Importance of Energy Intakes, Physical Activity, and Adherence to Gestational Weight Gain Guidelines

Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed >300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting "recommended weight gain advice" were 3 times more likely to meet total GWG recommendations (OR: 3.2, < 0.05); women who complied with weekly GWG goals minimized PPWR (OR: 4.2, < 0.02). In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs

Use of Near-Infrared Spectroscopic Analysis of Second Trimester Amniotic Fluid to Assess Preterm Births

This pilot study investigated the possibility that metabolomic differences exist in second trimester of women delivering at term (≥37 weeks, n = 216) and preterm (≤35 weeks, n = 11). For this retrospective study, biobanked AF samples underwent near-infrared (NIR) spectral analysis using wavelengths from 700 to 1050 nm. Spectral data was compressed then optimized by multilinear regression to create a calibration model. The resultant model was able to classify term and preterm births based on differing AF metabolomic profiles with a sensitivity and specificity of 100%. When groups were classified using a prematurity index (PI), there was a statistical difference (P < 0.001) between the predicted preterm group (PI 0.77 ± 0.08) and the term group (PI 1.00 ± 0.02). In conclusion, the 2nd trimester AF samples showed distinct differences in metabolomic profiles between patients delivering preterm as compared to those at term in functional groups related to proteins, carbohydrates, fats, polyols, and water

Limiting Excess Weight Gain in Healthy Pregnant Women: Importance of Energy Intakes, Physical Activity, and Adherence to Gestational Weight Gain Guidelines

Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed >300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting “recommended weight gain advice” were 3 times more likely to meet total GWG recommendations (OR: 3.2, P<0.05); women who complied with weekly GWG goals minimized PPWR (OR: 4.2, P<0.02). In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs

Individual, social and environmental factors influencing physical activity levels and behaviours of multiethnic socio-economically disadvantaged urban mothers in Canada: A mixed methods approach

<p>Abstract</p> <p>Background</p> <p>Existing data provide little insight into the physical activity context of multiethnic socio-economically disadvantaged mothers in Canada. Our primary objectives were: (1) to use focus group methodology to develop tools to identify the individual, social, and environmental factors influencing utilitarian and leisure time physical activities (LTPA) of multiethnic SED mothers; and (2) to use a women specific physical activity survey tool to assess psychosocial barriers and supports and to quantify individual physical activity (PA) levels of multi-ethnic SED mothers in Canada.</p> <p>Methods</p> <p>Qualitative focus group sessions were conducted in West, Central and Eastern Canada with multiethnic SED mothers (n = 6 focus groups; n = 42 SED mothers) and with health and recreation professionals (HRPs) (n = 5 focus groups; n = 25 HRPs) involved in community PA programming for multiethnic SED mothers. Administration of the women specific Kaiser Physical Activity Survey (KPAS) tool was completed by consenting SED mothers (n = 59).</p> <p>Results</p> <p>More than half of SED mothers were employed and had higher total PA scores with occupation included than unemployed mothers. However, nearly 60% of both groups were overweight or obese. Barriers to LTPA included the lack of available, affordable and accessible LTPA programs that responded to cultural and social needs. Concerns for safety, nonsupportive cultural and social norms and the winter climate were identified as key barriers to both utilitarian and LTPA.</p> <p>Conclusions</p> <p>Findings show that multiethnic SED mothers experience many barriers to utilitarian and LTPA opportunities within their communities. The varying LTPA levels among these multi-ethnic SED mothers and the occurrence of overweight and obesity suggests that current LTPA programs are likely insufficient to maintain healthy body weights.</p

Association of low intake of milk and vitamin D during pregnancy with decreased birth weight

BACKGROUND: Some pregnant women may be advised or choose to restrict milk consumption and may not take appropriate supplements. We hypothesized that maternal milk restriction during pregnancy, which can reduce intakes of protein, calcium, riboflavin and vitamin D, might represent a health risk by lowering infant birth weight. METHODS: We screened women between the ages of 19 and 45 years who were attending prenatal programs in Calgary, Alberta (51°N) for low milk consumption (≤ 250 mL/d). Using repeat dietary recalls, we compared these women and their offspring with women whose daily milk consumption exceeded 250 mL (1 cup). Birth weight, length and head circumference were obtained from birth records. RESULTS: Women who consumed ≤ 250 mL/d of milk (n = 72) gave birth to infants who weighed less than those born to women who consumed more (n = 207; 3410 g v. 3530 g, respectively; p = 0.07). Infant lengths and head circumferences were similar. Women who restricted milk intake had statistically significantly lower intakes of protein and vitamin D as well. In multivariate analyses controlled for previously established predictors of infant birth weight, milk consumption and vitamin D intake were both significant predictors of birth weight. Each additional cup of milk daily was associated with a 41 g increase in birth weight (95% confidence interval [CI] 14.0–75.1 g); each additional microgram of vitamin D, with an 11 g increase (95% CI 1.2–20.7 g). Neither protein, riboflavin nor calcium intake was found to predict birth weight. INTERPRETATION: Milk and vitamin D intakes during pregnancy are each associated with infant birth weight, independently of other risk factors

Prediction of child health by household density and asset-based indices in impoverished indigenous villages in rural Panamá

Chronic infection over a 16-month period and stunting of preschool children were compared between more spatially dense versus dispersed households in rural Panama´ . Chronic protozoan infection was associated with higher household density, lower household wealth index, poor household water quality, yard defecation, and the practice of not washing hands with soap before eating. Models for chronic diarrhea confirmed the importance of household wealth, water quality, sanitation, and hygiene practices. Furthermore, chronic protozoan infection was an important predictor for low height-for-age, along with low household wealth index scores, but not household density. Thus, despite better access to health related infrastructure in the more densely populated households, chronic protozoan infection was more common, and was associated with higher rates of child stunting, compared with more dispersed households