Impact of Maternal Physical Activity and Infant Feeding Practices on Infant Weight Gain and Adiposity

Increasing evidence supports the contribution of intrauterine environmental exposures on obesity risk in offspring. Few studies have included maternal and infant lifestyle factors. Our objective was to study the impact of maternal physical activity, infant feeding, and screen time on offspring weight gain and adiposity. In a prospective cohort study, 246 mothers underwent testing during pregnancy to assess glucose tolerance status and insulin sensitivity. Anthropometry and questionnaires on physical activity, infant feeding, and screen time were completed. Multiple-linear regression was performed to examine the impact of maternal and infant factors on infant weight gain and weight-for-length z-score at 1 year. Infant weight outcomes were negatively predicted by maternal pregravid vigorous/sport index and exclusive breastfeeding duration. After adjustment, each unit increase in maternal pregravid vigorous/sport index decreased infant weight gain by 218.6 g (t=2.44, P=0.016) and weight-for-length z-score by 0.20 (t=2.17, P=0.031). Each month of exclusive breastfeeding reduced infant weight gain by 116.4 g (t=3.97, P<0.001) and weight-for-length z-score by 0.08 (t=2.59, P=0.01). Maternal pregravid physical activity and exclusive breastfeeding duration are associated with weight gain and adiposity as early as 1 year of age

Risk of falls and its association with activities of daily living and depression among elderly residing in a rural area in Bangalore, Karnataka

Background: According to 2011 censes, elderly account for 8.6% of Indian population and is projected to become 20% by 2050. Early identification and prevention of fall-related factors would play a vital role in reducing the health costs in elderly. The objective of the study was to assess the risk of falls among elderly residing in Mugalur subcentre, Bangalore Urban.Methods: A cross-sectional study was conducted at the ten villages of Mugalur subcenter, from March-May 2019 using a structured questionnaire that was administered through a face-validated interview. Systemic random sampling was done from the ten villages, proportionate allocation was done to reach a calculated sample size of 220. Timed up and go test (TUG) was done for all participants.Results: Mean age of the study population was 69.05±8.3years. Among the study subjects, 40 (18.2%) had moderate risk of fall and 9 (4.1%) were seen to have high risk of fall. 26 (11.8%) subjects had a fall in past one year. TUG test showed a median value of 18.5 seconds, and 179 (18.4%) elderly had TUG result ≥13 sec. According to Geriatric Depression scale (GDS-15), 18 (8.2%) subjects were found to be severely depressed. Significant association was seen between the GDS-15 scores and risk of falls according to Fisher’s exact test. The mean TUG score was shown to have a significant association with the risk of falls according to ANOVA.Conclusions: Moderate to high risk of fall is seen among 22.3% of the elderly. Significant association was seen between age, TUG score and depression with risk of falls.  

iGlarLixi effectively reduces residual hyperglycaemia in patients with type 2 diabetes on basal insulin: A post hoc analysis from the LixiLan-L study

Globally, nearly half of patients with type 2 diabetes (T2D) do not successfully achieve target HbA1c with basal insulin, despite meeting fasting plasma glucose (FPG) targets. In this post hoc analysis of the LixiLan-L study, we determined whether iGlarLixi, a fixed-ratio combination of insulin glargine Gla-100 (iGlar) and the glucagon-like peptide-1 receptor agonist lixisenatide (Lixi), addresses the challenge of reducing residual hyperglycaemia in patients with T2D. In LixiLan-L, a randomized, open-label study, 1018 patients with T2D on basal insulin for ≥6 months ± oral antidiabetes drugs entered a 6-week run-in period, during which they were switched to and/or optimized for a daily dose of iGlar while continuing only metformin. Following the run-in period, 736 patients were then randomized to receive iGlarLixi or were continued on iGlar for 30 weeks ± metformin. Residual hyperglycaemia was defined as HbA1c ≥ 7.0% despite FPG of &lt;140 mg/dL. The proportion of patients with residual hyperglycaemia was similar in both treatment arms at screening (~~42%), and increased after the run-in period (~~62%). After 30 weeks, the proportion of patients with residual hyperglycaemia declined to 23.8% in the iGlarLixi versus 47.1% in the iGlar arm (P &lt;.0001). The proportion of patients achieving both HbA1c (&lt;7.0%) and FPG (&lt;140 mg/dL) targets was higher in the iGlarLixi compared with the iGlar arm (50.3% vs. 27.4%, respectively; P &lt;.0001). iGlarLixi effectively reduces residual hyperglycaemia in patients with T2D on basal insulin therapy

Increased Risk of Cardiovascular Disease in Young Women Following Gestational Diabetes Mellitus

OBJECTIVE—To determine whether women with gestational diabetes mellitus (GDM) have an increased risk of cardiovascular disease (CVD) following pregnancy

Impact of maternal metabolic abnormalities in pregnancy on human milk and subsequent infant metabolic development: methodology and design

<p>Abstract</p> <p>Background</p> <p>Childhood obesity is on the rise and is a major risk factor for type 2 diabetes later in life. Recent evidence indicates that abnormalities that increase risk for diabetes may be initiated early in infancy. Since the offspring of women with diabetes have an increased long-term risk for obesity and type 2 diabetes, the impact of maternal metabolic abnormalities on early nutrition and infant metabolic trajectories is of considerable interest. Human breast milk, the preferred food during infancy, contains not only nutrients but also an array of bioactive substances including metabolic hormones. Nonetheless, only a few studies have reported concentrations of metabolic hormones in human milk specifically from women with metabolic abnormalities. We aim to investigate the impact of maternal metabolic abnormalities in pregnancy on human milk hormones and subsequently on infant development over the first year of life. The objective of this report is to present the methodology and design of this study.</p> <p>Methods/Design</p> <p>The current investigation is a prospective study conducted within ongoing cohort studies of women and their offspring. Pregnant women attending outpatient obstetrics clinics in Toronto, Canada were recruited. Between April 2009 and July 2010, a total of 216 pregnant women underwent a baseline oral glucose tolerance test and provided medical and lifestyle history. Follow-up visits and telephone interviews are conducted and expected to be completed in October 2011. Upon delivery, infant birth anthropometry measurements and human breast milk samples are collected. At 3 and 12 months postpartum, mothers and infants are invited for follow-up assessments. Interim telephone interviews are conducted during the first year of offspring life to characterize infant feeding and supplementation behaviors.</p> <p>Discussion</p> <p>An improved understanding of the link between maternal metabolic abnormalities in pregnancy and early infant nutrition may assist in the development of optimal prevention and intervention strategies and in the protection of nutritionally vulnerable offspring who are at risk for obesity and diabetes later in life.</p