity behaviours in new mothers

Describing objectively measured physical activity levels, patterns, and correlates in a cross sectional sample of infants and toddlers from South Africa.

BACKGROUND: Physical activity is considered to have health benefits across the lifespan but levels, patterns, and correlates have not been well described in infants and toddlers under the age of two years. METHODS: This study aimed to describe objectively and subjectively measured physical activity in a group of South African infants aged 3- to 24-months (n = 140), and to investigate individual and maternal correlates of physical activity in this sample. Infants' physical activity was measured using an Axivity AX3 wrist-worn accelerometer for one week and the mean vector magnitude was calculated. In addition, mothers reported the average amount of time their infant spent in various types of activities (including in front of the TV), their beliefs about infants' physical activity, access to equipment in the home environment, and ages of motor development milestone attainment. Analysis of variance (ANOVA) and pair-wise correlations were used to test age and sex differences and associations with potential correlates. RESULTS: There were significant age and sex effects on the distribution of time spent at different physical activity intensities (Wilks' lambda = 0.06, p < 0.01). In all cases, the trend was for boys to spend more time in higher intensity physical activity and less time in lower intensity activity than girls; and for time spent in higher intensity activities to be higher in older children. Time spent outside was higher in boys, and this reached significance at 18-months (F = 3.84, p = 0.02). Less concern around floor play was associated with higher physical activity at 12-months in females only (p = 0.03, r = 0.54), and no other maternal beliefs were correlated with physical activity. The majority (94%) of children were exceeding TV time recommendations. When controlling for age and sex, overall TV time was positively associated with BMI z-score (β=0.01, p = 0.05). CONCLUSION: This study is the first to show sex and age differences in the patterns of physical activity, and to report on objectively measured and maternal reported physical activity and sedentary behaviour in the first two years of life in South Africa infants. Infants and toddlers should be provided with as many opportunities to be active through play as possible, and TV time should be limited

Socioeconomic variation in diet and activity-related behaviours of Australian children and adolescents aged 2–16 years

BackgroundEvidence for age-related variation in the relationship between obesity-related behaviours and socioeconomic position may assist in the targeting of dietary and physical activity interventions among children.ObjectiveTo investigate the relationship between different indicators of socioeconomic position and obesity-related behaviours across childhood and adolescence.MethodsData were from 4487 children aged 2 to 16 years participating in the cross-sectional 2007 Australian National Children\u27s Nutrition and Physical Activity Survey. Socioeconomic position was defined by the highest education of the primary or secondary carer and parental income. Activity was assessed using recall methods with physical activity also assessed using pedometers. Intake of energy-dense drinks and snack foods, fruits and vegetables was assessed using 2&thinsp;&times;&thinsp;24-h dietary recalls.ResultsA socioeconomic gradient was evident for each dietary measure (although in age-specific analyses, not for energy-dense snacks in older children), as well as television viewing, but not physical activity. Whether each behaviour was most strongly related to parental income or education of the primary or secondary carer was age and sex dependent. The socioeconomic gradient was strongest for television viewing time and consumption of fruit and energy-dense drinks.ConclusionsA strong socioeconomic gradient in eating behaviours and television viewing time was observed. Relationships for particular behaviours differed by age, sex and how socioeconomic position was defined. Socioeconomic indicators define different population groups and represent different components of socioeconomic position. These findings may provide insights into who should be targeted in preventive health efforts at different life stages

Parents’ engagement in an Australian school- and home-based group RCT to reduce children’s sitting time and promote physical activity: Transform-Us!

Session - S34 Involvement of parents in multicomponent school-based interventions targeting energy balance related behaviours among children and adolescents: Lessons learned from process evaluation: abstract S34.2Conference Theme: Promoting Healthy Eating and Activity WorldwidePURPOSE: Transform-Us! was a 3-year group RCT aiming to determine the effectiveness of strategies to reduce 8-year old Australian children’s sedentary behaviour (SB) or promote their physical activity (PA), or both (PA+SB) compared with usual practice (C) at school and home. METHOD: Process evaluation data were collected at post--‐intervention (T3) Nov/Dec 2011. Nine newsletters per year were …postprin

Strategies to promote children\u27s school based physical activity : Transform-Us! Mid-intervention findings

Session 202 - School based interventions: paper 276This journal suppl. entitled: Be Avtive 2012Many children engage in suboptimal levels of PA despite the associated health risks. Schools (n=20) in the Transform-Us! program were randomized to one of four intervention arms that target increases in children’s PA (PA), reductions in sedentary behavior (SB), both behaviors (SB+PA) or control current practice (C). This examination focuses on the PA promotion strategies employed in the PA and SB+PA arms compared with the C arm. To promote children’s PA each PA and SB+PA class was provided with sporting and circus equipment; asphalt line markings were installed at the school; and teachers were asked to encourage PA. Grade 3 children at participating schools were invited to take part in evaluation assessments including the completion of a self-report survey. Findings from the PA promotion strategy questions at baseline (Feb–June 2010), and T2 (Nov/Dec) are reported here. Children (n=425, 55% female) were asked to respond (yes/no) to five items asking about social support for PA from their class teacher, which were then summed to create a ‘teacher social support’ scale. Children were also asked to indicate if ‘there are markings on the walls or on the school playground to help us play games’ (perceived availability of line markings); if they are ‘allowed to use school sports equipment during recess and lunch breaks’ (perceived accessibility of sports equipment); and how much they like ‘the areas to play in at school’ using a 5-point Likert scale (perceived school environment). Between baseline and T2, teacher social support increased in both PA (1.7[1.4] vs 2.1[1.4]) and SB arms (1.9[1.4] vs 2.4[1.4) but declined in C (2.0[1.4] vs 1.7[1.5]). For all three arms, increases were seen in perceived availability of line markings (PA: 53.2% vs 69.4%; SB+PA: 59.3% vs 71.4%; C: 60.0% vs 69.8%); perceived accessibility of sport equipment (PA: 87.7% vs 97.2%: SB+PA: 80.7 vs 94%; C: 85.4% vs 97.6%); and perceived school environment (PA: 1.44[0.9] vs 1.42[0.8]; SB+PA: 1.5[0.8] vs 1.6[0.7]; C: 1.4[0.9] vs 1.5[0.7]) between baseline and T2. All findings were significant at a 1% probability level. At the mid-intervention time point, findings suggest that PA strategies have increased perceived availability of line markings, accessibility of sport equipment, and perceived school environment in children allocated to the PA and SB+PA arms. However, there were also unexpected increases in the C arm for three out of four items. Post-intervention findings will add to these preliminary findings

Combretastatin-A4 disrupts neovascular development in non-neoplastic tissue

Combretastatin-A4 phosphate (cis -CA-4) is a tubulin-binding agent currently undergoing clinical trials as an anti-tumour drug. We have investigated whether CA-4 functions as a tumour-specific anti-vascular agent using the hyperplastic thyroid as a novel in vivo model of neovascularization. CA-4 elicited pathological changes in normal tissue, manifested as the induction of multiple, discrete intravascular thrombi. These vascular-damaging effects indicate that CA-4P does not function as a tumour-specific agent but targets neovasculature irrespective of the primary angiogenic stimulus. © 2001 Cancer Research Campaign http://www.bjcancer.co

Chemotherapy-induced nausea and vomiting in daily clinical practice: a community hospital-based study

Background Chemotherapy-induced nausea and vomiting (CINV) are major adverse effects of cancer chemotherapy. This study investigated: (1) the impact of CINV on patients' health-related quality of life (HRQL) in daily clinical practice; (2) the association between patient characteristics and type of antiemetics and CINV; and (3) the role of CINV in physicians' decisions to modify antiemetic treatment. Patients and methods This prospective, multicenter study was conducted in nine general hospitals in the Netherlands. During three consecutive chemotherapy cycles, patients used a diary to record episodes of nausea, vomiting and antiemetic use. For each cycle, these ratings were made 1 day prior to and 7 days after having received chemotherapy. The influence of CINV on patients' HRQL was evaluated with the Functional Living Index-Emesis (FLIE) questionnaire at day 6 of each treatment cycle. (Changes in) antiemetic use were recorded by the treating nurse. Patient inclusion took place between May 2005 and May 2007. Results Two hundred seventy-seven patients were enrolled in the study. Acute and delayed nausea during the first treatment cycle was reported by 39% and 68% of the patients, respectively. The comparable figures for acute and delayed vomiting were 12% and 23%. During the first and subsequent treatment cycle, approximately one-third of the patients indicated that CINV had a substantial impact on their daily lives. Female patients and younger patients reported significantly more CINV than male and older patients. At all treatment cycles, patients receiving treatment with moderately emetogenic chemotherapy, containing anthracycline, reported more acute nausea than patients receiving highly emetogenic chemotherapy. Acute vomiting was associated significantly with change in (i.e., additional) antiemetic treatment. Delayed CINV did not influence antiemetic treatment. Conclusion CINV continues to be a problem that adversely affects the daily lives of patients. CINV is worse in women and in younger patients. In daily clinical practice, acute CINV, but not delayed CINV, results in changes in antiemetic treatment. In view of the effects of not only acute, but also delayed CINV on daily life, more attention should be paid to adjustment of antiemetic treatment to cover CINV complaints, later during the chemotherapy cycle

Dual-modality gene reporter for in vivo imaging

The ability to track cells and their patterns of gene expression in living organisms can increase our understanding of tissue development and disease. Gene reporters for bioluminescence, fluorescence, radionuclide, and magnetic resonance imaging (MRI) have been described but these suffer variously from limited depth penetration, spatial resolution, and sensitivity. We describe here a gene reporter, based on the organic anion transporting protein Oatp1a1, which mediates uptake of a clinically approved, Gd(3+)-based, hepatotrophic contrast agent (gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid). Cells expressing the reporter showed readily reversible, intense, and positive contrast (up to 7.8-fold signal enhancement) in T1-weighted magnetic resonance images acquired in vivo. The maximum signal enhancement obtained so far is more than double that produced by MRI gene reporters described previously. Exchanging the Gd(3+) ion for the radionuclide, (111)In, also allowed detection by single-photon emission computed tomography, thus combining the spatial resolution of MRI with the sensitivity of radionuclide imaging

Determinants of Change in Physical Activity in Children 0-6 years of Age: A Systematic Review of Quantitative Literature.

Background Understanding the determinants of children’s health behaviours is important to develop successful behaviour-change interventions. Objective We aimed to synthesise the evidence around determinants (‘preceding predictors’) of change in physical activity (PA) in young children (0–6 years of age). Methods As part of a suite of reviews, prospective quantitative studies investigating change in physical activity in children aged 0–6 years were identified from eight databases (to October 2015): MEDLINE, Embase, CINAHL, PsycINFO, Web of Knowledge, British Nursing Index, Applied Social Sciences Index and Abstracts, and Sociological Abstracts. Determinants and direction of association were extracted, described and synthesised according to the socio-ecological model (individual, interpersonal, organisational, community, policy). Results Forty-four determinants, predominantly in the interpersonal and organisational domains, were reported across 44 papers (six prospective cohort, 38 interventional); 14 determinants were assessed in four or more papers. Parental monitoring showed a consistent positive association with change in PA; provider training was positively associated with change in children’s moderate-to-vigorous PA only. Five (sex, parental goal setting, social support, motor skill training and increased time for PA) showed no clear association. A further seven (child knowledge, parental knowledge, parental motivation, parenting skills, parental self-efficacy, curriculum materials and portable equipment) were consistently not associated with change in children’s PA. Maternal role-modelling was positively associated with change in PA in all three studies in which it was examined. Conclusions A range of studied determinants of change in young children’s PA were identified, but only parental monitoring was found to be consistently positively associated. More evidence dealing with community and policy domains from low-/middle-income countries and about lesser-explored modifiable family- and childcare-related determinants is required. International Prospective Register for Systematic Reviews (PROSPERO) Registration Number CRD42012002881. Electronic supplementary material The online version of this article (doi:10.1007/s40279-016-0656-0) contains supplementary material, which is available to authorized users

Is gestational weight gain and early postpartum weight retention associated with clinician advice in first time mothers?

Objective: Excess gestational weight gain (GWG) and postpartum weight retention increase risk for multiple maternal and child health complications. It is necessary to determine factors which influence maternal weight across the perinatal period. The aim of this study was to describe change in maternal body mass index (BMI) from prepregnancy to early postpartum, document weight advice provided by clinicians and assess associations of advice received with maternal weight gain during and following pregnancy.Methods: First-time mothers (n=448) and their newborns who attended first-time parent groups at their local Maternal and Child Health Centres were recruited to the InFANT Extend cluster randomised controlled trial. Baseline data collection occurred when women were approximately three months postpartum. Women completed a written questionnaire assessing their own health and the provision of weight-related advice received by clinicians. Prepregnancy weight and GWG were self-reported. Postpartum height and weight were objectively measured.Results: Mean GWG was 14.0 &plusmn; 6.08 kg and 41.0% of women experienced excess gestational weight gain. Mean PPWR was 4.3 &plusmn; 5.75 kg and mean BMI increased from 24.8 &plusmn; 4.9 kg/m&sup2; pre-pregnancy to 26.2 &plusmn; 4.9 kg/m&sup2; at three months postpartum. The proportion of women classified obese (BMI&ge; 30kg/m2) almost doubled from prepregnancy(11.8%) to three months postpartum (21.7%) (p&lt;0.001). 54.4% of all women reported receiving advice regarding how much weight to gain during pregnancy and 42.6% reported receiving advice to avoid excess GWG. During the postpartum period, just 5.8% of women reported receiving advice about how much they should weigh and 8.3% reported receiving advice about programs to support weight loss. No associations were found between provision of clinician advice with gestational weight gain or postpartum weight retention.Conclusion: More intensive approaches are required, opposed to provision of advice alone, to influence healthy maternal weight across the perinatal period in the interest of best maternal and child health outcomes