Sample records for include weight gain

  1. Pregnant women lack accurate knowledge of their BMI and recommended gestational weight gain.

    PubMed

    Jeffs, Emma; Haszard, Jillian J; Sharp, Benjamin; Gullam, Joanna; Paterson, Helen

    2016-08-05

    To investigate pregnant women's knowledge of their body mass index (BMI) and their knowledge of gestational weight gain guidelines. Participants were recruited when attending their nuchal translucency scan at between 11 and 13 weeks, 6-days gestation in Dunedin or Christchurch, New Zealand. Recruitment staff measured participants' weight and height. By way of a self-administered, paper-based survey, participants were asked to identify their body size (including: underweight (BMI <18.5 kg/m2); normal weight (18.5-24.9); overweight (25-29.9); and obese (≥30)), and recommended gestational weight gain (including the 2009 Institute of Medicine guidelines for healthy weight gain in pregnancy, along with the options: "I should not gain any weight in my pregnancy", plus "It does not matter how much weight I gain"). Participant-measured BMI was compared to responses for perceived BMI and recommended gestational weight gain to assess accuracy. Demographic predictors of accuracy were also investigated. In total, 644 women were included. Sixty-six percent of these correctly identified their BMI category, however only 31% identified their correct gestational weight gain recommendation. Overweight and obese women were much more likely to underestimate their BMI than normal weight women (p<0.001 for both). Overweight and obese women were also more likely to overestimate their weight gain recommendation (OR=4, p<0.001; OR=18, p<0.001, respectively) while normal weight women were more likely to underestimate their weight gain recommendation (p<0.001). Independent of BMI, women of New Zealand European ethnicity were less likely to underestimate their recommended gestational weight gain compared to other women of non-Māori/non-Pacific Island ethnicity (p=0.001), whereas younger women (p=0.012) were more likely to underestimate recommended gestational weight gain. The present study indicates that New Zealand women, particularly those who are overweight and obese, lack accurate knowledge of their own body size, and this may lead to an under- or over-estimation of appropriate gestational weight gain, which may in turn lead to increased risk of poor health outcomes in pregnancy. Education strategies related to healthy weight gain in pregnancy are urgently required.

  2. Reversal of olanzapine-induced weight gain in a patient with schizophrenia by switching to asenapine: a case report.

    PubMed

    Okazaki, Kosuke; Yamamuro, Kazuhiko; Kishimoto, Toshifumi

    2017-01-01

    Antipsychotics are effective for treating schizophrenia, but atypical antipsychotics can cause several adverse side effects including weight gain, hyperprolactinemia, and extrapyramidal symptoms. Moreover, weight gain increases the risk of metabolic diseases. We treated a case of olanzapine-induced weight gain in a 41-year-old man with schizophrenia by switching his medication from olanzapine to asenapine. The weight gain improved after switching the medication, from 80.3 to 75.0 kg, a weight loss of 6.6%, and there was no significant worsening of psychological symptoms or other adverse effects. Asenapine might be effective for treating patients with schizophrenia who experience olanzapine-induced weight gain.

  3. Accelerated weight gain among children during summer versus school year and related racial/ethnic disparities: a systematic review.

    PubMed

    Franckle, Rebecca; Adler, Rachel; Davison, Kirsten

    2014-06-12

    The objective of this study was to compile and summarize research examining variations in weight gain among students during the summer in comparison to the school year, with a focus on racial/ethnic disparities and students who are at risk of overweight. A systematic search of PubMed and Embase was conducted. Reference lists of identified articles and Google Scholar were also reviewed. Studies that assessed summer weight gain in school children were included. Inclusion criteria were: 1) a focus on children and adolescents aged 5 to 17 attending school; 2) a measured body composition before and after the summer vacation; 3) English-language articles; and 4) publication in a peer-reviewed journal since January 1, 1990. Data were extracted from selected studies in the following categories: study purpose, setting, study design, population, sample size, data collection method, and findings. Seven eligible studies were included in the review. Six of the 7 studies reported accelerated summer weight gain for at least a portion of the study population, with an effect of summer on weight gain identified for the following subgroups: black, Hispanic, and overweight children and adolescents. There may be a trend in increased rate of weight gain during summer school vacation, particularly for high-risk groups, including certain racial/ethnic populations and overweight children and adolescents. Potential solutions for the problem of accelerated summer weight gain include greater access to recreational facilities, physical activity programming, and summer food programs. Further research in this area is needed as summer weight gain may exacerbate existing health disparities.

  4. [A dose-response analysis on the association of gestational weight gain rate and the normal term neonate birth weight].

    PubMed

    Mao, Yuanyuan; Hu, Wenbin; Liu, Qin; Liu, Li; Li, Yuanming; Shen, Yueping

    2015-08-01

    To examine the dose-response relationship between gestational weight gain rate and the neonate birth weight. A total of 18 868 women with singleton gestations who delivered between January 2006 and December 2013 were included in this study. Maternal and neonate details of these women were drawn from the Perinatal Monitoring System database. Gestational weight gain rate was defined as the total weight gain during the last and first prenatal care visits divided by the interval weeks. Both Multiple logistic regression analysis and restricted cubic spline methods were performed. Confounding factors included maternal age, education, pre-pregnancy body mass index (BMI), state of residence, parity, gestational weeks of prenatal care entry, and sex of the neonate. The adjusted odds ratio for macrosomia was associated with gestational weight gain rate in lower pre-pregnancy BMI (OR = 3.15, 95% CI: 1.40-7.07), normal (OR = 3.64, 95% CI: 2.84-4.66) or overweight (OR = 2.37, 95% CI: 1.71-3.27). The odds ratios of low birth weight appeared a decrease in those women with lower pre-pregnancy BMI (OR = 0.28, 95% CI: 0.13-0.61) while the normal weight (OR = 0.37, 95% CI: 0.22-0.64) group with gestational weight gain, the rate showed an increase. Association of gestational weight gain rate for macrosomia was found a S-curve in those term delivery women (non-linearity test P < 0.000 1). However, L-curve was observed for low birth weight and gestational weight gain rate in term births (non-linearity test P < 0.000 1). A S-curve was seen between gestational weight gain rate and term delivered macrosomia while L-curve was observed among term delivered low birth weight neonates.

  5. Effects of physical activity during pregnancy and gestational weight gain on newborn weight and length at birth in Warmińsko-Mazurskie province.

    PubMed

    Przybyłowicz, Katarzyna; Przybyłowicz, Mariusz; Grzybiak, Marek; Janiszewska, Katarzyna

    2014-01-01

    Epidemiological research has identified a relationship between maternal physical activity, early nutrition and infant birth weight with likelihood of developing future diseases. The aim of the study was to determine a relationship between gestational weight gain and physical activity during pregnancy to the nutritional status of newborns. The presented study was conducted in the period from February 2010 until November 2012 in the gynecological and obstetric clinics in Warmińsko-Mazurskie voivodeship with various levels of reference. The research subjects included 510 women in the puerperal period aged 18-36. The scope of the research included an assessment of the selected anthropometric parameters of both pregnant women (body mass, height, BMI, gestational weight gain) and newborns (infant birth weight, infant length, Ponderal Index), as well as an analysis of the connections between the gestational weight gain, physical activity during pregnancy and anthropometric parameters of newborns. In the study group there was a significant percentage of women characterised by an inactive lifestyle and excessive gestational weight gain. There were significantly higher neonatal birth anthropometric parameters in women with abnormal excessive gestational weight gain than in women with normal and inappropriate - low gestational weight gain. The highest percentage of women with appropriate weight gain was observed in the group of women who are physically active, although this requires confirmation in larger population. Our studies have not shown statistically significant differences between the gestational weight gain and nutritional status of newborns in relation to the level of physical activity of pregnant women.

  6. Adjusted poor weight gain for birth weight and gestational age as a predictor of severe ROP in VLBW infants.

    PubMed

    Aydemir, O; Sarikabadayi, Y U; Aydemir, C; Tunay, Z O; Tok, L; Erdeve, O; Oguz, S S; Uras, N; Dilmen, U

    2011-06-01

    To analyze relative weight gain by 2-week intervals up to 6 weeks after birth in order to predict the development of retinopathy of prematurity (ROP) requiring treatment among very low birth weight (BW) infants. A prospective study including infants with BW ≤1500 g born in a single tertiary intensive care unit over 1-year period was conducted. Body weight measurements were recorded weekly and relative weight gains (g/kg/day) were calculated. The main outcome was development of ROP requiring treatment. Mean BW and gestational age (GA) of the whole cohort were 1165±223 g and 29.3±2.3 weeks, respectively. Relative weight gain at 2 weeks and 4 weeks postnatal age were significantly lower in infants with severe ROP (P=0.041 and P=0.017, respectively). Relative weight gain at 6 weeks was not different between groups. Infants with severe ROP gained 6.7±4 g/kg/day in the first 4 weeks of life, compared with 9.3±4.5 g/kg/day for those with mild or no ROP. After adjusted for BW and GA in logistic regression poor relative weight gain in the first 4 weeks was found to be related to severe ROP (P=0.015). When all the other risk factors significant for severe ROP were included in the logistic regression poor weight gain did not arise as an independent risk factor. Poor postnatal weight gain in the first 4 weeks of life is the end result of several comorbidities rather than being an independent risk factor. Poor weight gain can be an additional predictor of severe ROP in very low BW infants.

  7. Accelerated Weight Gain Among Children During Summer Versus School Year and Related Racial/Ethnic Disparities: A Systematic Review

    PubMed Central

    Adler, Rachel; Davison, Kirsten

    2014-01-01

    Introduction The objective of this study was to compile and summarize research examining variations in weight gain among students during the summer in comparison to the school year, with a focus on racial/ethnic disparities and students who are at risk of overweight. Methods A systematic search of PubMed and Embase was conducted. Reference lists of identified articles and Google Scholar were also reviewed. Studies that assessed summer weight gain in school children were included. Inclusion criteria were: 1) a focus on children and adolescents aged 5 to 17 attending school; 2) a measured body composition before and after the summer vacation; 3) English-language articles; and 4) publication in a peer-reviewed journal since January 1, 1990. Data were extracted from selected studies in the following categories: study purpose, setting, study design, population, sample size, data collection method, and findings. Results Seven eligible studies were included in the review. Six of the 7 studies reported accelerated summer weight gain for at least a portion of the study population, with an effect of summer on weight gain identified for the following subgroups: black, Hispanic, and overweight children and adolescents. Conclusion There may be a trend in increased rate of weight gain during summer school vacation, particularly for high-risk groups, including certain racial/ethnic populations and overweight children and adolescents. Potential solutions for the problem of accelerated summer weight gain include greater access to recreational facilities, physical activity programming, and summer food programs. Further research in this area is needed as summer weight gain may exacerbate existing health disparities. PMID:24921899

  8. The association between weight gain during pregnancy and intertwin delivery weight discordance using 2011-2015 birth registration data from the USA.

    PubMed

    Xiao, Yanni; Shen, Minxue; Ma, Shujuan; Tao, Xuan; Wen, Shi Wu; Tan, Hongzhuan

    2018-06-01

    To assess the effect of weight gain during pregnancy on intertwin delivery weight discordance. In the present retrospective cohort study using twin delivery records, data were extracted from the 2011-2015 USA birth registration dataset created by the Centers for Disease Control and Prevention. The outcome variable was delivery weight discordance. The nonlinear association of weight gain during pregnancy with delivery weight discordance was examined using a generalized additive model, adjusting for potential confounders. A total of 255 627 twin pairs were included in this analysis. Weight gain during pregnancy showed an inverse, yet nonlinear, association with intertwin delivery weight discordance. Women with weight gain of approximately 25 kg exhibited the lowest level of discordance. When stratified by pre-pregnancy body mass index, the association of weight gain with discordance became insignificant among obese women. When categorizing weight gain according to recommendations from the Institute of Medicine, inadequate weight gain was associated with increased risk of discordance among women of any pre-pregnancy body mass index. Twin pregnancies with maternal weight gain of approximately 25 kg demonstrated the lowest risk of developing intertwin delivery weight discordance, while inadequate weight gain was a risk factor for delivery weight discordance in all pre-pregnancy body mass index categories. © 2018 International Federation of Gynecology and Obstetrics.

  9. Antipsychotic metabolic effects: weight gain, diabetes mellitus, and lipid abnormalities.

    PubMed

    McIntyre, R S; McCann, S M; Kennedy, S H

    2001-04-01

    To review published and nonpublished literature describing changes in weight, glucose homeostasis, and lipid milieu with antipsychotics. A Medline search was completed using the words weight gain, diabetes mellitus, cholesterol, triglycerides, risperidone, clozapine, olanzapine, quetiapine, ziprasidone, predictors, prolactin, obesity, and conventional antipsychotics. Publications, including original articles, review articles, letters to the editor, abstracts or posters presented at professional meetings in the last 4 years, and references from published articles, were collected. Manufacturers, including Eli Lilly Canada Inc, JanssenOrtho Inc, Pfizer Canada Inc, AstraZeneca Inc, and Novartis Pharmaceuticals, were contacted to retrieve additional medical information. The topic of antipsychotic-induced weight gain is understudied, and there are relatively few well-controlled studies. Weight gain as a side effect has been described with both conventional and atypical antipsychotics. Moreover, some atypical antipsychotics are associated with de novo diabetes mellitus and increased serum triglyceride levels. Predictors of weight gain may be age, baseline body mass index, appetite stimulation, previous antipsychotic exposure, and antipsychotic treatment duration. Significant weight gain is reported with the existing atypical antipsychotics. The weight gain described is highly distressing to patients, may reduce treatment adherence, and may increase the relative risk for diabetes mellitus and hypertriglyceridemia. Physicians employing these agents should routinely monitor weight, fasting blood glucose, and lipid profiles.

  10. Gestational Weight Gain and its Relation with Birth Weight of the Newborn.

    PubMed

    Thapa, Meena; Paneru, Rupa

    2017-01-01

    Gestational weight gain is an important predictor of the health of the newborn. It is affected by body mass index of the women. This study was conducted to find out gestational weight gain according to Institute of Medicine 2009 recommendation and relationship of newborn birth weight to body mass index and gestational weight gain of the women. It was cross sectional, hospital based study. The women, who attended at term pregnancy for delivery and having recorded first trimester body weight, were included in the study. Their body mass index was calculated and they were stratified into 4 groups according to body mass index. The gestational weight gain was calculated by subtracting first trimester body weight from body weight at the time of admission for delivery. All the women were followed till delivery. The newborn birth weight was taken immediately after delivery. A total of 227 women were enrolled in the study. More than half of the women had normal body mass index. There were 84 (37%) overweight and obese women. Mean gestational weight gain was 10.21 kg, and mean weight of the newborn was 3.05 kg. There were equal number of women who had adequate weight gain and less weight gain according to recommendation. Excess weight gain was seen in 34 (15%) women. Women of higher body mass index and women who had gain more weight during pregnancy had larger newborns. Body mass index and gestational weight gain of the women were important predictors of birth weight of the newborn. There is a positive correlation between gestational weight gain of the women and birth weight of the newborn.

  11. Psychosocial influences on weight gain attitudes and behaviors during pregnancy.

    PubMed

    Dipietro, Janet A; Millet, Sarah; Costigan, Kathleen A; Gurewitsch, Edith; Caulfield, Laura E

    2003-10-01

    To examine pregnant women's weight-related attitudes and behaviors in relation to a constellation of psychosocial characteristics, prepregnancy body habitus, and gestational weight gain. One hundred-thirty women with low-risk, normal pregnancies. Cross-sectional, observational study assessed attitudes about weight gain at 36 weeks' gestation. Psychosocial characteristics, including anxiety, depression, social support, emotionality, and pregnancy-specific and nonspecific stress appraisal were assessed between 28 and 36 weeks' gestation. Principal components factor analysis, Pearson correlations, t tests, and analysis of variance. A range of positive and negative attitudes about weight gain was expressed. Twenty-one percent (n=27) of the sample endorsed at least one weight-restrictive behavior during pregnancy. Women who reported more weight-restrictive behaviors were more anxious (r=.24, P<.01), depressed (r=.29,P<.001), angry (r=.29, P<.001), stressed (r=.23, P<.01), and felt less uplifted (r=-.21, P<.05) about their pregnancies in general. Higher Positive Pregnancy Body Image scores were associated with feeling better about the pregnancy in general (r=.35, P<.001), fewer depressive symptoms, and less anger (both r=.20, both P<.01). Women who were self conscious about their weight gain felt more hassled by their pregnancies (r=.21, P<.05), greater anger (r=.21, P<.05), and more support from partners (r=.22, P<.05). Prepregnancy body mass index was unrelated, but negative attitudes about weight gain existed even among women who gained within recommended ranges. Women's attitudes about weight gain in pregnancy are imbedded in their orientation toward pregnancy as well as their general psychological functioning. Effective nutrition counseling for pregnant women should include consideration of weight-restrictive behaviors, the degree to which the pregnancy is perceived as positive and uplifting, and whether weight gain attitudes may be associated with their relationship with a spouse or partner.

  12. Associations between body mass index and maternal weight gain on the delivery of LGA infants in Chinese women with gestational diabetes mellitus.

    PubMed

    Chen, Qi; Wei, J; Tong, M; Yu, L; Lee, A C; Gao, Y F; Zhao, M

    2015-01-01

    Women with gestational diabetes mellitus (GDM) are at increased risk for maternal and fetal complications including delivery of large for gestational age (LGA) infants. Maternal body mass index (BMI) and excessive weight gain during pregnancy are associated with delivery of LGA infants. However, whether maternal BMI and weight gain are associated with LGA infants in women with GDM is unclear. Data on 1049 pregnant women who developed GDM were collected from a university teaching hospital in China and retrospectively analyzed. Data included maternal BMI, weight gain, incidence of LGA and gestational week at diagnosis. The incidence of LGA infants was significantly associated with maternal BMI (p=0.0002) in women with GDM. The odds of delivery of LGA for obese or overweight pregnant women are 3.8 or 2 times more than normal weight pregnant women. The incidence of LGA infants was also significantly associated with maternal weight gain in women with GDM. The odds ratio of delivery of LGA for pregnant women with excessive weight gain was 3.3 times more than pregnant women with normal weight gain. The effect of weight gain was not significantly different between different maternal BMI. The incidence of delivery of LGA infants in Chinese women with GDM who were overweight or obese is higher than Caucasians, Hispanic, and Asian-Americans. The effects of maternal BMI and weight gain on the delivery of LGA infants by women with GDM are additive. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Yoga practice is associated with attenuated weight gain in healthy, middle-aged men and women.

    PubMed

    Kristal, Alan R; Littman, Alyson J; Benitez, Denise; White, Emily

    2005-01-01

    Yoga is promoted or weight maintenance, but there is little evidence of its efficacy. To examine whether yoga practice is associated with lower mean 10-year weight gain after age 45. Participants included 15,550 adults, aged 53 to 57 years, recruited to the Vitamin and Lifestyle (VITAL) cohort study between 2000 and 2002. Physical activity (including yoga) during the past 10 years, diet, height, and weight at recruitment and at ages 30 and 45. All measures were based on self-reporting, and past weight was retrospectively ascertained. Multiple regression analyses were used to examined covariate-adjusted associations between yoga practice and weight change from age 45 to recruitment, and polychotomous logistic regression was used to examine associations of yoga practice with the relative odds of weight maintenance (within 5%) and weight loss (> 5%) compared to weight gain. Yoga practice for four or more years was associated with a 3.1-lb lower weight gain among normal weight (BMI < 25) participants [9.5 lbs versus 12.6 Ibs] and an 18.5-lb lower weight gain among overweight participants [-5.0 lbs versus 13.5 Ibs] (both P for trend <.001). Among overweight individuals, 4+ years of yoga practice was associated with a relative odds of 1.85 (95% confidence interval [CI] 0.63-5.42) for weight maintenance (within 5%) and 3.88 (95% Cl 1.30-9.88) for weight loss (> 5%) compared to weight gain (P for trend .026 and .003, respectively). Regular yoga practice was associated with attenuated weight gain, most strongly among individuals who were overweight. Although causal inference from this observational study is not possible, results are consistent with the hypothesis that regular yoga practice can benefit individuals who wish to maintain or lose weight.

  14. Maternal fat, but not lean, mass is increased among overweight/obese women with excess gestational weight gain.

    PubMed

    Berggren, Erica K; Groh-Wargo, Sharon; Presley, Larraine; Hauguel-de Mouzon, Sylvie; Catalano, Patrick M

    2016-06-01

    Weight gain in pregnancy is an essential physiologic adaptation that supports growth and development of a fetus and is distributed among lean mass that includes total body water and fat mass gains. Although gestational weight gain provides a source of energy for the mother and fetus, excess gestational weight gain may underlie reported associations between parity and future metabolic disorders and is linked to postpartum weight retention and insulin resistance. Although weight gain often is proposed as a modifiable variable to mitigate adverse maternal and offspring health outcomes, our knowledge of specific maternal body composition changes with weight gain and the potential metabolic consequences is limited. Furthermore, although gestational weight gain alters maternal body composition, the impact of excess weight gain on fat and lean mass is not well-studied. Understanding the accrual of fat and lean body mass may improve our understanding of the role of excessive gestational weight gain and metabolic dysfunction. The purpose of our study was to quantify the relationship between gestational weight gain and maternal fat and lean body mass accrual and to compare fat and lean body mass accrual according to the 2009 Institute of Medicine Guidelines for Gestational Weight Gain in Pregnancy adherence. We hypothesized that exceeding current weight gain guidelines would be associated with greater fat, compared with lean body, mass accrual. This is a secondary analysis of a randomized controlled trial of 49 overweight/obese women; all 49 are included in this secondary analysis. Maternal weight and body composition were collected in early (13 0/6 to 16 6/7 weeks gestation) and late (34 0/7 to 36 6/7 weeks gestation) pregnancy with the use of air densitometry. Correlations were drawn between gestational weight gain and change in fat and lean body mass. We compared change in fat and lean body mass by adherence to the 2009 Institute of Medicine Guidelines for Gestational Weight Gain in Pregnancy. Nonparametric tests and chi-square analyses were performed; a probability value of <.05 was significant. Early pregnancy body mass index was 30.3 kg/m(2) (interquartile range [IQR], 28.5-35.2 kg/m(2)); women gained 9.0 kg (IQR, 5.3-13.2 kg). Overweight and obese women were equally likely to gain excess weight (48% vs 35%; P = .6). Weight gain correlated strongly with fat mass change (r = 0.87; P < .001); women with excess vs adequate vs inadequate weight gain had greater fat mass change overall (5.2 [IQR, 4.2-8.1] vs 0.2 [IQR, -0.4-2.2] vs -2.7 [IQR, -5.2- -0.7] kg, respectively; P < .001) and in all pairwise comparisons. Weight gain also correlated with lean body mass change (r = 0.52; P = .001), but women with excess vs adequate weight gain had similar lean body mass change (8.4 [IQR, 7.2-10.1] vs 7.8 [IQR, 6.0-8.7] kg; P = .1). Excess gestational weight gain is associated primarily with maternal fat, but not with lean body mass accrual. Our results may help explain the reason that excess gestational weight gain or fat mass accrual is associated with long-term obesity, metabolic dysfunction, and cardiovascular disease risk. Copyright © 2015 Elsevier Inc. All rights reserved.

  15. Effect of multivitamin and vitamin A supplements on weight gain during pregnancy among HIV-1-infected women.

    PubMed

    Villamor, Eduardo; Msamanga, Gernard; Spiegelman, Donna; Antelman, Gretchen; Peterson, Karen E; Hunter, David J; Fawzi, Wafaie W

    2002-11-01

    The pattern of weight gain during pregnancy among HIV-infected women is largely unknown. Multivitamin supplementation was shown to be effective in preventing adverse pregnancy outcomes among HIV-positive women. These protective effects could be mediated in part by an improvement in the pattern of gestational weight gain. We examined the effects of multivitamin and vitamin A supplements on weight gain during the second and third trimesters of pregnancy among HIV-infected women. We enrolled 1075 pregnant, HIV-1-positive women from Dar es Salaam, Tanzania, in a randomized, placebo-controlled trial. Using a 2-by-2 factorial design, we assigned each woman to 1 of 4 regimens: multivitamins (thiamine, riboflavin, niacin, folic acid, and vitamins B-6, B-12, C, and E), vitamin A, multivitamins including vitamin A, or placebo. The women took these oral supplements daily and were weighed monthly until the end of pregnancy. The mean rate of weight gain was 306 g/wk during the second trimester and 247 g/wk during the third trimester. During the third trimester, average weight gain was significantly greater (by 304 g; 95% CI: 17, 590; P = 0.04) and the risk of low rate of weight gain (

  16. Psychosocial working conditions and weight gain among employees.

    PubMed

    Lallukka, T; Laaksonen, M; Martikainen, P; Sarlio-Lähteenkorva, S; Lahelma, E

    2005-08-01

    To study the associations between psychosocial working conditions and weight gain. Data from postal questionnaires (response rate 67%) sent to 40- to 60-y-old women (n=7093) and men (n=1799) employed by the City of Helsinki in 2000-2002 were analysed. Weight gain during the previous 12 months was the outcome variable in logistic regression analyses. Independent variables included Karasek's job demands and job control, work fatigue, working overtime, work-related mental strain, social support and the work-home interface. The final models were adjusted for age, education, marital status, physical strain and body mass index. In the previous 12 months, 25% of women and 19% of men reported weight gain. Work fatigue and working overtime were associated with weight gain in both sexes. Women who were dissatisfied with combining paid work and family life were more likely to have gained weight. Men with low job demands were less likely to have gained weight. All of these associations were independent of each other. Few work-related factors were associated with weight gain. However, our study suggests that work fatigue and working overtime are potential risk factors for weight gain. These findings need to be confirmed in prospective studies.

  17. Importance of early weight changes to predict long-term weight gain during psychotropic drug treatment.

    PubMed

    Vandenberghe, Frederik; Gholam-Rezaee, Mehdi; Saigí-Morgui, Núria; Delacrétaz, Aurélie; Choong, Eva; Solida-Tozzi, Alessandra; Kolly, Stéphane; Thonney, Jacques; Gallo, Sylfa Fassassi; Hedjal, Ahmed; Ambresin, Anne-Emmanuelle; von Gunten, Armin; Conus, Philippe; Eap, Chin B

    2015-11-01

    Psychotropic drugs can induce substantial weight gain, particularly during the first 6 months of treatment. The authors aimed to determine the potential predictive power of an early weight gain after the introduction of weight gain-inducing psychotropic drugs on long-term weight gain. Data were obtained from a 1-year longitudinal study ongoing since 2007 including 351 psychiatric (ICD-10) patients, with metabolic parameters monitored (baseline and/or 1, 3, 6, 9, 12 months) and with compliance ascertained. International Diabetes Federation and World Health Organization definitions were used to define metabolic syndrome and obesity, respectively. Prevalences of metabolic syndrome and obesity were 22% and 17%, respectively, at baseline and 32% and 24% after 1 year. Receiver operating characteristic analyses indicated that an early weight gain > 5% after a period of 1 month is the best predictor for important long-term weight gain (≥ 15% after 3 months: sensitivity, 67%; specificity, 88%; ≥ 20% after 12 months: sensitivity, 47%; specificity, 89%). This analysis identified most patients (97% for 3 months, 93% for 12 months) who had weight gain ≤ 5% after 1 month as continuing to have a moderate weight gain after 3 and 12 months. Its predictive power was confirmed by fitting a longitudinal multivariate model (difference between groups in 1 year of 6.4% weight increase as compared to baseline, P = .0001). Following prescription of weight gain-inducing psychotropic drugs, a 5% threshold for weight gain after 1 month should raise clinician concerns about weight-controlling strategies. © Copyright 2015 Physicians Postgraduate Press, Inc.

  18. Employment, work hours and weight gain among middle-aged women.

    PubMed

    Au, N; Hauck, K; Hollingsworth, B

    2013-05-01

    To investigate the influence of employment and work hours on weight gain and weight loss among middle-aged women. Quantile regression techniques were used to estimate the influence of employment and hours worked on percentage weight change over 2 years across the entire distribution of weight change in a cohort of middle-aged women. A range of controls was included in the models to isolate the effect of work status. A total of 9276 women aged 45-50 years at baseline who were present in both the 1996 and 1998 surveys of the Australian Longitudinal Study of Women's Health. The women were a representative sample of the Australian population. Being out of the labour force or unemployed was associated with lower weight gain and higher weight loss than being employed. The association was stronger at low to moderate levels of weight gain. Among employed women, working regular (35-40), long (41-48) or very long (49+) hours was associated with increasingly higher levels of weight gain compared with working part-time hours. The association was stronger for women with greater weight gain overall. The association between unemployment and weight change became insignificant when health status was controlled for. Employment was associated with more weight gain and less weight loss. Among the employed, working longer hours was associated with more weight gain, especially at the higher levels of weight gain where the health consequences are more serious. These findings suggest that as women work longer hours they are more likely to make lifestyle choices that are associated with weight gain.

  19. Associations of the pre-pregnancy body mass index and gestational weight gain with pregnancy outcomes in Taiwanese women.

    PubMed

    Tsai, I-Hsien; Chen, Chih-Ping; Sun, Fang-Ju; Wu, Chia-Hsun; Yeh, Sung-Ling

    2012-01-01

    Pre-pregnancy weight and gestational weight gain (GWG) are important factors in both maternal and infant outcomes. Little information is available in relation to different levels of pre-pregnancy body mass index (BMI) and body weight gain on obstetric outcomes in Taiwan. This study investigated the associations between pregnancy complications with pre-pregnant BMI and GWG, in Taiwanese women. Data were extracted from a delivery room information bank on all women delivering singleton babies in a medical center. Eight hundred and sixty pregnant women were included. The collected variables included basic information, GWG, and pregnancy and neonatal outcomes. Pregnant women were categorized according to their pre-pregnant BMI and GWG to evaluate the impacts of pre-pregnant BMI and maternal weight gain on the risk of pregnancy complications. Univariate and multivariable logistic regression analyses were performed, and odds ratios were calculated. Pre-pregnancy BMI>=24 kg/m2 increased the risks of gestational diabetes mellitus, preeclampsia, and preterm labor. Preeclampsia and Cesarean delivery were positively associated with high weight gains (>18 kg), whereas a low birth weight and preterm labor were strongly associated with low weight gains (<10 kg). A higher birth weight was found with a GWG of >14 kg in women who were underweight and normal weight before pregnancy. An appropriate maternal BMI (18.5-24 kg/m2) at conception followed by a suitable gestational weight gain (10-14 kg) has substantial impact on the overall health of pregnant women and would lead to better obstetric management for Taiwanese women.

  20. Antipsychotic induced weight gain in schizophrenia:mechanisms and management.

    PubMed

    Rege, Sanil

    2008-05-01

    The aim of the present paper was to describe the mechanisms and management of antipsychotic-induced weight gain in schizophrenia patients. A comprehensive literature review of all available articles on the mechanisms and management of antipsychotic-induced weight gain was done by searching databases PsychINFO and PubMed. A summary of the available guidelines for monitoring of antipsychotic-induced weight gain and metabolic syndrome is also provided. There has been a substantial increase in the number of studies investigating the mechanisms and management of antipsychotic-induced weight gain after 2002. These include advances in the understanding of pharmacogenomics of weight gain and several randomized controlled trials (RCTs) evaluating pharmacological and psychological treatments to promote weight loss. The most effective strategy for prevention of weight gain is the choice of antipsychotic medication with low weight gain potential. In individuals with established weight gain and metabolic issues, switching to an antipsychotic agent with lower weight gain potential and/or lifestyle modifications with physical activity are most effective in promoting weight loss. Pharmacological agents such as orlistat and sibutramine are effective in general obesity but have not been sufficiently evaluated in antipsychotic-induced weight gain. The case to prescribe routine pharmacological treatment to promote weight loss is weak. Long-term, pragmatic studies are required to inform clinical practice. Weight gain in schizophrenia is associated with significant physical and psychological morbidity. Achieving an optimal trade-off between effectiveness and side-effects of antipsychotic agents, although difficult, is achievable. This should be based on three main principles: (i) a shared decision-making model between the patient, clinician and carer(s) when choosing an antipsychotic; (ii) a commitment to baseline and follow-up monitoring with explicit identification of the responsible individual or team; and (iii) the adoption of clear structured protocols for clinicians to follow in case of clinically significant weight gain and metabolic issues, which should incorporate greater collaboration between various health professionals from psychiatric and medical specialist services.

  1. Weight Gain After Breast Cancer Diagnosis and All-Cause Mortality: Systematic Review and Meta-Analysis

    PubMed Central

    Bracken, Michael B.; Sanft, Tara B.; Ligibel, Jennifer A.; Harrigan, Maura; Irwin, Melinda L.

    2015-01-01

    Background: Overweight and obesity are associated with breast cancer mortality. However, the relationship between postdiagnosis weight gain and mortality is unclear. We conducted a systematic review and meta-analysis of weight gain after breast cancer diagnosis and breast cancer–specific, all-cause mortality and recurrence outcomes. Methods: Electronic databases identified articles up through December 2014, including: PubMed (1966-present), EMBASE (1974-present), CINAHL (1982-present), and Web of Science. Language and publication status were unrestricted. Cohort studies and clinical trials measuring weight change after diagnosis and all-cause/breast cancer–specific mortality or recurrence were considered. Participants were women age 18 years or older with stage I-IIIC breast cancer. Fixed effects analysis summarized the association between weight gain (≥5.0% body weight) and all-cause mortality; all tests were two-sided. Results: Twelve studies (n = 23 832) were included. Weight gain (≥5.0%) compared with maintenance (<±5.0%) was associated with increased all-cause mortality (hazard ratio [HR] = 1.12, 95% confidence interval [CI] = 1.03 to 1.22, P = .01, I2 = 55.0%). Higher risk of mortality was apparent for weight gain ≥10.0% (HR = 1.23, 95% CI = 1.09 to 1.39, P < .001); 5% to 10.0% weight gain was not associated with all-cause mortality (P = .40). The association was not statistically significant for those with a prediagnosis body mass index (BMI) of less than 25kg/m2 (HR = 1.14, 95% CI = 0.99 to 1.31, P = .07) or with a BMI of 25kg/m2 or higher (HR = 1.00, 95% CI = 0.86 to 1.16, P = .19). Weight gain of 10.0% or more was not associated with hazard of breast cancer–specific mortality (HR = 1.17, 95% CI = 1.00 to 1.38, P = .05). Conclusions: Weight gain after diagnosis of breast cancer is associated with higher all-cause mortality rates compared with maintaining body weight. Adverse effects are greater for weight gains of 10.0% or higher. PMID:26424778

  2. Factors influencing acute weight change in patients with schizophrenia treated with olanzapine, haloperidol, or risperidone.

    PubMed

    Basson, B R; Kinon, B J; Taylor, C C; Szymanski, K A; Gilmore, J A; Tollefson, G D

    2001-04-01

    Clinical factors predicting weight change in patients with schizophrenia and related disorders during acute treatment with the antipsychotic drugs olanzapine, risperidone, and haloperidol were sought through retrospective analyses. Six-week body-weight data from 2 trials, study 1 comparing olanzapine and haloperidol (N = 1,369) and study 2 olanzapine and risperidone (N = 268), were analyzed. Effects of 8 clinically relevant covariates--therapy, clinical outcome (Brief Psychiatric Rating Scale), baseline body mass index (BBMI), increased appetite, age, gender, race, and dose--on weight were compared. In study 1, olanzapine (vs. haloperidol) therapy, better clinical outcome, lower BBMI, and nonwhite race significantly affected weight gain. Effects of increased appetite and male gender on weight gain were significant for olanzapine but not for haloperidol. In study 2, better clinical outcome, lower BBMI, and younger age significantly affected weight gain. Increased appetite was more frequent during olanzapine treatment than during haloperidol, but not significantly different from risperidone. Significant differences in effect on weight change were found between olanzapine and haloperidol but not between olanzapine and risperidone. No evidence was found that lower antipsychotic drug doses were associated with lower weight gain. This report identifies predictive factors of acute weight change in patients with schizophrenia. Similar factors across antipsychotic drugs in predicting greater weight gain included better clinical outcome, low BBMI, and nonwhite race. Factors differing between conventional (haloperidol) and atypical (olanzapine) agents included increased appetite and gender. Choice of atypical antipsychotic drug (olanzapine vs. risperidone) was of minor importance with regard to influence on acute weight gain.

  3. Excessive Gestational Weight Gain in the First Trimester among Women with Normal Glucose Tolerance and Resulting Neonatal Adiposity

    PubMed Central

    Josefson, Jami L.; Simons, Hannah; Zeiss, Dinah M.; Metzger, Boyd E.

    2016-01-01

    Objective To assess whether weight gain above or below Institute of Medicine (IOM) recommended amounts in an ethnically diverse obstetric population with normal glucose tolerance is associated with differences in neonatal adiposity. Study Design In this prospective cohort study, healthy women with normal glucose tolerance based on the International Association of Diabetes and Pregnancy Study Groups guidelines were enrolled. Gestational weight at multiple time points were collected. Neonatal adiposity was measured by air displacement plethysmography at 24-72 hours of life. Analyses included Fisher's exact test, ANOVA, and a trajectory analysis using a group-based weight gain trajectory model with a censored normal distribution. Result Overweight and obese women were more likely to exceed IOM weight gain guidelines. Regardless, there was no significant difference in %body fat of neonates born to mothers who either met or exceeded gestational weight gain guidelines. Gestational weight gain timing influenced neonatal anthropometrics: women who gained excessively by the first prenatal visit had neonates with significantly higher birth weight (3.91 kg vs. 3.45 kg, p<0.001), and %body fat (13.7% vs. 10.9%, p=0.0001) compared to women who had steady, moderate gestational weight gain. Conclusion Avoidance of excessive gestational weight gain in the first trimester may prevent high amounts of neonatal adiposity. PMID:27583397

  4. Gestational Weight Gain: Association with Adverse Pregnancy Outcomes.

    PubMed

    Hannaford, Karen E; Tuuli, Methodius G; Odibo, Linda; Macones, George A; Odibo, Anthony O

    2017-01-01

    Background  It is unclear how adherence to the Institute of Medicine's (IOM) guidelines for weight gain affects pregnancy outcomes. Objective  We investigated how weight gain outside the IOM's recommendations affects the risks of adverse pregnancy outcomes. Study Design  We performed a secondary analysis of a prospective cohort study including singleton, nonanomalous fetuses. The risks of small for gestational age (SGA), macrosomia, preeclampsia, cesarean delivery, gestational diabetes, or preterm birth were calculated for patients who gained weight below or above the IOM's recommendations based on body mass index category. A time-to-event analysis was performed to account for gestational age at delivery. A Cox proportional model was fit to estimate hazard ratios accounting for possible confounders. Results  Women who gained weight below recommendations were 2.5 times more likely to deliver SGA and twice as likely to deliver preterm. Normal-weight patients who gained below recommendations were 2.5 times more likely to deliver SGA and twice as likely to deliver preterm. Obese patients who gained inadequate weight were 2.5 times more likely to deliver SGA. Conclusion  Among normal-weight patients, adhering to IOM recommendations may prevent growth abnormalities and preterm delivery. Among obese patients, a minimum weight gain requirement may prevent SGA infants. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Behavioural interventions for weight management in pregnancy: a systematic review of quantitative and qualitative data.

    PubMed

    Campbell, Fiona; Johnson, Maxine; Messina, Josie; Guillaume, Louise; Goyder, Elizabeth

    2011-06-22

    There is a rising prevalence of excessive weight gain in pregnancy and an increasing number of pregnant women who are overweight or obese at the start of the pregnancy. Excessive weight gain during pregnancy is associated with adverse maternal and neonatal consequences and increases the risk of long-term obesity. Pregnancy therefore may be a key time to prevent excessive weight gain and improve the health of women and their unborn child. This systematic review sought to assess the effectiveness of behavioural interventions to prevent excessive weight gain in pregnancy and explore the factors that influence intervention effectiveness. We undertook a systematic review of quantitative and qualitative evidence. This included a meta-analysis of controlled trials of diet and physical activity interventions to prevent excessive weight gain during pregnancy and a thematic synthesis of qualitative studies that investigated the views of women on weight management during pregnancy. A thorough search of eleven electronic bibliographic databases, reference lists of included studies, relevant review articles and experts in the field were contacted to identify potentially relevant studies.Two independent reviewers extracted data. RevMan software was used to perform the meta-analyses. Qualitative data was subject to thematic analysis. Both quantitative and qualitative data were aligned using a matrix framework. Five controlled trials and eight qualitative studies were included. The overall pooled effect size found no significant difference in gestational weight gain amongst participants in the intervention group compared with the control group (mean difference -0.28 95% CI -0.64 to 0.09). The study designs, participants and interventions all varied markedly and there was significant heterogeneity within this comparison in the meta-analysis (I2 67%). Subgroup and sensitivity analysis did not identify contextual elements that influenced the effectiveness of the intervention.In a thematic analysis of the qualitative studies, three major themes emerged relating to women's views of weight management in pregnancy: pregnancy as a time of transition and change, conflicting and contradictory messages and a perceived lack of control. When the results of both quantitative and qualitative data were aligned it was clear that some of the barriers that women described in achieving healthy weight gain in pregnancy were not addressed by the interventions evaluated. This may have contributed to the limited effectiveness of the interventions. Despite intense and often tailored interventions there was no statistically significant effect on weight gain during pregnancy. Inadequate and often contradictory information regarding healthy weight management was reported by women in qualitative studies and this was addressed in the interventions but this in itself was insufficient to lead to reduced weight gain. Multiple types of interventions, including community based strategies are needed to address this complex health problem.

  6. 3 Steps for Setting Healthy Eating Goals

    Cancer.gov

    3 Steps for Setting Healthy Eating Goals; weight Loss; quit smoking and weight loss; quitting smoking and weight loss; quit smoking weight loss; quitting smoking weight loss; weight loss and quitting smoking; weight loss smoking; weight loss and smoking; stop smoking; stop smoking and weight loss; stop smoking weight loss; stop smoking weight gain women; stopped smoking weight gain; i stopped smoking and i gained weight; stopped smoking gained weight; stop smoking weight gain; stop smoking and weight gain; stop smoking weight gain; stop smoking gain weight; stop smoking without weight gain; effects of smoking; side effects of quitting smoking weight gain; effects of smoking on weight loss; side effects of quitting smoking weight gain; smoking weight loss effects; effects giving up smoking; effect quit smoking; side effects when giving up smoking; effect quit smoking; when giving up smoking what side effects; leaving smoking effects; effects after stop smoking; quitting smoking effects; cigarette smoking; if i stop smoking will I gain weight; stopping cigarette smoking; quitting smoking cigarettes; when you stop smoking cigarettes; quit cigarette smoking; how to quit smoking cigarettes without gaining weight; ways to help stop smoking cigarettes; quitting cigarette smoking; smoking cessation; smoking cessation and weight gain; smoking cessation weight gain; weight gain and smoking cessation; weight gain smoking cessation; you quit; weight gain when you quit smoking; can you gain weight from quitting smoking; do you gain weight from quitting smoking; can quitting smoking make you gain weight; will quitting smoking make you gain weight; after you quit smoking cigarettes; does quitting smoking cause you to gain weight; when you quit smoking; you quit smoking; help you quit smoking; weight gain giving up smoking; after giving up smoking; put on weight; quit smoking put on weight; how to stop smoking and not put on weight; how to not put on weight when quitting smoking; put on weight after quitting smoking; does quitting smoking make you put on weight; weight after; weight gain after quit smoking; gained weight after quitting smoking; why people gain weight after quitting smoking; i gained weight after quitting smoking; how to gain weight after quitting smoking; do people gain weight after quitting smoking; gaining weight after quit smoking; gain weight after quit smoking; gaining weight after stopping smoking; gaining weight after smoking; not smoking; tips to quit smoking and not gain weight; how to not gain weight when you quit smoking; how not to gain weight while quitting smoking; quit smoking not gain weight; quitting smoking and not gaining weight; stop smoking and not gain weight; how to quit smoking and not gain weight; how to not gain weight when quitting smoking; tips for quitting smoking and not gaining weight; how to not gain weight when you quit smoking; how to avoid weight gain when quitting smoking; smoking weight; weight gain when quit smoking; weight gain with quitting smoking; gaining weight quitting smoking; gaining weight from quitting smoking; weight gain while quitting smoking; gaining weight while quitting smoking; gain weight quit smoking; weight gain and quitting smoking; weight gain from quitting smoking; weight gain quit smoking; weight gain; cigarette weight gain; about weight gain; quit smoking weight; smoking weight gain; quit smoking without weight gain

  7. Preterm Infant Massage Therapy Research: A Review

    PubMed Central

    Field, Tiffany; Diego, Miguel; Hernandez-Reif, Maria

    2010-01-01

    In this paper, preterm infant massage therapy studies are reviewed. Massage therapy has led to weight gain in preterm infants when moderate pressure massage was provided. In studies on passive movement of the limbs, preterm infants also gained significantly more weight, and their bone density also increased. Research on ways of delivering the massage is also explored including using mothers versus therapists and the added effects of using oils. The use of mothers as therapists was effective in at least one study. The use of oils including coconut oil and safflower oil enhanced the average weight gain, and the transcutaneous absorption of oil also increased triglycerides. In addition, the use of synthetic oil increased vagal activity, which may indirectly contribute to weight gain. The weight gain was associated with shorter hospital stays and, thereby, significant hospital cost savings. Despite these benefits, preterm infant massage is only practiced in 38% of neonatal intensive care units. This may relate to the underlying mechanisms not being well understood. The increases noted in vagal activity, gastric motility, insulin and IGF-1 levels following moderate pressure massage are potential underlying mechanisms. However, those variables combined do not explain all of the variance in weight gain, highlighting the need for additional mechanism studies. PMID:20137814

  8. Maternal nutrition, inadequate gestational weight gain and birth weight: results from a prospective birth cohort.

    PubMed

    Diemert, Anke; Lezius, Susanne; Pagenkemper, Mirja; Hansen, Gudula; Drozdowska, Alina; Hecher, Kurt; Arck, Petra; Zyriax, Birgit C

    2016-08-15

    The aim of our study was to examine maternal weight gain as well as nutrient intake in pregnancy throughout each trimester compared to current recommendations in a low-risk population and its correlation to birth weight. Additionally, we have investigated the association of maternal nutrition with gestational weight gain and birth weight in an economically unrestricted population. Our analysis was carried out in a population-based prospective birth cohort in Hamburg, Germany. 200 pregnant women and 197 infants born at term were included in the analysis. Maternal body weight, weight gain throughout gestation, and birth weight, macro- and micronutrients were assessed based on a 24 h dietary recall in each trimester. Our main outcome measures were weight gain, birth weight, and self-reported dietary intake in each trimester in comparison to current recommendations. One third of the women were characterized by an elevated pre-pregnancy BMI, 60 % did not comply with current weight gain recommendations. Particularly overweight and obese women gained more weight than recommended. In a multivariate analysis birth weight correlated significantly with maternal BMI (p = 0.020), total weight gain (p = 0.020) and gestational week (p < 0.001). Compared to guidelines mean percentage of energy derived from fat (p = 0.002) and protein (p < 0.001) was significantly higher, whereas carbohydrate (p = 0.033) intake was lower. Mean fiber intake was significantly lower (p < 0.001). Saturated fat and sugar contributed largely to energy consumption. Gestational weight gain correlated significantly with energy (p = 0.027), carbohydrates (p = 0.008), monosaccharides and saccharose (p = 0.006) intake. 98 % of the pregnant women were below the iodine recommendation, while none of the women reached the required folate, vitamin D, and iron intake. During gestation appropriate individual advice as to nutrient intake and weight gain seems to be of high priority. Pregnancy should be used as a 'window of opportunity' for behavioral changes.

  9. Maternal Determinants of Birth Weight in Northern Ghana

    PubMed Central

    Abubakari, Abdulai; Kynast-Wolf, Gisela; Jahn, Albrecht

    2015-01-01

    Objectives Weight at birth is usually considered as an indicator of the health status of a given society. As a result this study was designed to investigate the association between birth weight and maternal factors such as gestational weight gain, pre—pregnancy BMI and socio—economic status in Northern Ghana. Methods The study was a facility-based cross-sectional survey conducted in two districts in the Northern region of Ghana. These districts were purposively sampled to represent a mix of urban, peri—urban and rural population. The current study included 419 mother-infant pairs who delivered at term (37–42 weeks). Mother’s height, pre-pregnancy weight and weight changes were generated from the antenatal records. Questionnaires were administered to establish socio-economic and demographic information of respondents. Maternal factors associated with birth weight were examined using multiple and univariate regressions. Results The mothers were generally well nourished before conception (Underweight 3.82%, Normal 57.76%, Overweight 25.06% and Obesity 13.37%) but approximately half of them could not gain adequate weight according to Institute of Medicine recommendations (Low weight gain 49.64%, Adequate weight gain 42.96% and Excessive weight gain 7.40%). Infants whose mothers had excess weight gain were 431g (95% CI 18–444) heavier compared to those whose mothers gained normal weight, while those whose mothers gained less were 479g (95% CI -682– (-276) lighter. Infants of mothers who were overweight and obese before conception were 246g (95% CI 87–405) and 595g (95% CI 375–815) respectively heavier than those of normal mothers, whereas those whose mothers were underweight were 305g (95% CI -565 –(-44) lighter. The mean birth weight observed was 2.98 ± 0.68 kg. Conclusion Our findings show that pre-pregnancy body mass index and weight gain during pregnancy influence birth weight. Therefore, emphasis should be placed on counseling and assisting pregnant women to stay within the recommended weight gain ranges. PMID:26281013

  10. Examining the provisional guidelines for weight gain in twin pregnancies: a retrospective cohort study.

    PubMed

    Lutsiv, Olha; Hulman, Adam; Woolcott, Christy; Beyene, Joseph; Giglia, Lucy; Armson, B Anthony; Dodds, Linda; Neupane, Binod; McDonald, Sarah D

    2017-09-29

    Weight gain during pregnancy has an important impact on maternal and neonatal health. Unlike the Institute of Medicine (IOM) recommendations for weight gain in singleton pregnancies, those for twin gestations are termed "provisional", as they are based on limited data. The objectives of this study were to determine the neonatal and maternal outcomes associated with gaining weight below, within and above the IOM provisional guidelines on gestational weight gain in twin pregnancies, and additionally, to explore ranges of gestational weight gain among women who delivered twins at the recommended gestational age and birth weight, and those who did not. A retrospective cohort study of women who gave birth to twins at ≥20 weeks gestation, with a birth weight ≥ 500 g was conducted in Nova Scotia, Canada (2003-2014). Our primary outcome of interest was small for gestational age (<10th percentile). In order to account for gestational age at delivery, weekly rates of 2nd and 3rd trimester weight gain were used to categorize women as gaining below, within, or above guidelines. We performed traditional regression analyses for maternal outcomes, and to account for the correlated nature of the neonatal outcomes in twins, we used generalized estimating equations (GEE). A total of 1482 twins and 741 mothers were included, of whom 27%, 43%, and 30% gained below, within, and above guidelines, respectively. The incidence of small for gestational age in these three groups was 30%, 21%, and 20%, respectively, and relative to gaining within guidelines, the adjusted odds ratios were 1.44 (95% CI 1.01-2.06) for gaining below and 0.92 (95% CI 0.62-1.36) for gaining above. The gestational weight gain in women who delivered twins at 37-42 weeks with average birth weight ≥ 2500 g and those who delivered twins outside of the recommend ranges were comparable to each other and the IOM recommendations. While gestational weight gain below guidelines for twins was associated with some adverse neonatal outcomes, additional research exploring alternate ranges of gestational weight gain in twin pregnancies is warranted, in order to optimize neonatal and maternal outcomes.

  11. Rapid weight gain during infancy and early childhood is related to higher anthropometric measurements in preadolescence.

    PubMed

    Nanri, H; Shirasawa, T; Ochiai, H; Nomoto, S; Hoshino, H; Kokaze, A

    2017-05-01

    This study examined the relationship between rapid weight gain during infancy and/or early childhood and anthropometric measurements [body mass index (BMI), percent body fat (%BF), waist circumference (WC) and waist-to-height ratio (WHtR)] in preadolescence by sex. Subjects were fourth-grade school children (aged 9 to 10 years) from elementary schools in Ina-town, Japan, in 2010. Measurements of height, weight, %BF and WC were conducted for each subject. We obtained data on height and weight of subjects at birth, age 1.5 years and age 3 years from the Maternal and Child Health handbook. Rapid weight gain was defined as a change in weight-for-age standard deviation score greater than 0.67 from birth to age 1.5 years (infancy) or from age 1.5 to 3 years (early childhood). All anthropometric variables (BMI, %BF, WC and WHtR) at age 9 to 10 years were significantly higher in the rapid weight gain during both infancy and early childhood period group than in the no rapid weight gain group, regardless of sex. When compared with the no rapid weight gain group, rapid weight gain during early childhood period had significantly higher BMI and WC in boys and BMI, %BF and WC in girls. Compared with the no rapid weight gain group, the rapid weight gain during infancy group had a significantly higher WC in boys and significantly higher BMI and WC in girls. Rapid weight gain during both infancy and early childhood was related to higher anthropometric measurements, including WHtR, among Japanese preadolescents, regardless of sex. This study suggests that rapid weight gain during infancy and early childhood may be a risk factor for general/abdominal obesity later in life. © 2017 The Authors. Child: Care, Health and Development Published by John Wiley & Sons Ltd.

  12. Associations Among Obesity, Acute Weight Gain, and Response to Treatment with Olanzapine in Adolescent Schizophrenia

    PubMed Central

    Correll, Christoph U.; Tohen, Mauricio; DelBello, Melissa P.; Ganocy, Stephen J.; Findling, Robert L.; Chang, Kiki

    2013-01-01

    Abstract Objective The purpose of this study was to investigate associations between body weight and illness characteristics, including weight gain and therapeutic efficacy, in adolescents with schizophrenia. Methods Adolescents ages 13–17 years (n=107) with American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) schizophrenia enrolled in a 6 week, double-blind, placebo-controlled trial comparing olanzapine and placebo. Therapeutic response was assessed by the Brief Psychiatric Rating Scale for Children (BPRS-C). Secondary outcomes included the Clinical Global Impressions-Severity (CGI-S) scale and Positive and Negative Syndrome Scale (PANSS). Obesity was defined as sex-/age-adjusted body mass index (BMI)≥95th percentile. Linear regression was used to analyze the relationship between weight gain and psychiatric symptom improvement; logistic regression was conducted to identify predictors of baseline obesity. Results Weight gain was significantly correlated with greater BPRS-C reduction among olanzapine-treated subjects (r=−0.31, p<0.01), whereas a trend was observed among placebo-treated subjects (r=−0.31, p=0.08). However, this relationship became nonsignificant when analyses were controlled for duration of olanzapine treatment (p=0.12), and a treatment by weight gain interaction did not emerge in a repeated-measures mixed model analysis that included time in the study (t=1.27, p=0.21). Additionally, weight gain ≥7% was not significantly associated with response or remission. Among 17 adolescents (16%) with obesity at study entry, obesity was not significantly associated with endpoint BPRS-C illness severity. However, girls (p=0.03), individuals hospitalized within the past year (p=0.02), and those with less severe overall (p=0.03) and negative symptoms (p=0.003) according to the CGI-S and PANSS negative subscale, respectively, were more likely to be obese at baseline. Conclusion Baseline obesity was associated with lower illness severity, which could be mediated by greater treatment adherence, leading to more weight gain. Olanzapine-related weight gain was not independently associated with symptomatic outcome when controlling for treatment duration. Additional studies are needed to extend these findings to other disorders and medications. PMID:24111982

  13. Beliefs and practices of First Nation women about weight gain during pregnancy and lactation: implications for women's health.

    PubMed

    Vallianatos, Helen; Brennand, Erin A; Raine, Kim; Stephen, Queenie; Petawabano, Beatrice; Dannenbaum, David; Willows, Noreen D

    2006-03-01

    Many Cree women in northern Quebec experience excessive weight gain during pregnancy and retain the weight between pregnancies. This contributes to poor maternal-fetal outcomes and increased rates of obesity-related health problems. The purpose of this qualitative descriptive study was to explore (a) Cree women's perceptions of weight gain in pregnancy and weight loss following pregnancy, (b) the barriers that women face in maintaining a healthy body weight, and (c) the sociocultural context of health. Semi-structured interviews were conducted with 30 women who had given birth within the preceding 12 months. Many women spoke of the negative health consequences of excessive weight gain, yet they found it difficult to lose weight due to individual constraints such as lack of time, cultural beliefs about diet while breastfeeding, and community constraints including lack of child care and lack of community programs for mothers.

  14. Postnatal growth outcomes and influence of maternal gestational weight gain: a prospective cohort study in rural Vietnam.

    PubMed

    Hanieh, Sarah; Ha, Tran T; Simpson, Julie A; Thuy, Tran T; Khuong, Nguyen C; Thoang, Dang D; Tran, Thach D; Tuan, Tran; Fisher, Jane; Biggs, Beverley-Ann

    2014-09-30

    Suboptimal weight gain during pregnancy may result in adverse outcomes for both the mother and child, including increased risk of pre-eclampsia and gestational diabetes, delivery of low birth weight and small-for-gestational age (SGA) infants, and preterm delivery. The objectives of this study were to identify maternal predictors of rate of weight gain in pregnancy, and to evaluate the association of gestational weight gain with infant postnatal growth outcomes. We conducted a prospective cohort study of infants born to women who had previously participated in a double-blind cluster randomized controlled trial of antenatal micronutrient supplementation, in Ha Nam province, Vietnam. Pregnant women (n = 1258) were seen at enrolment and 32 weeks gestation, and infants (n = 965) were followed until 6 months of age. Primary outcome was infant anthropometric indicators at 6 months of age (weight for age, length for age, weight for height z scores), and infant weight gain velocity during the first 6 months of life. Low body mass index (<18.5 kg/m2) was present in 26% of women, and rate of gestational weight gain was 0.4 kg per week [SD 0.12]. Rate of weight gain during pregnancy was significantly associated with infant weight-for-age (MD 1.13, 95% CI 0.58 to 1.68), length-for-age (MD 1.11, 95% CI 0.66 to 1.55), weight-for-length z scores (MD 0.63, 95% CI 0.07 to 1.19), and infant weight gain velocity during the first 6 months of life (MD 93.6 g per month, 95% CI 8.2 to 179.0). Rate of gestational weight gain is predictive of postnatal growth at six months of age in this setting. Public health programs should be targeted towards improving body mass index and weight gain in pregnant women in rural Vietnam.

  15. Bioavailable Insulin-Like Growth Factor-I Inversely Related to Weight Gain in Postmenopausal Women regardless of Exogenous Estrogen

    PubMed Central

    Jung, Su Yon; Hursting, Stephen D.; Guindani, Michele; Vitolins, Mara Z.; Paskett, Electra; Chang, Shine

    2014-01-01

    Background Weight gain, insulin-like growth factor-I (IGF-I) levels, and excess exogenous steroid hormone use are putative cancer risk factors, yet their interconnected pathways have not been fully characterized. This cross-sectional study investigated the relationship between plasma IGF-I levels and weight gain according to body mass index (BMI), leptin levels, and exogenous estrogen use among postmenopausal women. Methods This study included 794 postmenopausal women who enrolled in an ancillary study of the Women's Health Initiative Observational Study between February 1995 and July 1998. The relationship between IGF-I levels and weight gain was analyzed using ordinal logistic regression. We used the molar ratio of IGF-I to IGF binding protein-3 (IGF-I/IGFBP-3) or circulating IGF-I levels adjusting for IGFBP-3 as a proxy of bioavailable IGF-I. The plasma concentrations were expressed as quartiles. Results Among the obese group, women in the third quartile (Q3) of IGF-I and highest quartile of IGF-I/IGFBP-3 were less likely to gain weight (>3% from baseline) than were women in the first quartiles (Q1). Among the normal weight group, women in Q2 and Q3 of IGF-I/IGFBP-3 were 70% less likely than those in Q1 to gain weight. Among current estrogen users, Q3 of IGF-I/IGFBP-3 had 0.5 times the odds of gaining weight than Q1. Conclusions Bioavailable IGF-I levels were inversely related to weight gain overall. Impact Although weight gain was not consistent with increases in IGF-I levels among postmenopausal women in this report, avoidance of weight gain as a strategy to reduce cancer risk may be recommend. PMID:24363252

  16. Relationship Between Excessive Gestational Weight Gain and Neonatal Adiposity in Women With Mild Gestational Diabetes Mellitus.

    PubMed

    Blackwell, Sean C; Landon, Mark B; Mele, Lisa; Reddy, Uma M; Casey, Brian M; Wapner, Ronald J; Varner, Michael W; Rouse, Dwight J; Thorp, John M; Sciscione, Anthony; Catalano, Patrick; Saade, George; Caritis, Steve N; Sorokin, Yoram; Grobman, William A

    2016-12-01

    To evaluate the relationships among excessive gestational weight gain, neonatal adiposity, and adverse obstetric outcomes in women with mild gestational diabetes mellitus. This is a secondary analysis of a multicenter randomized clinical trial of women with mild gestational diabetes mellitus. Based on self-reported prepregnancy body weight, gestational weight gain was categorized as excessive if it was greater than 2009 Institute of Medicine guidelines. Maternal outcomes and neonatal anthropomorphic characteristics were compared between women with excessive weight gain and those without excessive weight gain. Multiple linear and logistic regression analyses were performed to adjust for confounding factors. We studied 841 women who participated in the main trial and had prepregnancy body mass index (BMI) and delivery information available (n=431 treatment group, n=410 no treatment). After adjustment for factors including treatment and prepregnancy BMI, excessive weight gain remained associated with large for gestational age (adjusted odds ratio [OR] 2.94, 95% confidence interval [CI] 1.81-4.93), birth weight greater than 4,000 g (adjusted OR 2.56, 95% CI 1.54-4.40), preeclampsia (adjusted OR 2.96, 95% CI 1.35-7.03), and cesarean delivery for labor arrest (adjusted OR 2.37, 95% CI 1.30-4.44). In addition, excessive weight gain was independently associated with increased total neonatal fat (P<.001) and birth weight (P<.001). In women with both treated and untreated mild gestational diabetes mellitus, excessive gestational weight gain was independently associated with both greater birth weight and adiposity.

  17. Pregnant women's perceptions of gestational weight gain: A systematic review and meta-synthesis of qualitative research.

    PubMed

    Vanstone, Meredith; Kandasamy, Sujane; Giacomini, Mita; DeJean, Deirdre; McDonald, Sarah D

    2017-10-01

    Excess gestational weight gain has numerous negative health outcomes for women and children, including high blood pressure, diabetes, and cesarean section (maternal) and high birth weight, trauma at birth, and asphyxia (infants). Excess weight gain in pregnancy is associated with a higher risk of long-term obesity in both mothers and children. Despite a concerted public health effort, the proportion of pregnant women gaining weight in excess of national guidelines continues to increase. To understand this phenomenon and offer suggestions for improving interventions, we conducted a systematic review of qualitative research on pregnant women's perceptions and experiences of weight gain in pregnancy. We used the methodology of qualitative meta-synthesis to analyze 42 empirical qualitative research studies conducted in high-income countries and published between 2005 and 2015. With this synthesis, we provide an account of the underlying factors and circumstances (barriers, facilitators, and motivators) that pregnant women identify as important for appropriate weight gain. We also offer a description of the strategies identified by pregnant women as acceptable and appropriate ways to promote healthy weight gain. Through our integrative analysis, we identify women's common perception on the struggle to enact health behaviors and physical, social, and environmental factors outside of their control. Effective and sensitive interventions to encourage healthy weight gain in pregnancy must consider the social environment in which decisions about weight take place. © 2016 John Wiley & Sons Ltd.

  18. Interventions for preventing excessive weight gain during pregnancy

    PubMed Central

    Muktabhant, Benja; Lumbiganon, Pisake; Ngamjarus, Chetta; Dowswell, Therese

    2014-01-01

    Background Excessive weight gain during pregnancy is associated with multiple maternal and neonatal complications. However, interventions to prevent excessive weight gain during pregnancy have not been adequately evaluated. Objectives To evaluate the effectiveness of interventions for preventing excessive weight gain during pregnancy and associated pregnancy complications. Search methods We searched the Cochrane Pregnancy and Childbirth Group’s Trials Register (20 October 2011) and MEDLINE (1966 to 20 October 2011). Selection criteria All randomised controlled trials and quasi-randomised trials of interventions for preventing excessive weight gain during pregnancy. Data collection and analysis We assessed for inclusion all potential studies we identified as a result of the search strategy. At least two review authors independently assessed trial quality and extracted data. We resolved discrepancies through discussion. We have presented results using risk ratio (RR) for categorical data and mean difference for continuous data. We analysed data using a fixed-effect model. Main results We included 28 studies involving 3976 women; 27 of these studies with 3964 women contributed data to the analyses. Interventions focused on a broad range of interventions. However, for most outcomes we could not combine data in a meta-analysis, and where we did pool data, no more than two or three studies could be combined for a particular intervention and outcome. Overall, results from this review were mainly not statistically significant, and where there did appear to be differences between intervention and control groups, results were not consistent. For women in general clinic populations one (behavioural counselling versus standard care) of three interventions examined was associated with a reduction in the rate of excessive weight gain (RR 0.72, 95% confidence interval 0.54 to 0.95); for women in high-risk groups no intervention appeared to reduce excess weight gain. There were inconsistent results for mean weight gain (reported in all but one of the included studies). We found a statistically significant effect on mean weight gain for five interventions in the general population and for two interventions in high-risk groups. Most studies did not show statistically significant effects on maternal complications, and none reported significant effects on adverse neonatal outcomes. Authors’ conclusions There is not enough evidence to recommend any intervention for preventing excessive weight gain during pregnancy, due to the significant methodological limitations of included studies and the small observed effect sizes. More high-quality randomised controlled trials with adequate sample sizes are required to evaluate the effectiveness of potential interventions. PMID:22513947

  19. The role of environmental quality in gestational weight gain among U.S. pregnant women

    EPA Science Inventory

    From 2000-2009, 44% of United States (US) pregnant women had gestational weight gain (GWG) above and 20% had GWG below the recommended range of 15 to 40 pounds, which depends on starting weight. GWG outside the recommended range is associated with adverse outcomes including pre-e...

  20. [Corporal image and pregnancy: A look at psychometric properties of the French translation of the Pregnancy and Weigh Gain Attitude Scale].

    PubMed

    Rousseau, A; Bouillon, A; Lefebvre, L; Séjourné, N; Denis, A

    2016-08-01

    Body dissatisfaction among pregnant women can provoke behaviors to control weight gain and make them more vulnerable to eating disorders. Body dissatisfaction and strategies to control weight during pregnancy can have many consequences for both the mother and baby. Excessive weight gain may cause complications during childbirth and, reciprocally, a too weak weight gain could be associated with the risk of having a baby with a very low birth weight. Thus, it appears important to have a tool to detect these body image disorders in this population. As far as we know, no French-speaking tool exists, and the objective of this study was to investigate the psychometric properties of the French translation of the Pregnancy and Weight Gain Attitude Scale (PWGAS), which assesses the attitudes about weight gain during pregnancy. The sample consisted of 553 women (29.32±4.82 years) in their third trimester of pregnancy. Participants were volunteer women recruited in hospitals during obstetric consultation. All participants completed an anamnestic questionnaire, the PWGAS and a questionnaire assessing body dissatisfaction (Body Shape Questionnaire [BSQ]). The PWGAS, in its original version, includes 18 items and consists of four subscales: Positive Pregnancy Body Image; Negative Pregnancy Body Image; Indifference toward Weight Gain and Weight Gain Restrictive Behaviors. The instrument was translated and verified by expert translators. Confirmatory factor analysis of the original version showed fit indices below recommended limits. An exploratory factor analysis on the PWGAS revealed the existence of five factors: "Fear about weight gain" (4 items); "Absence of weight gain preoccupation" (2 items); "Positive attitudes about weight gain" (4 items); "Feeling overwhelmed by weight gain" (3 items); and "Control over weight gain" (3 items). The goodness-of-fit of the five-factor model was satisfactory. The PWGAS (total and factors) is negatively correlated with the BSQ demonstrating its concurrent validity. The PWGAS has satisfactory psychometric properties. This questionnaire could certainly be integrated in the monitoring of pregnant women in order to detect and guide those who show negative attitudes about the weight gain so that they can benefit from adequate care and prevent the development of eating disorders. Copyright © 2015 L’Encéphale, Paris. Published by Elsevier Masson SAS. All rights reserved.

  1. Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length.

    PubMed

    Sámano, Reyna; Martínez-Rojano, Hugo; Chico-Barba, Gabriela; Godínez-Martínez, Estela; Sánchez-Jiménez, Bernarda; Montiel-Ojeda, Diana; Tolentino, Maricruz

    2017-09-27

    Introduction : Gestational weight gain is an important modifiable factor known to influence fetal outcomes including birth weight and adiposity. Leptin is normally correlated with adiposity and is also known to increase throughout pregnancy, as the placenta becomes a source of leptin synthesis. Several studies have reported positive correlations between cord blood leptin level and either birthweight or size for gestational age, as well as body mass index (BMI). Objective : To determine the correlation of prenatal leptin concentration in pregnant adolescents with their gestational weight gain, postpartum weight retention, and weight/length of their newborn. Methods : A cohort study was conducted on pregnant Mexican adolescents from Gestational Week 26-28 to three months postpartum ( n = 168 mother-child dyads). An anthropometric assessment was made of each pregnant adolescent, and the serum level of leptin and the intake of energy were determined. The newborn was evaluated each month during postpartum. Clinical records were reviewed to obtain sociodemographic data. Bivariate correlations, tests for repeating measurements and logistic regression models were performed. Results : Leptin concentration gradually increased during the third trimester of pregnancy. At Gestation Week 36, leptin level correlated with gestational weight gain. When comparing adolescents that had the lowest and highest concentration of leptin, the former presented a mean of 6 kg less in gestational weight gain (inter-subject leptin concentration, p = 0.001; inter-subject energy intake, p = 0.497). Leptin concentration and gestational weight gain exerted an effect on the weight of the newborn (inter-subject leptin concentration for Week 32, p = 0.024; inter-subject gestational weight gain, p = 0.011). Newborn length was associated with leptin concentration at Week 28 (leptin effect, p = 0.003; effect of gestational weight gain, p = 0.722). Conclusions : Pregnant adolescents with leptin concentration over 20 ng/mL showed a greater gestational weight gain. Leptin concentration correlated with length and weight of the newborn.

  2. Serum Concentration of Leptin in Pregnant Adolescents Correlated with Gestational Weight Gain, Postpartum Weight Retention and Newborn Weight/Length

    PubMed Central

    Sámano, Reyna; Martínez-Rojano, Hugo; Godínez-Martínez, Estela; Sánchez-Jiménez, Bernarda; Montiel-Ojeda, Diana; Tolentino, Maricruz

    2017-01-01

    Introduction: Gestational weight gain is an important modifiable factor known to influence fetal outcomes including birth weight and adiposity. Leptin is normally correlated with adiposity and is also known to increase throughout pregnancy, as the placenta becomes a source of leptin synthesis. Several studies have reported positive correlations between cord blood leptin level and either birthweight or size for gestational age, as well as body mass index (BMI). Objective: To determine the correlation of prenatal leptin concentration in pregnant adolescents with their gestational weight gain, postpartum weight retention, and weight/length of their newborn. Methods: A cohort study was conducted on pregnant Mexican adolescents from Gestational Week 26–28 to three months postpartum (n = 168 mother–child dyads). An anthropometric assessment was made of each pregnant adolescent, and the serum level of leptin and the intake of energy were determined. The newborn was evaluated each month during postpartum. Clinical records were reviewed to obtain sociodemographic data. Bivariate correlations, tests for repeating measurements and logistic regression models were performed. Results: Leptin concentration gradually increased during the third trimester of pregnancy. At Gestation Week 36, leptin level correlated with gestational weight gain. When comparing adolescents that had the lowest and highest concentration of leptin, the former presented a mean of 6 kg less in gestational weight gain (inter-subject leptin concentration, p = 0.001; inter-subject energy intake, p = 0.497). Leptin concentration and gestational weight gain exerted an effect on the weight of the newborn (inter-subject leptin concentration for Week 32, p = 0.024; inter-subject gestational weight gain, p = 0.011). Newborn length was associated with leptin concentration at Week 28 (leptin effect, p = 0.003; effect of gestational weight gain, p = 0.722). Conclusions: Pregnant adolescents with leptin concentration over 20 ng/mL showed a greater gestational weight gain. Leptin concentration correlated with length and weight of the newborn. PMID:28953229

  3. Gestational weight gain and its associated factors in Harari Regional State: Institution based cross-sectional study, Eastern Ethiopia.

    PubMed

    Asefa, Fekede; Nemomsa, Dereje

    2016-08-30

    Gestational weight gain is an important factor that supports optimal outcome for mothers and their infant. Whereas women who do not gain enough weight during pregnancy have a risk of bearing a baby with low birth weight, those who gain excessive weight are at increased risk of preeclampsia and gestational diabetes. Nonetheless, data on gestational weight gain and its determinants are scarce in developing countries, as it is difficult to collect the information throughout the pregnancy period. Therefore, the aim of the study was to assess weight gain during pregnancy and its associated factors. The study employed a health facility based quantitative cross-sectional study design in Harari Regional State. The study included 411 women who had given birth at health institutions from January to July of 2014. The researchers collected both primary and secondary data by using a structured questionnaire and a checklist. Using logistic regression, the factors associated with gestational weight gain were assessed and, based on the United States Institute of Medicine criteria, gestational weight gains were categorized as inadequate, adequate and excessive. The study revealed that 69.3 %, 28 %, and 2.7 % of the women gained inadequate, adequate and excess gestational weight, respectively. The mean gestational weight gain was 8.96 (SD ±3.27) kg. The factors associated with adequate gestational weight gain were body mass index ≥ 25Kg/m(2) at early pregnancy (AOR = 3.2, 95 % CI 1.6, 6.3); engaging in regular physical exercise (AOR = 2.1, 95 % CI 1.2, 3.6); Antenatal care visit of ≥4 times (AOR = 2.9, 95 % CI 1.7, 5.2); consuming fruit and vegetable (AOR = 2.7, 95 % CI 1.2, 6.6), and meat (AOR = 2.7, 95 % CI 1.1, 97.2). Generally, a small proportion of the women gained adequate gestational weight. The women who were with higher body mass index at early pregnancy, who frequently visited Antenatal care visit, and who consumed diverse food items were more likely to measure adequate gestational weight.

  4. Adequacy of Prenatal Care and Gestational Weight Gain

    PubMed Central

    Crandell, Jamie L.; Jones-Vessey, Kathleen

    2016-01-01

    Abstract Background: The goal of prenatal care is to maximize health outcomes for a woman and her fetus. We examined how prenatal care is associated with meeting the 2009 Institute of Medicine (IOM) guidelines for gestational weight gain. Sample: The study used deidentified birth certificate data supplied by the North Carolina State Center for Health Statistics. The sample included 197,354 women (≥18 years) who delivered singleton full-term infants in 2011 and 2012. Methods: A generalized multinomial model was used to identify how adequate prenatal care was associated with the odds of gaining excessive or insufficient weight during pregnancy according to the 2009 IOM guidelines. The model adjusted for prepregnancy body size, sociodemographic factors, and birth weight. Results: A total of 197,354 women (≥18 years) delivered singleton full-term infants. The odds ratio (OR) for excessive weight gain was 2.44 (95% CI 2.37–2.50) in overweight and 2.33 (95% CI 2.27–2.40) in obese women compared with normal weight women. The OR for insufficient weight gain was 1.15 (95% CI 1.09–1.22) for underweight and 1.34 (95% CI 1.30–1.39) for obese women compared with normal weight women. Prenatal care at the inadequate or intermediate levels was associated with insufficient weight gain (OR: 1.32, 95% CI 1.27–1.38; OR: 1.15, 95% CI 1.09–1.21, respectively) compared with adequate prenatal care. Women with inadequate care were less likely to gain excessive weight (OR: 0.88, 95% CI 0.86–0.91). Conclusions: Whereas prenatal care was effective for preventing insufficient weight gain regardless of prepregnancy body size, educational background, and racial/ethnic group, there were no indications that adequate prenatal care was associated with reduced risk for excessive gestational weight gain. Further research is needed to improve prenatal care programs for preventing excess weight gain. PMID:26741198

  5. Pharmacogenetics of leptin in antipsychotic-associated weight gain and obesity-related complications

    PubMed Central

    Lee, Amy K; Bishop, Jefrey R

    2013-01-01

    Second-generation antipsychotics can greatly improve symptoms of psychosis-spectrum disorders. Unfortunately, these drugs are associated with weight gain, which increases a patient’s risk for developing chronic diseases including Type 2 diabetes, cardiovascular diseases or other obesity-related complications. There are interindividual differences in weight gain resulting from antipsychotic drug use that may be explained by pharmacodynamic characteristics of these agents as well as clinical factors. In addition, genetic variations in pathways associated with satiety are increasingly recognized as potential contributors to antipsychotic-associated weight gain. Polymorphisms in the leptin gene, as well as the leptin receptor gene, are potential pharmacogenetic markers associated with these outcomes. This article summarizes evidence for the associations of the leptin gene and the leptin receptor gene polymorphisms with antipsychotic-induced weight gain, potential mechanisms underlying these relationships, and discusses areas for future pharmacogenetic investigation. PMID:21787190

  6. Predictors and correlates for weight changes in patients co-treated with olanzapine and weight mitigating agents; a post-hoc analysis.

    PubMed

    Stauffer, Virginia L; Lipkovich, Ilya; Hoffmann, Vicki Poole; Heinloth, Alexandra N; McGregor, H Scott; Kinon, Bruce J

    2009-03-28

    This study focuses on exploring the relationship between changes in appetite or eating behaviors and subsequent weight change for adult patients with schizophrenia or bipolar disorder treated with olanzapine and adjunctive potential weight mitigating pharmacotherapy. The aim is not to compare different weight mitigating agents, but to evaluate patients' characteristics and changes in their eating behaviors during treatment. Identification of patient subgroups with different degrees of susceptibility to the effect of weight mitigating agents during olanzapine treatment may aid clinicians in treatment decisions. Data were obtained from 3 randomized, double-blind, placebo-controlled, 16-week clinical trials. Included were 158 patients with schizophrenia or bipolar disorder and a body mass index (BMI) > or = 25 kg/m2 who had received olanzapine treatment in combination with nizatidine (n = 68), sibutramine (n = 42), or amantadine (n = 48). Individual patients were analyzed for categorical weight loss > or= 2 kg and weight gain > or = 1 kg. Variables that were evaluated as potential predictors of weight outcomes included baseline patient characteristics, factors of the Eating Inventory, individual items of the Eating Behavior Assessment, and the Visual Analog Scale. Predictors/correlates of weight loss > or = 2 kg included: high baseline BMI, low baseline interest in food, and a decrease from baseline to endpoint in appetite, hunger, or cravings for carbohydrates. Reduced cognitive restraint, increase in hunger, and increased overeating were associated with a higher probability of weight gain > or = 1 kg. The association between weight gain and lack of cognitive restraint in the presence of increased appetite suggests potential benefit of psychoeducational counseling in conjunction with adjunctive pharmacotherapeutic agents in limiting weight gain during antipsychotic drug therapy. This analysis was not a clinical trial and did not involve any medical intervention.

  7. Changes in job strain and subsequent weight gain: a longitudinal study, based on the Danish Nurse Cohort.

    PubMed

    Vesterlund, Gitte Kingo; Keller, Amélie Cléo; Heitmann, Berit Lilienthal

    2018-04-01

    Obesity as well as job strain is increasing, and job strain might contribute to weight gain. The objective of the current study was to examine associations between longitudinal alterations in the components of job strain and subsequent weight gain. The study was designed as a prospective cohort study with three questionnaire surveys enabling measurement of job-strain alterations over 6 years and subsequent measurements of weight gain after further 10 years of follow-up. ANCOVA and trend analyses were conducted. Job demands were measured as job busyness and speed, and control as amount of influence. Employed nurses in Denmark. We included a sub-sample of 6188 female nurses from the Danish Nurse Cohort, which consisted of the nurses who participated in surveys in 1993, 1999 and 2009. A linear trend in weight gain was seen in nurses who were often busy in 1999 between those who were rarely v. sometimes v. often busy in 1993 (P=0·03), with the largest weight gain in individuals with sustained high busyness in both years. Loss of influence between 1993 and 1999 was associated with larger subsequent weight gain than sustained high influence (P=0·003) or sustained low influence (P=0·02). For speed, no associations were found. Busyness, speed and influence differed in their relationship to subsequent weight gain. A decrease in job influence and a sustained burden of busyness were most strongly related to subsequent weight gain. Focus on job strain reduction and healthy diet is essential for public health.

  8. Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

    PubMed Central

    de Souza, A. C.; Peterson, K. E.; Cufino, E.; Gardner, J.; Craveiro, M. V.; Ascherio, A.

    1999-01-01

    This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara. PMID:10612885

  9. Relationship between health services, socioeconomic variables and inadequate weight gain among Brazilian children.

    PubMed

    de Souza, A C; Peterson, K E; Cufino, E; Gardner, J; Craveiro, M V; Ascherio, A

    1999-01-01

    This ecological analysis assessed the relative contribution of behavioural, health services and socioeconomic variables to inadequate weight gain in infants (0-11 months) and children (12-23 months) in 140 municipalities in the State of Ceara, north-east Brazil. To assess the total effect of selected variables, we fitted three unique sets of multivariate linear regression models to the prevalence of inadequate weight gain in infants and in children. The final predictive models included variables from the three sets. Findings showed that participation in growth monitoring and urbanization were inversely and significantly associated with the prevalence of inadequate weight gain in infants, accounting for 38.3% of the variation. Female illiteracy rate, participation in growth monitoring and degree of urbanization were all positively associated with prevalence of inadequate weight gain in children. Together, these factors explained 25.6% of the variation. Our results suggest that efforts to reduce the average municipality-specific female illiteracy rate, in combination with participation in growth monitoring, may be effective in reducing municipality-level prevalence of inadequate weight gain in infants and children in Ceara.

  10. Acute weight gain, gender, and therapeutic response to antipsychotics in the treatment of patients with schizophrenia

    PubMed Central

    Ascher-Svanum, Haya; Stensland, Michael; Zhao, Zhongyun; Kinon, Bruce J

    2005-01-01

    Background Previous research indicated that women are more vulnerable than men to adverse psychological consequences of weight gain. Other research has suggested that weight gain experienced during antipsychotic therapy may also psychologically impact women more negatively. This study assessed the impact of acute treatment-emergent weight gain on clinical and functional outcomes of patients with schizophrenia by patient gender and antipsychotic treatment (olanzapine or haloperidol). Methods Data were drawn from the acute phase (first 6-weeks) of a double-blind randomized clinical trial of olanzapine versus haloperidol in the treatment of 1296 men and 700 women with schizophrenia-spectrum disorders. The associations between weight change and change in core schizophrenia symptoms, depressive symptoms, and functional status were examined post-hoc for men and women and for each medication group. Core schizophrenia symptoms (positive and negative) were measured with the Brief Psychiatric Rating Scale (BPRS), depressive symptoms with the BPRS Anxiety/Depression Scale and the Montgomery-Asberg Depression Rating Scale, and functional status with the mental and physical component scores on the Medical Outcome Survey-Short Form 36. Statistical analysis included methods that controlled for treatment duration. Results Weight gain during 6-week treatment with olanzapine and haloperidol was significantly associated with improvements in core schizophrenia symptoms, depressive symptoms, mental functioning, and physical functioning for men and women alike. The conditional probability of clinical response (20% reduction in core schizophrenia symptom), given a clinically significant weight gain (at least 7% of baseline weight), showed that about half of the patients who lost weight responded to treatment, whereas three-quarters of the patients who had a clinically significant weight gain responded to treatment. The positive associations between therapeutic response and weight gain were similar for the olanzapine and haloperidol treatment groups. Improved outcomes were, however, more pronounced for the olanzapine-treated patients, and more olanzapine-treated patients gained weight. Conclusions The findings of significant relationships between treatment-emergent weight gain and improvements in clinical and functional status at 6-weeks suggest that patients who have greater treatment-emergent weight gain are more likely to benefit from treatment with olanzapine or haloperidol regardless of gender. PMID:15649317

  11. Birth weight and infant growth: optimal infant weight gain versus optimal infant weight.

    PubMed

    Xiong, Xu; Wightkin, Joan; Magnus, Jeanette H; Pridjian, Gabriella; Acuna, Juan M; Buekens, Pierre

    2007-01-01

    Infant growth assessment often focuses on "optimal" infant weights and lengths at specific ages, while de-emphasizing infant weight gain. Objective of this study was to examine infant growth patterns by measuring infant weight gain relative to birth weight. We conducted this study based on data collected in a prospective cohort study including 3,302 births with follow up examinations of infants between the ages of 8 and 18 months. All infants were participants in the Louisiana State Women, Infant and Children Supplemental Food Program between 1999 and 2001. Growth was assessed by infant weight gain percentage (IWG%, defined as infant weight gain divided by birth weight) as well as by mean z-scores and percentiles for weight-for-age, length-for-age, and weight-for-length calculated based on growth charts published by the U.S. Centers for Disease Control (CDC). An inverse relationship was noted between birth weight category and IWG% (from 613.9% for infants with birth weights <1500 g to 151.3% for infants with birth weights of 4000 g or more). In contrast, low birth weight infants had lower weight-for-age, weight-for-length z-scores and percentiles compared to normal birth weight infants according to CDC growth charts. Although low birth weight infants had lower anthropometric measures compared to a national reference population, they had significant catch-up growth; High birth weight infants had significant slow-down growth. We suggest that growth assessments should compare infants' anthropometric data to their own previous growth measures as well as to a reference population. Further studies are needed to identify optimal ranges of infant weight gain.

  12. Weight gain as a barrier to smoking cessation among military personnel.

    PubMed

    Russ, C R; Fonseca, V P; Peterson, A L; Blackman, L R; Robbins, A S

    2001-01-01

    To assess the relationships between active-duty military status, military weight standards, concern about weight gain, and anticipated relapse after smoking cessation. Cross-sectional study. Hospital-based tobacco cessation program. Two hundred fifty-two enrollees, of 253 eligible, to a tobacco cessation program in 1999 (135 men, 117 women; 43% on active duty in the military). Independent variables included gender, body mass index (weight/height2), and military status. Dependent variables included about weight gain with smoking cessation and anticipated relapse. In multivariate regression analyses that controlled for gender and body mass index, active-duty military status was associated with an elevated level of concern about weight gain (1.9-point increase on a 10-point scale; 95% confidence interval [CI], 1.0- to 2.8-point increase), as well as higher anticipated relapse (odds ratio [OR] = 3.6; 95% CI, 1.3 to 9.8). Among subjects who were close to or over the U.S. Air Force maximum allowable weight for height, the analogous OR for active-duty military status was 6.9 (p = .02). Occupational weight standards or expectations may pose additional barriers for individuals contemplating or attempting smoking cessation, as they do among active-duty military personnel. These barriers are likely to hinder efforts to decrease smoking prevalence in certain groups.

  13. The effect of the pre-pregnancy weight of the mother and the gestational weight gain on the bilirubin level of term newborn.

    PubMed

    Özdek, Suat; Kul, Mustafa; Barış Akcan, Abdullah; Çekmez, Ferhat; Aydemir, Gökhan; Aydınöz, Seçil; Karademir, Ferhan; Süleymanoğlu, Selami

    2016-01-01

    Jaundice is a problem in newborns. There are many maternal and infant-related factors affecting neonatal jaundice. The maternal pre-pregnancy weight, maternal body mass index (BMI) and gestational weight gain may have an effect on the newborn bilirubin levels. We research the effect of the maternal pre-pregnancy weight and gestational weight gain on the bilirubin levels of the newborn infants in the first 2 weeks prospectively. Term and healthy infants who were born between 38 and 42 weeks in our clinic were included in the study. Maternal pre-pregnancy BMIs were calculated. Babies were divided into three groups according to their mothers' advised amount of gestational weight gain. Total serum bilirubin (TSB) values of the newborns were measured in the 2nd, 5th and 15th postnatal days. In our study, the 5th and 15th day capillary bilirubin level of the babies with mothers who gained more weight than the advised amount during pregnancy were found statistically significant higher compared to the other two groups (p < 0.05). Similarly, the hematocrit level of the babies with mothers who gained more weight than the advised amount were found statistically significant higher compared to the other two groups (p < 0.05). We conclude that the babies with mothers who gained more weight than the advised amount were under risk for newborn jaundice. Therefore, these babies should be monitored more closely for neonatal jaundice and prolonged jaundice.

  14. Association of Weight Loss and Medication Adherence Among Adults With Type 2 Diabetes Mellitus: SHIELD (Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes)☆

    PubMed Central

    Grandy, Susan; Fox, Kathleen M.; Hardy, Elise

    2013-01-01

    Background Adherence to prescribed diabetes medications is suboptimal, which can lead to poor glycemic control and diabetic complications. Treatment-related weight gain is a side effect of some oral antidiabetic agents and insulin, which may negatively affect adherence to therapy. Objective This study investigated whether adults with type 2 diabetes mellitus (T2DM) who lost weight had better medication adherence than those who gained weight. Methods Weight change over 1 year (2007 to 2008) was assessed among respondents in the US Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). Weight loss of >1.0%, ≥3%, and ≥5% of weight was compared with weight gain of ≥1.0%. Medication adherence was assessed using the Morisky 4-item questionnaire for medication-taking behavior, with lower scores representing better adherence. Results There were 746 T2DM respondents who lost >1.0%, 483 who lost ≥3%, 310 who lost ≥5%, and 670 who gained ≥1.0% of weight. Each weight-loss group had significantly lower Morisky scores than the weight-gain group; mean scores of 0.389 versus 0.473 (P = 0.050) for the >1.0% weight-loss group, 0.365 versus 0.473 (P = 0.026) for the ≥3% weight-loss group, and 0.334 versus 0.473 (P = 0.014) for the ≥5% weight-loss group. Significantly fewer respondents who lost weight had received insulin, sulfonylurea, or thiazolidinedione therapy (57%) compared with respondents who gained weight (64%) (P = 0.002). Demographics, exercise habits, and dieting were similar between weight-loss and weight-gain groups. Conclusions T2DM respondents with weight loss had significantly better medication adherence and were less likely to be on treatment regimens that increase weight than T2DM respondents with weight gain. These findings suggest that strategies that lead to weight loss, including use of diabetes medications associated with weight loss, may improve medication adherence. PMID:24465048

  15. Weight Gain and Obesity in Infants and Young Children Exposed to Prolonged Antibiotic Prophylaxis.

    PubMed

    Edmonson, M Bruce; Eickhoff, Jens C

    2017-02-01

    An association between antibiotic use and excessive weight gain or obesity in healthy infants and young children has been reported, but evidence is inconsistent and based on observational studies of growth in relation to incidental antibiotic exposures. To evaluate whether prolonged antibiotic exposure is associated with weight gain in children participating in a clinical trial of antibiotic prophylaxis to prevent recurrent urinary tract infection. Secondary analysis of data from the Randomized Intervention for Children With Vesicoureteral Reflux Study, a 2-year randomized clinical trial that enrolled participants from 2007 to 2011. All 607 children who were randomized to receive antibiotic (n = 302) or placebo (n = 305) were included. Children with urinary tract anomalies, premature birth, or major comorbidities were excluded from participation. Trimethoprim-sulfamethoxazole or placebo taken orally, once daily, for 2 years. Weight gain as measured by change in weight-for-age z score from baseline to the end-of-study visit at 24 months. Secondary outcomes included weight gain at 6, 12, and 18 months and the prevalence of overweight or obesity at 24 months. Participants had a median age of 12 months (range, 2-71 months) and 558 of 607 (91.9%) were female. Anthropometric data were complete at the 24-month visit for 428 children (214 in the trimethoprim-sulfamethoxazole group and 214 in the placebo group). Weight gain in the trimethoprim-sulfamethoxazole group and the placebo group was similar (mean [SD] change in weight-for-age z score: +0.14 [0.83] and +0.18 [0.85], respectively; difference, -0.04 [95% CI, -0.19 to 0.12]; P = .65). There was no significant difference in weight gain at 6, 12, or 18 months or in the prevalence of overweight or obesity at 24 months (24.8% vs 25.7%; P = .82). Subgroup analyses showed no significant interaction between weight gain effect and age, sex, history of breastfeeding, prior antibiotic use, adherence to study medication, or development of urinary tract infection during the study. Based on a secondary analysis of data from a large clinical trial of trimethoprim-sulfamethoxazole prophylaxis, there was no evidence that prolonged exposure to this antibiotic has a concurrent effect on weight gain or the prevalence of overweight or obesity in healthy infants and young children.

  16. The association of gestational weight gain per institute of medicine guidelines and prepregnancy body mass index on outcomes of twin pregnancies.

    PubMed

    González-Quintero, Victor H; Kathiresan, Anupama S Q; Tudela, Felipe José; Rhea, Debbie; Desch, Cheryl; Istwan, Niki

    2012-06-01

    To determine if current recommendations for weight gain in twin pregnancies according to maternal prepregnancy body mass index (PPBMI) influence perinatal outcomes. We identified women with twins enrolled in a maternity risk screening and education program with initial screening and prenatal care initiated at <20 weeks and delivery at >23.9 weeks. Women with normal, overweight, or obese PPBMI were included (n = 5129). Pregnancy outcomes were compared between those women with weight gain meeting or exceeding 2009 Institute of Medicine recommendations and patients who did not meet weight gain guidelines. Rates of spontaneous preterm delivery at <35 weeks were higher in all PPBMI groups for those with weight gain below guidelines. In all PPBMI groups, numbers of pregnancies with both infants weighing >2500 g or >1500 g were significantly higher for women gaining weight at or above guidelines. Logistic regression analysis was utilized to assess multivariate impact on outcome of spontaneous preterm delivery at <35 weeks showing that regardless of PPBMI level, women who gain below recommended guidelines are 50% more likely to deliver spontaneously at <35 weeks. In twin pregnancies, weight gain below recommended guidelines determined by maternal PPBMI is associated with higher rates of spontaneous preterm delivery at <35 weeks. Copyright © 2012 Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

  17. [Combined influence of preconception body mass index and gestational weight gain on fetal growth].

    PubMed

    Mardones, Francisco; García-Huidobro, Trinidad; Ralph, Constanza; Farías, Marcelo; Domínguez, Angélica; Rojas, Iván; Urrutia, M Teresa

    2011-06-01

    The Chilean Ministry of Health has been using standards for nutritional evaluation and weight gain recommendations during pregnancy in the last 25 years. In the meantime new standards have been developed. To study the combined influence of preconception maternal nutritional status and gestational weight gain, using new standards to classify those parameters, on perinatal outcomes. A cohort of 11,465 healthy pregnant women was prospectively followed until term. Their pre-gestational nutritional status was classified using the body mass index cut-offs in use in the United States (USA). Their gestational weight gain was classified using categories proposed in a Danish study. Perinatal outcomes included were risky birth weight, i.e. < 3000 g and ≥ 4000 g, and cesarean delivery. Relative risks for those perinatal outcomes were calculated for all combined categories of pre-gestational nutritional status and gestational weight gain. Relative risks of almost all gestational weight gain results were statistically significant for women having a normal pre-gestational nutritional status meanwhile all of them were not significant for underweight women. Overweight and obese women had similar relative risks values as normal women. However, many of them were not significant, especially in obese women. There is an independent and combined influence of preconception nutritional status and gestational weight gain on perinatal outcomes, when using standards to classify those parameters developed in the USA and Denmark, respectively.

  18. Interventions for Weight Gain Prevention During the Transition to Young Adulthood: A review of the literature

    PubMed Central

    Laska, Melissa N.; Pelletier, Jennifer E.; Larson, Nicole I.; Story, Mary

    2012-01-01

    Purpose To review studies examining weight gain prevention interventions among young adults. Methods A snowball strategy was used to identify relevant studies, beginning with systematic PubMed, MEDLINE, PsychInfo, ERIC, and CINAHL searches. Included studies: (a) were published from 1985-2011, (b) were completed in the US or Canada, (a) focused on weight gain prevention among young adults ages 18-35 years, assessing weight, body mass index (BMI), body composition, diet or physical activity as an outcome, and (d) included pre- and post-intervention assessments. Results Thirty-seven interventions were identified. Ten interventions assessed weight, BMI, or body composition; twenty-seven addressed other relevant outcomes (e.g., diet, physical activity). Of the studies examining weight or body composition, six evaluated university courses or seminar-based interventions. Overall, many studies focused on individual-level intervention delivery and changes in weight-related knowledge and/or skills, though some incorporated relatively unique aspects (e.g., focusing on eating disorders and obesity simultaneously, using online technology, providing personalized feedback on weight change). Most showed promising results as small-scale pilot studies but lacked data from fully-powered randomized trials. Conclusions There is an urgent need to develop effective young adult-focused weight gain prevention strategies. This review identified promising areas for future work, though much additional research is needed. PMID:22443834

  19. The Primary Results of the Treating Adult Smokers at Risk for Weight Gain with Interactive Technology (TARGIT) Study.

    PubMed

    Johnson, Karen C; Thomas, Fridtjof; Richey, Phyllis; Tran, Quynh T; Tylavsky, Fran; Miro, Danielle; Coday, Mace

    2017-10-01

    To evaluate whether a behavioral weight management program combined with a smoking cessation program delivered via interactive technology could prevent postcessation weight gain. Three hundred and thirty young adult smokers, age 18 to 35 years, were randomized to a smoking cessation program alone (comparison group), which included behavioral counseling and nicotine replacement, or to a behavioral weight management program adapted from the Look AHEAD trial plus the same smoking cessation program (intervention group). The Treating Adult Smokers at Risk for Weight Gain with Interactive Technology study randomized 164 participants to the comparison group and 166 participants to the intervention group. On average, the participants gained 0.91 kg after 24 months in the trial (comparison group + 1.45 kg and intervention group + 0.32; P = 0.157). The only variable systematically affecting weight change over time was smoking abstinence, in which those who were abstinent, on average, gained 0.14 kg more per month compared with those who continued to smoke (P < 0.001). In exploratory analyses, the intervention participants who were abstinent at 6 months had numerically smaller weight gains compared with abstinent participants in the comparison group, but these differences were not statistically significant. Providing an intensive weight gain prevention program combined with a smoking cessation program via interactive technology was not associated with greater long-term weight gain prevention. © 2017 The Obesity Society.

  20. Factors Associated With Women's Plans to Gain Weight Categorized as Above or Below the National Guidelines During Pregnancy.

    PubMed

    Park, Christina K; Timm, Valerie; Neupane, Binod; Beyene, Joseph; Schmidt, Louis A; McDonald, Sarah D

    2015-03-01

    Given that planning to gain gestational weight categorized as above the national guidelines is associated with actually gaining above the guidelines, we sought to identify physical, lifestyle, knowledge, and psychological factors associated with planned weight gain. Using a piloted, self-administered questionnaire, a cross-sectional study of women with singleton pregnancies was conducted. Women's plans for weight gain were categorized as above, within, or below the guidelines. Univariate and multivariate analyses were performed. The response rate was 90.7% (n = 330). Compared with women whose plans to gain weight were within the guidelines, women whose plans to gain were above the guidelines were more likely to be older (adjusted odds ratio [aOR] 1.09 per year; 95% CI 1.03 to 1.16), to have a greater pre-pregnancy BMI (aOR 1.17 per unit of BMI; 95% CI 1.10 to 1.25), to drink more than one glass of soft drink or juice per day (aOR 2.73; 95% CI 1.27 to 5.87), and to report receiving a recommendation by their care provider to gain weight above the guidelines (aOR 5.46; 95% CI 1.56 to 19.05). Women whose plans to gain weight were categorized as below the guidelines were more likely to eat lunch in front of a screen (aOR 2.27; 95% CI 1.11 to 4.66) and to aspire to greater social desirability (aOR 2.51; 95% CI 1.01 to 6.22). Modifiable factors associated with planned gestational weight gain categorized as above the guidelines included soft drink or juice consumption and having a recommendation from a care provider, while planned weight gain categorized as below the guidelines was associated with eating lunch in front of a screen and social desirability.

  1. Early prediction of olanzapine-induced weight gain for schizophrenia patients.

    PubMed

    Lin, Ching-Hua; Lin, Shih-Chi; Huang, Yu-Hui; Wang, Fu-Chiang; Huang, Chun-Jen

    2018-05-01

    The aim of this study was to determine whether weight changes at week 2 or other factors predicted weight gain at week 6 for schizophrenia patients receiving olanzapine. This study was the secondary analysis of a six-week trial for 94 patients receiving olanzapine (5 mg/d) plus trifluoperazine (5 mg/d), or olanzapine (10 mg/d) alone. Patients were included in analysis only if they had completed the 6-week trial (per protocol analysis). Weight gain was defined as a 7% or greater increase of the patient's baseline weight. The receiver operating characteristic curve was employed to determine the optimal cutoff points of statistically significant predictors. Eleven of the 67 patients completing the 6-week trial were classified as weight gainers. Weight change at week 2 was the statistically significant predictor for ultimate weight gain at week 6. A weight change of 1.0 kg at week 2 appeared to be the optimal cutoff point, with a sensitivity of 0.92, a specificity of 0.75, and an AUC of 0.85. Using weight change at week 2 to predict weight gain at week 6 is favorable in terms of both specificity and sensitivity. Weight change of 1.0 kg or more at 2 weeks is a reliable predictor. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. A conceptual model of psychosocial risk and protective factors for excessive gestational weight gain.

    PubMed

    Hill, Briony; Skouteris, Helen; McCabe, Marita; Milgrom, Jeannette; Kent, Bridie; Herring, Sharon J; Hartley-Clark, Linda; Gale, Janette

    2013-02-01

    nearly half of all women exceed the guideline recommended pregnancy weight gain for their Body Mass Index (BMI) category. Excessive gestational weight gain (GWG) is correlated positively with postpartum weight retention and is a predictor of long-term, higher BMI in mothers and their children. Psychosocial factors are generally not targeted in GWG behaviour change interventions, however, multifactorial, conceptual models that include these factors, may be useful in determining the pathways that contribute to excessive GWG. We propose a conceptual model, underpinned by health behaviour change theory, which outlines the psychosocial determinants of GWG, including the role of motivation and self-efficacy towards healthy behaviours. This model is based on a review of the existing literature in this area. there is increasing evidence to show that psychosocial factors, such as increased depressive symptoms, anxiety, lower self-esteem and body image dissatisfaction, are associated with excessive GWG. What is less known is how these factors might lead to excessive GWG. Our conceptual model proposes a pathway of factors that affect GWG, and may be useful for understanding the mechanisms by which interventions impact on weight management during pregnancy. This involves tracking the relationships among maternal psychosocial factors, including body image concerns, motivation to adopt healthy lifestyle behaviours, confidence in adopting healthy lifestyle behaviours for the purposes of weight management, and actual behaviour changes. health-care providers may improve weight gain outcomes in pregnancy if they assess and address psychosocial factors in pregnancy. Copyright © 2011 Elsevier Ltd. All rights reserved.

  3. Changes in body weight and food choice in those attempting smoking cessation: a cluster randomised controlled trial

    PubMed Central

    2012-01-01

    Background Fear of weight gain is a barrier to smoking cessation and significant cause of relapse for many people. The provision of nutritional advice as part of a smoking cessation programme may assist some in smoking cessation and perhaps limit weight gain. The aim of this study was to determine the effect of a structured programme of dietary advice on weight change and food choice, in adults attempting smoking cessation. Methods Cluster randomised controlled design. Classes randomised to intervention commenced a 24-week intervention, focussed on improving food choice and minimising weight gain. Classes randomised to control received “usual care”. Results Twenty-seven classes in Greater Glasgow were randomised between January and August 2008. Analysis, including those who continued to smoke, showed that actual weight gain and percentage weight gain was similar in both groups. Examination of data for those successful at giving up smoking showed greater mean weight gain in intervention subjects (3.9 (SD 3.1) vs. 2.7 (SD 3.7) kg). Between group differences were not significant (p = 0.23, 95% CI −0.9 to 3.5). In comparison to baseline improved consumption of fruit and vegetables and breakfast cereal were reported in the intervention group. A higher percentage of control participants continued smoking (74% vs. 66%). Conclusions The intervention was not successful at minimising weight gain in comparison to control but was successful in facilitating some sustained improvements in the dietary habits of intervention participants. Improved quit rates in the intervention group suggest that continued contact with advisors may have reduced anxieties regarding weight gain and encouraged cessation despite weight gain. Research should continue in this area as evidence suggests that the negative effects of obesity could outweigh the health benefits achieved through reductions in smoking prevalence. Trial registration Current Controlled Trials ISRCTN73824458 PMID:22642755

  4. Soft Drinks and Weight Gain: How Strong Is the Link?

    PubMed Central

    Wolff, Emily; Dansinger, Michael L.

    2008-01-01

    Context Soft drink consumption in the United States has tripled in recent decades, paralleling the dramatic increases in obesity prevalence. The purpose of this clinical review is to evaluate the extent to which current scientific evidence supports a causal link between sugar-sweetened soft drink consumption and weight gain. Evidence acquisition MEDLINE search of articles published in all languages between 1966 and December 2006 containing key words or medical subheadings, such as “soft drinks” and “weight.” Additional articles were obtained by reviewing references of retrieved articles, including a recent systematic review. All reports with cross-sectional, prospective cohort, or clinical trial data in humans were considered. Evidence synthesis Six of 15 cross-sectional and 6 of 10 prospective cohort studies identified statistically significant associations between soft drink consumption and increased body weight. There were 5 clinical trials; the two that involved adolescents indicated that efforts to reduce sugar-sweetened soft drinks slowed weight gain. In adults, 3 small experimental studies suggested that consumption of sugar-sweetened soft drinks caused weight gain; however, no trial in adults was longer than 10 weeks or included more than 41 participants. No trial reported the effects on lipids. Conclusions Although observational studies support the hypothesis that sugar-sweetened soft drinks cause weight gain, a paucity of hypothesis-confirming clinical trial data has left the issue open to debate. Given the magnitude of the public health concern, larger and longer intervention trials should be considered to clarify the specific effects of sugar-sweetened soft drinks on body weight and other cardiovascular risk factors. PMID:18924641

  5. [Nutritional Status of Japanese Women of Childbearing Age and the Ideal Weight Range for Pregnancy].

    PubMed

    Nomura, Kyoko; Kodama, Hiroko; Kido, Michiko

    2018-01-01

    According to the recent 2015 Nutrition Survey, the prevalence of being underweight (Body Mass Index, BMI <18.5 kg/m 2 ) among women in their 20s is 22.3%. Women of childbearing age tend to have a lower intake of protein and their total energy intake is lower than the requirements established by the 2015 Dietary Reference Intakes for Japanese. There is a growing body of evidence showing that underweight women tend to bear small babies and that these babies have an increased risk of diabetes or cancer in their adulthood. In order to prevent Japanese women from bearing small babies, the literature has suggested that women of childbearing age should be encouraged to remain at a normal weight before pregnancy. For optimal weight gain during pregnancy, existing guidelines recommend different ranges of weight gain based on prepregnancy BMI. Owing to the absence of official GWG recommendations in Asian countries, including China and Taiwan, the US Institute of Medicine (IOM) guidelines are generally followed. However, Asian women are smaller and experience lower weight gains; therefore, excessive weight gain may lead to harmful events including macrosomia, preterm birth, preeclampsia, gestational diabetes, pregnancy-induced hypertension, and short- and long-term postpartum weight retention. Thus, an accurate GWG range should be determined for Asian women. We introduce one epidemiological study in which the optimal weight gain range was investigated by analyzing receiver-operating characteristic curves together with potential research ideas in this field with the aim of encouraging young researchers to solve this public health problem affecting mothers and children.

  6. Association between Prepregnancy Body Mass Index and Gestational Weight Gain with Size, Tempo, and Velocity of Infant Growth: Analysis of the Newborn Epigenetic Study Cohort.

    PubMed

    Fuemmeler, Bernard F; Wang, Lin; Iversen, Edwin S; Maguire, Rachel; Murphy, Susan K; Hoyo, Cathrine

    2016-06-01

    The first 1000 days of life is a critical period of infant growth that has been linked to future adult health. Understanding prenatal factors that contribute to variation in growth during this period could inform successful prevention strategies. Prenatal and maternal characteristics, including prepregnancy obesity and gestational weight gain were evaluated in relation to weight growth trajectories during the first 24 months of life using the SuperImposition by Translation and Rotation (SITAR) method, which provides estimates of infant size, timing to peak velocity, and growth velocity. The study sample included 704 mother-infant dyads from a multiethnic prebirth cohort from the Southeastern United States. The total number of weight measures was 8670 (median number per child = 14). Several prenatal and maternal characteristics were linked with infant growth parameters. The primary findings show that compared to women with a prepregnancy BMI between 18 and 24.9, women with a prepregnancy BMI ≥40 had infants that were 8% larger during the first 24 months, a delayed tempo of around 9 days, and a slower velocity. Mothers who had greater than adequate gestational weight gain had infants that were 5% larger even after controlling for prepregnancy BMI and several other covariates. The findings contribute new data on the associations between gestational weight gain and aspects of early growth using the SITAR method, and support a growing consensus in the literature that both prepregnancy BMI and gestational weight gain relate independently to risk for greater postnatal weight growth.

  7. Association between Prepregnancy Body Mass Index and Gestational Weight Gain with Size, Tempo, and Velocity of Infant Growth: Analysis of the Newborn Epigenetic Study Cohort

    PubMed Central

    Wang, Lin; Iversen, Edwin S.; Maguire, Rachel; Murphy, Susan K.; Hoyo, Cathrine

    2016-01-01

    Abstract Background: The first 1000 days of life is a critical period of infant growth that has been linked to future adult health. Understanding prenatal factors that contribute to variation in growth during this period could inform successful prevention strategies. Methods: Prenatal and maternal characteristics, including prepregnancy obesity and gestational weight gain were evaluated in relation to weight growth trajectories during the first 24 months of life using the SuperImposition by Translation and Rotation (SITAR) method, which provides estimates of infant size, timing to peak velocity, and growth velocity. The study sample included 704 mother-infant dyads from a multiethnic prebirth cohort from the Southeastern United States. The total number of weight measures was 8670 (median number per child = 14). Results: Several prenatal and maternal characteristics were linked with infant growth parameters. The primary findings show that compared to women with a prepregnancy BMI between 18 and 24.9, women with a prepregnancy BMI ≥40 had infants that were 8% larger during the first 24 months, a delayed tempo of around 9 days, and a slower velocity. Mothers who had greater than adequate gestational weight gain had infants that were 5% larger even after controlling for prepregnancy BMI and several other covariates. Conclusions: The findings contribute new data on the associations between gestational weight gain and aspects of early growth using the SITAR method, and support a growing consensus in the literature that both prepregnancy BMI and gestational weight gain relate independently to risk for greater postnatal weight growth. PMID:27135650

  8. Exercise during pregnancy and its association with gestational weight gain.

    PubMed

    Harris, Shericka T; Liu, Jihong; Wilcox, Sara; Moran, Robert; Gallagher, Alexa

    2015-03-01

    We examined the association between exercise during pregnancy and meeting gestational weight gain recommendations. Data came from the 2009 South Carolina Pregnancy Risk Assessment Monitoring System (n = 856). Women reported their participation in exercise/sports activities before and during pregnancy, including the number of months and types of exercise. We developed an exercise index (EI), the product of the number of months spent in exercise and average metabolic equivalents for specific exercise. The 2009 Institute of Medicine's guideline was used to categorize gestational weight gain into three classes: inadequate, adequate, and excessive. Multinomial logistic regression models were used to adjust for confounders. Over 46 % of women exceeded the recommended weight gain during pregnancy. Nearly one third (31.9 %) of women reported exercising ≥3 times a week at any time during pregnancy. Compared to women who did not report this level of exercise during pregnancy, exercising women were more likely to meet gestational weight gain recommendations (32.7 vs. 18.7 %) and had a lower odds of excessive gestational weight gain [adjusted odds ratio (AOR) 0.43, 95 % confidence interval 0.24-0.78]. Women with an EI above the median value of those women who exercised or women who exercised ≥3 times a week for 6-9 months during pregnancy had lower odds of excessive gestational weight gain (AOR for EI 0.20, 0.08-0.49; AOR for months 0.26, 0.12-0.56, respectively). Our findings support the need to promote or increase exercise during pregnancy to reduce the high proportion of women who are gaining excessive weight.

  9. Body weight gain induced by a newer antipsychotic agent reversed as negative symptoms improved.

    PubMed

    Koga, M; Nakayama, K

    2005-07-01

    We describe a patient in whom improvement in negative symptoms contributed to early weight loss and subsequent long-term improvement in weight management. Case report. A 26-year-old woman with schizophrenia gained 7 kg over the course of 1 year after starting treatment with olanzapine. However, as negative symptoms gradually improved with treatment, she became motivated to diet and exercise regularly. She quickly lost 9 kg and subsequently maintained optimal weight (55 kg; body mass index, 24.1 kg/m(2) ). Important strategies for minimizing weight gain in patients taking antipsychotic agents include improving negative symptoms of avolition and apathy, regular monitoring of body weight and potential medical consequences of overweight and obesity, and educating the patient about the importance of diet and regular exercise.

  10. Leptin levels in patients with anorexia nervosa following day/inpatient treatment do not predict weight 1 year post-referral.

    PubMed

    Seitz, Jochen; Bühren, Katharina; Biemann, Ronald; Timmesfeld, Nina; Dempfle, Astrid; Winter, Sibylle Maria; Egberts, Karin; Fleischhaker, Christian; Wewetzer, Christoph; Herpertz-Dahlmann, Beate; Hebebrand, Johannes; Föcker, Manuel

    2016-09-01

    Elevated serum leptin levels following rapid therapeutically induced weight gain in anorexia nervosa (AN) patients are discussed as a potential biomarker for renewed weight loss as a result of leptin-related suppression of appetite and increased energy expenditure. This study aims to analyze the predictive value of leptin levels at discharge as well as the average rate of weight gain during inpatient or day patient treatment for body weight at 1-year follow-up. 121 patients were recruited from the longitudinal Anorexia Nervosa Day patient versus Inpatient (ANDI) trial. Serum leptin levels were analyzed at referral and discharge. A multiple linear regression analysis to predict age-adjusted body mass index (BMI-SDS) at 1-year follow-up was performed. Leptin levels, the average rate of weight gain, premorbid BMI-SDS, BMI-SDS at referral, age and illness duration were included as independent variables. Neither leptin levels at discharge nor rate of weight gain significantly predicted BMI-SDS at 1-year follow-up explaining only 1.8 and 0.4 % of the variance, respectively. According to our results, leptin levels at discharge and average rate of weight gain did not exhibit any value in predicting weight at 1-year follow-up in our longitudinal observation study of adolescent patients with AN. Thus, research should focus on other potential factors to predict weight at follow-up. As elevated leptin levels and average rate of weight gain did not pose a risk for reduced weight, we found no evidence for the beneficial effect of slow refeeding in patients with acute AN.

  11. Effect of the INSIGHT Responsive Parenting Intervention on Rapid Infant Weight Gain and Overweight Status at Age 1 Year: A Randomized Clinical Trial.

    PubMed

    Savage, Jennifer S; Birch, Leann L; Marini, Michele; Anzman-Frasca, Stephanie; Paul, Ian M

    2016-08-01

    Rapid infant weight gain is associated with later obesity, but interventions to prevent rapid infant growth and reduce risk for overweight status in infancy are lacking. To examine the effect of a responsive parenting (RP) intervention on infant weight gain between birth and 28 weeks and overweight status at age 1 year. The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is an ongoing randomized clinical trial comparing an RP intervention designed to prevent childhood obesity with a safety control. The study includes primiparous mother-newborn dyads (n = 291) and was conducted at the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, in addition to home visits. Enrollment was initiated in January 2012, and evaluable population analyses for this study were conducted between April 2015 and November 2015. At 2 weeks post partum, initial intervention materials appropriate to the assigned treatment group were mailed to the participant's home. Research nurses conducted home visits at 3 weeks, 16 weeks, 28 weeks, and 40 weeks, and a research center visit occurred at 1 year. The Intervention Nurses Start Infants Growing on Healthy Trajectories curriculum included messages about infant feeding, sleep hygiene, active social play, emotion regulation, and growth record education. The control group received a developmentally appropriate home safety intervention also delivered by nurse home visitors. Conditional weight gain from birth to 28 weeks was calculated. General linear models examined intervention effect on conditional weight gain. The intervention's effect on infant weight-for-length percentiles was tested using analysis of variance. Logistic regression compared the odds of overweight status (weight for length ≥95th percentile) at 1 year as a function of conditional weight gain. Of the mothers included in the study, 246 were white (88%), 260 were non-Hispanic (93%), 210 were married (75%), and 201 were working full time (72%) at time of enrollment. The mean conditional weight gain score was lower among infants in the RP group compared with the control group (-0.18; 95% CI, -0.36 to -0.001), reflecting that the RP infants gained weight more slowly than control group infants (0.18; 95% CI, 0.02-0.34); this effect did not differ by feeding mode (predominantly fed breast milk or not). Infants in the RP group also had lower mean weight-for-length percentiles at 1 year than infants in the control group (57.5%; 95% CI, 52.56%-62.37% vs 64.4%; 95% CI, 59.94%-69.26%; P = .04) and were less likely to be overweight at age 1 year (5.5% vs 12.7%; P = .05). An RP intervention is associated with reduced rapid weight gain during the first 6 months after birth and overweight status at age 1 year. clinicaltrials.gov Identifier: NCT01167270.

  12. Association between subthalamic nucleus deep brain stimulation and weight gain: Results of a case-control study.

    PubMed

    Strowd, Roy E; Herco, Maja; Passmore-Griffin, Leah; Avery, Bradley; Haq, Ihtsham; Tatter, Stephen B; Tate, Jessica; Siddiqui, Mustafa S

    2016-01-01

    To evaluate whether weight change in patients with Parkinson's disease (PD) is different in those undergoing deep brain stimulation (DBS) of the subthalamic nucleus (STN) compared to those not undergoing DBS. A retrospective case-control study was performed in PD patients who had undergone STN DBS (cases) compared to matched PD patients without DBS (controls). Demographic and clinical data including Unified Parkinson's Disease Rating Scale (UPDRS) motor scores were collected. Repeated measures mixed model regression was used to identify variables associated with weight gain. Thirty-five cases and 34 controls were identified. Baseline age, gender, diagnosis and weight were similar. Duration of diagnosis was longer in cases (6.3 vs 4.9 years, p=0.0015). At 21.3 months, cases gained 2.9 kg (+4.65%) while controls lost 1.8 kg (-3.05%, p<0.02). Postoperative UPDRS motor scores improved by 49% indicating surgical efficacy. Only younger age (p=0.0002) and DBS (p=0.008) were significantly associated with weight gain. In this case-control study, PD patients undergoing STN DBS experienced post-operative weight gain that was significantly different from the weight loss observed in non-DBS PD controls. Patients, especially overweight individuals, should be informed that STN DBS can result in weight gain. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. No global consensus: a cross-sectional survey of maternal weight policies

    PubMed Central

    2014-01-01

    Background Growing evidence suggests that maternal prepregnancy weight and gestational weight gain are risk factors for perinatal complications and subsequent maternal and child health. Postpartum weight retention is also associated with adverse birth outcomes and maternal obesity. Clinical guidelines addressing healthy weight before, during, and after pregnancy have been introduced in some countries, but at present a systematic accounting for these policies has not been conducted. The objective of the present study was to conduct a cross-national comparison of maternal weight guidelines. Methods This cross sectional survey administered a questionnaire online to key informants with expertise on the subject of maternal weight to assess the presence and content of preconceptional, pregnancy and postpartum maternal weight guidelines, their rationale and availability. We searched 195 countries, identified potential informants in 80 and received surveys representing 66 countries. We estimated the proportion of countries with guidelines by region, income, and formal or informal policy, and described and compared guideline content, including a rubric to assess presence or absence of 4 guidelines: encourage healthy preconceptional weight, antenatal weighing, encourage appropriate gestational gain, and encourage attainment of healthy postpartum weight. Results Fifty-three countries reported either a formal or informal policy regarding maternal weight. The majority of these policies included guidelines to assess maternal weight at the first prenatal visit (90%), to monitor gestational weight gain during pregnancy (81%), and to provide recommendations to women about healthy gestational weight gain (62%). Guidelines related to preconceptional (42%) and postpartum (13%) weight were less common. Only 8% of countries reported policies that included all 4 fundamental guidelines. Guideline content and rationale varied considerably between countries, and respondents perceived that within their country, policies were not widely known. Conclusions These results suggest that maternal weight is a concern throughout the world. However, we found a lack of international consensus on the content of guidelines. Further research is needed to understand which recommendations or interventions work best with respect to maternal weight in different country settings, and how pregnancy weight policies impact clinical practices and health outcomes for the mother and child. PMID:24884985

  14. Behavioral intervention to promote smoking cessation and prevent weight gain: A systematic review and meta-analysis

    PubMed Central

    Spring, Bonnie; Howe, Dorothea; Berendsen, Mark; McFadden, H. Gene; Hitchcock, Kristin; Rademaker, Alfred W.; Hitsman, Brian

    2009-01-01

    Aims The prospect of weight gain discourages many cigarette smokers from quitting. Practice guidelines offer varied advice about managing weight gain after quitting smoking, but no systematic review and meta-analysis have been available. We reviewed evidence to determine whether behavioral weight control intervention compromises smoking cessation attempts, and if it offers an effective way to reduce post-cessation weight gain. Methods We identified randomized controlled trials that compared combined smoking treatment and behavioral weight control to smoking treatment alone for adult smokers. English-language studies were identified through searches of PubMed, Ovid MEDLINE, CINAHL, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials. Of 779 articles identified and 35 potentially relevant RCTs screened, 10 met criteria and were included in the meta-analysis. Results Patients who received both smoking treatment and weight treatment showed increased abstinence (OR=1.29, 95% CI=1.01,1.64) and reduced weight gain (g = -0.30, 95% CI=-0.63, -0.04) in the short term (<3 months) compared with patients who received smoking treatment alone. Differences in abstinence (OR=1.23, 95% CI=0.85, 1.79) and weight control (g= -0.17, 95% CI=-0.42, 0.07) were no longer significant in the long term (>6 months). Conclusions Findings provide no evidence that combining smoking treatment and behavioral weight control produces any harm and significant evidence of short-term benefit for both abstinence and weight control. However, the absence of long-term enhancement of either smoking cessation or weight control by the time-limited interventions studied to date provides insufficient basis to recommend societal expenditures on weight gain prevention treatment for patients who are quitting smoking. PMID:19549058

  15. Change in active transportation and weight gain in pregnancy.

    PubMed

    Skreden, Marianne; Øverby, Nina C; Sagedal, Linda R; Vistad, Ingvild; Torstveit, Monica K; Lohne-Seiler, Hilde; Bere, Elling

    2016-01-27

    Pregnancy is characterised by large weight gain over a short period, and often a notable change in mode of transportation. This makes pregnancy suitable for examining the plausible, but in the scientific literature still unclear, association between active transportation and weight gain. We hypothesize that women continuing an active mode of transportation to work or school from pre- to early pregnancy will have a lower gestational weight gain (GWG) than those who change to a less active mode of transportation. We analysed prospective data from the Norwegian Fit for Delivery (NFFD) trial. Between September 2009 and February 2013 606 women were consecutively enrolled in median gestational week 16 (range; 8-20). Of 219 women who used an active mode of transportation (biking, walking, public transportation) pre-pregnancy, 66 (30%) converted to a less active mode in early pregnancy ("active-less active" group), and 153 (70%) continued with active transportation ("active-active" group). Pre-pregnancy weight was self-reported. Weight at gestational (GA) weeks 16, 30, 36, and at term delivery was objectively measured. Weight gain was compared between the two groups. Linear mixed effects analysis of the repeated weight measures was performed including the group*time interaction. A significant overall group effect was observed for the four time points together ("active-active" group: 77.3 kg vs. "active-less active" group: 78.8 kg, p = 0.008). The interaction term group*time was significant indicating different weight gain throughout pregnancy for the two groups; the mean differences between the groups were 0.7 kg at week 16, 1.4 kg at week 30, 2.1 kg at week 36, and 2.2 kg at term delivery, respectively. The findings indicate that active transportation is one possible approach to prevent excessive weight gain in pregnancy.

  16. Gestational weight gain according to Institute of Medicine recommendations in relation to infant size and body composition.

    PubMed

    Henriksson, P; Eriksson, B; Forsum, E; Löf, M

    2015-10-01

    Intrauterine life may be a critical period for programming childhood obesity; however, there is insufficient knowledge concerning how gestational weight gain (GWG) affects infant fat mass (FM) and fat-free mass (FFM). The aim of this study was to investigate relationships between GWG according to Institute of Medicine (IOM) recommendations and infant size, FM and FFM. We also investigated if the associations were different for normal-weight and overweight/obese women. This study included 312 healthy Swedish mother-infant pairs. Infant body composition at 1 week of age was assessed using air-displacement plethysmography. Maternal GWG was defined as below, within or above the 2009 IOM recommendations. Multiple regression analyses were used. Compared with women whose weight gain was within IOM recommendations, women with weight gain below the recommendations had infants that were shorter (-0.7 cm, P = 0.008) when adjusting for confounders. Normal-weight women exceeding IOM recommendations had infants with higher FM (+58 g, P = 0.008) compared with normal-weight women who gained within the recommendations. No corresponding association was observed for overweight/obese women. Inadequate GWG was associated with shorter infants, while excessive GWG was associated with greater infant FM for women who were of normal weight before pregnancy. © 2014 World Obesity.

  17. Participants' Voices From Within a Healthy Lifestyle Group.

    PubMed

    Park, Tanya; Foster, Kim; Usher, Kim

    2017-02-01

    Weight gain is a serious health concern. People with mental illnesses are at increased risk of weight gain. The primary treatment is lifestyle changes such as increasing physical activity and dietary changes. This qualitative study explored the experience of people with schizophrenia who participated in a healthy lifestyle program. Four themes were identified. The findings indicate that benefits of the program were more than physical health improvements and included regular access to a health professional, gaining social relationships, and a sense of belonging. Future recommendations include retaining a group structure in lifestyle interventions to facilitate these additional benefits.

  18. Maternal and neonatal outcomes among obese women with weight gain below the new Institute of Medicine recommendations.

    PubMed

    Blomberg, Marie

    2011-05-01

    To estimate whether weight loss or low gestational weight gain in class I-III obese women is associated with adverse maternal and neonatal outcomes compared with gestational weight gain within the new Institute of Medicine recommendations. This was a population-based cohort study, which included 32,991 obesity class I, 10,068 obesity class II, and 3,536 obesity class III women who were divided into four gestational weight gain categories. Women with low (0-4.9 kg) or no gestational weight gain were compared with women gaining the recommended 5-9 kg concerning obstetric and neonatal outcome after suitable adjustments. Women in obesity class III who lost weight during pregnancy had a decreased risk of cesarean delivery (24.4%; odds ratio [OR] 0.77, 95% confidence interval [CI] 0.60-0.99), large-for-gestational-age births (11.2%, OR 0.64, 95% CI 0.46-0.90), and no significantly increased risk for pre-eclampsia, excessive bleeding during delivery, instrumental delivery, low Apgar score, or fetal distress compared with obese (class III) women gaining within the Institute of Medicine recommendations. There was an increased risk for small for gestational age, 3.7% (OR 2.34, 95% CI 1.15-4.76) among women in obesity class III losing weight, but there was no significantly increased risk of small for gestational age in the same group with low weight gain. Obese women (class II and III) who lose weight during pregnancy seem to have a decreased or unaffected risk for cesarean delivery, large for gestational age, pre-eclampsia, excessive postpartum bleeding, instrumental delivery, low Apgar score, and fetal distress. The twofold increased risk of small for gestational age in obesity class III and weight loss (3.7%) is slightly above the overall prevalence of small-for-gestational-age births in Sweden (3.6%).

  19. Algorithms for the prediction of retinopathy of prematurity based on postnatal weight gain.

    PubMed

    Binenbaum, Gil

    2013-06-01

    Current ROP screening guidelines represent a simple risk model with two dichotomized factors, birth weight and gestational age at birth. Pioneering work has shown that tracking postnatal weight gain, a surrogate for low insulin-like growth factor 1, may capture the influence of many other ROP risk factors and improve risk prediction. Models including weight gain, such as WINROP, ROPScore, and CHOP ROP, have demonstrated accurate ROP risk assessment and a potentially large reduction in ROP examinations, compared to current guidelines. However, there is a need for larger studies, and generalizability is limited in countries with developing neonatal care systems. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Association between overweight and characteristics of young adult students: support for nursing care1

    PubMed Central

    Santiago, Jênifa Cavalcante dos Santos; Moreira, Thereza Maria Magalhães; Florêncio, Raquel Sampaio

    2015-01-01

    OBJECTIVE: to verify associations between overweight and the characteristics of young adult students to support nursing care. METHOD: case-control study conducted with young adults from public schools. The sample was composed of 441 participants (147 cases and 294 controls, with and without excess weight, respectively). Sociodemographic and clinical characteristics were collected together with exposure factors and anthropometrics. Multiple logistic regression was used. The study received Institutional Review Board approval. RESULTS: statistically significant association with overweight: non-Caucasian, having a partner; weight gain during adolescence, mother's excess weight, the use of obesogenic medication, augmented diastolic blood pressure, of abdominal circumference and waist/hip ratio. In addition to these, schooling and weight gain during childhood were also included in the multivariate analysis. After adjustment, the final model included: having a partner, weight gain during adolescence, augmented diastolic blood pressure and abdominal circumference. CONCLUSION: the analysis of predictor variables for excess weight among young adult students supports nurses in planning and developing educational practices aimed to prevent this clinical condition, which is a risk factor for other chronic comorbidities, such as cardiovascular diseases. PMID:26039295

  1. Perspectives on weight gain and lifestyle practices during pregnancy among women with a history of macrosomia: a qualitative study in the Republic of Ireland

    PubMed Central

    2013-01-01

    Background Excessive weight gain during pregnancy is a major risk factor for macrosomia (high birth weight delivery). This study aimed to explore views about weight gain and lifestyle practices during pregnancy among women with a history of macrosomia. Methods A qualitative descriptive study was conducted. Twenty-one second-time mothers whose first infant was macrosomic (>4 kg) were recruited from a randomised trial in a large maternity hospital in the Republic of Ireland. Semi-structured interviews were conducted with participants at both 6 and 12 months after their second pregnancy. Inductive thematic analysis was used to identify distinct themes. Results The mothers believed in following their prenatal food cravings to meet their baby’s needs, but this led some to eat excessively. Many of the women cut back heavily on physical activity during pregnancy due to perceived risks to the baby. Physical conditions and discomforts during pregnancy often limited maternal control over weight and lifestyle practices. The women were not particularly concerned about weight gain during pregnancy and most did not favour the notion of introducing weight gain guidelines into routine antenatal care. Common differences perceived by the women between their first and second pregnancy included: increased concern about weight gain in their second pregnancy due to prior difficulties with postpartum weight loss and increased time demands in their second pregnancy impeded healthy lifestyle practices. Most women did not alter their perspectives on weight gain and lifestyle practices in their second pregnancy in response to having a macrosomic infant in their first pregnancy. Conclusions This analysis exposed numerous barriers to healthy pregnancy weight gain. The findings suggest that women may need to be advised to follow their prenatal food cravings in moderation. Pregnant women with children already may benefit from education on time-efficient methods of integrating healthy eating practices and physical activity into their lifestyles. Women with a history of macrosomia may need information about the importance of avoiding high weight gain in subsequent pregnancies. PMID:24195741

  2. The Impact of Weight Gain on Motivation, Compliance, and Metabolic Control in Patients with Type 2 Diabetes Mellitus

    PubMed Central

    Pi-Sunyer, F. Xavier

    2010-01-01

    Patients with type 2 diabetes, approximately 85% of whom are overweight or obese, often have an increased incidence of cardiovascular disease (CVD) risk factors such as hypertension and dyslipidemia. Both type 2 diabetes and obesity are independent risk factors for CVD. Unfortunately, many therapies aimed at maintaining and improving glucose control are associated with weight gain. Among the older antidiabetes agents, most, including the insulin secretagogues and sensitizers, can lead to weight gain, except for metformin, which is weight-neutral. Among the newer agents, the dipeptidyl peptidase-4 inhibitors generally are weight-neutral in addition to lowering glucose, while the glucagon-like peptide–1 receptor agonists lead to weight reduction. Patients with type 2 diabetes are at an increased risk for both diabetes-and CV-related outcomes, and weight reduction is an important component of diabetes management. Weight gain in patients with type 2 diabetes can contribute to patient frustration and may negatively impact their compliance to therapeutic regimens. The selection of antidiabetes agents that not only improve glucose control but reduce or have a neutral effect on weight with beneficial effects on lipids are ideal options for managing patients with type 2 diabetes. PMID:19820278

  3. Weight gain by gut microbiota manipulation in productive animals.

    PubMed

    Angelakis, Emmanouil

    2017-05-01

    Antibiotics, prebiotics and probiotics are widely used as growth promoters in agriculture. In the 1940s, use of Streptomyces aureofaciens probiotics resulted in weight gain in animals, which led to the discovery of chlortetracycline. Tetracyclines, macrolides, avoparcin and penicillins have been commonly used in livestock agriculture to promote growth through increased food intake, weight gain, and improved herd health. Prebiotic supplements including oligosaccharides, fructooligosaccharides, and galactosyl-lactose improve the growth performance of animals. Probiotics used in animal feed are mainly bacterial strains of Gram-positive bacteria and have been effectively used for weight gain in chickens, pigs, ruminants and in aquaculture. Antibiotics, prebiotics and probiotics all modify the gut microbiota and the effect of a probiotic species on the digestive flora is probably determined by bacteriocin production. Regulations governing the introduction of novel probiotics and prebiotics vary by geographical region and bias is very common in industry-funded studies. Probiotic and prebiotic foods have been consumed for centuries, either as natural components of food, or as fermented foods and it is possible to cause the same weight gain effects in humans as in animals. This review presents the use of growth promoters in food-producing animals to influence food intake and weight gain. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. A review of national health policies and professional guidelines on maternal obesity and weight gain in pregnancy.

    PubMed

    Schumann, N L; Brinsden, H; Lobstein, T

    2014-08-01

    Maternal obesity creates an additional demand for health-care services, as the routine obstetric care pathway requires alterations to ensure the most optimal care for obese women of childbearing age. This review examines the extent to which relevant national health documents reflect and respond to the health implications of maternal obesity and excessive gestational weight gain. A targeted search of peer-reviewed publications and grey literature was conducted for each country to identify national health documents, which were subsequently content analyzed according to an adapted framework. A total of 37 documents were identified, including one policy, 10 strategies and 26 guidelines, published within the last 10 years. Out of the 31 countries investigated, only 13 countries address maternal obesity while none address excessive gestational weight gain. We found inconsistencies and gaps in the recommendations to health-care service providers for the management of maternal obesity and weight gain in pregnancy. The findings show that only limited guidance on maternal obesity and gestational weight gain exists. The authors recommend that international, evidence-based guidelines on the management of maternal obesity and excessive gestational weight gain should be developed to reduce the associated health-care and economic costs. © 2014 The Authors. Clinical Obesity © 2014 World Obesity.

  5. Weight-control behaviors and subsequent weight change among adolescents and young adult females123

    PubMed Central

    Haines, Jess; Rosner, Bernard; Willett, Walter C

    2010-01-01

    Background: Little is known about the effectiveness of behavioral strategies to prevent long-term weight gain among adolescents and young adults. Objective: The objective was to assess the relation of dietary and physical activity weight-control strategies, alone and together, with subsequent weight change. Design: This was a prospective study of 4456 female adolescents and young adults aged 14–22 y in the ongoing Growing Up Today Study. Weight-control behaviors, including dietary approaches and physical activity, were self-reported in 2001 and were used to predict weight change from 2001 to 2005. Results: In 2001–2002, 23.7% of female adolescents and young adults were trying to maintain their weight and another 54.4% were trying to lose weight. Approximately 25% used each of the following weight-control strategies: not eating snacks, following low-calorie or low-fat diets, and limiting portion sizes. In addition, 47.7% reported exercising at least occasionally for weight control. During 4 y of follow-up, participants gained an average of 3.3 kg. None of the dietary approaches to weight control predicted less weight change; however, females who exercised ≥5 d/wk gained significantly less weight than did their peers (−0.9 kg; 95% CI: −1.4, −0.4). The most successful strategy for weight-gain prevention among the females was to limit portion sizes (−1.9 kg; 95% CI: −2.6, −1.1) combined with frequent exercise. Conclusions: Our results suggest that physical activity is a necessary strategy for long-term weight control among adolescents and young adult females. Combining dietary weight-control approaches with physical activity is the most effective method for reducing weight gain. PMID:19889827

  6. Impact of Maternal Glucose and Gestational Weight Gain on Child Obesity over the First Decade of Life in Normal Birth Weight Infants.

    PubMed

    Hillier, Teresa A; Pedula, Kathryn L; Vesco, Kimberly K; Oshiro, Caryn E S; Ogasawara, Keith K

    2016-08-01

    Objective To determine, among children with normal birth weight, if maternal hyperglycemia and weight gain independently increase childhood obesity risk in a very large diverse population. Methods Study population was 24,141 individuals (mothers and their normal birth weight offspring, born 1995-2003) among a diverse population with universal GDM screening [50-g glucose-challenge test (GCT); 3 h. 100 g oral glucose tolerance test (OGTT) if GCT+]. Among the 13,037 full-term offspring with normal birth weight (2500-4000 g), annual measured height/weight was ascertained between ages 2 and 10 years to calculate gender-specific BMI-for-age percentiles using USA norms (1960-1995 standard). Results Among children who began life with normal birth weight, we found a significant trend for developing both childhood overweight (>85 %ile) and obesity (>95 %ile) during the first decade of life with both maternal hyperglycemia (normal GCT, GCT+ but no GDM, GDM) and excessive gestational weight gain [>40 pounds (18.1 kg)]; p < 0.0001 for both trends. These maternal glucose and/or weight gain effects to imprint for childhood obesity in the first decade remained after adjustment for potential confounders including maternal age, parity, as well as pre-pregnancy BMI. The attributable risk (%) for childhood obesity was 28.5 % (95 % CI 15.9-41.1) for GDM and 16.4 % (95 % CI 9.4-23.2) for excessive gestational weight gain. Conclusions for Practice Both maternal hyperglycemia and excessive weight gain have independent effects to increase childhood obesity risk. Future research should focus on prevention efforts during pregnancy as a potential window of opportunity to reduce childhood obesity.

  7. Is weight gain really a catalyst for broader recovery?: The impact of weight gain on psychological symptoms in the treatment of adolescent anorexia nervosa.

    PubMed

    Accurso, Erin C; Ciao, Anna C; Fitzsimmons-Craft, Ellen E; Lock, James D; Le Grange, Daniel

    2014-05-01

    The main aims of this study were to describe change in psychological outcomes for adolescents with anorexia nervosa across two treatments, and to explore predictors of change, including baseline demographic and clinical characteristics, as well as weight gain over time. Participants were 121 adolescents with anorexia nervosa from a two-site (Chicago and Stanford) randomized controlled trial who received either family-based treatment or individual adolescent supportive psychotherapy. Psychological symptoms (i.e., eating disorder psychopathology, depressive symptoms, and self-esteem) were assessed at baseline, end of treatment, 6-month, and 12-month follow-up. Conditional multilevel growth models were used to test for predictors of slope for each outcome. Most psychological symptoms improved significantly from baseline to 12 month follow-up, regardless of treatment type. Depressive symptoms and dietary restraint were most improved, weight and shape concerns were least improved, and self-esteem was not at all improved. Weight gain emerged as a significant predictor of improved eating disorder pathology, with earlier weight gain having a greater impact on symptom improvement than later weight gain. Adolescents who presented with more severe, complex, and enduring clinical presentations (i.e., longer duration of illness, greater eating disorder pathology, binge-eating/purging subtype) also appeared to benefit more psychologically from treatment. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Implementation of Feeding Guidelines Hastens the Time to Initiation of Enteral Feeds and Improves Growth Velocity in Very Low Birth-Weight Infants.

    PubMed

    Culpepper, Christine; Hendrickson, Kendra; Marshall, Susan; Benes, Jessica; Grover, Theresa R

    2017-04-01

    Growth and nutrition are critical in neonatal care. Whether feeding guidelines improve growth and nutrition and reduce morbidity is unknown. Feeding guidelines for very low birth-weight (VLBW) infants were implemented in our neonatal intensive care unit (NICU) to start and achieve full enteral feeds sooner, and increase weight gain over the first month. Feeding guidelines for VLBW infants were implemented in January 2014, stratified by birth weight (<750, 750-1000, and 1000-1500 g). After trophic feedings, enteral feedings were advanced by 20 to 30 mL/kg/d.Data were analyzed for 2 years prior (baseline) and 6 months after (guideline) guidelines were implemented and included days to initiation of enteral feeds, days on total parenteral nutrition (TPN), and weight gain over the first month. Potential concomitant factors that could affect feeding tolerance were examined including indomethacin or dopamine treatment, delivery room cardiopulmonary resuscitation, and growth restriction. A total of 95 infants with a birth weight of less than 1500 g were included (59 baseline and 36 guideline). Days to start enteral feeds decreased by 47% (P < .01) and days on TPN decreased by 25% (16 days vs 11 days; P < .01). Weight gain over the first month of life increased by 15% (p < .05). Dopamine and indomethacin use decreased during the study period, and small for gestational age infants were overrepresented in the guideline group. Establishment of feeding guidelines for VLBW infants in our NICU reduced the days to start feeds and days on TPN while increasing weight gain over the first month. Improving growth and nutrition and reducing need for TPN in this vulnerable population may ultimately prevent infection and improve neurodevelopmental outcomes.

  9. Who is maintaining weight in a middle-aged population in Sweden? A longitudinal analysis over 10 years.

    PubMed

    Nafziger, Anne N; Lindvall, Kristina; Norberg, Margareta; Stenlund, Hans; Wall, Stig; Jenkins, Paul L; Pearson, Thomas A; Weinehall, Lars

    2007-06-12

    Obesity has primarily been addressed with interventions to promote weight loss and these have been largely unsuccessful. Primary prevention of obesity through support of weight maintenance may be a preferable strategy although to date this has not been the main focus of public health interventions. The aim of this study is to characterize who is not gaining weight during a 10 year period in Sweden. Cross-sectional and longitudinal studies were conducted in adults aged 30, 40, 50 and 60 years during the Västerbotten Intervention Programme in Sweden. Height, weight, demographics and selected cardiovascular risk factors were collected on each participant. Prevalences of obesity were calculated for the 40, 50 and 60 year olds from the cross-sectional studies between 1990 and 2004. In the longitudinal study, 10-year non-gain (lost weight or maintained body weight within 3% of baseline weight) or weight gain (> or = 3%) was calculated for individuals aged 30, 40, or 50 years at baseline. A multivariate logistic regression model was built to predict weight non-gain. There were 82,927 adults included in the cross-sectional studies which had an average annual participation rate of 63%. Prevalence of obesity [body mass index (BMI) in kg/m2 > or = 30] increased from 9.4% in 1990 to 17.5% in 2004, and 60 year olds had the highest prevalence of obesity. 14,867 adults with a BMI of 18.5-29.9 at baseline participated in the longitudinal surveys which had a participation rate of 74%. 5242 adults (35.3%) were categorized as non-gainers. Older age, being female, classified as overweight by baseline BMI, later survey year, baseline diagnosis of diabetes, and lack of snuff use increased the chances of not gaining weight. Educational efforts should be broadened to include those adults who are usually considered to be at low risk for weight gain--younger individuals, those of normal body weight, and those without health conditions (e.g. diabetes type 2) and cardiovascular risk factors--as these are the individuals who are least likely to maintain their body weight over a 10 year period. The importance of focusing obesity prevention efforts on such individuals has not been widely recognized.

  10. Slimming World in Stop Smoking Services (SWISSS): study protocol for a randomized controlled trial.

    PubMed

    Lycett, Deborah; Aveyard, Paul; Farmer, Andrew; Lewis, Amanda; Munafò, Marcus

    2013-06-19

    Quitting smokers gain weight. This deters some from trying to stop smoking and may explain the increased incidence of type 2 diabetes after cessation. Dieting when stopping smoking may be counterproductive. Hunger increases cravings for smoking and tackling two behaviours together may undermine quitting success. A meta-analysis of randomized controlled trials (RCTs) showed individualized dietary support may prevent weight gain, although there is insufficient evidence whether it undermines smoking cessation. Commercial weight management providers (CWMPs), such as Slimming World, provide individualized dietary support for National Health Service (NHS) patients; however, there is no evidence that they can prevent cessation-related weight gain.Our objective is to determine whether attending Slimming World from quit date, through referral from NHS Stop Smoking Services, is more effective than usual care at preventing cessation-related weight gain. This RCT will examine the effectiveness of usual cessation support plus referral to Slimming World compared to usual cessation support alone. Healthy weight, overweight and obese adult smokers attending Stop Smoking Services will be included. The primary outcome is weight change in quitters 12 weeks post-randomization. Multivariable linear regression analysis will compare weight change between trial arms and adjust for known predictors of cessation-related weight gain.We will recruit 320 participants, with 160 participants in each arm. An alpha error rate of 5% and 90% power will detect a 2 kg (SD = 2.5) difference in weight gain at 12 weeks, assuming 20% remain abstinent by then. This trial will establish whether referral to the 12-week Slimming World programme plus usual care is an effective intervention to prevent cessation-related weight gain. If so, we will seek to establish whether weight control comes at the expense of a successful quit attempt in a further non-inferiority trial.Positive results from both these trials would provide a potential solution to cessation-related weight gain, which could be rolled out across England within Stop Smoking Services to better meet the needs of 0.75 million smokers stopping with NHS support every year. Current Controlled Trials ISRCTN65705512.

  11. Modern molecular study of weight gain related to antidepressant treatment: clinical implications of the pharmacogenetic testing.

    PubMed

    Ageu, Luminiţa Ştefania; Levai, Codrina Mihaela; Andreescu, Nicoleta Ioana; Grigoraş, Mirela Loredana; Hogea, Lavinia Maria; Chiriac, Daniela Veronica; Folescu, Roxana; Bredicean, Ana Cristina; Nussbaum, Liliana Maria; Enătescu, Virgil Radu; Poroch, Vladimir; Lupu, Viorel; Puiu, Maria; Nussbaum, Laura Alexandra

    2018-01-01

    Antidepressant medication influences cellular lipogenesis, being associated with metabolic side effects including weight gain. Due to the increasing use of antidepressants in children and adolescents, their metabolic and endocrine adverse effects are of particular concern, especially within this pediatric population that appears to be at greater risk. Genetic factors with a possible influence on antidepressant's adverse effects include CYP [cytochrome P450 (CYP450)] polymorphisms. We target to evaluate the efficacy of the pharmacogenetic testing, when prescribing antidepressants, in correlation with the occurrence of adverse events and weight gain. Our research was performed between the years 2010 and 2016, in the University Clinic of Child and Adolescent Psychiatry, Timisoara, Romania. We recruited 80 patients, children and adolescents with depressive disorders. Our study sample was divided in two groups: G1 - 40 patients took treatment after pharmacogenetic testing, and G2 - 40 patients without pharmacogenetic testing before the treatment election. Our results show statistically significant differences concerning the weight gain for groups G1 (with pharmacogenetic testing) and G2 (without pharmacogenetic testing). The CYP genotype and the pharmacogenetic testing, for choosing the personalized antidepressant therapy in children and adolescents with depressive disorders, proved to be good predictors for the response to antidepressants and the side effects registered, especially for weight gain. The significant correlations between the CYP polymorphisms for group G2 (without pharmacogenetic testing) and the weight gain/body mass index (BMI) increase, as major side effects induced by antidepressants, proved the fact that the pharmacogenetic screening is needed in the future clinical practice, allowing for individualized, tailored treatment, especially for at-risk pediatric categories.

  12. Effect of the INSIGHT Responsive Parenting Intervention on Rapid Infant Weight Gain and Overweight Status at Age 1 Year

    PubMed Central

    Savage, Jennifer S.; Birch, Leann L.; Marini, Michele; Anzman-Frasca, Stephanie; Paul, Ian M.

    2016-01-01

    IMPORTANCE Rapid infant weight gain is associated with later obesity, but interventions to prevent rapid infant growth and reduce risk for overweight status in infancy are lacking. OBJECTIVE To examine the effect of a responsive parenting (RP) intervention on infant weight gain between birth and 28 weeks and overweight status at age 1 year. DESIGN, SETTING, AND PARTICIPANTS The Intervention Nurses Start Infants Growing on Healthy Trajectories (INSIGHT) study is an ongoing randomized clinical trial comparing an RP intervention designed to prevent childhood obesity with a safety control. The study includes primiparous mother-newborn dyads (n = 291) and was conducted at the Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, in addition to home visits. Enrollment was initiated in January 2012, and evaluable population analyses for this study were conducted between April 2015 and November 2015. INTERVENTIONS At 2 weeks post partum, initial intervention materials appropriate to the assigned treatment group were mailed to the participant’s home. Research nurses conducted home visits at 3 weeks, 16 weeks, 28 weeks, and 40 weeks, and a research center visit occurred at 1 year. The Intervention Nurses Start Infants Growing on Healthy Trajectories curriculum included messages about infant feeding, sleep hygiene, active social play, emotion regulation, and growth record education. The control group received a developmentally appropriate home safety intervention also delivered by nurse home visitors. MAIN OUTCOMES AND MEASURES Conditional weight gain from birth to 28 weeks was calculated. General linear models examined intervention effect on conditional weight gain. The intervention’s effect on infant weight-for-length percentiles was tested using analysis of variance. Logistic regression compared the odds of overweight status (weight for length ≥95th percentile) at 1 year as a function of conditional weight gain. RESULTS Of the mothers included in the study, 246 were white (88%), 260 were non-Hispanic (93%), 210 were married (75%), and 201 were working full time (72%) at time of enrollment. The mean conditional weight gain score was lower among infants in the RP group compared with the control group (−0.18; 95% CI, −0.36 to −0.001), reflecting that the RP infants gained weight more slowly than control group infants (0.18; 95% CI, 0.02–0.34); this effect did not differ by feeding mode (predominantly fed breast milk or not). Infants in the RP group also had lower mean weight-for-length percentiles at 1 year than infants in the control group (57.5%; 95% CI, 52.56%–62.37% vs 64.4%; 95% CI, 59.94%–69.26%; P = .04) and were less likely to be overweight at age 1 year (5.5% vs 12.7%; P = .05). CONCLUSIONS AND RELEVANCE An RP intervention is associated with reduced rapid weight gain during the first 6 months after birth and overweight status at age 1 year. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01167270. PMID:27271455

  13. A systematic review and metaanalysis of energy intake and weight gain in pregnancy.

    PubMed

    Jebeile, Hiba; Mijatovic, Jovana; Louie, Jimmy Chun Yu; Prvan, Tania; Brand-Miller, Jennie C

    2016-04-01

    Gestational weight gain within the recommended range produces optimal pregnancy outcomes, yet many women exceed the guidelines. Official recommendations to increase energy intake by ∼ 1000 kJ/day in pregnancy may be excessive. To determine by metaanalysis of relevant studies whether greater increments in energy intake from early to late pregnancy corresponded to greater or excessive gestational weight gain. We systematically searched electronic databases for observational and intervention studies published from 1990 to the present. The databases included Ovid Medline, Cochrane Library, Excerpta Medica DataBASE (EMBASE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Science Direct. In addition we hand-searched reference lists of all identified articles. Studies were included if they reported gestational weight gain and energy intake in early and late gestation in women of any age with a singleton pregnancy. Search also encompassed journals emerging from both developed and developing countries. Studies were individually assessed for quality based on the Quality Criteria Checklist obtained from the Evidence Analysis Manual: Steps in the academy evidence analysis process. Publication bias was plotted by the use of a funnel plot with standard mean difference against standard error. Identified studies were meta-analyzed and stratified by body mass index, study design, dietary methodology, and country status (developed/developing) by the use of a random-effects model. Of 2487 articles screened, 18 studies met inclusion criteria. On average, women gained 12.0 (2.8) kg (standardized mean difference = 1.306, P < .0005) yet reported only a small increment in energy intake that did not reach statistical significance (∼475 kJ/day, standard mean difference = 0.266, P = .016). Irrespective of baseline body mass index, study design, dietary methodology, or country status, changes in energy intake were not significantly correlated to the amount of gestational weight gain (r = 0.321, P = .11). Despite rapid physiologic weight gain, women report little or no change in energy intake during pregnancy. Current recommendations to increase energy intake by ∼ 1000 kJ/day may, therefore, encourage excessive weight gain and adverse pregnancy outcomes. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Metformin for treatment of antipsychotic-induced weight gain: a randomized, placebo-controlled study.

    PubMed

    Wang, Man; Tong, Jian-hua; Zhu, Gang; Liang, Guang-ming; Yan, Hong-fei; Wang, Xiu-zhen

    2012-06-01

    To evaluate the efficacy of metformin for treatment of antipsychotic-induced weight gain. Seventy-two patients with first-episode schizophrenia who gained more than 7% of their predrug weight were randomly assigned to receive 1000 mg/d of metformin or placebo in addition to their ongoing treatment for 12 weeks using a double-blind study design. The primary outcome was change in body weight. The secondary outcomes included changes in body mass index, fasting glucose and insulin, and insulin resistance index. Of the 72 patients who were randomly assigned, 66 (91.6%) completed treatments. The body weight, body mass index, fasting insulin and insulin resistance index decreased significantly in the metformin group, but increased in the placebo group during the 12-week follow-up period. Significantly more patients in the metformin group lost their baseline weight by more than 7%, which was the cutoff for clinically meaningful weight loss. Metformin was tolerated well by majority patients. Metformin was effective and safe in attenuating antipsychotic-induced weight gain and insulin resistance in first-episode schizophrenia patients. Patients displayed good adherence to metformin. Copyright © 2012 Elsevier B.V. All rights reserved.

  15. Weight gain after adjuvant chemotherapy in patients with early breast cancer in Istanbul Turkey.

    PubMed

    Basaran, Gul; Turhal, Nazım Serdar; Cabuk, Devrim; Yurt, Nevin; Yurtseven, Gul; Gumus, Mahmut; Teomete, Mehmet; Dane, Faysal; Yumuk, Perran Fulden

    2011-06-01

    Weight gain is a well-known and unwanted complication of adjuvant chemotherapy in breast cancer. We observed that the female Turkish cancer patients frequently gain weight with adjuvant treatment of breast cancer and planned to examine the magnitude of this problem in early breast cancer patients treated at our hospital. A total of 176 early breast cancer patients who received their adjuvant systemic therapy in Marmara University Hospital between 2003 and 2007 are included in the study. We recorded their weight before and after chemotherapy and also a year after chemotherapy to find out whether the change with weight is transitory. We have also recorded demographic information, including the educational level, menopausal status, the type of chemotherapy or hormonal treatment administered stage of disease, marital status, occupation and the underlying diseases to analyze the relationship between change in weight and these parameters. Median age of patients was 53 and 72% of patients were postmenopausal. Educational level was equally distributed for primary education (27%), high school (40%), and university (33%). The majority of the patients (76%) was married, had two children (69%) and was housewife (60%). Family history of any cancer was high (32%). Most of the patients had stage II cancer (56%), received anthracyclines+/- taxane based chemotherapy (98%) and had no underlying disease (68%). The majority also did not smoke (73%) or drink alcohol (93%). A total of 67% and 72% patients gained weight upon completion and one year after completion of chemotherapy. Mean weight before the chemotherapy, upon completion of chemotherapy and one year after completion of chemotherapy were 68.9 kg, 70.6 kg (P = 0.000) and 71.9 kg (P = 0.000) respectively. Mean body mass index was 27.1 at baseline, 27.8 upon completion of chemotherapy (P = 0.000) and 28.3 one year after completion of chemotherapy (P = 0.000). Age, menopausal status, multiparity and presence of comorbid diseases had statistically significant impact on weight gain following adjuvant therapy in breast cancer patients (P = 0.000, P = 0.008, P = 0.015 and P = 0.017 respectively). This study shows that Turkish women with early breast cancer gain weight after adjuvant systemic therapy, in line with European and American counterparts. This increase in weight is maintained at least one year after adjuvant therapy. Given the adverse consequences of weight gain in terms of both breast cancer prognosis and general health, it is necessary to inform patients about this change and to develop strategies for weight maintenance during and after systemic therapy.

  16. Significant weight loss following clozapine use, how is it possible? A case report and review of published cases and literature relevant to the subject.

    PubMed

    Tungaraza, Tongeji E

    2016-10-01

    It has been repeatedly shown that clozapine is more efficacious than other antipsychotics in the management of treatment-resistant schizophrenia. However, clozapine is associated with a number of side effects including weight gain. Antipsychotic-induced weight gain has been linked with a number of untoward events including psychological factors such as stigma and low self-esteem, and physical factors such as metabolic syndromes and untimely death. The mechanism underlying antipsychotic (including clozapine)-induced weight gain is not clearly understood, although it is said to involve several brain areas, several neurotransmitters, neuropeptides and genetic factors. To some individuals however, clozapine use is associated with significant weight loss (13.5-50% of body weight). The observed weight loss in these groups of patients has not been attributed to any underlying diagnosable physical disorders. There have been a handful cases published with this phenomenon, which seems to be contrary to what is expected when clozapine is prescribed. From the currently published cases three groups emerge - those who lost weight simply by taking clozapine, those who lost weight due to improved mental state, engaging in diet and increased exercise, and those for whom weight loss was a sign of a poor response to clozapine. A case of JX who has a diagnosis of schizoaffective disorder is presented. JX lost over 26% of her body weight when she was prescribed clozapine. A detailed review of other published cases is undertaken. The underlying mechanisms involving weight loss are discussed and the implications to clinicians are highlighted. Coordinated studies to examine these groups of patients may provide some insight, not only in the mechanism of clozapine-induced weight loss, but also in the better management of patients with treatment-resistant schizophrenia involving clozapine use.

  17. [Atypical antipsychotic-induced weight gain].

    PubMed

    Godlewska, Beata R; Olajossy-Hilkesberger, Luiza; Marmurowska-Michałowska, Halina; Olajossy, Marcin; Landowski, Jerzy

    2006-01-01

    Introduction of a new group of antipsychotic drugs, called atypical because of the proprieties differing them from classical neuroleptics, gave hope for the beginning of a new era in treatment of psychoses, including schizophrenia. Different mechanisms of action not only resulted in a broader spectrum of action and high efficacy but also in a relative lack of extrapiramidal symptoms. However, atypical neuroleptics are not totally free from adverse effects. Symptoms such as sedation, metabolic changes and weight gain, often very quick and severe - present also in the case of classical drugs, but put to the background by extrapiramidal symptoms--have become prominent. Weight gain is important both from the clinical and subjective point of view--as associated with serious somatic consequences and as a source of enormous mental distress. These problems are addressed in this review, with the focus on weight gain associated with the use of specific atypical neuroleptics.

  18. A role for hypothalamic AMP-activated protein kinase in the mediation of hyperphagia and weight gain induced by chronic treatment with olanzapine in female rats.

    PubMed

    Sejima, Ei; Yamauchi, Atsushi; Nishioku, Tsuyoshi; Koga, Mitsuhisa; Nakagama, Kengo; Dohgu, Shinya; Futagami, Kojiro; Kataoka, Yasufumi

    2011-10-01

    Olanzapine is known to be advantageous with respect to outcome and drug compliance in patients with schizophrenia. However, olanzapine has adverse effects, including a higher incidence of weight gain and metabolic disturbances, when compared with those of other antipsychotic agents. The mechanisms underlying these adverse events remain obscure. Female rats were orally administered olanzapine (2 mg/kg) or vehicle once a day for 2 weeks to ascertain if hypothalamic AMP-activated protein kinase (AMPK) mediates olanzapine-induced weight gain and hyperphagia. Body weight and food intake in each rat were evaluated every day and every two days, respectively. After the termination of drug treatment, we measured the protein levels of AMPK and phosphorylated AMPK in the hypothalamus using western blot analyses. Olanzapine significantly increased body weight and food intake. The phosphorylation levels of AMPK were significantly elevated by olanzapine. These results suggest that activation of hypothalamic AMPK may mediate hyperphagia and weight gain induced by chronic treatment with olanzapine.

  19. 2009 IOM guidelines for gestational weight gain: how well do they predict outcomes across ethnic groups?

    PubMed

    Khanolkar, Amal R; Hanley, Gillian E; Koupil, Ilona; Janssen, Patricia A

    2017-11-13

    To determine whether the Institute Of Medicine's (IOM) 2009 guidelines for weight-gain during pregnancy are predictive of maternal and infant outcomes in ethnic minority populations. We designed a population-based study using administrative data on 181,948 women who delivered live singleton births in Washington State between 2006-2008. We examined risks of gestational hypertension, preeclampsia/eclampsia, cesarean delivery, and extended hospital stay in White, Black, Native-American, East-Asian, Hispanic, South-Asian and Hawaiian/Pacific islander women according to whether they gained more or less weight during pregnancy than recommended by IOM guidelines. We also examined risks of neonatal outcomes including Apgar score <7 at 5 min, admission to NICU, requirement for ventilation, and a diagnosis of small or large for gestational age at birth. Gaining too much weight was associated with increased odds for gestational hypertension (adjusted OR (aOR) ranged between 1.53-2.22), preeclampsia/eclampsia (aOR 1.44-1.81), cesarean delivery (aOR 1.07-1.38) and extended hospital stay (aOR 1.06-1.28) in all ethnic groups. Gaining too little weight was associated with decreased odds for gestational hypertension and delivery by cesarean section in Whites, Blacks and Hispanics. Gaining less weight or more weight than recommended was associated with increased odds for small for gestational age and large for gestational age infants respectively, in all ethnic groups. Adherence to the 2009 IOM guidelines for weight gain during pregnancy reduces risk for various adverse maternal outcomes in all ethnic groups studied. However, the guidelines were less predictive of infant outcomes with the exception of small and large for gestational age. GWG: Gestational weight gain; IOM/NRC; Institute of Medicine and National Research Council; NICU: Neonatal intensive care need for ventilation; SGA: Small for gestational age; LGA: Large for gestational age; BERD: Birth Events Records Database; CHARS: Comprehensive Hospital Discharge Abstract Reporting System; ICD: International Classification of Disease; LMP: Last menstrual period; OR: Odds ratio.

  20. Weight Changes in Patients with Differentiated Thyroid Carcinoma during Postoperative Long-Term Follow-up under Thyroid Stimulating Hormone Suppression

    PubMed Central

    Sohn, Seo Young; Joung, Ji Young; Cho, Yoon Young; Park, Sun Mi; Jin, Sang Man; Chung, Jae Hoon

    2015-01-01

    Background There are limited data about whether patients who receive initial treatment for differentiated thyroid cancer (DTC) gain or lose weight during long-term follow-up under thyroid stimulating hormone (TSH) suppression. This study was aimed to evaluate whether DTC patients under TSH suppression experience long-term weight gain after initial treatment. We also examined the impact of the radioactive iodine ablation therapy (RAIT) preparation method on changes of weight, comparing thyroid hormone withdrawal (THW) and recombinant human TSH (rhTSH). Methods We retrospectively reviewed 700 DTC patients who underwent a total thyroidectomy followed by either RAIT and levothyroxine (T4) replacement or T4 replacement alone. The control group included 350 age-matched patients with benign thyroid nodules followed during same period. Anthropometric data were measured at baseline, 1 to 2 years, and 3 to 4 years after thyroidectomy. Comparisons were made between weight and body mass index (BMI) at baseline and follow-up. Results Significant gains in weight and BMI were observed 3 to 4 years after initial treatment for female DTC but not in male patients. These gains among female DTC patients were also significant compared to age-matched control. Women in the THW group gained a significant amount of weight and BMI compared to baseline, while there was no increase in weight or BMI in the rhTSH group. There were no changes in weight and BMI in men according to RAIT preparation methods. Conclusion Female DTC patients showed significant gains in weight and BMI during long-term follow-up after initial treatment. These changes were seen only in patients who underwent THW for RAIT. PMID:26248858

  1. Metformin for olanzapine-induced weight gain: a systematic review and meta-analysis.

    PubMed

    Praharaj, Samir Kumar; Jana, Amlan Kusum; Goyal, Nishant; Sinha, Vinod Kumar

    2011-03-01

    Olanzapine is an atypical antipsychotic that is useful in schizophrenia and bipolar affective disorder, but its use is associated with troublesome weight gain and metabolic syndrome. A variety of pharmacological agents has been studied in the efforts to reverse weight gain induced by olanzapine, but current evidence is insufficient to support any particular pharmacological approach. We conducted a systematic review and meta-analysis of randomized controlled trials of metformin for the treatment of olanzapine-induced weight gain. Systematic review of the literature revealed 12 studies that had assessed metformin for antipsychotic-induced weight gain. Of these, four studies (n= 105) met the review inclusion criteria and were included in the final analysis. Meta-analysis was performed to see the effect size of the treatment on body weight, waist circumference and body-mass index (BMI). Weighted mean difference (WMD) for body weight was 5.02 (95% CI 3.93, 6.10) kg lower with metformin as compared with placebo at 12 weeks. For waist circumference, the test for heterogeneity was significant (P= 0.00002, I(2) = 85.1%). Therefore, a random effects model was used to calculate WMD, which was 1.42 (95% CI 0.29, 3.13) cm lower with metformin as compared with placebo at 12 weeks. For BMI, WMD was 1.82 (95% CI 1.44, 2.19) kg m(-2) lower with metformin as compared with placebo at 12 weeks. Existing data suggest that short term modest weight loss is possible with metformin in patients with olanzapine-induced weight gain. © 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society.

  2. The association of birth weight and infant growth with childhood autonomic nervous system activity and its mediating effects on energy-balance-related behaviours-the ABCD study.

    PubMed

    van Deutekom, Arend W; Chinapaw, Mai Jm; Gademan, Maaike Gj; Twisk, Jos Wr; Gemke, Reinoud Jbj; Vrijkotte, Tanja Gm

    2016-08-01

    The purpose of this study was to examine the association of birth weight and infant growth with childhood autonomic nervous system (ANS) activity and to assess whether ANS activity mediates the associations of birth weight and infant growth with energy-balance-related behaviours, including energy intake, satiety response, physical activity and screen time. In 2089 children, we prospectively collected birth weight, infant growth defined as conditional weight and height gain between birth and 12 months and-at 5 years-indices of cardiac ANS activity and parent-reported energy-balance-related behaviours. A mediation analysis was conducted, based on MacKinnon's multivariate extension of the product-of-coefficients strategy. Birth weight and infant height gain were inversely associated with sympathetic, but not parasympathetic, activity at age 5. Infant weight gain was not associated with childhood ANS activity. Infant weight gain was predictive of increased childhood screen time and infant height gain of diminished childhood energy intake, but sympathetic activity did not mediate these associations. Low-birth-weight children have higher sympathetic activity, which is considered a risk factor for cardiovascular disease. Height gain in infancy seems to be beneficial for childhood sympathetic activity. However, sympathetic activity was no mediator of the associations of infant growth with childhood energy-balance-related behaviours. As individual differences in ANS activity predict increased risk of cardiovascular disease, these differences may offer insight into the early-life origins of chronic diseases and provide further basis for public health strategies to optimize birth weight and infant growth. © The Author 2016; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  3. Weight gain potential affects pregnancy rates in bovine embryo recipients raised under pasture conditions.

    PubMed

    Fernandes, Carlos Antonio de Carvalho; Palhao, Miller Pereira; Figueiredo, Ana Cristina Silva; Ribeiro, Josiane Rossi; Fonseca e Silva, Fabyano; Viana, Joao Henrique Moreira

    2016-01-01

    The aim of the present study was to evaluate the effect of differences in body weight gain after embryo transfer on the pregnancy rates of crossbred heifers used as recipients and raised under a grazing system. The study was performed during the dry (April to September) and the rainy (October to March) seasons. The embryos transferred were produced by in vitro fertilization. The body weight of each recipient was measured immediately before the embryo transfer and 23 to 25 days later, when the diagnosis of pregnancy was performed by ultrasonography. The associations among initial body weight (IBW), daily body weight gain (DWG), season, and pregnancy rate were evaluated using a logistic procedure that included the effect of the IBW, season, and linear and quadratic effects of the DWG. Altogether, there was no effect of season and pregnancy rates did not change between the dry and rainy seasons (42.3 vs. 45.8%, respectively; P > 0.05). However, the pregnancy rate was greater in the recipients with daily body weight gains over 250 g/day, regardless of the season. In addition, the pregnancy rate of the recipients was better (P < 0.04) explained by a logistic regression model that included the linear and quadratic effects of the DWG. The probability of each heifer to become pregnant according to DWG is explained by the follow equation: P(y = 1) = (Exp((-1.06703 + 0.0108 * DWG - 0.00002 * DWG ^ 2)))/(1 + Exp((-1.6703 + 0.0108 * DWG - 0.00002 * DWG ^ 2))). In conclusion, body weight gain potential is a critical factor for the pregnancy rates of in vitro embryo recipients managed under grazing systems.

  4. Lifestyle and Behavioral Management of Polycystic Ovary Syndrome.

    PubMed

    Brennan, Leah; Teede, Helena; Skouteris, Helen; Linardon, Jake; Hill, Briony; Moran, Lisa

    2017-08-01

    Polycystic ovary syndrome (PCOS) is a common condition with serious physiological and psychological health consequences. It affects women across their reproductive lifespan and is associated with pregnancy complications, including gestational diabetes, preeclampsia, and large gestational-age babies. PCOS is associated with excess weight gain, which, in turn, exacerbates the health burden of PCOS. Therefore, weight management, including a modest weight loss, maintenance of weight loss, prevention of weight gain, and prevention of excess gestational weight gain, is a first-line treatment for women with PCOS during and independent of pregnancy. Despite evidence-based guidelines, international position statements, and Cochrane reviews promoting lifestyle interventions for PCOS, the optimal complexity, intensity, and behavioral components of lifestyle interventions for women with PCOS are not well understood. The focus of this narrative review is the evidence supporting the use of behavioral strategies in weight management interventions for reproductive-aged women to apply to PCOS. Behavioral theories, behavior change strategies, and psychological correlates of weight management have been thoroughly explored in weight loss interventions in the general population, reproductive-aged women, and peri-natal women. This article uses this parallel body of research to inform suggestions regarding lifestyle interventions in women with PCOS. Outcomes of weight management programs in women with PCOS are likely to be improved with the inclusion of behavioral and psychological strategies, including goal setting, self-monitoring, cognitive restructuring, problem solving, and relapse prevention. Strategies targeting improved motivation, social support, and psychological well-being are also important. These can be applied to the clinical management of women with PCOS at different reproductive life stages.

  5. A narrative literature review of the development of obesity in infancy and childhood.

    PubMed

    Robinson, Sally; Yardy, Katie; Carter, Victoria

    2012-12-01

    This narrative review explains the development of excess weight gain in babies and children. It takes a life course approach which includes genetics, pre-conception, pregnancy, infancy and childhood. The paper focuses on feeding behaviours, physical activity, parental influences and the wider social and environmental context. Risk factors which can cumulatively lead to excess childhood weight gain include: under- or overweight during pregnancy; the presence of diabetes during pregnancy; low or high birth weight; having obese parents; early weaning; prolonged formula feeding; rapid weight gain in the first year; disinhibited eating patterns and the consistent availability of energy dense food at home; feeding practices which are not responsive to the child's cues; insufficient sleep among preschool children; sedentary parents; low parental education; living in poor socio-economic circumstances; absence, or perceived absence, of safe play areas; parents who lack time or confidence to authoritatively parent; environments where there is poor access to affordable lower energy dense foods; and parents who do not accept that excess weight is a health problem. Recommendations for health professionals are made.

  6. Gestational weight gain in overweight and obese women enrolled in a healthy lifestyle and eating habits program.

    PubMed

    Petrella, E; Malavolti, M; Bertarini, V; Pignatti, L; Neri, I; Battistini, N C; Facchinetti, F

    2014-09-01

    To determine whether changes in lifestyle in women with BMI > 25 could decrease gestational weight gain and unfavorable pregnancy outcomes. Women with BMI > 25 were randomized at 1st trimester to no intervention or a Therapeutic Lifestyle Changes (TLC) Program including diet (overweight: 1700 kcal/day, obese: 1800 kcal/day) and mild physical activity (30 min/day, 3 times/week). At baseline and at the 36th week women filled-in a Food Frequency Questionnaire. gestational weight gain, gestational diabetes mellitus, gestational hypertension, preterm delivery. Data stratified by BMI categories. Socio-demographic features were similar between groups (TLC: 33 cases, 28 cases). At term, gestational weight gain in obese women randomized to TLC group was lower (6.7 ± 4.3 kg) versus controls (10.1 ± 5.6 kg, p = 0.047). Gestational diabetes mellitus, gestational hypertension and preterm delivery were also significantly lower. TLC was an independent factor in preventing gestational weight gain, gestational diabetes mellitus, gestational hypertension. Significant changes in eating habits occurred in the TLC group, which increased the number of snacks, the intake of fruits-vegetables and decreased the consumption of sugar. A caloric restriction associated to changes in eating behavior and constant physical activity, is able to reduce gestational weight gain and related pregnancy complications in obese women.

  7. Development and Pilot Testing of the Eating4two Mobile Phone App to Monitor Gestational Weight Gain.

    PubMed

    Knight-Agarwal, Catherine; Davis, Deborah Lee; Williams, Lauren; Davey, Rachel; Cox, Robert; Clarke, Adam

    2015-06-05

    The number of pregnant women with a body mass index (BMI) of 30kg/m(2) or more is increasing, which has important implications for antenatal care. Various resource-intensive interventions have attempted to assist women in managing their weight gain during pregnancy with limited success. A mobile phone app has been proposed as a convenient and cost-effective alternative to face-to-face interventions. This paper describes the process of developing and pilot testing the Eating4Two app, which aims to provide women with a simple gestational weight gain (GWG) calculator, general dietary information, and the motivation to achieve a healthy weight gain during pregnancy. The project involved the development of app components, including a graphing function that allows the user to record their weight throughout the pregnancy and to receive real-time feedback on weight gain progress and general information on antenatal nutrition. Stakeholder consultation was used to inform development. The app was pilot tested with 10 pregnant women using a mixed method approach via an online survey, 2 focus groups, and 1 individual interview. The Eating4Two app took 7 months to develop and evaluate. It involved several disciplines--including nutrition and dietetics, midwifery, public health, and information technology--at the University of Canberra. Participants found the Eating4Two app to be a motivational tool but would have liked scales or other markers on the graph that demonstrated exact weight gain. They also liked the nutrition information; however, many felt it should be formatted in a more user friendly way. The Eating4Two app was viewed by participants in our study as an innovative support system to help motivate healthy behaviors during pregnancy and as a credible resource for accessing nutrition-focused information. The feedback provided by participants will assist with refining the current prototype for use in a clinical intervention trial.

  8. Development and Pilot Testing of the Eating4two Mobile Phone App to Monitor Gestational Weight Gain

    PubMed Central

    Davis, Deborah Lee; Williams, Lauren; Davey, Rachel; Cox, Robert; Clarke, Adam

    2015-01-01

    Background The number of pregnant women with a body mass index (BMI) of 30kg/m2 or more is increasing, which has important implications for antenatal care. Various resource-intensive interventions have attempted to assist women in managing their weight gain during pregnancy with limited success. A mobile phone app has been proposed as a convenient and cost-effective alternative to face-to-face interventions. Objective This paper describes the process of developing and pilot testing the Eating4Two app, which aims to provide women with a simple gestational weight gain (GWG) calculator, general dietary information, and the motivation to achieve a healthy weight gain during pregnancy. Methods The project involved the development of app components, including a graphing function that allows the user to record their weight throughout the pregnancy and to receive real-time feedback on weight gain progress and general information on antenatal nutrition. Stakeholder consultation was used to inform development. The app was pilot tested with 10 pregnant women using a mixed method approach via an online survey, 2 focus groups, and 1 individual interview. Results The Eating4Two app took 7 months to develop and evaluate. It involved several disciplines--including nutrition and dietetics, midwifery, public health, and information technology--at the University of Canberra. Participants found the Eating4Two app to be a motivational tool but would have liked scales or other markers on the graph that demonstrated exact weight gain. They also liked the nutrition information; however, many felt it should be formatted in a more user friendly way. Conclusions The Eating4Two app was viewed by participants in our study as an innovative support system to help motivate healthy behaviors during pregnancy and as a credible resource for accessing nutrition-focused information. The feedback provided by participants will assist with refining the current prototype for use in a clinical intervention trial. PMID:26048313

  9. How should gestational weight gain be assessed? A comparison of existing methods and a novel method, area under the weight gain curve

    PubMed Central

    Kleinman, Ken P; Oken, Emily; Radesky, Jenny S; Rich-Edwards, Janet W; Peterson, Karen E; Gillman, Matthew W

    2007-01-01

    Background Gestational weight gain is important to assess for epidemiological and public health purposes: it is correlated with infant growth and may be related to maternal outcomes such as reproductive health and chronic disease risk. Methods commonly used to assess weight gain incorporate assumptions that are usually not borne out, such as a linear weight gain, or do not account for differential length of gestation. Methods We introduce a novel method to assess gestational weight gain, the area under the weight gain curve. This is easily interpretable as the additional pound-days carried due to pregnancy and avoids many flaws in alternative assessments. We compare the performance of the simple difference, weekly gain, Institute of Medicine categories and the area under the weight gain curve in predicting birthweight and maternal weight retention at 6, 12, 24 and 36 months post-partum. The analytic sample comprises 2016 participants in Project Viva, an observational prospective cohort study of pregnant women in Massachusetts. Results For birthweight outcomes, none of the weight gain measures is a meaningfully superior predictor. For 6-month postpartum weight retention the simple difference is superior, while for 12-, 24- and 36-month weight retention the area under the weight gain curve is superior. Conclusions These findings are plausible biologically: the same amount of weight gained early vs later in the pregnancy may reflect increased maternal fat stores. The timing of weight gain is reflected best in the area under the weight gain curve. Different methods of measuring gestational weight gain may be appropriate depending on the context. PMID:17715174

  10. Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years

    PubMed Central

    Deierlein, Andrea L.; Siega-Riz, Anna Maria; Herring, Amy H.; Adair, Linda S.; Daniels, Julie L.

    2011-01-01

    Objective To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length z-scores (WLZ) between early infancy and 3 years. Methods Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n=476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ, and WLZ associated with GWG. Results In early infancy, compared to infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ, and WLZ. Excessive GWG≥200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. Conclusions GWG represents a modifiable behavioral factor that is associated with offspring anthropometric outcomes. More longitudinal studies that utilize maternal and pediatric body composition measures are necessary to understand the nature of this association. PMID:22434753

  11. Perceived stress and anhedonia predict short-and long-term weight change, respectively, in healthy adults.

    PubMed

    Ibrahim, Mostafa; Thearle, Marie S; Krakoff, Jonathan; Gluck, Marci E

    2016-04-01

    Perceived stress; emotional eating; anhedonia; depression and dietary restraint, hunger, and disinhibition have been studied as risk factors for obesity. However, the majority of studies have been cross-sectional and the directionality of these relationships remains unclear. In this longitudinal study, we assess their impact on future weight change. Psychological predictors of weight change in short- (6month) and long-term (>1year) periods were studied in 65 lean and obese individuals in two cohorts. Subjects participated in studies of food intake and metabolism that did not include any type of medication or weight loss interventions. They completed psychological questionnaires at baseline and weight change was monitored at follow-up visits. At six months, perceived stress predicted weight gain (r(2)=0.23, P=0.02). There was a significant interaction (r(2)=.38, P=0.009) between perceived stress and positive emotional eating, such that higher scores in both predicted greater weight gain, while those with low stress but high emotional eating scores lost weight. For long-term, higher anhedonia scores predicted weight gain (r(2)=0.24, P=0.04). Depression moderated these effects such that higher scores in both predicted weight gain but higher depression and lower anhedonia scores predicted weight loss. There are different behavioral determinants for short- and long-term weight change. Targeting perceived stress may help with short-term weight loss while depression and anhedonia may be better targets for long-term weight regulation. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Discrimination and Excessive Weight Gain During Pregnancy Among Black and Latina Young Women

    PubMed Central

    Reid, Allecia E.; Rosenthal, Lisa; Earnshaw, Valerie A.; Lewis, Tené T.; Lewis, Jessica B.; Stasko, Emily C.; Tobin, Jonathan N.; Ickovics, Jeannette R.

    2016-01-01

    Rationale Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. Objective We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Method Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Results Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Conclusion Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women. PMID:27038321

  13. Knowledge, attitudes, and beliefs regarding weight gain during pregnancy among Hispanic women.

    PubMed

    Tovar, Alison; Chasan-Taber, Lisa; Bermudez, Odilia I; Hyatt, Raymond R; Must, Aviva

    2010-11-01

    Pregnancy weight gain may be a risk factor for the development of obesity highlighting the importance of identifying psychosocial risk factors for pregnancy weight gain. The goal of this qualitative pilot study was to evaluate knowledge, attitudes and beliefs regarding weight gain during pregnancy among predominantly Puerto Rican women, a group with higher rates of obesity as compared to non-Hispanic white women. We conducted four focus groups stratified by level of acculturation and BMI. Women reported receiving advice about pregnancy weight gain predominantly from nutritionists and family members rather than from their physicians. The majority of overweight/obese women reported that they had not received any recommendations for weight gain during pregnancy from physicians. Pregnancy weight gain advice was not consistent with the 1990 Institute of Medicine Guidelines. Overall, attitudes towards weight gain recommendations differed by weight status, whereas feelings and dietary beliefs about weight gain differed according to level of acculturation. Our findings inform behavior change strategies for meeting pregnancy weight gain recommendations.

  14. Knowledge, Attitudes, and Beliefs Regarding Weight Gain During Pregnancy Among Hispanic Women

    PubMed Central

    Chasan-Taber, Lisa; Bermudez, Odilia I.; Hyatt, Raymond R.; Must, Aviva

    2012-01-01

    Pregnancy weight gain may be a risk factor for the development of obesity highlighting the importance of identifying psychosocial risk factors for pregnancy weight gain. The goal of this qualitative pilot study was to evaluate knowledge, attitudes and beliefs regarding weight gain during pregnancy among predominantly Puerto Rican women, a group with higher rates of obesity as compared to non-Hispanic white women. We conducted four focus groups stratified by level of acculturation and BMI. Women reported receiving advice about pregnancy weight gain predominantly from nutritionists and family members rather than from their physicians. The majority of overweight/obese women reported that they had not received any recommendations for weight gain during pregnancy from physicians. Pregnancy weight gain advice was not consistent with the 1990 Institute of Medicine Guidelines. Overall, attitudes towards weight gain recommendations differed by weight status, whereas feelings and dietary beliefs about weight gain differed according to level of acculturation. Our findings inform behavior change strategies for meeting pregnancy weight gain recommendations. PMID:19760160

  15. Early rapid weight gain and subsequent overweight and obesity in middle childhood in Peru.

    PubMed

    Penny, Mary E; Jimenez, M Michelle; Marin, R Margot

    2016-01-01

    Rapid postnatal weight gain is associated with risk of overweight and obesity, but it's unclear whether this holds in populations exposed to concurrent obesogenic risk factors and for children who have been extensively breastfed. This study investigates whether an increase in weight for age from birth to 1 year (infancy) and from 1 to 5 years (early childhood) predicts overweight and obesity, and waist circumference at 8 years, using data from a longitudinal cohort study in Peru. Generalized estimating equations (GEE) models were constructed for overweight and obesity, obesity alone and waist circumference at 8 years versus rapid weight gain in infancy, and early childhood including adjusted models to account for confounders. Rapid weight gain in both periods was associated with double the risk of overweight and obesity, obesity alone at 8 years and increased waist circumference even after controlling for maternal BMI and education level, sex of child, height-for-age at 8 years, consumption of "fast food" and number of days of active exercise. The association was significant, with some differences, for children in both rural and urban environments. Rapid weight gain in infancy and in early childhood in Peru is associated with overweight and obesity at age 8 years even when considering other determinants of childhood obesity.

  16. Parent-Reported Bullying and Child Weight Gain between Ages 6 and 15.

    PubMed

    Sutin, Angelina R; Robinson, Eric; Daly, Michael; Terracciano, Antonio

    2016-12-01

    Childhood bullying has long-term negative mental and physical health correlates, including weight gain and symptoms of depression. The purpose of this research is to examine whether bullying in the first year of school is associated with greater weight gain by early adolescence and whether adolescent depressive symptoms mediate this association. Data were drawn from the Longitudinal Study of Australian Children. Children (N = 3929) were measured every 2 years; BMI and waist circumference were available from ages 4 to 15. Parents reported on bullying at age 6. Children reported on their depressive symptoms at ages 12-13. Participants who weighed in the obese category at age 4 had an over 50% increased risk of being bullied in school at age 6. Being bullied at age 6 was associated with excess weight gain between ages 6 and 15, defined as either BMI or waist circumference. Depressive symptoms at age 12 partially explained the association between bullying and increases in adiposity. None of the associations varied by gender. Similar to other forms of peer victimization, bullying early in school is associated with greater weight gain through early adolescence; depressive symptom is one mechanism that contributes to this association.

  17. Gender differences in predictors of body weight and body weight change in healthy adults.

    PubMed

    Chiriboga, David E; Ma, Yunsheng; Li, Wenjun; Olendzki, Barbara C; Pagoto, Sherry L; Merriam, Philip A; Matthews, Charles E; Hebert, James R; Ockene, Ira S

    2008-01-01

    Overweight and obesity are important predictors of a wide variety of health problems. Analysis of naturally occurring changes in body weight can provide valuable insights in improving our understanding of the influence of demographic, lifestyle, and psychosocial factors on weight gain in middle-age adults. To identify gender-specific predictors of body weight using cross-sectional and longitudinal analyses. Anthropometric, lifestyle and psychosocial factors were measured at baseline and then quarterly for 1 year in 572 healthy adult volunteers from Central Massachusetts who were recruited between 1994 and 1998. Linear mixed models were used to analyze the relationship between body weight and potential predictors, including demographic (e.g., age, educational level), lifestyle (e.g., diet, physical activity, smoking), and psychosocial (e.g., anxiety, depression) factors. Over the 1-year study period, on average, men gained 0.3 kg and women lost 0.2 kg. Predictors of lower body weight at baseline in both men and women included current cigarette smoking, greater leisure-time physical activity, and lower depression and anxiety scores. Lower body weights were associated with a lower percentage of caloric intake from protein and greater occupational physical activity levels only among men; and with higher education level only among women. Longitudinal predictors of 1-year weight gain among women included increased total caloric intake and decreased leisure-time physical activity, and among men, greater anxiety scores. Demographic, lifestyle and psychosocial factors are independently related to naturally occurring changes in body weight and have marked differential gender effects. These effects should be taken into consideration when designing interventions for weight-loss and maintenance at the individual and population levels.

  18. Commuting by car: weight gain among physically active adults.

    PubMed

    Sugiyama, Takemi; Ding, Ding; Owen, Neville

    2013-02-01

    Prolonged sitting, including time spent sitting in cars, is detrimentally associated with health outcomes. This study examined whether commuting by car was associated with adults' weight gain over 4 years. Among 822 adult residents of Adelaide, Australia, weight change was ascertained from self-reported weight at baseline (2003-2004) and at follow-up (2007-2008). Using time spent for car commuting and work status at baseline, participants were categorized as non-car commuters, occasional car commuters, and daily car commuters. Multilevel linear regression (conducted in 2012) examined associations of weight change with car-commuting category, adjusting for potential confounding variables, for the whole sample, and among those who were physically inactive or active (≥150 minutes/week) in their leisure time. For the overall sample, adjusted mean weight gain (95% CI) over 4 years was 1.26 (0.64, 1.89) kg for non-car commuters; 1.53 (0.69, 2.37) kg for occasional car commuters; and 2.18 (1.44, 2.92) kg for daily car commuters (p for trend=0.090). Stratified analyses found a stronger association for those with sufficient leisure-time physical activity. For non-car commuters with sufficient leisure-time physical activity, the adjusted mean weight gain was 0.46 (-0.43, 1.35) kg, which was not significantly greater than 0. Over 4 years, those who used cars daily for commuting tended to gain more weight than those who did not commute by car. This relationship was pronounced among those who were physically active during leisure time. Reducing sedentary time may prevent weight gain among physically active adults. Copyright © 2013 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  19. Effect of intermittent kangaroo mother care on weight gain of low birth weight neonates with delayed weight gain.

    PubMed

    Samra, Nashwa M; Taweel, Amal El; Cadwell, Karin

    2013-01-01

    To evaluate intermittent Kangaroo Mother Care (KMC) with additional opportunities to breastfeed on weight gain of low birth weight (LBW) neonates with delayed weight gain. 40 LBW neonates were followed to see whether KMC with additional opportunities to breastfeed improved weight gain. In the KMC group, the mean age of regaining birth weight was significantly less (15.68 vs. 24.56 days) and the average daily weight gain was significantly higher (22.09 vs. 10.39 g, p < .001) than controls. KMC with additional opportunities to breastfeed was found to be an effective intervention for LBWs with delayed weight gain and should be considered to be an effective strategy.

  20. High weight gain during pregnancy increases the risk for emergency caesarean section - Population-based data from the Swedish Maternal Health Care Register 2011-2012.

    PubMed

    Nilses, Carin; Persson, Margareta; Lindkvist, Marie; Petersson, Kerstin; Mogren, Ingrid

    2017-03-01

    The aim was to investigate maternal background factors' significance in relation to risk of elective and emergency caesarean sections (CS) in Sweden. Population-based, retrospective, cross-sectional study. The Swedish Maternal Health Care Register (MHCR) is a national quality register that collects data on pregnancy, delivery and postpartum period. All women registered in MHCR 2011 to 2012 were included in the study sample (N = 178,716). The risk of elective and emergency caesarean section in relation to age, parity, education, country of origin, weight in early pregnancy and weight gain during pregnancy was calculated in logistic regression models. Multiparous women demonstrated a doubled risk of elective CS compared to primiparous women, but their risk for emergency CS was halved. Overweight and obesity at enrolment in antenatal care increased the risk for emergency CS, irrespective of parity. Weight gain above recommended international levels (Institute of Medicine, IOM) during pregnancy increased the risk for emergency CS for women with normal weight, overweight or obesity. There is a need of national guidelines on recommended weight gain during pregnancy in Sweden. We suggest that the usefulness of the IOM guidelines for weight gain during pregnancy should be evaluated in the Swedish context. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study.

    PubMed

    Alberico, Salvatore; Montico, Marcella; Barresi, Valentina; Monasta, Lorenzo; Businelli, Caterina; Soini, Valentina; Erenbourg, Anna; Ronfani, Luca; Maso, Gianpaolo

    2014-01-15

    It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson's chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia. Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia. Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored.

  2. The role of gestational diabetes, pre-pregnancy body mass index and gestational weight gain on the risk of newborn macrosomia: results from a prospective multicentre study

    PubMed Central

    2014-01-01

    Background It is crucial to identify in large population samples the most important determinants of excessive fetal growth. The aim of the study was to evaluate the independent role of pre-pregnancy body mass index (BMI), gestational weight gain and gestational diabetes on the risk of macrosomia. Methods A prospective study collected data on mode of delivery and maternal/neonatal outcomes in eleven Hospitals in Italy. Multiple pregnancies and preterm deliveries were excluded. The sample included 14109 women with complete records. Associations between exposure variables and newborn macrosomia were analyzed using Pearson’s chi squared test. Multiple logistic regression models were built to assess the independent association between potential predictors and macrosomia. Results Maternal obesity (adjusted OR 1.7, 95% CI 1.4-2.2), excessive gestational weight gain (adjusted OR 1.9, 95% CI 1.6-2.2) and diabetes (adjusted OR 2.1, 95% CI 1.5-3.0 for gestational; adjusted OR 3.0, 95% CI 1.2-7.6 for pre-gestational) resulted to be independent predictors of macrosomia, when adjusted for other recognized risk factors. Since no significant interaction was found between pre-gestational BMI and gestational weight gain, excessive weight gain should be considered an independent risk factor for macrosomia. In the sub-group of women affected by gestational or pre-gestational diabetes, pre-gestational BMI was not significantly associated to macrosomia, while excessive pregnancy weight gain, maternal height and gestational age at delivery were significantly associated. In this sub-population, pregnancy weight gain less than recommended was not significantly associated to a reduction in macrosomia. Conclusions Our findings indicate that maternal obesity, gestational weight gain excess and diabetes should be considered as independent risk factors for newborn macrosomia. To adequately evaluate the clinical evolution of pregnancy all three variables need to be carefully assessed and monitored. PMID:24428895

  3. Effects of an antenatal dietary intervention on maternal anthropometric measures in pregnant women with obesity

    PubMed Central

    Kannieappan, Lavern M.; Grivell, Rosalie M.; Deussen, Andrea R.; Moran, Lisa J.; Yelland, Lisa N.; Owens, Julie A.

    2015-01-01

    Objective The effect of providing antenatal dietary and lifestyle advice on secondary measures of maternal anthropometry was evaluated and their correlation with both gestational weight gain and infant birth weight was assessed. Methods In a multicenter, randomized controlled trial, pregnant women with BMI of ≥25 kg/m2 received either Lifestyle Advice or Standard Care. Maternal anthropometric outcomes included arm circumference, biceps, triceps, and subscapular skinfold thickness measurements (SFTM), percentage body fat (BF), gestational weight gain, and infant birth weight. The intention to treat principles were utilized by the analyses. Results The measurements were obtained from 807 (74.7%) women in the Lifestyle Advice Group and 775 (72.3%) women in the Standard Care Group. There were no statistically significant differences identified between the treatment groups with regards to arm circumference, biceps, triceps, and subscapular SFTM, or percentage BF at 36‐week gestation. Maternal anthropometric measurements were not significantly correlated with either gestational weight gain or infant birth weight. Conclusions Among pregnant women with a BMI of ≥25 kg/m2, maternal SFTM were not modified by an antenatal dietary and lifestyle intervention. Furthermore, maternal SFTM correlate poorly with both gestational weight gain and infant birth weight. PMID:26175260

  4. Effect of protein intake and weight gain velocity on body fat mass at 6 months of age: the EU Childhood Obesity Programme.

    PubMed

    Escribano, J; Luque, V; Ferre, N; Mendez-Riera, G; Koletzko, B; Grote, V; Demmelmair, H; Bluck, L; Wright, A; Closa-Monasterolo, R

    2012-04-01

    Higher protein intake during the first year of life is associated with increased weight gain velocity and body mass index (BMI). However, the relationship of protein intake and weight gain velocity with body composition is unclear. To assess if the increases in weight gain velocity and BMI induced by protein intake early in life are related to an increase in fat or fat-free mass. In all, 41 infants randomized at birth to a higher or lower protein content formula (HP=17 and LP=24, respectively) and 25 breastfed infants were included. Anthropometric measures were assessed at baseline, 6, 12 and 24 months, and fat-free mass (FFM) and fat mass (FM) were assessed by isotope dilution at 6 months. Weight gain velocity (g per month) during the first 6 months of life was significantly higher among HP infants (807.8 (±93.8) vs 724.2 (±110.0) (P=0.015)). Weight gain velocity strongly correlated with FM z-score (r=0.564, P<0.001) but showed no association with FFM z-scores. FFM showed no association with BMI. Nevertheless, FM strongly correlated with BMI at 6, 12 and 24 months (r=0.475, P<0.001; r=0.332, P=0.007 and r=0.247, P=0.051, respectively). FFM and FM z-scores did not differ significantly between HP and LP infants (0.32±1.75 vs -0.31±1.17 and 0.54±2.81 vs -0.02±1.65, respectively). Our findings support the hypothesis that higher protein intakes early in life are associated with faster weight gain and in turn to higher adiposity. This mechanism could be a determinant factor for later obesity risk.

  5. Weight Gain and Somatization are Associated With the Onset of Gastroesophageal Reflux Diseases: Results of Two 5-year Follow-up Studies.

    PubMed

    Barcelo, Marta; Alvarez Sanchez, Angel; Garcia Sanchez, Raquel; Diaz-Rubio, Manuel; Rey, Enrique

    2016-03-01

    Although 2% to 4% of the population develop gastroesophageal reflux disease (GERD) annually, factors associated with the onset of GERD are scarcely known. To assess whether such factors include weight gain and psychological distress. Two cohorts (first: N=222; second N=754) drawn from 2 case-control studies were followed up for around 5 years. In 2004, all participants were directly interviewed using a validated questionnaire to collect data on body weight, height, GERD symptoms, and psychological distress. In 2009 to 2010, these same participants were again interviewed using the same methodology. The response rate was 83.3% in cohort 1 and 39.1% in cohort 2, after a follow-up of 4.3±0.7 and 5.6±0.3 years, respectively. The multivariate analysis showed only weight gain and psychological distress as being independently associated with the onset of GERD in both cohorts. Weight gain per kilogram showed an adjusted odds ratio (OR) of 1.21 (1.01-1.44) in the first cohort, and a gain of 5 kg or more showed an adjusted OR of 4.65 (1.72-12.53) in the second. Somatization scores showed an adjusted OR of 1.09 (1.04-1.15) in the first cohort (measured as Minnesota Multiphasic Personality Inventory 2 hypochondriasis score) and 2.88 (1.04-8.02) in the second (measured as psychosomatic symptoms score). Body mass index on attaining overweight or obese status was associated with the onset of GERD in the unadjusted but not in the adjusted analysis. Weight gain and somatization are the main factors associated with the onset of GERD. The association between GERD and obesity is just the ultimate consequence of gaining weight.

  6. Interpersonal psychotherapy for the prevention of excess weight gain and eating disorders: A brief case study.

    PubMed

    Tanofsky-Kraff, Marian; Shomaker, Lauren B; Young, Jami F; Wilfley, Denise E

    2016-06-01

    This article presents a brief case study of "Jane Doe," a 13-year-old, non-Hispanic White girl 2 participating in a clinical research trial of interpersonal psychotherapy-weight gain (IPT-WG). Girls at-risk for adult obesity and binge eating disorder (BED) were randomly assigned to take part in 12 weeks of preventative group treatment. Jane's IPT-WG group included five other early adolescent girls (mostly aged 12-13) at risk for adult obesity and BED. The case of Jane illustrates a successful example of IPT-WG for the prevention of excessive weight gain and for the prevention of BED. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  7. Effect of Intermittent Kangaroo Mother Care on Weight Gain of Low Birth Weight Neonates With Delayed Weight Gain

    PubMed Central

    Samra, Nashwa M.; Taweel, Amal El; Cadwell, Karin

    2013-01-01

    Objective: To evaluate intermittent Kangaroo Mother Care (KMC) with additional opportunities to breastfeed on weight gain of low birth weight (LBW) neonates with delayed weight gain. Methods: 40 LBW neonates were followed to see whether KMC with additional opportunities to breastfeed improved weight gain. Results: In the KMC group, the mean age of regaining birth weight was significantly less (15.68 vs. 24.56 days) and the average daily weight gain was significantly higher (22.09 vs. 10.39 g, p < .001) than controls. Conclusion: KMC with additional opportunities to breastfeed was found to be an effective intervention for LBWs with delayed weight gain and should be considered to be an effective strategy. PMID:24868132

  8. Influence of Intensive Diabetes Treatment on Body Weight and Composition of Adults With Type 1 Diabetes in the Diabetes Control and Complications Trial

    PubMed Central

    2009-01-01

    OBJECTIVE To examine the differential effects of intensive and conventional diabetes therapy on weight gain and body composition in adults with type 1 diabetes. RESEARCH DESIGN AND METHODS Between 1982 and 1989, 1,246 adults (aged 18–39 years) in the Diabetes Control and Complications Trial were randomly assigned to either conventional therapy (1–2 injections of insulin per day) or intensive therapy (multiple daily injections or continuous subcutaneous infusion with frequent blood-glucose testing). Height and weight were measured at baseline and at annual visits for an average of 6 years (range 3–9). Body composition was assessed cross-sectionally with bioelectrical impedance analysis during 1992, at which time waist and hip circumferences were measured. RESULTS Intensively treated patients gained an average of 4.75 kg more than their conventionally treated counterparts (P < 0.0001). This represented excess increases in BMI of 1.5 kg/m2 among men and 1.8 kg/m2 among women. Growth-curve analysis showed that weight gain was most rapid during the first year of therapy. Intensive therapy patients were also more likely to become overweight (BMI ≥ 27.8 kg/m2 for men, ≥27.3 kg/m2 for women) or experience major weight gain (BMI increased ≥5 kg/m2). Waist-to-hip ratios, however, did not differ between treatment groups. Major weight gain was associated with higher percentages of body fat and greater fat-free mass, but among patients without major weight gain, those receiving intensive therapy had greater fat-free mass with no difference in adiposity. CONCLUSIONS Intensive therapy for type 1 diabetes produces substantial excess weight gain compared with conventional therapy. However, the additional weight appears to include lean tissue as well as fat. PMID:11574431

  9. Total cost comparison of standard antenatal care with a weight gain restriction programme for obese pregnant women.

    PubMed

    de Keyser, N; Josefsson, A; Monfils, W G; Claesson, I M; Carlsson, P; Sydsjö, A; Sydsjö, G

    2011-05-01

    To perform a cost comparison of a weight gain restriction programme for obese pregnant women with standard antenatal care, and to identify if there were differences in healthcare costs within the intervention group related to degree of gestational weight gain or degree of obesity at programme entry. A comparison of mean healthcare costs for participants of an intervention study at antenatal care clinics with controls in south-east Sweden. In total, 155 women in an intervention group attempted to restrict their gestational weight gain to <7 kg. The control group comprised 193 women. Mean costs during pregnancy, delivery and the neonatal period were compared with the costs of standard care. Costs were converted from Swedish Kronor to Euros (€). Healthcare costs during pregnancy were lower in the intervention group. There was no significant difference in total healthcare costs (i.e. sum of costs during pregnancy, delivery and the neonatal period) between the intervention group and the control group. Within the intervention group, the subgroup that gained 4.5-9.5 kg had the lowest costs. The total cost, including intervention costs, was € 1283 more per woman/infant in the intervention group compared with the control group (P=0.025). The degree of obesity at programme entry had no bearing on the outcome. The weight gain restriction programme for obese pregnant women was effective in restricting gestational weight gain to <7 kg, but had a higher total cost compared with standard antenatal care. Copyright © 2011 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. Excess pregnancy weight gain and long-term obesity: one decade later.

    PubMed

    Rooney, Brenda L; Schauberger, Charles W

    2002-08-01

    To estimate the impact of excess pregnancy weight gain and failure to lose weight by 6 months postpartum on excess weight 8-10 years later. Seven hundred ninety-five women were observed through pregnancy and 6 months postpartum to examine factors that affect weight loss. Weight was recorded 10 years later through a medical record review to examine the impact of retained weight on long-term obesity. Overall weight change at last follow-up and body mass index (BMI) were examined by pregnancy weight gain appropriateness according to the Institute of Medicine guidelines for weight gain during pregnancy. Of the original cohort, 540 women had a documented weight beyond 5 years (mean = 8.5 years). The average weight gain from prepregnancy to follow-up was 6.3 kg. There was no difference in weight gain by prepregnancy BMI. Women who gained less than the recommended amount during their pregnancy were 4.1 kg heavier at follow-up, those gaining the recommended amount were 6.5 kg heavier, and those gaining more than recommended were 8.4 kg heavier (P =.01). Women who lost all pregnancy weight by 6 months postpartum were 2.4 kg heavier at follow-up than women with retained weight, who weighed 8.3 kg more at follow-up (P =.01). Women who breast-fed and women who participated in aerobic exercise also had significantly lower weight gains. Excess weight gain and failure to lose weight after pregnancy are important and identifiable predictors of long-term obesity. Breast-feeding and exercise may be beneficial to control long-term weight.

  11. Exploring the diet and lifestyle changes contributing to weight gain among Australian West African women following migration: A qualitative study.

    PubMed

    Babatunde-Sowole, Olutoyin O; Power, Tamara; Davidson, Patricia; Ballard, Charlotte; Jackson, Debra

    2018-04-10

    This paper reports on women's experiences of weight gain and obesity as they became acculturated to the Australian diet and lifestyle. Migrants from sub-Saharan Africa have a much higher risk of obesity than the native population when settling in industrialised countries. Qualitative. Women in this study reported weight gain post-migration. This was attributed to increased access to a wide variety of food including takeaway food and more sedentary lifestyles. Obesity has long-term consequences for health and well-being. Further research is needed to support a healthy transition to life in Australia. Gaining insight into the underlying reasons that West African immigrants to Australia become obese could contribute to assisting health professionals design culturally appropriate interventions and health education programmes to support new arrivals.

  12. Interventions to reduce weight gain in schizophrenia.

    PubMed

    Faulkner, G; Cohn, T; Remington, G

    2007-01-24

    Weight gain is common for people with schizophrenia and this has serious implications for health and well being. To determine the effects of both pharmacological (excluding medication switching) and non pharmacological strategies for reducing or preventing weight gain in people with schizophrenia. We searched key databases and the Cochrane Schizophrenia Group's trials register (April 2006), reference sections within relevant papers, hand searched key journals, and contacted the first author of each relevant study and other experts to collect further information. We included all clinical randomised controlled trials comparing any pharmacological or non pharmacological intervention for weight gain (diet and exercise counselling) with standard care or other treatments for people with schizophrenia or schizophrenia-like illnesses. We reliably selected, quality assessed and extracted data from studies. As weight is a continuous outcome measurement, weighted mean differences (WMD) of the change from baseline were calculated. The primary outcome measure was weight loss. Twenty-three randomised controlled trials met the inclusion criteria for this review. Five trials assessed a cognitive/behavioural intervention and eighteen assessed a pharmacological adjunct. In terms of prevention, two cognitive/behavioural trials showed significant treatment effect (mean weight change) at end of treatment (n=104, 2 RCTs, WMD -3.38 kg CI -4.2 to -2.0). Pharmacological adjunct treatments were significant with a modest prevention of weight gain (n=274, 6 RCTs, WMD - 1.16 kg CI -1.9 to -0.4). In terms of treatments for weight loss, we found significantly greater weight reduction in the cognitive behavioural intervention group (n=129, 3 RCTs, WMD -1.69 kg CI -2.8 to -0.6) compared with standard care. Modest weight loss can be achieved with selective pharmacological and non pharmacological interventions. However, interpretation is limited by the small number of studies, small sample size, short study duration and by variability of the interventions themselves, their intensity and duration. Future studies adequately powered, with longer treatment duration and rigorous methodology will be needed in further evaluating the efficacy and safety of weight loss interventions for moderating weight gain. At this stage, there is insufficient evidence to support the general use of pharmacological interventions for weight management in people with schizophrenia.

  13. [Research advance in assessment of nutritional status of children].

    PubMed

    Li, Hai-Qi

    2014-01-01

    Malnutrition is not a simple disease, which occurs in the condition when the body does not get the right amount of nutrients to maintain healthy tissues and organ functions. Malnutrition generally refers both to undernutrition and overnutrition, but usually it is used to refer solely to a deficiency of nutrition. Infants and young children are the most vulnerable because of their high nutritional requirements for growth and development. Growth is an important indicator of health and nutritional status of a child. Generally, underweight, studding and wasting are used as the indicators of malnutrition. In fact, a gain in height is a better indicator of the adequacy of a diet than a gain in weight. Rates of weight gain needs to accompany accelerated height gain to maintain normal body proportions (weight-for-height). Now therefore WHO recommends using weight-for-height as the indicator of malnutrition of epidemic intensity in communities and of nutritional condition evaluation, including treatment assessment. The assessment of nutritional status is commonly summarized by the mnemonic "ABCD," which stands for anthropometric measurement (A), biochemical or laboratory tests (B), clinical indicators (C) and dietary assessment (D). Children with malnutrition are required to ingest more than 30 essential nutrients including both functional, protective nutrients (type I) and growth nutrients (type II), in order to have a catch-up growth in weight and height.

  14. The effect of betahistine, a histamine H1 receptor agonist/H3 antagonist, on olanzapine-induced weight gain in first-episode schizophrenia patients.

    PubMed

    Poyurovsky, Michael; Pashinian, Artashes; Levi, Aya; Weizman, Ronit; Weizman, Abraham

    2005-03-01

    Histamine antagonism has been implicated in antipsychotic drug-induced weight gain. Betahistine, a histamine enhancer with H1 agonistic/H3 antagonistic properties (48 mg t.i.d.), was coadministered with olanzapine (10 mg/day) in three first-episode schizophrenia patients for 6 weeks. Body weight was measured at baseline and weekly thereafter. Clinical rating scales were completed at baseline and at week 6. All participants gained weight (mean weight gain 3.1+/-0.9 kg) and a similar pattern of weight gain was observed: an increase during the first 2 weeks and no additional weight gain (two patients) or minor weight loss (one patient) from weeks 3 to 6. None gained 7% of baseline weight, which is the cut-off for clinically significant weight gain. Betahistine was safe and well tolerated and did not interfere with the antipsychotic effect of olanzapine. Our findings justify a placebo-controlled evaluation of the putative weight-attenuating effect of betahistine in olanzapine-induced weight gain.

  15. Personalized Health Planning With Integrative Health Coaching to Reduce Obesity Risk Among Women Gaining Excess Weight During Pregnancy

    PubMed Central

    Yang, Nancy Y.; Wroth, Shelley; Parham, Catherine; Strait, Melva

    2013-01-01

    Health coaching is an emerging behavioral intervention to improve outcomes in chronic disease management and prevention; however, no studies have investigated its utility in postpartum women who have gained excess weight during pregnancy. A 32-year-old primigravida woman who was overweight at conception and gained 23 lbs more than Institute of Medicine recommendations for her pre-pregnancy body mass index participated in a 6-month personalized health planning with integrative health coaching (PHPIHC) intervention. The intervention included a baseline health risk assessment review with a healthcare provider and eight biweekly, 30-minute telephonic health coaching sessions. The participant demonstrated improvement in physical activity, energy expenditure, knowledge, and confidence to engage in healthpromoting behaviors. Although the participant did not reach the target weight by completion of the health coaching sessions, follow up 8 months later indicated she achieved the target goal (within 5% of prepregnancy weight). This case report suggests that PHP-IHC can support postpartum women in returning to pre-pregnancy weight after gaining excess gestational weight. Future research and clinical trials are needed to determine the best timing, length, and medium (online, in-person, telephonic) of PHP-IHC for postpartum women. PMID:24278848

  16. Weight Suppression But Not Symptom Improvement Predicts Weight Gain During Inpatient Treatment for Bulimia Nervosa.

    PubMed

    Hessler, Johannes Baltasar; Diedrich, Alice; Greetfeld, Martin; Schlegl, Sandra; Schwartz, Caroline; Voderholzer, Ulrich

    2018-03-01

    Fear of gaining weight is a common obstacle to seeking treatment for bulimia nervosa (BN). We investigated changes in body mass index (BMI) during inpatient treatment for BN in relation to treatment outcome and weight suppression (WS). Female inpatients of a specialized eating disorders clinic were grouped as deteriorated/unchanged, reliably improved, and clinically significantly improved based on Eating Disorder Inventory-2 scores. Repeated measures ANOVA was employed to examine changes in BMI between admission and discharge depending on treatment outcome and WS. One-hundred seventy-nine patients were included. Overall, the average BMI significantly increased by 0.54 kg/m 2 (SD = 1.24). Repeated measures ANOVA revealed no association of change in BMI with treatment outcome [F(df) = 1.13 (2166), p = 0.327] but with WS [F(df) = 2.76 (3166), p < 0.044]. Bulimia nervosa can be successfully treated without causing excessive weight gain. Patients with higher WS might expect somewhat more weight gain. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  17. Obesity, weight gain, and ovarian cancer risk in African American women.

    PubMed

    Bandera, Elisa V; Qin, Bo; Moorman, Patricia G; Alberg, Anthony J; Barnholtz-Sloan, Jill S; Bondy, Melissa; Cote, Michele L; Funkhouser, Ellen; Peters, Edward S; Schwartz, Ann G; Terry, Paul; Schildkraut, Joellen M

    2016-08-01

    Although there is growing evidence that higher adiposity increases ovarian cancer risk, little is known about its impact in African American (AA) women, the racial/ethnic group with the highest prevalence of obesity. We evaluated the impact of body mass index (BMI) 1 year before diagnosis and weight gain since age 18 years on ovarian cancer risk in a population-based case-control study in AA women in 11 geographical areas in the US. Cases (n = 492) and age and site matched controls (n = 696) were identified through rapid case ascertainment and random-digit-dialing, respectively. Information was collected on demographic and lifestyle factors, including self-reported height, weight at age 18 and weight 1 year before diagnosis/interview. Multivariable logistic regression was used to compute odds ratios (OR) and 95% confidence intervals (CI), adjusting for potential covariates. Obese women had elevated ovarian cancer risk, particularly for BMI ≥ 40 kg/m(2) compared to BMI <25 (OR = 1.72, 95% CI: 1.12-2.66; p for trend: 0.03). There was also a strong association with weight gain since age 18 (OR: 1.52; 95% CI: 1.07-2.16; p for trend: 0.02) comparing the highest to lowest quartile. In stratified analyses by menopausal status, the association with BMI and weight gain was limited to postmenopausal women, with a 15% (95% CI: 1.05-1.23) increase in risk per 5 kg/m(2) of BMI and 6% (95% CI: 1.01-1.10) increase in risk per 5 kg of weight gain. Excluding hormone therapy users essentially did not change results. Obesity and excessive adult weight gain may increase ovarian cancer risk in post-menopausal AA women. © 2016 UICC.

  18. The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia.

    PubMed

    Bakhotmah, Balkees Abed

    2011-08-10

    During Ramadan fast, approximately one billion Muslims abstain from food and fluid between the hours of sunrise to sunset, and usually eat a large meal after sunset and another meal before sunrise. Many studies reported good health-related outcomes of fasting including weight loss. The objective of this study is to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a group of families in Jeddah, Western Saudi Arabia. A Cross-section study using a pre-designed questionnaire to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a representative cohort of Saudis living in Jeddah. It was piloted on 173 nutrition students and administered by them to their families. A total of 173 Saudi families were interviewed. One out of 5 indicated that their expenditure increases during Ramadan. Approximately two thirds of the respondents (59.5%) reported weight gain after Ramadan. When asked about their perspective explanations for that: 40% attributed that to types of foods being rich in fat and carbohydrates particularly date in (Sunset meal) 97.7% and rice in (Dawn meal) 80.9%. One third (31.2%) indicated that it was due to relative lack of physical exercise in Ramadan and 14.5% referred that to increase in food consumption. Two thirds (65.2%) of those with increased expenditure reported weight gain. Surprisingly weight gain and not weight loss was reported after Ramadan by Saudis which indicates timely needed life-style and dietary modification programs for a population which reports one of the highest prevalence rates of diabetes.

  19. Discrimination and excessive weight gain during pregnancy among Black and Latina young women.

    PubMed

    Reid, Allecia E; Rosenthal, Lisa; Earnshaw, Valerie A; Lewis, Tené T; Lewis, Jessica B; Stasko, Emily C; Tobin, Jonathan N; Ickovics, Jeannette R

    2016-05-01

    Excessive weight gain during pregnancy is a major determinant of later life obesity among both Black and Latina women and their offspring. However, psychosocial determinants of this risk, including everyday discrimination, and potential moderators of such effects remain unexplored. We examined the influence of discrimination, a culturally relevant stressor, on odds of gaining weight beyond Institute of Medicine recommendations during pregnancy. Whether the effect was moderated by race/ethnicity, age, or depressive symptoms was also examined. Participants were 413 Black and Latina pregnant young women, ages 14-21 years. Experience with discrimination and all moderators were assessed in the second trimester. Last weight recorded in the third trimester was abstracted from medical records and used to determine excessive weight gain. Ever experiencing discrimination was associated with a 71% increase in the odds of excessive weight gain. The effect of discrimination was primarily present among women who attributed this treatment to membership in a historically oppressed group (e.g., ethnic minority, female) or to membership in other stigmatized groups (e.g., overweight). The effect of ever experiencing discrimination was not moderated by race/ethnicity or age but was moderated by depressive symptoms. Supporting the perspective of the environmental affordances model, discrimination strongly predicted excessive weight gain when women were low in depressive symptoms but had no effect when women were high in depressive symptoms. The moderating role of depressive symptoms was equivalent for Black and Latina women. Results highlight the role of discrimination in perpetuating weight-related health disparities and suggest opportunities for improving health outcomes among young pregnant women. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Schizophrenia and weight management: a systematic review of interventions to control weight.

    PubMed

    Faulkner, G; Soundy, A A; Lloyd, K

    2003-11-01

    Weight gain is a frequent side effect of antipsychotic medication which has serious implications for a patient's health and well being. This study systematically reviews the literature on the effectiveness of interventions designed to control weight gain in schizophrenia. A systematic search strategy was conducted of major databases in addition to citation searches. Study quality was rated. Sixteen studies met the inclusion criteria. Five of eight pharmacological intervention studies reported small reductions in weight (<5% baseline body weight). All behavioural (including diet and/or exercise) interventions reported small reductions in, or maintenance of, weight. Weight loss may be difficult but it is not impossible. Given the inconsistent results, the widespread use of pharmacological interventions cannot be recommended. Both dietary and exercise counselling set within a behavioural modification programme is necessary for sustained weight control.

  1. Review of Randomized Controlled Trials of Massage in Preterm Infants

    PubMed Central

    Niemi, Anna-Kaisa

    2017-01-01

    Preterm birth affects about 10% of infants born in the United States. Massage therapy is being used in some neonatal intensive care units for its potential beneficial effects on preterm infants. This article reviews published randomized controlled trials on the effects of massage in preterm infants. Most studies evaluating the effect of massage in weight gain in premature infants suggest a positive effect on weight gain. Increase in vagal tone has been reported in infants who receive massage and has been suggested as a possible mechanism for improved weight gain. More studies are needed on the underlying mechanisms of the effects of massage therapy on weight gain in preterm infants. While some trials suggest improvements in developmental scores, decreased stress behavior, positive effects on immune system, improved pain tolerance and earlier discharge from the hospital, the number of such studies is small and further evidence is needed. Further studies, including randomized controlled trials, are needed on the effects of massage in preterm infants. PMID:28368368

  2. Weight gain following treatment of hyperthyroidism.

    PubMed

    Dale, J; Daykin, J; Holder, R; Sheppard, M C; Franklyn, J A

    2001-08-01

    Patients frequently express concern that treating hyperthyroidism will lead to excessive weight gain. This study aimed to determine the extent of, and risk factors for, weight gain in an unselected group of hyperthyroid patients. We investigated 162 consecutive hyperthyroid patients followed for at least 6 months. Height, weight, clinical features, biochemistry and management were recorded at each clinic visit. Documented weight gain was 5.42 +/- 0.46 kg (mean +/- SE) and increase in BMI was 8.49 +/- 0.71%, over a mean 24.2 +/- 1.6 months. Pre-existing obesity, Graves' disease causing hyperthyroidism, weight loss before presentation and length of follow-up each independently predicted weight gain. Patients treated with thionamides or radioiodine gained a similar amount of weight (thionamides, n = 87, 5.16 +/- 0.63 kg vs. radioiodine, n = 62, 4.75 +/- 0.57 kg, P = 0.645), but patients who underwent thyroidectomy (n = 13) gained more weight (10.27 +/- 2.56 kg vs. others, P = 0.007). Development of hypothyroidism (even transiently) was associated with weight gain (never hypothyroid, n = 102, 4.57 +/- 0.52 kg, transiently hypothyroid, n = 29, 5.37 +/- 0.85 kg, on T4, n = 31, 8.06 +/- 1.42 kg, P = 0.014). This difference remained after correcting for length of follow-up. In the whole cohort, weight increased by 3.95 +/- 0.40 kg at 1 year (n = 144) to 9.91 +/- 1.62 kg after 4 years (n = 27) (P = 0.008), representing a mean weight gain of 3.66 +/- 0.44 kg/year. We have demonstrated marked weight gain after treatment of hyperthyroidism. Pre-existing obesity, a diagnosis of Graves' disease and prior weight loss independently predicted weight gain and weight continued to rise with time. Patients who became hypothyroid, despite T4 replacement, gained most weight.

  3. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life

    PubMed Central

    Zheng, Yan; Manson, JoAnn E.; Yuan, Changzheng; Liang, Matthew H.; Grodstein, Francine; Stampfer, Meir J.; Willett, Walter C.

    2017-01-01

    Importance Data describing the effects of weight gain across adulthood on overall health are important for weight control. Objective To examine the association of weight gain from early to middle adulthood with health outcomes later in life. Design, Setting, and Participants Cohort analysis of US women from the Nurses’ Health Study (1976-June 30, 2012) and US men from the Health Professionals Follow-Up Study (1986-January 31, 2012) who recalled weight during early adulthood (at age of 18 years in women; 21 years in men), and reported current weight during middle adulthood (at age of 55 years). Exposures Weight change from early to middle adulthood (age of 18 or 21 years to age of 55 years). Main Outcomes and Measures Beginning at the age of 55 years, participants were followed up to the incident disease outcomes. Cardiovascular disease, cancer, and death were confirmed by medical records or the National Death Index. A composite healthy aging outcome was defined as being free of 11 chronic diseases and major cognitive or physical impairment. Results A total of 92 837 women (97% white; mean [SD] weight gain: 12.6 kg [12.3 kg] over 37 years) and 25 303 men (97% white; mean [SD] weight gain: 9.7 kg [9.7 kg] over 34 years) were included in the analysis. For type 2 diabetes, the adjusted incidence per 100 000 person-years was 207 among women who gained a moderate amount of weight (≥2.5 kg to <10 kg) vs 110 among women who maintained a stable weight (weight loss ≤2.5 kg or gain <2.5 kg) (absolute rate difference [ARD] per 100 000 person-years, 98; 95% CI, 72 to 127) and 258 vs 147, respectively, among men (ARD, 111; 95% CI, 58 to 179); hypertension: 3415 vs 2754 among women (ARD, 662; 95% CI, 545 to 782) and 2861 vs 2366 among men (ARD, 495; 95% CI, 281 to 726); cardiovascular disease: 309 vs 248 among women (ARD, 61; 95% CI, 38 to 87) and 383 vs 340 among men (ARD, 43; 95% CI, −14 to 109); obesity-related cancer: 452 vs 415 among women (ARD, 37; 95% CI, 4 to 73) and 208 vs 165 among men (ARD, 42; 95% CI, 0.5 to 94). Among those who gained a moderate amount of weight, 3651 women (24%) and 2405 men (37%) achieved the composite healthy aging outcome. Among those who maintained a stable weight, 1528 women (27%) and 989 men (39%) achieved the composite healthy aging outcome. The multivariable-adjusted odds ratio for the composite healthy aging outcome associated with moderate weight gain was 0.78 (95% CI, 0.72 to 0.84) in women and 0.88 (95% CI, 0.79 to 0.97) in men. Higher amounts of weight gain were associated with greater risks of major chronic diseases and lower likelihood of healthy aging. Conclusions and Relevance In these cohorts of health professionals, weight gain during adulthood was associated with significantly increased risk of major chronic diseases and decreased odds of healthy aging. These findings may help counsel patients regarding the risks of weight gain. PMID:28719691

  4. Dietary macronutrients and food consumption as determinants of long-term weight change in adult populations: a systematic literature review

    PubMed Central

    Fogelholm, Mikael; Anderssen, Sigmund; Gunnarsdottir, Ingibjörg; Lahti-Koski, Marjaana

    2012-01-01

    This systematic literature review examined the role of dietary macronutrient composition, food consumption and dietary patterns in predicting weight or waist circumference (WC) change, with and without prior weight reduction. The literature search covered year 2000 and onwards. Prospective cohort studies, case–control studies and interventions were included. The studies had adult (18–70 y), mostly Caucasian participants. Out of a total of 1,517 abstracts, 119 full papers were identified as potentially relevant. After a careful scrutiny, 50 papers were quality graded as A (highest), B or C. Forty-three papers with grading A or B were included in evidence grading, which was done separately for all exposure-outcome combinations. The grade of evidence was classified as convincing, probable, suggestive or no conclusion. We found probable evidence for high intake of dietary fibre and nuts predicting less weight gain, and for high intake of meat in predicting more weight gain. Suggestive evidence was found for a protective role against increasing weight from whole grains, cereal fibre, high-fat dairy products and high scores in an index describing a prudent dietary pattern. Likewise, there was suggestive evidence for both fibre and fruit intake in protection against larger increases in WC. Also suggestive evidence was found for high intake of refined grains, and sweets and desserts in predicting more weight gain, and for refined (white) bread and high energy density in predicting larger increases in WC. The results suggested that the proportion of macronutrients in the diet was not important in predicting changes in weight or WC. In contrast, plenty of fibre-rich foods and dairy products, and less refined grains, meat and sugar-rich foods and drinks were associated with less weight gain in prospective cohort studies. The results on the role of dietary macronutrient composition in prevention of weight regain (after prior weight loss) were inconclusive. PMID:22893781

  5. A weight-gain-for-gestational-age z score chart for the assessment of maternal weight gain in pregnancy.

    PubMed

    Hutcheon, Jennifer A; Platt, Robert W; Abrams, Barbara; Himes, Katherine P; Simhan, Hyagriv N; Bodnar, Lisa M

    2013-05-01

    To establish the unbiased relation between maternal weight gain in pregnancy and perinatal health, a classification for maternal weight gain is needed that is uncorrelated with gestational age. The goal of this study was to create a weight-gain-for-gestational-age percentile and z score chart to describe the mean, SD, and selected percentiles of maternal weight gain throughout pregnancy in a contemporary cohort of US women. The study population was drawn from normal-weight women with uncomplicated, singleton pregnancies who delivered at the Magee-Womens Hospital in Pittsburgh, PA, 1998-2008. Analyses were based on a randomly selected subset of 648 women for whom serial prenatal weight measurements were available through medical chart record abstraction (6727 weight measurements). The pattern of maternal weight gain throughout gestation was estimated by using a random-effects regression model. The estimates were used to create a chart with the smoothed means, percentiles, and SDs of gestational weight gain for each week of pregnancy. This chart allows researchers to express total weight gain as an age-standardized z score, which can be used in epidemiologic analyses to study the association between pregnancy weight gain and adverse or physiologic pregnancy outcomes independent of gestational age.

  6. Postcessation weight gain concern as a barrier to smoking cessation: Assessment considerations and future directions.

    PubMed

    Germeroth, Lisa J; Levine, Michele D

    2018-01-01

    Concern about postcessation weight gain may be one potential barrier to quitting smoking. In this 'mini-review' of recent literature, we summarize findings on the relationship between postcessation weight gain concern and smoking cessation, and evaluate varied use of postcessation weight gain concern assessments and potential moderators of the postcessation weight gain concern-cessation association. We conducted a search using the terms "smoking" OR "smoking cessation" AND "weight concern" for articles published between January 1, 2011 and December 31, 2016. We identified 17 studies assessing postcessation weight gain concern, seven of which evaluated the postcessation weight gain concern-cessation association. The relationship between postcessation weight gain concern and smoking cessation was mixed. Recent studies varied in their assessments of postcessation weight gain concern, many of which were not validated and assessed correlates of this construct. Studies varied in their adjustment of demographic (e.g., sex), smoking-specific (e.g., smoking level), and weight-specific (e.g., body mass index) variables. The use of non-validated assessments and variability in testing covariates/moderators may contribute to conflicting results regarding the postcessation weight gain concern-cessation relationship. We recommend validating an assessment of postcessation weight gain concern, maintaining vigilance in testing and reporting covariates/moderators, and investigating trajectories of this construct over time and by smoking status to inform future assessment and intervention efforts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Effectiveness of a structured diet program in antipsychotic-induced weight gain in patients with schizophrenia.

    PubMed

    Direk, Nese; Ucok, Alp

    2008-01-01

    Objective.The aim of this study was to evaluate the effectiveness of a structured diet program in weight loss in patients with schizophrenia. Methods. A total of 38 outpatients diagnosed with schizophrenia according to DSM-IV and who had complaints of weight gain during treatment with various antipsychotic drugs were invited to participate in a 3-month structured diet program. Thirty-two patients and another 40 patients were included as the control group. At the beginning of the diet program, the patients were given a form in order to evaluate their eating habits, and blood samples were taken to measure plasma lipid profile, and fasting blood glucose (FBG) level. Patients' baseline weight, body mass index (BMI), and basal metabolism rate (BMR) were recorded. Results. Thirty-two patients with schizophrenia, who attended a 3-month structured diet program had mean weight loss of 6.19 kg, whereas patients in the control group gained 1.6 kg. Conclusion. Our findings show that a diet program is effective in managing antipsychotic-induced weight gain. The degree of weight loss seems to be correlated with the duration in which the patient is on the diet program. However; younger patients had less benefit from the diet program.

  8. Gestational weight gain and predicted changes in offspring anthropometrics between early infancy and 3 years.

    PubMed

    Deierlein, A L; Siega-Riz, A M; Herring, A H; Adair, L S; Daniels, J L

    2012-04-01

    To determine how gestational weight gain (GWG), categorized using the 2009 Institute of Medicine recommendations, relates to changes in offspring weight-for-age (WAZ), length-for-age (LAZ) and weight-for-length z-scores (WLZ) between early infancy and 3 years. Women with singleton infants were recruited from the third cohort of the Pregnancy, Infection, and Nutrition Study (2001-2005). Term infants with at least one weight or length measurement during the study period were included (n = 476). Multivariable linear mixed effects regression models estimated longitudinal changes in WAZ, LAZ and WLZ associated with GWG. In early infancy, compared with infants of women with adequate weight gain, those of women with excessive weight gains had higher WAZ, LAZ and WLZ. Excessive GWG ≥ 200% of the recommended amount was associated with faster rates of change in WAZ and LAZ and noticeably higher predicted mean WAZ and WLZ that persisted across the study period. GWG is associated with significant differences in offspring anthropometrics in early infancy that persisted to 3 years of age. More longitudinal studies that utilize maternal and paediatric body composition measures are necessary to understand the nature of this association. © 2012 The Authors. Pediatric Obesity © 2012 International Association for the Study of Obesity.

  9. Influence of pre-pregnancy leisure time physical activity on gestational and postpartum weight gain and birth weight - a cohort study.

    PubMed

    Hegaard, Hanne Kristine; Rode, Line; Katballe, Malene Kjær; Langberg, Henning; Ottesen, Bent; Damm, Peter

    2017-08-01

    In order to examine the association between pre-pregnancy leisure time physical activities and gestational weight gain, postpartum weight gain and birth weight, we analysed prospectively collected data from 1827 women with singleton term pregnancies. Women were categorised in groups of sedentary women, light exercisers, moderate exercisers and competitive athletes. The results showed that sedentary women on average gained 14.1 kg during pregnancy, whereas light exercisers gained 13.7 kg, moderate exercisers gained 14.3 kg and competitive athletes 16.1 kg. Competitive athletes had an increased risk of having a gestational weight gain above Institute of Medicine (IOM) recommendations with an odds ratio of 2.60 (1.32-5.15) compared to light exercisers. However, birth weight and one year postpartum weight was similar for all four groups. Thus, although competitive athletes gain more weight than recommended during pregnancy, this may not affect birth weight or postpartum weight. Impact statement What is already known on this subjectPrevious studies have found that increased pre-pregnancy physical activity is associated with lower gestational weight gain during the last trimester, but showed no association between the pre-pregnancy level of physical activity and mean birth weight. What the results of this study addWe found that women classified as competitive exercisers had a 2.6-fold increased risk of gaining more weight than recommended compared to light exercisers. Nearly 6 out of 10 women among the competitive exercisers gained more weight than recommended by IOM. Surprisingly, this did not appear to increase birth weight or post-partum weight gain, but other adverse effects cannot be excluded. What the implications are of these findings for clinical practice and/or further researchIn the clinical practice it may be relevant to focus on and advise pre-pregnancy competitive exercisers in order to prevent excessive gestational weight gain.

  10. Weight change from 3-year observational data: findings from the worldwide schizophrenia outpatient health outcomes database.

    PubMed

    Bushe, Chris J; Slooff, Cees J; Haddad, Peter M; Karagianis, Jamie L

    2012-06-01

    Weight change data from randomized clinical trials are often of limited duration and trials do not always report a full range of clinically relevant categorical end points. We conducted a post hoc analysis of data from the observational Worldwide Schizophrenia Outpatient Health Outcomes database (2000-2005) on weight change in 4,626 patients completing 3 years of antipsychotic monotherapy with amisulpride, clozapine, olanzapine, quetiapine, risperidone, and oral and depot first-generation antipsychotics (FGAs). Reported outcomes included mean and categorical weight changes and the trajectories of different measures of weight change. Mean weight gain was lowest with amisulpride (1.8 kg; 95% CI, 0.2-3.3) and highest with olanzapine (4.2 kg; 95% CI, 3.9-4.5). Weight change for all antipsychotics was most rapid during the first 6 months; subsequent weight change was slower but did not plateau. All drugs showed considerable individual variation in weight change. The proportion losing ≥7% of their baseline bodyweight was highest with quetiapine (10%; 95% CI, 7%-16%) and lowest with depot FGAs (5%; 95% CI, 3%-10%). Between 7% and 15% of patients moved into an overweight or obese body mass index (kg/m2)category (≥25). The degree of weight gain varied between antipsychotics. All antipsychotics were associated with significant (≥7%) weight loss and gain from baseline. The mean rate of weight gain was maximal during the first 6 months but continued over 3 years without a plateau in this specific cohort. Patients should receive regular monitoring of weight throughout treatment. © Copyright 2012 Physicians Postgraduate Press, Inc.

  11. Impact of sugars and sugar taxation on body weight control: A comprehensive literature review.

    PubMed

    Bes-Rastrollo, Maira; Sayon-Orea, Carmen; Ruiz-Canela, Miguel; Martinez-Gonzalez, Miguel A

    2016-07-01

    To conduct a comprehensive literature review in the field of added-sugar consumption on weight gain including the effect of fructose-containing caloric sweeteners and sugar taxation. A search of three databases was conducted in the time period from the inception of the databases to August 2015. Sensitive search strategies were used in order to retrieve systematic reviews (SR) of fructose, sucrose, or sugar-sweetened beverages (SSBs) on weight gain and metabolic adverse effects, conducted on humans and written in English, Spanish, or French. In addition, a review about SSB taxation and weight outcomes was conducted. The search yielded 24 SRs about SSBs and obesity, 23 SRs on fructose or SSBs and metabolic adverse effects, and 24 studies about SSB taxation and weight control. The majority of SRs, especially the most recent ones, with the highest quality and without any disclosed conflict of interest, suggested that the consumption of SSBs is a risk factor for obesity. The effect of fructose-containing caloric sweeteners, on weight gain is mediated by overconsumption of beverages with these sweeteners, leading to an extra provision of energy intake. The tax tool alone on added sugars appears insufficient to curb the obesity epidemic, but it needs to be included in a multicomponent structural strategy. © 2016 The Obesity Society.

  12. Metabolic markers during pregnancy and their association with maternal and newborn weight status.

    PubMed

    Perichart-Perera, Otilia; Muñoz-Manrique, Cinthya; Reyes-López, Angélica; Tolentino-Dolores, Maricruz; Espino Y Sosa, Salvador; Ramírez-González, Ma Cristina

    2017-01-01

    Obesity during pregnancy increases the risk of adverse clinical outcomes and is associated with low-grade chronic inflammation. We describe maternal metabolic risk and inflammation by maternal weight status, and evaluate the association of metabolic and inflammatory markers with birthweight in a group of pregnant Mexican women. This study derived from a prospective cohort of healthy pregnant women <14 weeks of gestation, receiving prenatal care at National Institute of Perinatology (Mexico, 2009-2013). Metabolic and inflammatory markers were measured in maternal serum in all three pregnancy trimesters (1st: 11.42±1.7; 2nd: 21.06±2.4; 3rd: 32.74±2.3 weeks). Pregestational weight was self-reported, and body mass index (BMI) was calculated. Gestational weight gain was evaluated in the third trimester. Newborn´s weight was measured at birth. We carried out correlations, general mixed linear model and regression analyses, based on pregestational weight (self-reported), body mass index (BMI), gestational weight gain (evaluated in the third trimester) and newborn weight (measured at birth). Of the 177 women included in the study (mean age = 26.93±8.49), thirty-eight percent (n = 67) were overweight or had obesity, and 32.8% (n = 58) showed excessive gestational weight gain. We found insulin, lipids (including total cholesterol, LDL-cholesterol, HDL-cholesterol, and triglycerides-TG), leptin and interleukin 1b (IL-1b) all increased significantly (p<0.05) during pregnancy. Pregestational maternal weight status altered longitudinal concentrations of insulin, leptin, adiponectin, TG and C reactive protein. Excessive gestational weight gain was associated with higher maternal insulin in the third trimester (p<0.05). Early pregnancy leptin and TNFα were determinants of birthweight in women with normal weight, but not in overweight or obese women. Maternal weight status affected the concentrations of insulin, leptin, adiponectin, triglycerides and C reactive protein throughout pregnancy. The role of early leptin and TNFα in fetal growth need further study given the association was only observed in normal weight women. This study presents data distribution of metabolic and inflammatory markers of normal weight and overweight/obese women that did not develop GDM, preeclampsia nor macrosomia.

  13. How Pregnant African-American Women View Pregnancy Weight Gain

    PubMed Central

    Groth, Susan W.; Morrison-Beedy, Dianne; Meng, Ying

    2012-01-01

    Objective To gain insight into how low-income, pregnant African-American women viewed their weight gain while pregnant and how they managed their weight during pregnancy. Design Descriptive study using three focus groups. Setting Women were recruited from urban prenatal care sites and the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) services in a medium-sized urban Northeastern city. Participants Twenty-six adult, low-income, pregnant African-American women, aged 18–39; the majority were within the first 20 weeks of pregnancy. Methods Three focus groups were conducted utilizing open-ended questions related to pregnancy weight gain. Content analysis was used to analyze the verbatim transcripts. Analysis focused on meaning, intention and context. Groups were compared and contrasted at the within and between group levels to identify themes. Results Four themes were identified that provided insight into how women viewed their pregnancy weight gain and managed weight gain during pregnancy: (a) pregnancy weight gain: no matter how much means a healthy baby; (b) weight retention: it happens; (c) there is a limit: weight gain impact on appearance; and (d) watching and waiting: plans for controlling weight. Conclusion Low-income African-American women, though cognizant of the likelihood of retention of weight following pregnancy, are not focused on limiting their gestational weight gain. The cultural acceptance of a larger body size along with the belief that gaining more weight is indicative of a healthy infant present challenges for interventions to limit excessive gestational weight gain. PMID:22789036

  14. Upweighting rare favourable alleles increases long-term genetic gain in genomic selection programs.

    PubMed

    Liu, Huiming; Meuwissen, Theo H E; Sørensen, Anders C; Berg, Peer

    2015-03-21

    The short-term impact of using different genomic prediction (GP) models in genomic selection has been intensively studied, but their long-term impact is poorly understood. Furthermore, long-term genetic gain of genomic selection is expected to improve by using Jannink's weighting (JW) method, in which rare favourable marker alleles are upweighted in the selection criterion. In this paper, we extend the JW method by including an additional parameter to decrease the emphasis on rare favourable alleles over the time horizon, with the purpose of further improving the long-term genetic gain. We call this new method dynamic weighting (DW). The paper explores the long-term impact of different GP models with or without weighting methods. Different selection criteria were tested by simulating a population of 500 animals with truncation selection of five males and 50 females. Selection criteria included unweighted and weighted genomic estimated breeding values using the JW or DW methods, for which ridge regression (RR) and Bayesian lasso (BL) were used to estimate marker effects. The impacts of these selection criteria were compared under three genetic architectures, i.e. varying numbers of QTL for the trait and for two time horizons of 15 (TH15) or 40 (TH40) generations. For unweighted GP, BL resulted in up to 21.4% higher long-term genetic gain and 23.5% lower rate of inbreeding under TH40 than RR. For weighted GP, DW resulted in 1.3 to 5.5% higher long-term gain compared to unweighted GP. JW, however, showed a 6.8% lower long-term genetic gain relative to unweighted GP when BL was used to estimate the marker effects. Under TH40, both DW and JW obtained significantly higher genetic gain than unweighted GP. With DW, the long-term genetic gain was increased by up to 30.8% relative to unweighted GP, and also increased by 8% relative to JW, although at the expense of a lower short-term gain. Irrespective of the number of QTL simulated, BL is superior to RR in maintaining genetic variance and therefore results in higher long-term genetic gain. Moreover, DW is a promising method with which high long-term genetic gain can be expected within a fixed time frame.

  15. Early life risk factors and their cumulative effects as predictors of overweight in Spanish children.

    PubMed

    Iguacel, Isabel; Escartín, Laura; Fernández-Alvira, Juan M; Iglesia, Iris; Labayen, Idoia; Moreno, Luis A; Samper, María Pilar; Rodríguez, Gerardo

    2018-05-01

    To explore early life risk factors of overweight/obesity at age 6 years and their cumulative effects on overweight/obesity at ages 2, 4 and 6 years. Altogether 1031 Spanish children were evaluated at birth and during a 6-year follow-up. Early life risk factors included: parental overweight/obesity, parental origin/ethnicity, maternal smoking during pregnancy, gestational weight gain, gestational age, birth weight, caesarean section, breastfeeding practices and rapid infant weight gain collected via hospital records. Cumulative effects were assessed by adding up those early risk factors that significantly increased the risk of overweight/obesity. We conducted binary logistic regression models. Rapid infant weight gain (OR 2.29, 99% CI 1.54-3.42), maternal overweight/obesity (OR 1.93, 99% CI 1.27-2.92), paternal overweight/obesity (OR 2.17, 99% CI 1.44-3.28), Latin American/Roma origin (OR 3.20, 99% CI 1.60-6.39) and smoking during pregnancy (OR 1.61, 99% CI 1.01-2.59) remained significant after adjusting for confounders. A higher number of early life risk factors accumulated was associated with overweight/obesity at age 6 years but not at age 2 and 4 years. Rapid infant weight gain, parental overweight/obesity, maternal smoking and origin/ethnicity predict childhood overweight/obesity and present cumulative effects. Monitoring children with rapid weight gain and supporting a healthy parental weight are important for childhood obesity prevention.

  16. HbA1c and Gestational Weight Gain Are Factors that Influence Neonatal Outcome in Mothers with Gestational Diabetes.

    PubMed

    Barquiel, Beatriz; Herranz, Lucrecia; Hillman, Natalia; Burgos, Ma Ángeles; Grande, Cristina; Tukia, Keleni M; Bartha, José Luis; Pallardo, Luis Felipe

    2016-06-01

    Maternal glucose and weight gain are related to neonatal outcome in women with gestational diabetes mellitus (GDM). The aim of this study was to explore the influence of average third-trimester HbA1c and excess gestational weight gain on GDM neonatal complications. This observational study included 2037 Spanish singleton pregnant women with GDM followed in our Diabetes and Pregnancy Unit. The maternal HbA1c level was measured monthly from GDM diagnosis to delivery. Women were compared by average HbA1c level and weight gain categorized into ≤ or > the current Institute of Medicine (IOM) recommendations for body mass index. The differential effects of these factors on large-for-gestational-age birth weight and a composite of neonatal complications were assessed. Women with an average third-trimester HbA1c ≥5.0% (n = 1319) gave birth to 7.3% versus 3.8% (p = 0.005) of large-for-gestational-age neonates and 22.0% versus 16.0% (p = 0.006) of neonates with complications. Women with excess gestational weight gain (n = 299) delivered 12.5% versus 5.2% (p < 0.001) of large-for-gestational-age neonates and 24.7% versus 19.0% (p = 0.022) of neonates with complications. In an adjusted multiple logistic regression analysis among mothers exposed to the respective risk factors, ∼47% and 52% of large-for-gestational-age neonates and 32% and 37% of neonatal complications were potentially preventable by attaining an average third-trimester HbA1c level <5.0% and optimizing gestational weight gain. Average third-trimester HbA1c level ≥5% and gestational weight gain above the IOM recommendation are relevant risk factors for neonatal complications in mothers with gestational diabetes.

  17. Intentions to Prevent Weight Gain in Older and Younger Adults; The Importance of Perceived Health and Appearance Consequences.

    PubMed

    Beeken, Rebecca J; Mahdi, Sundus; Johnson, Fiona; Meisel, Susanne F

    2018-01-01

    This study investigates whether health and appearance consequences predict intentions to prevent weight gain and whether these relationships differ in younger versus older adults and in men versus women. UK adults aged 18-26 years (younger adults; n = 584) or >45 years (older adults; n = 107) participated in an online survey. Logistic regression assessed associations between intentions to avoid gaining weight and age, gender as well as perceived negative consequences of weight gain for health and appearance. Co-variates were ethnicity, education, weight perception and perceived weight gain vulnerability. Interactions between age, gender and perceived health and appearance consequences of weight gain were also tested. Perceived negative appearance consequences of weight gain predicted weight gain prevention intentions (OR = 9.3, p < 0.001). Health concerns were not a significant predictor of intentions overall but were a strong predictor for older adults (age × health concern interaction: OR = 13.6, p > 0.01). Concerns about feeling unattractive predict intentions to prevent weight gain. However, health consequences of weight gain are only important motivators for older adults. Future research should identify ways to shift the focus of young people from appearance concerns towards the health benefits of maintaining a healthy weight. © 2018 The Author(s) Published by S. Karger GmbH, Freiburg.

  18. The effect of a short course of moderate pressure sunflower oil massage on the weight gain velocity and length of NICU stay in preterm infants.

    PubMed

    Taheri, Peymaneh Alizadeh; Goudarzi, Zahra; Shariat, Mamak; Nariman, Shahin; Matin, Elahe Nikzinat

    2018-02-01

    The aim of this study was to evaluate the efficacy of five-day course of sunflower oil massage with moderate pressure on the weight gain and length of NICU stay in preterm infants. Forty-four healthy preterm infants with a corrected gestational age of 30-36 weeks at the time of the study, were randomly assigned to the study group receiving body massage with sunflower oil and the control group receiving only routine NICU care. The massage was performed three times per day, each session including three consecutive five-minute stages, for five days. The primary outcome was to evaluate the efficacy of a short course of moderate pressure sunflower oil massage on the weight gain velocity. The secondary outcome was to compare the length of NICU stay between the two groups. During the study period, the increase in the average daily and fifth-day weight gain was significant in the intervention group. The length of NICU stay was shorter in the intervention group significantly. Our findings suggest that even a short course of body massage with sunflower oil for only five days increases preterm infants' weight gain and decreases their duration of NICU stay significantly. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Parent-Reported Bullying and Child Weight Gain between Ages 6 and 15

    PubMed Central

    Robinson, Eric; Daly, Michael; Terracciano, Antonio

    2016-01-01

    Abstract Background: Childhood bullying has long-term negative mental and physical health correlates, including weight gain and symptoms of depression. The purpose of this research is to examine whether bullying in the first year of school is associated with greater weight gain by early adolescence and whether adolescent depressive symptoms mediate this association. Methods: Data were drawn from the Longitudinal Study of Australian Children. Children (N = 3929) were measured every 2 years; BMI and waist circumference were available from ages 4 to 15. Parents reported on bullying at age 6. Children reported on their depressive symptoms at ages 12–13. Results: Participants who weighed in the obese category at age 4 had an over 50% increased risk of being bullied in school at age 6. Being bullied at age 6 was associated with excess weight gain between ages 6 and 15, defined as either BMI or waist circumference. Depressive symptoms at age 12 partially explained the association between bullying and increases in adiposity. None of the associations varied by gender. Conclusions: Similar to other forms of peer victimization, bullying early in school is associated with greater weight gain through early adolescence; depressive symptom is one mechanism that contributes to this association. PMID:27710013

  20. Antipsychotic-induced insulin resistance and postprandial hormonal dysregulation independent of weight gain or psychiatric disease.

    PubMed

    Teff, Karen L; Rickels, Michael R; Grudziak, Joanna; Fuller, Carissa; Nguyen, Huong-Lan; Rickels, Karl

    2013-09-01

    Atypical antipsychotic (AAP) medications that have revolutionized the treatment of mental illness have become stigmatized by metabolic side effects, including obesity and diabetes. It remains controversial whether the defects are treatment induced or disease related. Although the mechanisms underlying these metabolic defects are not understood, it is assumed that the initiating pathophysiology is weight gain, secondary to centrally mediated increases in appetite. To determine if the AAPs have detrimental metabolic effects independent of weight gain or psychiatric disease, we administered olanzapine, aripiprazole, or placebo for 9 days to healthy subjects (n = 10, each group) under controlled in-patient conditions while maintaining activity levels. Prior to and after the interventions, we conducted a meal challenge and a euglycemic-hyperinsulinemic clamp to evaluate insulin sensitivity and glucose disposal. We found that olanzapine, an AAP highly associated with weight gain, causes significant elevations in postprandial insulin, glucagon-like peptide 1 (GLP-1), and glucagon coincident with insulin resistance compared with placebo. Aripiprazole, an AAP considered metabolically sparing, induces insulin resistance but has no effect on postprandial hormones. Importantly, the metabolic changes occur in the absence of weight gain, increases in food intake and hunger, or psychiatric disease, suggesting that AAPs exert direct effects on tissues independent of mechanisms regulating eating behavior.

  1. Short-term increase of body weight triggers immunological variables in dogs.

    PubMed

    Van de Velde, H; Janssens, G P J; Stuyven, E; Cox, E; Buyse, J; Hesta, M

    2012-01-15

    Overweight in dogs is, as in other companion animals, a major risk factor for several metabolic disorders. However, it is not yet known whether immunity is challenged by increased body weight in dogs. The aim of this study was to investigate the effect of a short-term increase in body weight on immunological variables in adult healthy beagle dogs. Sixteen dogs, divided into a control group (CG) and weight gain group (WGG), were included. During a period of 13 weeks, the CG was fed at maintenance energy requirement (MER), whereas the WGG received a double amount of food. After 13 weeks, blood samples were taken for immunological and biochemical analyses. Weight gain and increased body condition score in the WGG were accompanied by a significant higher leptin concentration. Weight gain increased the number of lymphocytes and immunoglobulins A and M and was responsible for a higher proliferation of peripheral blood mononuclear cells (PBMC). Short-term increase of body weight thus seems to trigger immunological variables in dogs. Copyright © 2011 Elsevier B.V. All rights reserved.

  2. Neonates with Bartter syndrome have enormous fluid and sodium requirements.

    PubMed

    Azzi, Antonio; Chehade, Hassib; Deschênes, Georges

    2015-07-01

    Managing neonatal Bartter syndrome by achieving adequate weight gain is challenging. We assessed the correlation between weight gain in neonatal Bartter syndrome and the introduction of fluid and sodium supplementations and indomethacin during the first 4 weeks of life. Daily fluid and electrolytes requirements were analysed using linear regression and Spearman correlation coefficients. The weight gain coefficient was calculated as daily weight gain after physiological neonatal weight loss. We studied seven infants. The highest weight gain coefficients occurred between weeks two and four in the five neonates who either received prompt amounts of fluid (maximum 810 mL/kg/day) and sodium (maximum 70 mmol/kg/day) or were treated with indomethacin. For the two patients with the highest weight gain coefficient, water and sodium supplementations were decreased in weeks two to four leading to a significant negative Spearman correlation between weight gain and fluid supplements (r = -0.55 and -0.68) and weight gain and sodium supplementations (r = -0.96 and -0.72). The two patients with the lowest weight gain coefficient had positive Spearman correlation coefficients between weight gain and fluid and sodium supplementations. Infants with neonatal Bartter syndrome required rapid and enormous fluid and sodium supplementations or the early introduction of indomethacin treatment to achieve adequate weight gain during the early postnatal period. ©2015 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  3. Patterns and Composition of Weight Change in College Freshmen

    ERIC Educational Resources Information Center

    Leone, Ryan J.; Morgan, Amy L.; Ludy, Mary-Jon

    2015-01-01

    While it is well documented that college freshmen gain weight, there is a dearth of studies examining critical time periods for this weight change. Freshmen living on campus (n = 103; 21M, 82F) visited the laboratory in August/September, November, January, February/March, and April/May. Measurements at each visit included: weight, waist…

  4. Weight gain in healthy pregnant women in relation to pre-pregnancy BMI, diet and physical activity.

    PubMed

    Merkx, Astrid; Ausems, Marlein; Budé, Luc; de Vries, Raymond; Nieuwenhuijze, Marianne J

    2015-07-01

    to explore gestational weight gain in healthy women in relation to pre-pregnancy Body Mass Index, diet and physical activity. a cross-sectional survey was conducted among 455 healthy pregnant women of all gestational ages receiving antenatal care from an independent midwife in the Netherlands. Weight gain was assessed using the Institute of Medicine (IOM) guidelines and classified as below, within, or above the guidelines. A multinomial regression analysis was performed with weight gain classifications as the dependent variable (within IOM-guidelines as reference). Independent variables were pre-pregnancy Body Mass Index, diet (broken down into consumption of vegetables, fruit and fish) and physical activity (motivation to engage in physical activity, pre-pregnancy physical activity and decline in physical activity during pregnancy). Covariates were age, gestational age, parity, ethnicity, family income, education, perceived sleep deprivation, satisfaction with pre-pregnancy weight, estimated prepregnancy body mass index, smoking, having a weight gain goal and having received weight gain advice from the midwife. forty-two per cent of the women surveyed gained weight within the guidelines. Fourteen per cent of the women gained weight below the guidelines and 44 per cent gained weight above the guidelines. Weight gain within the guidelines, compared to both above and below the guidelines, was not associated with pre-pregnancy Body Mass Index nor with diet. A decline in physical activity was associated with weight gain above the guidelines (OR 0.54, 95 per cent CI 0.33-0.89). Weight gain below the guidelines was seen more often in women who perceived a greater sleep deprivation (OR 1.20, 95 per cent CI 1.02-1.41). Weight gain above the guidelines was seen less often in Caucasian women in comparison to non-Caucasian women (OR 0.22, 95 per cent CI 0.08-0.56) and with women who did not stop smoking during pregnancy (OR 0.49, 95 per cent CI 0.25-0.95). a decline in physical activity was the only modifiable factor in our population associated with weight gain above the gain recommended by the guidelines. Prevention of reduced physical activity during pregnancy seems a promising approach to promoting healthy weight gain. Interventions to promote healthy weight gain should focus on all women, regardless of pre-pregnancy body mass index. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Rate of gestational weight gain and preterm birth in relation to prepregnancy body mass indices and trimester: a follow-up study in China.

    PubMed

    Huang, Aiqun; Ji, Zhenpeng; Zhao, Wei; Hu, Huanqing; Yang, Qi; Chen, Dafang

    2016-08-12

    To evaluate the association between rate of gestational weight gain and preterm birth varying prepregnancy body mass indices and trimester. Data from Maternal and Newborn's Health Monitoring System on 17475 pregnant women who delivered live singletons at ≥ 28 weeks of gestation between October 2013 and September 2014 from 12 districts/counties of 6 provinces in China and started prenatal care at ≤ 12 weeks of gestation was analyzed. Gestational weight gain was categorized by rate of weight gain during the 2(nd) and 3(rd) trimester, based on the 2009 Institute of Medicine guidelines. Multivariable binary logistic regression models were conducted to investigate the association between rate of gestational weight gain and preterm birth stratified by prepregnancy body mass indices and trimester. Excessive weight gain occurred in 57.9 % pregnant women, and insufficient weight gain 12.5 %. Average rate of gestational weight gain in 2(nd) and 3(rd) trimester was independently associated with preterm birth (U-shaped), and the association varied by prepregnancy body mass indices and trimesters. In underweight women, excessive gestational weight gain was positively associated with preterm birth (OR 1.93, 95 % confidence interval (CI): 1.29- 2.88) when compared with women who gained adequately. While in overweight/obese women, insufficient gestational weight gain was positively associated with preterm birth (OR 3.92, 95 % CI: 1.13-13.67). When stratifying by trimester, we found that excessive weight gain in 3(rd) trimester had a significantly positive effect on preterm birth (OR 1.27, 95 % CI: 1.02-1.58). Excessive gestational weight gain among underweight pregnant women, insufficient gestational weight gain among overweight/obese women and excessive gestational weight gain in 3(rd) trimester were important predictors of preterm birth.

  6. Perceptions of low-income African-American mothers about excessive gestational weight gain.

    PubMed

    Herring, Sharon J; Henry, Tasmia Q; Klotz, Alicia A; Foster, Gary D; Whitaker, Robert C

    2012-12-01

    A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. In 2010-2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies' health. Family members, especially participants own mothers, strongly reinforced the need to "eat for two" to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Overall, low-income African-American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers' physical symptoms may be most effective for weight control.

  7. The Relationship of Violence and Traumatic Stress to Changes in Weight and Waist Circumference: Longitudinal Analyses from the Study of Women’s Health Across the Nation (SWAN)

    PubMed Central

    Garcia, Lorena; Qi, Lihong; Rasor, Marianne; Gold, Ellen B; Clark, Cari; Bromberger, Joyce

    2013-01-01

    Objective To investigate the associations of violence and traumatic stress with changes in weight and waist circumference, hypothesizing that violence in midlife would be associated with increases or decreases in weight and waist circumference. Methods The longitudinal cohort of the Study of Women’s Health Across the Nation (SWAN) comprised the study sample, which included an ethnically/racially and socially diverse group of 2870 women between the ages of 42 and 52 years at baseline. Women were followed annually for 10 years and assessments included weight and waist circumference measures and data on violence, health outcomes and confounders. Results At baseline, 8.6% Caucasian, 10.8% African American, 9.2% Chinese and 5.0% Japanese women reported violence and traumatic stress. Reporting violence and traumatic stress during follow-up was significantly associated with weight gain (OR=2.39, 95% CI= 1.28, 4.47), weight loss (OR=3.54, 95% CI=1.73, 7.22), and gain (OR=2.44, 95% CI =1.37, 4.37) or loss (OR=2.66, 95% CI=1.23, 5.77) in waist circumference, adjusting for age, race/ethnicity, education, marital status, and smoking. Conclusion Violence and traumatic stress against midlife women was associated with gains or losses in weight and waist circumference. PMID:24212978

  8. The relationship of violence and traumatic stress to changes in weight and waist circumference: longitudinal analyses from the study of women's health across the nation.

    PubMed

    Garcia, Lorena; Qi, Lihong; Rasor, Marianne; Clark, Cari Jo; Bromberger, Joyce; Gold, Ellen B

    2014-05-01

    This article investigates the associations of violence and traumatic stress with changes in weight and waist circumference, hypothesizing that violence in midlife would be associated with increases or decreases in weight and waist circumference. The longitudinal cohort of the Study of Women's Health Across the Nation comprised the study sample, which included an ethnically/racially and socially diverse group of 2,870 women between the ages of 42 and 52 years at baseline. Women were followed annually for 10 years, and assessments included weight and waist circumference measures and data on violence, health outcomes, and confounders. At baseline, 8.6% Caucasian, 10.8% African American, 9.2% Chinese, and 5.0% Japanese women reported violence and traumatic stress. Reporting violence and traumatic stress during follow-up was significantly associated with weight gain (odds ratio [OR] = 2.39, 95% confidence interval [CI] = [1.28-4.47]), weight loss (OR = 3.54, 95% CI = [1.73-7.22]), and gain (OR = 2.44, 95% CI = [1.37-4.37]) or loss (OR = 2.66, 95% CI = [1.23-5.77]) in waist circumference, adjusting for age, race/ethnicity, education, marital status, and smoking. Violence and traumatic stress against midlife women were associated with gains or losses in weight and waist circumference.

  9. Obesity, change of body mass index and subsequent physical and mental health functioning: a 12-year follow-up study among ageing employees.

    PubMed

    Svärd, Anna; Lahti, Jouni; Roos, Eira; Rahkonen, Ossi; Lahelma, Eero; Lallukka, Tea; Mänty, Minna

    2017-09-26

    Studies suggest an association between weight change and subsequent poor physical health functioning, whereas the association with mental health functioning is inconsistent. We aimed to examine whether obesity and change of body mass index among normal weight, overweight and obese women and men associate with changes in physical and mental health functioning. The Helsinki Health Study cohort includes Finnish municipal employees aged 40 to 60 in 2000-02 (phase 1, response rate 67%). Phase 2 mail survey (response rate 82%) took place in 2007 and phase 3 in 2012 (response rate 76%). This study included 5668 participants (82% women). Seven weight change categories were formed based on body mass index (BMI) (phase 1) and weight change (BMI change ≥5%) (phase 1-2). The Short Form 36 Health Survey (SF-36) measured physical and mental health functioning. The change in health functioning (phase 1-3) score was examined with repeated measures analyses. Covariates were age, sociodemographic factors, health behaviours, and somatic ill-health. Weight gain was common among women (34%) and men (25%). Weight-gaining normal weight (-1.3 points), overweight (-1.3 points) and obese (-3.6 points) women showed a greater decline in physical component summary scores than weight-maintaining normal weight women. Among weight-maintainers, only obese (-1.8 points) women showed a greater decline than weight-maintaining normal weight women. The associations were similar, but statistically non-significant for obese men. No statistically significant differences in the change in mental health functioning occurred. Preventing weight gain likely helps maintaining good physical health functioning and work ability.

  10. The role of a personalized dietary intervention in managing gestational weight gain: a prospective, controlled study in a low-risk antenatal population.

    PubMed

    Di Carlo, Costantino; Iannotti, Giuseppina; Sparice, Stefania; Chiacchio, Maria Pia; Greco, Elena; Tommaselli, Giovanni Antonio; Nappi, Carmine

    2014-04-01

    To compare the efficacy of a personal dietary intervention on gestational weight gain control with a general intervention promoting healthy eating. Prospective, controlled study including 154 low-risk pregnant women randomly allocated to two groups: 77 receiving a personalized diet plan and a close follow-up by a dietician (intervention group), 77 receiving standard dietary care by means of a brochure on healthy eating during pregnancy (control group). Pre-pregnancy weight, gestational age, height, weight and BMI at baseline, weight at term, gestational age at delivery and newborn weight were recorded for all participants. The primary end-point was the difference in body weight between baseline and term. Secondary end-points were the difference in body weight between pre-pregnancy and term and in newborn weights. Maternal weight gain at term was significantly lower both as compared to pre-pregnancy weight (8.2 ± 4.0 vs. 13.4 ± 4.2 kg; p < 0.001) and to weight at baseline (7.7 ± 3.8 vs. 13.7 ± 4.3 kg; p < 0.001) in the intervention group as compared to controls. A positive, significant correlation between the delta weight between baseline and term and newborn weight was observed in both groups, but stronger in patients from the intervention group (intervention group R = 0.76, p < 0.001; control group R = 0.35, p = 0.01). This study suggests that a personalized nutritional intervention, in which the dietician plays an active role within the obstetric team, may represent a successful approach in limiting weight gain in pregnant women.

  11. Proximal Femur Mechanical Adaptation to Weight Gain in Late Adolescence: A Six-Year Longitudinal Study

    PubMed Central

    Petit, Moira A; Beck, Thomas J; Hughes, Julie M; Lin, Hung-Mo; Bentley, Christy; Lloyd, Tom

    2008-01-01

    The effect of weight gain in late adolescence on bone is not clear. Young women who consistently gained weight (n = 23) from 17 to 22 yr of age had increased BMD but a lack of subperiosteal expansion compared with stable weight peers (n = 48). Bone strength increased appropriately for lean mass in both groups but decreased relative to body weight in weight gainers, suggesting increased bone fragility in weight gainers. Introduction Weight gain leading to obesity often starts in adolescence, yet little is known about its effects on bone. We used longitudinal data to examine the effects of weight gain in late adolescence (from 17 to 22 yr of age) on proximal femur BMD, geometry, and estimates of bending strength. Materials and Methods Participants were classified as either weight gainers (WG, n = 23) or stable weight (SW, n = 48) using a random coefficients model. Weight gainers had positive increases in weight (p < 0.05) at each clinic visit from age 17 onward. Proximal femur DXA scans (Hologic QDR 2000) taken annually from 17 to 22 yr of age were analyzed for areal BMD (g/cm2), subperiosteal width (cm), and bone cross-sectional area (CSA) at the proximal femoral shaft. Cortical thickness was measured, and section modulus (Z, cm3) was calculated as a measure of bone bending strength. Total body lean (g) and fat (g) mass were measured from DXA total body scans. Results Over ages 17–22, height remained stable in both groups. Weight remained static in the SW group but increased 14% on average in the WG group (p < 0.05). After controlling for age 17 baseline values, WG had higher BMD (+2.6%), thicker cortices (+3.6%), and greater bone CSA (+2.3%). Increased BMD did not translate to greater increases in bone bending strength (Z). The SW group achieved similar gains in Z by greater subperiosteal expansion. Bone strength index (SI = Z/height) normalized for body weight remained constant in the SW group but decreased significantly in the WG group. In contrast, SI normalized to lean mass did not change over time in either group. Other variables including physical activity, nutrition, and hormone levels (estradiol, testosterone, cortisol) did not differ significantly between groups. Conclusions These data suggest that weight gain in late adolescence may inhibit the periosteal expansion known to normally occur throughout life in long bones, resulting in decreased bone strength relative to body weight. PMID:17937533

  12. Almost All Antipsychotics Result in Weight Gain: A Meta-Analysis

    PubMed Central

    Bak, Maarten; Fransen, Annemarie; Janssen, Jouke; van Os, Jim; Drukker, Marjan

    2014-01-01

    Introduction Antipsychotics (AP) induce weight gain. However, reviews and meta-analyses generally are restricted to second generation antipsychotics (SGA) and do not stratify for duration of AP use. It is hypothesised that patients gain more weight if duration of AP use is longer. Method A meta-analysis was conducted of clinical trials of AP that reported weight change. Outcome measures were body weight change, change in BMI and clinically relevant weight change (7% weight gain or loss). Duration of AP-use was stratified as follows: ≤6 weeks, 6–16 weeks, 16–38 weeks and >38 weeks. Forest plots stratified by AP as well as by duration of use were generated and results were summarised in figures. Results 307 articles met inclusion criteria. The majority were AP switch studies. Almost all AP showed a degree of weight gain after prolonged use, except for amisulpride, aripiprazole and ziprasidone, for which prolonged exposure resulted in negligible weight change. The level of weight gain per AP varied from discrete to severe. Contrary to expectations, switch of AP did not result in weight loss for amisulpride, aripiprazole or ziprasidone. In AP-naive patients, weight gain was much more pronounced for all AP. Conclusion Given prolonged exposure, virtually all AP are associated with weight gain. The rational of switching AP to achieve weight reduction may be overrated. In AP-naive patients, weight gain is more pronounced. PMID:24763306

  13. Almost all antipsychotics result in weight gain: a meta-analysis.

    PubMed

    Bak, Maarten; Fransen, Annemarie; Janssen, Jouke; van Os, Jim; Drukker, Marjan

    2014-01-01

    Antipsychotics (AP) induce weight gain. However, reviews and meta-analyses generally are restricted to second generation antipsychotics (SGA) and do not stratify for duration of AP use. It is hypothesised that patients gain more weight if duration of AP use is longer. A meta-analysis was conducted of clinical trials of AP that reported weight change. Outcome measures were body weight change, change in BMI and clinically relevant weight change (7% weight gain or loss). Duration of AP-use was stratified as follows: ≤6 weeks, 6-16 weeks, 16-38 weeks and >38 weeks. Forest plots stratified by AP as well as by duration of use were generated and results were summarised in figures. 307 articles met inclusion criteria. The majority were AP switch studies. Almost all AP showed a degree of weight gain after prolonged use, except for amisulpride, aripiprazole and ziprasidone, for which prolonged exposure resulted in negligible weight change. The level of weight gain per AP varied from discrete to severe. Contrary to expectations, switch of AP did not result in weight loss for amisulpride, aripiprazole or ziprasidone. In AP-naive patients, weight gain was much more pronounced for all AP. Given prolonged exposure, virtually all AP are associated with weight gain. The rational of switching AP to achieve weight reduction may be overrated. In AP-naive patients, weight gain is more pronounced.

  14. Association of Pre-pregnancy BMI and Postpartum Weight Retention Before Second Pregnancy, Washington State, 2003-2013.

    PubMed

    Ketterl, Tyler G; Dundas, Nicolas J; Roncaioli, Steven A; Littman, Alyson J; Phipps, Amanda I

    2018-03-06

    Background Maternal overweight and obesity is one of the most common high-risk obstetric conditions associated with adverse birth outcomes. Smaller studies have suggested that pre-pregnancy body mass index (BMI) is associated with postpartum weight retention. Objective The primary objective of this study was to examine the association between pre-pregnancy BMI status and maternal weight retention. Study design We conducted a population-based retrospective cohort study using Washington State birth certificate data from 2003-2013. We included women who had two sequential births during this time period, with the second birth occurring within 18-36 months of the first singleton delivery date. BMI before a women's first pregnancy ("pre-pregnancy BMI") was categorized as normal (18.5-24.9 kg/m 2 ) and overweight/obese (25-40 kg/m 2 ). Women were classified as having returned to first pre-pregnancy BMI if their BMI before their second pregnancy was no more than 1 kg/m 2 more compared to their BMI before their first pregnancy. Analyses were stratified by gestational weight gain during the first pregnancy (below, met, exceeded recommended gestational weight gain). Results A total of 49,132 mothers were included in the study. Among women who met their recommended gestational weight gain, compared to mothers with a normal BMI, obese/overweight mothers were less likely to return to their pre-pregnancy BMI (76.5 vs 72.3%; RR Obese/Overweight  = 0.88; 95% CI: 0.85-0.92). A similar pattern was observed among women who exceeded their recommended gestational weight gain (62.6 vs 53.2%; RR Obese/Overweight  = 0.79, 95% CI: 0.78-0.80). Conclusion Pre-pregnancy BMI in the overweight/obese range is associated with a decreased likelihood of returning to pre-pregnancy BMI. Further research to support women during and after their pregnancy to promote behavior changes that prevent excessive weight gain during pregnancy and weight retention after birth is needed.

  15. Nut intake and 5-year changes in body weight and obesity risk in adults: results from the EPIC-PANACEA study.

    PubMed

    Freisling, Heinz; Noh, Hwayoung; Slimani, Nadia; Chajès, Véronique; May, Anne M; Peeters, Petra H; Weiderpass, Elisabete; Cross, Amanda J; Skeie, Guri; Jenab, Mazda; Mancini, Francesca R; Boutron-Ruault, Marie-Christine; Fagherazzi, Guy; Katzke, Verena A; Kühn, Tilman; Steffen, Annika; Boeing, Heiner; Tjønneland, Anne; Kyrø, Cecilie; Hansen, Camilla P; Overvad, Kim; Duell, Eric J; Redondo-Sánchez, Daniel; Amiano, Pilar; Navarro, Carmen; Barricarte, Aurelio; Perez-Cornago, Aurora; Tsilidis, Konstantinos K; Aune, Dagfinn; Ward, Heather; Trichopoulou, Antonia; Naska, Androniki; Orfanos, Philippos; Masala, Giovanna; Agnoli, Claudia; Berrino, Franco; Tumino, Rosario; Sacerdote, Carlotta; Mattiello, Amalia; Bueno-de-Mesquita, H Bas; Ericson, Ulrika; Sonestedt, Emily; Winkvist, Anna; Braaten, Tonje; Romieu, Isabelle; Sabaté, Joan

    2017-07-21

    There is inconsistent evidence regarding the relationship between higher intake of nuts, being an energy-dense food, and weight gain. We investigated the relationship between nut intake and changes in weight over 5 years. This study includes 373,293 men and women, 25-70 years old, recruited between 1992 and 2000 from 10 European countries in the European Prospective Investigation into Cancer and Nutrition (EPIC) study. Habitual intake of nuts including peanuts, together defined as nut intake, was estimated from country-specific validated dietary questionnaires. Body weight was measured at recruitment and self-reported 5 years later. The association between nut intake and body weight change was estimated using multilevel mixed linear regression models with center/country as random effect and nut intake and relevant confounders as fixed effects. The relative risk (RR) of becoming overweight or obese after 5 years was investigated using multivariate Poisson regressions stratified according to baseline body mass index (BMI). On average, study participants gained 2.1 kg (SD 5.0 kg) over 5 years. Compared to non-consumers, subjects in the highest quartile of nut intake had less weight gain over 5 years (-0.07 kg; 95% CI -0.12 to -0.02) (P trend = 0.025) and had 5% lower risk of becoming overweight (RR 0.95; 95% CI 0.92-0.98) or obese (RR 0.95; 95% CI 0.90-0.99) (both P trend <0.008). Higher intake of nuts is associated with reduced weight gain and a lower risk of becoming overweight or obese.

  16. Impact of cannabis treatment on the quality of life, weight and clinical disease activity in inflammatory bowel disease patients: a pilot prospective study.

    PubMed

    Lahat, Adi; Lang, Alon; Ben-Horin, Shomron

    2012-01-01

    Inflammatory bowel disease (IBD) patients suffer from significant morbidity and diminished life quality. The plant cannabis is beneficial in various gastrointestinal diseases, stimulating appetite and causing weight gain. Our aims were to assess whether treatment with inhaled cannabis improves quality of life, disease activity and promotes weight gain in these patients. Patients with long-standing IBD who were prescribed cannabis treatment were included. Two quality of life questionnaires and disease activity indexes were performed, and patient's body weight was measured before cannabis initiation and after 3 months' treatment. Thirteen patients were included. After 3 months' treatment, patients reported improvement in general health perception (p = 0.001), social functioning (p = 0.0002), ability to work (p = 0.0005), physical pain (p = 0.004) and depression (p = 0.007). A schematic scale of health perception showed an improved score from 4.1 ± 1.43 to 7 ± 1.42 (p = 0.0002). Patients had a weight gain of 4.3 ± 2 kg during treatment (range 2-8; p = 0.0002) and an average rise in BMI of 1.4 ± 0.61 (range 0.8-2.7; p = 0.002). The average Harvey-Bradshaw index was reduced from 11.36 ± 3.17 to 5.72 ± 2.68 (p = 0.001). Three months' treatment with inhaled cannabis improves quality of life measurements, disease activity index, and causes weight gain and rise in BMI in long-standing IBD patients. Copyright © 2011 S. Karger AG, Basel.

  17. Calculation of optimal gestation weight gain in pre-pregnancy underweight women due to body mass index change in relation to mother's height.

    PubMed

    Meštrović, Zoran; Roje, Damir; Vulić, Marko; Zec, Mirela

    2017-01-01

    Optimal gestational weight gain has not yet been clearly defined and remains one of the most controversial issues in modern perinatology. The role of optimal weight gain during pregnancy is critical, as it has a strong effect on perinatal outcomes. In this study, gestational body mass index (BMI) change, accounting for maternal height, was investigated as a new criterion for gestational weight gain determination, in the context of fetal growth assessment. We had focused on underweight women only, and aimed to assess whether the Institute of Medicine (IOM) guidelines could be considered acceptable or additional corrections are required in this subgroup of women. The study included 1205 pre-pregnancy underweight mothers and their neonates. Only mothers with singleton term pregnancies (37th-42nd week of gestation) with pre-gestational BMI < 18.5 kg/m 2 were enrolled. The share of small for gestational age (SGA) infants in the study population was 16.2 %. Our results showed the minimal recommended gestational weight gain of 12-14 kg and BMI change of 4-5 kg/m 2 to be associated with a lower prevalence of SGA newborns. Based on our results, the recommended upper limit of gestational mass change could definitely be substantially higher. Optimal weight gain in underweight women could be estimated in the very beginning of pregnancy as recommended BMI change, but recalculated in kilograms according to body height, which modulates the numerical calculation of BMI. Our proposal presents a further step forward towards individualized approach for each pregnant woman.

  18. Is Weight Gain after Smoking Cessation Inevitable?

    ERIC Educational Resources Information Center

    Talcott, Gerald W.; And Others

    1995-01-01

    Studied weight gain after smoking cessation in a naturalistic setting where all smokers quit and risk factors for postcessation weight gain were modified. Results showed no significant weight changes for smokers who quit. Suggests that an intensive program featuring dietary guidelines and increased physical activity can attenuate weight gain. (RJM)

  19. Seasonal variability in weight change during elementary school

    USDA-ARS?s Scientific Manuscript database

    Seasonal variation in weight gain across elementary school (kindergarten-5th grade) was examined among children who were healthy weight, overweight, or obese and from different racial and ethnic groups. The sample included 7,599 ethnically diverse students ages 5-7 years at baseline (Caucasian: 21.1...

  20. Preliminary Sizing and Performance Evaluation of Supersonic Cruise Aircraft

    NASA Technical Reports Server (NTRS)

    Fetterman, D. E., Jr.

    1976-01-01

    The basic processes of a method that performs sizing operations on a baseline aircraft and determines their subsequent effects on aerodynamics, propulsion, weights, and mission performance are described. The input requirements of the associated computer program are defined and its output listings explained. Results obtained by applying the method to an advanced supersonic technology concept are discussed. These results include the effects of wing loading, thrust-to-weight ratio, and technology improvements on range performance, and possible gains in both range and payload capability that become available through growth versions of the baseline aircraft. The results from an in depth contractual study that confirm the range gain predicted for a particular wing loading, thrust-to-weight ratio combination are also included.

  1. Characterizing and understanding body weight patterns in patients treated with pregabalin.

    PubMed

    Cabrera, Javier; Emir, Birol; Dills, Diana; Murphy, T Kevin; Whalen, Ed; Clair, Andrew

    2012-06-01

    We examined patterns of weight change among patients treated with pregabalin for up to 1 year. Patients with ≥1 pre-treatment weight measurement, ≥2 measurements in Period 1 (day 2-56), and ≥2 during Period 2 (day 57-356) were identified from pooled data of 106 studies including 43,525 patients. Seven patterns were developed and used for exploratory 'change point' analyses (day on-treatment when weight-change trend changed from initial trajectory) and to assess patterns of weight change by baseline weight/body mass index (BMI). A total of 3187 patients (from 41 studies) were eligible. 98.9% of patients were described by three of the seven patterns. The majority of patients (2607/3187 [81.8%]) remained within ±7% of baseline weight ('Pattern 4'). Fewer patients (463/3187 [14.5%]) were 'delayed weight gainers' (exceeded 7% weight gain in Period 2 but not Period 1 ['Pattern 6']), fewer still (82/3187 [2.6%]) were 'early weight gainers' (exceeded ≥7% baseline weight in Period 1 and remained above 7% or continued to gain weight in Period 2 ['Pattern 7']). Overall weight gainers (Patterns 6, 7) experienced 1-year weight gain (median [% change]) of +6.20 kg [+9.12%] and 5.46 kg [+13.9%] vs. 2.22 kg [+2.10%] for non-weight gainers (Pattern 4). Average baseline weight/BMI was lower for weight gainers (Patterns 6, 7) versus other patterns. Early weight gainers (Pattern 7) had change point day at day 40 versus day 54 for Pattern 4 and day 69 for Pattern 6. Use of concomitant medications and influence of comorbid conditions on weight should be considered as inherent variables when interpreting the study. The majority of patients treated with pregabalin (150-600 mg/day) for 1 year maintained weight within ±7% baseline weight. One in six patients gained ≥7% weight from baseline, and generally exceeded 7%, 2-12 months after treatment onset.

  2. The effects of various diets on glycemic outcomes during pregnancy: A systematic review and network meta-analysis.

    PubMed

    Ha, Vanessa; Bonner, Ashley J; Jadoo, Jaynendr K; Beyene, Joseph; Anand, Sonia S; de Souza, Russell J

    2017-01-01

    Evidence to support dietary modifications to improve glycemia during pregnancy is limited, and the benefits of diet beyond limiting gestational weight gain is unclear. Therefore, a systematic review and network meta-analysis of randomized trials was conducted to compare the effects of various common diets, stratified by the addition of gestational weight gain advice, on fasting glucose and insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in pregnant women. MEDLINE, EMBASE, Cochrane database, and reference lists of published studies were searched through April 2017. Randomized trials directly comparing two or more diets for ≥2-weeks were eligible. Bayesian network meta-analysis was performed for fasting glucose. Owing to a lack of similar dietary comparisons, a standard pairwise meta-analysis for the other glycemic outcomes was performed. The certainty of the pooled effect estimates was assessed using the GRADE tool. Twenty-one trials (1,865 participants) were included. In general, when given alongside gestational weight gain advice, fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only. However, fasting glucose increased in high unsaturated or monounsaturated fatty acids diets. In the absence of gestational weight gain advice, fasting glucose improved in DASH-style diets compared to standard of care. Although most were non-significant, similar trends were observed for these same diets for the other glycemic outcomes. Dietary comparisons ranged from moderate to very low in quality of evidence. Alongside with gestational weight gain advice, most diets, with the exception of a high unsaturated or a high monounsaturated fatty acid diet, demonstrated a fasting glucose improvement compared with gestational weight gain advice only. When gestational weight gain advice was not given, the DASH-style diet appeared optimal on fasting glucose. However, a small number of trials were identified and most dietary comparisons were underpowered to detect differences in glycemic outcomes. Further studies that are high in quality and adequately powered are needed to confirm these findings. PROSPERO CRD42015026008.

  3. The effects of various diets on glycemic outcomes during pregnancy: A systematic review and network meta-analysis

    PubMed Central

    Ha, Vanessa; Bonner, Ashley J.; Jadoo, Jaynendr K.; Beyene, Joseph; Anand, Sonia S.

    2017-01-01

    Aims Evidence to support dietary modifications to improve glycemia during pregnancy is limited, and the benefits of diet beyond limiting gestational weight gain is unclear. Therefore, a systematic review and network meta-analysis of randomized trials was conducted to compare the effects of various common diets, stratified by the addition of gestational weight gain advice, on fasting glucose and insulin, hemoglobin A1c (HbA1c), and homeostatic model assessment for insulin resistance (HOMA-IR) in pregnant women. Methods MEDLINE, EMBASE, Cochrane database, and reference lists of published studies were searched through April 2017. Randomized trials directly comparing two or more diets for ≥2-weeks were eligible. Bayesian network meta-analysis was performed for fasting glucose. Owing to a lack of similar dietary comparisons, a standard pairwise meta-analysis for the other glycemic outcomes was performed. The certainty of the pooled effect estimates was assessed using the GRADE tool. Results Twenty-one trials (1,865 participants) were included. In general, when given alongside gestational weight gain advice, fasting glucose improved in most diets compared to diets that gave gestational weight gain advice only. However, fasting glucose increased in high unsaturated or monounsaturated fatty acids diets. In the absence of gestational weight gain advice, fasting glucose improved in DASH-style diets compared to standard of care. Although most were non-significant, similar trends were observed for these same diets for the other glycemic outcomes. Dietary comparisons ranged from moderate to very low in quality of evidence. Conclusion/Interpretation Alongside with gestational weight gain advice, most diets, with the exception of a high unsaturated or a high monounsaturated fatty acid diet, demonstrated a fasting glucose improvement compared with gestational weight gain advice only. When gestational weight gain advice was not given, the DASH-style diet appeared optimal on fasting glucose. However, a small number of trials were identified and most dietary comparisons were underpowered to detect differences in glycemic outcomes. Further studies that are high in quality and adequately powered are needed to confirm these findings. Registration PROSPERO CRD42015026008 PMID:28771519

  4. Perceptions of low-income African-American mothers about excessive gestational weight gain

    PubMed Central

    Herring, Sharon J.; Henry, Tasmia Q.; Klotz, Alicia; Foster, Gary D.; Whitaker, Robert C.

    2013-01-01

    Objective A rising number of low-income African-American mothers gain more weight in pregnancy than is recommended, placing them at risk for poor maternal and fetal health outcomes. Little is known about the perceptions of mothers in this population that may influence excessive gestational weight gain. Methods In 2010–2011, we conducted 4 focus groups with 31 low-income, pregnant African-Americans in Philadelphia. Two readers independently coded the focus group transcripts to identify recurrent themes. Results We identified 9 themes around perceptions that encouraged or discouraged high gestational weight gain. Mothers attributed high weight gain to eating more in pregnancy, which was the result of being hungrier and the belief that consuming more calories while pregnant was essential for babies’ health. Family members, especially participants own mothers, strongly reinforced the need to “eat for two” to make a healthy baby. Mothers and their families recognized the link between poor fetal outcomes and low weight gains but not higher gains, and thus, most had a greater pre-occupation with too little food intake and weight gain rather than too much. Having physical symptoms from overeating and weight retention after previous pregnancies were factors that discouraged higher gains. Conclusions Low-income African American mothers had more perceptions encouraging high gestational weight gain than discouraging it. Interventions to prevent excessive weight gain need to be sensitive to these perceptions. Messages that link guideline recommended weight gain to optimal infant outcomes and mothers’ physical symptoms may be most effective for weight control. PMID:22160656

  5. Sociocultural influences on strategies to lose weight, gain weight, and increase muscles among ten cultural groups.

    PubMed

    McCabe, Marita P; Busija, Lucy; Fuller-Tyszkiewicz, Matthew; Ricciardelli, Lina; Mellor, David; Mussap, Alexander

    2015-01-01

    This study determined how sociocultural messages to change one's body are perceived by adolescents from different cultural groups. In total, 4904 adolescents, including Australian, Chilean, Chinese, Indo-Fijian, Indigenous Fijian, Greek, Malaysian, Chinese Malaysian, Tongans in New Zealand, and Tongans in Tonga, were surveyed about messages from family, peers, and the media to lose weight, gain weight, and increase muscles. Groups were best differentiated by family pressure to gain weight. Girls were more likely to receive the messages from multiple sociocultural sources whereas boys were more likely to receive the messages from the family. Some participants in a cultural group indicated higher, and others lower, levels of these sociocultural messages. These findings highlight the differences in sociocultural messages across cultural groups, but also that adolescents receive contrasting messages within a cultural group. These results demonstrate the difficulty in representing a particular message as being characteristic of each cultural group. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Influence of weekend lifestyle patterns on body weight.

    PubMed

    Racette, Susan B; Weiss, Edward P; Schechtman, Kenneth B; Steger-May, Karen; Villareal, Dennis T; Obert, Kathleen A; Holloszy, John O

    2008-08-01

    To determine whether alterations in diet and/or activity patterns during weekends contribute to weight gain or hinder weight loss. Randomized, controlled trial comparing 1 year of caloric restriction (CR) with 1 year of daily exercise (EX). Subjects included 48 healthy adults (30F, 18M) aged 50-60 years with BMI 23.5-29.9 kg/m(2). Body weight was measured on 7 consecutive mornings for a total of 165 weeks at baseline and 437 weeks during the 1-year interventions. Daily weight changes were calculated for weekends (Friday to Monday) and weekdays (Monday to Friday). Daily energy intake was estimated using food diaries; daily physical activity was measured using accelerometers. Both measures were validated against doubly labeled water (DLW). At baseline, participants consistently gained weight on weekend days (+0.06 +/- 0.03 kg/day, (mean +/- s.e.), P = 0.02), but not on weekdays (-0.02 +/- 0.02 kg/day, P = 0.18). This was attributable to higher dietary intake on Saturdays and lower physical activity on Sundays relative to weekdays (both P < 0.05). During the interventions, both CR and EX participants were in negative energy balance on weekdays (P < 0.005). On weekends, however, CR participants stopped losing weight, and EX participants gained weight (+0.08 +/- 0.03 kg/day, P < 0.0001) due to higher dietary intakes on weekends. This helps to explain the slower-than-expected rate of weight loss during the interventions. Alterations in lifestyle behaviors on weekends contribute to weight gain or cessation of weight loss on weekends. These results provide one explanation for the relatively slow rates of weight loss observed in many studies, and the difficulty with maintaining significant weight loss.

  7. Antipsychotic-Induced Changes in Blood Levels of Leptin in Schizophrenia: A Meta-Analysis

    PubMed Central

    Potvin, Stéphane; Zhornitsky, Simon; Stip, Emmanuel

    2015-01-01

    Objectives: Weight gain is a major side effect of antipsychotics (APs), which contributes to poor treatment adherence and significant morbidity. The mechanisms involved in AP-induced weight gain are incompletely understood. Recently, it has been proposed that changes in leptin, an cadipocyte-derived hormone exerting anorexigenic effects, may be involved in AP-induced weight gain. Thus far, studies on leptin changes during AP treatment have produced inconsistent results, prompting our group to perform a meta-analysis. Method: A search of the literature was performed using PubMed and Embase. Studies were included only if reporting peripheral levels of leptin before and after AP treatment in schizophrenia. Effect size estimates were calculated with Hedges g and were aggregated using a random effects model as results were heterogeneous (P < 0.10). Meta-regression analyses were performed using study length and changes in body mass index (BMI) as moderator variables. Results: Twenty-eight studies were retrieved, including 39 comparisons. A moderate and positive effect size was observed across studies. Olanzapine, clozapine, and quetiapine produced moderate leptin elevations, whereas haloperidol and risperidone were associated with small (nonsignificant) leptin changes. Across studies, BMI changes were significantly associated with increases in leptin levels. There was no effect of sex on AP-induced changes in leptin. Conclusions: A physiological role of leptin in AP-induced weight gain is supported because the most significant leptin increases were observed with APs inducing the most weight gain and because of the observed association between leptin increases and BMI changes. The overall increase in leptin levels suggests that leptin acts as a negative feedback signal in the event of fat increase. PMID:25886677

  8. Nonalcoholic Fatty Liver Disease and Fibrosis in Youth Taking Psychotropic Medications: Literature Review, Case Reports, and Management.

    PubMed

    Gracious, Barbara L; Bhatt, Ramona; Potter, Carol

    2015-10-01

    Nonalcoholic fatty liver disease (NAFLD) has become a worldwide epidemic because of the greater prevalence of obesity. Despite implications for youth with severe mental disorders, little has been published in the psychiatric literature about this increasingly common medical comorbidity. The goals of this article are to: 1) provide an overview of the epidemiology and pathophysiology of NAFLD, including progression to nonalcoholic steatohepatitis (NASH); 2) describe two clinical cases illustrating difficulties faced in management; and 3) review screening recommendations, differential diagnosis, and monitoring and intervention approaches. A literature review was conducted, including guidelines and recommendations, with case presentations including case and control liver histology biopsy photographs. NAFLD in childhood and adolescence, as a precursor to NASH, progresses to fibrosis in a small percentage of youth, leading to risk for early onset cirrhosis and the need for transplantation. The cases presented raise concern that youth with severe mental health disorders, already at greater risk for obesity and its sequelae, may be at higher risk for progression to NASH, potentially because of greater rates of weight gain on top of overweight or obese status, and to liver metabolism changes from psychotropic medications favoring fat deposition. Patients with rapid weight gain into the overweight or obese categories, or who develop elevated liver transaminases that persist across 3-6 months, should be screened or referred for screening by their psychotropic-providing clinicians for early detection, diagnosis, and co-management by a pediatric gastroenterologist, to decrease risk of progression to NASH, which is reversible if early and sufficient lifestyle change results in significant weight loss. There is urgent need for controlled research on the relationships among weight gain, psychotropic medications, ultrasound and biopsy findings, and rates of progression to NAFLD and NASH in youth taking weight-gain-inducing psychotropic medications.

  9. Interventions to reduce weight gain in schizophrenia

    PubMed Central

    Faulkner, Guy; Cohn, Tony; Remington, Gary

    2014-01-01

    Background Weight gain is common for people with schizophrenia and this has serious implications for health and well being. Objectives To determine the effects of both pharmacological (excluding medication switching) and non pharmacological strategies for reducing or preventing weight gain in people with schizophrenia. Search methods We searched key databases and the Cochrane Schizophrenia Group’s trials register (April 2006), reference sections within relevant papers, hand searched key journals, and contacted the first author of each relevant study and other experts to collect further information. Selection criteria We included all clinical randomised controlled trials comparing any pharmacological or non pharmacological intervention for weight gain (diet and exercise counselling) with standard care or other treatments for people with schizophrenia or schizophrenia-like illnesses. Data collection and analysis We reliably selected, quality assessed and extracted data from studies. As weight is a continuous outcome measurement, weighted mean differences (WMD) of the change from baseline were calculated. The primary outcome measure was weight loss. Main results Twenty-three randomised controlled trials met the inclusion criteria for this review. Five trials assessed a cognitive/behavioural intervention and eighteen assessed a pharmacological adjunct. In terms of prevention, two cognitive/behavioural trials showed significant treatment effect (mean weight change) at end of treatment (n=104, 2 RCTs, WMD −3.38 kg CI −4.2 to −2.0). Pharmacological adjunct treatments were significant with a modest prevention of weight gain (n=274, 6 RCTs, WMD − 1.16 kg CI −1.9 to −0.4). In terms of treatments for weight loss, we found significantly greater weight reduction in the cognitive behavioural intervention group (n=129, 3 RCTs, WMD −1.69 kg CI −2.8 to −0.6) compared with standard care. Authors’ conclusions Modest weight loss can be achieved with selective pharmacological and non pharmacological interventions. However, interpretation is limited by the small number of studies, small sample size, short study duration and by variability of the interventions themselves, their intensity and duration. Future studies adequately powered, with longer treatment duration and rigorous methodology will be needed in further evaluating the efficacy and safety of weight loss interventions for moderating weight gain. At this stage, there is insufficient evidence to support the general use of pharmacological interventions for weight management in people with schizophrenia. PMID:17253540

  10. Weight gain and smoking: perceptions and experiences of obese quitline participants.

    PubMed

    Bush, Terry; Hsu, Clarissa; Levine, Michele D; Magnusson, Brooke; Miles, Lyndsay

    2014-11-27

    Weight gain that commonly accompanies smoking cessation can undermine a person's attempt to quit and increase the risk for metabolic disorders. Research indicates that obese smokers have more weight concerns and gain more weight after quitting than non-obese smokers, yet little is known about possible reasons for these outcomes. We sought to gain an understanding of obese smokers' experiences of quitting and their attitudes and beliefs about the association between smoking and weight gain. In-depth semi-structured interviews were conducted with obese smokers who called a state tobacco quitline. Interviewers elicited discussion of obese smokers' thoughts about smoking, the effects of quitting on change in weight, challenges they faced with quitting, and how quitlines might better serve their needs. Participants (n = 29) discussed their fear of gaining weight after quitting, their beliefs about smoking and their weight and significant experiences related to quitting. Participants' awareness of weight gain associated with quitting was based on prior experience or observation of others who quit. Most viewed cessation as their primary goal and discussed other challenges as being more important than their weight, such as managing stress or coping with a chronic health condition. Although weight gain was viewed as less important than quitting, many talked about changes they had made to mitigate the anticipated weight gain. Weight gain is a concern for obese smokers interested in quitting. Understanding the relative importance of body weight and other challenges related to smoking cessation can help tailor interventions for the specific group of smokers who are obese and interested in smoking cessation.

  11. Acculturation and gestational weight gain in a predominantly Puerto Rican population.

    PubMed

    Tovar, Alison; Chasan-Taber, Lisa; Bermudez, Odilia I; Hyatt, Raymond R; Must, Aviva

    2012-11-21

    Identifying risk factors that affect excess weight gain during pregnancy is critical, especially among women who are at a higher risk for obesity. The goal of this study was to determine if acculturation, a possible risk factor, was associated with gestational weight gain in a predominantly Puerto Rican population. We utilized data from Proyecto Buena Salud, a prospective cohort study of Hispanic women in Western Massachusetts, United States. Height, weight and gestational age were abstracted from medical records among participants with full-term pregnancies (n=952). Gestational weight gain was calculated as the difference between delivery and prepregnancy weight. Acculturation (measured via a psychological acculturation scale, generation in the US, place of birth and spoken language preference) was assessed in early pregnancy. Adjusting for age, parity, perceived stress, gestational age, and prepregnancy weight, women who had at least one parent born in Puerto Rico/Dominican Republic (PR/DR) and both grandparents born in PR/DR had a significantly higher mean total gestational weight gain (0.9 kg for at least one parent born in PR/DR and 2.2 kg for grandparents born in PR/DR) and rate of weight gain (0.03 kg/wk for at least one parent born in PR/DR and 0.06 kg/wk for grandparents born in PR/DR) vs. women who were of PR/DR born. Similarly, women born in the US had significantly higher mean total gestational weight gain (1.0 kg) and rate of weight gain (0.03 kg/wk) vs. women who were PR/ DR born. Spoken language preference and psychological acculturation were not significantly associated with total or rate of pregnancy weight gain. We found that psychological acculturation was not associated with gestational weight gain while place of birth and higher generation in the US were significantly associated with higher gestational weight gain. We interpret these findings to suggest the potential importance of the US "obesogenic" environment in influencing unhealthy pregnancy weight gains over specific aspects of psychological acculturation.

  12. Fetal growth in relation to gestational weight gain in women with type 2 diabetes: an observational study.

    PubMed

    Parellada, C B; Asbjörnsdóttir, B; Ringholm, L; Damm, P; Mathiesen, E R

    2014-12-01

    To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI < 25, 25-29.9, ≥ 30 kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations). Excessive and non-excessive gestational weight gain were seen in 61 (43%) and 81 women (57%) with a median (range) gestational weight gain of 14.3 (9-32) vs. 7.0 (-5-16) kg (P < 0.001), respectively. Infants of women with excessive gestational weight gain were characterized by higher birth weight (3712 vs. 3258 g; P = 0.001), birth weight z-score (1.14 vs. -0.01, P = 0.001) and prevalence of large-for-gestational-age infants (48 vs. 20%; P < 0.001). In normal weight, overweight and obese women with non-excessive gestational weight gain, the median weight gain in the first half of pregnancy was 371, 114 and 81 g/week, and in the second half of pregnancy 483, 427 and 439 g/week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z-score independent of pre-pregnancy BMI, smoking, HbA1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06-0.14), P < 0.001]. Infant birth weight was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain. © 2014 The Authors. Diabetic Medicine published by John Wiley & Sons Ltd on behalf of Diabetes UK.

  13. Fetal growth in relation to gestational weight gain in women with Type 2 diabetes: an observational study

    PubMed Central

    Parellada, C B; Ásbjörnsdóttir, B; Ringholm, L; Damm, P; Mathiesen, E R

    2014-01-01

    Aims To evaluate fetal growth in relation to gestational weight gain in women with Type 2 diabetes. Methods A retrospective cohort study of 142 consecutive pregnancies in 28 women of normal weight, 39 overweight women and 75 obese women with Type 2 diabetes (pre-pregnancy BMI  < 25, 25–29.9,  ≥ 30 kg/m2, respectively). Gestational weight gain was categorized as excessive (exceeding the US Institute of Medicine recommendations) or as non-excessive (within or below the Institute of Medicine recommendations). Results Excessive and non-excessive gestational weight gain were seen in 61 (43%) and 81 women (57%) with a median (range) gestational weight gain of 14.3 (9–32) vs 7.0 (−5–16) kg (P < 0.001), respectively. Infants of women with excessive gestational weight gain were characterized by higher birth weight (3712 vs 3258 g; P = 0.001), birth weight z-score (1.14 vs -0.01, P = 0.001) and prevalence of large-for-gestational-age infants (48 vs 20%; P < 0.001). In normal weight, overweight and obese women with non-excessive gestational weight gain, the median weight gain in the first half of pregnancy was 371, 114 and 81 g/week, and in the second half of pregnancy 483, 427 and 439 g/week, respectively. In multiple linear regression analysis, gestational weight gain was associated with a higher infant birth weight z-score independent of pre-pregnancy BMI, smoking, HbA1c and insulin dose at last visit, ethnicity and parity [β=0.1 (95% CI 0.06–0.14), P < 0.001]. Conclusions Infant birth weight was almost 0.5 kg higher in women with Type 2 diabetes and excessive gestational weight gain than in women with Type 2 diabetes and non-excessive weight gain. PMID:25081349

  14. Treatment of Pediatric Graves' Disease Is Associated with Excessive Weight Gain

    PubMed Central

    van Veenendaal, Nicole R.

    2011-01-01

    Context: Little information is available about changes in body weight and body mass index in children before, during, and after treatment for Graves' disease (GD). Objective: Our objective was to examine changes in body weight after treatment for GD in children as related to clinical features. Design: The medical records of 43 pediatric patients with GD [35 girls and eight boys, aged 4.0–18.5 (mean 10.9) yr] were examined. Patients were included if clinical data were available for 1 yr before and after the diagnosis of GD. Main Outcome Measures: Weight, height, body mass index (BMI) z-scores, and thyroid hormone levels were assessed. Results: Overall, patients presented with an average BMI z-score of −0.02 ± 1.05 that was not different from the normal population (P = 0.921) or their premorbid values (P = 0.07). However, in the subset of patients who were initially overweight or obese in the premorbid state, the BMI decreased significantly during the development of hyperthyroidism (P < 0.05). After initiation of treatment, patients gained significant amounts of weight over the first 6 months leading to elevated BMI z-scores (P < 0.0001), and elevations in BMI persisted in about 25% of the patients. Conclusion: Excessive weight gain within 6 months of treatment is seen in children treated for GD, and the gain in weight can persist. PMID:21849528

  15. Longitudinal Associations Among Posttraumatic Stress Disorder, Disordered Eating, and Weight Gain in Military Men and Women

    PubMed Central

    Mitchell, K. S.; Porter, B.; Boyko, E. J.; Field, A. E.

    2016-01-01

    Abstract Obesity is a major health problem in the United States and a growing concern among members of the military. Posttraumatic stress disorder (PTSD) has been associated with overweight and obesity and may increase the risk of those conditions among military service members. Disordered eating behaviors have also been associated with PTSD and weight gain. However, eating disorders remain understudied in military samples. We investigated longitudinal associations among PTSD, disordered eating, and weight gain in the Millennium Cohort Study, which includes a nationally representative sample of male (n = 27,741) and female (n = 6,196) service members. PTSD at baseline (time 1; 2001–2003) was associated with disordered eating behaviors at time 2 (2004–2006), as well as weight change from time 2 to time 3 (2007–2008). Structural equation modeling results revealed that the association between PTSD and weight change from time 2 to time 3 was mediated by disordered eating symptoms. The association between PTSD and weight gain resulting from compensatory behaviors (vomiting, laxative use, fasting, overexercise) was significant for white participants only and for men but not women. PTSD was both directly and indirectly (through disordered eating) associated with weight change. These results highlight potentially important demographic differences in these associations and emphasize the need for further investigation of eating disorders in military service members. PMID:27283146

  16. Intake of Sweets, Snacks and Soft Drinks Predicts Weight Gain in Obese Pregnant Women: Detailed Analysis of the Results of a Randomised Controlled Trial

    PubMed Central

    Renault, Kristina M.; Carlsen, Emma M.; Nørgaard, Kirsten; Nilas, Lisbeth; Pryds, Ole; Secher, Niels J.; Olsen, Sjurdur F.; Halldorsson, Thorhallur I.

    2015-01-01

    Background Lifestyle interventions targeting obese pregnant women often result in modest reduction in gestational weight gain, pregnancy complications and related risk factors. Examining adherence to the intervention can, however, provide valuable information on the importance of the different factors targeted. Objective To evaluate improvements and relevance of different dietary factors targeted with respect to gestational weight gain in a 3-arm Randomised Controlled Trial (n=342) among obese pregnant women with BMI≥30 kg/m2. Methods Randomisation 1:1:1 to either hypocaloric Mediterranean type of diet and physical activity intervention (D+PA); physical activity intervention alone (PA); or control (C). Diet was assessed at baseline (weeks 11–14) and endpoint (weeks 36–37) using a validated food frequency questionnaire. Results During the intervention women in the D+PA group significantly lowered their intakes of added sugars and saturated fat and increased their protein intake by ~1% of total energy compared to controls. Of these dietary variables only intakes of added sugar appeared to be related to GWG, while no association was observed for saturated fat or protein. Further analyses revealed that foods that contributed to intake of added sugars, including sweets, snacks, cakes, and soft drinks were strongly associated with weight gain, with women consuming sweets ≥2/day having 5.4 kg (95% CI 2.1-8.7) greater weight gain than those with a low (<1wk) intake. The results for soft drinks were more conflicting, as women with high weight gain tended to favour artificially sweetened soft drinks. Conclusion In our sample of obese pregnant women, craving for sweets, snacks, and soft drinks strongly predicts GWG. Emphasis on reducing intakes of these foods may be more relevant for limiting gestational weight gain than encouraging strict compliance to more specific diets. Trial Registration ClinicalTrials.gov NCT01345149 PMID:26192183

  17. Intake of Sweets, Snacks and Soft Drinks Predicts Weight Gain in Obese Pregnant Women: Detailed Analysis of the Results of a Randomised Controlled Trial.

    PubMed

    Renault, Kristina M; Carlsen, Emma M; Nørgaard, Kirsten; Nilas, Lisbeth; Pryds, Ole; Secher, Niels J; Olsen, Sjurdur F; Halldorsson, Thorhallur I

    2015-01-01

    Lifestyle interventions targeting obese pregnant women often result in modest reduction in gestational weight gain, pregnancy complications and related risk factors. Examining adherence to the intervention can, however, provide valuable information on the importance of the different factors targeted. To evaluate improvements and relevance of different dietary factors targeted with respect to gestational weight gain in a 3-arm Randomised Controlled Trial (n=342) among obese pregnant women with BMI≥30 kg/m2. Randomisation 1:1:1 to either hypocaloric Mediterranean type of diet and physical activity intervention (D+PA); physical activity intervention alone (PA); or control (C). Diet was assessed at baseline (weeks 11-14) and endpoint (weeks 36-37) using a validated food frequency questionnaire. During the intervention women in the D+PA group significantly lowered their intakes of added sugars and saturated fat and increased their protein intake by ~1% of total energy compared to controls. Of these dietary variables only intakes of added sugar appeared to be related to GWG, while no association was observed for saturated fat or protein. Further analyses revealed that foods that contributed to intake of added sugars, including sweets, snacks, cakes, and soft drinks were strongly associated with weight gain, with women consuming sweets ≥2/day having 5.4 kg (95% CI 2.1-8.7) greater weight gain than those with a low (<1wk) intake. The results for soft drinks were more conflicting, as women with high weight gain tended to favour artificially sweetened soft drinks. In our sample of obese pregnant women, craving for sweets, snacks, and soft drinks strongly predicts GWG. Emphasis on reducing intakes of these foods may be more relevant for limiting gestational weight gain than encouraging strict compliance to more specific diets. ClinicalTrials.gov NCT01345149.

  18. Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study

    PubMed Central

    2014-01-01

    Background Excessive gestational weight gain (GWG) is associated with pregnancy complications, and Norwegian Health Authorities have adopted the GWG recommendations of the US Institute of Medicine and National Research Council (IOM). The aim of this study was to evaluate if a GWG outside the IOM recommendation in a Norwegian population is associated with increased risk of pregnancy complications like hypertension, low and high birth weight, preeclampsia, emergency caesarean delivery, and maternal post-partum weight retention (PPWR) at 6 and 18 months. Methods This study was performed in 56 101 pregnant women included in the prospective national Norwegian Mother and Child Cohort Study (MoBa) in the years 1999 to 2008. Women who delivered a singleton live born child during gestational week 37 to 42 were included. Maternal prepregnant and postpartum weight was collected from questionnaires at 17th week of gestation and 6 and 18 months postpartum. Results A weight gain less than the IOM recommendations (GWG < IOM rec.) increased the risk for giving birth to a low weight baby among normal weight nulliparous women. A weight gain higher than the IOM recommendations (GWG > IOM rec.) significantly increased the risk of pregnancy hypertension, a high birth weight baby, preeclampsia and emergency cesarean delivery in both nulliparous and parous normal weight women. Similar results were found for overweight women except for no increased risk for gestational hypertension in parous women with GWG > IOM rec. Seventy-four percent of the overweight nulliparous women and 66% of the obese women had a GWG > IOM rec. A GWG > IOM rec. resulted in increased risk of PPWR > 2 kg in all weight classes, but most women attained their prepregnant weight class by 18 months post-partum. Conclusions For prepregnant normal weight and overweight women a GWG > IOM rec. increased the risk for unfavorable birth outcomes in both nulliparous and parous women. A GWG > IOM rec. increased the risk of a PPWR > 2 kg at 18 months in all weight classes. This large study supports the Norwegian Health authorities’ recommendations for normal weight and overweight women to comply with the IOM rec. PMID:24917037

  19. Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study.

    PubMed

    Haugen, Margaretha; Brantsæter, Anne Lise; Winkvist, Anna; Lissner, Lauren; Alexander, Jan; Oftedal, Bente; Magnus, Per; Meltzer, Helle Margrete

    2014-06-11

    Excessive gestational weight gain (GWG) is associated with pregnancy complications, and Norwegian Health Authorities have adopted the GWG recommendations of the US Institute of Medicine and National Research Council (IOM). The aim of this study was to evaluate if a GWG outside the IOM recommendation in a Norwegian population is associated with increased risk of pregnancy complications like hypertension, low and high birth weight, preeclampsia, emergency caesarean delivery, and maternal post-partum weight retention (PPWR) at 6 and 18 months. This study was performed in 56 101 pregnant women included in the prospective national Norwegian Mother and Child Cohort Study (MoBa) in the years 1999 to 2008. Women who delivered a singleton live born child during gestational week 37 to 42 were included. Maternal prepregnant and postpartum weight was collected from questionnaires at 17th week of gestation and 6 and 18 months postpartum. A weight gain less than the IOM recommendations (GWG < IOM rec.) increased the risk for giving birth to a low weight baby among normal weight nulliparous women. A weight gain higher than the IOM recommendations (GWG > IOM rec.) significantly increased the risk of pregnancy hypertension, a high birth weight baby, preeclampsia and emergency cesarean delivery in both nulliparous and parous normal weight women. Similar results were found for overweight women except for no increased risk for gestational hypertension in parous women with GWG > IOM rec. Seventy-four percent of the overweight nulliparous women and 66% of the obese women had a GWG > IOM rec. A GWG > IOM rec. resulted in increased risk of PPWR > 2 kg in all weight classes, but most women attained their prepregnant weight class by 18 months post-partum. For prepregnant normal weight and overweight women a GWG > IOM rec. increased the risk for unfavorable birth outcomes in both nulliparous and parous women. A GWG > IOM rec. increased the risk of a PPWR > 2 kg at 18 months in all weight classes. This large study supports the Norwegian Health authorities' recommendations for normal weight and overweight women to comply with the IOM rec.

  20. Patient and Provider Perceptions of Weight Gain, Physical Activity, and Nutrition Counseling during Pregnancy: A Qualitative Study.

    PubMed

    Whitaker, Kara M; Wilcox, Sara; Liu, Jihong; Blair, Steven N; Pate, Russell R

    2016-01-01

    This study investigated patient and provider perceptions of weight gain, physical activity, and nutrition counseling during prenatal care visits. Individual qualitative interviews were conducted with 30 pregnant women between 20 and 30 weeks gestation (15 African American, 15 White) and 11 prenatal care providers (5 attending physicians, 5 residents, 1 nurse practitioner) in 2014. The majority of patients and providers reported receiving or giving advice on weight gain (87% and 100%, respectively), physical activity (87% and 91%), and nutrition (100% and 91%) during a prenatal visit. Discussion of counseling content was largely consistent between patients and providers. However, counseling was limited and not fully consistent with current weight gain, physical activity, or dietary guidelines during pregnancy. Most patients viewed provider advice positively, but some wanted more detailed information. Providers discussed many barriers to lifestyle counseling, including lack of time, inadequate training, concern about the sensitivity of the topic, lower education or income level of the patient, cultural differences, and lack of patient interest. Providers discussed weight gain, physical activity, and nutrition during prenatal care visits and patients accurately recalled this advice. However, counseling was limited and not fully consistent with guidelines. Future studies are needed to develop and evaluate the efficacy of interventions to help providers overcome perceived barriers and more effectively counsel women on weight and healthy lifestyles during pregnancy. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  1. Hormonal and metabolic effects of olanzapine and clozapine related to body weight in rodents.

    PubMed

    Albaugh, Vance L; Henry, Cathy R; Bello, Nicholas T; Hajnal, Andras; Lynch, Susan L; Halle, Beth; Lynch, Christopher J

    2006-01-01

    To characterize a model of atypical antipsychotic drug-induced obesity and evaluate its mechanism. Chronically, olanzapine or clozapine was self-administered via cookie dough to rodents (Sprague-Dawley or Wistar rats; C57Bl/6J or A/J mice). Chronic studies measured food intake, body weight, adiponectin, active ghrelin, leptin, insulin, tissue wet weights, glucose, clinical chemistry endpoints, and brain dopaminergic D2 receptor density. Acute studies examined food intake, ghrelin, leptin, and glucose tolerance. Olanzapine (1 to 8 mg/kg), but not clozapine, increased body weight in female rats only. Weight changes were detectable within 2 to 3 days and were associated with hyperphagia starting approximately 24 hours after the first dose. Chronic administration (12 to 29 days) led to adiposity, hyperleptinemia, and mild insulin resistance; no lipid abnormalities or changes in D2 receptor density were observed. Topiramate, which has reversed weight gain from atypical antipsychotics in humans, attenuated weight gain in rats. Acutely, olanzapine, but not clozapine, lowered plasma glucose and leptin. Increases in glucose, insulin, and leptin following a glucose challenge were also blunted. A model of olanzapine-induced obesity was characterized which shares characteristics of patients with atypical antipsychotic drug-induced obesity; these characteristics include hyperphagia, hyperleptinemia, insulin resistance, and weight gain attenuation by topiramate. This model may be a useful and inexpensive model of uncomplicated obesity amenable to rapid screening of weight loss drugs. Olanzapine-induced weight gain may be secondary to hyperphagia associated with acute lowering of plasma glucose and leptin, as well as the inability to increase plasma glucose and leptin following a glucose challenge.

  2. Pragmatic cluster randomised trial of a free telephone-based health coaching program to support women in managing weight gain during pregnancy: the Get Healthy in Pregnancy Trial.

    PubMed

    Clements, Vanessa; Leung, Kit; Khanal, Santosh; Raymond, Jane; Maxwell, Michelle; Rissel, Chris

    2016-08-30

    Excessive gestational weight gain can result in poor maternal and child health outcomes. Estimates from single studies indicate the prevalence of excessive gestational weight gain in Australia could lie between 38 and 67 %. The risk of excessive weight gain can be reduced through healthy eating and exercise. We describe the rationale and methods of the Get Healthy in Pregnancy Service, a trial service which aims to support women in achieving appropriate gestational weight gain through an existing telephone-based health coaching service. This study aims to compare the effectiveness of a telephone-based health coaching program versus provision of information only in supporting pregnant women to achieve appropriate gestational weight gain. A pragmatic stratified clustered randomised controlled trial will be conducted with 710 women who present to 5 hospitals for their first antenatal appointment during the recruitment period (6-8 months), have a pre-pregnancy body mass index (BMI) ≥ 18.50 (healthy weight or above), are 18 years and over, singleton gestation, English speaking, have no pre-existing medical conditions that may limit their ability to exercise or require a restricted diet and are 18 weeks or less gestation. Hospitals will be randomised into one of two intervention models: a) information only; or b) information plus 10 telephone-based health coaching sessions with a university qualified coach. Both interventions will set a weight-range target with pregnant women. The women attending antenatal clinics at participating hospitals will be screened at their initial hospital appointment to assess their eligibility. Women recruited to the trial will have a number of measures recorded including anthropometrics (self-reported height and weight) and dietary and physical activity scores during and following pregnancy. These measurements will be collected at baseline (prior to 18 weeks gestation), 36 weeks gestation and 12 months post-birth. This study responds to a need for an effective intervention that targets excessive gestational weight gain at a population level. This study investigates the potential for an innovative intervention combining two existing services; a free state-wide telephone-based health coaching service and hospital-based antenatal care to support pregnant women to achieve healthy weight gain during pregnancy. The use of existing services provides the potential for immediate post-study implementation. While the impacts of telephone-based lifestyle programmes have been tested in a number of settings, there are few studies which evaluate the effectiveness and acceptability of telephone support in achieving healthy gestational weight gain in association with routine antenatal care. ACTRN12615000397516 (Registration date: 26 June 2014, retrospectively registered).

  3. Effect of an intensive nutrition intervention of a high protein and low glycemic-index diet on weight of kidney transplant recipients: study protocol for a randomized clinical trial.

    PubMed

    Pedrollo, Elis Forcellini; Nicoletto, Bruna Bellincanta; Carpes, Larissa Salomoni; de Freitas, Júlia de Melo Cardoso; Buboltz, Julia Roberta; Forte, Cristina Carra; Bauer, Andrea Carla; Manfro, Roberto Ceratti; Souza, Gabriela Corrêa; Leitão, Cristiane Bauermann

    2017-09-06

    Excessive weight gain is commonly observed within the first year after kidney transplantation and is associated with negative outcomes, such as graft loss and cardiovascular events. The purpose of this study is to evaluate the effect of a high protein and low glycemic-index diet on preventing weight gain after kidney transplantation. We designed a prospective, single-center, open-label, randomized controlled study to compare the efficacy of a high protein (1.3-1.4 g/kg/day) and low-glycemic index diet versus a conventional diet (0.8-1.0 g/kg/day of protein) on preventing weight gain after kidney transplantation. A total of 120 eligible patients 2 months after transplantation will be recruited. Patients with an estimated glomerular filtration rate through the modification of diet of renal disease (MDRD) formula < 30 mL/min/1.73 m 2 or urinary albumin excretion > 300 mg/24 h will be excluded. Patients' diets will be allocated through simple sequential randomization. Patients will be followed-up for 12 months with nine clinic appointments with a dietitian and the evaluations will include nutritional assessment (anthropometrics, body composition, and resting metabolic rate) and laboratory tests. The primary outcome is weight maintenance or body weight gain under 5% after 12 months. Secondary outcomes include body composition, resting metabolic rate, satiety sensation, kidney function, and other metabolic parameters. Diets with higher protein content and lower glycemic index may lead to weight loss because of higher satiety sensation. However, there is a concern about the association of high protein intake and kidney damage. Nevertheless, there is little evidence on the impact of high protein intake on long-term kidney function outcome. Therefore, we designed a study to test if a high protein diet with low-glycemic index will be an effective and safe nutritional intervention to prevent weight gain in kidney transplant patients. ClinicalTrials.gov identifier, NCT02883777 . Registered on 3 August 2016.

  4. Maternal Weight Gain in Pregnancy and Risk of Obesity among Offspring: A Systematic Review

    PubMed Central

    Lau, Erica Y.; Liu, Junxiu; McDonald, Samantha M.

    2014-01-01

    Objectives. To systematically review the evidence from prospective and retrospective cohort studies on the association between gestational weight gain (GWG) and offspring's body weight. Methods. Electronic databases PubMed, Web of Science, CINAHL, and Academic Search Premiere were searched from inception through March 18, 2013. Included studies (n = 23) were English articles that examined the independent associations of GWG with body mass index (BMI) and/or overweight status in the offspring aged 2 to 18.9 years. Two authors independently extracted the data and assessed methodological quality of the included studies. Results. Evidence from cohort studies supports that total GWG and exceeding the Institute of Medicine maternal weight gain recommendation were associated with higher BMI z-score and elevated risk of overweight or obesity in offspring. The evidence of high rate of GWG during early- and mid-pregnancy is suggestive. Additionally, the evidence on inadequate GWG and net GWG in relation to body weight outcomes in offspring is insufficient to draw conclusions. Conclusions. These findings suggest that GWG is a potential risk factor for childhood obesity. However, findings should be interpreted with caution due to measurement issues of GWG and potential confounding effects of shared familial characteristics (i.e., genetics and maternal and child's lifestyle factors). PMID:25371815

  5. Individual, social and environmental factors and their association with weight in rural-dwelling women.

    PubMed

    Harrison, Cheryce L; Teede, Helena J; Kozica, Samantha; Zoungas, Sophia; Lombard, Catherine B

    2016-11-20

    Obesity is a major public health concern and women living in rural settings present a high-risk group. With contributing factors poorly explored, we evaluated their association with weight in rural Australian women. Women aged 18-50 years of any body mass index (BMI) were recruited between October 2012 and April 2013 as part of a larger, randomised controlled trial within 42 rural towns. Measured weight and height as well as self-reported measures of individual health, physical activity, dietary intake, self-management, social support and environmental perception were collected. Statistical analysis included linear regression for continuous variables as well as chi-squared and logistic regression for categorical variables with all results adjusted for clustering. 649 women with a mean baseline age and BMI of 39.6±6.7 years and 28.8±6.9 kg/m 2 respectively, were studied. Overall, 65% were overweight or obese and 60% overall reported recent weight gain. There was a high intention to self-manage weight, with 68% attempting to lose weight recently, compared to 20% of women reporting health professional engagement for weight management. Obese women reported increased weight gain, energy intake, sitting time and prevalence of pre-existing health conditions. There was an inverse relationship between increased weight and scores for self-management, social support and health environment perception. Many women in rural communities reported recent weight gain and were attempting to self-manage their weight with little external support. Implications for Public Health: Initiatives to prevent weight gain require a multifaceted approach, with self-management strategies and social support in tandem with building a positive local environmental perception. © 2016 Public Health Association of Australia.

  6. Influence of Body Mass Index on the Association of Weight Changes with Mortality in Hemodialysis Patients

    PubMed Central

    Cabezas-Rodriguez, Iván; Carrero, Juan Jesús; Zoccali, Carmine; Qureshi, Abdul Rashid; Ketteler, Markus; Floege, Jürgen; London, Gérard; Locatelli, Francesco; Gorriz, José Luis; Rutkowski, Boleslaw; Memmos, Dimitrios; Ferreira, Anibal; Covic, Adrian; Teplan, Vladimir; Bos, Willem-Jan; Kramar, Reinhard; Pavlovic, Drasko; Goldsmith, David; Nagy, Judit; Benedik, Miha; Verbeelen, Dierik; Tielemans, Christian; Wüthrich, Rudolf P.; Martin, Pierre-Yves; Martínez-Salgado, Carlos; Fernández-Martín, José Luis; Cannata-Andia, Jorge B.

    2013-01-01

    Summary Background and Objectives A high body mass index (BMI) is associated with lower mortality in patients undergoing hemodialysis. Short-term weight gains and losses are also related to lower and higher mortality risk, respectively. The implications of weight gain or loss may, however, differ between obese individuals and their nonobese counterparts. Design, Setting, Participants, & Measurements The Current Management of Secondary Hyperparathyroidism: A Multicenter Observational Study (COSMOS) is an observational study including 6797 European hemodialysis patients recruited between February 2005 and July 2007, with prospective data collection every 6 months for 3 years. Time-dependent Cox proportional hazard regressions assessed the effect of BMI and weight changes on mortality. Analyses were performed after patient stratification according to their starting BMI. Results Among 6296 patients with complete data, 1643 died. At study entry, 42% of patients had a normal weight (BMI, 20–25 kg/m2), 11% were underweight, 31% were overweight, and 16% were obese (BMI ≥30 kg/m2). Weight loss or gain (<1% or >1% of body weight) was strongly associated with higher rates of mortality or survival, respectively. After stratification by BMI categories, this was true in nonobese categories and especially in underweight patients. In obese patients, however, the association between weight loss and mortality was attenuated (hazard ratio, 1.28 [95% confidence interval (CI), 0.74 to 2.14]), and no survival benefit of gaining weight was seen (hazard ratio, 0.98 [95% CI, 0.59 to 1.62]). Conclusions Assuming that these weight changes were unintentional, our study brings attention to rapid weight variations as a clinical sign of health monitoring in hemodialysis patients. In addition, a patient’s BMI modifies the strength of the association between weight changes with mortality. PMID:24009217

  7. The design of maternal centered life-style modification program for weight gain management during pregnancy - a study protocol.

    PubMed

    Farajzadegan, Ziba; Pozveh, Zahra Amini

    2013-08-01

    Abnormal weight gain during pregnancy increases the adverse health outcomes during the pregnancy, delivery, and the postpartum period. Most of the pregnant women develop weight gain more than the recommended limits; therefore, interventions to manage such disproportionate weight gain are needed. In this paper, the design of the maternal centered life-style intervention study is described, which focuses on controlling weight gaining during pregnancy for all body mass index (BMI) groups. In our randomized field trial, 160 pregnant women with 6-10 weeks of gestational age who visit one of the participating Isfahan four urban public-health centers and 4 private obstetric offices are included. The maternal centered life-style intervention carried out by trained midwives is standardized in a protocol. All the participants are visited at 6-10, 11-15, 16-20, 21-25, 26-30, 31-34, 35-37, 38, 39, and 40 weeks of pregnancy. The women who are randomized in the intervention group receive maternal centered educational package of prenatal care for the pregnant woman and a log book in the first visit. Counselors accompany the pregnant women to maintain or develop a healthy life-style. Data collection will perform monthly measuring body weight, BMI. Because, we don't have structured protocol for weight management during pregnancy especially, in private sectors if the maternal centered life-style intervention proves to be effective, it will be suggested to merge this package to routine care. Therewith by empowering women to manage their weight the public-health burden can be reduced. Beside that private obstetricians also have structured protocol for their client management.

  8. Gender-specific effects of HIV protease inhibitors on body mass in mice.

    PubMed

    Wilson, Melinda E; Allred, Kimberly F; Kordik, Elizabeth M; Jasper, Deana K; Rosewell, Amanda N; Bisotti, Anthony J

    2007-05-01

    Protease inhibitors, as part of highly active anti-retroviral therapy (HAART), have significantly increased the lifespan of human immunodeficiency virus (HIV) infected patients. Several deleterious side effects including dyslipidemia and lipodystrophy, however, have been observed with HAART. Women are at a higher risk of developing adipose tissue alterations and these alterations have different characteristics as compared to men. We have previously demonstrated that in mice the HIV protease inhibitor, ritonavir, caused a reduction in weight gain in females, but had no effect on male mice. In the present study, we examined the potential causes of this difference in weight gain. Low-density lipoprotein receptor (LDL-R) null mice or wild-type C57BL/6 mice, were administered 15 mug/ml ritonavir or vehicle (0.01% ethanol) in the drinking water for 6 weeks. The percent of total body weight gained during the treatment period was measured and confirmed that female LDL-R gained significantly less weight with ritonavir treatment than males. In wild type mice, however, there was no effect of ritonavir treatment in either sex. Despite the weight loss in LDL-R null mice, ritonavir increased food intake, but no difference was observed in gonadal fat weight. Serum leptin levels were significantly lower in females. Ritonavir further suppressed leptin levels in (p < 0.05). Ritonavir did not alter serum adiponectin levels in either gender. To determine the source of these differences, female mice were ovariectomized remove the gonadal sex hormones. Ovariectomy prevented the weight loss induced by ritonavir (p < 0.05). Furthermore, leptin levels were no longer suppressed by ritonavir (p < 0.05). This study demonstrates that gonadal factors in females influence the hormonal control of weight gain changes induced by HIV protease inhibitors in an environment of elevated cholesterol.

  9. Body weight change of Abergelle breed and Abergelle crossbred goats fed hay supplemented with different level of concentrate mixture.

    PubMed

    Amare, Bewketu; Alemu, Tewodros; Deribe, Belay; Dagnachew, Alemu; Teshager, Natnael; Tsegaye, Alemu

    2018-03-01

    The experiment was conducted at Sekota District using 36 intact yearling males of pure Abergelle breed and Abergelle crossbred goats (50%) with a mean live weight of 18.92 ± 0.72 kg (mean ± SE). The objective of the experiment was to evaluate the effect of different levels of concentrate mixture supplementation on feed intake, live weight gain, and economic gain of the breeds. Goats were blocked based on initial body weight and were randomly assigned to the dietary treatments. The experimental design was a 2 × 3 factorial in RCBD (randomized complete block design). The treatments included ad libitum feeding of local grass hay and supplementation with three levels (184, 368, and 552 g/day) of concentrate mixture. The experiment consisted of 90 days of feeding. Daily, total dry matter and CP (crude protein) intakes were affected by diet and genotype (P < 0.01). Significant decrease (P < 0.001) in hay intake was observed as the level of the supplement increased. Besides, substitution rate increased with increasing levels of supplementation. Average daily body weight gains were significantly impacted only by diet. Animals fed on 184 significantly lower weights, while nonsignificant difference was observed in live weight gain between 368 and 552 supplemented group. Supplementation of 368 concentrate mix significantly improved (P < 0.05) feed intake, daily weight gain, and feed conversion efficiency. Supplementation of 368 g/day had showed significantly higher net return for both goat breeds. However, the Abergelle breed was significantly better in net profit and sensitivity than the crossbreed. Both genotypes performed better with the diet containing 368 g/day than that with 184 and 552 g/day of concentrate supplementation.

  10. Weight Gain in Children with Cleft Lip and Palate without Use of Palatal Plates

    PubMed Central

    da Silva Freitas, Renato; Lopes-Grego, Andrey Bernardo; Dietrich, Helena Luiza Douat; Cerchiari, Natacha Regina de Moraes; Nakakogue, Tabatha; Tonocchi, Rita; Gabardo, Juarez; da Silva, Éder David Borges; Forte, Antonio Jorge

    2012-01-01

    Goals/Background. To evaluate children's growth in the first year of life, who have cleft palate and lip, without the use of palatal plates. Materials/Method. Chart review was conducted, retrospectively, in the Center for Integral Assistance of Cleft Lip and Palate (CAIF), in Brazil, between 2008 and 2009. Results for both genders were compared to the data published by the World Health Organization (WHO) regarding average weight gain in children during their first year of life. Results. Patients with syndromic diagnosis and with cleft classified as preforamen were excluded, resulting in a final number of 112 patients: 56 male and 56 female. Similar patterns were seen comparing the two genders. Although it was observed weight gain below the average until the 11th month in male patients and until 9 months in female patients, both genders remained at the 50th percentile (p50) and improved after the 4th month of age for boys and the 9th month of age for girls. Conclusion. Children with cleft palate weigh less than regular children during their first months of life. At the end of the first year, weight gain is similar comparing normal and affected children. However, factors that optimized weight gain included choosing the best treatment for each case, proper guidance, and multiprofessional integrated care. PMID:23304489

  11. Growth of Mashona cattle on range in Zimbabwe. II. Estimates of genetic parameters and predicted response to selection.

    PubMed

    Tawonezvi, H P

    1989-08-01

    For 1,456 Mashona calves sired by 88 bulls heritability estimates from paternal half-sibs were 0.44 +/- 0.11 for birth weight, 0.38 +/- 0.10 for 205-day weaning weight, 0.39 +/- 0.10 for 18-month weight, 0.37 +/- 0.10 for pre-weaning daily liveweight gain and 0.41 +/- 0.11 for daily gain from weaning to 18 months of age. Genetic correlations were relatively low for birth weight with weaning weight (0.42 +/- 0.18), 18-month weight (0.56 +/- 0.16), pre-weaning gain (0.33 +/- 0.19) and post-weaning gain (0.36 +/- 0.19). Higher genetic correlations were observed for pre-weaning gain with weaning weight (0.98 +/- 0.01) and 18-month weight (0.59 +/- 0.14) and for 18-month weight with weaning weight (0.67 +/- 0.12) and post-weaning gain (0.73 +/- 0.10). Post-weaning daily gain was not significantly correlated genetically with both pre-weaning gain (-0.11 +/- 0.22) and weaning weight (-0.03 +/- 0.22). With 10% retention of males and 60% of females expected genetic improvements per generation from direct selection for weaning weight or 18-month weight were 8.11 kg and 12.12 kg respectively. These improvements would be reduced by 18% and 35% if selection indices were used to produce no correlated change in birth weight.

  12. A new model of the role of psychological and emotional distress in promoting obesity: conceptual review with implications for treatment and prevention.

    PubMed

    Hemmingsson, E

    2014-09-01

    The lack of significant treatment and prevention progress highlights the need for a more expanded strategy. Given the robust association between socioeconomic factors and obesity, combined with new insights into how socioeconomic disadvantage affects both behaviour and biology, a new causal model is proposed. The model posits that psychological and emotional distress is a fundamental link between socioeconomic disadvantage and weight gain. At particular risk are children growing up in a disharmonious family environment, mainly caused by parental socioeconomic disadvantage, where they are exposed to parental frustrations, relationship discord, a lack of support and cohesion, negative belief systems, unmet emotional needs and general insecurity. Without adequate resilience, such experiences increase the risk of psychological and emotional distress, including low self-esteem and self-worth, negative emotions, negative self-belief, powerlessness, depression, anxiety, insecurity and a heightened sensitivity to stress. These inner disturbances eventually cause a psycho-emotional overload, triggering a cascade of weight gain-inducing effects including maladaptive coping strategies such as eating to suppress negative emotions, chronic stress, appetite up-regulation, low-grade inflammation and possibly reduced basal metabolism. Over time, this causes obesity, circular causality and further weight gain. Tackling these proposed root causes of weight gain could potentially improve both treatment and prevention outcomes. © 2014 The Author. obesity reviews © 2014 World Obesity.

  13. Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women

    PubMed Central

    Sénéchal, M; Arguin, H; Bouchard, DR; Carpentier, AC; Ardilouze, JL; Dionne, IJ; Brochu, M

    2011-01-01

    Objective To examine the association between weight gain since menopause and weight regain after a weight loss program. Methods Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. Results All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Conclusion Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women. PMID:21966216

  14. Weight gain since menopause and its associations with weight loss maintenance in obese postmenopausal women.

    PubMed

    Sénéchal, M; Arguin, H; Bouchard, D R; Carpentier, A C; Ardilouze, J L; Dionne, I J; Brochu, M

    2011-01-01

    To examine the association between weight gain since menopause and weight regain after a weight loss program. Participants were 19 obese women who participated in a 15-week weight loss program and a 12-month follow-up. Main outcomes were: body composition, resting metabolic rate, energy intake, energy expenditure, and weight regain at follow-up. All body composition measures significantly decreased after intervention (all P ≤ 0.01) while all measures of fatness increased significantly after the 12-month follow-up (P ≤ 0.01). Body weight gain since menopause was associated with body weight regain (r = 0.65; P = 0.003) after follow-up even after adjustment for confounders. Weight gain since menopause is associated with body weight regain following the weight loss program. Therefore, weight gain since menopause should be considered as a factor influencing weight loss maintenance in older women.

  15. Radiologically Guided Placement of Mushroom-retained Gastrostomy Catheters: Long-term Outcomes of Use in 300 Patients at a Single Center.

    PubMed

    Ahmed, Osman; Jilani, Danial; Sheth, Sujay; Giger, Maryellen; Funaki, Brian

    2015-08-01

    To assess long-term outcomes including risk of complications and nutritional benefits of mushroom-retained (pull-type) gastrostomy catheters placed in patients by interventional radiologists. All patients who received pull-type gastrostomy tubes between 2010 and 2013 were retrospectively reviewed, including 142 men (average weight, 169.6 lb [76.32 kg]; mean age, 65.2 years; range, 22-92 years) and 158 women (average weight, 150.4 lb [67.68 kg]; mean age, 65.2 years; range, 18-98 years). Indications for placement were cerebrovascular accident (n = 80), failure to thrive (n = 71), other central nervous system disorder (n = 51), head and neck cancer (n = 47), and other malignancy (n = 51). Complications were recorded per Society of Interventional Radiology practice guidelines. Patient weight was documented at specific follow-up intervals. Statistical analysis was performed by using the Student t test and one-way analysis of variance for the effects of sex and indication for placement, respectively, on average weight change. The technical success rate was 98.4% (300 of 305 patients). Major and minor complications occurred at a rate of 3.7% (n = 11) and 13% (n = 39), respectively. Follow-up weight during the early (≤45 days), intermediate (≤180 days), and long-term (>180 days) periods was available for 71% (n = 214), 36% (n = 108), and 15% (n = 44) of the 300 patients, respectively. Weight gain occurred in 77% (160 of 214), 60% (65 of 108), and 73% (32 of 44) of the patients, respectively. Patients who gained weight gained 6.7, 10.6, and 16.3 lb (3.02, 4.77, and 7.34 kg) during each follow-up period, respectively. Average weight gain at follow-up in all patients was 4.2, 0.6, and 5.4 lb (1.89, 0.27, and 2.43 kg), respectively. No significant differences in average weight change were seen among groups when they were classified according to sex or indication for placement. Placement of mushroom-retained gastrostomy catheters is a viable long-term treatment option for enteral nutrition, with complication rates similar to those reported for other gastrostomy techniques. Improvement in nutrition status measured as weight gain was seen in most patients in both early and long-term periods. (©) RSNA, 2015.

  16. Performance of broilers fed on diets containing different amounts of chaya (Cnidoscolus aconitifolius) leaf meal.

    PubMed

    Sarmiento-Franco, L; McNab, J M; Pearson, R A; Belmar-Casso, R

    2002-05-01

    The performance and gut measurements of broilers fed on diets containing different amounts of chaya (Cnidoscolus aconitifolius) leaf meal (CLM) were examined in two experiments. In the first experiment, 60 Hubbard chickens (30 males and 30 females; 2 weeks old) were fed on five maize diets; these were formulated using 0, 150 (CLM150), 250 (CLM250) or 350 (CLM350) g CLM/kg, and the fifth diet contained soyabean. In the second experiment, 148 Ross male chicks, 1 day old, were fed on three isonitrogenous and isoenergetic maize-soyabean-based diets, which included 0 (control), 150 (C150) or 250 (C250) g CLM/kg. The diets were offered ad libitum for 2 or 3 weeks in the first and second experiments, respectively. Food intake, weight gain and the food:weight gain ratio were recorded. The weight of the gizzard and intestine and the weight and length of the caeca were also determined in the second experiment. In experiment 1, the birds fed on the maize-soyabean diet had a higher (p < 0.05) weight gain and final weight than birds fed on maize only or on the CLM150 diets. There were no differences for any of the variables studied between the birds fed on the maize-soyabean diet and those fed on the CLM250, nor between males and females. In the second experiment, weight gain, food intake and the food:weight gain ratio for birds fed on C250 were lower (p < 0.05) than those in birds fed on either the control or C150 diets. The weights of the gizzard and intestine were the lowest and the highest, respectively, in birds fed on C250 (p < 0.05). The length and weight of the caecum from birds fed on the control diet were lower (p < 0.05) than those of birds fed on either the C150 or C250 diets. The results from this study suggest that CLM may be included up to 150 g/kg in commercial diets without having an adverse effect on poultry performance, and may also be mixed with maize up to 250 g/kg to improve the performance of chickens fed on low-protein diets.

  17. The puzzle of self-reported weight gain in a month of fasting (Ramadan) among a cohort of Saudi families in Jeddah, Western Saudi Arabia

    PubMed Central

    2011-01-01

    Background During Ramadan fast, approximately one billion Muslims abstain from food and fluid between the hours of sunrise to sunset, and usually eat a large meal after sunset and another meal before sunrise. Many studies reported good health-related outcomes of fasting including weight loss. The objective of this study is to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a group of families in Jeddah, Western Saudi Arabia. Methods A Cross-section study using a pre-designed questionnaire to identify the local pattern of expenditure on food consumption, dietary habits during Ramadan and correlate that to self-reported weight gain after Ramadan in a representative cohort of Saudis living in Jeddah. It was piloted on 173 nutrition students and administered by them to their families. Results A total of 173 Saudi families were interviewed. One out of 5 indicated that their expenditure increases during Ramadan. Approximately two thirds of the respondents (59.5%) reported weight gain after Ramadan. When asked about their perspective explanations for that: 40% attributed that to types of foods being rich in fat and carbohydrates particularly date in (Sunset meal) 97.7% and rice in (Dawn meal) 80.9%. One third (31.2%) indicated that it was due to relative lack of physical exercise in Ramadan and 14.5% referred that to increase in food consumption. Two thirds (65.2%) of those with increased expenditure reported weight gain. Conclusion Surprisingly weight gain and not weight loss was reported after Ramadan by Saudis which indicates timely needed life-style and dietary modification programs for a population which reports one of the highest prevalence rates of diabetes. PMID:21831261

  18. Weight-related self-efficacy in relation to maternal body weight from early pregnancy to 2 years post-partum

    PubMed Central

    Lipsky, Leah M.; Strawderman, Myla S.; Olson, Christine M.

    2016-01-01

    Excessive gestational weight gain may lead to long-term increases in maternal body weight and associated health risks. The purpose of this study was to examine the relationship between maternal body weight and weight-related self-efficacy from early pregnancy to 2 years post-partum. Women with live, singleton term infants from a population-based cohort study were included (n = 595). Healthy eating self-efficacy and weight control self-efficacy were assessed prenatally and at 1 year and 2 years post-partum. Body weight was measured at early pregnancy, before delivery, and 6 weeks, 1 year and 2 years post-partum. Behavioural (smoking, breastfeeding) and sociodemographic (age, education, marital status, income) covariates were assessed by medical record review and baseline questionnaires. Multi-level linear regression models were used to examine the longitudinal associations of self-efficacy measures with body weight. Approximately half of the sample (57%) returned to early pregnancy weight at some point by 2 years post-partum, and 9% became overweight or obese at 2 years post-partum. Body weight over time was inversely related to healthy eating (β = −0.57, P = 0.02) and weight control (β = −0.99, P < 0.001) self-efficacy in the model controlling for both self-efficacy measures as well as time and behavioural and sociodemographic covariates. Weight-related self-efficacy may be an important target for interventions to reduce excessive gestational weight gain and post-partum weight gain. PMID:25244078

  19. Perceived weight status may contribute to education inequalities in five-year weight change among mid-aged women.

    PubMed

    Siu, Jessica; Giskes, Katrina; Shaw, Jonathan; Turrell, Gavin

    2011-06-01

    To examine education differences in five-year weight change among mid-aged adults, and to ascertain if this may be due to socioeconomic differences in perceived weight status or weight control behaviours (WCBs). Data were used from the Australian Diabetes, Obesity and Lifestyle Study. Mid-aged men and women with measured weights at both baseline (1999-2000) and follow-up (2004-2005) were included. Percent weight change over the five-year interval was calculated and perceived weight status, WCBs and highest attained education were collected at baseline. Low-educated men and women were more likely to be obese at baseline compared to their high-educated counterparts. Women with a certificate-level education had a greater five-year weight gain than those with a bachelor degree or higher. Perceived weight status or WCBs did not differ by education among men and women, however participants that perceived themselves as very overweight had less weight gain than those perceiving themselves as underweight or normal weight. WCBs were not associated with five-year weight change. The higher prevalence of overweight/obesity among low-educated women may be a consequence of greater weight gain in mid-adulthood. Education inequalities in overweight/obesity among men and women made be due (in part) to overweight or obese individuals in low-educated groups not perceiving themselves as having a weight problem. © 2011 The Authors. ANZJPH © 2011 Public Health Association of Australia.

  20. The association between inadequate gestational weight gain and infant mortality among U.S. infants born in 2002.

    PubMed

    Davis, Regina R; Hofferth, Sandra L

    2012-01-01

    The purpose of this study was to determine the relative importance of inadequate gestational weight gain as a cause of infant mortality. Birth and infant death certificate data were obtained from a random sample of 100,000 records from the National Center for Health Statistics (NCHS) 2002 Birth Cohort Linked Birth/Infant Death Data File. Descriptive and proportional hazards regression analyses were used to assess the odds of infant mortality associated with inadequate gestational weight gain compared to normal weight gain. Nearly 30% of women experienced inadequate weight gain. Infants born to women with inadequate gestational weight gain had odds of infant death that were 2.23 times the odds for infants born to women with normal weight gain. Increased odds remained after adjustment for gestational age, low birth weight, maternal age, maternal education, and maternal race. Among racial or ethnic subgroups, African American women were 1.3 times as likely as white women to have an infant die, but they were no more likely to have an infant die than white women if they had inadequate weight gain. There is a substantial and significant association between inadequate gestational weight gain and infant death that does not differ by race, ethnic group membership, or maternal age.

  1. Weight Gain during Pregnancy

    MedlinePlus

    ... Global Map Premature Birth Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal ... fitness > Weight gain during pregnancy Weight gain during pregnancy E-mail to a friend Please fill in ...

  2. Association of gestational weight gain expectations with advice on actual weight gain

    USDA-ARS?s Scientific Manuscript database

    To examine pregnant women's gestational weight gain expectations/advice from various sources (i.e., self, family/friends, physician) and the impact of these sources of expectations/advice on actual measured gestational weight gain. Pregnant women (n=230, 87.4% Caucasian, second pregnancy) in a cohor...

  3. Effect of gonadectomy on AgRP-induced weight gain in rats.

    PubMed

    Goodin, Sean Z; Kiechler, Alicia R; Keichler, Alicia R; Smith, Marissa; Wendt, Donna; Strader, April D

    2008-12-01

    Agouti-related peptide (AgRP), the endogenous antagonist to the melanocortin 3 and 4 receptors, elicits robust hyperphagia and weight gain in rodents when administered directly into the central nervous system. The relative influence of AgRP to cause weight gain in rodents partially depends on the activity level of the melanocortin agonist-producing proopiomelanocortin neurons. Both proopiomelanocortin and AgRP neurons within the arcuate nucleus receive energy storage information from circulating peripheral signals such as leptin and insulin. Another modulator of AgRP activity includes the cell surface molecule syndecan-3. Because leptin and insulin affect food intake in a sexually dimorphic way in rodents and syndecan-3-deficient mice regulate adiposity levels through distinct physiological mechanisms, we hypothesized that AgRP-induced weight gain would also be sexually dimorphic in rats. In the present study, the behavioral and physiological effects of centrally-administered AgRP in male and female were investigated. In male rats, AgRP (1 nmol) induced 5 days (P < 0.0001) of significantly elevated feeding compared with vehicle-treated controls, while females displayed 3 days of hyperphagia (P < 0.05). However, 1 wk after the injection, both male and female rats gained the same percent body weight (6%). Interestingly, female rats exhibited a greater reduction in energy expenditure (Vo2) following AgRP compared with male rats (P < 0.05). Removal of the gonads did not alter cumulative food intake in male or female rats but did attenuate the dramatic reduction in Vo2 exhibited by females. Both intact and gonadectomized rats demonstrated significantly increased respiratory quotient supporting the anabolic action of AgRP (P < 0.01). These findings are novel in that they reveal sex-specific underlying physiology used to achieve weight gain following central AgRP in rats.

  4. Prepregnancy body mass index, gestational weight gain, and birth weight in the BRISA cohort.

    PubMed

    Lima, Raina Jansen Cutrim Propp; Batista, Rosângela Fernandes Lucena; Ribeiro, Marizélia Rodrigues Costa; Ribeiro, Cecília Cláudia Costa; Simões, Vanda Maria Ferreira; Lima Neto, Pedro Martins; Silva, Antônio Augusto Moura da; Bettiol, Heloisa

    2018-01-01

    OBJECTIVE To analyze the effects of maternal pre-pregnancy body mass index and weight gain during pregnancy on the baby's birth weight. METHODS We conducted a cross-sectional study with 5,024 mothers and their newborns using a Brazilian birth cohort study. In the proposed model, estimated by structural equation modeling, we tested socioeconomic status, age, marital status, pre-pregnancy body mass index, smoking habit and alcohol consumption during pregnancy, hypertension and gestational diabetes, gestational weight gain, and type of delivery as determinants of the baby's birth weight. RESULTS For a gain of 4 kg/m2 (1 Standard Deviation [SD]) in pre-pregnancy body mass index, there was a 0.126 SD increase in birth weight, corresponding to 68 grams (p < 0.001). A 6 kg increase (1 SD) in gestational weight gain represented a 0.280 SD increase in newborn weight, correponding to 151.2 grams (p < 0.001). The positive effect of pre-pregnancy body mass index on birth weight was direct (standardized coefficient [SC] = 0.202; p < 0.001), but the negative indirect effect was small (SC = -0.076, p < 0.001) and partially mediated by the lower weight gain during pregnancy (SC = -0.070, p < 0.001). The positive effect of weight gain during pregnany on birth weight was predominantly direct (SC = 0.269, p < 0.001), with a small indirect effect of cesarean delivery (SC = 0.011; p < 0.001). Women with a higher pre-pregnancy body mass index gained less weight during pregnancy (p < 0.001). CONCLUSIONS The effect of gestational weight gain on the increase in birth weight was greater than that of pre-pregnancy body mass index.

  5. Low gestational weight gain and the risk of preterm birth and low birthweight: a systematic review and meta-analyses.

    PubMed

    Han, Zhen; Lutsiv, Olha; Mulla, Sohail; Rosen, Allison; Beyene, Joseph; McDonald, Sarah D

    2011-09-01

    Low gestational weight gain is common, with potential adverse perinatal outcomes. To determine the relation between low gestational weight gain and preterm birth and low birthweight in singletons in developing and developed countries. Medline, EMBASE and reference lists were searched, identifying 6,283 titles and abstracts. Following the MOOSE consensus statement, two assessors independently reviewed titles, abstracts, full articles, extracted data and assessed quality. Fifty-five studies, 37 cohort and 18 case-control, were included, involving 3,467,638 women. In the cohort studies (crude data, generally supported where available by adjusted data and case-control studies), women with low total gestational weight gain had increases in preterm birth <37 weeks [RR 1.64 (95%CI 1.62-1.65)], 32-36 weeks [RR 1.39 (95%CI 1.38-1.40)] and ≤ 32 weeks [RR 3.80 (95%CI 3.72-3.88)]. Low total gestational weight gain was associated with increased risks of low birthweight <2,500 g [RR 1.85 (95%CI 1.72-2.00)], in developing and developed countries [RR 1.84 (95%CI 1.71-1.99) and RR 3.02 (95%CI 1.37-6.63), respectively], 1,500-2,500 g [RR 2.02 (95%CI 1.88-2.17)] and <1,500 g (RR 2.00 (95%CI 1.67-2.40)]. Women with low weekly gestational weight gain were at increased risk of preterm birth [RR 1.56 (95%CI 1.26-1.94)], 32-36 weeks [RR 2.43 (95%CI 2.37-2.50)] and ≤ 32 weeks [RR 2.31 (95%CI 2.20-2.42)] but not low birthweight [RR 1.64 (95%CI 0.89-3.02)]. In this systematic review, we determined that singletons born to women with low total gestational weight gain have higher risks of preterm birth and low birthweight, with the lower the gain, the higher the risks. © 2011 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2011 Nordic Federation of Societies of Obstetrics and Gynecology.

  6. Obesity and weight management at menopause.

    PubMed

    Proietto, Joseph

    2017-06-01

    Many women report gaining weight as they transition through menopause. For most, the weight gain is modest and can be reduced with a conscious effort to limit energy intake and increase energy expenditure. However, many women who are already overweight and obese will gain more weight as they approach menopause. The aims of this paper are to explain the reasons for menopausal weight gain and to detail a method for achieving and sustaining a substantial weight loss. Weight gain during menopause is predominantly due to a reduction in spontaneous activity. For women who are lean, advice about controlling energy intake and increasing physical activity may be all that is required to prevent weight gain. For women who are overweight and obese rapid weight loss is best achieved with the help of a very low energy diet. This must be followed by lifelong behaviour modification with or without the help of hunger-suppressing pharmacotherapy.

  7. Influence of maternal age, birth-to-conception intervals and prior perinatal factors on perinatal outcomes.

    PubMed

    Farahati, M; Bozorgi, N; Luke, B

    1993-10-01

    This study evaluated the influence of prior perinatal factors on birth weight, length of gestation, and maternal pregravid and postpartum weights in subsequent pregnancies. The study sample included 47 women each with first, second and third pregnancies. Mean pregravid weight increased by 5.2 lb between the first and second pregnancies and by 4.4 lb between the second and third pregnancies. Total weight gain averaged 31 lb for the first pregnancy and 28.4 and 28.3 lb for the second and third pregnancies, respectively. Mean birth weight increased by 111 g between the first and second pregnancies and by 199 g between the second and third pregnancies. Mean gestational age was similar for all three pregnancies, averaging 39.5 weeks. Using stepwise forward multiple regression analyses, we determined that birth weight and length of gestation are both influenced significantly by prior birth weight and length of gestation; subsequent pregravid weight is influenced significantly by prior rate of gain, pregravid weight and postpartum weight; and postpartum weight is significantly influenced by prior rate of gain and birth weight. Comparisons across three pregnancies for the same woman showed that differences in birth-to-conception interval were not associated with higher postpartum weight or subsequent pregravid weight. These data indicate that in healthy, nonsmoking, low-risk women, the maternal and infant outcomes of pregnancies are significantly influenced by prior outcomes but not by either short birth-to-conception interval or greater maternal age.

  8. Yogurt consumption is associated with longitudinal changes of body weight and waist circumference: the framingham study

    USDA-ARS?s Scientific Manuscript database

    Yogurt, as a low-fat, nutrient-dense dairy product, may be beneficial in preventing weight gain. We aimed to examine the longitudinal association between yogurt consumption and annualized change in weight and waist circumference (WC) among adults. We included 3,285 adults (11,169 observations) parti...

  9. The effectiveness of weight management interventions in breastfeeding women--a systematic review and critical evaluation.

    PubMed

    Neville, Charlotte E; McKinley, Michelle C; Holmes, Valerie A; Spence, Dale; Woodside, Jayne V

    2014-09-01

    The postpartum period is a vulnerable time for excess weight retention, particularly for the increasing number of women who are overweight at the start of their pregnancy and subsequently find it difficult to lose additional weight gained during pregnancy. Although postpartum weight management interventions play an important role in breaking this potentially vicious cycle of weight gain, the effectiveness of such interventions in breastfeeding women remains unclear. Our aim was to systematically review the literature about the effectiveness of weight management interventions in breastfeeding women. Seven electronic databases were searched for eligible papers. Intervention studies included were carried out exclusively in breastfeeding mothers, ≤2 years postpartum and with a body mass index greater than 18.5 kg/m(2) , with an outcome measure of change in weight and/or body composition. Six studies met the selection criteria, and were stratified according to the type of intervention and outcome measures. Despite considerable heterogeneity among studies, the dietary-based intervention studies appeared to be the most efficacious in promoting weight loss; however, few studies were tailored toward the needs of breastfeeding women. Weight management interventions which include an energy-restricted diet may play a key role in successful postpartum weight loss for breastfeeding mothers. © 2014 Wiley Periodicals, Inc.

  10. Weight changes in euthyroid patients undergoing thyroidectomy.

    PubMed

    Jonklaas, Jacqueline; Nsouli-Maktabi, Hala

    2011-12-01

    Thyroidectomized patients frequently report weight gain resistant to weight loss efforts, identifying their thyroidectomy as the event precipitating subsequent weight gain. We wished to determine whether recently thyroidectomized euthyroid patients gained more weight over 1 year than matched euthyroid patients with preexisting hypothyroidism. We performed a retrospective chart review of subjects receiving medical care at an academic medical center. One hundred twenty patients had their weight and thyroid status documented after thyroidectomy and achievement of euthyroidism on thyroid hormone replacement, and one year later. Three additional groups of 120 patients with preexisting hypothyroidism, no thyroid disease, and thyroid cancer were matched for age, gender, menopausal status, height, and weight. Anthropometric data were documented at two time points 1 year apart. We compared the weight changes and body mass index changes occurring over a 1-year period in the four groups. Patients with recent postsurgical hypothyroidism gained 3.1 kg during the year, whereas matched patients with preexisting hypothyroidism gained 2.2 kg. The patients without thyroid disease and those with iatrogenic hyperthyroidism gained 1.3 and 1.2 kg, respectively. The weight gain in the thyroidectomized group was significantly greater than that in the matched hypothyroid group (p-value 0.004), the group without thyroid disease (p-value 0.001), and the patients with iatrogenic hyperthyroidism (p-value 0.001). Within the thyroidectomized group, the weight gain in menopausal women was greater than in either premenopausal women (4.4 vs. 2.3 kg, p-value 0.007) or men (4.4 vs. 2.5 kg, p-value 0.013). Patients who had undergone thyroidectomy in the previous year did, in fact, gain more weight than their matched counterparts with preexisting hypothyroidism. In addition, all patients with hypothyroidism, even though treated to achieve euthyroidism, experienced more weight gain than both subjects without hypothyroidism and subjects with iatrogenic hyperthyroidism. The greatest weight gain in the thyroidectomized group was in menopausal women. These data raise the question of an unidentified factor related to taking thyroid hormone replacement that is associated with weight gain, with an additional intriguing effect of thyroidectomy itself. Menopausal status confers additional risk. These groups should be targeted for diligent weight loss efforts.

  11. Hypothalamic ghrelin signalling mediates olanzapine-induced hyperphagia and weight gain in female rats.

    PubMed

    Zhang, Qingsheng; He, Meng; Deng, Chao; Wang, Hongqin; Lian, Jiamei; Huang, Xu-Feng

    2014-05-01

    Excessive weight gain is a major metabolic side effect of second-generation antipsychotics (SGAs) in the treatment of schizophrenia. Ghrelin is an orexigenic hormone secreted mainly from the stomach, which can induce weight gain and hyperphagia through regulating neuropeptides at the hypothalamus. Accumulating evidence implicates a relationship between ghrelin signalling and SGA-induced hyperphagia and weight gain. We report that olanzapine (a SGA with high weight gain liability) potently and time-dependently up-regulate ghrelin and ghrelin signalling, leading to hyperphagia and weight gain in female Sprague-Dawley rats, an action reversed by i.c.v. injection of a ghrelin receptor (GHS-R1a) antagonist. These findings indicate a crucial role of ghrelin signalling in hyperphagia induced by olanzapine, supporting the notion that GHS-R1a antagonist may be useful for pharmacological treatment of SGA-induced weight gain resulted from hyperphagia.

  12. New Discovery About Middle-Age Weight Gain

    MedlinePlus

    ... Middle-Age Weight Gain Follow us Photo: AdobeStock New Discovery About Middle-Age Weight Gain A TEAM ... findings could lead to the development of a new type of weight-loss medication. SOURCE: NIH Research ...

  13. COSP for Windows: Strategies for Rapid Analyses of Cyclic Oxidation Behavior

    NASA Technical Reports Server (NTRS)

    Smialek, James L.; Auping, Judith V.

    2002-01-01

    COSP is a publicly available computer program that models the cyclic oxidation weight gain and spallation process. Inputs to the model include the selection of an oxidation growth law and a spalling geometry, plus oxide phase, growth rate, spall constant, and cycle duration parameters. Output includes weight change, the amounts of retained and spalled oxide, the total oxygen and metal consumed, and the terminal rates of weight loss and metal consumption. The present version is Windows based and can accordingly be operated conveniently while other applications remain open for importing experimental weight change data, storing model output data, or plotting model curves. Point-and-click operating features include multiple drop-down menus for input parameters, data importing, and quick, on-screen plots showing one selection of the six output parameters for up to 10 models. A run summary text lists various characteristic parameters that are helpful in describing cyclic behavior, such as the maximum weight change, the number of cycles to reach the maximum weight gain or zero weight change, the ratio of these, and the final rate of weight loss. The program includes save and print options as well as a help file. Families of model curves readily show the sensitivity to various input parameters. The cyclic behaviors of nickel aluminide (NiAl) and a complex superalloy are shown to be properly fitted by model curves. However, caution is always advised regarding the uniqueness claimed for any specific set of input parameters,

  14. [Changes in body weight of the university students at university].

    PubMed

    Soto Ruiz, María Nelia; Aguinaga Ontonso, Inés; Canga Armayor, Navidad; Guillén-Grima, Francisco; Hermoso de Mendoza, Juana; Serrano Monzo, Inmaculada; Marín Fernández, Blanca

    2015-06-01

    One of the strategies for the prevention of the obesity is the identification of critical periods of gain weight. Some studies confirm gain weight during the university period. The purpose of the present study was to determine the changes in the body weight of the university students in Navarre. Prospective cohort study. Public University of Navarre and the University of Navarre, in Pamplona. Study examined weight change among 452 students attending at university in Pamplona, during first and third course. Four hundred and fifty two students completed the questionnaire. Weight and height were measures and body mass index was calculated. The mean body weight increased 0,600 kg, 1,8 kg for males and no change in body weight was observed in female. 44,7 % of students gained weight (60,8 % of men and 36,8 % of women), and the gain weight was of 3,4 kg. University years are a critical factor for the gain weight, particularly males. Consideration of this, is necessary the development of effective weight gain prevention strategies during the university. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  15. Antipsychotic-induced weight gain: a comprehensive research synthesis.

    PubMed

    Allison, D B; Mentore, J L; Heo, M; Chandler, L P; Cappelleri, J C; Infante, M C; Weiden, P J

    1999-11-01

    The purpose of this study was to estimate and compare the effects of antipsychotics-both the newer ones and the conventional ones-on body weight. A comprehensive literature search identified 81 English- and non-English-language articles that included data on weight change in antipsychotic-treated patients. For each agent, a meta-analysis and random effects metaregression estimated the weight change after 10 weeks of treatment at a standard dose. A comprehensive narrative review was also conducted on all articles that did not yield quantitative information but did yield important qualitative information. Placebo was associated with a mean weight reduction of 0.74 kg. Among conventional agents, mean weight change ranged from a reduction of 0.39 kg with molindone to an increase of 3.19 kg with thioridazine. Among newer antipsychotic agents, mean increases were as follows: clozapine, 4.45 kg; olanzapine, 4.15 kg; sertindole, 2.92 kg; risperidone, 2.10 kg; and ziprasidone, 0.04 kg. Insufficient data were available to evaluate quetiapine at 10 weeks. Both conventional and newer antipsychotics are associated with weight gain. Among the newer agents, clozapine appears to have the greatest potential to induce weight gain, and ziprasidone the least. The differences among newer agents may affect compliance with medication and health risk.

  16. Energy expenditure, spontaneous physical activity and with weight gain in kidney transplant recipients.

    PubMed

    Heng, Anne-Elisabeth; Montaurier, Christophe; Cano, Noël; Caillot, Nicolas; Blot, A; Meunier, Nathalie; Pereira, Bruno; Marceau, Geoffroy; Sapin, Vincent; Jouve, Christelle; Boirie, Yves; Deteix, Patrice; Morio, Beatrice

    2015-06-01

    Alterations in energy metabolism could trigger weight gain after renal transplantation. Nineteen transplanted non-diabetic men, 53 ± 1.6 years old, receiving calcineurin inhibitors but no corticosteroids were studied. They were compared with nine healthy men matched for height, age and lean body mass. Daily energy expenditure and its components (sleeping, basal and absorptive metabolic rates) were analyzed for 24 h in calorimetric chambers and for 4 days in free living conditions using calibrated accelerometry. Other variables known to influence energy expenditure were assessed: body composition, physical activity, 4-day food intake, drug consumption, serum C-reactive protein, interleukin-6, thyroid and parathyroid hormones, and epinephrine. Transplant recipients who gained more than 5% body weight after transplantation (n = 11, +11.0 ± 1.5 kg) were compared with those who did not (n = 8) and with the controls. Weight gain compared with non-weight gain patients and controls exhibited higher fat mass without change in lean body mass. Daily, sleeping and resting energy expenditure adjusted for lean body mass was significantly higher in non-weight gain (167.1 ± 4.2 kJ/kg/lean body mass/24 h, P < 0.05) compared with weight gain patients (147.4 ± 3.6) and controls (146.1 ± 4.6). Weight gain compared with controls and non-weight gain subjects had lower free living physical activity and a higher consumption of antihypertensive drugs and β-blockers. After kidney transplantation, weight gain patients were characterized by lower adjusted energy expenditure, reduced spontaneous physical activity but a more sedentary life style and a trend toward a higher energy intake explaining the reason they gained weight. The nWG KTR had increased resting and sleeping EE which protected them from weight gain. Such hypermetabolism was also observed in 24-h EE measurements. By comparison with the nWG patients, the WG transplant recipients were characterized by higher β-blocker consumption. These data could be helpful in the prevention of weight gain in kidney transplant recipients. Copyright © 2014. Published by Elsevier Ltd.

  17. Levamisole: A Positive Allosteric Modulator for the α3β4 Nicotinic Acetylcholine Receptors Prevents Weight Gain in the CD-1 Mice on a High Fat Diet.

    PubMed

    Lewis, Jeanne A; Yakel, Jerrel L; Pandya, Anshul A

    2017-01-01

    Neuronal nicotinic acetylcholine receptors (nAChRs) regulate the function of multiple neurotransmitter pathways throughout the central nervous system. This includes nAChRs found on the proopiomelanocortin neurons in the hypothalamus. Activation of these nAChRs by nicotine causes a decrease in the consumption of food in rodents. This study tested the effect of subtype selective allosteric modulators for nAChRs on the body weight of CD-1 mice. Levamisole, an allosteric modulator for the α3β4 subtype of nAChRs, prevented weight gain in mice that were fed a high fat diet. PNU-120596 and desformylflustrabromine were observed to be selective PAMs for the α7 and α4β2 nAChR, respectively. Both of these compounds failed to prevent weight gain in the CD-1 mice. These results suggest that the modulation of hypothalamic α3β4 nAChRs is an important factor in regulating food intake, and the PAMs for these receptors need further investigation as potential therapeutic agents for controlling weight gain. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  18. Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam

    PubMed Central

    Young, Melissa F.; Hong Nguyen, Phuong; Addo, O. Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-01-01

    Objective To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21–29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Methods Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Results Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21–29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46–0.70). Conclusion There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. Trial Registration ClinicalTrials.gov, NCT01665378 PMID:28114316

  19. Timing of Gestational Weight Gain on Fetal Growth and Infant Size at Birth in Vietnam.

    PubMed

    Young, Melissa F; Hong Nguyen, Phuong; Addo, O Yaw; Pham, Hoa; Nguyen, Son; Martorell, Reynaldo; Ramakrishnan, Usha

    2017-01-01

    To examine the importance of timing of gestational weight gain during three time periods: 1: ≤ 20 weeks gestation), 2: 21-29 weeks) and 3: ≥ 30 weeks) on fetal growth and infant birth size. Study uses secondary data from the PRECONCEPT randomized controlled trial in Thai Nguyen province, Vietnam (n = 1436). Prospective data were collected on women starting pre-pregnancy through delivery. Maternal conditional weight gain (CWG) was defined as window-specific weight gains, uncorrelated with pre-pregnancy body mass index and all prior body weights. Fetal biometry, was assessed by ultrasound measurements of head and abdomen circumferences, biparietal diameter, and femoral length throughout pregnancy. Birth size outcomes included weight and length, and head, abdomen and mid upper arm circumferences as well as small for gestational age (SGA). Adjusted generalized linear and logistic models were used to examine associations. Overall, three-quarters of women gained below the Institute of Medicine guidelines, and these women were 2.5 times more likely to give birth to a SGA infant. Maternal CWG in the first window (≤ 20 weeks), followed by 21-29 weeks, had the greatest association on all parameters of fetal growth (except abdomen circumference) and infant size at birth. For birth weight, a 1 SD increase CWG in the first 20 weeks had 3 times the influence compared to later CWG (≥ 30 weeks) (111 g vs. 39 g) and was associated with a 43% reduction in SGA risk (OR (95% CI): 0.57 (0.46-0.70). There is a need to target women before or early in pregnancy to ensure adequate nutrition to maximize impact on fetal growth and birth size. ClinicalTrials.gov, NCT01665378.

  20. Weight gain in preterm infants following parent-administered Vimala massage: a randomized controlled trial.

    PubMed

    Gonzalez, Alma Patricia; Vasquez-Mendoza, Guadalupe; García-Vela, Alfonso; Guzmán-Ramirez, Andres; Salazar-Torres, Marcos; Romero-Gutierrez, Gustavo

    2009-04-01

    Massage has been proposed as a way of facilitating development and growth of newborns through its effects on increasing blood flow, heart rate, digestion, and immunity. Massage might increase basal metabolism and nutrient absorption through endocrine effects such as increase in insulin and adrenaline and decrease in cortisol. Preliminary studies have suggested significant impact on weight gain with shortening of in-hospital stays of up to 6 days. We compared weight gain among preterm infants receiving Vimala massage plus usual care versus usual care alone. A randomized controlled trial was conducted. Sixty clinically stable preterm newborns with a corrected gestational age of 30 to 35 weeks receiving enteral nutrition in the hospital nursery were included. Half of them were assigned at random to receive Vimala massage twice daily for 10 days plus usual nursery care; the others received usual nursery care. Weight, head circumference, caloric intake, and nutritional method were recorded daily. Group characteristics were compared with analysis of variance, T test, and chi (2) test as appropriate. There were no differences between groups in gender, gestational age, initial weight, head circumference, and caloric intake and type of nutrition at baseline. Infants receiving massage had a larger weight gain versus the control group since the third day (188.2 +/- 41.20 g/kg versus 146.7 +/- 56.43 g/kg, P < 0.001). Hospital stay was shorter in infants receiving massage and usual nursery care (15.63 +/- 5.41 days versus 19.33 +/- 7.92 days, P = 0.03). The addition of parent-administered Vimala massage to usual nursery care resulted in increased weight gain and shorter hospital stay among clinically stable preterm newborns.

  1. Hormonal and Metabolic Effects of Olanzapine and Clozapine Related to Body Weight in Rodents

    PubMed Central

    Albaugh, Vance L.; Henry, Cathy R.; Bello, Nicholas T.; Hajnal, Andras; Lynch, Susan L.; Halle, Beth; Lynch, Christopher J.

    2009-01-01

    Objective To characterize a model of atypical antipsychotic drug-induced obesity and evaluate its mechanism. Research Methods and Procedures Chronically, olanzapine or clozapine was self-administered via cookie dough to rodents (Sprague-Dawley or Wistar rats; C57Bl/6J or A/J mice). Chronic studies measured food intake, body weight, adiponectin, active ghrelin, leptin, insulin, tissue wet weights, glucose, clinical chemistry endpoints, and brain dopaminergic D2 receptor density. Acute studies examined food intake, ghrelin, leptin, and glucose tolerance. Results Olanzapine (1 to 8 mg/kg), but not clozapine, increased body weight in female rats only. Weight changes were detectable within 2 to 3 days and were associated with hyperphagia starting ~24 hours after the first dose. Chronic administration (12 to 29 days) led to adiposity, hyperleptinemia, and mild insulin resistance; no lipid abnormalities or changes in D2 receptor density were observed. Topiramate, which has reversed weight gain from atypical anti-psychotics in humans, attenuated weight gain in rats. Acutely, olanzapine, but not clozapine, lowered plasma glucose and leptin. Increases in glucose, insulin, and leptin following a glucose challenge were also blunted. Discussion A model of olanzapine-induced obesity was characterized which shares characteristics of patients with atypical antipsychotic drug-induced obesity; these characteristics include hyperphagia, hyperleptinemia, insulin resistance, and weight gain attenuation by topiramate. This model may be a useful and inexpensive model of uncomplicated obesity amenable to rapid screening of weight loss drugs. Olanzapine-induced weight gain may be secondary to hyperphagia associated with acute lowering of plasma glucose and leptin, as well as the inability to increase plasma glucose and leptin following a glucose challenge. PMID:16493121

  2. Weight-gain misperceptions and the third-person effect in Black and White college-bound females: potential implications for healthy weight management.

    PubMed

    Webb, Jennifer B; Butler-Ajibade, Phoebe; Robinson, Seronda A; Lee, Shanique J

    2013-08-01

    Elements of social norm theory and communication theory on the third-person effect may prove useful in efforts to prevent excessive weight gain among emerging adults entering college. The present study explored the associations of race/ethnicity and BMI status with these socio-cognitive factors that may affect first-year weight regulation in a sample of Black (N = 247) and White (N = 94) college-bound females. Participants completed an online survey assessing first-year weight-gain perceived norms along with weight-change expectations and concerns. Results provided evidence of the persistence of the myth of the "Freshman 15", belief in the typicality of gaining weight during the first year of college, and significant concern about first-year weight gain. Initial findings further revealed a robust third-person effect whereby despite nearly 90% of the sample endorsing that first-year weight gain was common, only 12% expected they would experience weight gain. Main effects of race/ethnicity, BMI status, and their interaction further uncovered distinct patterns of findings. Preliminary results highlight the need for college health officials at both predominantly White as well as minority-serving institutions to adequately address the significant concern over first-year weight gain in conjunction with the desire to lose weight expressed by an appreciable number of incoming college females. Findings also advocate the utility of evaluating social norm theory and the third-person perceptual bias in the context of first-year weight gain to potentially enhance the design and effectiveness of healthy weight management initiatives among ethnically-diverse young women entering college. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. African American and White women׳s perceptions of weight gain, physical activity, and nutrition during pregnancy.

    PubMed

    Whitaker, Kara M; Wilcox, Sara; Liu, Jihong; Blair, Steven N; Pate, Russell R

    2016-03-01

    To describe African American and White women's perceptions of weight gain, physical activity, and nutrition during pregnancy and to explore differences in perceptions by race. Qualitative interview study. Two Ob/Gyn clinics in South Carolina, USA. Thirty pregnant women (15 African American, 15 White) between 20 and 30 weeks gestation, equally represented across pre-pregnancy BMI categories (10 normal weight, 10 overweight, and 10 obese). White women more frequently described intentions to meet weight gain, physical activity, and dietary guidelines in pregnancy than African American women. African American women were more concerned with inadequate weight gain while White women more commonly expressed concerns about excessive weight gain. More White women discussed the importance of physical activity for weight management. Regardless of race, few women described risks of excessive weight gain or benefits of physical activity as it relates to the baby's health. The primary cited barrier of healthy eating was the high cost of fresh produce. Several knowledge gaps as well as race differences were identified in women's perceptions and intentions toward weight gain, physical activity, and nutrition during pregnancy. Future interventions should seek to educate women about common misperceptions. It may be necessary to culturally tailor gestational weight gain interventions to optimise health outcomes. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. Effects of pre-pregnancy body mass index and gestational weight gain on infant anthropometric outcomes.

    PubMed

    Deierlein, Andrea L; Siega-Riz, Anna Maria; Adair, Linda S; Herring, Amy H

    2011-02-01

    To determine whether pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) influence infant postnatal growth. Participants were from the Pregnancy, Infection, and Nutrition study, a prospective pregnancy cohort. Term infants with weight or length measurements at approximately 6 months were included (n = 363). Multivariable regression estimated associations for weight-for-age (WAZ), length-for-age (LAZ), and weight-for-length z-scores (WLZ) and rapid infant weight gain with categorical maternal exposures defined with the 2009 Institute of Medicine recommendations. Pre-pregnancy overweight and obesity were associated with higher WAZ (linear regression coefficient [β], 0.32; 95% CI, 0.04-0.61) and WLZ (β, 0.39; 95% CI, 0.02-0.76), respectively. Pre-pregnancy BMI was not associated with LAZ. Excessive GWG was associated with higher WAZ (β, 0.39; 95% CI, 0.15-0.62) and LAZ (β, 0.34; 95% CI, 0.12-0.56). Excessive GWG ≥ 200% of recommended amount was associated with higher WAZ (β, 0.68; 95% CI, 0.28-1.07), LAZ (β, 0.45; 95% CI, 0.06-0.83), and WLZ (β, 0.43; 95% CI, 0.04-0.82). Risk of rapid weight gain increased across maternal exposure categories; however, none of the estimates were significant. Pre-pregnancy BMI and GWG are modifiable intrauterine exposures that influence infant postnatal anthropometric outcomes. Further investigation with infant body composition measurements is warranted. Copyright © 2011 Mosby, Inc. All rights reserved.

  5. Timing of Excessive Weight Gain During Pregnancy Modulates Newborn Anthropometry.

    PubMed

    Ruchat, Stephanie-May; Allard, Catherine; Doyon, Myriam; Lacroix, Marilyn; Guillemette, Laetitia; Patenaude, Julie; Battista, Marie-Claude; Ardilouze, Jean-Luc; Perron, Patrice; Bouchard, Luigi; Hivert, Marie-France

    2016-02-01

    Excessive gestational weight gain (GWG) is associated with increased birth weight and neonatal adiposity. However, timing of excessive GWG may have a differential impact on birth outcomes. The objective of this study was to compare the effect of early and mid/late excessive GWG on newborn anthropometry in the context of the Canadian clinical recommendations that are specific for first trimester and for second/third trimesters based on maternal pre-pregnancy BMI. We included 607 glucose-tolerant women in our main analyses, after excluding women who had less than the recommended total GWG. Maternal body weight was measured in early pregnancy, mid-pregnancy, and late pregnancy. Maternal and fetal clinical outcomes were collected, including newborn anthropometry. Women were divided into four groups according to the Canadian guidelines for GWG in the first and in the second/third trimesters: (1) "overall non-excessive" (reference group); (2) "early excessive GWG"; (3) "mid/late excessive GWG"; and (4) "overall excessive GWG." Differences in newborn anthropometry were tested across GWG categories. Women had a mean (±SD) pre-pregnancy BMI of 24.7 ± 5.2 kg/m(2) and total GWG of 15.3 ± 4.4 kg. Women with mid/late excessive GWG gave birth to heavier babies (gestational age-adjusted birth weight z-score 0.33 ± 0.91) compared with women in the reference group (0.00 ± 0.77, P = 0.007), whereas women with early excessive GWG gave birth to babies of similar weight (gestational age-adjusted z-score 0.01 ± 0.86) to the reference group (0.00 ± 0.77, P = 0.84). When we stratified our analyses and investigated women who gained within the recommendations for total GWG, mid/late excessive GWG specifically was associated with greater newborn size, similar to our main analyses. Excessive GWG in mid/late pregnancy in women who did not gain weight excessively in early pregnancy is associated with increased birth size, even in those who gained within the Canadian recommendations for total GWG. Copyright © 2016. Published by Elsevier Inc.

  6. Association between maternal nutritional status of pre pregnancy, gestational weight gain and preterm birth.

    PubMed

    Xinxo, Sonela; Bimbashi, Astrit; Z Kakarriqi, Eduard; Zaimi, Edmond

    2013-01-01

    Maternal nutritional status of pre pregnancy and gestational weight gain affects the preterm birth. The association between maternal nutritional status of pre pregnancy and preterm birth appears to be complex and varied by studies from different countries, thus this association between the gestational weight gain and preterm birth is more consolidated. The study aims to determine any association between the pre pregnancy maternal nutritional status, gestational weight gain and the preterm birth rate in the Albanian context. In case control study, we analyzed women who have delivered in obstetric institutions in Tirana during the year 2012. Body mass index and gestational weight gain of 150 women who had a preterm delivery were compared with those of 150 matched control women who had a normal delivery regarding the gestation age. The self-reported pre pregnancy weight, height, gestational weight gain, age, education and parity are collected through a structured questioner. The body mass index and gestational weight gain are categorized based on the Institute of Medicine recommendation. The multiple logistic regression is used to measure the association between the nutritional status of pre pregnancy and gestational weight gain and the preterm birth rate. The women which have a underweight status or obese of pre pregnancy are more likely to have a preterm birth compared to the women of a normal pre-pregnancy nutritional status (respectively OR =2.7 and 4.3 p<0.05). Women who do not reach the recommended gestational weight gain are more likely to have a preterm birth compared to the women which reach this weight (OR=1.8 p< 0.05). Maternal nutritional status and gestational weight gain affects the risk for preterm birth. Pre-pregnancy and gestation nutritional assessments should be part of routine prenatal visits.

  7. Neonatal Body Composition According to the Revised Institute of Medicine Recommendations for Maternal Weight Gain

    PubMed Central

    Huston-Presley, Larraine; Catalano, Patrick M.

    2012-01-01

    Background: In 2009, the Institute of Medicine (IOM) released revised pregnancy weight gain guidelines. There are limited data regarding the effect of maternal weight gain on newborn adiposity. Objective: The aim of this study was to estimate neonatal fat mass, lean body mass, and percentage body fat according to current Institute of Medicine (IOM) pregnancy weight gain guidelines. Design: This is a secondary analysis of a prospective observational cohort study of neonates delivered at least 36 wk gestation and evaluated for fat mass, lean body mass, and percentage body fat. Women with abnormal glucose tolerance testing and other known medical disorders or pregnancies with known fetal anomalies were excluded. Pregravid body mass index (BMI) was categorized as normal weight (<25 kg/m2), overweight (25–30 kg/m2), or obese (>30 kg/m2). Maternal weight gain was quantified as less than, equal to, or greater than current IOM guidelines. Newborn body composition measurements were compared according to weight gain and BMI categories. Results: A total of 439 maternal-newborn pairs were evaluated; 19.8% (n = 87) of women gained less than IOM guidelines; 31.9% (n = 140), equal to IOM guidelines; and 48.3% (n = 212), greater than IOM guidelines. Significant differences for each component of body composition were found when evaluated by IOM weight gain categories (all ANOVA, P < 0.001). When controlling for pregravid BMI, only weight gain for women who were of normal weight before pregnancy remained significant. Conclusion: Maternal weight gain during pregnancy is a significant contributor to newborn body composition, particularly for women who are of normal weight before pregnancy. PMID:22821895

  8. Gender differences in the impact of stressful life events on changes in body mass index.

    PubMed

    Udo, Tomoko; Grilo, Carlos M; McKee, Sherry A

    2014-12-01

    The positive association between stress and weight has been consistently demonstrated, particularly in women. The effect of stress on changes in weight, however, is less clear. A total of 33,425 participants in Wave 1 and Wave 2 surveys of the National Epidemiologic Survey on Alcohol and Related Condition (NESARC) were included in this study. The study examined the relationship between stressful life events during the 12months prior to the Wave 2 interview and changes in body mass index (BMI) between Wave 1 and Wave 2 interviews. Women reported significantly greater increases in BMI than men. Stressful life events, particularly job-related changes, legal problems, and death of family or friends, were associated significantly with increases in BMI among women but not men. In a nationally representative sample, stressful life events were associated with greater weight gain in women. Prevention of weight gain in women should focus on the behavioral and physiological mechanisms underlying female-specific effects of stressful life events on weight gain. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Maternal obesity and gestational weight gain are risk factors for infant death

    PubMed Central

    Bodnar, Lisa M.; Siminerio, Lara L.; Himes, Katherine P.; Hutcheon, Jennifer A.; Lash, Timothy L.; Parisi, Sara M.; Abrams, Barbara

    2015-01-01

    Objective To assess the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality. Methods We used Pennsylvania linked birth-infant death records (2003–2011) from infants without anomalies to underweight (n=58,973), normal weight (n=610,118), overweight (n=296,630), grade 1 obese (n=147,608), grade 2 obese (n=71,740), and grade 3 obese (n=47,277) mothers. Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z-scores of gestational weight gain and infant death after confounder adjustment. Results Infant mortality risk was lowest among normal weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grade 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal weight women. Conclusions Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. PMID:26572932

  10. Continuation of Gradual Weight Gain Necessary for the Onset of Puberty May Be Responsible for Obesity Later in Life

    PubMed Central

    Lehrer, Steven

    2016-01-01

    A continuation of the gradual weight gain necessary for the onset of puberty may be responsible for obesity later in life. Hypothetically, a group of brain nuclei form components of a single pubertal clock mechanism that drives pre-pubertal weight gain and governs the onset of puberty and fertility. No mechanism evolved to shut off pre-pubertal and pubertal weight and body fat gain after puberty. The weight gain continues unabated throughout life. A better understanding of the mechanism of puberty and pre-pubertal weight gain could provide new insights into obesity and diseases associated with obesity such as type 2 diabetes, dyslipidemia, hypertension, heart disease, depression, etc. PMID:26562472

  11. The impact of weight gain or loss on health care costs for employees at the Johnson & Johnson Family of Companies.

    PubMed

    Carls, Ginger Smith; Goetzel, Ron Z; Henke, Rachel Mosher; Bruno, Jennifer; Isaac, Fikry; McHugh, Janice

    2011-01-01

    To quantify the impact of weight gain or weight loss on health care costs. Employees completing at least two health risk assessments during 2002 to 2008 were classified as adding, losing, or staying at high/low risk for each of the nine health risks including overweight and obesity. Models for each risk were used to compare cost trends by controlling for employee characteristics. Employees who developed high risk for obesity (n = 405) experienced 9.9% points higher annual cost increases (95% confidence interval: 3.0%-16.8%) than those who remained at lower risk (n = 8015). Employees who moved from high to lower risk for obesity (n = 384), experienced annual cost increases that were 2.3% points lower (95% confidence interval: -7.4% to 2.8%) than those who remained high risk (n = 1699). Preventing weight gain through effective employee health promotion programs is likely to result in cost savings for employers.

  12. Individually Tailored, Adaptive Intervention to Manage Gestational Weight Gain: Protocol for a Randomized Controlled Trial in Women With Overweight and Obesity.

    PubMed

    Symons Downs, Danielle; Savage, Jennifer S; Rivera, Daniel E; Smyth, Joshua M; Rolls, Barbara J; Hohman, Emily E; McNitt, Katherine M; Kunselman, Allen R; Stetter, Christy; Pauley, Abigail M; Leonard, Krista S; Guo, Penghong

    2018-06-08

    High gestational weight gain is a major public health concern as it independently predicts adverse maternal and infant outcomes. Past interventions have had only limited success in effectively managing pregnancy weight gain, especially among women with overweight and obesity. Well-designed interventions are needed that take an individualized approach and target unique barriers to promote healthy weight gain. The primary aim of the study is to describe the study protocol for Healthy Mom Zone, an individually tailored, adaptive intervention for managing weight in pregnant women with overweight and obesity. The Healthy Mom Zone Intervention, based on theories of planned behavior and self-regulation and a model of energy balance, includes components (eg, education, self-monitoring, physical activity/healthy eating behaviors) that are adapted over the intervention (ie, increase in intensity) to better regulate weight gain. Decision rules inform when to adapt the intervention. In this randomized controlled trial, women are randomized to the intervention or standard care control group. The intervention is delivered from approximately 8-36 weeks gestation and includes step-ups in dosages (ie, Step-up 1 = education + physical activity + healthy eating active learning [cooking/recipes]; Step-up 2 = Step-up 1 + portion size, physical activity; Step-up 3 = Step-up 1 + 2 + grocery store feedback, physical activity); 5 maximum adaptations. Study measures are obtained at pre- and postintervention as well as daily (eg, weight), weekly (eg, energy intake/expenditure), and monthly (eg, psychological) over the study period. Analyses will include linear mixed-effects models, generalized estimating equations, and dynamical modeling to understand between-group and within-individual effects of the intervention on weight gain. Recruitment of 31 pregnant women with overweight and obesity has occurred from January 2016 through July 2017. Baseline data have been collected for all participants. To date, 24 participants have completed the intervention and postintervention follow-up assessments, 3 are currently in progress, 1 dropped out, and 3 women had early miscarriages and are no longer active in the study. Of the 24 participants, 13 women have completed the intervention to date, of which 1 (8%, 1/13) received only the baseline intervention, 3 (23%, 3/13) received baseline + step-up 1, 6 (46%, 6/13) received baseline + step-up 1 + step-up 2, and 3 (23%, 3/13) received baseline + step-up 1 + step-up 2 +step-up 3. Data analysis is still ongoing through spring 2018. This is one of the first intervention studies to use an individually tailored, adaptive design to manage weight gain in pregnancy. Results from this study will be useful in designing a larger randomized trial to examine efficacy of this intervention and developing strategies for clinical application. RR1-10.2196/9220. ©Danielle Symons Downs, Jennifer S Savage, Daniel E Rivera, Joshua M Smyth, Barbara J Rolls, Emily E Hohman, Katherine M McNitt, Allen R Kunselman, Christy Stetter, Abigail M Pauley, Krista S Leonard, Penghong Guo. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 08.06.2018.

  13. The cultural context of obesity: exploring perceptions of obesity and weight loss among Latina immigrants.

    PubMed

    Agne, April A; Daubert, Rebecca; Munoz, Maria L; Scarinci, Isabel; Cherrington, Andrea L

    2012-12-01

    This study used focus group methodology to examine perceptions of obesity and weight management among Latina immigrant women in Alabama. Four focus groups (N = 25) were conducted in Spanish as part of a participatory intervention development process. Participants were obese/overweight Latina immigrant women (BMI > 25) primarily recruited from a community hospital. The majority of participants were from Mexico. Participants described obesity in the context of short-term effects such as physical symptoms and aesthetics. Perceived weight gain was related to lifestyle changes since moving to the US. Social isolation, depression, and stress were reported to contribute to weight gain. Participants expressed interest in weight loss but emphasized a desire for programs that preserve traditional foods and include family. Weight-management programs designed for Latina immigrants should address their perceptions of obesity. This data also suggests that those interventions that preserve culture and incorporate family may have increased community buy-in.

  14. Long-term intake of saccharin decreases post-absortive energy expenditure at rest and is associated to greater weight gain relative to sucrose in wistar rats.

    PubMed

    Pinto, Denise Entrudo; Foletto, Kelly Carraro; Nunes, Ramiro Barcos; Lago, Pedro Dal; Bertoluci, Marcello Casaccia

    2017-01-01

    Non-nutritive sweeteners (NNS) have been associated with increased prevalence of obesity. In previous studies, we demonstrated that saccharin could induce an increase in weight gain either when compared to sucrose or to a non-sweetened control at a similar total caloric intake. These data raised the hypothesis that reduced energy expenditure (EE) could be a potential mechanism explaining greater weight gain with saccharin use in rats. The aim of the present study was to compare long-term energy expenditure at rest between rats using saccharin or sucrose and correlate it with weight gain. . In the present study, we examine the potential impact of saccharin compared to sucrose in the EE of Wistar rats. In a controlled experiment of 17 weeks, 24 Wistar rats were divided into 2 groups: saccharin-sweetened yogurt (SAC) or sucrose-sweetened yogurt (SUC), plus a free chow diet. Only rats that consumed at least 70% of the offered yogurt were included. EE (kcal/day) was determined at rest through open circuit indirect calorimetry system in the early post-absorptive period with determinations of both VO 2 consumption and CO 2 production. Measurements were evaluated at baseline, 5 and 12 weeks of dietary intervention. Weight gain, caloric intake (from yogurt, from chow and total) were determined weekly. Body weight and EE were similar between groups at baseline: ( p  = .35) and ( p  = .67) respectively. At the end of the study, SAC increased total weight gain significantly more in relation to SUC ( p  = .03). Cumulative total caloric intake (yogurt plus chow) was similar between groups during the whole period ( p  = .54). At 12 weeks, the EE was smaller in SAC compared to SUC ( p  = .009). Considering both groups, there was a strong negative correlation between total weight gain and change in EE observed [ r (20) = -.61, p  = .003]. However, when analyzing the groups separately we found that SUC maintained this inverse correlation [ r (8) = -.68, p  = .03], while SAC did not [ r (10) = -.33, p  = .29]. These data support the hypothesis that long-term use of saccharin may blunt post-absorptive EE at rest in Wistar rats, which is related to weight gain. On the other hand, long-term sucrose intake can increase energy expenditure in rats. This effect combined can explain, at least partially, the weight gain increases associated to saccharin in relation to sucrose in these animals.

  15. [Association between mothers' body mass index before pregnancy or weight gain during pregnancy and autism in children].

    PubMed

    Ling, Ziyu; Wang, Jianmin; Li, Xia; Zhong, Yan; Qin, Yuanyuan; Xie, Shengnan; Yang, Senbei; Zhang, Jing

    2015-09-01

    To explore the relationship between mothers' body mass index (BMI) before pregnancy or weight gain during pregnancy and autism in children. From 2013 to 2014, the 181 children with autism and 181 healthy children matched by sex and age from same area were included in this study. According to mothers' BMI before pregnancy, the selected cases were divided into 3 groups: low, normal and high group. Then 3 groups were divided into 3 subgroups based on mother' s weight gain during pregnancy: low, normal and high group, according to the recommendations of Institute of Medicine. Logistic regression analysis and χ(2) test were conducted with SPSS 18.0 software to analysis the relationship between mothers' BMI before pregnancy or weight gain during pregnancy and autism in children. The age and sex distributions of case group and control group were consistent (χ(2)=0.434, P>0.05). The mothers' BMI before pregnancy of case group was higher than that of control group (χ(2)=9.580, P<0.05) ,which was (21.28±3.80) kg/m(2) for case group and (19.87±2.83) kg/m(2) for control group. The proportion of cases in high BMI group (10.5%) was much higher than that in control group (2.8%) . The risk of children with autism in high BMI group was 3.7 times higher than that in normal BMI group (OR=3.71, 95% CI: 1.34-10.24). In normal BMI group, the proportion of mothers who had excessive weight gain during pregnancy was higher in case group (44.1%) than in control group (33.9%). In high BMI group, the proportion of mothers who had excessive weight gain was higher in case group (52.6%) than in control group (20.0%) . In normal BMI group (χ(2) =8.690, P<0.05) and high BMI group (χ(2)=4.775, P<0.05), the weight gain during pregnancy was associated with autism in children. Logistic regression analysis showed that mothers' BMI before pregnancy (unadjusted OR=1.89, 95% CI: 1.26-2.85, adjusted OR=1.52, 95% CI: 1.19-2.27) and weight gain during pregnancy were the risk factors for autism in children (unadjusted OR=1.63, 95% CI: 1.08-1.25, adjusted OR=1.64, 95% CI: 1.21-2.21). Overweight or obesity before pregnancy and excessive weight gain during pregnancy were associated with autism in children, suggesting that women who plan to be pregnant should pay attention to body weight control.

  16. Preventing weight gain in African American breast cancer survivors using smart scales and activity trackers: A randomized controlled pilot study

    PubMed Central

    Valle, Carmina G.; Deal, Allison M.; Tate, Deborah F.

    2016-01-01

    Purpose This study evaluated the feasibility and preliminary efficacy of two 6-month, self-regulation interventions that focused on daily self-weighing (DSW), and used objective monitoring and tailored feedback about weight (±activity), to prevent weight gain among African American breast cancer survivors. Methods Participants (n=35) were randomized to an intervention + activity monitoring (INT+), intervention (INT), or control (CON) group. Interventions included a wireless scale (±activity tracker) that transmitted objective data to a mobile app/website, emailed lessons, and tailored feedback based on objective weight (±activity data). Participants completed in-person and online assessments at baseline, 3 and 6 months. Results Ninety-four percent of participants completed assessments at 3 months, and 97% at 6 months. Median (IQR) weight change after 6 months was −0.9% (−4.4−0.1) in the INT+ (p=0.075; p=0.067 vs. CON) and −0.2% (−4.2−1.3) in the INT groups (p=0.463; p=0.357 vs. CON), versus a 0.2% (−0.7−1.7) gain in the CON group. The proportion of INT+, INT and CON participants that were at or below baseline weight was 72.7%, 53.8% and 45.5% respectively (effect sizes d=.64, d=.18). Most INT+ participants weighed and wore trackers ≥5 days/week (INT+, 81.9% vs. INT, 38.5% vs. CON, 0%; p< 0.0005; INT+, 72.7%). Both intervention groups perceived DSW as positive, and 100% would recommend the program to other breast cancer survivors. Conclusion An intervention focused on DSW as a self-monitoring strategy shows promise for preventing weight gain in breast cancer survivors. Implications for Cancer Survivors Daily self-monitoring of weight and activity may be a feasible and accessible approach to promote weight gain prevention in breast cancer survivors. PMID:27631874

  17. Weight-related self-efficacy in relation to maternal body weight from early pregnancy to 2 years post-partum.

    PubMed

    Lipsky, Leah M; Strawderman, Myla S; Olson, Christine M

    2016-07-01

    Excessive gestational weight gain may lead to long-term increases in maternal body weight and associated health risks. The purpose of this study was to examine the relationship between maternal body weight and weight-related self-efficacy from early pregnancy to 2 years post-partum. Women with live, singleton term infants from a population-based cohort study were included (n = 595). Healthy eating self-efficacy and weight control self-efficacy were assessed prenatally and at 1 year and 2 years post-partum. Body weight was measured at early pregnancy, before delivery, and 6 weeks, 1 year and 2 years post-partum. Behavioural (smoking, breastfeeding) and sociodemographic (age, education, marital status, income) covariates were assessed by medical record review and baseline questionnaires. Multi-level linear regression models were used to examine the longitudinal associations of self-efficacy measures with body weight. Approximately half of the sample (57%) returned to early pregnancy weight at some point by 2 years post-partum, and 9% became overweight or obese at 2 years post-partum. Body weight over time was inversely related to healthy eating (β = -0.57, P = 0.02) and weight control (β = -0.99, P < 0.001) self-efficacy in the model controlling for both self-efficacy measures as well as time and behavioural and sociodemographic covariates. Weight-related self-efficacy may be an important target for interventions to reduce excessive gestational weight gain and post-partum weight gain. © 2014 John Wiley & Sons Ltd.

  18. Low-income women's reproductive weight patterns empirically based clusters of prepregnant, gestational, and postpartum weights.

    PubMed

    Walker, Lorraine O

    2009-01-01

    Women have varying weight responses to pregnancy and the postpartum period. The purpose of this study was to derive sub-groups of women based on differing reproductive weight clusters; to validate clusters by reference to adequacy of gestational weight gain (GWG) and postpartum incremental weight shifts; and to examine associations between clusters and demographic, behavioral, and psychosocial variables. A cluster analysis was conducted of a multi-ethnic/racial sample of low-income women (n = 247). Clusters were derived from three weight variables: prepregnant body mass index, GWG, and postpartum retained weight. Five clusters were derived: Cluster 1, normal weight-high prenatal gain-average retain; cluster 2, normal weight-low prenatal gain-zero retain; cluster 3, high normal weight-high prenatal gain-high retain; cluster 4, obese-low prenatal gain-average retain; and cluster 5, overweight-very high prenatal gain-very high retain. Clusters differed with regard to postpartum weight shifts (p < .001), with clusters 3, 4, and 5, mostly gaining weight between 6 weeks and 12 months postpartum, whereas clusters 1 and 2 were losing weight. Clusters were also associated with race/ethnicity (p < .01), breastfeeding immediately postdelivery (p < .01), smoking at 12 months (p < .05), and reaching weight goals at 6 and 12 months (p < .001), but not depressive symptoms, fat intake habits, or physical activity. In a five-cluster solution, postpartum weight shifts, ethnicity, and initial breastfeeding were among factors associated with clusters. Monitoring of weight and appropriate intervention beyond the 6 weeks after birth is needed for low-income women in high normal weight, overweight, and obese clusters.

  19. Pre-Pregnancy Body Mass Index, Gestational Weight Gain, and Birth Weight: A Cohort Study in China.

    PubMed

    Yang, Shaoping; Peng, Anna; Wei, Sheng; Wu, Jing; Zhao, Jinzhu; Zhang, Yiming; Wang, Jing; Lu, Yuan; Yu, Yuzhen; Zhang, Bin

    2015-01-01

    To assess whether pre-pregnancy body mass index (BMI) modify the relationship between gestational weight gain (GWG) and child birth weight (specifically, presence or absence of low birth weight (LBW) or presence of absence of macrosomia), and estimates of the relative risk of macrosomia and LBW based on pre-pregnancy BMI were controlled in Wuhan, China. From June 30, 2011 to June 30, 2013. All data was collected and available from the perinatal health care system. Logistic regression models were used to estimate the independent association among pregnancy weight gain, LBW, normal birth weight, and macrosomia within different pre-pregnancy BMI groups. We built different logistic models for the 2009 Institute of Medicine (IOM) Guidelines and Chinese-recommended GWG which was made from this sample. The Chinese-recommended GWG was derived from the quartile values (25th-75th percentiles) of weight gain at the time of delivery in the subjects which comprised our sample. For LBW children, using the recommended weight gain of the IOM and Chinese women as a reference, the OR for a pregnancy weight gain below recommendations resulted in a positive relationship for lean and normal weight women, but not for overweight and obese women. For macrosomia, considering the IOM's recommended weight gain as a reference, the OR magnitude for pregnancy weight gain above recommendations resulted in a positive correlation for all women. The OR for a pregnancy weight gain below recommendations resulted in a negative relationship for normal BMI and lean women, but not for overweight and obese women based on the IOM recommendations, significant based on the recommended pregnancy weight gain for Chinese women. Of normal weight children, 56.6% were above the GWG based on IOM recommendations, but 26.97% of normal weight children were above the GWG based on Chinese recommendations. A GWG above IOM recommendations might not be helpful for Chinese women. We need unified criteria to classify adult BMI and to expand the sample size to improve representation and to elucidate the relationship between GWG and related outcomes for developing a Chinese GWG recommendation.

  20. Pre-Pregnancy Body Mass Index, Gestational Weight Gain, and Birth Weight: A Cohort Study in China

    PubMed Central

    Wei, Sheng; Wu, Jing; Zhao, Jinzhu; Zhang, Yiming; Wang, Jing; Lu, Yuan; Yu, Yuzhen; Zhang, Bin

    2015-01-01

    Objective To assess whether pre-pregnancy body mass index (BMI) modify the relationship between gestational weight gain (GWG) and child birth weight (specifically, presence or absence of low birth weight (LBW) or presence of absence of macrosomia), and estimates of the relative risk of macrosomia and LBW based on pre-pregnancy BMI were controlled in Wuhan, China. Methods From June 30, 2011 to June 30, 2013. All data was collected and available from the perinatal health care system. Logistic regression models were used to estimate the independent association among pregnancy weight gain, LBW, normal birth weight, and macrosomia within different pre-pregnancy BMI groups. We built different logistic models for the 2009 Institute of Medicine (IOM) Guidelines and Chinese-recommended GWG which was made from this sample. The Chinese-recommended GWG was derived from the quartile values (25th-75th percentiles) of weight gain at the time of delivery in the subjects which comprised our sample. Results For LBW children, using the recommended weight gain of the IOM and Chinese women as a reference, the OR for a pregnancy weight gain below recommendations resulted in a positive relationship for lean and normal weight women, but not for overweight and obese women. For macrosomia, considering the IOM’s recommended weight gain as a reference, the OR magnitude for pregnancy weight gain above recommendations resulted in a positive correlation for all women. The OR for a pregnancy weight gain below recommendations resulted in a negative relationship for normal BMI and lean women, but not for overweight and obese women based on the IOM recommendations, significant based on the recommended pregnancy weight gain for Chinese women. Of normal weight children, 56.6% were above the GWG based on IOM recommendations, but 26.97% of normal weight children were above the GWG based on Chinese recommendations. Conclusions A GWG above IOM recommendations might not be helpful for Chinese women. We need unified criteria to classify adult BMI and to expand the sample size to improve representation and to elucidate the relationship between GWG and related outcomes for developing a Chinese GWG recommendation. PMID:26115015

  1. The Effect of Adequate Gestational Weight Gain among Adolescents Relative to Adults of Equivalent Body Mass Index and the Risk of Preterm Birth, Cesarean Delivery, and Low Birth Weight.

    PubMed

    Houde, Michele; Dahdouh, Elias M; Mongrain, Vanessa; Dubuc, Elise; Francoeur, Diane; Balayla, Jacques

    2015-12-01

    To determine whether similar odds of cesarean delivery (C/S), preterm birth (PTB), and low birth weight (LBW) are observed among adolescents compared with body mass index (BMI)-equivalent adults in cases of adequate gestational weight gain. We conducted a retrospective, population-based, cohort study using the Center for Disease Control and Prevention's birth data files from the United States for 2012. We selected from the cohort all singleton, cephalic pregnancies and stratified them according to maternal age, prepregnancy BMI, and gestational weight gain following the 2009 Institute of Medicine (IOM) recommendations. The effect of adequate gestational weight gain among adolescents relative to adults of equivalent BMI on the risk of C/S, PTB, and LBW was estimated using logistic regression analysis, adjusting for relevant confounders. We analyzed a total of 3,960,796 births, of which 1,036,646 (26.1%) met the inclusion criteria. In adolescents and adults, likelihood of achieving ideal gestational weight gain decreased with greater prepregnancy BMI. Relative to adults, the overall odds of C/S in all adolescents were (adjusted odds ratio [95% confidence interval]) 0.61 (0.58 to 0.63). When comparing equivalent BMI categories, these odds were unchanged (P < .0001). The overall adjusted odds ratio of LBW was 1.15 (1.13 to 1.16). These odds were significantly higher when BMI stratification took place, decreasing with advancing BMI categories, from 1.23 (1.14 to 1.33) among the underweight, to nonsignificant differences in the obese classes (P < .05). Finally, when including only those achieving ideal weight gain, the overall odds of premature delivery (1.17 [1.14 to 1.20]) were higher among nonobese adolescents, while they were not found among the obese. When ideal gestational weight gain is attained, only nonobese adolescents exhibit a greater risk of LBW and preterm birth relative to adults of similar BMI, whereas the risk of C/S remains lower for all adolescents, independent of BMI. This information may be useful in the counseling of adolescent pregnancies. Copyright © 2015 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  2. Nutritional interventions for optimizing healthy body composition in older adults in the community: an umbrella review of systematic reviews.

    PubMed

    Schultz, Timothy J; Roupas, Peter; Wiechula, Richard; Krause, Debra; Gravier, Susan; Tuckett, Anthony; Hines, Sonia; Kitson, Alison

    2016-08-01

    Optimizing body composition for healthy aging in the community is a significant challenge. There are a number of potential interventions available for older people to support both weight gain (for those who are underweight) and weight loss (for overweight or obese people). While the benefits of weight gain for underweight people are generally clearly defined, the value of weight loss in overweight or obese people is less clear, particularly for older people. This umbrella review aimed to measure the effectiveness of nutritional interventions for optimizing healthy body composition in older adults living in the community and to explore theirqualitative perceptions. The participants were older adults, 60 years of age or older, living in the community. The review examinedsix types of nutritional interventions: (i) dietary programs, (ii) nutritional supplements, (iii) meal replacements, (iv) food groups, (v) food delivery support and eating behavior, and (vi) nutritional counselling or education. This umbrella review considered any quantitative systematic reviews and meta-analyses of effectiveness, or qualitative systematic reviews, or a combination (i.e. comprehensive reviews). The quantitative outcome measures of body composition were: (i) nutritional status (e.g. proportion of overweight or underweight patients); (ii) fat mass (kg), (iii) lean mass or muscle mass (kg), (iv) weight (kg) or BMI (kg/m), (v) bone mass (kg) or bone measures such as bone mineral density, and (vi) hydration status. The phenomena of interestwere the qualitative perceptions and experiences of participants. We developed an iterative search strategy for nine bibliometric databases and gray literature. Critical appraisal of 13 studies was conducted independently in pairs using standard Joanna Briggs Institute tools. Six medium quality and seven high quality studies were identified. Data was extracted independently in pairs from all 13 included studies using the standard Joanna Briggs Institute data extraction tool. Only quantitative studies of effectiveness were included. The strength of evidence assessing the effectiveness of interventionswas graded using a traffic light system (green, amber, red). An overall assessment of the quality of the evidence for each comparison was undertaken. More systematic reviews investigating weight gain than those investigating weight loss were included. Studies onweight gain showed improved body composition for oral nutritional supplements on its own, for oral nutritional supplements in combination with resistance exercise training, and for oral nutritional supplements in combination with nutrition counselling. Studies on weight loss showed that diet in combination with exercise, diet in combination with exercise and nutrition counselling, and nutrition counselling on its own all can lead to reduced weight in older people. The outcomes of lean mass and weight/BMI were responsive to nutritional interventions, but fat mass did not vary. There were no qualitative reviews identified. Although effective interventions for weight gain and weight loss to optimize body composition of older people in the community were identified,making long term, clinically relevant changes in body composition is difficult. Multiple interventions are more effective than single interventions.

  3. Iatrogenic Subclinical Hyperthyroidism Does Not Promote Weight Loss.

    PubMed

    Kedia, Rohit; Lowes, Alicia; Gillis, Sarah; Markert, Ronald; Koroscil, Thomas

    2016-02-01

    Among patients who have undergone total thyroidectomy, do those with thyroid cancer being kept iatrogenically subclinical hyperthyroid (SCH) differ from euthyroid patients in long-term weight change? In a retrospective study, medical records identified 291 patients who had undergone a thyroidectomy for differentiated thyroid cancer or benign thyroid disease. Weight, thyroid-stimulating hormone, and levothyroxine dose were measured presurgery and 1, 2, and 3 years postsurgery. Of 291 patients, 147 were in the SCH group and 144 were in the euthyroid group. At all 3 years both groups gained weight from baseline, but the two groups did not differ in weight change from baseline at any time period: year 1 (SCH mean 0.4% ± 6.2% weight gain vs euthyroid group mean 2.2% ± 6.6% weight gain; P = 0.12), year 2 (SCH mean 1.1% ± 9.1% weight gain vs euthyroid mean 2.9% ± 7.8% weight gain; P = 0.22), and year 3 (SCH mean 2.6% ± 9.2% weight gain vs euthyroid mean 3.1% ± 11.1% weight gain; P = 0.49). Among total thyroidectomy patients, weight change did not differ between SCH patients and euthyroid patients at years 1 through 3. As such, the use of levothyroxine to induce SCH did not lead to long-term weight change when compared with euthyroid patients.

  4. Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance.

    PubMed

    Barber, Thomas M; Dimitriadis, George K; Andreou, Avgi; Franks, Stephen

    2016-06-01

    Polycystic ovary syndrome (PCOS) is a common condition that typically develops in reproductive-age women. The cardinal clinical and biochemical characteristics of PCOS include reproductive dysfunction and hyperandrogenic features. PCOS is also strongly associated with obesity based on data from epidemiological and genetic studies. Accordingly, PCOS often becomes manifest in those women who carry a genetic predisposition to its development, and who also gain weight. The role of weight gain and obesity in the development of PCOS is mediated at least in part, through worsening of insulin resistance. Compensatory hyperinsulinaemia that develops in this context disrupts ovarian function, with enhanced androgen production and arrest of ovarian follicular development. Insulin resistance also contributes to the strong association of PCOS with adverse metabolic risk, including dysglycaemia, dyslipidaemia and fatty liver. Conversely, modest weight loss of just 5% body weight with improvement in insulin sensitivity, frequently results in clinically meaningful improvements in hyperandrogenic, reproductive and metabolic features. Future developments of novel therapies for obese women with PCOS should focus on promotion of weight loss and improvement in insulin sensitivity. In this context, therapies that complement lifestyle changes such as dietary modification and exercise, particularly during the maintenance phase of weight loss are important. Putative novel targets for therapy in PCOS include human brown adipose tissue. © 2016 Royal College of Physicians.

  5. Weight Gain in Infancy and Overweight or Obesity in Childhood across the Gestational Spectrum: a Prospective Birth Cohort Study.

    PubMed

    Wang, Guoying; Johnson, Sara; Gong, Yiwei; Polk, Sarah; Divall, Sara; Radovick, Sally; Moon, Margaret; Paige, David; Hong, Xiumei; Caruso, Deanna; Chen, Zhu; Mallow, Eric; Walker, Sheila O; Mao, Guangyun; Pearson, Colleen; Wang, Mei-Cheng; Zuckerman, Barry; Cheng, Tina L; Wang, Xiaobin

    2016-07-15

    This study aimed to investigate the optimal degree of weight gain across the gestational spectrum in 1971 children enrolled at birth and followed up to age 7 years. Weight gain in infancy was categorized into four groups based on weight gain z-scores: slow (<-0.67), on track (-0.67 to 0.67), rapid (0.67 to 1.28), and extremely rapid (>1.28). Underweight and overweight or obesity (OWO) were defined as a body mass index ≤5(th) and ≥85(th) percentile, respectively, for age and gender. In our population, OWO was far more common than underweight (39.7% vs. 3.6%). Weight gain tracked strongly from age 4 to 24 months, and was positively associated with OWO and an unfavorable pattern of metabolic biomarkers, although the degree of weight gain for the risk was different across gestational categories. Extremely rapid weight gain led to a particularly high risk of OWO among children born early term and late preterm: odds ratio: 3.3 (95% confidence interval: 1.9 to 5.5) and 3.7 (1.8 to 7.5), respectively, as compared to those with on track weight gain. Our findings suggest that monitoring and ensuring optimal weight gain across the entire gestational spectrum beginning from birth represents a first step towards primary prevention of childhood obesity.

  6. Effect of Gestational Weight Gain and Prepregnancy Body Mass Index in Adolescent Mothers on Weight and Body Mass Index of Adolescent Offspring.

    PubMed

    Groth, Susan W; Holland, Margaret L; Smith, Joyce A; Meng, Ying; Kitzman, Harriet

    2017-11-01

    The purpose of the study was to examine the association of the gestational weight gain and prepregnancy body mass index (BMI) of low-income adolescent mothers with the risk of their children being overweight and/or obese in late adolescence. Study subjects were low-income, primiparous adolescents (n = 360) who self-identified as black and participated in the New Mothers Study in Memphis, Tennessee, and their children. Gestational weight gain was examined as a continuous variable and also categorized into overgain, recommended gain, and undergain following the 2009 Institute of Medicine guidelines. The effects of maternal prepregnancy BMI percentiles and calculated BMI were also considered. Multivariable logistic and linear regression models were used. The main outcome measures were offspring overweight, obesity, and BMI. Thirty-nine percent of offspring were overweight or obese. Higher maternal gestational weight gain increased the risk for offspring overweight and obesity. There was an interaction between gestational weight gain and prepregnancy BMI: offspring of mothers with a BMI percentile ≤76 were at greater risk of obesity with higher maternal weight gain. If mothers with a BMI percentile between the 29th and 83rd percentiles overgained, offspring were at greater risk for overweight. Using calculated BMIs, if a mother's BMI was ≤26 kg/m 2 , offspring risk for obesity was greater with higher gestational weight gain. High gestational weight gain had a larger effect on offspring overweight and obesity if maternal prepregnancy BMI percentile was ≤76. The gestational weight gain of primiparous adolescents who self-identified as black had an effect on offspring weight. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  7. Urinary concentrations of bisphenol A and phthalate metabolites and weight change: a prospective investigation in US women

    PubMed Central

    Song, Y; Hauser, R; Hu, FB; Franke, AA; Liu, S; Sun, Q

    2015-01-01

    OBJECTIVE Both bisphenol A (BPA) and phthalates are known endocrine-disrupting chemicals for which there is widespread general population exposure. Human exposure occurs through dietary and non-dietary routes. Although animal studies have suggested a potential role of these chemicals in obesity, evidence from human studies is sparse and inconsistent, and prospective evidence is lacking. This study evaluated urinary concentrations of BPA and major phthalate metabolites in relation to prospective weight change. METHODS The study population was from the controls in a prospective case-control study of type 2 diabetes in the Nurses’ Health Study (NHS) and NHSII. A total of 977 participants provided first-morning-void urine samples in 1996–2002. Urinary concentrations of BPA and nine phthalate metabolites were measured using liquid chromatography–mass spectrometry. Body weights were self-reported at baseline and updated biennially thereafter for 10 years. RESULTS On average, the women gained 2.09 kg (95% confidence interval (CI), − 2.27 to 6.80 kg) during the 10-year follow-up. In multivariate analysis with adjustment of lifestyle and dietary factors, in comparison with women in the lowest quartile of BPA concentration, those in the highest quartile had 0.23 kg per year (95% CI, 0.07–0.38 kg per year) greater weight gain during the 10-year follow-up (P-trend = 0.02). Several phthalate metabolites, including phthalic acid, MBzP and monobutyl phthalate, were also associated with faster prospective weight gain in a dose-response fashion (P-trend < 0.01), whereas other phthalates metabolites, including MEP and monoethylhexyl phthalate, were not monotonically associated with body weight change. CONCLUSIONS These data suggest urinary concentrations of BPA and certain individual phthalate metabolites that were associated with modestly greater weight gain in a dose-response fashion. These data are consistent with a potential role of BPA and phthalates in obesity, although more prospective data are needed to corroborate these observations. PMID:24722546

  8. Urinary concentrations of bisphenol A and phthalate metabolites and weight change: a prospective investigation in US women.

    PubMed

    Song, Y; Hauser, R; Hu, F B; Franke, A A; Liu, S; Sun, Q

    2014-12-01

    Both bisphenol A (BPA) and phthalates are known endocrine-disrupting chemicals for which there is widespread general population exposure. Human exposure occurs through dietary and non-dietary routes. Although animal studies have suggested a potential role of these chemicals in obesity, evidence from human studies is sparse and inconsistent, and prospective evidence is lacking. This study evaluated urinary concentrations of BPA and major phthalate metabolites in relation to prospective weight change. The study population was from the controls in a prospective case-control study of type 2 diabetes in the Nurses' Health Study (NHS) and NHSII. A total of 977 participants provided first-morning-void urine samples in 1996-2002. Urinary concentrations of BPA and nine phthalate metabolites were measured using liquid chromatography-mass spectrometry. Body weights were self-reported at baseline and updated biennially thereafter for 10 years. On average, the women gained 2.09 kg (95% confidence interval (CI), -2.27 to 6.80 kg) during the 10-year follow-up. In multivariate analysis with adjustment of lifestyle and dietary factors, in comparison with women in the lowest quartile of BPA concentration, those in the highest quartile had 0.23 kg per year (95% CI, 0.07-0.38 kg per year) greater weight gain during the 10-year follow-up (P-trend=0.02). Several phthalate metabolites, including phthalic acid, MBzP and monobutyl phthalate, were also associated with faster prospective weight gain in a dose-response fashion (P-trend<0.01), whereas other phthalates metabolites, including MEP and monoethylhexyl phthalate, were not monotonically associated with body weight change. These data suggest urinary concentrations of BPA and certain individual phthalate metabolites that were associated with modestly greater weight gain in a dose-response fashion. These data are consistent with a potential role of BPA and phthalates in obesity, although more prospective data are needed to corroborate these observations.

  9. Gestational Weight Gain and Post-Partum Weight Loss Among Young, Low-Income, Ethnic Minority Women

    PubMed Central

    ROTHBERG, Bonnie E. Gould; MAGRIPLES, Urania; KERSHAW, Trace S.; RISING, Sharon Schindler; ICKOVICS, Jeannette R.

    2010-01-01

    Objective Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by Institute of Medicine (IOM). Methods Women aged 14-25 receiving prenatal care and delivering singleton infants at term (N=427). Medical record review and four structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories. Results Only 22% of participants gained gestational weight within IOM guidelines. 62% exceeded maximum recommendations -- more common among those overweight/obese (BMI≥25.0; p<0.0001). 52% retained ≥10 pounds one-year postpartum. Increased weight gain and retention documented among smokers and women with pregnancy-induced hypertension; breastfeeding promoted postpartum weight loss (all p<.02). BMI by race interaction suggested healthier outcomes for Latinas (p=0.02). Conclusion Excessive pregnancy weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions. PMID:20974459

  10. Postnatal Weight Gain Modifies Severity and Functional Outcome of Oxygen-Induced Proliferative Retinopathy

    PubMed Central

    Stahl, Andreas; Chen, Jing; Sapieha, Przemyslaw; Seaward, Molly R.; Krah, Nathan M.; Dennison, Roberta J.; Favazza, Tara; Bucher, Felicitas; Löfqvist, Chatarina; Ong, Huy; Hellström, Ann; Chemtob, Sylvain; Akula, James D.; Smith, Lois E.H.

    2010-01-01

    In clinical studies, postnatal weight gain is strongly associated with retinopathy of prematurity (ROP). However, animal studies are needed to investigate the pathophysiological mechanisms of how postnatal weight gain affects the severity of ROP. In the present study, we identify nutritional supply as one potent parameter that affects the extent of retinopathy in mice with identical birth weights and the same genetic background. Wild-type pups with poor postnatal nutrition and poor weight gain (PWG) exhibit a remarkably prolonged phase of retinopathy compared to medium weight gain or extensive weight gain pups. A high (r2 = 0.83) parabolic association between postnatal weight gain and oxygen-induced retinopathy severity is observed, as is a significantly prolonged phase of proliferative retinopathy in PWG pups (20 days) compared with extensive weight gain pups (6 days). The extended retinopathy is concomitant with prolonged overexpression of retinal vascular endothelial growth factor in PWG pups. Importantly, PWG pups show low serum levels of nonfasting glucose, insulin, and insulin-like growth factor-1 as well as high levels of ghrelin in the early postoxygen-induced retinopathy phase, a combination indicative of poor metabolic supply. These differences translate into visual deficits in adult PWG mice, as demonstrated by impaired bipolar and proximal neuronal function. Together, these results provide evidence for a pathophysiological correlation between poor postnatal nutritional supply, slow weight gain, prolonged retinal vascular endothelial growth factor overexpression, protracted retinopathy, and reduced final visual outcome. PMID:21056995

  11. Postnatal weight gain modifies severity and functional outcome of oxygen-induced proliferative retinopathy.

    PubMed

    Stahl, Andreas; Chen, Jing; Sapieha, Przemyslaw; Seaward, Molly R; Krah, Nathan M; Dennison, Roberta J; Favazza, Tara; Bucher, Felicitas; Löfqvist, Chatarina; Ong, Huy; Hellström, Ann; Chemtob, Sylvain; Akula, James D; Smith, Lois E H

    2010-12-01

    In clinical studies, postnatal weight gain is strongly associated with retinopathy of prematurity (ROP). However, animal studies are needed to investigate the pathophysiological mechanisms of how postnatal weight gain affects the severity of ROP. In the present study, we identify nutritional supply as one potent parameter that affects the extent of retinopathy in mice with identical birth weights and the same genetic background. Wild-type pups with poor postnatal nutrition and poor weight gain (PWG) exhibit a remarkably prolonged phase of retinopathy compared to medium weight gain or extensive weight gain pups. A high (r(2) = 0.83) parabolic association between postnatal weight gain and oxygen-induced retinopathy severity is observed, as is a significantly prolonged phase of proliferative retinopathy in PWG pups (20 days) compared with extensive weight gain pups (6 days). The extended retinopathy is concomitant with prolonged overexpression of retinal vascular endothelial growth factor in PWG pups. Importantly, PWG pups show low serum levels of nonfasting glucose, insulin, and insulin-like growth factor-1 as well as high levels of ghrelin in the early postoxygen-induced retinopathy phase, a combination indicative of poor metabolic supply. These differences translate into visual deficits in adult PWG mice, as demonstrated by impaired bipolar and proximal neuronal function. Together, these results provide evidence for a pathophysiological correlation between poor postnatal nutritional supply, slow weight gain, prolonged retinal vascular endothelial growth factor overexpression, protracted retinopathy, and reduced final visual outcome.

  12. Weight gain in women diagnosed with breast cancer.

    PubMed

    Demark-Wahnefried, W; Rimer, B K; Winer, E P

    1997-05-01

    This review of the literature indicates that weight gain is a common observation among women after the diagnosis of breast cancer. Gains in weight range from 0 to 50 lb and are influenced by menopausal status; nodal status; and the type, duration, and intensity of treatment. Weight gain appears to be greater among premenopausal women; among those who are node positive; and among those receiving higher dose, longer duration, and multiagent regimens. Psychosocial research suggests that weight gain has a profoundly negative impact on quality of life in patients with breast cancer. Recent findings also suggest that weight gain during therapy may increase the risk of recurrence and decrease survival. Although weight gain in patients with breast cancer is clinically well appreciated, little research has been conducted to investigate the underlying mechanisms of energy imbalance. Changes in rates of metabolism, physical activity, and dietary intake are all plausible mechanisms and call for more research. Further study will provide valuable insight into the problem of weight gain and encourage effective interventions to improve the quality and quantity of life for the woman with breast cancer. Until more is known, however, dietetics practitioners will have to monitor and work individually with patients with breast cancer and use empirical approaches to achieve the important goal of weight management.

  13. Weight Changes in Euthyroid Patients Undergoing Thyroidectomy

    PubMed Central

    Nsouli-Maktabi, Hala

    2011-01-01

    Background Thyroidectomized patients frequently report weight gain resistant to weight loss efforts, identifying their thyroidectomy as the event precipitating subsequent weight gain. We wished to determine whether recently thyroidectomized euthyroid patients gained more weight over 1 year than matched euthyroid patients with preexisting hypothyroidism. Methods We performed a retrospective chart review of subjects receiving medical care at an academic medical center. One hundred twenty patients had their weight and thyroid status documented after thyroidectomy and achievement of euthyroidism on thyroid hormone replacement, and one year later. Three additional groups of 120 patients with preexisting hypothyroidism, no thyroid disease, and thyroid cancer were matched for age, gender, menopausal status, height, and weight. Anthropometric data were documented at two time points 1 year apart. We compared the weight changes and body mass index changes occurring over a 1-year period in the four groups. Results Patients with recent postsurgical hypothyroidism gained 3.1 kg during the year, whereas matched patients with preexisting hypothyroidism gained 2.2 kg. The patients without thyroid disease and those with iatrogenic hyperthyroidism gained 1.3 and 1.2 kg, respectively. The weight gain in the thyroidectomized group was significantly greater than that in the matched hypothyroid group (p-value 0.004), the group without thyroid disease (p-value 0.001), and the patients with iatrogenic hyperthyroidism (p-value 0.001). Within the thyroidectomized group, the weight gain in menopausal women was greater than in either premenopausal women (4.4 vs. 2.3 kg, p-value 0.007) or men (4.4 vs. 2.5 kg, p-value 0.013). Conclusion Patients who had undergone thyroidectomy in the previous year did, in fact, gain more weight than their matched counterparts with preexisting hypothyroidism. In addition, all patients with hypothyroidism, even though treated to achieve euthyroidism, experienced more weight gain than both subjects without hypothyroidism and subjects with iatrogenic hyperthyroidism. The greatest weight gain in the thyroidectomized group was in menopausal women. These data raise the question of an unidentified factor related to taking thyroid hormone replacement that is associated with weight gain, with an additional intriguing effect of thyroidectomy itself. Menopausal status confers additional risk. These groups should be targeted for diligent weight loss efforts. PMID:22066482

  14. Weight Control in Adolescents: Focus Groups With Korean Adolescents and Their Teachers.

    PubMed

    Chae, Sun-Mi; Yeo, Ji-Young; Hwang, Ji-Hye; Lee, Ji-Hye; Lim, Jiyoung; Kwon, Insook

    This qualitative descriptive study sought to identify perceptions about and status of weight control in adolescents from the perspective of adolescents and their teachers. Focus groups were used with six separate groups, 20 adolescents divided into four groups and 14 teachers divided into two groups. The qualitative data were analyzed using a thematic analysis in NVivo 11.0. Consolidated criteria for reporting qualitative studies (COREQ) were followed. We extracted three themes and 12 sub-themes with 52 meaningful codes. Both adolescents and teachers stated that perceptions about weight control in adolescents were overly weighted toward management of one's appearance. The adolescents reported an increase in weight gained during adolescence, especially after entering high school, and they noted a lack of participation in physical activities and the presence of unhealthy dietary behaviors. However, adolescents perceived excessive weight gain during adolescence as natural, as long as they studied hard. Their teachers and parents were also permissive about weight gain resulted from study. The participants suggested that a weight control program for adolescents should be conducted in schools and should include every student in order to avoid discrimination. In addition, teacher involvement was emphasized to promote participation of adolescents in a school program. Our findings indicate that adolescents, especially those in a society emphasizing academics, need to practice healthy weight control behaviors. A school-based weight control program involving teachers and peers would be suitable and should be provided to all students regardless of weight classification. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Weight Fluctuation and Postmenopausal Breast Cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study.

    PubMed

    Komaroff, Marina

    2016-01-01

    The aim of this study is to investigate if weight fluctuation is an independent risk factor for postmenopausal breast cancer (PBC) among women who gained weight in adult years. NHANES I Epidemiologic Follow-Up Study (NHEFS) database was used in the study. Women that were cancers-free at enrollment and diagnosed for the first time with breast cancer at age 50 or greater were considered cases. Controls were chosen from the subset of cancers-free women and matched to cases by years of follow-up and status of body mass index (BMI) at 25 years of age. Weight fluctuation was measured by the root-mean-square-error (RMSE) from a simple linear regression model for each woman with their body mass index (BMI) regressed on age (started at 25 years) while women with the positive slope from this regression were defined as weight gainers. Data were analyzed using conditional logistic regression models. A total of 158 women were included into the study. The conditional logistic regression adjusted for weight gain demonstrated positive association between weight fluctuation in adult years and postmenopausal breast cancers (odds ratio/OR = 1.67; 95% confidence interval/CI: 1.06-2.66). The data suggested that long-term weight fluctuation was significant risk factor for PBC among women who gained weight in adult years. This finding underscores the importance of maintaining lost weight and avoiding weight fluctuation.

  16. Weight Fluctuation and Postmenopausal Breast Cancer in the National Health and Nutrition Examination Survey I Epidemiologic Follow-Up Study

    PubMed Central

    Komaroff, Marina

    2016-01-01

    Objective. The aim of this study is to investigate if weight fluctuation is an independent risk factor for postmenopausal breast cancer (PBC) among women who gained weight in adult years. Methods. NHANES I Epidemiologic Follow-Up Study (NHEFS) database was used in the study. Women that were cancers-free at enrollment and diagnosed for the first time with breast cancer at age 50 or greater were considered cases. Controls were chosen from the subset of cancers-free women and matched to cases by years of follow-up and status of body mass index (BMI) at 25 years of age. Weight fluctuation was measured by the root-mean-square-error (RMSE) from a simple linear regression model for each woman with their body mass index (BMI) regressed on age (started at 25 years) while women with the positive slope from this regression were defined as weight gainers. Data were analyzed using conditional logistic regression models. Results. A total of 158 women were included into the study. The conditional logistic regression adjusted for weight gain demonstrated positive association between weight fluctuation in adult years and postmenopausal breast cancers (odds ratio/OR = 1.67; 95% confidence interval/CI: 1.06–2.66). Conclusions. The data suggested that long-term weight fluctuation was significant risk factor for PBC among women who gained weight in adult years. This finding underscores the importance of maintaining lost weight and avoiding weight fluctuation. PMID:26953120

  17. Birth weight, maternal weight and childhood leukaemia

    PubMed Central

    McLaughlin, C C; Baptiste, M S; Schymura, M J; Nasca, P C; Zdeb, M S

    2006-01-01

    There is mounting evidence that childhood leukaemia is associated with high birth weight, but few studies have examined the relationship between leukaemia and other perinatal factors that influence birth weight, such as maternal weight or gestational weight gain. This case-cohort study included 916 acute lymphocytic leukaemia (ALL) and 154 acute myeloid leukaemia (AML) cases diagnosed prior to age 10 years between 1985 and 2001 and born in New York State excluding New York City between 1978 and 2001. Controls (n=9686) were selected from the birth cohorts for the same years. Moderate increased risk of both ALL and AML was associated with birth weight 3500 g or more. For ALL, however, there was evidence of effect modification with birth weight and maternal prepregnancy weight. High birth weight was associated with ALL only when the mother was not overweight while heavier maternal weight was associated with ALL only when the infant was not high birth weight. Increased pregnancy-related weight gain was associated with ALL. For AML, birth weight under 3000 g and higher prepregnancy weight were both associated with increased risk. These findings suggest childhood leukaemia may be related to factors influencing abnormal fetal growth patterns. PMID:16736025

  18. Changes in Energy Metabolism after Continuous Positive Airway Pressure for Obstructive Sleep Apnea.

    PubMed

    Tachikawa, Ryo; Ikeda, Kaori; Minami, Takuma; Matsumoto, Takeshi; Hamada, Satoshi; Murase, Kimihiko; Tanizawa, Kiminobu; Inouchi, Morito; Oga, Toru; Akamizu, Takashi; Mishima, Michiaki; Chin, Kazuo

    2016-09-15

    Disrupted energy homeostasis in obstructive sleep apnea (OSA) may lead to weight gain. Paradoxically, treating OSA with continuous positive airway pressure (CPAP) may also promote weight gain, although the underlying mechanism remains unclear. To explore the underlying mechanism by which patients with OSA gain weight after CPAP. A comprehensive assessment of energy metabolism was performed in 63 newly diagnosed OSA study participants (51 men; 60.8 ± 10.1 yr; apnea-hypopnea index >20 h(-1)) at baseline, CPAP initiation, and at a 3-month follow-up. Measurements included polysomnography, body weight, body composition, basal metabolic rate (BMR), hormones (norepinephrine, cortisol, leptin, ghrelin, insulin-like growth factor-1), dietary intake, eating behavior, and physical activity. BMR significantly decreased after CPAP (1,584 kcal/d at baseline, 1,561 kcal/d at CPAP initiation, and 1,508 kcal/d at follow-up; P < 0.001), whereas physical activity and total caloric intake did not significantly change. In multivariate regression, baseline apnea-hypopnea index, Δurine norepinephrine, and CPAP adherence were significant predictors of ΔBMR. The weight gainers had higher leptin levels, lower ghrelin levels, and higher eating behavior scores than the non-weight gainers, indicating a positive energy balance and disordered eating behavior among the weight gainers. Among the parameters related to energy metabolism, increased caloric intake was a particularly significant predictor of weight gain. Although a reduction in BMR after CPAP predisposes to a positive energy balance, dietary intake and eating behavior had greater impacts on weight change. These findings highlight the importance of lifestyle modifications combined with CPAP. Clinical trial registered with http://www.umin.ac.jp/english/ (UMIN000012639).

  19. Genetic correlations between mature cow weight and productive and reproductive traits in Nellore cattle.

    PubMed

    Regatieri, I C; Boligon, A A; Baldi, F; Albuquerque, L G

    2012-08-29

    We investigated genetic associations between mature cow weight (MW) and weaning weight (WW), yearling weight (YW), weight gain from birth to weaning (GBW), weight gain from weaning to yearling (GWY), weaning hip height (WHH), yearling hip height (YHH), scrotal circumference (SC), and age at first calving (AFC). Data from 127,104 Nellore animals born between 1993 and 2006, belonging to Agropecuária Jacarezinho Ltda., were analyzed. (Co)variance components were obtained by the restricted maximum likelihood method, applying an animal model in a multi-traits analysis. The model included direct genetic and residual effects as random effects, the fixed effects of contemporary group, and the linear and quadratic effects of animal age at recording (except for AFC, GBW, and GWY) and age of cow at calving as covariates (except for MW). The numbers of days from birth to weaning and from weaning to yearling were included as covariates for GBW and GWY, respectively. Estimated direct heritabilities were 0.43 ± 0.02 (MW), 0.33 ± 0.01 (WW), 0.36 ± 0.01 (YW), 0.28 ± 0.02 (GBW), 0.31 ± 0.01 (GWY), 0.44 ± 0.02 (WHH), 0.48 ± 0.02 (YHH), 0.44 ± 0.01 (SC), and 0.16 ± 0.03 (AFC). Genetic correlations between MW and productive traits were positive and of medium to high magnitude (ranging from 0.47 ± 0.03 to 0.71 ± 0.01). A positive and low genetic correlation was observed between MW and SC (0.24 ± 0.04). A negative genetic correlation (-0.19 ± 0.03) was estimated between MW and AFC. Selection to increase weight or weight gains at any age, as well as hip height, will change MW in the same direction. Selection for higher SC may lead to a long-term increase in MW. The AFC can be included in selection indices to improve the reproductive performance of beef cattle without significant changes in MW.

  20. Maternal pre-pregnancy BMI, gestational weight gain, and infant birth weight: A within-family analysis in the United States.

    PubMed

    Yan, Ji

    2015-07-01

    In the United States, the high prevalence of unhealthy preconception body weight and inappropriate gestational weight gain among pregnant women is an important public health concern. However, the relationship among pre-pregnancy BMI, gestational weight gain, and newborn birth weight has not been well established. This study uses a very large dataset of sibling births and a within-family design to thoroughly address this issue. The baseline analysis controlling for mother fixed effects indicates maternal preconception overweight, preconception obesity, and excessive gestational weight gain significantly increase the risk of having a high birth weight baby, respectively, by 1.3, 3 and 3.9 percentage points, while underweight before pregnancy and inadequate gestational weight gain increase the low birth weight incidence by 1.4 and 2 percentage points. The benchmark results are robust in a variety of sensitivity checks. Since poor birth outcomes especially high birth weight and low birth weight have lasting adverse impacts on one's health, education, and socio-economic outcomes later in life, the findings of this research suggest promoting healthy weight among women before pregnancy and preventing inappropriate weight gain during pregnancy can generate significant intergenerational benefits. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Predictors of the relationships between nutritional supplement use and weight-modification goals of U.S. Army soldiers.

    PubMed

    Austin, Krista G; Carvey, Christina E; Farina, Emily K; Lieberman, Harris R

    2013-08-01

    U.S. Army Soldiers must meet body weight and composition standards and consequently may use nutritional supplements (NS) purported to assist in weight modification (WM). Nutritional supplements are dietary supplements (DS) and foods intended to supplement the diet. This study assessed relationships between NS use, demographic characteristics, health-related behaviors, and WM goals among U.S. Army personnel. Participants (N = 990) self-reported NS use, categorized as energy drinks, sport nutrition products, or DS, and WM goal (lose, gain, or maintain) was ascertained by survey. DS were subcategorized as health, weight-loss, weight-gain, or other DS. Chi-square and logistic regression were used to assess relationships between predictors, NS use, and WM goal. Most respondents (70.3% ± 1.7%) consumed some NS; however, overall NS use was not related to WM goal. Significant relationships were observed between predictors (tobacco use, age, body-mass index, fitness score, general health, and eating habits) and both WM goal and NS use. Respondents attempting to lose or maintain weight were less likely to consume energy drinks and weight-gain DS. WM goal is related to multiple health behaviors including tobacco use, physical fitness score, and self-perception of health and eating behavior. NS are consumed in this population regardless of WM goal.

  2. Effects of Experimental Sleep Restriction on Weight Gain, Caloric Intake, and Meal Timing in Healthy Adults

    PubMed Central

    Spaeth, Andrea M.; Dinges, David F.; Goel, Namni

    2013-01-01

    Study Objectives: Examine sleep restriction's effects on weight gain, daily caloric intake, and meal timing. Design: Repeated-measures experiments assessing body weight at admittance and discharge in all subjects (N = 225) and caloric intake and meal timing across days following 2 baseline nights, 5 sleep restriction nights and 2 recovery nights or across days following control condition nights in a subset of subjects (n = 37). Setting: Controlled laboratory environment. Participants: Two hundred twenty-five healthy adults aged 22-50 y (n = 198 sleep-restricted subjects; n = 31 with caloric intake data; n = 27 control subjects; n = 6 with caloric intake data). Interventions: Approximately 8-to-1 randomization to an experimental condition (including five consecutive nights of 4 h time in bed [TIB]/night, 04:00-08:00) or to a control condition (all nights 10 h TIB/night, 22:00-08:00). Measurements and Results: Sleep-restricted subjects gained more weight (0.97 ± 1.4 kg) than control subjects (0.11 ± 1.9 kg; d = 0.51, P = 0.007). Among sleep-restricted subjects, African Americans gained more weight than Caucasians (d = 0.37, P = 0.003) and males gained more weight than females (d = 0.38, P = 0.004). Sleep-restricted subjects consumed extra calories (130.0 ± 43.0% of daily caloric requirement) during days with a delayed bedtime (04:00) compared with control subjects who did not consume extra calories (100.6 ± 11.4%; d = 0.94, P = 0.003) during corresponding days. In sleep-restricted subjects, increased daily caloric intake was due to more meals and the consumption of 552.9 ± 265.8 additional calories between 22:00-03:59. The percentage of calories derived from fat was greater during late-night hours (22:00-03:59, 33.0 ± 0.08%) compared to daytime (08:00-14:59, 28.2 ± 0.05%) and evening hours (15:00-21:59, 29.4 ± 0.06%; Ps < 0.05). Conclusions: In the largest, most diverse healthy sample studied to date under controlled laboratory conditions, sleep restriction promoted weight gain. Chronically sleep-restricted adults with late bedtimes may be more susceptible to weight gain due to greater daily caloric intake and the consumption of calories during late-night hours. Citation: Spaeth AM; Dinges DF; Goel N. Effects of experimental sleep restriction on weight gain, caloric intake, and meal timing in healthy adults. SLEEP 2013;36(7):981-990. PMID:23814334

  3. Comparative genomics analysis of Lactobacillus species associated with weight gain or weight protection.

    PubMed

    Drissi, F; Merhej, V; Angelakis, E; El Kaoutari, A; Carrière, F; Henrissat, B; Raoult, D

    2014-02-24

    Some Lactobacillus species are associated with obesity and weight gain while others are associated with weight loss. Lactobacillus spp. and bifidobacteria represent a major bacterial population of the small intestine where lipids and simple carbohydrates are absorbed, particularly in the duodenum and jejunum. The objective of this study was to identify Lactobacillus spp. proteins involved in carbohydrate and lipid metabolism associated with weight modifications. We examined a total of 13 complete genomes belonging to seven different Lactobacillus spp. previously associated with weight gain or weight protection. We combined the data obtained from the Rapid Annotation using Subsystem Technology, Batch CD-Search and Gene Ontology to classify gene function in each genome. We observed major differences between the two groups of genomes. Weight gain-associated Lactobacillus spp. appear to lack enzymes involved in the catabolism of fructose, defense against oxidative stress and the synthesis of dextrin, L-rhamnose and acetate. Weight protection-associated Lactobacillus spp. encoded a significant gene amount of glucose permease. Regarding lipid metabolism, thiolases were only encoded in the genome of weight gain-associated Lactobacillus spp. In addition, we identified 18 different types of bacteriocins in the studied genomes, and weight gain-associated Lactobacillus spp. encoded more bacteriocins than weight protection-associated Lactobacillus spp. The results of this study revealed that weight protection-associated Lactobacillus spp. have developed defense mechanisms for enhanced glycolysis and defense against oxidative stress. Weight gain-associated Lactobacillus spp. possess a limited ability to breakdown fructose or glucose and might reduce ileal brake effects.

  4. The Role of Dairy in Effectiveness and Cost of Treatment of Children With Moderate Acute Malnutrition: A Narrative Review.

    PubMed

    Suri, Devika J; Moorthy, Denish; Rosenberg, Irwin H

    2016-06-01

    Dairy is recommended in specially formulated supplementary foods to treat children with moderate acute malnutrition (MAM) but with limited evidence and added cost. Review studies of ready-to-use foods (RUFs) versus fortified blended foods (FBFs) to determine whether inclusion of dairy modifies the comparative effectiveness and cost. We reviewed literature comparing FBF and RUF in treatment of MAM among children younger than 5 years in developing countries. Outcomes of recovery from MAM, weight, and length gain were compared among treatment categories: FBF with dairy (FBF+), FBF without dairy (FBF-), RUF with dairy (RUF+), and RUF without dairy (RUF-). Supplement cost was compared per 500 kcal. Eight studies were included. Rations were heterogeneous in energy and type of dairy. Overall, RUF+, RUF-, and FBF+ performed similarly, with higher recovery and weight gain compared with FBF-. RUF+ had higher recovery (in 5 of 6 comparisons), weight gain (4 of 4), and length gain (1 of 4) versus FBF-. The RUF+ had higher recovery (1 of 2) versus FBF+, with no other differences. The RUF- versus FBF+ had no differences (0 of 2). The RUF- had higher recovery (1 of 2), weight gain (2 of 2) versus FBF-. Four studies reported supplement costs, which averaged US$0.15 (FBF-), US$0.18 (FBF+), US$0.18 (RUF-), and US$0.37 (RUF+) per 500 kcal. There is a consistent benefit of FBF that include dairy in treatment of children with MAM. Benefits of dairy in RUF require further investigation. Evidence from rigorous quantitative analysis of existing data, cost-effectiveness, and prospective trials will be essential in determining policy on treatment for children with MAM. © The Author(s) 2016.

  5. Postpartum weight change among HIV-infected mothers by antiretroviral prophylaxis and infant feeding modality in a research setting.

    PubMed

    Cames, Cecile; Cournil, Amandine; de Vincenzi, Isabelle; Gaillard, Philippe; Meda, Nicolas; Luchters, Stanley; Nduati, Ruth; Naidu, Kevindra; Newell, Marie-Louise; Read, Jennifer S; Bork, Kirsten

    2014-01-02

    To assess the relationship between infant feeding, triple-antiretroviral prophylaxis and weight from 2 weeks (baseline) to 6 months postpartum among HIV-infected mothers in a mother-to-child transmission (MTCT) of HIV-prevention trial in five sub-Saharan African sites. HIV-infected pregnant women with CD4 cell counts of 200-500 cells/μl were counselled to choose breastfeeding to 6 months or replacement feeding from delivery. They were randomized to receive perinatal zidovudine and single-dose nevirapine or triple-antiretroviral MTCT prophylaxis until breastfeeding cessation. Mixed-effect linear models were used to compare maternal weight trajectories over time by infant feeding mode. Antiretroviral prophylaxis and BMI at baseline were examined as potential effect modifiers. Among 797 mothers, 620 (78%) initiated breastfeeding. Wasting (BMI <18.5) was rare at baseline (2%), whereas overweight/obesity (BMI ≥ 25) was common (40%). In the model including all women, breastfeeding was not associated with weight loss up to 6 months, irrespective of baseline BMI and antiretroviral prophylaxis. Triple-antiretroviral prophylaxis was associated with weight gain among replacement-feeding mothers with baseline BMI at least 25 (+0.54 kg/month; P < 0.0001). In the model including breastfeeding mothers only, triple-antiretroviral prophylaxis was associated with weight gain among mothers with baseline BMI at least 25 who ceased breastfeeding before 3 months postpartum (+0.33 kg/month; P = 0.03). The results suggest that breastfeeding up to 6 months postpartum is not detrimental for postpartum weight among well nourished HIV-infected mothers at intermediate-disease stage. In the absence of breastfeeding or after weaning, triple-antiretroviral prophylaxis is associated with weight gain among women with high BMI, even after cessation of prophylaxis.

  6. Trends and determinants of weight gains among OECD countries: an ecological study.

    PubMed

    Nghiem, S; Vu, X-B; Barnett, A

    2018-06-01

    Obesity has become a global issue with abundant evidence to indicate that the prevalence of obesity in many nations has increased over time. The literature also reports a strong association between obesity and economic development, but the trend that obesity growth rates may converge over time has not been examined. We propose a conceptual framework and conduct an ecological analysis on the relationship between economic development and weight gain. We also test the hypothesis that weight gain converges among countries over time and examine determinants of weight gains. This is a longitudinal study of 34 Organisation for Economic Cooperation and Development (OECD) countries in the years 1980-2008 using publicly available data. We apply a dynamic economic growth model to test the hypothesis that the rate of weight gains across countries may converge over time. We also investigate the determinants of weight gains using a longitudinal regression tree analysis. We do not find evidence that the growth rates of body weight across countries converged for all countries. However, there were groups of countries in which the growth rates of body weight converge, with five groups for males and seven groups for females. The predicted growth rates of body weight peak when gross domestic product (GDP) per capita reaches US$47,000 for males and US$37,000 for females in OECD countries. National levels of consumption of sugar, fat and alcohol were the most important contributors to national weight gains. National weight gains follow an inverse U-shape curve with economic development. Excessive calorie intake is the main contributor to weight gains. Copyright © 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  7. Maternal obesity and gestational weight gain are risk factors for infant death.

    PubMed

    Bodnar, Lisa M; Siminerio, Lara L; Himes, Katherine P; Hutcheon, Jennifer A; Lash, Timothy L; Parisi, Sara M; Abrams, Barbara

    2016-02-01

    Assessment of the joint and independent relationships of gestational weight gain and prepregnancy body mass index (BMI) on risk of infant mortality was performed. This study used Pennsylvania linked birth-infant death records (2003-2011) from infants without anomalies born to mothers with prepregnancy BMI categorized as underweight (n = 58,973), normal weight (n = 610,118), overweight (n = 296,630), grade 1 obesity (n = 147,608), grade 2 obesity (n = 71,740), and grade 3 obesity (n = 47,277). Multivariable logistic regression models stratified by BMI category were used to estimate dose-response associations between z scores of gestational weight gain and infant death after confounder adjustment. Infant mortality risk was lowest among normal-weight women and increased with rising BMI category. For all BMI groups except for grade 3 obesity, there were U-shaped associations between gestational weight gain and risk of infant death. Weight loss and very low weight gain among women with grades 1 and 2 obesity were associated with high risks of infant mortality. However, even when gestational weight gain in women with obesity was optimized, the predicted risk of infant death remained higher than that of normal-weight women. Interventions aimed at substantially reducing preconception weight among women with obesity and avoiding very low or very high gestational weight gain may reduce risk of infant death. © 2015 The Obesity Society.

  8. Long-term influences of body-weight changes, independent of the attained weight, on risk of impaired glucose tolerance and Type 2 diabetes.

    PubMed

    Black, E; Holst, C; Astrup, A; Toubro, S; Echwald, S; Pedersen, O; Sørensen, T I A

    2005-09-01

    To investigate if weight gain during adulthood has effects on the risk of developing impaired glucose tolerance (IGT) or Type 2 diabetes beyond effect of attained weight. Data were obtained from a longitudinal study of two cohorts: one of juvenile-onset obese (n = 248) and one of randomly selected control (n = 320) men, weighed at average ages of 20, 33, 44 and 51 years, respectively. For any given BMI, the risk of IGT was higher the greater the weight gain since age 20 (odds ratio of 1.10 per unit kg/m2 of BMI gain, confidence interval 1.03-1.17, P = 0.004), and weight gain during both the early and later ages contributed to the increased risk. Obese men, maintaining weight since age 20, had lower risk of IGT than non-obese men who became similarly obese by age 51. The risk of Type 2 diabetes increased by weight gain in early adult life, but not by more recent weight gain in the later periods, probably because of the development of Type 2 diabetes leading to weight loss. Independent of attained level of body weight in middle-aged men, weight gain is associated with increased risk of IGT, and is greater in those not overweight in childhood.

  9. Teaching Chilean mothers to massage their full-term infants: effects on maternal breast-feeding and infant weight gain at age 2 and 4 months.

    PubMed

    Serrano, Maria Sylvia Campos; Doren, Francisca Márquez; Wilson, Lynda

    2010-01-01

    The purpose of this study was to evaluate the effects of massage on infant weight gain and exclusive maternal breast-feeding of an intervention that involved teaching mothers to massage their full-term infants. The sample included 100 healthy newborn infants who were receiving primary healthcare at 3 health centers in a low-income neighborhood of Santiago, Chile. The control group included 65 infants and the massage group included 35 infants. During their second well-child clinic visit, clinic nurses provided instruction to massage-group mothers about how to massage their infants, based on the methods of the Baby's First Massage program (http://www.babysfirstmassage.com/Scripts/default.asp). Mothers were encouraged to massage their infants for 10 to 15 minutes at least once a day, starting when their infants were 15 days old. There was no difference in the mean weights of the infants between the massage and control groups at baseline, but at age 2 months, massage group infants weighed significantly more than control-group infants. There were no weight differences between the 2 groups at age 4 months. There were no differences between the 2 groups on the incidence of exclusive maternal breast-feeding at age 2 or 4 months. The findings suggest that teaching mothers to massage their newborn infants may have a beneficial effect on the infant's early weight gain. There is a need for additional studies to evaluate the effect of maternal massage on other health and welfare outcomes for both mothers and infants.

  10. Preventing weight gain in adults: the pound of prevention study.

    PubMed Central

    Jeffery, R W; French, S A

    1999-01-01

    OBJECTIVES: This study examined whether weight gain with age could be prevented through the use of a low-intensity intervention. METHODS: Participants, 228 men and 998 women recruited from diverse sources, were randomized to one of the following groups: (1) no-contact control, (2) education through monthly newsletters, or (3) education plus incentives for participation. All participants were weighed and completed questionnaires about behaviors and attitudes related to weight at baseline and annually for 3 years thereafter. RESULTS: Individuals in intervention groups reported favorable changes over time in frequency of weighting and healthy dieting practices relative to those in the control group. These behavior changes were in turn related to a reduced rate of weight gain over time. However, weight gain over 3 years did not differ significantly by treatment group. CONCLUSIONS: This low-intensity educational approach to weight gain prevention sustained interest over a lengthy time period and was associated positively with behavior change, but it was not strong enough to significantly reduce weight gain with age. PMID:10224988

  11. Description of a healthy lifestyle intervention for people with serious mental illness taking second-generation antipsychotics.

    PubMed

    Park, Tanya; Usher, Kim; Foster, Kim

    2011-12-01

    Weight gain and obesity has reached epidemic proportions, with the prevalence of metabolic syndrome (MetS) reaching 20-25% of the global population. MetS is a cluster of metabolic abnormalities, including weight gain, associated with an increased risk of cardiovascular disease, diabetes, and stroke. While individuals in the general population are at risk of physical conditions, such as MetS, people with mental illness are at even higher risk. The increased incidence of MetS for people with serious mental illness has been linked to the use of second-generation antipsychotic medication. This paper describes the content, structure, and development of 'Passport 4 Life', a healthy lifestyle intervention to maintain weight and prevent further weight gain for people with serious mental illness. While there are a number of diet and lifestyle programmes available for the general population, Passport 4 Life was specifically designed as an intervention to address the needs of people with serious mental illness taking second-generation antipsychotics. Passport 4 Life comprises 12 weekly group sessions that include the concepts and spirit of motivational interviewing, nutrition, and exercise education, combined with weekly exercise activity. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

  12. [Investigation into the clinical suitability of Institute of Medicine 2009 guidelines regarding weight gain during pregnancy for women with full term singleton fetus in China].

    PubMed

    Yang, Yan-dong; Yang, Hui-xia

    2012-09-01

    To study whether the current Institute of Medicine (IOM) pregnancy weight gain recommendations vary by pre-pregnancy body mass index (BMI) was suitable to Chinese people. A study was conducted on 4736 term singleton live birth gravidas, who were diagnosed normal glucose metabolism and delivered in Peking University First Hospital in 2005 and 2009, by reviewing the medical records. Based on the pre-pregnant BMI, the selected cases were divided into 3 groups: low body mass group (BMI < 18.5 kg/m(2), n = 465), normal body mass group (BMI 18.5 - 24.9 kg/m(2), n = 3549), over body mass group (BMI ≥ 25 kg/m(2), n = 722). All the cases were divided into 3 subgroups based on pregnancy weight gain as below, within, and above the IOM recommendations in each pre-pregnant BMI group. Totally 4736 newborns were divided by birth weight into 3 groups: normal birth weight group (weight 2500 - 4000 g, n = 4339), macrosomia group (weight ≥ 4000 g, n = 359) and low birth weight group (weight < 2500 g, n = 38). The difference of age, gestational age, pre-pregnant weight, pre-pregnant BMI and history of delivery of cases between 2005 and 2009 were analyzed. The difference of pregnancy outcome of women whose gestational weight gain was below, within, and above the IOM recommendations was analyzed. (1) Compared to mothers with pregnancy weight gain within IOM recommendations in low body mass group, risk of low birth weight in offspring was elevated tendency with pregnancy weight gain below IOM recommendations (OR = 3.71, 95%CI: 0.97 - 14.12, P = 0.055). (2) In normal body mass group, compared to women with pregnancy weight gain within IOM recommendations, risk of macrosomia in offspring was elevated with pregnancy weight gain above IOM recommendations (OR = 2.14, 95%CI: 1.62 - 2.83, P < 0.01). (3) In over body mass group, compared to women with pregnancy weight gain within IOM recommendations, risk of macrosomia in offspring was elevated (OR = 3.25, 95%CI: 1.65 - 6.39, P = 0.001) and risk of hypertensive disorders complicating pregnancy was high (OR = 1.79, 95%CI: 1.04 - 3.09, P = 0.037) in women with pregnancy weight gain above IOM recommendations. The current IOM pregnancy weight gain recommendations vary by pre-pregnancy BMI may be suitable to Chinese people.

  13. Fried food intake estimated by the multiple source method is associated with gestational weight gain.

    PubMed

    Sartorelli, Daniela S; Barbieri, Patrícia; Perdoná, Gleici C S

    2014-08-01

    This present study aimed to test the association between fried food intake estimated by a semiquantitative food frequency questionnaire (FFQ), multiple 24-hour dietary recalls (24hRs), and the application of the multiple source method (MSM) in relation to gestational weight gain at the second and third trimesters and weight gain ratio (observed weight gain/expected weight gain). We hypothesized that distinct relationships with weight gain would be found given the measurement errors of self-reported dietary approaches. A prospective study was conducted with 88 adult pregnant women. Fried food intake during pregnancy was assessed using a validated 85-item FFQ, two to six 24hRs per woman, and the MSM with and without frequency of food intake as covariate. Linear regression models were used to evaluate the relationship between fried food estimated by the methods and weight gain. For every 100-g increment of fried food intake, the β (95% confidence interval) for weight gain was β 1.87 (0.34, 3.40) and β 2.00 0.55, 3.45) for estimates using MSM with and without the frequency of intake as covariate, respectively, after multiple adjustments. We found that fried food intake estimated by the FFQ and 24hRs β 0.40 (-0.68, 1.48) and β 0.49 (-0.53, 1.52), respectively, was unrelated to weight gain. In relation to weight gain ratio, a positive association was found for estimates using the MSM with [β 0.29 (0.03, 0.54)] and without the frequency of intake as covariate [β 0.31 (0.07, 0.55)]; and no associations were found for estimates by the FFQ or 24hRs. The data showed that fried food intake estimated the MSM, but not by the FFQ and 24hRs, is associated with excessive weight gain during pregnancy. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Gestational Weight Gain: Results from the Delta Healthy Sprouts Comparative Impact Trial.

    PubMed

    Thomson, Jessica L; Tussing-Humphreys, Lisa M; Goodman, Melissa H; Olender, Sarah E

    2016-01-01

    Introduction. Delta Healthy Sprouts trial was designed to test the comparative impact of two home visiting programs on weight status, dietary intake, and health behaviors of Southern African American women and their infants. Results pertaining to the primary outcome, gestational weight gain, are reported. Methods. Participants (n = 82), enrolled early in their second trimester of pregnancy, were randomly assigned to one of two treatment arms. Gestational weight gain, measured at six monthly home visits, was calculated by subtracting measured weight at each visit from self-reported prepregnancy weight. Weight gain was classified as under, within, or exceeding the Institute of Medicine recommendations based on prepregnancy body mass index. Chi-square tests and generalized linear mixed models were used to test for significant differences in percentages of participants within recommended weight gain ranges. Results. Differences in percentages of participants within the gestational weight gain guidelines were not significant between treatment arms across all visits. Conclusions. Enhancing the gestational nutrition and physical activity components of an existing home visiting program is feasible in a high risk population of primarily low income African American women. The impact of these enhancements on appropriate gestational weight gain is questionable given the more basic living needs of such women. This trial is registered with ClinicalTrials.gov NCT01746394, registered 4 December 2012.

  15. Gestational Weight Gain and Interpregnancy Weight Change in Adolescent Mothers.

    PubMed

    Whelan, Emily; Armson, B Anthony; Ashley-Martin, Jillian; MacSween, Kayla; Woolcott, Christy

    2017-06-01

    To examine the association between gestational weight gain (GWG) and interpregnancy weight change (IPWC) in adolescent mothers (younger than 20 years), and to determine if this association differs from adult women (aged 20-35 years). Retrospective cohort study. We included 3055 adolescents and 17,090 adult women with singleton pregnancies recorded in the Nova Scotia Atlee Perinatal Database with a subsequent pregnancy occurring between 2003 and 2014. GWG in the first pregnancy was categorized as below, within, or above the current Institute of Medicine recommendations. IPWC was defined as the difference between the prepregnancy weights of the 2 pregnancies. Analyses were adjusted for parity, body mass index in the first pregnancy, and time between pregnancies. Relative to adolescents with GWG within the recommendations, those who gained below had a 2.7 kg (95% confidence interval [CI], 1.4-3.9) lower mean IPWC whereas those who gained above had a 4.2 kg (95% CI, 3.3-5.1) higher mean IPWC. Smaller differences in IPWC between GWG categories were observed in adult women; relative to those with GWG within the recommendations, adults who gained below had a 1.3 kg (95% CI, 0.9-1.7) lower mean IPWC and those who gained above had a 2.9 kg (95% CI, 2.6-3.2) higher mean IPWC. Mean IPWC differed across GWG categories and the differences were greater in adolescents than in adult women. This difference should be considered when assessing whether specific GWG recommendations are needed for adolescents. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

  16. Maternal weight change between 1 and 2 years postpartum: the importance of 1 year weight retention.

    PubMed

    Lipsky, Leah M; Strawderman, Myla S; Olson, Christine M

    2012-07-01

    Pregnancy weight gain may lead to long-term increases in maternal BMI for some women. The objective of this study was to examine maternal body weight change 1y-2y postpartum, and to compare classifications of 2y weight retention with and without accounting for 1y-2y weight gain. Early pregnancy body weight (EPW, first trimester) was measured or imputed, and follow-up measures obtained before delivery, 1 year postpartum (1y) and 2 years postpartum (2y) in an observational cohort study of women seeking prenatal care in several counties in upstate New York (n = 413). Baseline height was measured; demographic and behavioral data were obtained from questionnaires and medical records. Associations of 1y-2y weight change (kg) and 1y-2y weight gain (≥2.25 kg) with anthropometric, socioeconomic, and behavioral variables were evaluated using linear and logistic regressions. While mean ± SE 1y-2y weight change was 0.009 ± 4.6 kg, 1y-2y weight gain (≥2.25 kg) was common (n = 108, 26%). Odds of weight gain 1y-2y were higher for overweight (OR(adj) = 2.63, CI(95%) = 1.43-4.82) and obese (OR(adj) = 2.93, CI(95%) = 1.62-5.27) women than for women with BMI <25. Two year weight retention (2y-EPW ≥2.25 kg) was misclassified in 38% (n = 37) of women when 1y-2y weight gain was ignored. One year weight retention (1YWR) (1y-EPW) was negatively related to 1y-2y weight change (β(adj) ± SE = -0.28 ± 0.04, P < 0.001) and weight gain (≥2.25 kg) (OR(adj) = 0.91, CI(95%) = 0.87-0.95). Relations between 1y weight retention and 1y-2y weight change were attenuated for women with higher early pregnancy BMI. Weight change 1y-2y was predicted primarily by an inverse relation with 1y weight retention. The high frequency of weight gain has important implications for classification of postpartum weight retention.

  17. Maternal Weight Change Between 1 and 2 Years Postpartum: The Importance of 1 Year Weight Retention

    PubMed Central

    Lipsky, Leah M.; Strawderman, Myla S.; Olson, Christine M.

    2016-01-01

    Pregnancy weight gain may lead to long-term increases in maternal BMI for some women. The objective of this study was to examine maternal body weight change 1y–2y postpartum, and to compare classifications of 2y weight retention with and without accounting for 1y–2y weight gain. Early pregnancy body weight (EPW, first trimester) was measured or imputed, and follow-up measures obtained before delivery, 1 year postpartum (1y) and 2 years postpartum (2y) in an observational cohort study of women seeking prenatal care in several counties in upstate New York (n = 413). Baseline height was measured; demographic and behavioral data were obtained from questionnaires and medical records. Associations of 1y–2y weight change (kg) and 1y–2y weight gain (≥2.25 kg) with anthropometric, socioeconomic, and behavioral variables were evaluated using linear and logistic regressions. While mean ± SE 1y–2y weight change was 0.009 ± 4.6 kg, 1y–2y weight gain (≥2.25 kg) was common (n = 108, 26%). Odds of weight gain 1y–2y were higher for overweight (ORadj = 2.63, CI95% = 1.43–4.82) and obese (ORadj = 2.93, CI95% = 1.62–5.27) women than for women with BMI <25. Two year weight retention (2y–EPW ≥2.25 kg) was misclassified in 38% (n = 37) of women when 1y–2y weight gain was ignored. One year weight retention (1YWR) (1y–EPW) was negatively related to 1y–2y weight change (βadj ± SE = −0.28 ± 0.04, P < 0.001) and weight gain (≥2.25 kg) (ORadj = 0.91, CI95% = 0.87–0.95). Relations between 1y weight retention and 1y–2y weight change were attenuated for women with higher early pregnancy BMI. Weight change 1y–2y was predicted primarily by an inverse relation with 1y weight retention. The high frequency of weight gain has important implications for classification of postpartum weight retention. PMID:22334257

  18. Association between gestational weight gain and perinatal outcomes in women with chronic hypertension.

    PubMed

    Yee, Lynn M; Caughey, Aaron B; Cheng, Yvonne W

    2017-09-01

    Gestational weight gain above or below the 2009 National Academy of Medicine guidelines has been associated with adverse maternal and neonatal outcomes. Although it has been well established that excess gestational weight gain is associated with the development of gestational hypertension and preeclampsia, the relationship between gestational weight gain and adverse perinatal outcomes among women with pregestational (chronic) hypertension is less clear. The objective of this study was to examine the relationship between gestational weight gain above and below National Academy of Medicine guidelines and perinatal outcomes in a large, population-based cohort of women with chronic hypertension. This is a population-based retrospective cohort study of women with chronic hypertension who had term, singleton, vertex births in the United States from 2012 through 2014. Prepregnancy body mass index was calculated using self-reported prepregnancy weight and height. Women were categorized into 4 groups based on gestational weight gain and prepregnancy body mass index: (1) weight gain less than, (2) weight gain within, (3) weight gain 1-19 lb in excess of, and (4) weight gain ≥20 lb in excess of the National Academy of Medicine guidelines. The χ 2 tests and multivariable logistic regression analysis were used for statistical comparisons. Stratified analyses by body mass index category were additionally performed. In this large birth cohort, 101,259 women met criteria for inclusion. Compared to hypertensive women who had gestational weight gain within guidelines, hypertensive women with weight gain ≥20 lb over National Academy of Medicine guidelines were more likely to have eclampsia (adjusted odds ratio, 1.93; 95% confidence interval, 1.54-2.42) and cesarean delivery (adjusted odds ratio, 1.60; 95% confidence interval, 1.50-1.70). Excess weight gain ≥20 lb over National Academy of Medicine guidelines was also associated with increased odds of 5-minute Apgar <7 (adjusted odds ratio, 1.29; 95% confidence interval, 1.13-1.47), neonatal intensive care unit admission (adjusted odds ratio, 1.23; 95% confidence interval, 1.14-1.33), and large-for-gestational-age neonates (adjusted odds ratio, 2.41; 95% confidence interval, 2.27-2.56) as well as decreased odds of small-for-gestational-age status (adjusted odds ratio, 0.52; 95% confidence interval, 0.46-0.58). Weight gain 1-19 lb over guidelines was associated with similar fetal growth outcomes although with a smaller effect size. In contrast, weight gain less than National Academy of Medicine guidelines was not associated with adverse maternal outcomes but was associated with increased odds of small for gestational age (adjusted odds ratio, 1.31; 95% confidence interval, 1.21-1.52) and decreased odds of large-for-gestational-age status (adjusted odds ratio, 0.86; 95% confidence interval, 0.81-0.92). Analysis of maternal and neonatal outcomes stratified by body mass index demonstrated similar findings. Women with chronic hypertension who gain less weight than National Academy of Medicine guidelines experience increased odds of small-for-gestational-age neonates, whereas excess weight gain ≥20 lb over National Academy of Medicine guidelines is associated with cesarean delivery, eclampsia, 5-minute Apgar <7, neonatal intensive care unit admission, and large-for-gestational-age neonates. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The Theory, Development, and Implementation of an e-Intervention to Prevent Excessive Gestational Weight Gain: e-Moms Roc

    PubMed Central

    Uesugi, Keriann H.; Niederdeppe, Jeff; Gay, Geri K.; Olson, Christine M.

    2014-01-01

    Abstract Background: Gaining more weight during pregnancy than is recommended by the Institute of Medicine is prevalent and contributes to the development of obesity in women. This article describes the development and use of e-Moms of Rochester (e-Moms Roc), an electronic intervention (e-intervention), to address this health issue in a socioeconomically diverse sample of pregnant women. Materials and Methods: Formative research in the form of intercept interviews, in-depth interviews, and focus groups was conducted to inform the design of the e-intervention. The Web site continuously tracked each participant's use of e-intervention features. Results: An e-intervention, including Web site and mobile phone components, was developed and implemented in a randomized control trial. Formative research informed the design. Participants in all arms accessed blogs, local resources, articles, frequently asked questions, and events. Participants in the intervention arms also accessed the weight gain tracker and diet and physical activity goal-setting tools. Overall, 80% of women logged into the Web site and used a tool or feature at least twice. Among those in the intervention arm, 70% used the weight gain tracker, but only 40% used the diet and physical activity goal-setting tools. Conclusions: To maximize and sustain potential usage of e-Moms Roc over time, the e-intervention included customized reminders, tailored content, and community features such as blogs and resources. Usage was comparable to those in other weight studies with young adults and higher than reported in a published study with pregnant women. This e-intervention specifically designed for pregnant women was used by the majority of women. PMID:25354350

  20. Change in diet, physical activity, and body weight among young-adults during the transition from high school to college.

    PubMed

    Wengreen, Heidi J; Moncur, Cara

    2009-07-22

    The freshmen year of college is likely a critical period for risk of weight gain among young-adults. A longitudinal observational study was conducted to examine changes in weight, dietary intake, and other health-related behaviors among first-year college students (n = 186) attending a public University in the western United States. Weight was measured at the beginning and end of fall semester (August - December 2005). Participants completed surveys about dietary intake, physical activity and other health-related behaviors during the last six months of high school (January - June 2005) in August 2005 and during their first semester of college (August - December 2005) in December 2005. 159 students (n = 102 women, 57 men) completed both assessments. The average BMI at the baseline assessment was 23.0 (standard deviation (SD) 3.8). Although the average amount of weight gained during the 15-week study was modest (1.5 kg), 23% of participants gained > or = 5% of their baseline body weight. Average weight gain among those who gained > or = 5% of baseline body weight was 4.5 kg. Those who gained > or = 5% of body weight reported less physical activity during college than high school, were more likely to eat breakfast, and slept more than were those who did not gain > or = 5% of body weight. Almost one quarter of students gained a significant amount of weight during their first semester of college. This research provides further support for the implementation of education or other strategies aimed at helping young-adults entering college to achieve or maintain a healthy body weight.

  1. The influence of gestational weight gain on the development of gestational hypertension in obese women.

    PubMed

    Barton, John R; Joy, Saju D; Rhea, Debbie J; Sibai, Amanda J; Sibai, Baha M

    2015-06-01

    The objective of this study was to examine the influence of gestational weight gain on the development of gestational hypertension/preeclampsia (GHTN/PE) in women with an obese prepregnancy body mass index (BMI). Obese women with a singleton pregnancy enrolled at < 20 weeks were studied. Data were classified according to reported gestational weight gain (losing weight, under-gaining, within target, and over-gaining) from the recommended range of 11 to 9.7 kg and by obesity class (class 1 = BMI 30-34.9 kg/m(2), class 2 = 35-39.9 kg/m(2), class 3 = 40-49.9 kg/m(2), and class 4 ≥ 50 kg/m(2)). Rates of GHTN/PE were compared by weight gain group overall and within obesity class using Pearson chi-square statistics. For the 27,898 obese women studied, rates of GHTN/PE increased with increasing class of obesity (15.2% for class 1 and 32.0% for class 4). The incidence of GHTN/PE in obese women was not modified with weight loss or weight gain below recommended levels. Overall for obese women, over-gaining weight was associated with higher rates of GHTN/PE compared with those with a target rate for obesity classes 1 to 3 (each p < 0.001). Below recommended gestational weight gain did not reduce the risk for GHTN/PE in women with an obese prepregnancy BMI. These data support a gestational weight gain goal ≤ 9.7 kg in obese gravidas. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  2. Insulin detemir attenuates food intake, body weight gain and fat mass gain in diet-induced obese Sprague-Dawley rats.

    PubMed

    Rojas, J M; Printz, R L; Niswender, K D

    2011-07-04

    Initiation and intensification of insulin therapy commonly causes weight gain, a barrier to therapy. A contrasting body of evidence indicates that insulin functions as an adiposity negative feedback signal and reduces food intake, weight gain and adiposity via action in the central nervous system. Basal insulin analogs, detemir (Det) and glargine (Glar), have been associated with less hypoglycemia compared with neutral protamine hagedorn insulin, and Det with less weight gain, especially in patients with higher body mass index (BMI). We sought to determine whether insulin therapy per se causes body weight and fat mass gain when delivered via a clinically relevant subcutaneous (SC) route in the absence of hypoglycemia and glycosuria in non-diabetic lean and diet-induced obese rats. Rats were exposed to either a low-fat diet (LFD; 13.5% fat) or high-fat diet (HFD; 60% fat), and received Det (0.5 U kg(-1)), Glar (0.2 U kg(-1)) or vehicle (Veh) SC once daily for 4 weeks. These dosages of insulin were equipotent in rats with respect to blood-glucose concentration and did not induce hypoglycemia. As predicted by current models of energy homeostasis, neither insulin Det nor Glar therapy affected food intake and weight gain in LFD rats. Det treatment significantly attenuated food intake, body weight gain and fat mass gain relative to the Glar and Veh in high-fat fed animals, mirroring observations in humans. That neither insulin group gained excess weight, suggests weight gain with SC basal insulin therapy may not be inevitable. Our data further suggest that Det possesses a unique property to attenuate the development of obesity associated with a HFD.

  3. The effect of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women: a systematic review protocol.

    PubMed

    Spencer, Lisa; Rollo, Megan; Hauck, Yvonne; MacDonald-Wicks, Lesley; Wood, Lisa; Hutchesson, Melinda; Giglia, Roslyn; Smith, Roger; Collins, Clare

    2015-01-01

    What are the effects of weight management interventions that include a diet component on weight-related outcomes in pregnant and postpartum women?The primary objective of this systematic review is to evaluate the effectiveness of weight management interventions which include a diet component and are aimed at limiting gestational weight gain and postpartum weight retention in women.The second objective of this systematic review is to investigate included intervention components with respect to effect on weight-related outcomes. This may include, but is not limited to: length of intervention, use of face-to-face counselling, group or individual consultations, use of other interventions components including exercise, use of goals and use of support tools like food diaries, coaching, including email or text message support. Around half of all women of reproductive age are either overweight or obese, with women aged 25-34 years having a greater risk of substantial weight gain compared with men of all ages. Excessive gestational weight gain (GWG) and postpartum weight retention (PPWR) may play a significant role in long term obesity. Having one child doubles the five- and 10-year obesity incidence for women, with many women who gain excessive weight during pregnancy remaining obese permanently. Excessive GWG and/or PPWR can also significantly contribute to short- and long-term adverse health outcomes for mother, baby and future pregnancies.Maternal obesity increases the risk of pregnancy related complications such as pre-eclampsia, gestational diabetes mellitus, stillbirth and the rate of caesarean section. Childhood obesity is a further long term complication of maternal obesity for offspring, which may persist in to adulthood. Excess GWG is also a risk factor for PPWR both in the short and long-term. Nehring et al. conducted a meta-analysis with over 65,000 women showing that, compared to women who gained weight within recommendations during pregnancy, women with GWG above Institute of Medicine weight gain recommendations, retained an additional 3.1 kg and 4.7kg after three and greater than or equal to 15 years postpartum, respectively. The health risk associated with PPWR is highlighted in a study of 151,025 Swedish women followed between 1992 and 2001.The study identified the risk of adverse pregnancy outcomes for those who gained three or more units of Body Mass Index (kg/m2) between consecutive pregnancies (an average of two years) was much higher compared with women whose BMI changed from -1.0 and 0.9 units. Long-term chronic disease risk may also be affected by PPWR as weight retention at the end of the first year post-partum has been found to be a predictor of maternal overweight 15 years later.With around 14-20% of women retaining 5kg or more 12 months postpartum, the risk of developing conditions like diabetes, metabolic syndrome and cardiovascular disease may be increased. It becomes evident that interventions which aim to support attainment of healthy weight both in the antenatal and postpartum periods are key health priorities for women during this life stage.Lifestyle factors of overweight, having poor diet quality, and not undertaking enough moderate-to-vigorous physical activity are amongst the top five predictors of mortality in women. Additionally it is noted that, for many women, pregnancy and the postpartum period are associated with a reduction in physical activity. It is known that a combination of poor dietary choices, an increase in sedentary time and reduction in physical activity are all contributors to the development of overweight and obesity. With this in mind, current research has focused on lifestyle interventions to limit GWG and PPWR. Thangaratinam et al. reviewed 44 randomized controlled trials (7278 women) where interventions including diet, physical activity or both were evaluated for their influence on maternal weight during pregnancy. Results indicate that all were significantly effective in reducing GWG compared with the control group. More specifically, dietary interventions were the most effective in reducing weight gain, with a mean weight loss of -3.84kg compared with -0.72kg and -1.06kg for physical activity and the mixed (diet plus physical activity) approach, respectively. This finding is supported by Hill and colleagues' recent systematic review of theory based interventions to limit GWG. Included studies in this review reported an underpinning theory base and were classified as adopting a dietary, physical activity or mixed approach. Hill et al. concluded that studies which included a diet intervention were significantly more effective at limiting GWG.In 2011 Tanentsapf et al. reviewed the effect of dietary interventions alone for reducing GWG in normal weight, overweight and obese pregnant women. This review analysed 13 randomized controlled trials and quasi-randomized controlled trials with a dietary intervention to prevent excessive GWG in women. The review concluded that dietary interventions during pregnancy were effective in reducing GWG with an effect of -1.92kg (n=1434) compared with the control group.Tanentsapf et al. identified that trials differed in the conduct of the interventions with various diet and non-diet related components utilised. Dietary approaches were highly variable with some trials focusing only on calorie restriction and others included additional target macronutrient distribution for intake. Some trials further provided feedback based on maternal weight gain guidelines. Interventions also varied in delivery method with a variety of modes used, including face-to-face, individual or group consultations and/or written correspondence. The frequency of communication, despite the type or mix, also changed from trial to trial with additional methods via telephone, posted materials, feedback or food diaries utilised. The inclusion of physical activity in addition to diet intervention was also common. Whilst the recent review by Tanentsapf et al. identified that dietary interventions are effective in reducing GWG, the review did not investigate the impact that different intervention components, delivery methods or dietary counselling approaches had on gestational weight management. It remains unclear as to which intervention components optimize GWG in women.The impact of lifestyle interventions has also been investigated in the postpartum period. The recent systematic review from van der Pligt et al. reported seven of 11 studies reviewed were successful in limiting PPWR. As with studies aimed at limiting GWG, interventions included in van der Pligt et al.'s review differed greatly in their conduct. Six of these seven studies included both dietary and physical activity components for the intervention, with the final successful study including a diet only intervention. Five of the successful studies recruited overweight or obese women only. Intervention time varied considerably in successful studies with some running for as little at ten days, and others up to six months.Bertz et al. demonstrated that their 12-week behavior modification intervention which targeted diet alone or diet and exercise, including two individual sessions with a dietitian and physical therapist, provision of scales for weight self-monitoring and bi-weekly text messages was successful in achieving significant weight loss following the intervention, and sustained at one year. The diet intervention and the diet and exercise intervention yielded significant weight loss compared to the control. Following 12 weeks a reduction of -8.3 +/- 4.2kg for diet intervention and -6.9 +/- 3.0kg for diet and exercise was observed. Additionally after one year, the diet intervention showed -10.2 +/- 5.7kg reduction and -7.3 +/- 6.3kg for the diet and exercise intervention (p<0.001). Colleran et al. also found significant weight change results by implementing a 16-week intervention which consisted of weekly individual sessions with a dietitian regarding calorie restriction, two additional home visits regarding exercise, weekly food diary completion and email support. The intervention group had greater weight loss compared to the control group (-5.8kg +/- 3.5kg vs -1.6kg +/- 5.4kg). It can be seen that various methods have been utilized in investigating the impact of diet and physical activity interventions on PPWR. The review by van der Pligt et al. highlights the impact successful lifestyle interventions can have on postpartum weight change. However, this review did not investigate the different intervention strategies utilized. It remains unclear as to the optimal setting, delivery method, diet strategy, contact frequency or intervention length to limit PPWR.Previous systematic reviews for both GWG and PPWR have focused on the effectiveness of lifestyle interventions as a whole for weight management in pregnant and postpartum women. And despite Tanentsapf et al.'s focus on dietary interventions for GWG, much is still unknown about the effectiveness of differing diet interventions over the antenatal and postpartum period. Specifically, the impact of differing diet intervention strategies on maternal weight gain is not known. Firstly, this systematic review will focus on whether weight management interventions which include a dietary component are effective in pregnant and postpartum women. In addition to this, this review will investigate the different intervention strategies utilized and their effectiveness in maternal weight management. A search of systematic review protocol databases has shown that there is no current review underway for this topic.

  4. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis123

    PubMed Central

    Pan, An; Willett, Walter C; Hu, Frank B

    2013-01-01

    Background: The relation between sugar-sweetened beverages (SSBs) and body weight remains controversial. Objective: We conducted a systematic review and meta-analysis to summarize the evidence in children and adults. Design: We searched PubMed, EMBASE, and Cochrane databases through March 2013 for prospective cohort studies and randomized controlled trials (RCTs) that evaluated the SSB-weight relation. Separate meta-analyses were conducted in children and adults and for cohorts and RCTs by using random- and fixed-effects models. Results: Thirty-two original articles were included in our meta-analyses: 20 in children (15 cohort studies, n = 25,745; 5 trials, n = 2772) and 12 in adults (7 cohort studies, n = 174,252; 5 trials, n = 292). In cohort studies, one daily serving increment of SSBs was associated with a 0.06 (95% CI: 0.02, 0.10) and 0.05 (95% CI: 0.03, 0.07)-unit increase in BMI in children and 0.22 kg (95% CI: 0.09, 0.34 kg) and 0.12 kg (95% CI: 0.10, 0.14 kg) weight gain in adults over 1 y in random- and fixed-effects models, respectively. RCTs in children showed reductions in BMI gain when SSBs were reduced [random and fixed effects: −0.17 (95% CI: −0.39, 0.05) and −0.12 (95% CI: −0.22, −0.2)], whereas RCTs in adults showed increases in body weight when SSBs were added (random and fixed effects: 0.85 kg; 95% CI: 0.50, 1.20 kg). Sensitivity analyses of RCTs in children showed more pronounced benefits in preventing weight gain in SSB substitution trials (compared with school-based educational programs) and among overweight children (compared with normal-weight children). Conclusion: Our systematic review and meta-analysis of prospective cohort studies and RCTs provides evidence that SSB consumption promotes weight gain in children and adults. PMID:23966427

  5. Postpartum Depressive Symptoms: Gestational Weight Gain as a Risk Factor for Adolescents Who Are Overweight or Obese.

    PubMed

    Cunningham, Shayna D; Mokshagundam, Shilpa; Chai, Hannah; Lewis, Jessica B; Levine, Jessica; Tobin, Jonathan N; Ickovics, Jeannette R

    2018-03-01

    Obesity is a risk factor for adverse physical health outcomes during pregnancy. Much less is known about the association between obesity and maternal mental health. Evidence suggests that prenatal depression is associated with excessive weight gain during pregnancy and that this relationship may vary according to pregravid body mass index (BMI). Young women may be particularly vulnerable to postpartum depression. The objective of this study is to examine the association between prepregnancy BMI, gestational weight gain, and postpartum depressive symptoms among adolescents. Participants were 505 pregnant adolescents aged 14 to 21 years followed during pregnancy and 6 months postpartum. Data were collected via interviews and medical record abstraction. Multilevel linear mixed models were used to test the association between excessive gestational weight gain as defined by National Academy of Medicine Guidelines and postpartum depressive symptoms measured via the validated Center for Epidemiologic Studies Depression (CES-D) scale. Analyses controlled for sociodemographic factors (maternal age, race, ethnicity, relationship status), health behaviors (nutrition, physical activity), prenatal depressive symptoms, and postpartum weight retention. Prepregnancy BMI was classified as follows: 11% underweight, 53% healthy weight, 19% overweight, and 18% obese. One-half (50%) of participants exceeded recommended guidelines for gestational weight gain. Adolescents with excessive gestational weight gain who entered pregnancy overweight or obese had significantly higher postpartum depressive symptoms (β, 2.41; SE, 1.06 vs β, 2.58; SE, 1.08, respectively; both P < .05) compared with those with healthy prepregnancy BMI and appropriate gestational weight gain. Adolescents who gained gestational weight within clinically recommended guidelines were not at risk for increased depressive symptoms. Adolescents who enter pregnancy overweight or obese and experience excessive weight gain may be at increased risk for postpartum depressive symptoms. Health care providers should offer preventive interventions during pregnancy and the interconceptional period to support healthy weight gain and safeguard women's mental health. © 2018 by the American College of Nurse-Midwives.

  6. Longitudinal associations between sleep duration and subsequent weight gain: A systematic review

    PubMed Central

    Magee, Lorrie

    2011-01-01

    Objective To systematically examine the relationship between sleep duration and subsequent weight gain in observational longitudinal human studies Methods Systematic review of twenty longitudinal studies published from 2004-October 31, 2010 Results While adult studies (n=13) reported inconsistent results on the relationship between sleep duration and subsequent weight gain, studies with children (n=7) more consistently reported a positive relationship between short sleep duration and weight gain. Conclusion While shorter sleep duration consistently predicts subsequent weight gain in children, the relationship is not clear in adults. We discuss possible limitations of the current studies: 1.) the diminishing association between short sleep duration on weight gain over time after transition to short sleep, 2.) lack of inclusion of appropriate confounding, mediating, and moderating variables (i.e. sleep complaints and sedentary behavior), and 3.) measurement issues. PMID:21784678

  7. Glucagon-like peptide-1 analogs against antipsychotic-induced weight gain: potential physiological benefits

    PubMed Central

    2012-01-01

    Background Antipsychotic-induced weight gain constitutes a major unresolved clinical problem which may ultimately be associated with reducing life expectancy by 25 years. Overweight is associated with brain deterioration, cognitive decline and poor quality of life, factors which are already compromised in normal weight patients with schizophrenia. Here we outline the current strategies against antipsychotic-induced weight gain, and we describe peripheral and cerebral effects of the gut hormone glucagon-like peptide-1 (GLP-1). Moreover, we account for similarities in brain changes between schizophrenia and overweight patients. Discussion Current interventions against antipsychotic-induced weight gain do not facilitate a substantial and lasting weight loss. GLP-1 analogs used in the treatment of type 2 diabetes are associated with significant and sustained weight loss in overweight patients. Potential effects of treating schizophrenia patients with antipsychotic-induced weight gain with GLP-1 analogs are discussed. Conclusions We propose that adjunctive treatment with GLP-1 analogs may constitute a new avenue to treat and prevent metabolic and cerebral deficiencies in schizophrenia patients with antipsychotic-induced weight gain. Clinical research to support this idea is highly warranted. PMID:22891821

  8. Does dose matter in reducing gestational weight gain in exercise interventions? A systematic review of literature.

    PubMed

    McDonald, Samantha M; Liu, Jihong; Wilcox, Sara; Lau, Erica Y; Archer, Edward

    2016-04-01

    The purpose of this review was to examine the relationship between exercise dose and reductions in weight gain during pregnancy in exercise interventions. Systematic literature review. Four electronic research databases (PubMed, Web of Science, CINAHL, and Academic Search Premiere) were used to identify exercise interventions conducted with pregnant women. Eligible articles must have satisfied the following criteria: inclusion of a control condition, exercise as a major intervention component, weight gain measured and reported for each experimental condition, description of exercise dose (frequency, intensity and duration), and utilized an adequate number of control conditions to assess independent effects of exercise on weight gain. The literature search identified 4837 articles. Of these, 174 abstracts were screened and 21 intervention studies (18 exercise-only, 3 exercise/diet) were eligible for review. Only 38% of the interventions achieved statistically significant reductions in gestational weight gain. Successful interventions possessed higher adherence and lower attrition rates and were predominantly conducted among normal weight populations. No clear patterns or consistencies of exercise dose and reductions in weight gain were evident. An exercise dose associated with reductions in weight gain was unquantifiable among these interventions. Adherence and retention rates were strong contributors to the success of exercise interventions on gestational weight gain. It is strongly suggested that future researchers investigate methods to increase adherence and compliance, especially among overweight and obese women, and utilize objective measurement tools to accurately evaluate exercise dose performed by the participants and the impact on body composition and weight gain. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  9. Does dose matter in reducing gestational weight gain in exercise interventions? A systematic review of literature

    PubMed Central

    McDonald, Samantha M.; Liu, Jihong; Wilcox, Sara; Lau, Erica Y.; Archer, Edward

    2015-01-01

    Objective This purpose of this review was to examine the relationship between exercise dose and reductions in weight gain during pregnancy in exercise interventions. Design and Methods Four electronic research databases (PubMed, Web of Science, CINAHL, and Academic Search Premiere) were used to identify exercise interventions conducted with pregnant women. Eligible articles must have satisfied the following criteria: inclusion of a control condition, exercise as a major intervention component, weight gain measured and reported for each experimental condition, description of exercise dose (frequency, intensity and duration), and utilized an adequate number of control conditions to assess independent effects of exercise on weight gain. Results The literature search identified 4837 articles, of these, 174 abstracts were screened and 21 intervention studies (18 exercise-only, 3 exercise/diet) were eligible for review. Only 38% of the interventions achieved statistically significant reductions in weight gain during pregnancy. Successful interventions possessed higher adherence and lower attrition rates and were predominantly conducted among normal weight populations. No clear patterns or consistencies of exercise dose and weight gain were evident. Conclusions Adherence and retention rates were strong contributors to the success of exercise interventions on weight gain during pregnancy. However, an exercise dose associated with reductions in weight gain was unquantifiable among these interventions. It is strongly suggested that future researchers investigate methods to increase adherence and compliance, especially among overweight and obese women, and utilize objective measurement tools to accurately evaluate exercise dose performed by the participants and the impact on both body composition and weight gain. PMID:25846125

  10. [Smoking and changes in body weight: can physiopathology and genetics explain this association?].

    PubMed

    Chatkin, Raquel; Chatkin, José Miguel

    2007-01-01

    Tobacco use is the leading preventable cause of death in most countries, including Brazil. Smoking cessation is an important strategy for reducing the morbidity and mortality associated with tobacco-related diseases. An inverse relationship between nicotine use and body weight has been reported, in which body weight tends to be lower among smokers than among nonsmokers. Smoking abstinence results in an increase in body weight for both males and females. On average, sustained quitters gain from 5 to 6 kg, although approximately 10% gain more than 10 kg. Pharmacological treatment for smoking cessation attenuates weight gain. The importance of smoking cessation as a contributing cause of the current obesity epidemic has been little studied. In the USA, the rate of obesity attributable to smoking cessation has been estimated at approximately 6.0 and 3.2% for males and females, respectively. Although the mechanisms are unclear, there is evidence that dopamine and serotonin are appetite suppressants. The administration of nicotine, regardless of the delivery system, acutely raises the levels of these neurotransmitters in the brain, reducing the need for energy intake and consequently suppressing appetite. In addition, nicotine has a direct effect on adipose tissue metabolism, influencing the rate of weight gain following smoking cessation. Leptin, ghrelin and neuropeptide Y are substances that might constitute factors involved in the inverse relationship between nicotine and body mass index, although their roles as determinants or consequences of this relationship have yet to be determined.

  11. Infant Body Composition and Adipokine Concentrations in Relation to Maternal Gestational Weight Gain

    PubMed Central

    Estampador, Angela C.; Pomeroy, Jeremy; Renström, Frida; Nelson, Scott M.; Mogren, Ingrid; Persson, Margareta; Sattar, Naveed; Domellöf, Magnus; Franks, Paul W.

    2014-01-01

    OBJECTIVE To investigate associations of maternal gestational weight gain and body composition and their impact on offspring body composition and adipocytokine, glucose, and insulin concentrations at age 4 months. RESEARCH DESIGN AND METHODS This was a prospective study including 31 mother-infant pairs (N = 62). Maternal body composition was assessed using doubly labeled water. Infant body composition was assessed at 4 months using air displacement plethysmography, and venous blood was assayed for glucose, insulin, adiponectin, interleukin-6 (IL-6), and leptin concentrations. RESULTS Rate of gestational weight gain in midpregnancy was significantly associated with infant fat mass (r = 0.41, P = 0.03); rate of gestational weight in late pregnancy was significantly associated with infant fat-free mass (r = 0.37, P = 0.04). Infant birth weight was also strongly correlated with infant fat-free mass at 4 months (r = 0.63, P = 0.0002). Maternal BMI and maternal fat mass were strongly inversely associated with infant IL-6 concentrations (r = −0.60, P = 0.002 and r = −0.52, P = 0.01, respectively). Infant fat-free mass was inversely related to infant adiponectin concentrations (r = −0.48, P = 0.008) and positively correlated with infant blood glucose adjusted for insulin concentrations (r = 0.42, P = 0.04). No significant associations for leptin were observed. CONCLUSIONS Timing of maternal weight gain differentially impacts body composition of the 4-month-old infant, which in turn appears to affect the infant’s glucose and adipokine concentrations. PMID:24623025

  12. Promotion of healthy weight-control practices in young athletes.

    PubMed

    2005-12-01

    Children and adolescents are often involved in sports in which weight loss or weight gain is perceived as an advantage. This policy statement describes unhealthy weight-control practices that may be harmful to the health and/or performance of athletes. Healthy methods of weight loss and weight gain are discussed, and physicians are given resources and recommendations that can be used to counsel athletes, parents, coaches, and school administrators in discouraging inappropriate weight-control behaviors and encouraging healthy methods of weight gain or loss, when needed.

  13. The impact of first time mother’s body mass index or excessive weight gain in pregnancy on genital tract trauma at birth

    PubMed Central

    Gallagher, Kelly; Migliaccio, Laura; Rogers, Rebecca G; Leeman, Lawrence; Hervey, Elizabeth; Qualls, Clifford

    2013-01-01

    Objective To explore the impact of body mass index BMI or pregnancy weight gain on the presence, site and severity of genital tract trauma at childbirth in nulliparous women. Methods The present study is a sub-analysis of a prospective cohort of healthy nulliparous women recruited during pregnancy and followed through birth. Weight gain during pregnancy and pre-pregnancy BMI were recorded. At birth, women underwent detailed mapping of genital tract trauma. For analyses, women were dichotomized into obese(BMI ≥30) versus non obese(BMI <30) at baseline as well as into those who gained weight as recommended by the Institute of Medicine (IOM) and those who gained more than the recommended amount to determine the impact of obesity or excessive weight gain on rates of genital tract trauma. Results Data from 445 women were available for analysis. Presence and severity of genital tract trauma did not vary between obese and non-obese women (P = NS). Likewise women who gained more than the IOM recommended weight did not have a higher incidence of perineal lacerations (53% vs 51% with perineal lacerations, P= .61). Obese women were more likely to gain in excess of the IOM guidelines during pregnancy (75% vs 50% excessive weight gain, obese vs non-obese women, P<0.001). Conclusion A woman’s BMI or excessive weight gain in pregnancy did not influence her risk of genital tract trauma at birth. PMID:24588877

  14. Gestational Weight Gain and Pregnancy Outcomes in Relation to Body Mass Index in Asian Indian Women.

    PubMed

    Bhavadharini, Balaji; Anjana, Ranjit Mohan; Deepa, Mohan; Jayashree, Gopal; Nrutya, Subramanyam; Shobana, Mahadevan; Malanda, Belma; Kayal, Arivudainambi; Belton, Anne; Joseph, Kurian; Rekha, Kurian; Uma, Ram; Mohan, Viswanathan

    2017-01-01

    The aim of the study was to compare the weight gain during pregnancy (using Institute of Medicine guidelines) among Asian Indians across different body mass index (BMI) categories (using World Health Organization Asia Pacific BMI cut points) and to compare the pregnancy outcomes in each of the different BMI categories. Retrospective records of 2728 pregnant women attending antenatal clinics and private maternity centers in Chennai, South India, from January 2011 to January 2014 were studied. Pregnancy outcomes were analyzed in relation to BMI and weight gain across different BMI categories. Overweight and obese women who gained more weight during pregnancy were at high risk of delivering macrosomic infants (overweight - odds ratio [OR]: 2.3, 95% confidence interval [CI]: 1.1-5.2, P = 0.02 and obese - OR: 1.6, 95% CI: 1.1-2.4, P = 0.01). In addition, obese women who gained more weight were also at high risk of preterm labor (OR: 2.1, 95% CI: 1.1-3.8; P = 0.01), cesarean section (OR: 1.9, 95% CI: 1.4-2.5; P < 0.001), and preeclampsia (OR: 2.8, 95% CI: 1.1-7.2, P = 0.03). Normal weight and overweight women who gained less weight had a protective effect from cesarean section and macrosomia. Overweight/obese women who gained more weight than recommended are at a high risk of developing adverse pregnancy outcomes. Normal and overweight women who gained weight less than recommended have low risk for cesarean section and macrosomia. However, they have a higher (statistically insignificant) risk for low birth weight and preterm birth. This highlights the need for gaining adequate weight during pregnancy.

  15. Smoking Habits and Body Weight Over the Adult Lifespan in Postmenopausal Women.

    PubMed

    Kabat, Geoffrey C; Heo, Moonseong; Allison, Matthew; Johnson, Karen C; Ho, Gloria Y F; Tindle, Hilary A; Asao, Keiko; LaMonte, Michael J; Giovino, Gary A; Rohan, Thomas E

    2017-03-01

    The inter-relationships between smoking habits and weight gain are complex. However, few studies have examined the association of smoking habits with weight gain over the life course. Major smoking parameters and weight gain over time were examined in a large cohort of postmenopausal women aged 50-79 years at enrollment between 1993 and 1998 (N=161,808) and followed through 2014 (analyses conducted in 2016). Cross-sectional analyses were used to assess the association of smoking and body weight at baseline. Retrospective data were used to correlate smoking status with body weight over a 45-year period prior to enrollment. In addition, the association of smoking with weight gain over 6 years of follow-up was examined. At baseline, women who had quit smoking prior to enrollment weighed 4.7 kg more than current smokers and 2.6 kg more than never smokers. Former, never, and current smokers all gained weight over the 45-year period from age 18 years to time of enrollment (average age, 63 years): 16.8, 16.4, and 14.6 kg, respectively. In prospective analyses, women who were current smokers at baseline but who quit smoking during follow-up gained more than 5 kg by Year 6 compared with current smokers at baseline who continued to smoke. Among long-term quitters, greater intensity of smoking and more recent quitting were associated with greater weight gain. These results suggest that excess weight gain associated with smoking cessation occurs soon after quitting and is modest relative to weight gain in never smokers over the adult lifespan. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  16. Adult weight gain and colorectal adenomas-a systematic review and meta-analysis.

    PubMed

    Schlesinger, S; Aleksandrova, K; Abar, L; Vieria, A R; Vingeliene, S; Polemiti, E; Stevens, C A T; Greenwood, D C; Chan, D S M; Aune, D; Norat, T

    2017-06-01

    Colorectal adenomas are known as precursors for the majority of colorectal carcinomas. While weight gain during adulthood has been identified as a risk factor for colorectal cancer, the association is less clear for colorectal adenomas. We conducted a systematic review and meta-analysis to quantify the evidence on this association. We searched Medline up to September 2016 to identify observational (prospective, cross-sectional and retrospective) studies on weight gain during adulthood and colorectal adenoma occurrence and recurrence. We conducted meta-analysis on high weight gain versus stable weight, linear and non-linear dose-response meta-analyses to analyze the association. Summary odds ratios (OR) and 95% confidence intervals (95% CI) were estimated using a random effects model. For colorectal adenoma occurrence, the summary OR was 1.39 (95% CI: 1.17-1.65; I2: 43%, N = 9 studies, cases = 5507) comparing high (midpoint: 17.4 kg) versus stable weight gain during adulthood and with each 5 kg weight gain the odds increased by 7% (2%-11%; I2: 65%, N = 7 studies). Although there was indication of non-linearity (Pnon-linearity < 0.001) there was an increased odds of colorectal adenoma throughout the whole range of weight gain. Three studies were identified investigating the association between weight gain and colorectal adenoma recurrence and data were limited to draw firm conclusions. Even a small amount of adult weight gain was related to a higher odds of colorectal adenoma occurrence. Our findings add to the benefits of weight control in adulthood regarding colorectal adenoma occurrence, which might be relevant for early prevention of colorectal cancer. © The Author 2017. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  17. Variation in the relationship between gestational diabetes diagnosis and total gestational weight gain by race/ethnicity.

    PubMed

    Chakkalakal, Rosette J; Gebretsadik, Tebeb; Jagasia, Shubhada; Shintani, Ayumi; Elasy, Tom A

    2015-04-01

    Prior research suggests that women diagnosed and treated for gestational diabetes mellitus (GDM) gain less total gestational weight than normoglycemic women. Our study finds that race/ethnicity modifies this association. Relative to normoglycemic women, non-Hispanic white women with GDM gain less weight but non-Hispanic black and Hispanic women gain more weight. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Gestational weight gain and subsequent postpartum weight loss among young, low-income, ethnic minority women.

    PubMed

    Gould Rothberg, Bonnie E; Magriples, Urania; Kershaw, Trace S; Rising, Sharon Schindler; Ickovics, Jeannette R

    2011-01-01

    Document weight change trajectories that lead to gestational weight gain or postpartum weight loss outside clinical recommendations established by the Institute of Medicine. Women aged 14-25 receiving prenatal care and delivering singleton infants at term (n = 427). Medical record review and 4 structured interviews conducted: second and third trimester, 6- and 12-months postpartum. Longitudinal mixed modeling to evaluate weight change trajectories. Only 22% of participants gained gestational weight within Institute of Medicine guidelines. There were 62% that exceeded maximum recommendations-more common among those overweight/obese (body mass index ≥25.0; P < .0001). 52% retained ≥10 lb 1-year postpartum. Increased weight gain and retention documented among smokers and women with pregnancy-induced hypertension; breastfeeding promoted postpartum weight loss (all P < .02). Body mass index by race interaction suggested healthier outcomes for Latinas (P = .02). Excessive pregnancy weight gain and inadequate postpartum weight loss are highly prevalent among young low-income ethnic minority women. Pregnancy and postpartum are critical junctures for weight management interventions. Copyright © 2011 Mosby, Inc. All rights reserved.

  19. Associations of maternal pre-pregnancy underweight with small-for-gestational-age and spontaneous preterm birth, and optimal gestational weight gain in Japanese women.

    PubMed

    Fujiwara, Kana; Aoki, Shigeru; Kurasawa, Kentaro; Okuda, Mika; Takahashi, Tsuneo; Hirahara, Fumiki

    2014-04-01

    To determine associations of maternal pre-pregnancy underweight with poor outcomes and evaluate how gestational weight gain affects risks for such outcomes in pre-pregnancy underweight Japanese women. By analyzing the January 2001-December 2012 hospital database, we retrospectively identified 6954 women with pre-pregnancy normal weights (body mass index, 18.5-24.9 kg/m²) and 1057 pre-pregnancy underweight women (body mass index, <18.5 kg/m²) who delivered at the Perinatal Maternity and Neonatal Center of Yokohama City University. These women were stratified by weekly weight gain during the second/third trimesters to investigate associations of gestational weight gain with spontaneous preterm birth and small for gestational age (SGA). Spontaneous preterm birth and SGA incidences were compared with those of women meeting Institute of Medicine (IO M) guidelines to determine optimal weight gain in Japanese women. Preterm birth and SGA incidences were significantly higher in pre-pregnancy underweight than in pre-pregnancy normal weight women (4.6% vs 2.4% [P=0.005] and 13.9% vs 9.7% [P = 0.003], respectively). For pre-pregnancy normal weight women, preterm birth incidence was significantly higher in those with weight gain of less than 0.2 kg/week than in those IOM guidelines. For pre-pregnancy underweight women, preterm birth and SGA incidences were significantly higher in those with weight gain of less than 0.3 kg/week than in those meeting IOM guidelines. Preterm birth and SGA incidences did not differ significantly between pre-pregnancy normal weight women with weight gain of 0.2 kg/week or more and pre-pregnancy underweight women with weight gain of 0.3 kg/week or more, as compared to women meeting IOM guidelines. These results suggest that IOM guidelines for gestational weight gain may lack external validity in Japanese women. © 2014 The Authors. Journal of Obstetrics and Gynaecology Research © 2014 Japan Society of Obstetrics and Gynecology.

  20. Weight gain in children on oxcarbazepine monotherapy.

    PubMed

    Garoufi, Anastasia; Vartzelis, George; Tsentidis, Charalambos; Attilakos, Achilleas; Koemtzidou, Evangelia; Kossiva, Lydia; Katsarou, Eustathia; Soldatou, Alexandra

    2016-05-01

    Studies of the effect of oxcarbazepine (OXC) on body growth of children with epilepsy are rare and their results are controversial. To the contrary, many studies have shown significant weight gain following valproate (VPA) treatment. To prospectively evaluate the effect of OXC monotherapy on growth patterns of children with epilepsy and compare it with the effect of VPA monotherapy. Fifty-nine otherwise healthy children, aged 3.7-15.9 years, with primary generalized, partial or partial with secondary generalization seizure disorder, were included in the study. Twenty six children were placed on OXC and thirty three on VPA monotherapy. Body weight (BW), height and body mass index (BMI) as well as their standard deviation scores (SDS), were evaluated prior to as well as 8 months post initiation of OXC or VPA therapy. Eight months post OXC-treatment, BW, SDS-BW, BMI and SDS-BMI increased significantly. The increase was similar to that observed in the VPA group. An additional 15.4% of children in the OXC group and 21.2% in the VPA group became overweight or obese. The effect of both OXC and VPA therapy on linear growth did not reach statistical significance. Similarly to VPA, OXC monotherapy resulted in a significant weight gain in children with epilepsy. Careful monitoring for excess weight gain along with counseling on adapting a healthy lifestyle should be offered to children on OXC therapy. Copyright © 2016 Elsevier B.V. All rights reserved.

  1. Relationship of pressure to be thin with gains in body weight and fat mass in adolescents.

    PubMed

    Suelter, C S; Schvey, N; Kelly, N R; Shanks, M; Thompson, K A; Mehari, R; Brady, S; Yanovski, S Z; Melby, C L; Tanofsky-Kraff, M; Yanovski, J A; Shomaker, L B

    2018-01-01

    Sociocultural pressure to be thin is commonly reported by adolescents; yet, to what extent such pressure is associated with weight gain has not been evaluated longitudinally. Examine whether pressure to be thin was positively associated with weight and fat gain in adolescents. Participants were 196 healthy adolescent (age 15 ± 1 years old) girls (65%) and boys of varying weights (BMI 25 ± 7 kg/m 2 ) studied at baseline and 1-year follow-up. At baseline, adolescents and their mothers reported pressure to be thin by questionnaire. At baseline and follow-up, BMI was calculated, and fat mass was assessed with air displacement plethysmography. Multiple regression was used to examine associations between baseline pressure to be thin and 1-year changes in BMI and fat mass. Accounting for multiple covariates, including baseline BMI or fat, adolescent-reported pressure from parents and peers and mother-reported pressure toward their teen were associated with greater gains in either adolescent BMI or fat (ps < .05). Adolescent weight status was a moderator of multiple effects (ps < .05). Parental and peer pressure to be thin were associated with increases in BMI and fat mass during adolescence, particularly in heavier adolescents. Further research is necessary to clarify how this association operates reciprocally and to identify underlying explanatory mechanisms. © 2016 World Obesity Federation.

  2. Comparison of standardized versus individualized caloric prescriptions in the nutritional rehabilitation of inpatients with anorexia nervosa

    PubMed Central

    Haynos, Ann F.; Snipes, Cassandra; Guarda, Angela; Mayer, Laurel E.; Attia, Evelyn

    2015-01-01

    Objective Sparse research informs how caloric prescriptions should be advanced during nutritional rehabilitation of inpatients with anorexia nervosa (AN). This study compared the impact of a standardized caloric increase approach, in which increases occurred on a predetermined schedule, to an individualized approach, in which increases occurred only following insufficient weight gain, on rate, pattern, and cumulative amount of weight gain and other weight restoration outcomes. Method This study followed a natural experiment design comparing AN inpatients consecutively admitted before (n = 35) and after (n = 35) an institutional change from individualized to standardized caloric prescriptions. Authors examined the impact of prescription plan on weekly weight gain in the first treatment month using multilevel modeling. Within a subsample remaining inpatient through weight restoration (n = 40), multiple regressions examined the impact of caloric prescription plan on time to weight restoration, length of hospitalization, maximum caloric prescription, discharge BMI, and incidence of activity restriction and edema. Results There were significant interactions between prescription plan and quadratic time on average weekly weight gain (p = .03) and linear time on cumulative weekly weight gain (p < .001). Under the standardized plan, patients gained in an accelerated curvilinear pattern (p = .04) and, therefore, gained cumulatively greater amounts of weight over time (p < .001). Additionally, 30% fewer patients required activity restriction under the standardized plan. Discussion Standardized caloric prescriptions may confer advantage by facilitating accelerated early weight gain and lower incidence of bed rest without increasing the incidence of refeeding syndrome. PMID:26769581

  3. Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial.

    PubMed

    Davis, Deborah; Davey, Rachel; Williams, Lauren T; Foureur, Maralyn; Nohr, Ellen; Knight-Agarwal, Catherine; Lawlis, Tanya; Oats, Jeremy; Skouteris, Helen; Fuller-Tyszkiewicz, Matthew

    2018-05-30

    Approximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy. The primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention. This randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women's weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care. Recruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign. Feasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy. Australian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo). RR1-10.2196/9920. ©Deborah Davis, Rachel Davey, Lauren T. Williams, Maralyn Foureur, Ellen Nohr, Catherine Knight-Agarwal, Tanya Lawlis, Jeremy Oats, Helen Skouteris, Matthew Fuller-Tyszkiewicz. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 30.05.2018.

  4. Lactobacillus reuteri and Escherichia coli in the human gut microbiota may predict weight gain associated with vancomycin treatment

    PubMed Central

    Million, M; Thuny, F; Angelakis, E; Casalta, J-P; Giorgi, R; Habib, G; Raoult, D

    2013-01-01

    Background: Antibiotics, used for 60 years to promote weight gain in animals, have been linked to obesity in adults and in children when administered during early infancy. Lactobacillus reuteri has been linked to obesity and weight gain in children affected with Kwashiorkor using ready-to-use therapeutic food. In contrast, Escherichia coli has been linked with the absence of obesity. Both of these bacteria are resistant to vancomycin. Objectives and methods: We assessed vancomycin-associated weight and gut microbiota changes, and tested whether bacterial species previously linked with body mass index (BMI) predict weight gain at 1 year. All endocarditis patients treated with vancomycin or amoxicillin in our center were included from January 2008 to December 2010. Bacteroidetes, Firmicutes, Lactobacillus and Methanobrevibacter smithii were quantified using real-time PCR on samples obtained during the 4–6 weeks antibiotic regimen. L. reuteri, L. plantarum, L. rhamnosus, Bifidobacterium animalis and E. coli were quantified on stool samples obtained during the first week of antibiotics. Results: Of the193 patients included in the study, 102 were treated with vancomycin and 91 with amoxicillin. Vancomycin was associated with a 10% BMI increase (odds ratio (OR) 14.1; 95% confidence interval (CI; 1.03–194); P=0.047) and acquired obesity (4/41 versus 0/56, P=0.01). In patients treated with vancomycin, Firmicutes, Bacteroidetes and Lactobacillus increased, whereas M. smithii decreased (P<0.05). The absence of E. coli was an independent predictor of weight gain (OR=10.7; 95% CI (1.4–82.0); P=0.02). Strikingly, a patient with an 18% BMI increase showed a dramatic increase of L. reuteri but no increase of E. coli. Conclusion: The acquired obesity observed in patients treated with vancomycin may be related to a modulation of the gut microbiota rather than a direct antibiotic effect. L. reuteri, which is resistant to vancomycin and produces broad bacteriocins, may have an instrumental role in this effect. PMID:24018615

  5. Comparative genomics analysis of Lactobacillus species associated with weight gain or weight protection

    PubMed Central

    Drissi, F; Merhej, V; Angelakis, E; El Kaoutari, A; Carrière, F; Henrissat, B; Raoult, D

    2014-01-01

    BACKGROUND: Some Lactobacillus species are associated with obesity and weight gain while others are associated with weight loss. Lactobacillus spp. and bifidobacteria represent a major bacterial population of the small intestine where lipids and simple carbohydrates are absorbed, particularly in the duodenum and jejunum. The objective of this study was to identify Lactobacillus spp. proteins involved in carbohydrate and lipid metabolism associated with weight modifications. METHODS: We examined a total of 13 complete genomes belonging to seven different Lactobacillus spp. previously associated with weight gain or weight protection. We combined the data obtained from the Rapid Annotation using Subsystem Technology, Batch CD-Search and Gene Ontology to classify gene function in each genome. RESULTS: We observed major differences between the two groups of genomes. Weight gain-associated Lactobacillus spp. appear to lack enzymes involved in the catabolism of fructose, defense against oxidative stress and the synthesis of dextrin, L-rhamnose and acetate. Weight protection-associated Lactobacillus spp. encoded a significant gene amount of glucose permease. Regarding lipid metabolism, thiolases were only encoded in the genome of weight gain-associated Lactobacillus spp. In addition, we identified 18 different types of bacteriocins in the studied genomes, and weight gain-associated Lactobacillus spp. encoded more bacteriocins than weight protection-associated Lactobacillus spp. CONCLUSIONS: The results of this study revealed that weight protection-associated Lactobacillus spp. have developed defense mechanisms for enhanced glycolysis and defense against oxidative stress. Weight gain-associated Lactobacillus spp. possess a limited ability to breakdown fructose or glucose and might reduce ileal brake effects. PMID:24567124

  6. Diet quality, physical activity, smoking status, and weight fluctuation are associated with weight change in women and men.

    PubMed

    Kimokoti, Ruth W; Newby, P K; Gona, Philimon; Zhu, Lei; Jasuja, Guneet K; Pencina, Michael J; McKeon-O'Malley, Catherine; Fox, Caroline S; D'Agostino, Ralph B; Millen, Barbara E

    2010-07-01

    The effect of diet quality on weight change, relative to other body weight determinants, is insufficiently understood. Furthermore, research on long-term weight change in U.S. adults is limited. We evaluated prospectively patterns and predictors of weight change in Framingham Offspring/Spouse (FOS) women and men (n = 1515) aged > or =30 y with BMI > or = 18.5 kg/m2 and without cardiovascular disease, diabetes, and cancer at baseline over a 16-y period. Diet quality was assessed using the validated Framingham Nutritional Risk Score. In women, older age (P < 0.0001) and physical activity (P < 0.05) were associated with lower weight gain. Diet quality interacted with former smoking status (P-interaction = 0.02); former smokers with lower diet quality gained an additional 5.2 kg compared with those with higher diet quality (multivariable-adjusted P-trend = 0.06). Among men, older age (P < 0.0001) and current smoking (P < 0.01) were associated with lower weight gain, and weight fluctuation (P < 0.01) and former smoking status (P < 0.0001) were associated with greater weight gain. Age was the strongest predictor of weight change in both women (partial R(2) = 11%) and men (partial R(2) = 8.6%). Normal- and overweight women gained more than obese women (P < 0.05) and younger adults gained more weight than older adults (P < 0.0001). Patterns and predictors of weight change differ by sex. Age in both sexes and physical activity among women as well as weight fluctuation and smoking status in men were stronger predictors of weight change than diet quality among FOS adults. Women who stopped smoking over follow-up and had poor diet quality gained the most weight. Preventive interventions need to be sex-specific and consider lifestyle factors.

  7. Saccharin and aspartame, compared with sucrose, induce greater weight gain in adult Wistar rats, at similar total caloric intake levels.

    PubMed

    Feijó, Fernanda de Matos; Ballard, Cíntia Reis; Foletto, Kelly Carraro; Batista, Bruna Aparecida Melo; Neves, Alice Magagnin; Ribeiro, Maria Flávia Marques; Bertoluci, Marcello Casaccia

    2013-01-01

    It has been suggested that the use of nonnutritive sweeteners (NNSs) can lead to weight gain, but evidence regarding their real effect in body weight and satiety is still inconclusive. Using a rat model, the present study compares the effect of saccharin and aspartame to sucrose in body weight gain and in caloric intake. Twenty-nine male Wistar rats received plain yogurt sweetened with 20% sucrose, 0.3% sodium saccharin or 0.4% aspartame, in addition to chow and water ad libitum, while physical activity was restrained. Measurements of cumulative body weight gain, total caloric intake, caloric intake of chow and caloric intake of sweetened yogurt were performed weekly for 12 weeks. Results showed that addition of either saccharin or aspartame to yogurt resulted in increased weight gain compared to addition of sucrose, however total caloric intake was similar among groups. In conclusion, greater weight gain was promoted by the use of saccharin or aspartame, compared with sucrose, and this weight gain was unrelated to caloric intake. We speculate that a decrease in energy expenditure or increase in fluid retention might be involved. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Transferring preterm infants from incubators to open cots at 1600 g: a multicentre randomised controlled trial.

    PubMed

    New, K; Flint, A; Bogossian, F; East, C; Davies, M W

    2012-03-01

    To determine the effects on weight gain and temperature control of transferring preterm infants from incubators to open cots at a weight of 1600 g versus a weight of 1800 g. Randomised controlled trial. One tertiary and two regional neonatal units in public hospitals in Queensland, Australia. 182 preterm infants born with a birth weight less than 1600 g, who were at least 48 h old; had not required ventilation or continuous positive airways pressure within the last 48 h; were medically stable with no oxygen requirement, or significant apnoea or bradycardia; did not require phototherapy; and were enterally fed with an intake (breast milk/formula) of at least 60 ml/kg/day. Transfer into an open cot at 1600 or 1800 g. The primary outcomes were temperature stability and average daily weight gain over the first 14 days following transfer to an open cot. 90 infants in the 1600 g group and 92 infants in the 1800 g group were included in the analysis. Over the first 72 h, more infants in the 1800 g group had temperatures <36.4°C than the 1600 g group (p=0.03). From post-transfer to discharge, the 1600 g group had more temperatures >37.1°C (p=0.02). Average daily weight gain in the 1600 g group was 17.07 (SD±4.5) g/kg/day and in the 1800 g group, 13.97 (SD±4.7) g/kg/day (p=<0.001). Medically stable, preterm infants can be transferred to open cots at a birth weight of 1600 g without any significant adverse effects on temperature stability or weight gain. ACTRN12606000518561 (http://www.anzctr.org.au).

  9. Weight-loss strategies of South African female university students and comparison of weight management-related characteristics between dieters and non-dieters.

    PubMed

    Senekal, Marjanne; Lasker, Gabrielle L; van Velden, Lindsay; Laubscher, Ria; Temple, Norman J

    2016-09-01

    Female university students are at risk for weight gain and use of inappropriate weight-loss strategies. By gaining a greater understanding of the weight-loss strategies used by and weight management related characteristics of these students, effective weight management interventions for this vulnerable group can be developed. Two hundred and fifty female students from South Africa universities, aged 18-25 years, participated in this cross-sectional study; 162 attempted weight loss during the year preceding the study (dieters) and 88 were non-dieters. Weight and height were measured and BMI (kg/m(2)) computed. A self-administered questionnaire was used to record all other variables. Weight loss strategies were described for dieters and compared between BMI groups within the dieters group. Weight management related characteristics were compared between dieters and non-dieters. Statistical tests included Pearson Chi-square test, independent samples t-test or Mann-Whitney U test (depending on distribution of the data). Predictors for a higher BMI and being overweight/obese (BMI ≥25 kg/m(2)) were identified using regression models. Healthy weight-loss strategies included increased exercise and fruit/vegetable intake and decreased intake of sugar and fat containing items; unhealthy methods included eating little food and skipping meals; and extreme weight loss strategies included laxatives and vomiting. The most commonly used weight-loss product was Herbex. Dieters were characterized by a higher BMI, overestimation of their weight (especially normal weight students), dissatisfaction with weight and select body parts, higher intake of breakfast and healthy foods, lower intake of unhealthy foods, higher levels of vigorous physical activity, higher use of select informal weight-loss information sources and experiencing more pressure to lose weight from mothers, siblings and friends. Predictors of higher BMI and/or increased risk for BMI ≥25 included weight-loss attempt during the past year, race, dissatisfaction with waist, perception of currently being "chubby," and higher frequencies of intake of a snack and fatty foods. Attempting weight-loss is common among female students and predicts BMI. Healthy (mainly), unhealthy and extreme weight loss methods are used. Dieters are characterized by a less realistic body image, lower body satisfaction, higher pressure to lose weight, use of informal weight-management information and a healthier life-style.

  10. Gestational diabetes mellitus and interpregnancy weight change: A population-based cohort study

    PubMed Central

    Sorbye, L. M.; Skjaerven, R.; Klungsoyr, K.; Morken, N. H.

    2017-01-01

    Background Being overweight is an important risk factor for Gestational Diabetes Mellitus (GDM), but the underlying mechanisms are not understood. Weight change between pregnancies has been suggested to be an independent mechanism behind GDM. We assessed the risk for GDM in second pregnancy by change in Body Mass Index (BMI) from first to second pregnancy and whether BMI and gestational weight gain modified the risk. Methods and findings In this observational cohort, we included 24,198 mothers and their 2 first pregnancies in data from the Medical Birth Registry of Norway (2006–2014). Weight change, defined as prepregnant BMI in second pregnancy minus prepregnant BMI in first pregnancy, was divided into 6 categories by units BMI (kilo/square meter). Relative risk (RR) estimates were obtained by general linear models for the binary family and adjusted for maternal age at second delivery, country of birth, education, smoking in pregnancy, interpregnancy interval, and year of second birth. Analyses were stratified by BMI (first pregnancy) and gestational weight gain (second pregnancy). Compared to women with stable BMI (−1 to 1), women who gained weight between pregnancies had higher risk of GDM—gaining 1 to 2 units: adjusted RR 2.0 (95% CI 1.5 to 2.7), 2 to 4 units: RR 2.6 (2.0 to 3.5), and ≥4 units: RR 5.4 (4.0 to 7.4). Risk increased significantly both for women with BMI below and above 25 at first pregnancy, although it increased more for the former group. A limitation in our study was the limited data on BMI in 2 pregnancies. Conclusions The risk of GDM increased with increasing weight gain from first to second pregnancy, and more strongly among women with BMI < 25 in first pregnancy. Our results suggest weight change as a metabolic mechanism behind the increased risk of GDM, thus weight change should be acknowledged as an independent factor for screening GDM in clinical guidelines. Promoting healthy weight from preconception through the postpartum period should be a target. PMID:28763446

  11. Nicotine Replacement: Effects on Postcessation Weight Gain.

    ERIC Educational Resources Information Center

    Gross, Janet; And Others

    1989-01-01

    Examined nicotine replacement effects on postcessation weight gain in smoking cessation volunteers. Randomly assigned abstinent subjects to active nicotine or placebo gum conditions for 10 weeks. Analyses revealed strong evidence for gum effect on weight gain, with active gum users gaining mean total of 3.8 pounds compared with 7.8 pounds for…

  12. Substance Use, Disordered Eating, and Weight Gain: Describing the Prevention and Treatment Needs of Incarcerated Women.

    PubMed

    Drach, Linda L; Maher, Julie E; Braun, Margaret J F; Murray, Stefanie L; Sazie, Elizabeth

    2016-04-01

    Weight-related concerns are associated with women's substance use and treatment relapse. The prevalence of overweight, obesity, disordered eating behavior, and substance abuse history was assessed among female inmates incarcerated for 6 to 24 months at an Oregon state prison, using a self-administered survey and physical measurements. Average weight gain was 20 pounds, 87% of women were overweight (39%) or obese (48%), and 24% reported using one or more unhealthy strategies to lose weight in the past 6 months. Women who used tobacco and illicit substances before incarceration gained more weight. Integrating nutrition and weight gain issues into substance abuse treatment could benefit incarcerated women--both soon after entering prison to prevent weight gain and close to release to prevent relapse into substance use. © The Author(s) 2016.

  13. The impact of lifestyle on Barrett's Esophagus: A precursor to esophageal adenocarcinoma.

    PubMed

    Navab, Farhad; Nathanson, Brian H; Desilets, David J

    2015-12-01

    Barrett's Esophagus (BE), particularly long-segment Barrett's Esophagus, and the age of onset of Barrett's Esophagus are risk factors for esophageal adenocarcinoma. However, it is unknown if lifestyle factors such as alcohol abuse, tobacco use, weight gains that increase the risk of developing BE and esophageal adenocarcinoma affect its length or age at diagnosis. In a retrospective, cross-sectional analysis, we analyzed 158 newly diagnosed adult BE patients at a 600-bed tertiary care center in the United States from 1999 to 2008. We constructed generalized linear models for the outcomes of BE length and age at diagnosis. Predictors of interest included current or prior alcohol abuse, tobacco use, weight gain over the last 5 years, and body mass index (BMI). 71 (45%) had length ≥ 3 cm. Barrett's Esophagus length was positively correlated with hiatal hernia length (r=0.67, p<0.001) and heartburn duration (r=0.36, p<0.001). Multivariate results showed no significant relationship between alcohol abuse, tobacco use, weight gain or BMI and BE length. Patients with weight gain, current tobacco use, and male gender were diagnosed at a significantly younger age than their peers (for example, the adjusted mean age at diagnosis for current tobacco users vs. non-smokers was 49.2 years vs. 54.7 years, p=0.029). Lifestyle factors did not appear to affect Barrett's Esophagus length but weight gains, smoking, and male gender were associated with a diagnosis at a significantly younger age. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Proliferation capacity of T-lymphocytes is affected transiently after a long-term weight gain in Beagle dogs.

    PubMed

    Van de Velde, H; Janssens, G P J; Rochus, K; Duchateau, L; Scharek-Tedin, L; Zentek, J; Nguyen, P; Cox, E; Buyse, J; Biourge, V; Hesta, M

    2013-04-15

    Across species obesity is associated with several disorders but in companion animals little information is available on the impact of chronic obesity on immune competence. The aim of the present study was to investigate whether weight gain and stable obese bodyweight affects the immune cell response. Obesity was induced in eight adult healthy beagle dogs (weight gain group; WGG) by a weight gain period (WGP) of 47 weeks, which was immediately followed by a period (stable period: SP) of stable obesity of 26 weeks. Eight adult healthy beagle dogs were included as a control group (CG) and remained at their ideal bodyweight throughout the entire study. Body composition was measured at five intervening time-points. Concentration of serum leptin and inflammatory cytokines, functionality of lymphocytes and phagocytic activity of neutrophils and monocytes were evaluated at ten intervening time-points. Serum leptin concentration was rising during the WGP in the WGG but went to lower concentrations during the SP. At the end of long-term weight gain, a decreased mitogen-induced proliferation of T-lymphocytes was noted but this alteration seemed to be transient after stabilization of bodyweight. This finding may imply an altered immune response for dogs with different energy balances. However, no systemic low grade inflammation or alteration in other immune cell functions was observed. Consequently it is suggested that the change in energy balance during the onset of obesity (becoming obese versus being obese), evokes an additional obesity-related disorder in dogs, i.e. impaired T-lymphocyte immune function. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Does access to fast food lead to super-sized pregnant women and whopper babies?

    PubMed

    Lhila, Aparna

    2011-12-01

    Rise in the availability of fast-food restaurants has been blamed, at least partly, for the increasing obesity in the U.S. The existing studies of obesity have focused primarily on children, adolescents, and adults, and this paper extends the literature by raising a little-studied question and using nationally representative data to answer it. It examines the relationship between the supply of fast-food restaurants and weight gain of pregnant women and their newborns. I study prenatal weight gain because excessive weight gain has been linked to postpartum overweight/obesity and I study both tails of the birthweight distribution because the origin of obesity may be traced to the prenatal period and both tail outcomes have been associated with obesity later in life. I merge the 1998 and 2004 Natality Detail Files with the Area Resource File, and County Business Patterns, which provide data on the number of fast-food restaurants in the metropolitan area where the mother resides. The empirical model includes an extensive list of MSA characteristics and MSA fixed effects to control for factors that may be correlated with both health outcomes and restaurants' location decision. Results reveal that the fast-food and weight gain relationship is robust to the inclusion of these controls but these controls greatly mitigate the fast food-infant health relationship. Greater access to fast-food restaurants is positively related to mothers' probability of excessive weight gain but it does not share a statistically significant relationship with birthweight. These relationships hold in all the socioeconomic and demographic subgroups studied. 2011 Elsevier B.V. All rights reserved.

  16. Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle-Eastern females

    PubMed Central

    Papazian, Tatiana; Abi Tayeh, Georges; Sibai, Darine; Hout, Hala; Melki, Imad

    2017-01-01

    Background Studies on the relative impact of body mass index in women in childbearing age and gestational weight gain on neonatal outcomes are scarce in the Middle East. Objectives The primary objective of this research was to assess the impact of maternal body mass index (BMI) and gestational weight gain (GWG) on neonatal outcomes. The effect of maternal age and folic acid supplementation before and during pregnancy was also examined. Subjects and methods This is a retrospective cross sectional observational study of 1000 full term deliveries of women enrolled thru the National Collaborative Perinatal Neonatal Network, in Lebanon. Maternal characteristics such as age, BMI and GWG and neonatal outcomes such as weight, height, head circumference and Apgar score were the primary studied variables in this study. Total maternal weight gain were compared to the guidelines depicted by the Institute of Medicine (IOM). Results The negative outcomes of newborns such as lean body weight and macrosomia were significantly present in women who gained respectively below or above the IOM’s cut-off points. Pregestational body mass index influenced significantly the infants’ birth weight, in both the underweight and obese categories. Birth height, head circumference and Apgar score were not influenced by pregestational body mass index or gestational weight gain. No significant associations were found between maternal age and pregestational body mass index and gestational weight gain. Conclusion Studies evaluating the impact of weight before and during pregnancy on neonatal outcomes and anthropometrics measurements are lacking in the Middle East. Our results highlight the importance of nutritional counseling in order to shed the extra weights before conceiving and monitor weight gain to avoid the negative impact on feto-maternal health. PMID:28715482

  17. Impact of maternal body mass index and gestational weight gain on neonatal outcomes among healthy Middle-Eastern females.

    PubMed

    Papazian, Tatiana; Abi Tayeh, Georges; Sibai, Darine; Hout, Hala; Melki, Imad; Rabbaa Khabbaz, Lydia

    2017-01-01

    Studies on the relative impact of body mass index in women in childbearing age and gestational weight gain on neonatal outcomes are scarce in the Middle East. The primary objective of this research was to assess the impact of maternal body mass index (BMI) and gestational weight gain (GWG) on neonatal outcomes. The effect of maternal age and folic acid supplementation before and during pregnancy was also examined. This is a retrospective cross sectional observational study of 1000 full term deliveries of women enrolled thru the National Collaborative Perinatal Neonatal Network, in Lebanon. Maternal characteristics such as age, BMI and GWG and neonatal outcomes such as weight, height, head circumference and Apgar score were the primary studied variables in this study. Total maternal weight gain were compared to the guidelines depicted by the Institute of Medicine (IOM). The negative outcomes of newborns such as lean body weight and macrosomia were significantly present in women who gained respectively below or above the IOM's cut-off points. Pregestational body mass index influenced significantly the infants' birth weight, in both the underweight and obese categories. Birth height, head circumference and Apgar score were not influenced by pregestational body mass index or gestational weight gain. No significant associations were found between maternal age and pregestational body mass index and gestational weight gain. Studies evaluating the impact of weight before and during pregnancy on neonatal outcomes and anthropometrics measurements are lacking in the Middle East. Our results highlight the importance of nutritional counseling in order to shed the extra weights before conceiving and monitor weight gain to avoid the negative impact on feto-maternal health.

  18. [Breast feeding and systemic blood pressure in infants].

    PubMed

    Hernández-González, Martha A; Díaz-De-León, Luz V; Guízar-Mendoza, Juan M; Amador-Licona, Norma; Cipriano-González, Marisol; Díaz-Pérez, Raúl; Murillo-Ortiz, Blanca O; De-la-Roca-Chiapas, José María; Solorio-Meza, Sergio Eduardo

    2012-01-01

    Blood pressure levels in childhood influence these levels in adulthood, and breastfeeding has been considered such as a cardioprotective. We evaluated the association between blood pressure levels and feeding type in a group of infants. We conducted a comparative cross-sectional study in term infants with appropriate weight at birth, to compare blood pressure levels in those children with exclusively breastfeeding, mixed-feeding and formula feeding. The comparison of groups was performed using ANOVA and multiple regression analysis was used to identify variables associated with mean arterial blood pressure levels. A p value < 0.05 was considered significant. We included 20 men and 24 women per group. Infant Formula Feeding had higher current weight and weight gain compared with the other two groups (p < 0.05). Systolic, diastolic and mean blood pressure levels, as well as respiratory and heart rate were higher in the groups of exclusively formula feeding and mixed-feeding than in those with exclusively breastfeeding (p < 0.05). Multiple regression analysis identified that variables associated with mean blood pressure levels were current body mass index, weight gain and formula feeding. Infants in breastfeeding show lower blood pressure, BMI and weight gain.

  19. Association of gain and loss of weight before and after menopause with risk of postmenopausal breast cancer in the Iowa women's health study.

    PubMed

    Harvie, Michelle; Howell, Anthony; Vierkant, Robert A; Kumar, Nagi; Cerhan, James R; Kelemen, Linda E; Folsom, Aaron R; Sellers, Thomas A

    2005-03-01

    Obesity and adult weight gain are well-established risk factors for postmenopausal breast cancer. Although there are a few studies demonstrating the contribution of adult weight gain to breast cancer risk, whether weight gain during a critical time period is specifically associated with risk, or whether subsequent weight loss among women who have gained weight will reduce the excess risk, is not firmly established. We investigated the association of changes in weight (loss or gain in excess of 5% of body weight) using two risk factor models: (a) age 18 to 30 years and age 30 years to menopause and (b) age 30 years to menopause and after the menopause to the baseline study in 1986 on risk of postmenopausal breast cancer in a prospective cohort of 33,660 postmenopausal women in Iowa. Over 15 years of follow-up, 1,987 cases of breast cancer occurred. Data were analyzed using proportional hazards regression models adjusted for established breast cancer risk factors. The most frequently observed pattern of body weight over time was a consistent increase; these women were observed to have the highest rates of breast cancer and served as the reference category for all comparisons. The lowest-risk groups were (a) women who maintained or lost weight from age 18 to 30 years and then lost weight from age 30 years to menopause [risk ratio (RR), 0.36; 95% confidence interval (95% CI), 0.22-0.60] and (b) women who maintained or lost weight from age 30 years to menopause and then lost weight after the menopause (RR, 0.48; 95% CI, 0.22-0.65). Women who gained weight from age 30 years to menopause but then lost weight after the menopause experienced risk reductions (RR, 0.77; 95% CI, 0.64-0.92) although perhaps slightly smaller in magnitude than women who maintained their weight in both time intervals (RR, 0.63; 95% CI, 0.55-0.73). Women who gained weight from age 18 to 30 years and then lost weight from age 30 years to menopause had comparable risk reductions (RR, 0.61; 95% CI, 0.46-0.8) with women who maintained their weight in both time intervals (RR, 0.73; 95% CI, 0.64-0.84). Women who gained weight during the period from age 30 years to menopause but who had stable weight after menopause had rates similar to the reference group. These data suggest prevention of weight gain between age 18 years and menopause or weight loss and maintenance during these years reduces risk of postmenopausal breast cancer.

  20. Inadequate gestational weight gain and adverse pregnancy outcomes among normal weight women in China

    PubMed Central

    Wen, Tingyuan; Lv, Yanwei

    2015-01-01

    Objective: The objective of the paper is to find the association between inadequate gestational weight gain and pregnancy outcomes in normal weight women in China. Method: A retrospective study was conducted among 13,776 normal weight pregnant women who received antenatal care and delivered singleton infants at the participating hospital during August, 2009 to July, 2013. Adverse pregnancy outcomes like low birth weight (LBW), preterm birth, birth asphyxia, neonatal intensive care unit (NICU) admission and length of hospital stay were compared and analyzed between two groups with inadequate and adequate gestational weight gain. Results: According to the IOM recommendations, inadequate gestational weight gain was found to be 14.7% in this study. Women with inadequate gestational weight gain (GWG) were found to be at a higher risk for LBW (aOR = 2.13, 95% CI: 1.75, 2.86) and preterm birth (aOR = 1.44, 95% CI: 1.21, 1.67) than those in the adequate gestational weight gain group, after adjusting for monthly family income, maternal education, occupation, and whether they received any advice regarding benefits of gestational weight gain and residential area. However, inadequate GWG was not associated with longer hospital stay (aOR = 1.13, 95% CI: 0.91-1.43) in adjusted model. In addition, the rate of birth asphyxia and NICU admission were similar in both groups (P > 0.05). Conclusions: Normal weight pregnant women with GWG below the recommended AIOM 2009 guidelines were found to be at an increased risk of low birth weight and preterm birth. PMID:25932249

  1. Inadequate gestational weight gain and adverse pregnancy outcomes among normal weight women in China.

    PubMed

    Wen, Tingyuan; Lv, Yanwei

    2015-01-01

    The objective of the paper is to find the association between inadequate gestational weight gain and pregnancy outcomes in normal weight women in China. A retrospective study was conducted among 13,776 normal weight pregnant women who received antenatal care and delivered singleton infants at the participating hospital during August, 2009 to July, 2013. Adverse pregnancy outcomes like low birth weight (LBW), preterm birth, birth asphyxia, neonatal intensive care unit (NICU) admission and length of hospital stay were compared and analyzed between two groups with inadequate and adequate gestational weight gain. According to the IOM recommendations, inadequate gestational weight gain was found to be 14.7% in this study. Women with inadequate gestational weight gain (GWG) were found to be at a higher risk for LBW (aOR = 2.13, 95% CI: 1.75, 2.86) and preterm birth (aOR = 1.44, 95% CI: 1.21, 1.67) than those in the adequate gestational weight gain group, after adjusting for monthly family income, maternal education, occupation, and whether they received any advice regarding benefits of gestational weight gain and residential area. However, inadequate GWG was not associated with longer hospital stay (aOR = 1.13, 95% CI: 0.91-1.43) in adjusted model. In addition, the rate of birth asphyxia and NICU admission were similar in both groups (P > 0.05). Normal weight pregnant women with GWG below the recommended AIOM 2009 guidelines were found to be at an increased risk of low birth weight and preterm birth.

  2. Determinants of Weight Gain during the First Two Years of Life—The GECKO Drenthe Birth Cohort

    PubMed Central

    Küpers, Leanne K.; L’Abée, Carianne; Bocca, Gianni; Stolk, Ronald P.; Sauer, Pieter J. J.; Corpeleijn, Eva

    2015-01-01

    Objectives To explain weight gain patterns in the first two years of life, we compared the predictive values of potential risk factors individually and within four different domains: prenatal, nutrition, lifestyle and socioeconomic factors. Methods In a Dutch population-based birth cohort, length and weight were measured in 2475 infants at 1, 6, 12 and 24 months. Factors that might influence weight gain (e.g. birth weight, parental BMI, breastfeeding, hours of sleep and maternal education) were retrieved from health care files and parental questionnaires. Factors were compared with linear regression to best explain differences in weight gain, defined as changes in Z-score of weight-for-age and weight-for-length over 1–6, 6–12 and 12–24 months. In a two-step approach, factors were first studied individually for their association with growth velocity, followed by a comparison of the explained variance of the four domains. Results Birth weight and type of feeding were most importantly related to weight gain in the first six months. Breastfeeding versus formula feeding showed distinct growth patterns in the first six months, but not thereafter. From six months onwards, the ability to explain differences in weight gain decreased substantially (from R2 total = 38.7% to R2 total<7%). Conclusion Birth weight and breast feeding were most important to explain early weight gain, especially in the first six months of life. After the first six months of life other yet undetermined factors start to play a role. PMID:26192417

  3. [Body weight change and health outcomes in middle-aged men--a prospective study results].

    PubMed

    Kaleta, Dorota; Kwaśniewska, Magdalena; Bednarek-Gejo, Anna; Dziankowska-Zaborszczyk, Elzbieta; Jegier, Anna; Kostka, Tomasz; Drygas, Wojciech K

    2005-01-01

    In recent years more attention is paid to the role of body weight change and cardiovascular disease risk. The aim of the study was to evaluate correlation between body weight change and risk of ischaemic heart disease (IHD) and selected cardiovascular disease risk in middle-aged male during long-term surveillance. The study was conducted among group of healthy male volunteers (n=189) aged 30-49 years at baseline. Prevalence of disease due to cardiovascular causes was ascertained in study participants during an average follow-up of 17.7 +/- 4.4 years. Changes in weight were classified in three categories: stable weight (+/- 5 kg), weight gain (>5 kg) or weight loss (>5 kg). Logistic regression analysis was performed to study the correlation between weight change and Relative Risk (RR) of cardiovascular disease in the examined subjects. All analyses were adjusted for age, smoking and level of leisure-time physical activity. In this study 48.4% men maintained weight, 5.9% lowered weight and 45.7% gained weight. Ischaemic heart disease was diagnosed in 12.2% of men, including non fatal myocardial infarction in 5.3%, hypertension in 40.7%, and hyperchoesterolaemia in 62.4%, respectively. Among participants with weight gain of more than 5 kg total cardiovascular disease risk was 4 times higher (adjusted RR=4.07, 95% CI, 1.33-12.44), ischaemic heart disease 3 times higher (adjusted RR=3.27, 95% CI, 1.17-9.17), and hypercholesterolaemia 2 times higher (adjusted RR=2.15, 95% CI, 1.09-4.24) in comparison with those with stable weight. This study results suggests that maintaining stable weight during adulthood can be effective strategy for lowering cardiovascular disease risk.

  4. Start of insulin therapy in patients with type 2 diabetes mellitus promotes the influx of macrophages into subcutaneous adipose tissue.

    PubMed

    Jansen, H J; Stienstra, R; van Diepen, J A; Hijmans, A; van der Laak, J A; Vervoort, G M M; Tack, C J

    2013-12-01

    Insulin therapy in patients with type 2 diabetes mellitus is accompanied by weight gain characterised by an increase in abdominal fat mass. The expansion of adipose tissue mass is generally paralleled by profound morphological and inflammatory changes. We hypothesised that the insulin-associated increase in fat mass would also result in changes in the morphology of human subcutaneous adipose tissue and in increased inflammation, especially when weight gain was excessive. We investigated the effects of weight gain on adipocyte size, macrophage influx, and mRNA expression and protein levels of key inflammatory markers within the adipose tissue in patients with type 2 diabetes mellitus before and 6 months after starting insulin therapy. As expected, insulin therapy significantly increased body weight. At the level of the subcutaneous adipose tissue, insulin treatment led to an influx of macrophages. When comparing patients gaining no or little weight with patients gaining >4% body weight after 6 months of insulin therapy, both subgroups displayed an increase in macrophage influx. However, individuals who had gained weight had higher protein levels of monocyte chemoattractant protein-1, TNF-α and IL-1β after 6 months of insulin therapy compared with those who had not gained weight. We conclude that insulin therapy in patients with type 2 diabetes mellitus improved glycaemic control but also induced body weight gain and an influx of macrophages into the subcutaneous adipose tissue. In patients characterised by a pronounced insulin-associated weight gain, the influx of macrophages into the adipose tissue was accompanied by a more pronounced inflammatory status. ClinicalTrials.gov: NCT00781495. The study was funded by European Foundation for the Study of Diabetes and the Dutch Diabetes Research Foundation.

  5. Multiple socioeconomic determinants of weight gain: the Helsinki Health Study.

    PubMed

    Loman, Tina; Lallukka, Tea; Laaksonen, Mikko; Rahkonen, Ossi; Lahelma, Eero

    2013-03-22

    Socioeconomic differences in weight gain have been found, but several socioeconomic determinants have not been simultaneously studied using a longitudinal design. The aim of this study was to examine multiple socioeconomic determinants of weight gain. Mail surveys were conducted in 2000-2002 among 40 to 60-year old employees of the City of Helsinki, Finland (n = 8,960, response rate 67%). A follow-up survey was conducted among the baseline respondents in 2007 with a mean follow-up of 5 to 7 years (n = 7,332, response rate 83%). The outcome measure was weight gain of 5 kg or more over the follow-up. Socioeconomic position was measured by parental education, childhood economic difficulties, own education, occupational class, household income, home ownership and current economic difficulties. Multivariable logistic regression models were fitted adjusting simultaneously for all covariates in the final model. Of women 27% and of men 24% gained 5 kg or more in weight over the follow-up. Among women, after adjusting for age, baseline weight and all socioeconomic determinants, those with basic (OR 1.40 95% CI 1.11-1.76) or intermediate education (OR 1.43 95% CI 1.08-1.90), renters (OR 1.18 95% CI 1.03-1.36) and those with occasional (OR 1.19 95% CI 1.03-1.38) or frequent (OR 1.50 95% CI 1.26-1.79) economic difficulties had increased risk of weight gain. Among men, after full adjustment, having current frequent economic difficulties (OR 1.70 95% CI 1.15-2.49) remained associated with weight gain. Current economic difficulties among both women and men, and among women low education and renting, were associated with weight gain. Prevention of weight gain among ageing people would benefit from focusing in particular on those with economic difficulties.

  6. Using Mid-Upper Arm Circumference to End Treatment of Severe Acute Malnutrition Leads to Higher Weight Gains in the Most Malnourished Children

    PubMed Central

    Dale, Nancy M.; Myatt, Mark; Prudhon, Claudine; Briend, André

    2013-01-01

    Objective The World Health Organization recommends discharging children admitted to nutrition programs treating severe acute malnutrition, with a low mid-upper arm circumference (MUAC <115 mm) when weight gain is >15%. When this recommendation is followed, the most severely malnourished children receive a shorter treatment compared to children that are less severely malnourished. This study assesses whether using MUAC >125 mm as discharge criteria eliminates this effect. Methods and Findings Data from 753 children cured from a Médecins Sans Frontières outpatient nutrition program in Gedaref, North Sudan were analyzed. MUAC >125 mm was used as discharge criteria. Length of stay and percent weight gain of children were compared in relation to nutritional status on admission. Children with low MUAC on admission had a longer duration of treatment (p = 0.000) and also a higher percent weight gain (p = 0.000) than children with higher MUAC. Similar results with weight-for-height z-scores categories were shown with both duration of treatment (p = 0.000) and percent weight gain (p = 0.000). Conclusion This study shows that using MUAC as the discharge criteria eliminates the effect of shorter treatment in most severely malnourished children compared to least severely malnourished, as is observed with percent weight gain. The findings directly address the main concern that has been identified with the current WHO recommendation of using percent weight gain. MUAC could be used as discharge criteria, instead of percent weight gain, as having a longer duration of treatment and a higher percent weight gain for the most malnourished is highly desirable. PMID:23418442

  7. Two models for weight gain and hyperphagia as side effects of atypical antipsychotics in male rats: validation with olanzapine and ziprasidone.

    PubMed

    Shobo, Miwako; Yamada, Hiroshi; Mihara, Takuma; Kondo, Yuji; Irie, Megumi; Harada, Katsuya; Ni, Keni; Matsuoka, Nobuya; Kayama, Yukihiko

    2011-01-20

    Body weight gain is one of the most serious side effects associated with clinical use of antipsychotics. However, the mechanisms by which antipsychotics induce body weight gain are unknown, and no reliable animal models of antipsychotics-induced weight gain have been established. The present studies were designed to establish male rat models of weight gain induced by chronic and acute treatment with antipsychotics. Six-week chronic treatment with olanzapine (5, 7.5, and 10mg/kg/day) in male Sprague-Dawley rats fed a daily diet resembling a human macronutrient diet, significantly increased body weight gain and weight of fatty tissues. In contrast, ziprasidone (1.25, 2.5, and 5mg/kg/day) administration caused no observable adverse effects. We then investigated feeding behavior with acute antipsychotic treatment in male rats using an automated food measurement apparatus. Rats were allowed restricted access to normal laboratory chow (4h/day). With acute olanzapine (0.5, 1, and 2mg/kg, i.p.) treatment in the light phase, food intake volume and duration were significantly increased, while treatment with ziprasidone (0.3, 1, and 3mg/kg, i.p.) did not increase food intake volume or meal time duration. Findings from the present studies showed that chronic treatment with olanzapine in male rats induced body weight gain, and acute injection induced hyperphagia, suggesting that hyperphagia may be involved in the weight gain and obesity-inducing properties of chronically administered olanzapine. These animal models may provide useful experimental platforms for analysis of the mechanism of hyperphagia and evaluating the potential risk of novel antipsychotics to induce weight gain in humans. Copyright © 2010 Elsevier B.V. All rights reserved.

  8. Association study of the HTR2C, leptin and adiponectin genes and serum marker analyses in clozapine treated long-term patients with schizophrenia.

    PubMed

    Klemettilä, J-P; Kampman, O; Seppälä, N; Viikki, M; Hämäläinen, M; Moilanen, E; Mononen, N; Lehtimäki, T; Leinonen, E

    2015-02-01

    Clozapine treatment is associated with weight gain and cardio-metabolic consequences among patients with schizophrenia. Polymorphisms of leptin, serotonin receptor HTR2C and adiponectin genes have been associated with antipsychotic-induced weight gain and metabolic comorbidity. However, the results of the studies so far are inconclusive. The aim of the present study was first to test for a possible role of serum leptin and adiponectin levels as a marker of weight gain in association with inflammatory cytokines/adipokines (IL-6, IL-1Ra, hs-CRP and adipsin), and second to study associations between SNPs LEP rs7799039 (-2548 A/G), ADIPOQ rs1501299 and HTR2C rs1414334 and weight gain and levels of leptin and adiponectin, in 190 patients with schizophrenia on clozapine treatment, with retrospectively assessed weight change and cross-sectionally measured cytokine levels. A strong association was found between serum levels of leptin and weight gain and cytokines/adipokines related to metabolic comorbidity, especially among female patients (in women leptin vs. weight gain, IL-6 and IL-1Ra, P<0.001; in men leptin vs. weight gain, P=0.026, leptin vs. IL-1Ra, P<0.001). In male patients low adiponectin level was a more specific marker of clozapine-induced weight gain (P=0.037). The results of the present study do not support a major role of SNPs LEP rs7799039, ADIPOQ rs1501299 and HTR2C rs1414334 in the regulation of weight gain or association of serum levels of leptin and adiponectin and corresponding studied SNPs in patients with schizophrenia on clozapine treatment. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  9. The bias in current measures of gestational weight gain

    PubMed Central

    Hutcheon, Jennifer A; Bodnar, Lisa M; Joseph, KS; Abrams, Barbara; Simhan, Hyagriv N; Platt, Robert W

    2014-01-01

    Summary Conventional measures of gestational weight gain (GWG), such as average rate of weight gain, are likely correlated with gestational duration. Such correlation could introduce bias to epidemiologic studies of GWG and adverse perinatal outcomes because many perinatal outcomes are also correlated with gestational duration. This study aimed to quantify the extent to which currently-used GWG measures may bias the apparent relation between maternal weight gain and risk of preterm birth. For each woman in a provincial perinatal database registry (British Columbia, Canada, 2000–2009), a total GWG was simulated such that it was uncorrelated with risk of preterm birth. The simulation was based on serial antenatal GWG measurements from a sample of term pregnancies. Simulated GWGs were classified using 3 approaches: total weight gain (kg), average rate of weight gain (kg/week) or adequacy of gestational weight gain in relation to Institute of Medicine recommendations, and their association with preterm birth ≤ 32 weeks was explored using logistic regression. All measures of GWG induced an apparent association between GWG and preterm birth ≤32 weeks even when, by design, none existed. Odds ratios in the lowest fifths of each GWG measure compared with the middle fifths ranged from 4.4 [95% CI 3.6, 5.4] (total weight gain) to 1.6 [95% CI 1.3, 2.0] (Institute of Medicine adequacy ratio). Conventional measures of GWG introduce serious bias to the study of maternal weight gain and preterm birth. A new measure of GWG that is uncorrelated with gestational duration is needed. PMID:22324496

  10. Cystic fibrosis

    MedlinePlus

    ... in newborns may include: Delayed growth Failure to gain weight normally during childhood No bowel movements in first 24 to 48 hours of life Salty-tasting skin Symptoms related to bowel function may include: Belly pain from severe constipation Increased ...

  11. Postpartum weight retention risk factors and relationship to obesity at 1 year.

    PubMed

    Endres, Loraine K; Straub, Heather; McKinney, Chelsea; Plunkett, Beth; Minkovitz, Cynthia S; Schetter, Chris D; Ramey, Sharon; Wang, Chi; Hobel, Calvin; Raju, Tonse; Shalowitz, Madeleine U

    2015-01-01

    To explore risk factors for postpartum weight retention at 1 year after delivery in predominantly low-income women. Data were collected from 774 women with complete height and weight information from participants in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Community Child Health Network, a national five-site, prospective cohort study. Participants were enrolled primarily in the hospitals immediately after delivery. Maternal interviews conducted at 1, 6, and 12 months postpartum identified risk factors for weight retention and included direct measurement of height and weight at 6 and 12 months. Logistic regression assessed the independent contribution of postpartum weight retention on obesity. Women had a mean prepregnancy weight of 161.5 lbs (body mass index [BMI] 27.7). Women gained a mean of 32 lbs while pregnant and had a 1-year mean postpartum weight of 172.6 lbs (BMI 29.4). Approximately 75% of women were heavier 1 year postpartum than they were prepregnancy, including 47.4% retaining more than 10 lbs and 24.2% more than 20 lbs. Women retaining at least 20 lbs were more often African American, younger, poor, less educated, or on pubic insurance. Race and socioeconomic disparities were associated with high prepregnancy BMI and excessive weight gain during pregnancy, associations that were attenuated by breastfeeding at 6 months and moderate exercise. Of the 39.8 with normal prepregnancy BMI, one third became overweight or obese 1 year postpartum. Postpartum weight retention is a significant contributor to the risk for obesity 1 year postpartum, including for women of normal weight prepregnancy. Postpartum, potentially modifiable behaviors may lower the risk. III.

  12. Impact of nulliparous women's body mass index or excessive weight gain in pregnancy on genital tract trauma at birth.

    PubMed

    Gallagher, Kelly; Migliaccio, Laura; Rogers, Rebecca G; Leeman, Lawrence; Hervey, Elizabeth; Qualls, Clifford

    2014-01-01

    The purpose of this study was to explore the impact of body mass index (BMI) or pregnancy weight gain on the presence, site, and severity of genital tract trauma at childbirth in nulliparous women. The present study is a subanalysis of a prospective cohort of healthy nulliparous women recruited during pregnancy and followed through birth. Weight gain during pregnancy and prepregnancy BMI were recorded. At birth, women underwent detailed mapping of genital tract trauma. For analyses, women were dichotomized into obese (BMI ≥ 30) versus nonobese (BMI < 30) at baseline as well as into those who gained weight as recommended by the Institute of Medicine (IOM) and those who gained more than the recommended amount to determine the impact of obesity or excessive weight gain on rates of genital tract trauma. Data from 445 women were available for analysis. Presence and severity of genital tract trauma did not vary between obese and nonobese women (51% vs 53%, P = .64). Likewise, women who had more than the IOM-recommended weight gain did not have a higher incidence of perineal lacerations (52% versus 53% with perineal lacerations, P = .69). Obese women were more likely to gain in excess of the IOM guidelines during pregnancy (75% vs 50% excessive weight gain in obese vs nonobese women, respectively; P < .001). A woman's BMI or excessive weight gain in pregnancy did not influence her risk of genital tract trauma at birth. © 2014 by the American College of Nurse-Midwives.

  13. Parenthood and Trajectories of Change in Body Weight Over the Life Course

    PubMed Central

    Umberson, Debra; Liu, Hui; Mirowsky, John; Reczek, Corinne

    2011-01-01

    Scholars call for greater attention to social contexts that promote and deter risk factors for health. Parenthood transforms social contexts in a myriad of ways that may influence long-term patterns of weight gain. Life course features of parenthood such as age at first birth, parity, and living with a minor child may further influence weight gain. Moreover, the social and biological features of parenthood vary in systematic ways for women and men, raising questions about how social contexts might differentially affect weight patterns by gender. We consider how parenthood influences trajectories of change in body weight over a fifteen year period (from 1986 to 2001) with growth curve analysis of data from the Americans' Changing Lives Survey, conducted with adults aged 24 and older in the contiguous United States (N=3,617). Findings suggest that parents gain weight more rapidly than the childless throughout the study period and that this weight gain occurs for both men and women. Men and women who have their first child earlier or later than about age 27 have accelerated weight gain, living with a minor child is associated with heavier weight for men than women, and parity is associated with greater weight gain for women than men. We conclude that parenthood contributes to a long term, cumulative process of weight gain for American women and men but life course factors that accelerate this process may differ by gender. PMID:21925781

  14. Addressing barriers to maternal nutrition in low‐ and middle‐income countries: A review of the evidence and programme implications

    PubMed Central

    Landry, Megan

    2017-01-01

    Abstract Adequate maternal nutrition during the “first 1,000 days” window is critical from conception through the first 6 months of life to improve nutritional status and reduce the risk of poor birth outcomes, such as low birthweight and preterm birth. Unfortunately, many programmes have targeted implementation and monitoring of nutrition interventions to infants and young children, rather than to women during pregnancy or post‐partum. A literature review was conducted to identify barriers to food choice and consumption during pregnancy and lactation and to examine how low‐ and middle‐income countries have addressed maternal nutrition in programmes. A literature review of peer‐reviewed and grey literature was conducted, and titles and abstracts reviewed by authors. Twenty‐three studies were included in this review. Barriers to adequate nutrition during pregnancy included cultural beliefs related to knowledge of quantity of food to eat during pregnancy, amount of weight to gain during pregnancy, and “eating down” during pregnancy for fear of delivering a large baby. Foods considered inappropriate for consumption during pregnancy or lactation contributed to food restriction. Drivers of food choice were influenced by food aversions, economic constraints, and household food availability. Counselling on maternal diet and weight gain during pregnancy was seldom carried out. Programming to support healthy maternal diet and gestational weight gain during pregnancy is scant. Tailored, culturally resonant nutrition education and counselling on diet during pregnancy and lactation and weight gain during pregnancy, as well as monitoring of progress in maternal nutrition, are areas of needed attention. PMID:28836343

  15. Modifying the risk of atypical antipsychotics in the treatment of juvenile-onset schizophrenia.

    PubMed

    Townsend, Lisa; Findling, Robert L

    2010-02-01

    This review summarizes the evidence for use of typical and atypical antipsychotic medications for the treatment of juvenile-onset schizophrenia. We highlight the risks and benefits of antipsychotic agents for youth with this disorder, paying special attention to weight gain and metabolic effects, an area of specific concern within child and adolescent psychiatry. We describe the seriousness of juvenile-onset schizophrenia and its impact on long-term functioning, noting that pharmacological treatment remains the standard of care for this disorder. We focus on weight gain and metabolic effects associated with atypical agents and review strategies to modify risks associated with these agents. We summarize strategies for attenuating the risk of weight gain for youth on atypical antipsychotics, including what is known about nutritional counseling and exercise programs as well as pharmacotherapy with adjunctive weight loss agents. Given the negative consequences associated with untreated schizophrenia, it appears that the most effective way to improve the risk:benefit ratio in the treatment of adolescents with schizophrenia is to reduce the risks associated with pharmacological treatment.

  16. Meal size is a critical driver of weight gain in early childhood.

    PubMed

    Syrad, Hayley; Llewellyn, Clare H; Johnson, Laura; Boniface, David; Jebb, Susan A; van Jaarsveld, Cornelia H M; Wardle, Jane

    2016-06-20

    Larger serving sizes and more frequent eating episodes have been implicated in the rising prevalence of obesity at a population level. This study examines the relative contributions of meal size and frequency to weight gain in a large sample of British children. Using 3-day diet diaries from 1939 children aged 21 months from the Gemini twin cohort, we assessed prospective associations between meal size, meal frequency and weight gain from two to five years. Separate longitudinal analyses demonstrated that every 10 kcal increase in meal size was associated with 1.5 g/wk or 4% (p = 0.005) faster growth rate, while meal frequency was not independently associated with growth (β = 0.3 g/wk p = 0.20). Including both meal parameters in the model strengthened associations (meal size: β = 2.6 g/wk, p < 0.001; meal frequency: β = 1.0 g/wk, p = 0.001). Taken together, the implication is that meal size promotes faster growth regardless of frequency, but meal frequency has a significant effect only if meal size is assumed to be held constant. Clearer advice on meal size and frequency, especially advice on appropriate meal size, may help prevent excess weight gain.

  17. Maintaining vigorous activity attenuates 7-yr weight gain in 8340 runners.

    PubMed

    Williams, Paul T

    2007-05-01

    Body weight generally increases with aging in Western societies. Although training studies show that exercise produces acute weight loss, it is unclear whether the long-term maintenance of vigorous exercise attenuates the trajectory of age-related weight gain. Specifically, prior studies have not tested whether the maintenance of physical activity, in the absence of any change in activity, prevents weight gain. Prospective study of 6119 male and 2221 female runners whose running distances changed < 5 km x wk(-1) between baseline and follow-up surveys 7 yr later. On average, men who maintained modest (0-23 km x wk(-1)), intermediate (24-47 km x wk(-1)), or prolonged running distances (> or = 48 km x wk(-1)) all gained weight through age 64; however, those who maintained > or = 48 km x wk(-1) had one half the average annual weight gain of those who maintained < 24 km x wk(-1). For example, between the ages of 35 and 44 in men and 30 and 39 yr in women, those who maintained < 24 km x wk(-1) gained, on average, 2.1 and 2.9 kg more per decade than those averaging > 48 km x wk(-1). Age-related weight gain, and its attenuation by maintained exercise, were both greater in younger than in older men. Men's gains in waist circumference with age, and its attenuation by maintaining running, were the same in older and younger men. Regardless of age, women increased their body weight, waist circumference, and hip circumference over time, and these measurements were attenuated in proportion to their maintained running distance. In both sexes, running disproportionately prevented more extreme increases in weight. As they aged, men and women gained less weight in proportion to their levels of sustained vigorous activity. This long-term beneficial effect is in addition to the acute weight loss that occurs with increased activity.

  18. Polycystic ovary syndrome: insight into pathogenesis and a common association with insulin resistance.

    PubMed

    Barber, Thomas M; Dimitriadis, George K; Andreou, Avgi; Franks, Stephen

    2015-12-01

    Polycystic ovary syndrome (PCOS) is a common condition that typically develops in reproductive-age women. The cardinal clinical and biochemical characteristics of PCOS include reproductive dysfunction and hyperandrogenic features. PCOS is also strongly associated with obesity based on data from epidemiological and genetic studies. Accordingly, PCOS often becomes manifest in those women who carry a genetic predisposition to its development, and who also gain weight. The role of weight gain and obesity in the development of PCOS is mediated at least in part, through worsening of insulin resistance. Compensatory hyperinsulinaemia that develops in this context disrupts ovarian function, with enhanced androgen production and arrest of ovarian follicular development. Insulin resistance also contributes to the strong association of PCOS with adverse metabolic risk, including dysglycaemia, dyslipidaemia and fatty liver. Conversely, modest weight loss of just 5% body weight with improvement in insulin sensitivity, frequently results in clinically meaningful improvements in hyperandrogenic, reproductive and metabolic features. Future developments of novel therapies for obese women with PCOS should focus on promotion of weight loss and improvement in insulin sensitivity. In this context, therapies that complement lifestyle changes such as dietary modification and exercise, particularly during the maintenance phase of weight loss are important. Putative novel targets for therapy in PCOS include human brown adipose tissue. © Royal College of Physicians 2015. All rights reserved.

  19. Socioeconomic position in childhood and adulthood and weight gain over 34 years: the Alameda County Study.

    PubMed

    Baltrus, Peter Thomas; Everson-Rose, Susan A; Lynch, John W; Raghunathan, Trivellore E; Kaplan, George A

    2007-08-01

    Socioeconomic position (SEP) has been shown to be related to obesity and weight gain, especially among women. It is unclear how different measures of socioeconomic position may impact weight gain over long periods of time, and whether the effect of different measures vary by gender and age group. We examined the effect of childhood socioeconomic position, education, occupation, and log household income on a measure of weight gain using individual growth mixed regression models and Alameda County Study data collected over thirty four years(1965-1999). Analyses were performed in four groups stratified by gender and age at baseline: women, 17-30 years (n = 945) and 31-40 years (n = 712); men, 17-30 years (n = 766) and 31-40 years (n = 608). Low childhood SEP was associated with increased weight gain among women 17-30 (0.13 kg/year, p < 0.001). Low educational status was associated with increased weight gain among women 17-30 (0.14 kg/year, p = 0.030), 31-40 (0.14 kg/year, p = 0.014), and men 17-30 (0.20 kg/year, p = 0.001). Log household income was inversely associated with weight gain among men 31-40 (-0.10 kg/yr, p = 0.16). Long-term weight gain in adulthood is associated with childhood SEP and education in women and education and income in men.

  20. Sweet taste of saccharin induces weight gain without increasing caloric intake, not related to insulin-resistance in Wistar rats.

    PubMed

    Foletto, Kelly Carraro; Melo Batista, Bruna Aparecida; Neves, Alice Magagnin; de Matos Feijó, Fernanda; Ballard, Cíntia Reis; Marques Ribeiro, Maria Flávia; Bertoluci, Marcello Casaccia

    2016-01-01

    In a previous study, we showed that saccharin can induce weight gain when compared with sucrose in Wistar rats despite similar total caloric intake. We now question whether it could be due to the sweet taste of saccharin per se. We also aimed to address if this weight gain is associated with insulin-resistance and to increases in gut peptides such as leptin and PYY in the fasting state. In a 14 week experiment, 16 male Wistar rats received either saccharin-sweetened yogurt or non-sweetened yogurt daily in addition to chow and water ad lib. We measured daily food intake and weight gain weekly. At the end of the experiment, we evaluated fasting leptin, glucose, insulin, PYY and determined insulin resistance through HOMA-IR. Cumulative weight gain and food intake were evaluated through linear mixed models. Results showed that saccharin induced greater weight gain when compared with non-sweetened control (p = 0.027) despite a similar total caloric intake. There were no differences in HOMA-IR, fasting leptin or PYY levels between groups. We conclude that saccharin sweet taste can induce mild weight gain in Wistar rats without increasing total caloric intake. This weight gain was not related with insulin-resistance nor changes in fasting leptin or PYY in Wistar rats. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Personality type influence the gestational weight gain.

    PubMed

    Franik, Grzegorz; Lipka, Nela; Kopyto, Katarzyna; Kopocińska, Joanna; Owczarek, Aleksander; Sikora, Jerzy; Madej, Paweł; Chudek, Jerzy; Olszanecka-Glinianowicz, Magdalena

    2017-08-01

    Pregnancy is frequently followed by the development of obesity. Aside from psychological factors, hormonal changes influence weight gain in pregnant women. We attempted to assess the potential association between personality type and the extent of gestational weight gain. The study group involved 773 women after term delivery (age 26.3 ± 3.9 years, body mass before pregnancy 61.2 ± 11.1 kg). Weight gain during pregnancy was calculated by using self-reported body mass prior to and during the 38th week of pregnancy. Personality type was assessed using the Polish version of the Framingham Type A Behavior Patterns Questionnaire (adapted by Juczynski). Two hundred forty-six (31.8%) study subjects represented type A personalities, 272 (35.2%) type B and 255 (33.0%) an indirect type. Gestational weight gain was related to the behavior patterns questionnaire score and age. In women <30 years with type A personality, the weight gain was higher than in women with type B behavior of the same age. In women >30, the gestational weight gain was larger for type B personalities. Type A personality and increased urgency in younger pregnant women increases the risk of developing obesity during pregnancy in women below 30 years old. A higher level of competitiveness demonstrates a risk factor of excessive weight gain during pregnancy regardless of age.

  2. A randomized, placebo-controlled study of zonisamide to prevent olanzapine-associated weight gain.

    PubMed

    McElroy, Susan L; Winstanley, Erin; Mori, Nicole; Martens, Brian; McCoy, Jessica; Moeller, Dianna; Guerdjikova, Anna I; Keck, Paul E

    2012-04-01

    Weight gain is commonly observed with olanzapine treatment. Zonisamide is an antiepileptic drug associated with weight loss. This study examined the effectiveness of zonisamide in preventing weight gain in 42 patients beginning olanzapine for bipolar disorder or schizophrenia. Each patient had a body mass index of 22 mg/kg or greater and was randomized to taking olanzapine with either zonisamide (n = 20) or placebo (n = 22) for 16 weeks. The primary outcome measure was change in body weight in kilograms from baseline. In the primary analysis using longitudinal regression, patients who received zonisamide had a significantly slower rate of weight gain and increase in body mass index than those who received placebo. The patients treated with zonisamide gained a mean (SD) of 0.9 (3.3) kg, whereas those treated with placebo gained a mean (SD) of 5.0 (5.5) kg; P = 0.01. None of the patients in the zonisamide group, compared with 7 patients (33%) in the placebo group, gained 7% of body weight or greater from baseline (Fisher exact test, P = 0.009). The zonisamide group, however, reported significantly more cognitive impairment as an adverse event than the placebo group (25% vs 0, respectively; P = 0.02). Zonisamide was effective for mitigating weight gain in patients with bipolar disorder or schizophrenia initiating treatment with olanzapine but was associated with cognitive impairment as an adverse event.

  3. Pregnancy eating attributes study (PEAS): a cohort study examining behavioral and environmental influences on diet and weight change in pregnancy and postpartum.

    PubMed

    Nansel, Tonja R; Lipsky, Leah M; Siega-Riz, Anna Maria; Burger, Kyle; Faith, Myles; Liu, Aiyi

    2016-01-01

    The rising prevalence of maternal overweight/obesity and excessive gestational weight gain poses a serious public health concern due to the contribution of these factors to increased risk of negative health outcomes for both mother and child. Scant intervention research has indicated moderate short-term improvement in maternal diet and gestational weight gain, with little evidence of long-term behavior change, in parallel with findings from interventions outside of pregnancy. Recent laboratory-based findings from neuroscience implicate aberrant reward processing of food at the brain level ("food reward sensitivity," the between-individual variation in the response to food stimuli) as a contributor to eating beyond energy needs. However, scant research has examined the influence of these processes on weight change in population-based settings, and the relevance of these processes to pregnancy-related weight change has not been explored. The purpose of the Pregnancy Eating Attributes Study (PEAS) is to examine the role of food reward sensitivity in maternal diet and weight change during pregnancy and postpartum. The study examines the interplay of food reward sensitivity with behavioral control, home food environment, and related aspects of eating behavior in the context of weight-related biomedical, psychosocial, genetic and behavioral factors including physical activity, stress, sleep and depression. Women of varying baseline weight status (n = 450) are enrolled early in pregnancy and followed, along with their infants, until 1 year postpartum. Assessments occur during each trimester of pregnancy, and postpartum at approximately 2 months, 6 months, 9 months and 12 months. Maternal food reward, self-control, home food environment, eating behaviors, dietary intake, health behaviors, and anthropometrics are assessed along with maternal and infant clinical and biological data, infant anthropometrics, and feeding practices. Primary exposures of interest include food reward sensitivity, behavioral control, and home food environment. Primary outcomes include gestational weight gain, postpartum weight retention and maternal diet quality. With increasing evidence suggesting the relevance of food reward sensitivity for understanding eating behavior, PEAS aims to advance understanding of the determinants of eating behavior during pregnancy, informing future interventions for improving maternal diet and weight change, and leading to improved maternal and child health and weight trajectories. Clinicaltrials.gov, NCT02217462. Date of registration: August 13, 2014.

  4. The cultural context of obesity: Exploring perceptions of obesity and weight loss among Latina immigrants

    PubMed Central

    Agne, April A.; Daubert, Rebecca; Munoz, Maria L.; Scarinci, Isabel; Cherrington, Andrea L.

    2013-01-01

    Background This study used focus group methodology to examine perceptions of obesity and weight management among Latina immigrant women in Alabama. Methods Four focus groups (N=25) were conducted in Spanish as part of a participatory intervention development process. Participants were obese/overweight Latina immigrant women (BMI >25) primarily recruited from a community hospital. Results The majority of participants were from Mexico. Participants described obesity in the context of short-term effects such as physical symptoms and aesthetics. Perceived weight gain was related to lifestyle changes since moving to the U.S. Social isolation, depression, and stress were reported to contribute to weight gain. Participants expressed interest in weight loss but emphasized a desire for programs that preserve traditional foods and include family. Conclusion Weight-management programs designed for Latina immigrants should address their perceptions of obesity. This data also suggests that those interventions that preserve culture and incorporate family may have increased community buy-in. PMID:22130571

  5. Peer Status and Victimization as Possible Reinforcements of Adolescent Girls’ and Boys’ Weight-Related Behaviors and Cognitions

    PubMed Central

    Prinstein, Mitchell J.

    2010-01-01

    Objective Reciprocal longitudinal associations among weight-related behaviors and cognitions and peer relations constructs were examined among adolescent males and females. Methods Participants included 576 adolescents aged 10–14 years, in grades 6–8. Measures assessed body dissatisfaction, negative weight-related cognitions, weight management behaviors, muscle-gaining behaviors, body mass index (BMI), likeability, popularity, and victimization at two time points, approximately 11 months apart. Multiple group path analyses were conducted to examine the reciprocal longitudinal associations between the peer relations constructs and weight-related behaviors and cognitions, controlling for participants’ Time 1 BMI, pubertal development, and age. Results Higher levels of body dissatisfaction were associated longitudinally with decreases in popularity. Higher popularity and lower likeability each were associated longitudinally with increases in negative body-related cognitions. Higher popularity was associated longitudinally with muscle-gaining behaviors for boys. Conclusions Findings suggest highly popular and disliked adolescents may be at greater risk of weight-related behaviors and cognitions than other adolescents. PMID:19667053

  6. Atypical antipsychotics, insulin resistance and weight; a meta-analysis of healthy volunteer studies.

    PubMed

    Burghardt, Kyle J; Seyoum, Berhane; Mallisho, Abdullah; Burghardt, Paul R; Kowluru, Renu A; Yi, Zhengping

    2018-04-20

    Atypical antipsychotics increase the risk of diabetes and cardiovascular disease through their side effects of insulin resistance and weight gain. The populations for which atypical antipsychotics are used carry a baseline risk of metabolic dysregulation prior to medication which has made it difficult to fully understand whether atypical antipsychotics cause insulin resistance and weight gain directly. The purpose of this work was to conduct a systematic review and meta-analysis of atypical antipsychotic trials in healthy volunteers to better understand their effects on insulin sensitivity and weight gain. Furthermore, we aimed to evaluate the occurrence of insulin resistance with or without weight gain and with treatment length by using subgroup and meta-regression techniques. Overall, the meta-analysis provides evidence that atypical antipsychotics decrease insulin sensitivity (standardized mean difference=-0.437, p<0.001) and increase weight (standardized mean difference=0.591, p<0.001) in healthy volunteers. It was found that decreases in insulin sensitivity were potentially dependent on treatment length but not weight gain. Decreases in insulin sensitivity occurred in multi-dose studies <13days while weight gain occurred in studies 14days and longer (max 28days). These findings provide preliminary evidence that atypical antipsychotics cause insulin resistance and weight gain directly, independent of psychiatric disease and may be associated with length of treatment. Further, well-designed studies to assess the co-occurrence of insulin resistance and weight gain and to understand the mechanisms and sequence by which they occur are required. Copyright © 2018 Elsevier Inc. All rights reserved.

  7. Advice given by community members to pregnant women: a mixed methods study.

    PubMed

    Verma, Bianca A; Nichols, Lauren P; Plegue, Melissa A; Moniz, Michelle H; Rai, Manisha; Chang, Tammy

    2016-11-09

    Smoking and excess weight gain during pregnancy have been shown to have serious health consequences for both mothers and their infants. Advice from friends and family on these topics influences pregnant women's behaviors. The purpose of our study was to compare the advice that community members give pregnant women about smoking versus the advice they give about pregnancy weight gain. A survey was sent via text messaging to adults in a diverse, low-income primary care clinic in 2015. Respondents were asked what advice (if any) they have given pregnant women about smoking or gestational weight gain and their comfort-level discussing the topics. Descriptive statistics were used to characterize the sample population and to determine response rates. Open-ended responses were analyzed qualitatively using grounded theory analysis with an overall convergent parallel mixed methods design. Respondents (n = 370) were 77 % female, 40 % black, and 25 % reported education of high school or less. More respondents had spoken to pregnant women about smoking (40 %, n = 147) than weight gain (20 %, n = 73). Among individuals who had not discussed either topic (n = 181), more reported discomfort in talking about weight gain (65 %) compared to smoking (34 %; p < 0.0001). Advice about smoking during pregnancy (n = 148) was frequently negative, recommending abstinence and identifying smoking as harmful for baby and/or mother. Advice about weight gain in pregnancy (n = 74) revealed a breadth of messages, from reassurance about all weight gain ("Eat away" or "It's ok if you are gaining weight"), to specific warnings against excess weight gain ("Too much was dangerous for her and the baby."). Many community members give advice to pregnant women. Their advice reveals varied perspectives on the effects of pregnancy weight gain. Compared to a nearly ubiquitous understanding of the harms of smoking during pregnancy, community members demonstrated less awareness of and willingness to discuss the harms of excessive weight gain. Beyond educating pregnant women, community-level interventions may also be important to ensure that the information pregnant women receive supports healthy behaviors and promotes the long-term health of both moms and babies.

  8. Major depressive disorder, antidepressant use, and subsequent 2-year weight change patterns in the Netherlands Study of Depression and Anxiety.

    PubMed

    Gibson-Smith, Deborah; Bot, Mariska; Milaneschi, Yuri; Twisk, Jos W; Visser, Marjolein; Brouwer, Ingeborg A; Penninx, Brenda W J H

    2016-02-01

    Although depression and obesity are bidirectionally associated, little is known about weight changes following major depressive disorder (MDD). This study compared 2-year weight changes between patients with current MDD (cMDD), patients with remitted MDD (rMDD), and healthy controls. Additionally, we examined the relationship between antidepressant medication use and 2-year weight change. Data from 2,542 adults aged 18-65 y were sourced from the Netherlands Study of Depression and Anxiety. Data were collected at baseline and after 2, 4, and 6 years (September 2004-April 2013). Depression status (DSM-IV criteria for MDD) was established with the Composite International Diagnostic Interview. Subsequent 2-year weight changes were categorized as weight loss (> 5% loss), weight stable (within 5% weight loss or gain), and weight gain (> 5% gain). The association of depression status with subsequent weight change, with weight stable as reference category, was studied by combining all repeated measurements in a mixed multinomial logistical regression model. cMDD, but not rMDD, was significantly associated with both weight gain and weight loss over a 2-year period after adjustment for covariates (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.37-2.03; P < .001; and OR = 1.27; 95% CI 1.01-1.61; P = .045, respectively). Antidepressant use was associated with weight gain (SSRIs: OR = 1.26; 95% CI, 1.05-1.52; other antidepressants: OR = 1.36; 95% CI, 1.00-1.84; P < .05 for both), but not after considering depression status. Compared to cMDD patients who lost weight, those who gained weight had lower initial weight, were younger, had more comorbid anxiety disorders, and reported poorer quality of mood and reduced appetite as depressive symptoms. Compared to controls, cMDD participants have greater odds of either gaining or losing weight over a 2-year period, regardless of antidepressant use. © Copyright 2015 Physicians Postgraduate Press, Inc.

  9. Practices of weight regulation among elite athletes in combat sports: a matter of mental advantage?

    PubMed

    Pettersson, Stefan; Ekström, Marianne Pipping; Berg, Christina M

    2013-01-01

    The combination of extensive weight loss and inadequate nutritional strategies used to lose weight rapidly for competition in weight-category sports may negatively affect athletic performance and health. To explore the reasoning of elite combat-sport athletes about rapid weight loss and regaining of weight before competitions. Qualitative study. With grounded theory as a theoretical framework, we employed a cross-examinational approach including interviews, observations, and Internet sources. Sports observations were obtained at competitions and statements by combat-sport athletes were collected on the Internet. Participants in the interviews were 14 Swedish national team athletes (9 men, 5 women; age range, 18 to 36 years) in 3 Olympic combat sports (wrestling, judo, and taekwondo). Semistructured interviews with 14 athletes from the Swedish national teams in wrestling, judo, and taekwondo were conducted at a location of each participant's choice. The field observations were conducted at European competitions in these 3 sports. In addition, interviews and statements made by athletes in combat sports were collected on the Internet. Positive aspects of weight regulation other than gaining physical advantage emerged from the data during the analysis: sport identity, mental diversion, and mental advantage. Together and individually, these categories point toward the positive aspects of weight regulation experienced by the athletes. Practicing weight regulation mediates a self-image of being "a real athlete." Weight regulation is also considered mentally important as a part of the precompetition preparation, serving as a coping strategy by creating a feeling of increased focus and commitment. Moreover, a mental advantage relative to one's opponents can be gained through the practice of weight regulation. Weight regulation has mentally important functions extending beyond the common notion that combat-sport athletes reduce their weight merely to gain a physical edge over their opponents.

  10. Effect of body image on pregnancy weight gain.

    PubMed

    Mehta, Ushma J; Siega-Riz, Anna Maria; Herring, Amy H

    2011-04-01

    The majority of women gain more weight during pregnancy than what is recommended. Since gestational weight gain is related to short and long-term maternal health outcomes, it is important to identify women at greater risk of not adhering to guidelines. The objective of this study was to examine the relationship between body image and gestational weight gain. The Body Image Assessment for Obesity tool was used to measure ideal and current body sizes in 1,192 women participating in the Pregnancy, Infection and Nutrition Study. Descriptive and multivariable techniques were used to assess the effects of ideal body size and discrepancy score (current-ideal body sizes), which reflected the level of body dissatisfaction, on gestational weight gain. Women who preferred to be thinner had increased risk of excessive gain if they started the pregnancy at a BMI ≤26 kg/m(2) but a decreased risk if they were overweight or obese. Comparing those who preferred thin body silhouettes to those who preferred average size silhouettes, low income women had increased risk of inadequate weight gain [RR = 1.76 (1.08, 2.88)] while those with lower education were at risk of excessive gain [RR = 1.11 (1.00, 1.22)]. Our results revealed that body image was associated with gestational weight gain but the relationship is complex. Identifying factors that affect whether certain women are at greater risk of gaining outside of guidelines may improve our ability to decrease pregnancy-related health problems.

  11. Contracting with outpatient hemodialysis patients to improve adherence to treatment.

    PubMed

    Laidlaw, J K; Beeken, J E; Whitney, F W; Reyes, A A

    1999-02-01

    The purpose of this study was to examine the relationship between contingency contracting and adherence to prescribed therapy in outpatient chronic hemodialysis patients. A quasi-experimental, pretest/posttest design was used. The sample included 15 hemodialysis patients, 6 in the phosphorus group and 9 in the weight-gain group. The study was conducted at an outpatient hemodialysis center in a Midwestern rural state. Specific variables investigated were interdialytic weight gains and serum phosphorus levels that reflect adherence to fluid restrictions and to taking phosphate-binding medications. Weekly interviews were conducted with each patient and content analysis of interview data was completed to identify categories related to adherence and nonadherence. Pre- and postcontract weight gains and phosphorus levels were analyzed with a paired two sample t-test. The categories related to adherence and nonadherence included physiological, psychological, environmental, locus of control/self-control/self-praise, economical, medical, knowledge deficit, health benefits, family support, and social support. Adherence to taking phosphate-binding medication responded more favorably to contingency contracting than did adherence to fluid restrictions. Chronic outpatient hemodialysis patients in the sample responded to the use of contingency contracting and developed techniques to remember to take phosphate-binding medications in order to lower serum phosphorus medications.

  12. Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?

    PubMed

    Adair, Linda S; Martorell, Reynaldo; Stein, Aryeh D; Hallal, Pedro C; Sachdev, Harshpal S; Prabhakaran, Dorairaj; Wills, Andrew K; Norris, Shane A; Dahly, Darren L; Lee, Nanette R; Victora, Cesar G

    2009-05-01

    Promoting catch-up growth in malnourished children has health benefits, but recent evidence suggests that accelerated child weight gain increases adult chronic disease risk. We aimed to determine how birth weight (BW) and weight gain to midchildhood relate to blood pressure (BP) in young adults. We pooled data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa. We used conditional weight (CW), a residual of current weight regressed on prior weights, to represent deviations from expected weight gain from 0 to 12, 12 to 24, 24 to 48 mo, and 48 mo to adulthood. Adult BP and risk of prehypertension or hypertension (P/HTN) were modeled before and after adjustment for adult body mass index (BMI) and height. Interactions of CWs with small size-for-gestational age (SGA) at birth were tested. Higher CWs were associated with increased BP and odds of P/HTN, with coefficients proportional to the contribution of each CW to adult BMI. Adjusted for adult height and BMI, no child CW was associated with adult BP, but 1 SD of BW was related to a 0.5-mm Hg lower systolic BP and a 9% lower odds of P/HTN. BW and CW associations with systolic BP and P/HTN were not different between adults born SGA and those with normal BW, but higher CW at 48 mo was associated with higher diastolic BP in those born SGA. Greater weight gain at any age relates to elevated adult BP, but faster weight gains in infancy and young childhood do not pose a higher risk than do gains at other ages.

  13. Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter?123

    PubMed Central

    Martorell, Reynaldo; Stein, Aryeh D; Hallal, Pedro C; Sachdev, Harshpal S; Prabhakaran, Dorairaj; Wills, Andrew K; Norris, Shane A; Dahly, Darren L; Lee, Nanette R; Victora, Cesar G

    2009-01-01

    Background: Promoting catch-up growth in malnourished children has health benefits, but recent evidence suggests that accelerated child weight gain increases adult chronic disease risk. Objective: We aimed to determine how birth weight (BW) and weight gain to midchildhood relate to blood pressure (BP) in young adults. Design: We pooled data from birth cohorts in Brazil, Guatemala, India, the Philippines, and South Africa. We used conditional weight (CW), a residual of current weight regressed on prior weights, to represent deviations from expected weight gain from 0 to 12, 12 to 24, 24 to 48 mo, and 48 mo to adulthood. Adult BP and risk of prehypertension or hypertension (P/HTN) were modeled before and after adjustment for adult body mass index (BMI) and height. Interactions of CWs with small size-for-gestational age (SGA) at birth were tested. Results: Higher CWs were associated with increased BP and odds of P/HTN, with coefficients proportional to the contribution of each CW to adult BMI. Adjusted for adult height and BMI, no child CW was associated with adult BP, but 1 SD of BW was related to a 0.5-mm Hg lower systolic BP and a 9% lower odds of P/HTN. BW and CW associations with systolic BP and P/HTN were not different between adults born SGA and those with normal BW, but higher CW at 48 mo was associated with higher diastolic BP in those born SGA. Conclusions: Greater weight gain at any age relates to elevated adult BP, but faster weight gains in infancy and young childhood do not pose a higher risk than do gains at other ages. PMID:19297457

  14. Attenuating effect of reboxetine on appetite and weight gain in olanzapine-treated schizophrenia patients: a double-blind placebo-controlled study.

    PubMed

    Poyurovsky, Michael; Fuchs, Camil; Pashinian, Artashez; Levi, Aya; Faragian, Sarit; Maayan, Rachel; Gil-Ad, Irit

    2007-06-01

    Search for safe and effective strategies to diminish weight gain associated with second generation antipsychotics (SGAs) is imperative. In the present study, we sought to replicate our preliminary findings, which indicated that coadministration of the selective norepinephrine reuptake inhibitor reboxetine attenuates olanzapine-induced weight gain. Fifty-nine patients hospitalized for first-episode DSM-IV schizophrenic disorder participated in this randomized double-blind study. Reboxetine (4 mg/day; 31 patients) or placebo (29 patients) was coadministered with olanzapine (10 mg/day) for 6 weeks. Analysis was by intention-to-treat. Nine patients in each group prematurely discontinued the trial. Olanzapine/reboxetine-treated patients showed a significantly lower increase in body weight (mean = 3.31 kg, SD = 2.73) than their olanzapine/placebo-treated counterparts (mean = 4.91 kg, SD = 2.45). Significantly fewer olanzapine/reboxetine-treated patients gained at least 7% of their initial weight, the cutoff for clinically significant weight gain (6 [19.4%] of 31 patients vs 13 [46.4%] of 28 patients). Seven (22.6%) olanzapine/reboxetine-treated patients compared to only one patient (3.6%) in the olanzapine/placebo group revealed no weight change or even modest weight loss. Appetite increase was significantly lower in the olanzapine/reboxetine than olanzapine/placebo group and was correlated with attenuation of weight gain. Reboxetine addition was safe and well tolerated. The results confirm that coadministration of reboxetine promotes a clinically meaningful attenuation of olanzapine-induced weight gain in schizophrenia patients. If substantiated in long-term studies, along with behavioral management and diet counseling, reboxetine may have a clinical utility in controlling SGA-induced weight gain.

  15. Determinants of weight gain in the action to control cardiovascular risk in diabetes trial.

    PubMed

    Fonseca, Vivian; McDuffie, Roberta; Calles, Jorge; Cohen, Robert M; Feeney, Patricia; Feinglos, Mark; Gerstein, Hertzel C; Ismail-Beigi, Faramarz; Morgan, Timothy M; Pop-Busui, Rodica; Riddle, Matthew C

    2013-08-01

    Identify determinants of weight gain in people with type 2 diabetes mellitus (T2DM) allocated to intensive versus standard glycemic control in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial. We studied determinants of weight gain over 2 years in 8,929 participants (4,425 intensive arm and 4,504 standard arm) with T2DM in the ACCORD trial. We used general linear models to examine the association between each baseline characteristic and weight change at the 2-year visit. We fit a linear regression of change in weight and A1C and used general linear models to examine the association between each medication at baseline and weight change at the 2-year visit, stratified by glycemia allocation. There was significantly more weight gain in the intensive glycemia arm of the trial compared with the standard arm (3.0 ± 7.0 vs. 0.3 ± 6.3 kg). On multivariate analysis, younger age, male sex, Asian race, no smoking history, high A1C, baseline BMI of 25-35, high waist circumference, baseline insulin use, and baseline metformin use were independently associated with weight gain over 2 years. Reduction of A1C from baseline was consistently associated with weight gain only when baseline A1C was elevated. Medication usage accounted for <15% of the variability of weight change, with initiation of thiazolidinedione (TZD) use the most prominent factor. Intensive participants who never took insulin or a TZD had an average weight loss of 2.9 kg during the first 2 years of the trial. In contrast, intensive participants who had never previously used insulin or TZD but began this combination after enrolling in the ACCORD trial had a weight gain of 4.6-5.3 kg at 2 years. Weight gain in ACCORD was greater with intensive than with standard treatment and generally associated with reduction of A1C from elevated baseline values. Initiation of TZD and/or insulin therapy was the most important medication-related factor associated with weight gain.

  16. Effects of a 10-week weight control program on obese patients with schizophrenia or schizoaffective disorder: a 12-month follow up.

    PubMed

    Chen, Chih-Ken; Chen, Yi-Chih; Huang, Yu-Shu

    2009-02-01

    Weight gain secondary to antipsychotic medication is associated with many serious conditions, including type II diabetes mellitus, hypertension, and coronary heart disease, and also with poor medication compliance. Weight control programs may be of benefit to outpatients with schizophrenia, but also raise an issue of cost-effectiveness. We aimed to evaluate the effectiveness of a 10-week weight control program for outpatients taking atypical antipsychotics for treatment of schizophrenia, and to follow up the effects of this weight control program in controlling weight gain after termination of the program. A total of 33 patients with schizophrenia and antipsychotic-related obesity were enrolled in a 10-week multimodal weight control program. The patients' weights were recorded at baseline, week 4, week 8, week 10 (end of the intervention), week 12, week 24, and week 48. Secondary measures included blood sugar levels, cholesterol levels, triglyceride levels, quality of life and mental health. For those who completed the weight control program, there was a mean weight loss of 2.1 kg by the end of the intervention, 3.7 kg over 6 months, and 2.7 kg over 12 months. The mean body mass index decreased by 0.8, 1.5 and 1.1 at week 10, week 24 and week 48, respectively, all with statistical significance. The 10-week weight control program was effective in terms of weight reduction among obese patients with schizophrenia or schizoaffective disorder, and the weight reduction effect lasted for up to 6 months, and up to 12 months in some cases.

  17. Effects of early pregnancy BMI, mid-gestational weight gain, glucose and lipid levels in pregnancy on offspring's birth weight and subcutaneous fat: a population-based cohort study.

    PubMed

    Sommer, Christine; Sletner, Line; Mørkrid, Kjersti; Jenum, Anne Karen; Birkeland, Kåre Inge

    2015-04-03

    Maternal glucose and lipid levels are associated with neonatal anthropometry of the offspring, also independently of maternal body mass index (BMI). Gestational weight gain, however, is often not accounted for. The objective was to explore whether the effects of maternal glucose and lipid levels on offspring's birth weight and subcutaneous fat were independent of early pregnancy BMI and mid-gestational weight gain. In a population-based, multi-ethnic, prospective cohort of 699 women and their offspring, maternal anthropometrics were collected in gestational week 15 and 28. Maternal fasting plasma lipids, fasting and 2-hour glucose post 75 g glucose load, were collected in gestational week 28. Maternal risk factors were standardized using z-scores. Outcomes were neonatal birth weight and sum of skinfolds in four different regions. Mean (standard deviation) birth weight was 3491 ± 498 g and mean sum of skinfolds was 18.2 ± 3.9 mm. Maternal fasting glucose and HDL-cholesterol were predictors of birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain as well as early pregnancy BMI, gestational week at inclusion, maternal age, parity, smoking status, ethnic origin, gestational age and offspring's sex. However, weight gain was the strongest independent predictor of both birth weight and neonatal sum of skinfolds, with a 0.21 kg/week increased weight gain giving a 110.7 (95% confidence interval 76.6-144.9) g heavier neonate, and with 0.72 (0.38-1.06) mm larger sum of skinfolds. The effect size of mother's early pregnancy BMI on birth weight was higher in non-Europeans than in Europeans. Maternal fasting glucose and HDL-cholesterol were predictors of offspring's birth weight, and fasting and 2-hour glucose were predictors of neonatal sum of skinfolds, independently of weight gain. Mid-gestational weight gain was a stronger predictor of both birth weight and neonatal sum of skinfolds than early pregnancy BMI, maternal glucose and lipid levels.

  18. Patterns of gestational weight gain and birthweight outcomes in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Fetal Growth Studies-Singletons: a prospective study.

    PubMed

    Pugh, Sarah J; Albert, Paul S; Kim, Sungduk; Grobman, William; Hinkle, Stefanie N; Newman, Roger B; Wing, Deborah A; Grantz, Katherine L

    2017-09-01

    Inadequate or excessive total gestational weight gain is associated with increased risks of small- and large-for-gestational-age births, respectively, but evidence is sparse regarding overall and trimester-specific patterns of gestational weight gain in relation to these risks. Characterizing the interrelationship between patterns of gestational weight gain across trimesters can reveal whether the trajectory of gestational weight gain in the first trimester sets the path for gestational weight gain in subsequent trimesters, thereby serving as an early marker for at-risk pregnancies. We sought to describe overall trajectories of gestational weight gain across gestation and assess the risk of adverse birthweight outcomes associated with the overall trajectory and whether the timing of gestational weight gain (first vs second/third trimester) is differentially associated with adverse outcomes. We conducted a secondary analysis of a prospective cohort of 2802 singleton pregnancies from 12 US prenatal centers (2009 through 2013). Small and large for gestational age were calculated using sex-specific birthweight references <5th, <10th, or ≥90th percentiles, respectively. At each of the research visits, women's weight was measured following a standardized anthropometric protocol. Maternal weight at antenatal clinical visits was also abstracted from the prenatal records. Semiparametric, group-based, latent class, trajectory models estimated overall gestational weight gain and separate first- and second-/third-trimester trajectories to assess tracking. Robust Poisson regression was used to estimate the relative risk of small- and large-for-gestational-age outcomes by the probability of trajectory membership. We tested whether relationships were modified by prepregnancy body mass index. There were 2779 women with a mean of 15 (SD 5) weights measured across gestation. Four distinct gestational weight gain trajectories were identified based on the lowest Bayesian information criterion value, classifying 10.0%, 41.8%, 39.2%, and 9.0% of the population from lowest to highest weight gain trajectories, with an inflection at 14 weeks. The average rate in each trajectory group from lowest to highest for 0-<14 weeks was -0.20, 0.04, 0.21, and 0.52 kg/wk and for 14-39 weeks was 0.29, 0.48, 0.63, and 0.79 kg/wk, respectively; the second lowest gaining trajectory resembled the Institute of Medicine recommendations and was designated as the reference with the other trajectories classified as low, moderate-high, or high. Accuracy of assignment was assessed and found to be high (median posterior probability 0.99, interquartile range 0.99-1.00). Compared with the referent trajectory, a low overall trajectory, but not other trajectories, was associated with a 1.55-fold (95% confidence interval, 1.06-2.25) and 1.58-fold (95% confidence interval, 0.88-2.82) increased risk of small-for-gestational-age <10th and <5th, respectively, while a moderate-high and high trajectory were associated with a 1.78-fold (95% confidence interval, 1.31-2.41) and 2.45-fold (95% confidence interval, 1.66-3.61) increased risk of large for gestational age, respectively. In a separate analysis investigating whether early (<14 weeks) gestational weight gain tracked with later (≥14 weeks) gestational weight gain, only 49% (n = 127) of women in the low first-trimester trajectory group continued as low in the second/third trimester, and had a 1.59-fold increased risk of small for gestational age; for the other 51% (n = 129) of women without a subsequently low second-/third-trimester gestational weight gain trajectory, there was no increased risk of small for gestational age (relative risk, 0.75; 95% confidence interval, 0.47-1.38). Prepregnancy body mass index did not modify the association between gestational weight gain trajectory and small for gestational age (P = 0.52) or large for gestational age (P = .69). Our findings are reassuring for women who experience weight loss or excessive weight gain in the first trimester; however, the risk of small or large for gestational age is significantly increased if women gain weight below or above the reference trajectory in the second/third trimester. Published by Elsevier Inc.

  19. Review of Childhood Obesity: From Epidemiology, Etiology, and Comorbidities to Clinical Assessment and Treatment.

    PubMed

    Kumar, Seema; Kelly, Aaron S

    2017-02-01

    Childhood obesity has emerged as an important public health problem in the United States and other countries in the world. Currently 1 in 3 children in the United States is afflicted with overweight or obesity. The increasing prevalence of childhood obesity is associated with emergence of comorbidities previously considered to be "adult" diseases including type 2 diabetes mellitus, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, and dyslipidemia. The most common cause of obesity in children is a positive energy balance due to caloric intake in excess of caloric expenditure combined with a genetic predisposition for weight gain. Most obese children do not have an underlying endocrine or single genetic cause for their weight gain. Evaluation of children with obesity is aimed at determining the cause of weight gain and assessing for comorbidities resulting from excess weight. Family-based lifestyle interventions, including dietary modifications and increased physical activity, are the cornerstone of weight management in children. A staged approach to pediatric weight management is recommended with consideration of the age of the child, severity of obesity, and presence of obesity-related comorbidities in determining the initial stage of treatment. Lifestyle interventions have shown only modest effect on weight loss, particularly in children with severe obesity. There is limited information on the efficacy and safety of medications for weight loss in children. Bariatric surgery has been found to be effective in decreasing excess weight and improving comorbidities in adolescents with severe obesity. However, there are limited data on the long-term efficacy and safety of bariatric surgery in adolescents. For this comprehensive review, the literature was scanned from 1994 to 2016 using PubMed using the following search terms: childhood obesity, pediatric obesity, childhood overweight, bariatric surgery, and adolescents. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  20. Higher Pre-pregnancy BMI and Excessive Gestational Weight Gain are Risk Factors for Rapid Weight Gain in Infants.

    PubMed

    Subhan, Fatheema Begum; Colman, Ian; McCargar, Linda; Bell, Rhonda C

    2017-06-01

    Objective To describe the effects of maternal pre-pregnancy body mass index (BMI) and gestational weight gain (GWG) on infant anthropometrics at birth and 3 months and infant growth rates between birth and 3 months. Methods Body weight prior to and during pregnancy and infant weight and length at birth and 3 months were collected from 600 mother-infant pairs. Adherence to GWG was based on IOM recommendations. Age and sex specific z-scores were calculated for infant weight and length at birth and 3 months. Rapid postnatal growth was defined as a difference of >0.67 in weight-for-age z-score between birth and 3 months. Relationships between maternal and infant characteristics were analysed using multilinear regression. Results Most women (65%) had a normal pre-pregnancy BMI and 57% gained above GWG recommendations. Infants were 39.3 ± 1.2 weeks and 3431 ± 447.9 g at birth. At 3 months postpartum 60% were exclusively breast fed while 38% received breast milk and formula. Having a pre-pregnancy BMI >25 kg/m 2 was associated with higher z-scores for birth weight and weight-for-age at 3 months. Gaining above recommendations was associated with higher z-scores for birth weight, weight-for-age and BMI. Infants who experienced rapid postnatal growth had higher odds of being born to women who gained above recommendations. Conclusion for Practice Excessive GWG is associated with higher birth weight and rapid weight gain in infants. Interventions that optimize GWG should explore effects on total and rates of early infant growth.

  1. Prepare, a randomized trial to promote and evaluate weight loss among overweight and obese women planning pregnancy: Study design and rationale

    PubMed Central

    Vesco, Kimberly K.; Funk, Kristine L.; Karanja, Njeri; Smith, Ning; Stevens, Victor J.

    2017-01-01

    Background Women who are overweight or have obesity at pregnancy onset, and those who gain excessive weight during pregnancy, are at increased risk of pregnancy-related complications and large for gestational age infants. Objective This report describes methodology for the Prepare study, a randomized, controlled clinical trial testing a preconception and pregnancy weight management program for women who are overweight or have obesity (BMI ≥ 27 kg/m2). Outcomes This trial examines multiple pregnancy and neonatal outcomes, with the primary outcome being gestational weight gain (GWG). Secondary outcomes include change in weight before conception, offspring birth weight adjusted for gestational age, offspring weight for length, and pregnancy diet quality and physical activity level. Methods Nonpregnant women who anticipate becoming pregnant in the next 2 years are randomly assigned to an intervention program or a usual care control condition. Intervention participants receive weight management counseling by telephone before and during pregnancy, with weekly contacts during the first 6 months and monthly contacts for the next 18 months. Intervention participants also have unlimited access to a study website that provides self-management tools. All participants who become pregnant are contacted at 20 weeks' gestation to assess physical activity levels and dietary habits. All other outcome data are obtained from medical records. Intervention satisfaction is assessed via questionnaire. Summary This clinical trial tests the efficacy of an intervention program designed to help overweight and obese women achieve healthy lifestyle changes that will result in a healthy weight prior to pregnancy and appropriate weight gain during pregnancy. PMID:27394386

  2. Early Weight Development of Goats Experimentally Infected with Mycobacterium avium subsp. paratuberculosis

    PubMed Central

    Malone, Alyssa N.; Fletcher, Darcy M.; Vogt, Megan B.; Meyer, Stephen K.; Hess, Ann M.; Eckstein, Torsten M.

    2013-01-01

    Johne’s disease is an infectious chronic inflammatory bowel disease in ruminants. The key factor for the management of this disease is an early positive diagnosis. Unfortunately, most diagnostics detect animals with Johne’s disease in the clinical stage with positive serology and/or positive fecal cultures. However, for effective management of the disease within herds, it is important to detect infected animals as early as possible. This might only be possible with the help of parameters not specific for Johne’s disease but that give an early indication for chronic infections such as weight development. Here we report our findings on the development of total body weight and weight gain during the first six months of goats experimentally infected to induce Johne’s disease. Twenty dairy goat kids age 2 to 5 days were included in this study. Goats were divided into two groups: a negative control group and a positive infected group. The weight was obtained weekly throughout the study. Goats of the positive group were infected at the age of seven weeks. We detected significant changes in weight gain and total body weight as early as one week after infection. Differences are significant throughout the six month time period. Weight as a non-specific parameter should be used to monitor infection especially in studies on Johne’s disease using the goat model. Our study suggests that goats with Johne’s disease have a reduced weight gain and reduced weight when compared with healthy goats of the same age. PMID:24349564

  3. The cost-effectiveness of weight management programmes in a postnatal population.

    PubMed

    Rawdin, A C; Duenas, A; Chilcott, J B

    2014-09-01

    The aim of the study was to estimate the cost-effectiveness of a weight management programme including elements of physical exercise and dietary restriction which are designed to help women lose excess weight gained during pregnancy in the vulnerable postnatal period and inhibit the development of behaviours which could lead to future excess weight gain and obesity. A mathematical model based on a regression equation predicting change in weight over a fifteen year postnatal period was developed. The model included programme effectiveness and resource data based on a randomized controlled trial of a weight management programme implemented in a postnatal population in the United States. Utility and mortality data based on body mass index categories were also included. The model adopted a National Health Service (NHS) and personal social services (PSS) perspective, a lifetime time horizon and estimated the cost effectiveness of a weight management programme against a no change comparator in terms of an incremental cost-effectiveness ratio (ICER). The baseline results show that the difference in weight between women who received the weight management programme and women who received the control intervention was 3.02 kg at six months and 3.53 kg at fifteen years following childbirth. This results in an ICER of £7355 per quality adjusted life year (QALY) for women who were married at childbirth. The estimated ICER would suggest that such a weight management programme is cost-effective at a NICE threshold of £20,000 per QALY. However significant structural and evidence based uncertainty is present in the analysis. Copyright © 2014 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  4. Heterosis and direct effects for Charolais-sired calf weight and growth, cow weight and weight change, and ratios of cow and calf weights and weight changes across warm season lactation in Romosinuano, Angus, and F cows in Arkansas.

    PubMed

    Riley, D G; Burke, J M; Chase, C C; Coleman, S W

    2016-01-01

    The use of Brahman in cow-calf production offers some adaptation to the harsh characteristics of endophyte-infected tall fescue. Criollo breeds, such as the Romosinuano, may have similar adaptation. The objectives were to estimate genetic effects in Romosinuano, Angus, and crossbred cows for their weights, weights of their calves, and ratios (calf weight:cow weight and cow weight change:calf weight gain) across lactation and to assess the influence of forage on traits and estimates. Cows ( = 91) were bred to Charolais bulls after their second parity. Calves ( = 214) were born from 2006 to 2009. Cows and calves were weighed in early (April and June), mid- (July), and late lactation (August and October). Animal was a random effect in analyses of calf data; sire was random in analyses of cow records and ratios. Fixed effects investigated included calf age, calf sex, cow age-year combinations, sire breed of cow, dam breed of cow, and interactions. Subsequent analyses evaluated the effect of forage grazed: endophyte-free or endophyte-infected tall fescue. Estimates of maternal heterosis for calf weight ranged from 9.3 ± 4.3 to 15.4 ± 5.7 kg from mid-lactation through weaning ( < 0.05). Romosinuano direct effects (of the cow) were -6.8 ± 3.0 and -8.9 ± 4.2 kg for weights recorded in April and June. Calf weights and weight gains from birth were greater ( < 0.05) for calves of cows grazing endophyte-free tall fescue except in mid-summer. Cow weight change from April to each time was negative for Angus cows and lower ( < 0.05) than other groups. Cows grazing endophyte-free tall fescue were heavier ( < 0.05) at all times but had more weight loss in late lactation. Angus cows had the lowest ( < 0.05) ratios (negative) of cow weight change:calf weight gain, indicating an energy-deficit condition. Cows grazing endophyte-free tall fescue had more negative ( < 0.05) values for this trait but not in early lactation ( < 0.05). Estimates of heterosis ranged from 12.8 ± 9.5 to 28.6 ± 9.4 kg for cow weight, 7.9 ± 3.0 to 15.8 ± 5.0 kg for cow weight change, and 0.07 ± 0.03 to 0.27 ± 0.1 for cow weight change:calf weight gain. Direct Romosinuano effects ranged from 14.8 ± 4.2 to 49.8 ± 7.7 kg for cow weight change and 0.2 ± 0.04 to 0.51 ± 0.14 for cow weight change:calf weight gain. The adaptive ability of Romosinuano in temperate fescue regions may be favorable with respect to relative cow and calf weight but may be a consequence of lower milk-producing ability.

  5. Adverse effects of high-intensity sweeteners on energy intake and weight control in male and obesity-prone female rats

    PubMed Central

    Swithers, Susan E.; Sample, Camille H.; Davidson, T.L.

    2014-01-01

    The use of high-intensity sweeteners has been proposed as a method to combat increasing rates of overweight and obesity in the human population. However, previous work with male rats suggests that consumption of such sweeteners might contribute to, rather than ameliorate, weight gain. The goals of the present experiments were to assess whether intake of high-intensity sweeteners is associated with increased food intake and body weight gain in female rats; to evaluate whether this effect depends on composition of the maintenance diet (i.e., standard chow compared to diets high in energy, fat and sugar [HE diets]); and to determine whether the phenotype of the rats with regard to propensity to gain weight on HE diets affects the consequences of consuming high-intensity sweeteners. The data demonstrated that female rats fed a low-fat, standard laboratory chow diet did not gain extra weight when fed yogurt dietary supplements sweetened with saccharin compared to those fed glucose-sweetened dietary supplements. However, female rats maintained on a “Westernized” diet high in fat and sugar (HE diet) showed significant increases in energy intake, weight gain and adiposity when given saccharin-sweetened compared to glucose-sweetened yogurt supplements. These differences were most pronounced in female rats known to be prone to obesity prior to the introduction of the yogurt diets. Both selectively-bred Crl:OP[CD] rats, and outbred Sprague-Dawley rats fed an HE diet showing high levels of weight gain (DIO rats) had increased weight gain in response to consuming saccharin-sweetened compared to glucose-sweetened supplements. However, in male rats fed an HE diet, saccharin-sweetened supplements produced extra weight gain regardless of obesity phenotype. These results suggest that the most negative consequences of consuming high-intensity sweeteners may occur in those most likely to use them for weight control, females consuming a “Westernized” diet and already prone to excess weight gain. PMID:23398432

  6. Subcutaneous administration of monosodium glutamate to pregnant mice reduces weight gain in pups during lactation.

    PubMed

    Park, Ji-Hun; Choi, Tae-Saeng

    2016-04-01

    Administering monosodium glutamate (MSG) to neonatal rodents induces obesity and type 2 diabetes. In addition, several studies have shown that MSG administered to pregnant animals can cross the placenta and reach the foetus. The present study was performed to investigate the effects of administering MSG to pregnant ICR mice on dam and neonatal growth. Pregnant mice were treated with 60 or 120 mg MSG once daily from day 5 of pregnancy to one day before parturition by subcutaneous injection. In addition, the body weights of the neonates were determined until nine weeks of age. The birth weights of neonates were not different between the control and MSG-treated groups. However, MSG treatment resulted in a lower body weight gain of neonates during lactation. In addition, this underweight of the MSG-treated group at weaning returned to normal compared with the control group at five weeks of age. Cross-fostering experiments indicated that the lower body weight gain of neonates in the MSG-treated group during lactation was due to its effects on the dam. Serum prolactin levels and mammary gland development of the mice were examined next to determine the reasons for this lactation problem. Although there were no differences in prolactin levels, morphological analyses of the mammary glands revealed apparent differences, including low numbers and altered phenotype of alveoli, between the control and MSG-treated groups. Taken together, our results show that treating pregnant mice with excess MSG induced lower neonate body weight gain during lactation. © The Author(s) 2015.

  7. Maternal pre-pregnancy obesity and gestational weight gain influence neonatal neurobehaviour.

    PubMed

    Aubuchon-Endsley, Nicki; Morales, Monique; Giudice, Christina; Bublitz, Margaret H; Lester, Barry M; Salisbury, Amy L; Stroud, Laura R

    2017-04-01

    Maternal weight before and during pregnancy is associated with offspring neurobehaviour in childhood. We investigated maternal weight prior to and during pregnancy in relation to neonatal neurobehaviour. We hypothesized that maternal obesity and excessive gestational weight gain would be associated with poor neonatal attention and affective functioning. Participants (n = 261) were recruited, weighed and interviewed during their third trimester of pregnancy. Pre-pregnancy weight was self-reported and validated for 210 participants, with robust agreement with medical chart review (r = 0.99). Neurobehaviour was measured with the NICU Network Neurobehavioural Scale (NNNS) administered on Days 2 and 32 postpartum. Maternal exclusion criteria included severe or persistent physical or mental health conditions (e.g. chronic disease or diagnoses of Bipolar Disorder or Psychotic Spectrum Disorders), excessive substance use, and social service/foster care involvement or difficulty understanding English. Infants were from singleton, full-term (37-42 weeks gestation) births with no major medical concerns. Outcome variables were summary scores on the NNNS (n = 75-86). For women obese prior to pregnancy, those gaining in excess of Institute of Medicine guidelines had infants with poorer regulation, lower arousal and higher lethargy. There were no main effects of maternal pre-pregnancy body mass index on neurobehaviour. Women gaining above Institute of Medicine recommendations had neonates with better quality of movement. Additional studies to replicate and extend results past the neonatal period are needed. Results could support underlying mechanisms explaining associations between maternal perinatal weight and offspring outcomes. These mechanisms may inform future prevention/intervention strategies. © 2016 Blackwell Publishing Ltd. © 2016 Blackwell Publishing Ltd.

  8. Evaluating a small change approach to preventing long term weight gain in overweight and obese adults--Study rationale, design, and methods.

    PubMed

    Ross, Robert; Hill, James O; Latimer, Amy; Day, Andrew G

    2016-03-01

    Despite the rapid rise in obesity worldwide, few strategies have been effective in treating this epidemic. An emerging strategy is to focus on preventing excessive weight gain rather than weight reduction. The proposed intervention, small change approach (SCA), is an innovative weight gain prevention strategy in which individuals monitor their usual nutrition and physical activity patterns and then make modest but sustainable alterations through behavioral intervention techniques (self-regulation, goal setting) enough to reduce overall energy balance by 100 to 200 kcal per day (e.g., reduce caloric intake by 100 kcal per day and/or increase daily step count by ~2000 steps (~100 kcal) per day). The primary aim of the trial is to determine whether small changes in energy expenditure and/or energy intake prevent weight gain in overweight and obese men and women long-term. The pre-specified primary and secondary assessments are at 2 and 3 years post-randomization respectively. The primary outcome is change in body weight. Secondary outcomes include body composition variables (adipose tissue distribution and lean mass distribution) and cardiorespiratory fitness (VO2peak). We randomized 320 primarily White (n=305) overweight and obese men and women to one of 2 conditions: 1) usual care (UC), 2) small change approach (SCA). Participant involvement in the study is 3 years; 2 year intervention with a 1 year follow-up. Our study findings will indicate whether there is value in clinicians adopting a SCA to lifestyle counseling for their patients who are overweight and obese. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Protective effects of green tea on olanzapine-induced-metabolic syndrome in rats.

    PubMed

    Razavi, Bibi Marjan; Lookian, Fariba; Hosseinzadeh, Hossein

    2017-08-01

    Atypical antipsychotics particularly olanzapine are associated with obesity and serious metabolic disturbances. As green tea (Camellia sinensis) is generally associated with beneficial effects on obesity and other metabolic disturbances, this study was undertaken to evaluate the effect of green tea aqueous extract (GTAE) on olanzapine induced weight gain and metabolic abnormalities in rats. Male Wistar rats were divided into eight groups: control, olanzapine (5mg/kg/day, IP.), GTAE (25, 50 and 100mg/kg/day, IP.) plus olanzapine and GTAE (25, 50 and 100mg/kg/day, IP.). Treatments were continued for 11 days. Body weight gain, average food and water intake were measured during the experiment. Plasma lipid, glucose and leptin levels, mean systolic blood pressure and total locomotion were evaluated at the end of experiment. Olanzapine induced significant weight gain at the end of treatment (10.38% of body weight) when compared to control (3.13% of body weight) in male Wistar rats. Average food and water intake were increased by olanzapine treatment. 11days olanzapine administration led to hyperleptinemia, hyperglycemia and dyslipidemia. Olanzapine also increased mean systolic blood pressure and decreased total locomotion. GTAE decreased significantly body weight gain and average food and water intake, improved the changes in lipid profile as well as fasting blood glucose, and finally decreased hyperleptinemia and hypertension induced by olanzapine. Results of this study demonstrated that GTAE could exert protective effects against olanzapine induced obesity partially due to its lowering effect on leptin. GTAE improved other metabolic abnormalities including dyslipidemia, hyperglycemia and hypertension induced by olanzapine in rats. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. Famine, third-trimester pregnancy weight gain, and intrauterine growth: the Dutch Famine Birth Cohort Study.

    PubMed

    Stein, A D; Ravelli, A C; Lumey, L H

    1995-02-01

    Data from the Dutch Famine Birth Cohort Study were analyzed to assess the influence of acute famine on the relation of maternal weight gain to birth weight, length, and ponderal index. Records were examined for 734 women receiving at least one month of prenatal care and delivering live-born singleton females at the University of Amsterdam Teaching Hospital between August 1944 and April 1946. This period preceded, encompassed, and followed the Hunger Winter, a severe famine. After adjusting for covariates, weight loss or low to moderate (< or = 0.5 kg/week) weight gain was strongly associated with (p < 0.001 for each model) with offspring birth weight, length, and ponderal index and with trimester of famine exposure. At weight gains greater than 0.5 kg/week further weight gain was not associated with birth size. Among women losing weight or gaining < or = 0.5 kg/week the association between third-trimester weight change and birth weight among mother-daughter pairs exposed to famine in early or mid-pregnancy was stronger than the association observed among the unexposed cohort or among those exposed only late in pregnancy. Our results suggest that acute maternal nutritional deprivation affects fetal growth only below a threshold and that, conversely, even after a famine period offspring birth size does not respond in a linear fashion to ad libitum maternal feeding.

  11. Evolution of body weight parameters up to 3 years after solid organ transplantation: The prospective Swiss Transplant Cohort Study.

    PubMed

    Beckmann, Sonja; Nikolic, Nataša; Denhaerynck, Kris; Binet, Isabelle; Koller, Michael; Boely, Elsa; De Geest, Sabina

    2017-03-01

    Obesity and weight gain are serious concerns after solid organ transplantation (Tx); however, no unbiased comparison regarding body weight parameter evolution across organ groups has yet been performed. Using data from the prospective nationwide Swiss Transplant Cohort Study, we compared the evolution of weight parameters up to 3 years post-Tx in 1359 adult kidney (58.3%), liver (21.7%), lung (11.6%), and heart (8.4%) recipients transplanted between May 2008 and May 2012. Changes in mean weight and body mass index (BMI) category were compared to reference values from 6 months post-Tx. At 3 years post-Tx, compared to other organ groups, liver Tx recipients showed the greatest weight gain (mean 4.8±10.4 kg), 57.4% gained >5% body weight, and they had the highest incidence of obesity (38.1%). After 3 years, based on their BMI categories at 6 months, normal weight and obese liver Tx patients, as well as underweight kidney, lung and heart Tx patients had the highest weight gains. Judged against international Tx patient data, the majority of our Swiss Tx recipients' experienced lower post-Tx weight gain. However, our findings show weight gain pattern differences, both within and across organ Tx groups that call for preventive measures. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Body composition of term healthy Indian newborns.

    PubMed

    Jain, V; Kurpad, A V; Kumar, B; Devi, S; Sreenivas, V; Paul, V K

    2016-04-01

    Previous anthropometry-based studies have suggested that in Indian newborns fat mass is conserved at the expense of lean tissue. This study was undertaken to assess the body composition of Indian newborns and to evaluate its relation with parents' anthropometry, birth weight and early postnatal weight gain. Body composition of healthy term singleton newborns was assessed by the deuterium dilution method in the second week of life. Anthropometry was carried out at birth and on the day of study. Data from 127 babies were analyzed. Birth weight was 2969±383 g. Body composition was assessed at a mean age of 12.7±3.1 days. Fat and fat-free mass were 354±246 and 2764±402 g, respectively, and fat mass percentage (FM%) was 11.3±7.3%. Birth weight and fat-free mass were higher among boys, but no gender difference was noted in FM%. Birth weight was positively correlated with fat as well as fat-free mass but not FM%. FM% showed positive correlation with gain in weight from birth to the day of assessment. This is the first study from India to report body composition in newborns using deuterium dilution. FM% was comparable to that reported for Western populations for babies of similar age. Our results suggest that the percentage of fat and fat-free mass is relatively constant over the range of birth weights included in this study, and greater weight gain during early postnatal period results in greater increase in FM%.

  13. Weight changes and lifestyle behaviors in women after breast cancer diagnosis: a cross-sectional study.

    PubMed

    Yaw, Yong Heng; Shariff, Zalilah Mohd; Kandiah, Mirnalini; Mun, Chan Yoke; Yusof, Rokiah Mohd; Othman, Zabedah; Saibul, Nurfaizah; Weay, Yong Heng; Hashim, Zailina

    2011-05-13

    Weight gain rather than weight loss often occurs after breast cancer diagnosis despite breast cancer survivors frequently reported making healthful lifestyle changes. This study describes the prevalence and magnitude of changes in weight before and after breast cancer diagnosis and examines lifestyle behaviors of breast cancer survivors with stable weight, weight gain or weight loss. Respondents were 368 women with breast cancer characterized by stages I, II and III. All were recruited from hospitals or breast cancer support groups and had completed conventional treatment. Current weight and height were measured while weight at cancer diagnosis and 1 year before diagnosis were self-reported. Weight change was calculated as the difference between current weight and weight a year preceding breast cancer diagnosis. A 24-hour diet recall and Global Physical Activity Questionnaire assessed dietary intake and physical activity, respectively. Differences in lifestyle behaviors among weight change groups were examined using Analysis of Covariance (ANCOVA). Mean weight change from a year preceding diagnosis to study entry was 2.73 kg (95% CI: 1.90-3.55). Most women (63.3%) experienced weight gain rather than weight loss (36.7%) with a higher percentage (47.8%) having at least 5% weight gain (47.8%) rather than weight loss (22%), respectively. Compared to other weight change groups, women in >10% weight gain group had the lowest fruit and vegetable servings (1.58 servings/day; 95% CI: 1.36-1.82) and highest servings of dairy products (0.41 servings/day; 95% CI: 0.30-0.52). Weight gain was evident in this sample of women after breast cancer diagnosis. Information on magnitude of weight change after breast cancer diagnosis and lifestyle behaviors of breast cancer survivors with varying degrees of weight change could facilitate the development and targeting of effective intervention strategies to achieve healthy weight and optimal health for better survival.

  14. Control systems engineering for optimizing a prenatal weight gain intervention to regulate infant birth weight.

    PubMed

    Savage, Jennifer S; Downs, Danielle Symons; Dong, Yuwen; Rivera, Daniel E

    2014-07-01

    We used dynamical systems modeling to describe how a prenatal behavioral intervention that adapts to the needs of each pregnant woman may help manage gestational weight gain and alter the obesogenic intrauterine environment to regulate infant birth weight. This approach relies on integrating mechanistic energy balance, theory of planned behavior, and self-regulation models to describe how internal processes can be impacted by intervention dosages, and reinforce positive outcomes (e.g., healthy eating and physical activity) to moderate gestational weight gain and affect birth weight. A simulated hypothetical case study from MATLAB with Simulink showed how, in response to our adaptive intervention, self-regulation helps adjust perceived behavioral control. This, in turn, changes the woman's intention and behavior with respect to healthy eating and physical activity during pregnancy, affecting gestational weight gain and infant birth weight. This article demonstrates the potential for real-world applications of an adaptive intervention to manage gestational weight gain and moderate infant birth weight. This model could be expanded to examine the long-term sustainable impacts of an intervention that varies according to the participant's needs on maternal postpartum weight retention and child postnatal eating behavior.

  15. Effect of diet and exercise intervention in Chinese pregnant women on gestational weight gain and perinatal outcomes: A quasi-experimental study.

    PubMed

    Liu, Yan Qun; Liu, Yun; Hua, Yun; Chen, Xiao Li

    2017-08-01

    Aim To determine the effect of a diet and exercise intervention in pregnant women on total gestational weight gain, weekly weight gain, 42-days postpartum weight retention, mode of delivery, and infant birth weight. One hundred and one eligible Chinese pregnant women whose pre-pregnancy body mass index ranged from 18.5 to 24.9 were recruited between June 2013 and June 2014 from a tertiary hospital. Ninety participants, 45 in each group, completed the study. Intervention women received three face-to-face interventions and three follow-up phone calls which were developed based on the Transtheoretical Model. Gestational weight was measured at each prenatal check. Mode of delivery and infant birth weight were collected from the medical record. The 42-days postpartum weight was measured during the postpartum visits. (1) The total gestational weight gain and mean weight gain per week in the intervention group were significantly less than the control group (P=0.045 and P=0.008 respectively). (2) Infant birth weight was significantly lower in the intervention group (P=0.012). (3) Postpartum weight retention was significantly less in the intervention group (P=0.001). 4) There were not significant differences in mode of delivery. 5) Infant birth weight was significantly less than the control group (P=0.012). The lifestyle intervention significantly reduced gestational weight gain, optimized infant weight and lowered postpartum weight retention. Promotion of gestational weight management is needed and cultural health beliefs about pregnancy and postpartum practices should be considered when developing the intervention plan. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Longitudinal weight gain in women identified with polycystic ovary syndrome: results of an observational study in young women.

    PubMed

    Teede, Helena J; Joham, Anju E; Paul, Eldho; Moran, Lisa J; Loxton, Deborah; Jolley, Damien; Lombard, Catherine

    2013-08-01

    Polycystic ovary syndrome (PCOS) affects 6-18% of women. The natural history of weight gain in women with PCOS has not been well described. Here we aimed to examine longitudinal weight gain in women with and without PCOS and to assess the association between obesity and PCOS prevalence. The observational study was set in the general community. Participants were women randomly selected from the national health insurance scheme (Medicare) database. Mailed survey data were collected by the Australian Longitudinal Study on Women's Health. Data from respondents to survey 4, aged 28-33 years (2006, n = 9,145) were analyzed. The main outcome measures were PCOS prevalence and body mass index (BMI). Self-reported PCOS prevalence was 5.8% (95% CI: 5.3%-6.4%). Women reporting PCOS had higher weight, mean BMI [2.5 kg/m(2) (95% CI: 1.9-3.1)], and greater 10-year weight gain [2.6 kg (95% CI: 1.2-4.0)]. BMI was the strongest correlate of PCOS status with every BMI increment increasing the risk of reporting PCOS by 9.2% (95% CI: 6%-12%). This community based observational study with longitudinal reporting of weight shows that weight, BMI, and 10-year weight gain were higher in PCOS. We report the novel finding that obesity and greater weight gain are significantly associated with PCOS status. Considering the prevalence, major health and economic burden of PCOS, the increasing weight gain in young women, and established benefits of weight loss, these results have major public health implications. Copyright © 2012 The Obesity Society.

  17. Longitudinal changes in gestational weight gain and the association with intrauterine fetal growth.

    PubMed

    Hinkle, Stefanie N; Johns, Alicia M; Albert, Paul S; Kim, Sungduk; Grantz, Katherine L

    2015-07-01

    Total pregnancy weight gain has been associated with infant birthweight; however, most prior studies lacked repeat ultrasound measurements. Understanding of the longitudinal changes in maternal weight gain and intrauterine changes in fetal anthropometrics is limited. Prospective data from 1314 Scandinavian singleton pregnancies at high-risk for delivering small-for-gestational-age (SGA) were analyzed. Women had ≥1 (median 12) antenatal weight measurements. Ultrasounds were targeted at 17, 25, 33, and 37 weeks of gestation. Analyses involved a multi-step process. First, trajectories were estimated across gestation for maternal weight gain and fetal biometrics [abdominal circumference (AC, mm), biparietal diameter (BPD, mm), femur length (FL, mm), and estimated fetal weight (EFW, g)] using linear mixed models. Second, the association between maternal weight changes (per 5 kg) and corresponding fetal growth from 0 to 17, 17 to 28, and 28 to 37 weeks was estimated for each fetal parameter adjusting for prepregnancy body mass index, height, parity, chronic diseases, age, smoking, fetal sex, and weight gain up to the respective period as applicable. Third, the probability of fetal SGA, EFW <10th percentile, at the 3rd ultrasound was estimated across the spectrum of maternal weight gain rate by SGA status at the 2nd ultrasound. From 0 to 17 weeks, changes in maternal weight were most strongly associated with changes in BPD [β=0.51 per 5 kg (95%CI 0.26, 0.76)] and FL [β=0.46 per 5 kg (95%CI 0.26, 0.65)]. From 17 to 28 weeks, AC [β=2.92 per 5 kg (95%CI 1.62, 4.22)] and EFW [β=58.7 per 5 kg (95%CI 29.5, 88.0)] were more strongly associated with changes in maternal weight. Increased maternal weight gain was significantly associated with a reduced probability of intrauterine SGA; for a normal weight woman with SGA at the 2nd ultrasound, the probability of fetal SGA with a weight gain rate of 0.29 kg/w (10th percentile) was 59%, compared to 38% with a rate of 0.67 kg/w (90th percentile). Among women at high-risk for SGA, maternal weight gain was associated with fetal growth throughout pregnancy, but had a differential relationship with specific biometrics across gestation. For women with fetal SGA identified mid-pregnancy, increased antenatal weight gain was associated with a decreased probability of fetal SGA approximately 7 weeks later. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  18. Thyroid

    MedlinePlus

    Thyroid is used to treat the symptoms of hypothyroidism (a condition where the thyroid gland does not produce enough thyroid hormone). Symptoms of hypothyroidism include lack of energy, depression, constipation, weight gain, ...

  19. Dietary fat and weight gain among women in the Nurses' Health Study.

    PubMed

    Field, Alison E; Willett, Walter C; Lissner, Lauren; Colditz, Graham A

    2007-04-01

    To assess the association of dietary fat and weight gain among adult women and to investigate whether offspring of overweight parents have a greater predisposition to weight gain due to intake of dietary fat. This was an 8-year follow-up of 41,518 women in the Nurses' Health Study (NHS), a population-based, prospective cohort. The women were 41 to 68 years of age, free of cardiovascular disease, cancer, and diabetes in 1986 when "baseline" weight and diet were assessed. Eight years later (1994), changes in weight and dietary intake were assessed. Linear regression models were used to relate change in weight to fat intake and change in fat intake, using the percentage of energy from carbohydrate as the comparison, adjusted for age, BMI in 1986, leisure time physical activity, time spent sitting, percent of calories from protein, and change in percentage of calories from protein. Overall, there was a weak positive association between total fat intake (beta=0.11) and weight gain. Increases in monosaturated and polyunsaturated fat were not associated with weight gain, but increases in animal fat, saturated fat, and trans fat had a positive association with weight change. There was not strong evidence of effect modification by parental weight status (p=0.7 to 0.8 for percentage of calories from total fat, animal fat, and vegetable fat); however, the associations were stronger among the overweight compared with leaner women (p<0.05 for percentage of calories from each type of fat). Among overweight women, for every one percentage increase in percentage of calories from trans fat, women gained an additional 2.3 lb (95% confidence interval, 1.80 to 2.86). Our results show that, overall, percent of calories from fat has only a weak positive association with weight gain; however, percentage of calories from animal, saturated, and trans fat has stronger associations. There was no clear evidence that the diet-weight gain association was stronger among offspring of overweight parents, but dietary fat was associated with greater weight gain among overweight women.

  20. Phenotypic and Genetic Correlations of Feed Efficiency Traits with Growth and Carcass Traits in Nellore Cattle Selected for Postweaning Weight.

    PubMed

    Ceacero, Thais Matos; Mercadante, Maria Eugênia Zerlotti; Cyrillo, Joslaine Noely Dos Santos Gonçalves; Canesin, Roberta Carrilho; Bonilha, Sarah Figueiredo Martins; de Albuquerque, Lucia Galvão

    2016-01-01

    This study evaluated phenotypic (rph) and genetic correlations (rg) between 8 feed efficiency traits and other traits of economic interest including weight at selection (WS), loin-eye area (LEA), backfat thickness (BF), and rump fat thickness (RF) in Nellore cattle. Feed efficiency traits were gain:feed, residual feed intake (RFI), residual feed intake adjusted for backfat thickness (RFIb) and for backfat and rump fat thickness (RFIsf), residual body weight gain (RG), residual intake and body weight gain (RIG), and residual intake and body weight gain using RFIb (RIGb) and RFIsf (RIGsf). The variance components were estimated by the restricted maximum likelihood method using a two-trait animal model. The heritability estimates (h2) were 0.14, 0.24, 0.20, 0.22, 0.19, 0.15, 0.11 and 0.11 for gain:feed, RFI, RFIb, RFIsf, RG, RIG, RIGb and RIGsf, respectively. All rph values between traits were close to zero, except for the correlation of feed efficiency traits with dry matter intake and average daily gain. High rg values were observed for the correlation of dry matter intake, average daily gain and metabolic weight with WS and hip height (>0.61) and low to medium values (0.15 to 0.48) with the carcass traits (LEA, BF, RF). Among the feed efficiency traits, RG showed the highest rg with WS and hip height (0.34 and 0.25) and the lowest rg with subcutaneous fat thickness (-0.17 to 0.18). The rg values of RFI, RFIb and RFIsf with WS (0.17, 0.23 and 0.22), BF (0.37, 0.33 and 0.33) and RF (0.30, 0.31 and 0.32) were unfavorable. The rg values of gain:feed, RIG, RIGb and RIGsf with WS were low and favorable (0.07 to 0.22), while medium and unfavorable (-0.22 to -0.45) correlations were observed with fat thickness. The inclusion of subcutaneous fat thickness in the models used to calculate RFI did not reduce the rg between these traits. Selecting animals for higher feed efficiency will result in little or no genetic change in growth and will decrease subcutaneous fat thickness in the carcass.

  1. Diet Quality, Physical Activity, Smoking Status, and Weight Fluctuation Are Associated with Weight Change in Women and Men1–3

    PubMed Central

    Kimokoti, Ruth W.; Newby, P. K.; Gona, Philimon; Zhu, Lei; Jasuja, Guneet K.; Pencina, Michael J.; McKeon-O'Malley, Catherine; Fox, Caroline S.; D'Agostino, Ralph B.; Millen, Barbara E.

    2010-01-01

    The effect of diet quality on weight change, relative to other body weight determinants, is insufficiently understood. Furthermore, research on long-term weight change in U.S. adults is limited. We evaluated prospectively patterns and predictors of weight change in Framingham Offspring/Spouse (FOS) women and men (n = 1515) aged ≥30 y with BMI ≥ 18.5 kg/m2 and without cardiovascular disease, diabetes, and cancer at baseline over a 16-y period. Diet quality was assessed using the validated Framingham Nutritional Risk Score. In women, older age (P < 0.0001) and physical activity (P < 0.05) were associated with lower weight gain. Diet quality interacted with former smoking status (P-interaction = 0.02); former smokers with lower diet quality gained an additional 5.2 kg compared with those with higher diet quality (multivariable-adjusted P-trend = 0.06). Among men, older age (P < 0.0001) and current smoking (P < 0.01) were associated with lower weight gain, and weight fluctuation (P < 0.01) and former smoking status (P < 0.0001) were associated with greater weight gain. Age was the strongest predictor of weight change in both women (partial R2 = 11%) and men (partial R2 = 8.6%). Normal- and overweight women gained more than obese women (P < 0.05) and younger adults gained more weight than older adults (P < 0.0001). Patterns and predictors of weight change differ by sex. Age in both sexes and physical activity among women as well as weight fluctuation and smoking status in men were stronger predictors of weight change than diet quality among FOS adults. Women who stopped smoking over follow-up and had poor diet quality gained the most weight. Preventive interventions need to be sex-specific and consider lifestyle factors. PMID:20484553

  2. Pregnancy-associated obesity in black women in New York City.

    PubMed

    Lederman, Sally Ann; Alfasi, Goldie; Deckelbaum, Richard J

    2002-03-01

    To determine weight gain during pregnancy and weight changes postpartum in first-time mothers delivering at or near term. At about 2 weeks after delivery, 47 adult, Black and Hispanic women provided information on their prepregnancy weight and height and maximum pregnancy weight. Women reinterviewed at 2 and 6 months after delivery reported their most recent weight measurement and the date of that measurement. This information was used to compute each woman's prepregnancy body mass index, pregnancy weight gain, and weight loss postpartum. Information on infant feeding was also collected at each postpartum visit. About 2/3 of the women and 100% of the overweight and obese women gained excessive weight during pregnancy. Weight gain was most marked in women who started pregnancy overweight or obese. At 2 months postpartum, women were on average almost 18 lb above their prepregnancy weight. No additional maternal weight was lost by 6 months postpartum. Most infants were started on formula by 2 weeks of age. At 2 months of age, 85% were fed formula only and 91% of the infants were on WIC. Our results demonstrate a need for interventions to help women avoid obesity by regulating their pregnancy weight gain, losing weight for a longer period postpartum, and initiating and maintaining exclusive breast-feeding.

  3. Altered reward anticipation: Potential explanation for weight gain in schizophrenia?

    PubMed

    Grimm, Oliver; Kaiser, Stefan; Plichta, Michael M; Tobler, Philippe N

    2017-04-01

    Obesity and weight gain are severe complications of mental illness, especially schizophrenia. They result from changes in lifestyle and nutrition, side effects of medication and other, less well-understood factors. Recent studies suggest that obesity and weight gain are linked to psychopathology. Specifically, severe psychopathology is associated with greater weight dysregulation, typically weight gain. However, our knowledge about the neuroscientific basis of weight gain in schizophrenia is currently limited. We propose that altered reward anticipation, which in turn is related to striatal dopaminergic dysregulation, may explain why obesity is more prevalent in individuals with mental illness. We review evidence that reward anticipation and weight change are linked by a core deficit in dopaminergic striatal circuits. Several lines of evidence, running from animal studies to preclinical and clinical studies, suggest that striatal dopaminergic neurotransmission is a major hub for the regulation of eating behavior and that dopamine links eating behavior to other motivated behavior. From this perspective, the present review outlines a unifying perspective on dopaminergic reward anticipation as a theoretical frame to link weight gain, medication effects and psychopathology. We derive important but open empirical questions and present perspectives for new therapeutic concepts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Nutritional status and weight gain in pregnant women.

    PubMed

    Sato, Ana Paula Sayuri; Fujimori, Elizabeth

    2012-01-01

    This study described the nutritional status of 228 pregnant women and the influence of this on birth weight. This is a retrospective study, developed in a health center in the municipality of São Paulo, with data obtained from medical records. Linear regression analysis was carried out. An association was verified between the initial and final nutritional status (p<0.001). The mean of total weight gain in the pregnant women who began the pregnancy underweight was higher compared those who started overweight/obese (p=0.005). Weight gain was insufficient for 43.4% of the pregnant women with adequate initial weight and for 36.4% of all the pregnant women studied. However, 37.1% of those who began the pregnancy overweight/obese finished with excessive weight gain, a condition that ultimately affected almost a quarter of the pregnant women. Anemia and low birth weight were uncommon, however, in the linear regression analysis, birth weight was associated with weight gain (p<0.05). The study highlights the importance of nutritional care before and during pregnancy to promote maternal-infant health.

  5. Clinical Assessment of Weight Gain with Atypical Antipsychotics - Blonanserin vs Amisulpride.

    PubMed

    Deepak, T S; Raveesh, B N; Parashivamurthy, B M; Kumar, Ms Narendra; Majgi, Sumanth Mallikarjuna; Nagesh, H N

    2015-06-01

    Atypical antipsychotics appear to have the greatest potential to induce weight gain. Antipsychotic-induced weight gain is the one of main cause of non-compliance and discontinuation of treatment, often resulting in the relapse of psychosis. To compare the weight gain between amisulpride and blonanserin treatment, in persons with psychosis. Fifty six subjects with psychosis attending psychiatry department at KR Hospital, Mysore were randomized into two equal groups. After obtaining informed consent, subjects of group I received amisulpride tablets 200 mg BD, and group II received blonanserin tablets 4 mg BD, for eight weeks. Body weight, Body Mass Index (BMI) and Waist Hip Ratio (WHR) were measured at baseline, 4 weeks and 8 weeks. The mean weight gain with amisulpride at 4 weeks was 2.73 kg (5.21%) and at 8 weeks was 4.34 kg (8.28%) from the baseline. The mean weight gain with blonanserin at 4 weeks was 1.77 kg (3.46%) and at 8 weeks was 3.46 kg (6.75%) from the baseline. The mean BMI increase at 8 weeks with amisulpride was 1.66 ± 0.56 and with blonanserin was 1.34 ± 0.77. The mean WHR increase at 8 weeks with amisulpride was 0.036 ± 0.026 and with blonanserin was 0.029 ± 0.020. There was statistically significant increase in weight, BMI and WHR associated with both blonanserin and amisulpride at 8 weeks. But there was no statistically significant difference in those parameters between blonanserin and amisulpride, at eight weeks. Even though there was no significant difference in the weight gain caused by blonanserin, in comparison with amisulpride, both these drugs individually caused significant weight gain at 8 weeks, which is in contrast with the earlier studies, which needs to be further evaluated.

  6. Infant growth and later body composition: evidence from the 4-component model.

    PubMed

    Chomtho, Sirinuch; Wells, Jonathan Ck; Williams, Jane E; Davies, Peter Sw; Lucas, Alan; Fewtrell, Mary S

    2008-06-01

    Rapid weight gain in infancy is associated with higher body mass index in later life, but its relation with individual body-composition components remains unclear. We aimed to investigate associations between weight gain during different periods in infancy and later fat mass (FM) and fat-free mass (FFM). Body composition was assessed by using the 4-component model, dual-energy X-ray absorptiometry, and anthropometry in 234 healthy UK children and adolescents (105 boys; x +/- SD age: 11.4 +/- 3.8 y). Early growth measurements were prospective in 52 subjects and retrospective in 182. Relative weight gain was calculated as change in SD score (SDS) during different periods. Relative weight gain from 0 to 3 mo and from 3 to 6 mo showed positive relations with childhood FM, waist circumference, and trunk FM that were equivalent to increases in FMI (FM/height(2)) of 0.24 SDS (95% CI: 0.04, 0.44) and 0.50 SDS (0.25, 0.75) per 1-SDS increase in early weight and that were comparable to the effect of current obesity risk factors. Relative weight gain from 0 to 3 mo was also positively associated with later FFMI (FFM/height(2)). Relative weight gain from 6 to 12 mo was not associated with later body composition. Associations were independent of birth weight, sex, puberty, physical activity, socioeconomic class, ethnicity, and parental body mass index. In this Western population, greater relative weight gain during early infancy was positively associated with later FM and central fat distribution and with FFM. Rapid weight gain in infancy may be a risk factor for later adiposity. Early infancy may provide an opportunity for interventions aimed at reducing later obesity risk.

  7. Understanding the inter-relationship between improved glycaemic control, hypoglycaemia and weight change within a long-term economic model.

    PubMed

    McEwan, P; Evans, M; Kan, H; Bergenheim, K

    2010-05-01

    Current guidelines for the management of type 2 diabetes advocate the attainment of sustained near normal glycaemia levels. Metformin is widely accepted as the treatment of choice for the initiation of pharmacotherapy; however, secondary failure of oral monotherapy occurs in 60% of patients resulting in the need for multiple pharmacotherapies. Therapy-related consequences of treatment, such as weight gain and hypoglycaemia impact on the cost-effectiveness profile of various agents. We therefore sought to ascertain the respective contribution of hypoglycaemia, weight change and improved blood glucose control on second-line therapy options added to metformin. This study uses a simulation model designed to evaluate the cost utility of new therapies in a population of patients with type 2 diabetes mellitus. Standard model outputs include incidence of micro- and macrovascular complications and diabetes-specific and all-cause mortality. The mean discounted quality-adjusted life year (QALY) predicted by the model was 12.31 years. Reducing Glycosylated haemoglobin (HbA1c) by 1% gave a predicted gain of 0.413 QALYs per patient. A 3-kg weight loss and 30% reduction in hypoglycaemia frequency produced a combined QALY gain of 0.355, whereas the reverse gave a QALY decrement of 0.356. The results of this analysis quantify the QALY decrement that may result from adverse therapy effects. The beneficial effects of improved glycaemic control on QALYs may be offset by characteristic treatment-specific adverse effects, such as weight gain and hypoglycaemia frequency.

  8. Evaluation of green pepper (Capsicum annuum L.) juice on the weight gain and changes in lipid profile in C57BL/6 mice fed a high-fat diet.

    PubMed

    Kim, Na-Hyung; Park, Seong Hoon

    2015-01-01

    Capsicum pepper (green pepper, Capsicum annuum L.), a natural product available in many countries, is considered to be a food additive, with healthful or medical applications. The aim of this study was to evaluate green pepper juice for its potential to reduce weight gain and to determine its effects on lipid profiles in C57BL/6 mice fed a high-fat diet. Mice given a high-fat diet with green pepper juice gained significantly less weight and showed a significant decrease in serum triglycerides, total cholesterol, low density lipoproteins, and alanine aminotransferase compared to mice given only a high-fat diet (P < 0.05). Systolic and diastolic blood pressure, heart rate, and blood glucose levels (determined by using the intraperitoneal glucose tolerance test) in mice administered green pepper juice were similar to those in mice in the control group. In addition, abdominal fat volume (subcutaneous and visceral), which was quantified by using 4.7 T magnetic resonance imaging, including multi-slice spin-echo T2-weighted images, in mice administered a high-fat diet with green pepper juice tended to decrease compared to the fat volume of mice administered only a high-fat diet. These results suggest that green pepper juice, as a drink, may possibly be helpful in reducing weight gain by regulating the levels of serum lipids. © 2014 Society of Chemical Industry.

  9. Weight Gain and Metabolic Effects of Mood Stabilizers and Antipsychotics in Pediatric Bipolar Disorder: A Systematic Review and Pooled Analysis of Short-Term Trials

    ERIC Educational Resources Information Center

    Correll, Christoph U.

    2007-01-01

    Objective: To review weight and metabolic effects of mood-stabilizing treatments in pediatric bipolar disorder. Method: Systematic PubMed/Medline search of studies reporting on change in weight and/or glucose/lipid values with mood-stabilizing drugs in at least nine pediatric patients with bipolar disorder. Results: Nineteen studies, including 24…

  10. Reproductive performance and body weight changes in draught cows in a smallholder semi-arid farming area of Zimbabwe.

    PubMed

    Chimonyo, M; Kusina, N T; Hamudikuwanda, H; Nyoni, O

    2000-12-01

    The reproductive performance of 46 cows in a semi-arid, smallholder farming area of Zimbabwe was monitored for a year. Half the cows were used throughout the monitoring period for various draught purposes, including ploughing and procurement of farm produce for marketing using carts. All the cows lost body weight between July and October, after which the cows that were not worked gained weight until June of the following year. In contrast, the cows that were worked continued to lose body weight until January, throughout the time during which they were used to provide draught power, after which they gained weight. Body weights were significantly higher (p < 0.05) in non-working than in working cows in January and February. Ovarian activity was higher (p < 0.001) in non-working compared to working cows, particularly between November and February, while calving rates were also higher (p < 0.05) in non-working cows. It is concluded that using cows for draught purposes caused loss of body weight and reduced ovarian activity and conception rates.

  11. Dietary protein-to-carbohydrate ratio and added sugar as determinants of excessive gestational weight gain: a prospective cohort study.

    PubMed

    Maslova, Ekaterina; Halldorsson, Thorhallur I; Astrup, Arne; Olsen, Sjurdur F

    2015-02-10

    To examine the relation between the protein:carbohydrate (P/C) ratio and added sugar intake in pregnancy and gestational weight gain (GWG). A prebirth cohort including 103 119 pregnancies enrolled between 1996 and 2003. All women in Denmark were eligible to participate if they spoke Danish and were planning to carry to term.The pregnant women were recruited and enrolled during their first antenatal visit (6-10 weeks of gestation). Participants included women with live-born singletons and complete data on dietary intake and GWG, leaving 46 262 women for the analysis. Macronutrient intake was quantified using a validated food frequency questionnaire administered in the 25th week of gestation. The P/C ratio and added sugar intake were examined in quintiles. GWG was based on self-reported weight in gestational weeks 12 and 30 and defined as gain in g/week. We used multivariable linear regression, including adjusting for pre-pregnancy body mass index, to calculate relative change in GWG and 95% CI. Average GWG was 471(224) g/week. The adjusted weight gain was 16 g/week lower (95% CI 9 to 22, p for trend <0.001) in the highest (Q5) versus lowest (Q1) quintile of the P/C ratio (∼3% average reduction across the entire pregnancy). Weight gain for those with >20%E vs <12%E from protein was 36 g/week lower (95% CI 20 to 53, p for trend <0.0001; ∼8% average reduction). A high P/C ratio was inversely related to intake of added sugars. Added sugar consumption was strongly associated with GWG (Q5 vs Q1: 34, 95% CI 28 to 40 g/week, p for trend <0.0001). A high P/C ratio was associated with reduced GWG. This association appeared to be partly driven by a decrease in intake of added sugar. These results are consistent with randomised trials in non-pregnant participants. A dietary intervention targeting an increased P/C ratio with emphasis on reducing added sugar can contribute to reducing excessive GWG. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  12. Are Increased Weight and Appetite Useful Indicators of Depression in Children and Adolescents?

    PubMed Central

    Cole, David A.; Cho, Sun-Joo; Martin, Nina C.; Youngstrom, Eric A.; March, John S.; Findling, Robert L.; Compas, Bruce E.; Goodyer, Ian M.; Rohde, Paul; Weissman, Myrna; Essex, Marilyn J.; Hyde, Janet S.; Curry, John F.; Forehand, Rex; Slattery, Marcia J.; Felton, Julia W.; Maxwell, Melissa A.

    2012-01-01

    During childhood and adolescence, physiological, psychological, and behavioral processes strongly promote weight gain and increased appetite while also inhibiting weight loss and decreased appetite. The Diagnostic and Statistical Manual-IV (DSM–IV) treats both weight-gain/increased-appetite and weight-loss/decreased-appetite as symptoms of major depression during these developmental periods, despite the fact that one complements typical development and the other opposes it. To disentangle the developmental versus pathological correlates of weight and appetite disturbance in younger age groups, the current study examined symptoms of depression in an aggregated sample of 2307 children and adolescents, 47.25% of whom met criteria for major depressive disorder. A multigroup, multidimensional item response theory model generated three key results. First, weight loss and decreased appetite loaded strongly onto a general depression dimension; in contrast, weight gain and increased appetite did not. Instead, weight gain and increased appetite loaded onto a separate dimension that did not correlate strongly with general depression. Second, inclusion or exclusion of weight gain and increased appetite affected neither the nature of the general depression dimension nor the fidelity of major depressive disorder diagnosis. Third, the general depression dimension and the weight-gain/ increased-appetite dimension showed different patterns across age and gender. In child and adolescent populations, these results call into question the utility of weight gain and increased appetite as indicators of depression. This has serious implications for the diagnostic criteria of depression in children and adolescents. These findings inform a revision of the DSM, with implications for the diagnosis of depression in this age group and for research on depression. PMID:22686866

  13. How maternal malnutrition affects linear growth and development in the offspring.

    PubMed

    Papathakis, Peggy C; Singh, Lauren N; Manary, Mark J

    2016-11-05

    Maternal malnutrition is common in the developing world and has detrimental effects on both the mother and infant. Pre-pregnancy nutritional status and weight gain during pregnancy are positively related to fetal growth and development. Internationally, there is no agreement on the method of diagnosis or treatment of moderate or severe malnutrition during pregnancy. Establishing clear guidelines for diagnosis and treatment will be essential in elevating the problem. Possible anthropometric measurements used to detect and monitor maternal malnutrition include pre-pregnancy BMI, weight gain, and mid upper arm circumference. Food supplements have the potential to increase gestational weight gain and energy intake which are positively associated with fetal growth and development. Overall more studies are needed to conclude the impact of food/nutrient supplements on infant growth in undernourished pregnant women in developing countries. Currently, a study underway may provide much needed documentation of the benefits of treating malnutrition in pregnancy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  14. Food Insecurity and Chronic Disease123

    PubMed Central

    Laraia, Barbara A.

    2013-01-01

    Household food insecurity has been previously hypothesized to promote dependence on inexpensive, highly palatable foods that are energy dense. Such dependence, and the cyclical nature of having enough food in the beginning of the month followed by food scarcity at the end of the month, could lead to weight gain over a short period of time. Such dependence on energy-dense foods and weight gain may play a direct role in the development of chronic conditions. Other compounding factors that result from exposure to household food insecurity have been well described, including pathways by which stress promotes visceral fat accumulation and chronic disease. This symposium review paper summarizes the literature on the link between food insecurity and the following: 1) diet, 2) weight gain, and 3) chronic disease, especially among women. This paper also proposes a framework for considering how the lived experience of household food insecurity may potentiate the development of chronic disease by activating the stress response among individuals at critical developmental periods in a food-impoverished environment. PMID:23493536

  15. The effectiveness of lifestyle intervention in early pregnancy to prevent gestational diabetes mellitus in Chinese overweight and obese women: A quasi-experimental study.

    PubMed

    Sun, Yu; Zhao, Hong

    2016-05-01

    Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy and is associated with substantially elevated risk of adverse health outcomes for both mothers and offspring. This quasi-experimental trial was conducted to assess whether a lifestyle intervention in early pregnancy can reduce the incidence of GDM and excessive gestational weight (GWG) gain among Chinese overweight women. Convenience samples of 74 women in gestational weeks 8-12 with a BMI ≥ 24 kg/m(2) were enrolled. They were divided into intervention (N=37) or control group (N=37) according to the time sequence of seeing the doctor. The intervention group was provided with exercise, dietary, weight gain counseling and detailed plans at weeks 8-12 and every month in the second trimester. In addition, each counseling session included a personalized feedback based on their 5-day-records. Follow-up phone calls or emails were conducted every week between antenatal visits. The control group was just provided with exercise, dietary and weight gain counseling at weeks 8-12, besides the usual health education provided at the O&G outpatient department. The lifestyle intervention resulted in a lower incidence of gestational diabetes in the intervention group (9/32, 28.1%) compared with the control group (19/34, 55.9%), p=0.023. Women in the intervention group gained much less weight (6.86 ± 2.31 versus 10.08 ± 3.84 kg, p=0.000) at the end of second trimester. Lifestyle intervention in early pregnancy can reduce the incidence of GDM and prevent excessive maternal weight gain in overweight and obese pregnant women. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Maternal prepregnancy obesity and child neurodevelopment in the Collaborative Perinatal Project.

    PubMed

    Huang, Lisu; Yu, Xiaodan; Keim, Sarah; Li, Ling; Zhang, Lin; Zhang, Jun

    2014-06-01

    To examine the association between maternal prepregnancy weight and child neurodevelopment, and the effect of gestational weight gain. Using the U.S. Collaborative Perinatal Project data, 1959-76, a total of 30,212 women with a calculable prepregnancy body mass index (BMI) and gestational weight gain, and term singleton children followed up for more than 7 years were included in this study. Intelligence quotient (IQ) was measured at 7 years of age by Wechsler Intelligence Scales. Maternal prepregnancy BMI displayed inverted U-shaped associations with child IQ after adjustment for maternal age, maternal education levels, maternal race, marital status, socioeconomic status, smoking during pregnancy, parity and study center. Women with BMI at around 20 kg/m2 appeared to have the highest offspring IQ scores. After controlling for familial factors in the siblings' sample, maternal obesity (BMI≥30.0 kg/m2) was associated with lower Full-scale IQ (adjusted ß=-2.0, 95% confidence interval -3.5 to -0.5), and Verbal scale IQ (adjusted ß=-2.5, 95% confidence interval -4.0 to -1.0), using BMI of 18.5-24.9 kg/m2 as the reference category. Compared with children born to normal-weight women who gained 21-25 lb. during pregnancy, those born to obese women who gained more than 40 lb. had 6.5 points deficit in IQ after adjustment for potential confounders. Maternal prepregnancy obesity was associated with lower child IQ, and excessive weight gain accelerated the association. With obesity rising steadily, these results appear to raise serious public health concerns. © The Author 2014; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.

  17. Weight change across the start of three consecutive pregnancies and the risk of maternal morbidity and SGA birth at the second and third pregnancy

    PubMed Central

    Bhattacharya, Sohinee; Horgan, Graham W.

    2017-01-01

    Background Weight-change across parities and/or current BMI may influence maternal and fetal morbidity and requires to be differentiated to better inform weight-management guidance. Methods Direction, pattern and magnitude of weight-change across three consecutive parities and thereby two inter-pregnancy periods was described in 5079 women. The association between inter-pregnancy weight-change versus current BMI and adverse maternal events, SGA-birth and preterm delivery at second and third pregnancy were investigated by logistic regression. Results More women gained weight across the defined childbearing period than lost it, with ~35% of normal and overweight women gaining sufficient weight to move up a BMI-category. Nine patterns of weight-change were defined across two inter-pregnancy periods and 50% of women remained weight-stable throughout (within 2BMI units/period). Women who were overweight/obese at first pregnancy had higher risk of substantial weight-gain and loss (>10kg) during each of two inter-pregnancy periods. Inter-pregnancy weight-gain (> 2BMI units) between first and second pregnancy increased the risk of maternal morbidity (1or more event of hypertensive disease, caesarean-section, thromboembolism) at second pregnancy, while weight-loss (>2BMI units) increased the risk of SGA-birth. Similarly, increased risk of maternal morbidity at the third pregnancy was influenced by weight-gain during both inter-pregnancy periods but not by current BMI-category. Both weight-gain between first and second pregnancy, and being overweight/obese by third pregnancy protected the fetus against SGA-birth whereas weight-loss between second and third pregnancy doubled the SGA risk. Conclusion Half the women studied exhibited significant weight-fluctuations. This influenced their risk of maternal morbidity and SGA-birth at second and third pregnancy. PMID:28628636

  18. Birth weight and growth from infancy to late adolescence in relation to fat and lean mass in early old age: findings from the MRC National Survey of Health and Development.

    PubMed

    Bann, D; Wills, A; Cooper, R; Hardy, R; Aihie Sayer, A; Adams, J; Kuh, D

    2014-01-01

    High birth weight and greater weight gain in infancy have been associated with increased risk of obesity as assessed using body mass index, but few studies have examined associations with direct measures of fat and lean mass. This study examined associations of birth weight and weight and height gain in infancy, childhood and adolescence with fat and lean mass in early old age. A total of 746 men and 812 women in England, Scotland and Wales from the MRC National Survey of Health and Development whose heights and weights had been prospectively ascertained across childhood and adolescence and who had dual energy X-ray absorptiometry measures at age 60-64 years. Associations of birth weight and standardised weight and height (0-2 (weight only), 2-4, 4-7, 7-11, 11-15, 15-20 years) gain velocities with outcome measures were examined. Higher birth weight was associated with higher lean mass and lower android/gynoid ratio at age 60-64 years. For example, the mean difference in lean mass per 1 standard deviation increase in birth weight was 1.54 kg in males (95% confidence interval=1.04, 2.03) and 0.78 kg in females (0.41, 1.14). Greater weight gain in infancy was associated with higher lean mass, whereas greater gains in weight in later childhood and adolescence were associated with higher fat and lean mass, and fat/lean and android/gynoid ratios. Across growth intervals greater height gain was associated with higher lean but not fat mass, and with lower fat/lean and android/gynoid ratios. Findings suggest that growth in early life may have lasting effects on fat and lean mass. Greater weight gain before birth and in infancy may be beneficial by leading to higher lean mass, whereas greater weight gain in later childhood and adolescence may be detrimental by leading to higher fat/lean and android/gynoid ratios.

  19. Polygenic Risk, Appetite Traits, and Weight Gain in Middle Childhood: A Longitudinal Study.

    PubMed

    Steinsbekk, Silje; Belsky, Daniel; Guzey, Ismail Cuneyt; Wardle, Jane; Wichstrøm, Lars

    2016-02-01

    Genome-wide association studies have identified genetic risks for obesity. These genetic risks influence development of obesity partly by accelerating weight gain in childhood. Research is needed to identify mechanisms to inform intervention. Cross-sectional studies suggest appetite traits as a candidate mechanism. Longitudinal studies are needed to test whether appetite traits mediate genetic influences on children's weight gain. To test whether genetic risk for obesity predicts accelerated weight gain in middle childhood (ages 4-8 years) and whether genetic association with accelerated weight gain is mediated by appetite traits. Longitudinal study of a representative birth cohort at the Trondheim Early Secure Study, Trondheim, Norway, enrolled at age 4 years during 2007 to 2008, with follow-ups at ages 6 and 8 years. Participants were sampled from all children born in 2003 or 2004 who attended regular community health checkups for 4-year-olds (97.2% attendance; 82.0% consent rate, n = 2475). Nine hundred ninety-five children participated at age 4 years, 795 at age 6 years, and 699 at age 8 years. Analyses included 652 children with genotype, adiposity, and appetite data. Outcomes were body mass index and body-fat phenotypes measured from anthropometry (ages 4, 6, and 8 years) and bioelectrical impedance (ages 6 and 8 years). Genetic risk for obesity was measured using a genetic risk score composed of 32 single-nucleotide polymorphisms previously discovered in genome-wide association studies of adult body mass index. Appetite traits were measured at age 6 years with the Children's Eating Behavior Questionnaire. Of the 652 genotyped child participants, 323 (49.5%) were female, 58 (8.9%) were overweight, and 1 (0.2%) was obese. Children at higher genetic risk for obesity had higher baseline body mass index and fat mass compared with lower genetic risk peers, and they gained weight and fat mass more rapidly during follow-up. Each SD increase in genetic risk score was associated with a 0.22-point increase in BMI at age-4 baseline (for the intercept, unstandardized path coefficient B = 0.22 [95% CI, 0.06-0.38]; P = .008. Children with higher genetic risk scores also gained BMI points more rapidly from ages 4 to 6 years (B = 0.11 [95% CI, 0.03-0.20]; P = .01 ; β = 0.12) and from 6 to 8 years (B = 0.09 [95% CI, 0.00-0.19]; P = .05; β = 0.10), compared with their lower genetic risk peers. Children at higher genetic risk had higher levels of alleged obesogenic appetite traits than peers with lower genetic risk at age 6 years, but appetite traits did not mediate genetic associations with weight gain. The sum of the 5 indirect effects was B = -0.001 (95% CI, -0.02 -0.01); P = .86; β = 0.00. Genetic risk for obesity is associated with accelerated childhood weight gain. Interventions targeting childhood weight gain may provide one path to mitigating genetic risk. However, middle childhood appetite traits may not be a promising target for such interventions. Studies of early-childhood samples are needed to test whether appetite traits explain how genetic risks accelerate growth earlier in development.

  20. Clinically significant weight gain 1 year after occupational back injury.

    PubMed

    Keeney, Benjamin J; Fulton-Kehoe, Deborah; Wickizer, Thomas M; Turner, Judith A; Chan, Kwun Chuen Gary; Franklin, Gary M

    2013-03-01

    To examine the incidence of clinically significant weight gain 1 year after occupational back injury, and risk factors for that gain. A cohort of Washington State workers with wage-replacement benefits for back injuries completed baseline and 1-year follow-up telephone interviews. We obtained additional measures from claims and medical records. Among 1263 workers, 174 (13.8%) reported clinically significant weight gain (≥7%) 1 year after occupational back injury. Women and workers who had more than 180 days on wage replacement at 1 year were twice as likely (adjusted odds ratio = 2.17, 95% confidence interval = 1.54 to 3.07; adjusted odds ratio = 2.40, 95% confidence interval = 1.63 to 3.53, respectively; both P < 0.001) to have clinically significant weight gain. Women and workers on wage replacement for more than 180 days may be susceptible to clinically significant weight gain after occupational back injury.

  1. Clinically Significant Weight Gain One Year After Occupational Back Injury

    PubMed Central

    Keeney, Benjamin J.; Fulton-Kehoe, Deborah; Wickizer, Thomas M.; Turner, Judith A.; Chan, Kwun Chuen Gary; Franklin, Gary M.

    2014-01-01

    Objective To examine the incidence of clinically significant weight gain one year after occupational back injury, and risk factors for that gain. Methods A cohort of Washington State workers with wage-replacement benefits for back injuries completed baseline and 1-year follow-up telephone interviews. We obtained additional measures from claims and medical records. Results Among 1,263 workers, 174 (13.8%) reported clinically significant weight gain (≥7%) 1 year after occupational back injury. Women and workers who had >180 days on wage replacement at 1 year were twice as likely (adjusted OR=2.17, 95% CI=1.54–3.07; adjusted OR=2.40, 95% CI=1.63–3.53, respectively; both P<0.001) to have clinically significant weight gain. Conclusions Women and workers on wage replacement >180 days may be susceptible to clinically significant weight gain following occupational back injury. PMID:23247606

  2. Assessing the burden of treatment-emergent adverse events associated with atypical antipsychotic medications.

    PubMed

    Llorca, Pierre-Michel; Lançon, Christophe; Hartry, Ann; Brown, T Michelle; DiBenedetti, Dana B; Kamat, Siddhesh A; François, Clément

    2017-02-13

    Treatment of schizophrenia and major depressive disorder (MDD) with atypical antipsychotics (AAPs) show improved efficacy and reduced side effect burden compared with older antipsychotic medications. However, a risk of treatment-emergent adverse events (TEAEs) remains. TEAEs are hard to quantify and perspectives on the importance of TEAEs differ across patients and between patients and physicians. The current study is a qualitative assessment that investigates TEAEs of AAPs from both patient and physician perspectives to provide better understanding of the occurrence and burden of TEAEs associated with these medications. Focus groups comprised of patients with MDD and interviews with patients with schizophrenia were conducted at two qualitative research facilities, along with a physician focus group at one of the facilities. Information collected from patients included an exhaustive list of TEAEs experienced, and the frequency and level of bother of each TEAE; from psychiatrists, information included an exhaustive list of TEAEs based on personal observations and patient report, frequency of TEAEs, clinically important TEAEs, and levels of patient-perceived bother. Standard qualitative analysis methods were used to identify, quantify, characterize, and summarize patterns found in the data collected. A total of 42 patients (25 with MDD and 17 with schizophrenia) and 4 psychiatrists participated in the study. TEAEs reported as bothersome across both patients groups included cognitive issues, weight gain and/or increased appetite, low energy, extrapyramidal symptoms (EPS), and need to sleep/excessive sleep/excessive sleepiness. TEAEs considered more bothersome by patients with schizophrenia were weight gain, low energy, EPS, mental anxiety, and increased positive symptoms; those considered more bothersome by patients with MDD were cognitive issues, somnolence/sedation, and flat/restricted affect. TEAEs considered most clinically important by psychiatrists included metabolic syndrome, weight gain, neutropenia, hyperglycemia, and QT prolongation; those TEAEs considered most bothersome to patients from physicians' perspectives included weight gain, reduced sexual desire or performance, EPS, akathisia, and hormonal issues. The wide range of TEAEs that are both frequent and bothersome and the variation in perceived burden according to diagnosis highlight the need for a tailored TEAE-awareness approach when choosing an AAP.

  3. Effects of having a baby on weight gain.

    PubMed

    Brown, Wendy J; Hockey, Richard; Dobson, Annette J

    2010-02-01

    Women often blame weight gain in early adulthood on having a baby. The aim was to estimate the weight gain attributable to having a baby, after disentangling the effects of other factors that influence weight change at this life stage. A longitudinal study of a randomly selected cohort of 6458 Australian women, aged 18-23 years in 1996, was conducted. Self-report mailed surveys were completed in 1996, 2000, 2003, and 2006, and data were analyzed in 2008. On average, women gained weight at the rate of 0.93% per year (95% CI=0.89, 0.98) or 605 g/year (95% CI=580, 635) for a 65-kg woman. Over the 10-year study period, partnered women with one baby gained almost 4 kg more, and those with a partner but no baby gained 1.8 kg more, than unpartnered childless women (after adjustment for other significant factors: initial BMI and age; physical activity, sitting time, energy intake (2003); education level, hours in paid work, and smoking). Having a baby has a marked effect on 10-year weight gain, but there is also an effect attributable to getting married or living with a partner. Social and lifestyle as well as energy balance variables should be considered when developing strategies to prevent weight gain in young adult women. Copyright 2010 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  4. Information needs of cancer patients and survivors regarding diet, exercise and weight management: a qualitative study.

    PubMed

    James-Martin, G; Koczwara, B; Smith, E L; Miller, M D

    2014-05-01

    While advanced cancer is often associated with weight loss, curative cancer treatment is often associated with weight gain. Weight gain during treatment may be associated with greater risk of cancer recurrence and development of lifestyle diseases. Currently, limited resources are available to cancer patients focussed on weight control. This study assessed the information needs of patients undergoing curative chemotherapy regarding diet, exercise and weight management for the purpose of developing weight management resources. Focus groups were held with oncology practitioners, patients and survivors to determine current information provision and needs. Focus groups highlighted a perception that information provision regarding diet, exercise and weight management is insufficient and no routine assessment of weight occurs during chemotherapy. Barriers to information provision described included lack of resources and time, and practitioners' uncertainty regarding appropriate messages to provide. Patients wanted more information regarding diet, exercise and weight during treatment time. The findings of this study suggest an increase in provision of diet, exercise and weight management information is needed. This information should be evidence-based and delivered at an appropriate time by the preferred health care professional. It would also be beneficial to implement protocols regarding assessment of weight during treatment. © 2013 John Wiley & Sons Ltd.

  5. Rapid weight gain after birth predicts life history and reproductive strategy in Filipino males

    PubMed Central

    Kuzawa, Christopher W.; McDade, Thomas W.; Adair, Linda S.; Lee, Nanette

    2010-01-01

    Ecological cues during prenatal and postnatal development may allow organisms to adjust reproductive strategy. The hypothalamic-pituitary-gonadal (HPG) axis is a prime candidate for adaptive plasticity as a result of its critical period of birth to 6 mo (B6M) in humans and the role of testosterone in the development and maintenance of costly sexually dimorphic somatic and behavioral traits. We hypothesized that weight velocity specific to B6M would predict male life history characteristics, including maturational timing, reproductive hormones, adult size, strength, and sexual activity. Data come from 770 Filipino men (age 20.5–22.5 y) followed since birth, with predictor variables including birth weight and weight velocities calculated at 6-mo intervals during the first 2 y of life. As expected, infants who were breastfed experienced less diarrhea, lived in wealthier households with better hygiene, and grew faster from B6M. Males with rapid B6M growth reached puberty earlier and, as young adults, had higher testosterone levels, were taller, more muscular, and had higher grip strength. They also had sex earlier and were more likely to report having had sex in the past month, resulting in more lifetime sex partners. Relationships between B6M weight gain and physical outcomes were generally not present or weaker in female subjects. We conclude that rapid weight gain specific to the brief postnatal hypothalamic-pituitary-gonadal critical period predicts early maturation and sexual activity, elevated hormone production, and more costly adult somatic characteristics among the male subjects in this sample. These findings provide evidence for early life developmental plasticity in male life history and reproductive strategy in humans. PMID:20837542

  6. Short-term variability in body weight predicts long-term weight gain1

    PubMed Central

    Lowe, Michael R; Feig, Emily H; Winter, Samantha R; Stice, Eric

    2015-01-01

    Background: Body weight in lower animals and humans is highly stable despite a very large flux in energy intake and expenditure over time. Conversely, the existence of higher-than-average variability in weight may indicate a disruption in the mechanisms responsible for homeostatic weight regulation. Objective: In a sample chosen for weight-gain proneness, we evaluated whether weight variability over a 6-mo period predicted subsequent weight change from 6 to 24 mo. Design: A total of 171 nonobese women were recruited to participate in this longitudinal study in which weight was measured 4 times over 24 mo. The initial 3 weights were used to calculate weight variability with the use of a root mean square error approach to assess fluctuations in weight independent of trajectory. Linear regression analysis was used to examine whether weight variability in the initial 6 mo predicted weight change 18 mo later. Results: Greater weight variability significantly predicted amount of weight gained. This result was unchanged after control for baseline body mass index (BMI) and BMI change from baseline to 6 mo and for measures of disinhibition, restrained eating, and dieting. Conclusions: Elevated weight variability in young women may signal the degradation of body weight regulatory systems. In an obesogenic environment this may eventuate in accelerated weight gain, particularly in those with a genetic susceptibility toward overweight. Future research is needed to evaluate the reliability of weight variability as a predictor of future weight gain and the sources of its predictive effect. The trial on which this study is based is registered at clinicaltrials.gov as NCT00456131. PMID:26354535

  7. Short-term variability in body weight predicts long-term weight gain.

    PubMed

    Lowe, Michael R; Feig, Emily H; Winter, Samantha R; Stice, Eric

    2015-11-01

    Body weight in lower animals and humans is highly stable despite a very large flux in energy intake and expenditure over time. Conversely, the existence of higher-than-average variability in weight may indicate a disruption in the mechanisms responsible for homeostatic weight regulation. In a sample chosen for weight-gain proneness, we evaluated whether weight variability over a 6-mo period predicted subsequent weight change from 6 to 24 mo. A total of 171 nonobese women were recruited to participate in this longitudinal study in which weight was measured 4 times over 24 mo. The initial 3 weights were used to calculate weight variability with the use of a root mean square error approach to assess fluctuations in weight independent of trajectory. Linear regression analysis was used to examine whether weight variability in the initial 6 mo predicted weight change 18 mo later. Greater weight variability significantly predicted amount of weight gained. This result was unchanged after control for baseline body mass index (BMI) and BMI change from baseline to 6 mo and for measures of disinhibition, restrained eating, and dieting. Elevated weight variability in young women may signal the degradation of body weight regulatory systems. In an obesogenic environment this may eventuate in accelerated weight gain, particularly in those with a genetic susceptibility toward overweight. Future research is needed to evaluate the reliability of weight variability as a predictor of future weight gain and the sources of its predictive effect. The trial on which this study is based is registered at clinicaltrials.gov as NCT00456131. © 2015 American Society for Nutrition.

  8. [Body weight gain after radioiodine therapy in hyperthyroidism].

    PubMed

    Scheidhauer, K; Odatzidu, L; Kiencke, P; Schicha, H

    2002-02-01

    Analysis and follow up of body weight after radioiodine therapy (RITh) of hyperthyroidism, since excessive weight gain is a common complaint among these patients. Therapy and body weight related data of 100 consecutive RITh-patients were retrospectively analysed from the time before up to three years after RITh. All patients suffered from hyperthyroidism (Graves' disease or autonomy), but were adjusted to euthyroid levels after RITh. Patients' data were compared to a control group of 48 euthyroid patients out of the same ambulance and during the same time scale. All patients (RITh and controls) gained weight over the time. There was no statistically significant difference in BMI development over three years between RITh-patients and controls (5.5% resp. 4.9% increase). In the first year after RITh, weight gain of the RITh patients was higher indeed, but lower in the follow up, resulting in the same range of weight gain after three years as the controls. Besides that women showed a slightly higher increase of BMI than men, and so did younger patients compared to elder as well as patients with overweight already before RITh. An initially distinct increase of body weight after RITh of hyperthyroidism is mainly a compensation of pretherapeutic weight loss due to hyperthyroidism. Presupposing adequate euthyroid adjustment of thyroid metabolism after therapy, RITh is not responsible for later weight gain and adipositas.

  9. The effects of weight change on glomerular filtration rate.

    PubMed

    Chang, Alex; Greene, Tom H; Wang, Xuelei; Kendrick, Cynthia; Kramer, Holly; Wright, Jackson; Astor, Brad; Shafi, Tariq; Toto, Robert; Lewis, Julia; Appel, Lawrence J; Grams, Morgan

    2015-11-01

    Little is known about the effect of weight loss/gain on kidney function. Analyses are complicated by uncertainty about optimal body surface indexing strategies for measured glomerular filtration rate (mGFR). Using data from the African-American Study of Kidney Disease and Hypertension (AASK), we determined the association of change in weight with three different estimates of change in kidney function: (i) unindexed mGFR estimated by renal clearance of iodine-125-iothalamate, (ii) mGFR indexed to concurrently measured BSA and (iii) GFR estimated from serum creatinine (eGFR). All models were adjusted for baseline weight, time, randomization group and time-varying diuretic use. We also examined whether these relationships were consistent across a number of subgroups, including tertiles of baseline 24-h urine sodium excretion. In 1094 participants followed over an average of 3.6 years, a 5-kg weight gain was associated with a 1.10 mL/min/1.73 m(2) (95% CI: 0.87 to 1.33; P < 0.001) increase in unindexed mGFR. There was no association between weight change and mGFR indexed for concurrent BSA (per 5 kg weight gain, 0.21; 95% CI: -0.02 to 0.44; P = 0.1) or between weight change and eGFR (-0.09; 95% CI: -0.32 to 0.14; P = 0.4). The effect of weight change on unindexed mGFR was less pronounced in individuals with higher baseline sodium excretion (P = 0.08 for interaction). The association between weight change and kidney function varies depending on the method of assessment. Future clinical trials should examine the effect of intentional weight change on measured GFR or filtration markers robust to changes in muscle mass. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  10. Relations of thyroid function to body weight: cross-sectional and longitudinal observations in a community-based sample.

    PubMed

    Fox, Caroline S; Pencina, Michael J; D'Agostino, Ralph B; Murabito, Joanne M; Seely, Ellen W; Pearce, Elizabeth N; Vasan, Ramachandran S

    2008-03-24

    Overt hypothyroidism and hyperthyroidism may be associated with weight gain and loss. We assessed whether variations in thyroid function within the reference (physiologic) range are associated with body weight. Framingham Offspring Study participants (n=2407) who attended 2 consecutive routine examinations, were not receiving thyroid hormone therapy, and had baseline serum thyrotropin (TSH) concentrations of 0.5 to 5.0 mIU/L and follow-up concentrations of 0.5 to 10.0 mIU/L were included in this study. Baseline TSH concentrations were related to body weight and body weight change during 3.5 years of follow-up. At baseline, adjusted mean weight increased progressively from 64.5 to 70.2 kg in the lowest to highest TSH concentration quartiles in women (P< .001 for trend), and from 82.8 (lowest quartile) to 85.6 kg (highest quartile) in men (P= .007 for trend). During 3.5 years of follow-up, mean (SD) body weight increased by 1.5 (5.6) kg in women and 1.0 (5.0) kg in men. Baseline TSH concentrations were not associated with weight change during follow-up. However, an increase in TSH concentration at follow-up was positively associated with weight gain in women (0.5-2.3 kg across increasing quartiles of TSH concentration change; P< .001 for trend) and men (0.4-1.3 kg across quartiles of TSH concentration change; P= .007 for trend). Thyroid function (as assessed by serum TSH concentration) within the reference range is associated with body weight in both sexes. Our findings raise the possibility that modest increases in serum TSH concentrations within the reference range may be associated with weight gain.

  11. The effects of weight change on glomerular filtration rate

    PubMed Central

    Chang, Alex; Greene, Tom H.; Wang, Xuelei; Kendrick, Cynthia; Kramer, Holly; Wright, Jackson; Astor, Brad; Shafi, Tariq; Toto, Robert; Lewis, Julia; Appel, Lawrence J.; Grams, Morgan

    2015-01-01

    Background Little is known about the effect of weight loss/gain on kidney function. Analyses are complicated by uncertainty about optimal body surface indexing strategies for measured glomerular filtration rate (mGFR). Methods Using data from the African-American Study of Kidney Disease and Hypertension (AASK), we determined the association of change in weight with three different estimates of change in kidney function: (i) unindexed mGFR estimated by renal clearance of iodine-125-iothalamate, (ii) mGFR indexed to concurrently measured BSA and (iii) GFR estimated from serum creatinine (eGFR). All models were adjusted for baseline weight, time, randomization group and time-varying diuretic use. We also examined whether these relationships were consistent across a number of subgroups, including tertiles of baseline 24-h urine sodium excretion. Results In 1094 participants followed over an average of 3.6 years, a 5-kg weight gain was associated with a 1.10 mL/min/1.73 m2 (95% CI: 0.87 to 1.33; P < 0.001) increase in unindexed mGFR. There was no association between weight change and mGFR indexed for concurrent BSA (per 5 kg weight gain, 0.21; 95% CI: −0.02 to 0.44; P = 0.1) or between weight change and eGFR (−0.09; 95% CI: −0.32 to 0.14; P = 0.4). The effect of weight change on unindexed mGFR was less pronounced in individuals with higher baseline sodium excretion (P = 0.08 for interaction). Conclusion The association between weight change and kidney function varies depending on the method of assessment. Future clinical trials should examine the effect of intentional weight change on measured GFR or filtration markers robust to changes in muscle mass. PMID:26085555

  12. The State of the Summer: a Review of Child Summer Weight Gain and Efforts to Prevent It.

    PubMed

    Tanskey, Lindsay A; Goldberg, Jeanne; Chui, Kenneth; Must, Aviva; Sacheck, Jennifer

    2018-06-01

    Accumulating evidence shows that children in the USA gain weight more rapidly during the summer, when school is not in session. This narrative review spanning 2007 to 2017 summarizes efforts to characterize the problem, identify key determinants, and intervene to prevent excess summer weight gain. Summer weight gain remains a concern for elementary-age youth. Few studies have examined its determinants, but unfavorable summertime shifts in diet, physical activity, sedentary time, screen media use, and sleep have been reported. Increased structure is thought to protect against summer weight gain. Interventions to support physical activity and nutrition during the summer show promise, though large-scale impact on weight outcomes remains to be seen. Supporting health behaviors during the summer remains a priority for obesity prevention researchers, practitioners, and policymakers. Strategies to expand access to structured programs and reach beyond such programs to improve behaviors at home are of particular importance.

  13. Treatment of paediatric hyperthyroidism but not hypothyroidism has a significant effect on weight.

    PubMed

    Crocker, Melissa K; Kaplowitz, Paul

    2010-12-01

    Thyroid hormones are involved in metabolic regulation, but the degree to which they affect body weight and body mass index (BMI) in children is unclear. We examined the effect of hypo- and hyperthyroidism on weight and BMI at the time of diagnosis and after appropriate treatment. Prospective and retrospective case series. Children referred for thyroid dysfunction were enrolled prospectively if their total or free T4 was elevated with TSH <0·05 mIU/ml (N = 57) or if they had a subnormal total or free T4 and TSH >20 (N = 29). Almost all patients had at least 2 classic signs or symptoms including goitre, but hyperthyroid patients had more symptoms. Mean BMI z scores at the time of diagnosis did not significantly differ between the two groups. Males with hyperthyroidism complained of weight loss more frequently and had a lower pretreatment BMI z score than hyperthyroid females. Hypothyroid patients lost a minimal amount of weight by the first follow-up (mean of 0·3 kg) and on average gained weight by the second follow-up visit. In contrast hyperthyroid patients gained a mean of 3·4 kg at the first follow-up visit and a mean of 7·1 kg by the second. Correction of hypothyroidism resulted in minimal weight loss, suggesting that hypothyroidism does not cause significant weight gain in children. In contrast, correction of the hyperthyroid state had a somewhat greater impact on weight status. These results are consistent with prior reports but surprising given the opposite metabolic effects of hypo- and hyperthyroidism. © 2010 Blackwell Publishing Ltd.

  14. Treatment of pediatric hyperthyroidism but not hypothyroidism has a significant effect on weight

    PubMed Central

    Crocker, Melissa K.; Kaplowitz, Paul

    2010-01-01

    Objective Thyroid hormones are involved in metabolic regulation, but the degree to which they affect body weight and body mass index (BMI) in children is unclear. We examined the effect of hypo- and hyperthyroidism on weight and BMI at the time of diagnosis and after appropriate treatment. Design Prospective and retrospective case series Patients Children referred for thyroid dysfunction were enrolled prospectively if their total or free T4 was elevated with TSH <0.05 mIU/mL (N=57) or if they had a subnormal total or free T4 and TSH >20 (N=29). Results Almost all patients had at least 2 classic signs or symptoms including goiter, but hyperthyroid patients had more symptoms. Mean BMI z scores at the time of diagnosis did not significantly differ between the two groups. Males with hyperthyroidism complained of weight loss more frequently and had a lower pretreatment BMI z score than hyperthyroid females. Hypothyroid patients lost a minimal amount of weight by the first follow-up (mean of 0.3 kilograms (kg)) and on average gained weight by the second follow-up visit. In contrast hyperthyroid patients gained a mean of 3.4 kg at the first follow-up visit and a mean of 7.1 kg by the second. Conclusions Correction of hypothyroidism resulted in minimal weight loss, suggesting that hypothyroidism does not cause significant weight gain in children. In contrast, correction of the hyperthyroid state had a somewhat greater impact on weight status. These results are consistent with prior reports but surprising given the opposite metabolic effects of hypo- and hyperthyroidism. PMID:20874768

  15. Outrunning major weight gain: a prospective study of 8,340consistent runners during 7 years of follow-up

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Williams, Paul T.

    2006-01-06

    Background: Body weight increases with aging. Short-term,longitudinal exercise training studies suggest that increasing exerciseproduces acute weight loss, but it is not clear if the maintenance oflong-term, vigorous exercise attenuates age-related weight gain inproportion to the exercise dose. Methods: Prospective study of 6,119 maleand 2,221 female runners whose running distance changed less than 5 km/wkbetween their baseline and follow-up survey 7 years later. Results: Onaverage, men who ran modest (0-24 km/wk), intermediate (24-48 km/wk) orprolonged distances (>_48 km/wk) all gained weight throughage 64,however, those who ran ?48 km/wk had one-half the average annual weightgain of those who ran<24 km/wk. Age-related weightmore » gain, and itsreduction by running, were both greater in younger than older men. Incontrast, men s gain in waist circumference with age, and its reductionby running, were the same in older and younger men. Women increased theirbody weight and waist and hip circumferences over time, regardless ofage, which was also reduced in proportion to running distance. In bothsexes, running did not attenuate weight gain uniformly, but ratherdisproportionately prevented more extreme increases. Conclusion: Men andwomen who remain vigorously active gain less weight as they age and thereduction is in proportion to the exercise dose.« less

  16. Antenatal body mass index (BMI) and weight gain in pregnancy - its association with pregnancy and birthing complications.

    PubMed

    Maier, Josefine Theresia; Schalinski, Elisabeth; Gauger, Ulrich; Hellmeyer, Lars

    2016-05-01

    Overweight and obesity is a serious health risk in both developed and developing nations. It is a common finding among women in their reproductive age. Half of patients entering their pregnancy in the US have a BMI >25.0 and therefore qualify as overweight or obese. Moreover, there is a tendency towards increased weight gain during pregnancy. Studies have shown that gestational overweight is associated with complications in pregnancy and birthing as well as short-term and long-term impacts on neonatal outcome in childhood and adulthood. Five hundred and ninety-one women visiting our tertiary perinatal center in 2014 were analyzed for antenatal BMI, gestational weight gain, as well as pregnancy outcome and complication together with neonatal weight and outcome. Pregnancy weight gain was assessed based on the IOM guidelines (Institute of Medicine) issued in 2009. Twenty-nine percent of our population was overweight with a BMI of more than 25.0. The general weight gain was in every BMI group similar (median ranging from 12.0 to 14.0 kg). Approximately one third gained more than the appropriate amount (37%, P<0.001). Women with more gestational weight were at risk of labor induction (55.0% vs. 45.7% labor induction in total, P=0.007). Strikingly, those patients were found to have significantly higher rates of secondary cesarean section (22.4% vs. 15.4%) and decreased chances of spontaneous vaginal birth (57.5% vs. 61.4%) (P=0.008). Furthermore women with a pregnancy weight gain in excess of the guidelines gave birth to neonates with a higher birth weight (>75.centile, 28.3% vs. 21.3%, P<0.001). Altogether, one third of the analyzed population is already overweight or obese when entering pregnancy. A higher gestational weight gain than the recommended amount was found in 37% of cases. We found an association with pregnancy and birthing complications as well as higher infant weight. This highlights the importance of preconceptive and prenatal advice, and if necessary, intervention on BMI and weight gain.

  17. Temperament and body weight from ages 4 to 15 years.

    PubMed

    Sutin, A R; Kerr, J A; Terracciano, A

    2017-07-01

    In adulthood, conscientiousness and neuroticism are correlates of body weight and weight gain. The present research examines whether the childhood antecedents of these traits, persistence and negative reactivity, respectively, are associated with weight gain across childhood. We likewise examine sociability as a predictor of childhood weight gain and whether these three traits are associated with weight concerns and weight-management strategies in adolescence. Participants (N=4153) were drawn from the Longitudinal Study of Australian Children, an ongoing, population-based study of child and family health and well-being. At the baseline assessment, caregivers reported on their child's temperament. At every assessment from ages 4-5 to 14-15 years, study children were weighed and measured by trained staff; there were up to six biennial assessments of body mass index and waist circumference. At ages 14-15 years, study children (n=2975) also self-reported on their weight concerns and weight-management strategies. Study children rated lower in persistence or higher in negative reactivity in early childhood gained more weight between the ages of 4 and 15 years. Sociability was associated with weight gain among girls but not among boys. Lower persistence and higher negative reactivity at ages 4-5 years were also associated with greater weight concerns, restrained eating and use of unhealthy weight-management strategies at ages 14-15 years. Childhood traits related to conscientiousness and neuroticism are associated with objective weight gain across childhood and with concerns and strategies to manage weight in adolescence. These results are consistent with a lifespan perspective that indicates that trait psychological functioning contributes to health-related markers from childhood through old age.

  18. Low-dose naltrexone augmentation of nicotine replacement for smoking cessation with reduced weight gain: a randomized trial.

    PubMed

    Toll, Benjamin A; White, Marney; Wu, Ran; Meandzija, Boris; Jatlow, Peter; Makuch, Robert; O'Malley, Stephanie S

    2010-10-01

    Fear of weight gain is a significant obstacle to smoking cessation, preventing some smokers from attempting to quit. Several previous studies of naltrexone yielded promising results for minimization of post-quit weight gain. Given these encouraging findings, we endeavored to test whether minimization of weight gain might translate to better quit outcomes for a population that is particularly concerned about gaining weight upon quitting. Smokers (N=172) in this investigation were prospectively randomized to receive either 25 mg naltrexone or placebo for 27 weeks (1 week pre-, 26 weeks post-quit) for minimization of post-quit weight gain and smoking cessation. All participants received open label therapy with the nicotine patch for the first 8 weeks post-quit and behavioral counseling over the 27-week treatment. The 2 pre-specified primary outcomes were change in weight for continuously abstinent participants and biologically verified end-of-treatment 7-day point-prevalence abstinence at 26 weeks after the quit date. The difference in weight at 26 weeks post-quit between the naltrexone and placebo groups (naltrexone: 6.8 lbs ± 8.94 vs placebo: 9.7 lbs ± 9.19, p = 0.45) was not statistically different. Seven-day point-prevalence smoking abstinence rates at 26 weeks post-quit was not significantly different between the 2 groups (naltrexone: 22% vs placebo: 27%, p = 0.43). For smokers high in weight concern, the relatively small reduction in weight gain with low-dose naltrexone is not worth the potential for somewhat lower rates of smoking abstinence. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  19. Review of the Safety of Second-Generation Antipsychotics: Are They Really “Atypically” Safe for Youth and Adults?

    PubMed Central

    Rosenberg, David R.; Brooks, Beth Ann; Roberts, Mary W.; Diwadkar, Vaibhav A.

    2012-01-01

    Objective: There is general consensus that second-generation antipsychotics are at least as effective as and more tolerable than first-generation antipsychotics. We address questions of safety and tolerability in both the short-term and long-term use of these medications by reviewing the existing literature in youth and adults. Data Sources: A MEDLINE search was conducted via PubMed using the following keywords (in various combinations): typical antipsychotics, atypical antipsychotics, children, adolescents, side effects, weight gain, diabetes, metformin, metabolic syndrome, and CATIE. Only English-language articles published from 2000–2010 were included. The bibliographies of papers identified through MEDLINE searches were also reviewed. Results: Six adult studies were analyzed in detail. A summary of the data suggests that there may be a lower association of weight gain and diabetes with ziprasidone, aripiprazole, and haloperidol, while olanzapine, clozapine, quetiapine, and risperidone appear to be more highly associated. There may be less difference than originally thought concerning frequency of extrapyramidal side effects among these medications. All of these antipsychotics, including perphenazine, are similarly efficacious in treating psychosis, with the exception of clozapine, which demonstrates significantly more effectiveness. Although the studies on youth tend to be small (few subjects with large age ranges of 4 to 19 years) and short term in comparison to the adult studies, the data reviewed from 5 studies suggest that, in youth, olanzapine may be associated with the greatest weight gain, extrapyramidal side effects and metabolic changes are quite prevalent, and the antipsychotics studied seem to be similarly effective. Conclusions: Considering effectiveness, safety, and tolerability, this literature review suggests that in adults there may be a lower association of weight gain and diabetes with ziprasidone, aripiprazole, and haloperidol as compared with olanzapine, clozapine, quetiapine, and risperidone. Youth may be particularly sensitive to weight gain, especially with olanzapine, as well as extrapyramidal side effects and metabolic changes. The literature suggests similar effectiveness among the antipsychotics, perhaps with the exception of clozapine having greater effectiveness, at least in adults. PMID:23106030

  20. Endometriosis

    MedlinePlus

    ... ibuprofen (Advil), naproxen (Aleve), and acetaminophen (Tylenol). Prescription painkillers, if needed, for more severe pain. Regular exams ... or injections -- This treatment helps shrink growths. Side effects may include weight gain and depression. Gonadotropin-agonist ...

  1. Hernias

    MedlinePlus

    ... induce hernias: obesity or sudden weight gain lifting heavy objects diarrhea or constipation persistent coughing or sneezing ... might include pain when you cough, lift something heavy, or bend over. These types of hernias require ...

  2. Lower weight gain and hepatic lipid content in hamsters fed high fat diets supplemented with white rice protein, brown rice protein, soy protein, and their hydrolysates.

    PubMed

    Zhang, Huijuan; Bartley, Glenn E; Mitchell, Cheryl R; Zhang, Hui; Yokoyama, Wallace

    2011-10-26

    The physiological effects of the hydrolysates of white rice protein (WRP), brown rice protein (BRP), and soy protein (SP) hydrolyzed by the food grade enzyme, alcalase2.4 L, were compared to the original protein source. Male Syrian Golden hamsters were fed high-fat diets containing either 20% casein (control) or 20% extracted proteins or their hydrolysates as the protein source for 3 weeks. The brown rice protein hydrolysate (BRPH) diet group reduced weight gain 76% compared with the control. Animals fed the BRPH supplemented diet also had lower final body weight, liver weight, very low density lipoprotein cholesterol (VLDL-C), and liver cholesterol, and higher fecal fat and bile acid excretion than the control. Expression levels of hepatic genes for lipid oxidation, PPARα, ACOX1, and CPT1, were highest for hamsters fed the BRPH supplemented diet. Expression of CYP7A1, the gene regulating bile acid synthesis, was higher in all test groups. Expression of CYP51, a gene coding for an enzyme involved in cholesterol synthesis, was highest in the BRPH diet group. The results suggest that BRPH includes unique peptides that reduce weight gain and hepatic cholesterol synthesis.

  3. Position of the Academy of Nutrition and Dietetics: Obesity, Reproduction, and Pregnancy Outcomes.

    PubMed

    Stang, Jamie; Huffman, Laurel G

    2016-04-01

    It is the position of the Academy of Nutrition and Dietetics that all women of reproductive age receive education about maternal and fetal risks associated with prepregnancy obesity, excessive gestational weight gain, and significant postpartum weight retention, including potential benefits of lifestyle changes. Behavioral counseling to improve dietary intake and physical activity should be provided to overweight and obese women, beginning in the preconception period and continuing throughout pregnancy, for at least 12 to 18 months postpartum. Weight loss before pregnancy may improve fertility and reduce the risk of poor maternal-fetal outcomes, such as preterm birth, gestational diabetes, gestational hypertension, pre-eclampsia, assisted delivery, and select congenital anomalies. Lifestyle interventions that moderate gestational weight gain may reduce the risk of poor pregnancy outcomes, such as gestational diabetes, gestational hypertension, large for gestational age, and macrosomia, as well as lower the risk for significant postpartum retention. Postpartum interventions that promote healthy diet and physical activity behaviors may reduce postpartum weight retention and decrease obesity-related risks in subsequent pregnancies. Analysis of the evidence suggests that there is good evidence to support the role of diet, physical activity, and behavior changes in promoting optimal weight gain during pregnancy; however, there is currently a relative lack of evidence in other areas related to reproductive outcomes. Copyright © 2016 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.

  4. Weight gain as a consequence of living a modern lifestyle: a discussion of barriers to effective weight control and how to overcome them

    PubMed Central

    Seaman, David R.

    2013-01-01

    Objective The purpose of this commentary is to discuss modern lifestyle factors that promote weight gain and to suggest methods for clinicians to more effectively educate patients about weight management. Discussion Most adults in the United States are overweight or obese. Multiple factors related to the modern lifestyle appear to play causal roles. In general, the population maintains sedentary lives and overconsumes calorie-dense foods. In particular, refined carbohydrates negatively impact metabolism and stimulate neural addiction mechanisms, which facilitate weight gain. As adipose tissue mass accumulates, satiation centers in the hypothalamus become resistant to insulin and leptin, which leads to increased caloric consumption. Several behavior issues further augment weight gain, such as eating too quickly, a lack of sleep, high stress levels, and a lack of exercise. Finally, adipose tissue accumulation alters the body weight set point, which leads to metabolic changes that function to resist weight loss efforts. Each of these factors may work together to augment weight gain and promote obesity. Health care providers, such as chiropractic physicians, who educate patients on wellness, prevention, and lifestyle changes are well positioned to address these issues. Conclusion People need to be educated about the modern lifestyle factors that prevent effective weight management. Without this knowledge and the associated practical application of lifestyle choices that prevent weight gain, becoming overweight or obese appears to be an unavoidable consequence of living a modern lifestyle. PMID:25067929

  5. Development and Preliminary Validation of a Comprehensive Questionnaire to Assess Women’s Knowledge and Perception of the Current Weight Gain Guidelines during Pregnancy

    PubMed Central

    Ockenden, Holly; Gunnell, Katie; Giles, Audrey; Nerenberg, Kara; Goldfield, Gary; Manyanga, Taru; Adamo, Kristi

    2016-01-01

    The aim of this study was to develop and validate an electronic questionnaire, the Electronic Maternal Health Survey (EMat Health Survey), related to women’s knowledge and perceptions of the current gestational weight gain guidelines (GWG), as well as pregnancy-related health behaviours. Constructs addressed within the questionnaire include self-efficacy, locus of control, perceived barriers, and facilitators of physical activity and diet, outcome expectations, social environment and health practices. Content validity was examined using an expert panel (n = 7) and pilot testing items in a small sample (n = 5) of pregnant women and recent mothers (target population). Test re-test reliability was assessed among a sample (n = 71) of the target population. Reliability scores were calculated for all constructs (r and intra-class correlation coefficients (ICC)), those with a score of >0.5 were considered acceptable. The content validity of the questionnaire reflects the degree to which all relevant components of excessive GWG risk in women are included. Strong test-retest reliability was found in the current study, indicating that responses to the questionnaire were reliable in this population. The EMat Health Survey adds to the growing body of literature on maternal health and gestational weight gain by providing the first comprehensive questionnaire that can be self-administered and remotely accessed. The questionnaire can be completed in 15–25 min and collects useful data on various social determinants of health and GWG as well as associated health behaviours. This online tool may assist researchers by providing them with a platform to collect useful information in developing and tailoring interventions to better support women in achieving recommended weight gain targets in pregnancy. PMID:27916921

  6. Effectiveness of physical activity interventions on preventing gestational diabetes mellitus and excessive maternal weight gain: a meta-analysis.

    PubMed

    Sanabria-Martínez, G; García-Hermoso, A; Poyatos-León, R; Álvarez-Bueno, C; Sánchez-López, M; Martínez-Vizcaíno, V

    2015-08-01

    It is commonly accepted that pregnancy-related physiological changes (circulatory, respiratory, and locomotor) negatively influence the daily physical activity of pregnant women. The aim of this study is to conduct a meta-analysis of randomised controlled trials (RCTs) for assessing the effectiveness of physical exercise interventions during pregnancy to prevent gestational diabetes mellitus and excessive maternal weight gain. Keywords were used to conduct a computerised search in six databases: Cochrane Library Plus, Science Direct, EMBASE, PubMed, Web of Science, and ClinicalTrials.gov. Healthy pregnant women who were sedentary or had low levels of physical activity were selected for RCTs that included an exercise programme. Two independent reviewers extracted data and assessed the quality of the included studies. Of 4225 articles retrieved, 13 RCTs (2873 pregnant women) met the inclusion criteria. Pooled relative risk (RR) or weighted mean differences (WMDs) (depending on the outcome measure) were calculated using a random-effects model. Overall, physical exercise programmes during pregnancy decreased the risk of gestational diabetes mellitus (RR = 0.69; P = 0.009), particularly when the exercise programme was performed throughout pregnancy (RR = 0.64; P = 0.038). Furthermore, decreases were also observed in maternal weight (WMD = -1.14 kg; 95% CI -1.50 to -0.78; P < 0.001). No serious adverse effects were reported. Structured moderate physical exercise programmes during pregnancy decrease the risk of gestational diabetes mellitus and diminish maternal weight gain, and seem to be safe for the mother and the neonate; however, further studies are needed to establish recommendations. © 2015 Royal College of Obstetricians and Gynaecologists.

  7. Maternal History of Child Abuse and Obesity Risk in Offspring: Mediation by Weight in Pregnancy.

    PubMed

    Leonard, Stephanie A; Petito, Lucia C; Rehkopf, David H; Ritchie, Lorrene D; Abrams, Barbara

    2017-08-01

    Women's experience of childhood adversity may contribute to their children's risk of obesity. Possible causal pathways include higher maternal weight and gestational weight gain, which have been associated with both maternal childhood adversity and obesity in offspring. This study included 6718 mother-child pairs from the National Longitudinal Survey of Youth 1979 in the United States (1979-2012). We applied multiple log-binomial regression models to estimate associations between three markers of childhood adversity (physical abuse, household alcoholism, and household mental illness) and offspring obesity in childhood. We estimated natural direct effects to evaluate mediation by prepregnancy BMI and gestational weight gain. Among every 100 mothers who reported physical abuse in childhood, there were 3.7 (95% confidence interval: -0.1 to 7.5) excess cases of obesity in 2- to 5-year olds compared with mothers who did not report physical abuse. Differences in prepregnancy BMI, but not gestational weight gain, accounted for 25.7% of these excess cases. There was no evidence of a similar relationship for household alcoholism or mental illness or for obesity in older children. In this national, prospective cohort study, prepregnancy BMI partially explained an association between maternal physical abuse in childhood and obesity in preschool-age children. These findings underscore the importance of life-course exposures in the etiology of child obesity and the potential multi-generational consequences of child abuse. Research is needed to determine whether screening for childhood abuse and treatment of its sequelae could strengthen efforts to prevent obesity in mothers and their children.

  8. Parental Body Mass Index, Gestational Weight Gain, and Risk of Macrosomia: a Population-Based Case-Control Study in China.

    PubMed

    Yang, Shaoping; Zhou, Aifen; Xiong, Chao; Yang, Rong; Bassig, Bryan A; Hu, Ronghua; Zhang, Yiming; Yao, Cong; Zhang, Yaqi; Qiu, Lin; Qian, Zhengmin; Trevathan, Edwin; Flick, Louise; Xu, Shunqing; Wang, Youjie; Xia, Wei; Zheng, Tongzhang; Zhang, Bin

    2015-09-01

    The prevalence of macrosomia has risen markedly worldwide, including in China, during the past two decades. Few epidemiological studies, however, have investigated the risk factors for macrosomia in China. This study was designed to investigate the associations between parental anthropometric characteristics, gestational weight gain (GWG), and risk of macrosomia in China. This population-based, case-control study in Wuhan, China, included a total of 6341 subjects (870 cases and 5471 controls). Multivariable logistic regression was conducted to calculate odds ratios (OR) and 95% confidence intervals (CI). Mothers or fathers who were overweight or obese before pregnancy had an elevated risk of giving birth to a macrosomic infant compared with their normal weight counterparts. Women with GWG above the Institute of Medicine (IOM) recommendation had an adjusted OR of 6.09 [95% CI 5.04, 7.35] for delivering a macrosomic infant compared with women who had GWG within the IOM recommendation. When stratified by maternal pre-pregnancy body mass index (BMI), women who were underweight or normal weight before pregnancy were observed to have a higher risk of macrosomia birth associated with greater GWG. Parental pre-pregnancy overweight/obesity and excessive GWG during pregnancy were highly associated with macrosomia. The association with GWG was most pronounced in mothers who had a normal or underweight pre-pregnancy BMI. Weight control efforts before pregnancy for mothers and fathers as well as control of maternal gain during pregnancy may reduce the risk of macrosomia. © 2015 John Wiley & Sons Ltd.

  9. Association of Gestational Weight Gain With Maternal and Infant Outcomes

    PubMed Central

    Goldstein, Rebecca F.; Abell, Sally K.; Ranasinha, Sanjeeva; Misso, Marie; Boyle, Jacqueline A.; Black, Mary Helen; Li, Nan; Hu, Gang; Corrado, Francesco; Rode, Line; Kim, Young Ju; Haugen, Margaretha; Song, Won O.; Kim, Min Hyoung; Bogaerts, Annick; Devlieger, Roland; Chung, Judith H.

    2017-01-01

    Importance Body mass index (BMI) and gestational weight gain are increasing globally. In 2009, the Institute of Medicine (IOM) provided specific recommendations regarding the ideal gestational weight gain. However, the association between gestational weight gain consistent with theIOM guidelines and pregnancy outcomes is unclear. Objective To perform a systematic review, meta-analysis, and metaregression to evaluate associations between gestational weight gain above or below the IOM guidelines (gain of 12.5-18 kg for underweight women [BMI <18.5]; 11.5-16 kg for normal-weight women [BMI 18.5-24.9]; 7-11 kg for overweight women [BMI 25-29.9]; and 5-9 kg for obese women [BMI ≥30]) and maternal and infant outcomes. Data Sources and Study Selection Search of EMBASE, Evidence-Based Medicine Reviews, MEDLINE, and MEDLINE In-Process between January 1, 1999, and February 7, 2017, for observational studies stratified by prepregnancy BMI category and total gestational weight gain. Data Extraction and Synthesis Data were extracted by 2 independent reviewers. Odds ratios (ORs) and absolute risk differences (ARDs) per live birth were calculated using a random-effects model based on a subset of studies with available data. Main Outcomes and Measures Primary outcomes were small for gestational age (SGA), preterm birth, and large for gestational age (LGA). Secondary outcomes were macrosomia, cesarean delivery, and gestational diabetes mellitus. Results Of 5354 identified studies, 23 (n = 1 309 136 women) met inclusion criteria. Gestational weight gain was below or above guidelines in 23% and 47% of pregnancies, respectively. Gestational weight gain below the recommendations was associated with higher risk of SGA (OR, 1.53 [95% CI, 1.44-1.64]; ARD, 5% [95% CI, 4%-6%]) and preterm birth (OR, 1.70 [1.32-2.20]; ARD, 5% [3%-8%]) and lower risk of LGA (OR, 0.59 [0.55-0.64]; ARD, −2% [−10% to −6%]) and macrosomia (OR, 0.60 [0.52-0.68]; ARD, −2% [−3% to −1%]); cesarean delivery showed no significant difference (OR, 0.98 [0.96-1.02]; ARD, 0% [−2% to 1%]). Gestational weight gain above the recommendations was associated with lower risk of SGA (OR, 0.66 [0.63-0.69]; ARD, −3%; [−4% to −2%]) and preterm birth (OR, 0.77 [0.69-0.86]; ARD, −2% [−2% to −1%]) and higher risk of LGA (OR, 1.85 [1.76-1.95]; ARD, 4% [2%-5%]), macrosomia (OR, 1.95 [1.79-2.11]; ARD, 6% [4%-9%]), and cesarean delivery (OR, 1.30 [1.25-1.35]; ARD, 4% [3%-6%]). Gestational diabetes mellitus could not be evaluated because of the nature of available data. Conclusions and Relevance In this systematic review and meta-analysis of more than 1 million pregnant women, 47% had gestational weight gain greater than IOM recommendations and 23% had gestational weight gain less than IOM recommendations. Gestational weight gain greater than or less than guideline recommendations, compared with weight gain within recommended levels, was associated with higher risk of adverse maternal and infant outcomes. PMID:28586887

  10. Association of Gestational Weight Gain With Maternal and Infant Outcomes: A Systematic Review and Meta-analysis.

    PubMed

    Goldstein, Rebecca F; Abell, Sally K; Ranasinha, Sanjeeva; Misso, Marie; Boyle, Jacqueline A; Black, Mary Helen; Li, Nan; Hu, Gang; Corrado, Francesco; Rode, Line; Kim, Young Ju; Haugen, Margaretha; Song, Won O; Kim, Min Hyoung; Bogaerts, Annick; Devlieger, Roland; Chung, Judith H; Teede, Helena J

    2017-06-06

    Body mass index (BMI) and gestational weight gain are increasing globally. In 2009, the Institute of Medicine (IOM) provided specific recommendations regarding the ideal gestational weight gain. However, the association between gestational weight gain consistent with theIOM guidelines and pregnancy outcomes is unclear. To perform a systematic review, meta-analysis, and metaregression to evaluate associations between gestational weight gain above or below the IOM guidelines (gain of 12.5-18 kg for underweight women [BMI <18.5]; 11.5-16 kg for normal-weight women [BMI 18.5-24.9]; 7-11 kg for overweight women [BMI 25-29.9]; and 5-9 kg for obese women [BMI ≥30]) and maternal and infant outcomes. Search of EMBASE, Evidence-Based Medicine Reviews, MEDLINE, and MEDLINE In-Process between January 1, 1999, and February 7, 2017, for observational studies stratified by prepregnancy BMI category and total gestational weight gain. Data were extracted by 2 independent reviewers. Odds ratios (ORs) and absolute risk differences (ARDs) per live birth were calculated using a random-effects model based on a subset of studies with available data. Primary outcomes were small for gestational age (SGA), preterm birth, and large for gestational age (LGA). Secondary outcomes were macrosomia, cesarean delivery, and gestational diabetes mellitus. Of 5354 identified studies, 23 (n = 1 309 136 women) met inclusion criteria. Gestational weight gain was below or above guidelines in 23% and 47% of pregnancies, respectively. Gestational weight gain below the recommendations was associated with higher risk of SGA (OR, 1.53 [95% CI, 1.44-1.64]; ARD, 5% [95% CI, 4%-6%]) and preterm birth (OR, 1.70 [1.32-2.20]; ARD, 5% [3%-8%]) and lower risk of LGA (OR, 0.59 [0.55-0.64]; ARD, -2% [-10% to -6%]) and macrosomia (OR, 0.60 [0.52-0.68]; ARD, -2% [-3% to -1%]); cesarean delivery showed no significant difference (OR, 0.98 [0.96-1.02]; ARD, 0% [-2% to 1%]). Gestational weight gain above the recommendations was associated with lower risk of SGA (OR, 0.66 [0.63-0.69]; ARD, -3%; [-4% to -2%]) and preterm birth (OR, 0.77 [0.69-0.86]; ARD, -2% [-2% to -1%]) and higher risk of LGA (OR, 1.85 [1.76-1.95]; ARD, 4% [2%-5%]), macrosomia (OR, 1.95 [1.79-2.11]; ARD, 6% [4%-9%]), and cesarean delivery (OR, 1.30 [1.25-1.35]; ARD, 4% [3%-6%]). Gestational diabetes mellitus could not be evaluated because of the nature of available data. In this systematic review and meta-analysis of more than 1 million pregnant women, 47% had gestational weight gain greater than IOM recommendations and 23% had gestational weight gain less than IOM recommendations. Gestational weight gain greater than or less than guideline recommendations, compared with weight gain within recommended levels, was associated with higher risk of adverse maternal and infant outcomes.

  11. Linear state feedback, quadratic weights, and closed loop eigenstructures. M.S. Thesis

    NASA Technical Reports Server (NTRS)

    Thompson, P. M.

    1979-01-01

    Results are given on the relationships between closed loop eigenstructures, state feedback gain matrices of the linear state feedback problem, and quadratic weights of the linear quadratic regulator. Equations are derived for the angles of general multivariable root loci and linear quadratic optimal root loci, including angles of departure and approach. The generalized eigenvalue problem is used for the first time to compute angles of approach. Equations are also derived to find the sensitivity of closed loop eigenvalues and the directional derivatives of closed loop eigenvectors (with respect to a scalar multiplying the feedback gain matrix or the quadratic control weight). An equivalence class of quadratic weights that produce the same asymptotic eigenstructure is defined, sufficient conditions to be in it are given, a canonical element is defined, and an algorithm to find it is given. The behavior of the optimal root locus in the nonasymptotic region is shown to be different for quadratic weights with the same asymptotic properties.

  12. High Velocity Burner Rig Oxidation and Thermal Fatigue Behavior of Si3N4- and SiC Base Ceramics to 1370 Deg C

    NASA Technical Reports Server (NTRS)

    Sanders, W. A.; Johnston, J. R.

    1978-01-01

    One SiC material and three Si3N4 materials including hot-pressed Si3N4 as a baseline were exposed in a Mach-1-gas-velocity burner rig simulating a turbine engine environment. Criteria for the materials selection were: potential for gas-turbine usage, near-net-shape fabricability and commercial/domestic availability. Cyclic exposures of test vanes up to 250 cycles (50 hr at temperature) were at leading-edge temperatures to 1370 C. Materials and batches were compared as to weight change, surface change, fluorescent penetrant inspection, and thermal fatigue behavior. Hot-pressed Si3N4 survived the test to 1370 C with slight weight losses. Two types of reaction-sintered Si3N4 displayed high weight gains and considerable weight-change variability, with one material exhibiting superior thermal fatigue behavior. A siliconized SiC showed slight weight gains, but considerable batch variability in thermal fatigue.

  13. Transfer of preterm infants from incubator to open cot at lower versus higher body weight.

    PubMed

    New, K; Flenady, V; Davies, M W

    2004-01-01

    The use of incubators in helping to maintain a thermoneutral environment for preterm infants has become routine practice in neonatal nurseries. As one of the key criteria for discharging preterm infants from nurseries is their ability to maintain temperature, the infant will need to make the transition from incubator to open cot at some time before discharge. The timing of this transition is important because when an infant is challenged by cold, the infant attempts to increase its heat production to maintain body temperature. The increase in energy expenditure may affect weight gain. The practice of transferring infants from incubators to open cots usually occurs once a weight of around 1700-1800 g has been reached; however, this practice varies widely between neonatal units. This preferred weight mark appears to be largely based on tradition or the personal experience of clinicians, with little consideration of the infant's weight or gestational age at birth. The main objective was to assess the effects on weight gain and temperature control of a policy of transferring preterm infants from incubator to open cot at lower versus higher body weight. Searches were undertaken of MEDLINE from June 2003 back to 1966, CINAHL from June 2003 back to 1987 and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 1, 2003). The title and abstract of each retrieved study were examined to assess eligibility. If there was uncertainty, the full paper was examined. Trials in which preterm infants were randomly allocated to a policy of transfer from incubators to open cots at a lower body weight versus at a higher body weight. Quality assessments and data extraction for included trials were conducted independently by the reviewers. Data for individual trial results were analysed using relative risk (RR) and mean difference (MD). Results are presented with 95% confidence intervals (CI). Due to insufficient data, meta-analysis could not be undertaken. Four studies were identified as potentially eligible for inclusion in this review. Two studies were excluded as random allocation to the exposure was not employed. One study is pending, awaiting additional information from the authors. Therefore, one study involving 60 preterm infants, employing a matched-pairs design, which compared the transfer of infants to open cots at 1700 g versus 1800 g, is included in this review. Only two outcomes could be included from this study; return to incubator and daily weight gain. No statistically significant difference was shown for either return to incubator (RR 2.00, 95% CI 0.40 to 10.11) or daily weight gain [MD 4.00 g/day (95% CI -5.23, 13.23)]. Due to small numbers, effects on clinically important outcomes could not be adequately assessed. There is currently little evidence from randomised trials to inform practice on the preferred weight for transferring preterm infants from incubators to open cots. There is a need for larger randomised controlled trials to address this deficiency.

  14. [Eating attitudes, attitudes related to weight gain, and body satisfaction of pregnant adolescents].

    PubMed

    Oliboni, Carolina Marques; Alvarenga, Marle Dos Santos

    2015-12-01

    To assess attitudes about eating, weight gain and body image of pregnant adolescents. Pregnant adolescents (n=67) were assessed using the Body Image Questionnaire, the Attitude towards Weight Gain during Pregnancy scale (AWGP) and questions about risk behaviors for eating disorders and unhealthy weight control practices. Associations between variables were analyzed by ANOVA, Kruskal-Wallis test, Pearson and Spearman tests. The influence of the independent variables regarding skipping meals, body satisfaction and binge eating was evaluated by logistic regression. The average age of the adolescents was 15.3 years (SD=1.14) and their average gestational age was 21.9 weeks (SD=6.53). The average AWGP score was 52.6 points, indicating a positive attitude towards weight gain, and 82.1% of the pregnant girls were satisfied with their bodies. Obese girls had more body dissatisfaction (p=0.001), and overweight girls thought more about food (p=0.02) and eating (p=0.03). The frequency of reported binge eating was 41.8%, and the frequency of skipping meals was 19%. Regression analysis showed that the current Body Mass Index (p=0.03; OR=1.18) and the importance of body awareness and fitness before pregnancy (p=0.03; OR=4.63) were predictors of skipping meals. Higher socioeconomic level (p=0.04; OR=0.55) and greater concern with weight gain (p=0.03; OR=0.32) predicted binge eating. Even though the majority of the pregnant adolescents had positive attitudes toward weight gain and body satisfaction, those heavier and more concerned with weight gain had a higher risk of unhealthy attitudes, while those of lower social class, less concerned with weight gain and less embarrassed about their bodies during pregnancy, had a lower risk of unhealthy attitudes.

  15. Outcomes associated with preoperative weight loss after laparoscopic Roux-en-Y gastric bypass

    PubMed Central

    Blackledge, Camille; Graham, Laura A.; Gullick, Allison A.; Richman, Joshua; Stahl, Richard; Grams, Jayleen

    2016-01-01

    Background Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an effective treatment for achieving and maintaining weight loss and for improving obesity-related comorbidities. As part of the approval process for bariatric surgery, many insurance companies require patients to have documented recent participation in a supervised weight loss program. The goal of this study was to evaluate the relationship of preoperative weight changes with outcomes following LRYGB. Methods A retrospective review was conducted of adult patients undergoing LRYGB between 2008 and 2012 at a single institution. Patients were stratified into quartiles based on % excess weight gain (0–4.99 % and ≥5 % EWG) and % excess weight loss (0–4.99 % and ≥5 % EWL). Generalized linear models were used to examine differences in postoperative weight outcomes at 6, 12, and 24 months. Covariates included in the final adjusted models were determined using backwards stepwise selection. Results Of the 300 patients included in the study, there were no significant demographic differences among the quartiles. However, there was an increased time to operation for patients who gained or lost ≥5 % excess body weight (p < 0.001). Although there was no statistical significance in postoperative complications, there was a higher rate of complications in patients with ≥5 % EWG compared to those with ≥5 % EWL (12.5 vs. 4.8 %, respectively; p = 0.29). Unadjusted and adjusted generalized linear models showed no statistically significant association between preoperative % excess weight change and weight loss outcomes at 24 months. Conclusion Patients with the greatest % preoperative excess weight change had the longest intervals from initial visit to operation. No significant differences were seen in perioperative and postoperative outcomes. This study suggests preoperative weight loss requirements may delay the time to operation without improving postoperative outcomes or weight loss. PMID:26969666

  16. Excess Folic Acid Increases Lipid Storage, Weight Gain, and Adipose Tissue Inflammation in High Fat Diet-Fed Rats.

    PubMed

    Kelly, Karen B; Kennelly, John P; Ordonez, Marta; Nelson, Randal; Leonard, Kelly; Stabler, Sally; Gomez-Muñoz, Antonio; Field, Catherine J; Jacobs, René L

    2016-09-23

    Folic acid intake has increased to high levels in many countries, raising concerns about possible adverse effects, including disturbances to energy and lipid metabolism. Our aim was to investigate the effects of excess folic acid (EFA) intake compared to adequate folic acid (AFA) intake on metabolic health in a rodent model. We conducted these investigations in the setting of either a 15% energy low fat (LF) diet or 60% energy high fat (HF) diet. There was no difference in weight gain, fat mass, or glucose tolerance in EFA-fed rats compared to AFA-fed rats when they were fed a LF diet. However, rats fed EFA in combination with a HF diet had significantly greater weight gain and fat mass compared to rats fed AFA (p < 0.05). Gene expression analysis showed increased mRNA levels of peroxisome proliferator-activated receptor γ (PPARγ) and some of its target genes in adipose tissue of high fat-excess folic acid (HF-EFA) fed rats. Inflammation was increased in HF-EFA fed rats, associated with impaired glucose tolerance compared to high fat-adequate folic acid (HF-AFA) fed rats (p < 0.05). In addition, folic acid induced PPARγ expression and triglyceride accumulation in 3T3-L1 cells. Our results suggest that excess folic acid may exacerbate weight gain, fat accumulation, and inflammation caused by consumption of a HF diet.

  17. Selection of diet for culture of juvenile silver pomfret, Pampus argenteus

    NASA Astrophysics Data System (ADS)

    Peng, Shiming; Shi, Zhaohong; Yin, Fei; Sun, Peng; Wang, Jiangang

    2012-03-01

    Juvenile silver pomfret, Pampus argenteus, was grown in culture tanks for 9 weeks on four different diets, and their effects on fish growth, digestive enzyme activity, and body composition were assessed. The feeding regime was as follows: Diet 1: fish meat; Diet 2: fish meat+artificial feed; Diet 3: fish meat+artificial feed+Agamaki clam meat; Diet 4: fish meat+artificial feed+Agamaki clam+copepods. The greatest weight gain was associated with Diet 4, while the lowest weight gain was associated with Diet 1. No significant difference was observed in weight gain between fish receiving Diet 2 and Diet 3. Specific growth rate followed similar trends as weight gain. The feed conversion ratio (FCR) of fish fed Diet 1 was significantly higher than the other fish groups, but no significant differences were observed in FCRs of fish fed Diet 2, Diet 3 or Diet 4. There was also no significant difference in the hepatosomatic index (HSI) between the four diets. For fish that received Diets 2-4, containing artificial feed, higher protease activities were detected. A higher lipid content of the experimental diets also significantly increased lipase activities and body lipid content. No significant differences in amylase activity or body protein content were found between Diets 1-4. In conclusion, a variety of food components, including copepods and artificial feed, in the diet of silver pomfret significantly increased digestive enzyme activity and could improve growth performance.

  18. Adverse maternal and neonatal outcomes in women with preeclampsia in Iran.

    PubMed

    Omani-Samani, Reza; Ranjbaran, Mehdi; Amini, Payam; Esmailzadeh, Arezoo; Sepidarkish, Mahdi; Almasi-Hashiani, Amir

    2017-09-18

    Preeclampsia is relatively a common complication in pregnancy and is characterized by high blood pressure and protein in urine during pregnancy. Consistent with the adverse outcomes followed by preeclampsia, this study designed to investigate the how preeclampsia is associated with preterm, low birth weight (LBW), cesarean section, and weigh gain during pregnancy. In this population-based cross-sectional study, 5166 deliveries from 103 hospitals in Tehran (Capital of Iran) were included in the analysis in 2015. The independent variable was preeclampsia during pregnancy and weight gain during pregnancy, preterm birth, cesarean section, and LBW were considered as interested outcomes. The data were analyzed by statistical Stata software (version 13, Stata Inc., College Station, TX). Adjusted results showed that the mean of weight gain in women with preeclampsia was significantly higher than women without preeclampsia (mean difference: 1.77 kg, 95%CI: 0.76-12.78, p = .001). The adjusted odds ratio for preterm birth, cesarean section, and LBW were 4.19 (95%CI: 2.71-6.48, p = .001), 1.92 (95%CI: 1.24-2.98, p = .003), and 1.19 (95%CI: 0.61-2.31, p = .599), respectively. Weight gain in women with preeclampsia was higher than women without preeclampsia and also the odds of preterm birth, cesarean section and LBW in women with preeclampsia was higher than women without preeclampsia.

  19. Subacute thyroiditis

    MedlinePlus

    ... may release too little hormone, causing symptoms of hypothyroidism , including: Cold intolerance Constipation Fatigue Weight gain Dry ... often returns to normal. But in rare cases, hypothyroidism may be permanent. Exams and Tests Laboratory tests ...

  20. Development of muscularity and weight concerns in heterosexual and sexual minority males.

    PubMed

    Calzo, Jerel P; Corliss, Heather L; Blood, Emily A; Field, Alison E; Austin, S Bryn

    2013-01-01

    To examine the development of muscularity and weight concerns among heterosexual and sexual minority males in adolescence. Participants were 5,868 males from the Growing Up Today Study, a U.S. prospective cohort spanning ages 9-25 years. Generalized estimating equations were used to test sexual orientation differences in the development of muscularity concerns, weight gain attempts, and weight and shape concern. Desire for bigger muscles increased slightly each year across adolescence (β = .10, 95% C.I. = .09, .11) regardless of sexual orientation, but gay and bisexual participants reported greater desire for toned muscles than completely and mostly heterosexual males (β = .39, 95% C.I. = .21, .57). Desire for toned muscles did not change with age. Attempts to gain weight increased threefold across adolescence, with up to 30% reporting weight gain attempts by age 16. Although underweight males (the smallest weight status class) were most likely to attempt to gain weight, most of the observed weight gain attempts were by healthy (69%) and overweight/obese (27%) males, suggesting that most attempts were medically unnecessary and could lead to overweight. Sexual minority participants were 20% less likely to report weight gain attempts than completely heterosexual participants. Weight and shape concern increased with age, with gay and bisexual participants experiencing a significantly greater increase than heterosexual males. Sexual orientation modifies the development and expression of male weight and muscularity concerns. The findings have implications for early interventions for the prevention of obesity and eating disorder risk in heterosexual and sexual minority males. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  1. Development of Muscularity and Weight Concerns in Heterosexual and Sexual Minority Males

    PubMed Central

    Calzo, Jerel P.; Corliss, Heather L.; Blood, Emily A.; Field, Alison E.; Austin, S. Bryn

    2013-01-01

    Objective To examine the development of muscularity and weight concerns among heterosexual and sexual minority males in adolescence. Method Participants were 5,868 males from the Growing Up Today Study, a US prospective cohort spanning ages 9–25 years. Generalized estimating equations were used to test sexual orientation differences in the development of muscularity concerns, weight gain attempts, and weight and shape concern. Results Desire for bigger muscles increased slightly each year across adolescence (β =.10, 95% C.I.= .09, .11) regardless of sexual orientation, but gay and bisexual participants reported greater desire for toned muscles than completely and mostly heterosexual males (β=.39, 95% C.I.=.21, .57). Desire for toned muscles did not change with age. Attempts to gain weight increased three-fold across adolescence, with up to 30% reporting weight gain attempts by age 16. Although underweight males (the smallest weight status class) were most likely to attempt to gain weight, most of the observed weight gain attempts were by healthy (69%) and overweight/obese (27%) males, suggesting that most attempts were medically unnecessary and could lead to overweight. Sexual minority participants were 20% less likely to report weight gain attempts than completely heterosexual participants. Weight and shape concern increased with age, with gay and bisexual participants experiencing a significantly greater increase than heterosexual males. Conclusions Sexual orientation modifies the development and expression of male weight and muscularity concerns. The findings have implications for early interventions for the prevention of obesity and eating disorder risk in heterosexual and sexual minority males. PMID:23316852

  2. Lymphotoxin Regulates Commensal Responses to Enable Diet-Induced Obesity

    PubMed Central

    Upadhyay, Vaibhav; Poroyko, Valeriy; Kim, Tae-jin; Devkota, Suzanne; Fu, Sherry; Liu, Donald; Tumanov, Alexei V.; Koroleva, Ekaterina P.; Deng, Liufu; Nagler, Cathryn; Chang, Eugene; Tang, Hong; Fu, Yang-Xin

    2013-01-01

    The microbiota plays a critical, weight-promoting role in diet-induced obesity (DIO), but the pathways that cause the microbiota to induce weight gain are unknown. We report that mice deficient in lymphotoxin (LT), a key molecule in gut immunity, were resistant to DIO. Ltbr−/− mice differed in microbial community composition compared to their heterozygous littermates, including an overgrowth of segmented filamentous bacteria (SFB). Furthermore, cecal transplantation conferred leanness to germ-free recipients. Housing Ltbr−/− mice with their obese siblings rescued weight gain, demonstrating the communicability of the obese phenotype. Ltbr−/− animals lacked interleukin 23 (IL-23) and IL-22 that can regulate SFB. Mice deficient in these pathways also resisted DIO, demonstrating that intact mucosal immunity guides diet-induced changes to the microbiota to enable obesity. PMID:22922363

  3. The effect of increasing dairy calcium intake of adolescent girls on changes in body fat and weight.

    PubMed

    Lappe, Joan M; McMahon, Donald J; Laughlin, Ann; Hanson, Corrine; Desmangles, Jean Claude; Begley, Margaret; Schwartz, Misty

    2017-05-01

    Background: Overweight is epidemic in adolescents and is a major concern because it tracks into adulthood. Evidence supports the efficacy of high-calcium, high-dairy diets in achieving healthy weight in adults. However, no randomized controlled trials of the effect of dairy food on weight and body fat in adolescents have been reported to our knowledge. Objective: The aim was to determine whether increasing calcium intake to recommended amounts with dairy foods in adolescent girls with habitually low calcium intakes would decrease body fat gain compared with girls who continued their low calcium intake. Participants had above-the-median body mass index (BMI; in kg/m 2 ). Design: We enrolled 274 healthy postmenarcheal 13- to 14-y-old overweight girls who had calcium intakes of ≤600 mg/d in a 12-mo randomized controlled trial. Girls were randomly assigned in a 1:1 ratio to 1 of 2 groups within each of 3 BMI percentiles: 50th to <70th, 70th to <85th, and 85th to <98th. The assignments were 1 ) dairy, which included low-fat milk or yogurt servings providing ≥1200 mg Ca/d or 2 ) control, which included the usual diet of ≤600 mg Ca/d. Results: We failed to detect a statistically significant difference between groups in percentage of body fat gain over 12 mo (mean ± SEM: dairy 0.40% ± 0.53% > control; P < 0.45). The effect of the intervention did not differ by BMI percentile stratum. There was no difference in weight change between the 2 groups. Conclusion: Our findings that the dairy group gained body fat similar to the control group provide no support for dairy food as a stratagem to decrease body fat or weight gain in overweight adolescent girls. This trial was registered at clinicaltrials.gov as NCT01066806. © 2017 American Society for Nutrition.

  4. Body Weight Gain and Hyperphagia After Administration of SGLT-2 Inhibitor: A Case Report.

    PubMed

    Hamamoto, Hiromi; Noda, Mitsuhiko

    2015-12-07

    A detailed description is given of a case we encountered in which unexpectedly marked weight gain occurred following a treatment switch from a GLP-1 receptor agonist to an SGLT-2 inhibitor The patient, a 44-year-old man with type 2 diabetes mellitus, had gained about 10 kg in weight in the previous year. Therefore, metformin was replaced with liraglutide to obtain reduction of body weight. Although the patient lost about 8 kg (7%), during the 18-month period on the medication, the weight loss stabilized; therefore, the treatment was again switched to tofogliflozin to obtain further reduction of body weight. However, the patient reported increasing hunger and an exaggerated appetite from week 3 onward after the start of tofogliflozin, and gained about 9 kg in weight within 2 weeks, associated with a tendency towards increased HbA1c; therefore, tofogliflozin was discontinued. Immediate reinstitution of liraglutide resulted in reduction of the increased appetite, weight, and HbA1c level. Caution should be exercised against hyperphagia and weight gain due to hunger that may occur following discontinuation of a GLP-1 receptor agonist and/or initiation of an SGLT-2 inhibitor.

  5. Weight Status in the First 2 Years of Life and Neurodevelopmental Impairment in Extremely Low Gestational Age Newborns.

    PubMed

    Belfort, Mandy B; Kuban, Karl C K; O'Shea, T Michael; Allred, Elizabeth N; Ehrenkranz, Richard A; Engelke, Stephen C; Leviton, Alan

    2016-01-01

    To examine the extent to which weight gain and weight status in the first 2 years of life relate to the risk of neurodevelopmental impairment in extremely preterm infants. In a cohort of 1070 infants born between 23 and 27 weeks' gestation, we examined weight gain from 7-28 days of life (in quartiles) and weight z-score at 12 and 24 months corrected age (in 4 categories: <-2; ≥-2, <-1; ≥1, <1; and ≥1) in relation to these adverse neurodevelopmental outcomes: Bayley-II mental development index <55, Bayley-II psychomotor development index <55, cerebral palsy, Gross Motor Function Classification System ≥1 (cannot walk without assistance), microcephaly. We adjusted for confounders in logistic regression, stratified by sex, and performed separate analyses including the entire sample, and excluding children unable to walk without assistance (motor impairment). Weight gain in the lowest quartile from 7-28 days was not associated with higher risk of adverse outcomes. Children with a 12-month weight z-score <-2 were at increased risk for all adverse outcomes in girls, and for microcephaly and Gross Motor Function Classification System ≥1 in boys. However, excluding children with motor impairment attenuated all associations except that of weight z-score <-2 with microcephaly in girls. Similarly, most associations of low weight z-score at 24 months with adverse outcomes were attenuated with exclusion of children with motor impairment. Excluding children who have gross motor impairment appears to eliminate the association of low weight status with neurodevelopmental impairments at 2 years in extremely preterm infants. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Behavioral Treatment Approaches to Prevent Weight Gain Following Smoking Cessation.

    ERIC Educational Resources Information Center

    Grinstead, Olga A.

    Personality and physiological, cognitive, and environmental factors have all been suggested as critical variables in smoking cessation and relapse. Weight gain and the fear of weight gain after smoking cessation may also prevent many smokers from quitting. A sample of 45 adult smokers participated in a study in which three levels of preventive…

  7. The role of hunger state and dieting history in neural response to food cues: An event-related potential study.

    PubMed

    Feig, Emily H; Winter, Samantha R; Kounios, John; Erickson, Brian; Berkowitz, Staci A; Lowe, Michael R

    2017-10-01

    A history of dieting to lose weight has been shown to be a robust predictor of future weight gain. A potential factor in propensity towards weight gain is the nature of people's reactions to the abundance of highly palatable food cues in the environment. Event Related Potentials (ERPs) have revealed differences in how the brain processes food cues between obese and normal weight individuals, as well as between restrained and unrestrained eaters. However, comparisons by weight status are not informative regarding whether differences predate or follow weight gain in obese individuals and restrained eating has not consistently been found to predict future weight gain. The present study compared ERP responses to food cues in non-obese historic dieters (HDs) to non-obese never dieters (NDs). HDs showed a blunted N1 component relative to NDs overall, and delayed N1 and P2 components compared to NDs in the hungry state, suggesting that early, perceptual processing of food cues differs between these groups, especially when food-deprived. HDs also showed a more hunger-dependent sustained ERP (LPP) compared to NDs. Future research should test ERP-based food cue responsivity as a mediator between dieting history and future weight gain to better identify those most at risk for weight gain as well as the nature of their vulnerability. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Improvements in Cardiovascular Risk Factors in Young Adults in a Randomized Trial of Approaches to Weight Gain Prevention

    PubMed Central

    Wing, Rena R.; Tate, Deborah F.; Garcia, Katelyn R.; Bahnson, Judy; Lewis, Cora E.; Espeland, Mark A.

    2017-01-01

    Objective Weight gain occurs commonly in young adults and increases cardiovascular (CVD) risk. We previously reported that two self-regulation interventions reduced weight gain relative to control. Here we examine whether these interventions also benefit CVD risk factors. Methods SNAP (Study of Novel Approaches to Weight Gain Prevention) was a randomized trial in 2 academic settings (N=599; 18–35 years; body mass index 21–30 kg/m2) comparing two interventions (Self-Regulation with Small Changes; Self-Regulation with Large Changes) and Control. Small Changes taught participants to make daily small changes (approximately 100 calorie) in intake and activity. Large Changes taught participants to initially lose 5–10 pounds to buffer anticipated weight gains. CVD risk factors were assessed at baseline and 2 years in 471 participants. Results Although Large Changes was associated with more beneficial changes in glucose, insulin, and HOMA-IR than Control, these differences were not significant after adjusting for multiple comparisons or 2-year weight change. Comparison of participants grouped by percent weight change baseline to 2 years showed significant differences for several CVD risk factors, with no interaction with treatment condition. Conclusions Magnitude of weight change, rather than specific weight gain prevention interventions, was related to changes in CVD risk factors in young adults. PMID:28782918

  9. Efficacy of ranitidine in olanzapine-induced weight gain: a dose-response study.

    PubMed

    Mehta, Varun S; Ram, Daya

    2016-12-01

    Weight gain has long been recognized as a side-effect of atypical antipsychotic drugs. Numerous new approaches have been tried for prevention of weight gain, the H2 blockers being one of them. The study was conducted with the aim to evaluate the efficacy of ranitidine in olanzapine-induced weight gain at two fixed doses of 150 and 300 mg day -1 . Seventy-five inpatients with an ICD-10-DCR diagnosis of schizophrenia as their first episode were randomized into three groups of 25 patients each, receiving 150 mg day -1 ranitidine, 300 mg day -1 ranitidine and third group receiving only olanzapine. Their weight and body mass index (BMI) were measured at baseline and at intervals of 4 and 8 weeks. All patients were comparable with respect to their weight and BMI at baseline. When a change in the weight and BMI was assessed at 4 and 8 weeks from baseline, no significant difference was observed between the three groups. Ranitidine at doses of 150 and 300 mg day -1 when combined with olanzapine was ineffective in attenuating olanzapine-induced weight gain. The likely reasons could be the use of low doses for a shorter period of time, or mechanisms other than H2 receptors might play an important role in weight gain. © 2014 Wiley Publishing Asia Pty Ltd.

  10. Higher gestational weight gain is associated with increasing offspring birth weight independent of maternal glycemic control in women with type 1 diabetes.

    PubMed

    Secher, Anna L; Parellada, Clara B; Ringholm, Lene; Asbjörnsdóttir, Björg; Damm, Peter; Mathiesen, Elisabeth R

    2014-10-01

    We evaluate the association between gestational weight gain and offspring birth weight in singleton term pregnancies of women with type 1 diabetes. One hundred fifteen consecutive women referred at <14 weeks were retrospectively classified as underweight (prepregnancy BMI <18.5 kg/m(2); n = 1), normal weight (18.5-24.9; n = 65), overweight (25.0-29.9; n = 39), or obese (≥30.0; n = 10). Gestational weight gain was categorized as excessive, appropriate, or insufficient according to the Institute of Medicine recommendations for each BMI class. Women with nephropathy, preeclampsia, and/or preterm delivery were excluded because of restrictive impact on fetal growth and limited time for total weight gain. HbA1c was comparable at ∼6.6% (49 mmol/mol) at 8 weeks and ∼6.0% (42 mmol/mol) at 36 weeks between women with excessive (n = 62), appropriate (n = 37), and insufficient (n = 16) gestational weight gain. Diabetes duration was comparable, and median prepregnancy BMI was 25.3 (range 18-41) vs. 23.5 (18-31) vs. 22.7 (20-30) kg/m(2) (P = 0.05) in the three weight gain groups. Offspring birth weight and birth weight SD score decreased across the groups (3,681 [2,374-4,500] vs. 3,395 [2,910-4,322] vs. 3,295 [2,766-4,340] g [P = 0.02] and 1.08 [-1.90 to 3.25] vs. 0.45 [-0.83 to 3.18] vs. -0.02 [-1.51 to 2.96] [P = 0.009], respectively). In a multiple linear regression analysis, gestational weight gain (kg) was positively associated with offspring birth weight (g) (β = 19; P = 0.02) and birth weight SD score (β = 0.06; P = 0.008) when adjusted for prepregnancy BMI, HbA1c at 36 weeks, smoking, parity, and ethnicity. Higher gestational weight gain in women with type 1 diabetes was associated with increasing offspring birth weight independent of glycemic control and prepregnancy BMI. © 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  11. Self-perception of body weight status and weight control practices among adolescents in Malaysia.

    PubMed

    Zainuddin, Ahmad Ali; Manickam, Mala A; Baharudin, Azli; Omar, Azahadi; Cheong, Siew Man; Ambak, Rashidah; Ahmad, Mohamad Hasnan; Ghaffar, Suhaila Abdul

    2014-09-01

    The prevalence of overweight and obesity among adolescents is rising rapidly in many countries, including Malaysia. This article aims to present the associations between body mass index-based body weight status, body weight perception, and weight control practices among adolescents in Malaysia. The Malaysia School Based Nutrition Survey 2012, which included a body weight perception questionnaire and anthropometric measurements, was conducted on a representative sample of 40 011 students from Standard 4 until Form 5, with a 90.5% response rate. Comparing actual and perceived body weight status, the findings show that 13.8% of adolescents underestimated their weight, 35.0% overestimated, and 51.2% correctly judged their own weight. Significantly more normal weight girls felt they were overweight, whereas significantly more overweight boys perceived themselves as underweight. The overall appropriateness of weight control practices to body weight was 72.6%. Adolescents attempting to lose or gain weight need to have better understanding toward desirable behavioral changes. © 2014 APJPH.

  12. Effect of surfactants on weight gain in mice.

    PubMed

    Kaneene, J B; Ross, R W

    1986-03-01

    A study was conducted to determine if four surfactants can induce increased weight gain in the mouse. Basic-H, Triton X-100, Amway All Purpose Adjuvant and X-77 were put in water and fed to various groups of ICR 21 day old female mice for a period of 43 days. All the mice were clinically normal throughout the study period. Pathological examination of a random sample of the mice revealed no gross pathological changes. Similarly, histopathological examination of the lungs, livers and intestines did not reveal any visible lesions. Basic-H and Amway surfactants induced weight gain, though not significantly, better at 0.1% (V/V) concentration while X-77 and Triton X-100 induced weight gain better at 0.4% (V/V) concentration. Overall results show that none of the surfactants tested induced significant weight gain.

  13. Ethnic Differences in Gestational Weight Gain: A Population-Based Cohort Study in Norway.

    PubMed

    Kinnunen, Tarja I; Waage, Christin W; Sommer, Christine; Sletner, Line; Raitanen, Jani; Jenum, Anne Karen

    2016-07-01

    Objectives To explore ethnic differences in gestational weight gain (GWG). Methods This was a population-based cohort study conducted in primary care child health clinics in Groruddalen, Oslo, Norway. Participants were healthy pregnant women (n = 632) categorised to six ethnic groups (43 % were Western European women, the reference group). Body weight was measured at 15 and 28 weeks' gestation on average. Data on pre-pregnancy weight and total GWG until delivery were self-reported. The main method of analysis was linear regression adjusting for age, weeks' gestation, pre-pregnancy body mass index, education and severe nausea. Results No ethnic differences were observed in GWG by 15 weeks' gestation. By 28 weeks' gestation, Eastern European women had gained 2.71 kg (95 % confidence interval, CI 1.10-4.33) and Middle Eastern women 1.32 kg (95 % CI 0.14-2.50) more weight on average than the Western European women in the fully adjusted model. Among Eastern European women, the total adjusted GWG was 3.47 kg (95 % CI 1.33-5.61) above the reference group. Other ethnic groups (South Asian, East Asian and African) did not differ from the reference group. When including non-smokers (n = 522) only, observed between-group differences increased and Middle Eastern women gained more weight than the reference group by all time points. Conclusions Eastern European and Middle Eastern women had higher GWG on average than Western European women, especially among the non-smokers. Although prevention of excessive GWG is important for all pregnant women, these ethnic groups might need special attention during pregnancy.

  14. Cardiorespiratory costs of growth in low birth weight infants.

    PubMed

    Schulze, K; Kashyap, S; Ramakrishnan, R

    1993-02-01

    The energy cost of growth includes two components: the energy stored in new tissues and the energy expended in all energy requiring steps associated with nutrient intake and net tissue accretion. Most of the energy expended in growth is accounted for by the energy cost of tissue anabolism: peptide bonds, lipogenesis, substrate transport, etc. However, to the extent that additional work is required of the heart and lungs for growth-related increases in O2 and CO2 transport, increased energy is also expended in cardiorespiratory work. Indirect estimates of these costs can be gained by examining the effects of diet and weight gain on heart rate and respiratory frequency. We studied 66 healthy low birth weight infants, mean study weight = 2010 g, fed constant intakes of protein (2.25-3.9 g/kg per day) and energy (100-150 kcal/kg per day). These diets led to rates of weight gain ranging from 13.9 to 21.7 g/kg per day, among the diet groups. Bi-weekly 6-h assessments of energy expenditure, heart rate, respiratory frequency and state of sleep were made after full enteral intake was achieved. After adjustment of heart rate for the effect of postnatal age, heart rate during active sleep was related to weight gain (y = 0.97 x + 144, r2 = 0.15), nitrogen-energy ratio of the diet (y = 5.9 x + 139,2 r2 = 0.22), and energy expenditure (y = 0.53 x + 129, r2 = 0.13). Multiple regression analysis revealed that age-adjusted heart rate during active and quiet sleep was significantly related to a combination of the same three variables (r2 = 0.31).(ABSTRACT TRUNCATED AT 250 WORDS)

  15. Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study.

    PubMed

    Bao, Wei; Yeung, Edwina; Tobias, Deirdre K; Hu, Frank B; Vaag, Allan A; Chavarro, Jorge E; Mills, James L; Grunnet, Louise G; Bowers, Katherine; Ley, Sylvia H; Kiely, Michele; Olsen, Sjurdur F; Zhang, Cuilin

    2015-06-01

    Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM. We included 1,695 women who had incident GDM between 1991 and 2001, as part of the Diabetes & Women's Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models. We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjusted HRs of type 2 diabetes associated with each 1 kg/m(2) increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI and 1.16 (95% CI 1.13, 1.20) for most recent BMI. Moreover, each 5 kg increment of weight gain after GDM development was associated with a 27% higher risk of type 2 diabetes (adjusted HR 1.27; 95% CI 1.04, 1.54). Jointly, women who had a BMI ≥30.0 kg/m(2) at baseline and gained ≥5 kg after GDM had an adjusted HR of 43.19 (95% CI 13.60, 137.11), compared with women who had a BMI <25.0 kg/m(2) at baseline and gained <5 kg after GDM. Baseline BMI, most recent BMI and weight gain after GDM were significantly and positively associated with risk of progression from GDM to type 2 diabetes.

  16. Impact of Atypical Antipsychotic Therapy on Leptin, Ghrelin, and Adiponectin

    PubMed Central

    Jin, Hua; Meyer, Jonathan M.; Mudaliar, Sunder; Jeste, Dilip V.

    2009-01-01

    Background Many adverse effects of atypical antipsychotic treatment are associated with antagonism of monoamine receptors; however, data indicate that important metabolic effects, such as hypertriglyceridemia and impairment in glucose/insulin homeostasis, may not be related to these mechanisms, leading investigators to explore alternative hypotheses. Promising candidates include a possible impact of antipsychotics on peptide hormonal regulators of metabolic control such as leptin, ghrelin, and adiponectin. The purpose of this review is to summarize recent data on changes in these hormones during atypical antipsychotic treatment. Methods A Medline search was performed for papers published from January 1999 to January 2007 using key words antipsychotic, atypical antipsychotic, and individual atypical antipsychotic drug names cross-referenced with leptin, ghrelin, and adiponectin. Results The bulk of the published work focused on changes in body weight and serum leptin, with far less data on ghrelin, and adiponectin, and non-weight metabolic changes. Leptin changes were directly related to a medication’s weight gain liability, with no added antipsychotic effects on leptin signaling. Conflicting results emerged for the other markers, but all three long-term studies on ghrelin showed increased levels in patients on atypical antipsychotics with weight gain liabilities. Conclusions Leptin increases during antipsychotic treatment are a result of weight gain rather than a direct impact of atypical antipsychotics on leptin physiology. Preliminary long-term data show increased ghrelin levels, but this finding must be replicated. The association with antipsychotic effects on glucose and lipid metabolism and these hormones remains virtually unstudied. Future research should indicate whether ghrelin and other peptide hormones may be useful predictors of weight gain or metabolic changes in patients on antipsychotics. PMID:18206351

  17. Modeling potential effects of reduced calories in kids' meals with toy giveaways.

    PubMed

    Freij, Maysoun Y; Sell, Randall L; Bozack, Anne K; Weiss, Linda J; Garcia, Ana C

    2014-02-01

    Given the large proportion of daily calories attributable to fast food, there is growing interest in considering whether ordinances that restrict calories in kids' meals with toy giveaways could avert weight gain among children. Based upon a literature review and stakeholder feedback, a model was developed to estimate the potential number of children that could be affected by a statewide toy giveaway ordinance and the caloric savings should such a policy effectively reduce the number of calories in kids' meals with toy giveaways. Assumptions included the estimated number of children that eat fast food each day, the proportion that choose a kids' meal with a toy, the caloric savings of a kids' meal that meets nutrition standards, and the degree to which these savings could result in weight gain averted per child per year. Using New York as a case study, the model estimates that, on a typical day, 5% (163,571) of children 0-12 years of age in New York could be affected by a toy ordinance. A child who typically consumes fast food two times per week could avoid gaining approximately 2 pounds per year with an ordinance requiring kids' meals to be ≤550 calories. The amount of weight gain averted would vary according to the calorie limit set by the law and the frequency of consumption per week. Our model indicates that a reduction in calories in kids' meals with toy giveaways has the potential to positively affect weight gain in a considerable percentage of children. Limitations of the model are considered.

  18. Smoking cessation and subsequent weight change.

    PubMed

    Robertson, Lindsay; McGee, Rob; Hancox, Robert J

    2014-06-01

    People who quit smoking tend to gain more weight over time than those who continue to smoke. Previous research using clinical samples of smokers suggests that quitters typically experience a weight gain of approximately 5 kg in the year following smoking cessation, but these studies may overestimate the extent of weight gain in the general population. The existing population-based research in this area has some methodological limitations. We assessed a cohort of individuals born in Dunedin, New Zealand, between 1972-1973 at regular intervals from age 15 to 38. We used multiple linear regression analysis to investigate the association between smoking cessation at ages 21 years to 38 years and subsequent change in body mass index (BMI) and weight, controlling for baseline BMI, socioeconomic status, physical activity, alcohol use, and parity (women). Smoking status and outcome data were available at baseline and at follow-up for 914 study members. People who smoked at age 21 and who had quit by age 38 had a BMI on average 1.5 kg/m(2) greater than those who continued to smoke at age 38. This equated to a weight gain of approximately 5.7 kg in men and 5.1 kg in women above that of continuing smokers. However, the weight gain between age 21 and 38 among quitters was not significantly different to that of never-smokers. The amount of long-term weight gained after quitting smoking is likely to be lower than previous estimates based on research with clinical samples. On average, quitters do not experience greater weight gain than never-smokers.

  19. Consumption of Dairy Products in Relation to Changes in Anthropometric Variables in Adult Populations: A Systematic Review and Meta-Analysis of Cohort Studies

    PubMed Central

    Schwingshackl, Lukas; Hoffmann, Georg; Schwedhelm, Carolina; Kalle-Uhlmann, Tamara; Missbach, Benjamin; Knüppel, Sven; Boeing, Heiner

    2016-01-01

    Background The current state of knowledge regarding the association of dairy products and weight gain, overweight, and obesity is based on studies reporting contradicting and inconclusive results. The aim of the present study was thus to clarify the link between dairy consumption in relation to changes in anthropometric measures/adiposity by a meta-analytical approach. Methods For the meta-analysis PubMed, EMBASE, Web of Sciences, and google scholar were searched by two independent authors up to May 2016 with no restriction to language or calendar date. Prospective cohort studies reporting about intake of dairy consumption (including milk, yogurt, cheese, butter) and changes in body weight or waist circumference, risk of overweight, obesity, or weight gain were eligible. Pooled effects were calculated using a random effects model, and also a fixed effect model for sensitivity analysis. Due to the heterogeneity of statistical analytical approaches of the studies the analysis were done separately for beta-coefficients of changes in body weight and/or waist circumference per serving of dairy, for differences in weight gain/gain in waist circumference when comparing extreme categories of dairy consumption, and for odds ratios in regard to weight gain, overweight/obesity, or abdominal obesity. Findings 24 studies (27 reports) met the inclusion criteria for the systematic review, and 22 studies provided sufficient data for inclusion in the meta-analysis. The meta-analysis of the five studies on changes in body weight per serving of dairy no significant results could be found for whole fat dairy and low fat dairy. However, there was inverse association between changes in body weight for each serving’s increase of yogurt (beta: -40.99 gram/year, 95% CI, -48.09 to -33.88), whereas each serving’s increase of cheese was positively associated (beta: -10.97 gram/year, 95% CI, 2.86 to 19.07). Furthermore, the highest dairy intake category was associated with a reduced risk of abdominal obesity (OR: 0.85; 95% CI, 0.76 to 0.95), and risk of overweight (OR: 0.87; 95% CI, 0.76 to 1.00) compared to the lowest intake category. No significant association could be observed for risk of weight gain. Conclusion In summary the results of the meta-analysis still reflect that dairy consumption was not positively related to changes in body weight. Yogurt was the only dairy food that showed some evidence for a beneficial effect, where higher intakes were inversely associated a reduced risk of obesity, changes in body weight or waist circumference. Further research is needed, since the overall interpretation of the results is limited by heterogeneous risk estimates. PMID:27310919

  20. Weight satisfaction, management strategies and health beliefs in knee osteoarthritis patients attending an outpatient clinic.

    PubMed

    Ekram, A R M S; Cicuttini, F M; Teichtahl, A J; Crammond, B R; Lombard, C B; Liew, S M; Urquhart, D M; Wluka, A E

    2016-04-01

    Although weight control is important in managing knee osteoarthritis (OA), it is difficult to achieve. Understanding beliefs regarding weight management in people with knee OA may improve weight control. To examine differences in bodyweight satisfaction, weight management strategies and weight-related health-beliefs in obese, overweight and normal weight people with knee OA. The beliefs and attitudes to weight in 102 people with symptomatic knee OA were ascertained. Participants were classified as being obese, overweight or of normal weight. Although obese and overweight participants were less satisfied with their bodyweight, they were more likely to want to lose weight and to report dieting compared with normal weight participants(P < 0.001 for all) and also more likely to report weight gain in the past 6 months (P < 0.001). While most participants rated food intake to be a main determinant of health, this belief was more common in normal weight participants (P = 0.04). When asked about their own weight gain, obese participants more frequently believed genetic and metabolic factors to be important than normal and overweight participants (P = 0.01). While 51 (53%) believed that increasing activity was more important than dietary change to avoid weight gain, this was more commonly believed by obese and overweight participants (P < 0.05). Despite desiring and attempting to lose weight, obese people with symptomatic knee OA more commonly reported weight gain. Overweight and obese participants attributed weight gain to non-modifiable factors but believed physical activity is more important than dietary change in weight management. Thus, education regarding the importance of diet as compared with non-modifiable factors and physical activity may improve weight management in obese people with knee OA. © 2016 Royal Australasian College of Physicians.

  1. Changes in the body weight of term infants, born in the tropics, during the first seven days of life.

    PubMed

    Turner, Claudia; Carrara, Verena; Thien, Naw Aye Mya; Paw, Naw Moo Ku; Rijken, Marcus; McGready, Rose; Nosten, François

    2013-06-14

    Identifying unwell neonates, particularly in the first week of life, is often subjective. If normal values are known, calculating the weight lost or gained from birth weight can be a useful adjunct in the evaluation of the health of a neonate. Serial body weights of well, term, breast fed infants who were attending for routine follow up, were recorded at the Shoklo Malaria Research Unit clinic in Maela Camp for displaced persons on the Thailand Myanmar border. Newborn examination was routine. Weight loss, expressed as percent weight lost from birth weight, and weight gain, expressed as a velocity (g/kg/day), was calculated for the first seven days of life. The results from normal birth weight infants, low birth weight infants (<2.5 kg) and small for gestational age infants (SGA) were examined. In the first week of life there were no significant differences in weight gained or lost across the three study groups. The maximum weight lost was 4.4% (95% CI 4.1 - 4.6%), which occurred on day three. Weight gain ranged from 13 g/kg/day [95% CI 10 - 16] on day four to 18 g/kg/day [95% CI 15 - 20] on days six and seven. Use of these normal values for weight gain and loss, allows infants falling outside of the expected range (95% CI) to be easily identified and subsequently highlighted as needing further medical review.

  2. College Freshmen Students’ Perspectives on Weight Gain Prevention in the Digital Age: Web-Based Survey

    PubMed Central

    Turner-McGrievy, Gabrielle; Larsen, Chelsea A; Magradey, Karen; Brandt, Heather M; Wilcox, Sara; Sundstrom, Beth; West, Delia Smith

    2017-01-01

    Background College freshmen are highly vulnerable to experiencing weight gain, and this phenomenon is associated with an increased risk of chronic diseases and mortality in older adulthood. Technology offers an attractive and scalable way to deliver behavioral weight gain prevention interventions for this population. Weight gain prevention programs that harness the appeal and widespread reach of Web-based technologies (electronic health or eHealth) are increasingly being evaluated in college students. Yet, few of these interventions are informed by college students’ perspectives on weight gain prevention and related lifestyle behaviors. Objective The objective of this study was to assess college freshmen students’ concern about weight gain and associated topics, as well as their interest in and delivery medium preferences for eHealth programs focused on these topics. Methods Web-based surveys that addressed college freshmen students’ (convenience sample of N=50) perspectives on weight gain prevention were administered at the beginning and end of the fall 2015 semester as part of a longitudinal investigation of health-related issues and experiences in first semester college freshmen. Data on weight gain prevention-related concerns and corresponding interest in eHealth programs targeting topics of potential concern, as well as preferred program delivery medium and current technology use were gathered and analyzed using descriptive statistics. Results A considerable proportion of the freshmen sample expressed concern about weight gain (74%, 37/50) and both traditional (healthy diet: 86%, 43/50; physical activity: 64%, 32/50) and less frequently addressed (stress: 82%, 41/50; sleep: 74%, 37/50; anxiety and depression: 60%, 30/50) associated topics within the context of behavioral weight gain prevention. The proportion of students who reported interest in eHealth promotion programs targeting these topics was also generally high (ranging from 52% [26/50] for stress management to 70% [35/50] for eating a healthy diet and staying physically active). Email was the most frequently used electronic platform, with 96% (48/50) of students reporting current use of it. Email was also the most frequently cited preferred eHealth delivery platform, with 86% (43/50) of students selecting it. Facebook was preferred by the second greatest proportion of students (40%, 20/50). Conclusions Most college freshmen have concerns about an array of weight gain prevention topics and are generally open to the possibility of receiving eHealth interventions designed to address their concerns, preferably via email compared with popular social media platforms. These preliminary findings offer a foundation to build upon when it comes to future descriptive investigations focused on behavioral weight gain prevention among college freshmen in the digital age. PMID:29025698

  3. Antidepressant Use is Associated with Increased Energy Intake and Similar Levels of Physical Activity.

    PubMed

    Jensen-Otsu, Elsbeth; Austin, Gregory L

    2015-11-20

    Antidepressants have been associated with weight gain, but the causes are unclear. The aims of this study were to assess the association of antidepressant use with energy intake, macronutrient diet composition, and physical activity. We used data on medication use, energy intake, diet composition, and physical activity for 3073 eligible adults from the 2005-2006 National Health and Nutrition Examination Survey (NHANES). Potential confounding variables, including depression symptoms, were included in the models assessing energy intake, physical activity, and sedentary behavior. Antidepressant users reported consuming an additional (mean ± S.E.) 215 ± 73 kcal/day compared to non-users (p = 0.01). There were no differences in percent calories from sugar, fat, or alcohol between the two groups. Antidepressant users had similar frequencies of walking or biking, engaging in muscle-strengthening activities, and engaging in moderate or vigorous physical activity. Antidepressant users were more likely to use a computer for ≥2 h/day (OR 1.77; 95% CI: 1.09-2.90), but TV watching was similar between the two groups. These results suggest increased energy intake and sedentary behavior may contribute to weight gain associated with antidepressant use. Focusing on limiting food intake and sedentary behaviors may be important in mitigating the weight gain associated with antidepressant use.

  4. Antidepressant Use is Associated with Increased Energy Intake and Similar Levels of Physical Activity

    PubMed Central

    Jensen-Otsu, Elsbeth; Austin, Gregory L.

    2015-01-01

    Antidepressants have been associated with weight gain, but the causes are unclear. The aims of this study were to assess the association of antidepressant use with energy intake, macronutrient diet composition, and physical activity. We used data on medication use, energy intake, diet composition, and physical activity for 3073 eligible adults from the 2005–2006 National Health and Nutrition Examination Survey (NHANES). Potential confounding variables, including depression symptoms, were included in the models assessing energy intake, physical activity, and sedentary behavior. Antidepressant users reported consuming an additional (mean ± S.E.) 215 ± 73 kcal/day compared to non-users (p = 0.01). There were no differences in percent calories from sugar, fat, or alcohol between the two groups. Antidepressant users had similar frequencies of walking or biking, engaging in muscle-strengthening activities, and engaging in moderate or vigorous physical activity. Antidepressant users were more likely to use a computer for ≥2 h/day (OR 1.77; 95% CI: 1.09–2.90), but TV watching was similar between the two groups. These results suggest increased energy intake and sedentary behavior may contribute to weight gain associated with antidepressant use. Focusing on limiting food intake and sedentary behaviors may be important in mitigating the weight gain associated with antidepressant use. PMID:26610562

  5. RAGE regulates the metabolic and inflammatory response to high-fat feeding in mice.

    PubMed

    Song, Fei; Hurtado del Pozo, Carmen; Rosario, Rosa; Zou, Yu Shan; Ananthakrishnan, Radha; Xu, Xiaoyuan; Patel, Payal R; Benoit, Vivian M; Yan, Shi Fang; Li, Huilin; Friedman, Richard A; Kim, Jason K; Ramasamy, Ravichandran; Ferrante, Anthony W; Schmidt, Ann Marie

    2014-06-01

    In mammals, changes in the metabolic state, including obesity, fasting, cold challenge, and high-fat diets (HFDs), activate complex immune responses. In many strains of rodents, HFDs induce a rapid systemic inflammatory response and lead to obesity. Little is known about the molecular signals required for HFD-induced phenotypes. We studied the function of the receptor for advanced glycation end products (RAGE) in the development of phenotypes associated with high-fat feeding in mice. RAGE is highly expressed on immune cells, including macrophages. We found that high-fat feeding induced expression of RAGE ligand HMGB1 and carboxymethyllysine-advanced glycation end product epitopes in liver and adipose tissue. Genetic deficiency of RAGE prevented the effects of HFD on energy expenditure, weight gain, adipose tissue inflammation, and insulin resistance. RAGE deficiency had no effect on genetic forms of obesity caused by impaired melanocortin signaling. Hematopoietic deficiency of RAGE or treatment with soluble RAGE partially protected against peripheral HFD-induced inflammation and weight gain. These findings demonstrate that high-fat feeding induces peripheral inflammation and weight gain in a RAGE-dependent manner, providing a foothold in the pathways that regulate diet-induced obesity and offering the potential for therapeutic intervention. © 2014 by the American Diabetes Association.

  6. Maternal weight loss during exclusive breastfeeding is associated with reduced weight and length gain in daughters of HIV-infected Malawian women.

    PubMed

    Widen, Elizabeth M; Bentley, Margaret E; Kayira, Dumbani; Chasela, Charles S; Jamieson, Denise J; Tembo, Martin; Soko, Alice; Kourtis, Athena P; Flax, Valerie L; Ellington, Sascha R; van der Horst, Charles M; Adair, Linda S

    2013-07-01

    Maternal weight loss during exclusive breastfeeding may influence the growth of exclusively breast-fed infants through impaired quality or quantity of breast milk. This study evaluated how maternal weight loss from 2 to 24 wk postpartum was related to infant weight and length gain in 1309 lactating HIV-infected mothers and their exclusively breast-fed infants. Malawian mother-infant pairs in the Breastfeeding, Antiretrovirals, and Nutrition Study were randomized with a 2 × 3 factorial design to a 2-arm nutritional intervention with a lipid-based nutrient supplement (LNS), meeting nutritional needs of lactation, or no LNS and a 3-arm antiretroviral (ARV) intervention (maternal, infant, or no ARV regimen). Linear regression models were used to relate maternal weight loss (weight loss vs. no weight loss) to infant weight and length gain from birth to 24 mo, stratifying by gender and controlling for maternal BMI at 2 wk (mean ± SD: 23.2 ± 3.0 kg/m(2)) and interacting maternal BMI with weight loss. In adjusted models, compared with daughters of women who did not lose weight, length and weight gain were lower in daughters whose mothers had a lower BMI at 2 wk postpartum coupled with the weight loss. For example, among mothers with an initial BMI of 18 kg/m(2), daughters of those who lost weight gained less weight [β = -0.29 kg (95% CI: -0.53, -0.06)] and length [β = -0.88 cm (95% CI: -1.52, -0.23)] from birth to 24 wk than daughters of those who gained weight. Though effects were only observed in girls, suggesting possible gender differences in suckling and feeding behavior, these findings indicate that maternal weight loss with low energy reserves represents a risk factor for poor infant growth outcomes.

  7. Maternal Weight Loss during Exclusive Breastfeeding Is Associated with Reduced Weight and Length Gain in Daughters of HIV-Infected Malawian Women123

    PubMed Central

    Widen, Elizabeth M.; Bentley, Margaret E.; Kayira, Dumbani; Chasela, Charles S.; Jamieson, Denise J.; Tembo, Martin; Soko, Alice; Kourtis, Athena P.; Flax, Valerie L.; Ellington, Sascha R.; van der Horst, Charles M.; Adair, Linda S.

    2013-01-01

    Maternal weight loss during exclusive breastfeeding may influence the growth of exclusively breast-fed infants through impaired quality or quantity of breast milk. This study evaluated how maternal weight loss from 2 to 24 wk postpartum was related to infant weight and length gain in 1309 lactating HIV-infected mothers and their exclusively breast-fed infants. Malawian mother-infant pairs in the Breastfeeding, Antiretrovirals, and Nutrition Study were randomized with a 2 × 3 factorial design to a 2-arm nutritional intervention with a lipid-based nutrient supplement (LNS), meeting nutritional needs of lactation, or no LNS and a 3-arm antiretroviral (ARV) intervention (maternal, infant, or no ARV regimen). Linear regression models were used to relate maternal weight loss (weight loss vs. no weight loss) to infant weight and length gain from birth to 24 mo, stratifying by gender and controlling for maternal BMI at 2 wk (mean ± SD: 23.2 ± 3.0 kg/m2) and interacting maternal BMI with weight loss. In adjusted models, compared with daughters of women who did not lose weight, length and weight gain were lower in daughters whose mothers had a lower BMI at 2 wk postpartum coupled with the weight loss. For example, among mothers with an initial BMI of 18 kg/m2, daughters of those who lost weight gained less weight [β = −0.29 kg (95% CI: −0.53, −0.06)] and length [β = −0.88 cm (95% CI: −1.52, −0.23)] from birth to 24 wk than daughters of those who gained weight. Though effects were only observed in girls, suggesting possible gender differences in suckling and feeding behavior, these findings indicate that maternal weight loss with low energy reserves represents a risk factor for poor infant growth outcomes. PMID:23700341

  8. Nutritional rehabilitation in anorexia nervosa: review of the literature and implications for treatment

    PubMed Central

    2013-01-01

    Restoration of weight and nutritional status are key elements in the treatment of anorexia nervosa (AN). This review aims to describe issues related to the caloric requirements needed to gain and maintain weight for short and long-term recovery for AN inpatients and outpatients. We reviewed the literature in PubMed pertaining to nutritional restoration in AN between 1960–2012. Based on this search, several themes emerged: 1. AN eating behavior; 2. Weight restoration in AN; 3. Role of exercise and metabolism in resistance to weight gain; 3. Medical consequences of weight restoration; 4. Rate of weight gain; 5. Weight maintenance; and 6. Nutrient intake. A fair amount is known about overall caloric requirements for weight restoration and maintenance for AN. For example, starting at 30–40 kilocalories per kilogram per day (kcal/kg/day) with increases up to 70–100 kcal/kg/day can achieve a weight gain of 1–1.5 kg/week for inpatients. However, little is known about the effects of nutritional deficits on weight gain, or how to meet nutrient requirements for restoration of nutritional status. This review seeks to draw attention to the need for the development of a foundation of basic nutritional knowledge about AN so that future treatment can be evidenced-based. PMID:24200367

  9. Progestin-only contraceptives: effects on weight

    PubMed Central

    Lopez, Laureen M; Edelman, Alison; Chen, Mario; Otterness, Conrad; Trussell, James; Helmerhorst, Frans M

    2013-01-01

    Background Progestin-only contraceptives (POCs) are appropriate for many women who cannot or should not take estrogen. Many POCs are long-acting, cost-effective methods of preventing pregnancy. However, concern about weight gain can deter the initiation of contraceptives and cause early discontinuation among users. Objectives The primary objective was to evaluate the association between progestin-only contraceptive use and changes in body weight. Search methods Through May 2013, we searched MEDLINE, CENTRAL, POPLINE, LILACS, ClinicalTrials.gov, and ICTRP. The 2010 search also included EMBASE. For the initial review, we contacted investigators to identify other trials. Selection criteria All comparative studies were eligible that examined a POC versus another contraceptive method or no contraceptive. The primary outcome was mean change in body weight or mean change in body composition. We also considered the dichotomous outcome of loss or gain of a specified amount of weight. Data collection and analysis Two authors extracted the data. We computed the mean difference (MD) with 95% confidence interval (CI) for continuous variables. For dichotomous outcomes, the Mantel-Haenszel odds ratio (OR) with 95% CI was calculated. Main results We found 16 studies; one examined progestin-only pills, one studied the levonorgestrel-releasing intrauterine system (LNG-IUS), four examined an implant, and 10 focused on depot medroxyprogesterone acetate (DMPA). Outcomes examined were changes in body weight only (14 studies), changes in both body weight and body composition (1 study), and changes in body composition only (1 study). We did not conduct meta-analysis due to the various contraceptive methods and weight change measures. Comparison groups did not differ significantly for weight change in 12 studies. However, three studies showed weight change differences for POC users compared to women not using a hormonal method. In one study, weight gain (kg) was greater for the DMPA group than the group using a non-hormonal IUD in years one through three [(MD 2.28; 95% CI 1.79 to 2.77), (MD 2.71, 95% CI 2.12 to 3.30), and (MD 3.17; 95% CI 2.51 to 3.83), respectively]. The differences were notable within the normal weight and overweight subgroups. Two implant studies also showed differences in weight change. The implant group (six-capsule) had greater weight gain (kg) compared to the group using a non-hormonal IUD in both studies [(MD 0.47 (95% CI 0.29 to 0.65); (MD 1.10; 95% CI 0.36 to 1.84)]. In one of those studies, the implant group also had greater weight gain than a group using a barrier method or no contraceptive (MD 0.74; 95% CI 0.52 to 0.96). The two studies that assessed body composition change showed differences between POC users and women not using a hormonal method. Adolescents using DMPA had a greater increase in body fat (%) compared to a group not using a hormonal method (MD 11.00; 95% CI 2.64 to 19.36). The DMPA group also had a greater decrease in lean body mass (%) (MD −4.00; 95% CI −6.93 to −1.07). The other study reported differences between an LNG-IUS group and a non-hormonal IUD group in percent change in body fat mass (2.5% versus −1.3%, respectively; reported P value = 0.029) and percent change in lean body mass (−1.4% versus 1.0%, respectively; reported P value = 0.027). Authors’ conclusions The overall quality of evidence was moderate to low, given that the studies were evenly divided across the evidence quality groups (high, moderate, low, or very low quality). We found limited evidence of weight gain when using POCs. Mean gain was less than 2 kg for most studies up to 12 months. Weight change for the POC group generally did not differ significantly from that of the comparison group using another contraceptive. Two studies that assessed body composition showed that POC users had greater increases in body fat and decreases in lean body mass compared to users of non-hormonal methods. Appropriate counseling about typical weight gain may help reduce discontinuation of contraceptives due to perceptions of weight gain. PMID:23821307

  10. Medication adherence and subjective weight perception in patients with first-episode psychotic disorder.

    PubMed

    Wong, Mimi M C; Chen, E Y H; Lui, Simon S Y; Tso, Steve

    2011-10-01

    Medication adherence is critical to the management of psychotic disorder. Different factors associated with medication adherence have been investigated in previous studies. However, the association with subjective weight perception, which is related to the weight gain side effect of antipsychotics, has not been thoroughly investigated. Subjective weight perception may not equal objective weight status. This study tests the hypothesis that medication adherence is related to subjective weight perception in a group of patients with first-episode psychotic disorder who have taken antipsychotics for one year. This study recruited 160 participants with one-year histories of first-episode psychotic disorder and measured their actual and perceived weights, amount of weight gain in the past year, body size satisfaction and medication adherence levels. The associations between medication adherence and both the actual and perceived weight status were analyzed controlling for other confounding factors including insight, drug attitude, illness severity and other medication side effects. Stepwise multiple regression analysis found that the participants' perceived weight status, negative attitude toward their drugs and insight were the major factors associated with poor medication adherence. Of the participants who perceived themselves as being overweight, 86% believed that antipsychotics were responsible. Among those who had such beliefs, 72% had reduced their antipsychotic dosages on their own. About half of the participants had gained more than 7% of their baseline weight and 43.1% of the participants were found to be overweight after one year of treatment with antipsychotics. The results of this study indicate that medication adherence is associated with perceived weight status. Healthcare professionals should be aware of this relationship and address this issue early in the management of patients. Apart from weight management programs, education on a correct weight perception should be carried out with the promotion of proper drug attitudes and better insight for the improvement of medication adherence in the early course of psychotic disorder.

  11. Comparative effectiveness of adding weight control simultaneously or sequentially to smoking cessation quitlines: study protocol of a randomized controlled trial.

    PubMed

    Bush, Terry; Lovejoy, Jennifer; Javitz, Harold; Magnusson, Brooke; Torres, Alula Jimenez; Mahuna, Stacey; Benedict, Cody; Wassum, Ken; Spring, Bonnie

    2016-07-22

    Prevalence of multiple health risk behaviors is growing, and obesity and smoking are costly. Weight gain associated with quitting smoking is common and can interfere with quit success. Efficacy of adding weight management to tobacco cessation treatment has been tested with women in group sessions over an extended period of time, but has never been tested in real-world settings with men and women seeking help to quit. This paper describes the Best Quit study which tests the effectiveness of delivering tobacco and weight control interventions via existing quitline infrastructures. Eligible and consenting smokers (n = 2550) who call a telephone quitline will be randomized to one of three groups; the standard quitline or standard quitline plus a weight management program added either simultaneously or sequentially to the tobacco program. The study aims to test: 1) the effectiveness of the combined intervention on smoking cessation and weight, 2) the cost-effectiveness of the combined intervention on cessation and weight and 3) theoretically pre-specified mediators of treatment effects on cessation: reduced weight concerns, increased outcome expectancies about quitting and improved self-efficacy about quitting without weight gain. Baseline, 6 month and 12 month data will be analyzed using multivariate statistical analyses and groups will be compared on treatment adherence, quit rates and change in weight among abstinent participants. To determine if the association between group assignment and primary outcomes (30-day abstinence and change in weight at 6 months) is moderated by pre-determined baseline and process measures, interaction terms will be included in the regression models and their significance assessed. This study will generate information to inform whether adding weight management to a tobacco cessation intervention delivered by phone, mail and web for smokers seeking help to quit will help or harm quit rates and whether a simultaneous or sequential approach is better at increasing abstinence and reducing weight gain post quit. If proven effective, the combined intervention could be disseminated across the U.S. through quitlines and could encourage additional smokers who have not sought cessation treatment for fear of gaining weight to make quit attempts. Clinicaltrials.gov NCT01867983 . Registered: May 30, 2013.

  12. Weight gain in the first two years of life, asthma and atopy: the SCAALA cohort study.

    PubMed

    Matos, Sheila M A; Jesus, Sandra R; Saldiva, Silvia R D M; Prado, Matildes S; D'Innocenzo, Silvana; Assis, Ana M O; Rodrigues, Laura C; Alcantara-Neves, Neuza M; Cruz, Alvaro A; Simões, Silvia de Magalhães; Fiaccone, Rosemeire L; Barreto, Maurício L

    2014-11-01

    To evaluate the association between weight gain in the first two years of life and the occurrence of wheezing, asthma, serum IgE, skin reactivity and pulmonary function. Cohort study. The metropolitan region of Salvador, Bahia, Brazil. The association was studied between 1997 and 2005 in 669 children up to 11 years of age. Data were collected on asthma and risk factors, both current factors and those present in the first years of life. Weight gain was considered fast when the Z-score was >0·67. Poisson regression was used in the multivariate statistical analysis. Wheezing was reported in 25·6 % of the children. Weight gain was considered fast (Z-score >0·67) in 29·6 % of the children and slow (Z-score <-0·67) in 13·9 %. Children in the slow weight gain group had 36 % fewer symptoms of asthma (prevalence ratio = 0·65; 95 % CI 0·42, 0·99). Slower weight gain in the early years of life may constitute a protective factor against symptoms of asthma. The relevance of this finding for public health is not yet certain, since it is known that children with slow and fast weight gain may be more likely to develop adverse health consequences related to both these situations.

  13. Genetic response to selection for weaning weight or yearling weight or yearling weight and muscle score in Hereford cattle: efficiency of gain, growth, and carcass characteristics.

    PubMed

    Koch, R M; Cundiff, L V; Gregory, K E; Van Vleck, L D

    2004-03-01

    An experiment involving crosses among selection and control lines was conducted to partition direct and maternal additive genetic response to 20 yr of selection for 1) weaning weight, 2) yearling weight, and 3) index of yearling weight and muscle score. Selection response was evaluated for efficiency of gain, growth from birth through market weight, and carcass characteristics. Heritability and genetic correlations among traits were estimated using animal model analyses. Over a time-constant interval, selected lines were heavier, gained more weight, consumed more ME, and had more gain/ME than the control. Over a weight-constant interval, selected lines required fewer days, consumed less ME, had more efficient gains, and required less energy for maintenance than control. Direct and maternal responses were estimated from reciprocal crosses among unselected sires and dams of control and selection lines. Most of the genetic response to selection in all three lines was associated with direct genetic effects, and the highest proportion was from postweaning gain. Indirect responses of carcass characteristics to selection over the 20 yr were increased weight of carcasses that had more lean meat, produced with less feed per unit of gain. At a constant carcass weight, selected lines had 1.32 to 1.85% more retail product and 1.62 to 2.24% less fat trim and 10/100 to 25/100 degrees less marbling than control. At a constant age, heritability of direct and maternal effects and correlations between them were as follows: market weight, 0.36, 0.14, and 0.10; carcass weight, 0.26, 0.15, and 0.03; longissimus muscle area, 0.33, 0.00, and 0.00; marbling, 0.36, 0.07, and -0.35; fat thickness, 0.41, 0.05, and -0.18; percentage of kidney, pelvic, and heart fat, 0.12, 0.08, and -0.76; percentage of retail product, 0.46, 0.05, and -0.29; retail product weight, 0.44, 0.08, -0.14; and muscle score, 0.37, 0.14, and -0.54. Selection criteria in all lines improved efficiency of postweaning gain and increased the amount of salable lean meat on an age- or weight-constant basis, but carcasses had slightly lower marbling scores.

  14. Rebound weight gain as associated with high plasma norepinephrine levels that are mediated through polymorphisms in the beta2-adrenoceptor.

    PubMed

    Masuo, Kazuko; Katsuya, Tomohiro; Kawaguchi, Hideki; Fu, Yuxiao; Rakugi, Hiromi; Ogihara, Toshio; Tuck, Michael L

    2005-11-01

    A successful weight loss program is essential treatment for obesity-related diseases, but it is well known that the majority of individuals do not succeed in weight loss maintenance. The present study evaluates hormonal mechanisms and the relationship of beta2-adrenoceptor polymorphisms involved in individuals who regain weight after initially successful weight loss. Overweight Japanese men (n = 154) were enrolled in a 24-month weight loss program. Body mass index (BMI), total body fat mass, plasma norepinephrine (NE) and leptin levels, and beta2-adrenoceptor polymorphisms (Arg16Gly, Gln27Glu) were measured every 6 months for the 24-month period. Maintenance of weight loss was defined as significant weight loss (>or=10% reduction) from entry weight at 6 months and maintenance of the weight loss for an additional 18 months. Rebound weight gain was defined as significant weight loss at 6 months but subsequent regain of body weight during the next 18 months. The results showed that 37 subjects maintained weight loss during 24 months, whereas 36 subjects had rebound weight gain. The BMI at entry and calorie intake and physical activity at each period were similar between the two groups. Subjects who maintained weight loss had at entry a significantly lower fat mass and plasma NE levels compared to those with rebound weight gain. Body fat mass, NE, and leptin levels at entry predicted the degree of change in body weight during the 24-month study period. Subjects with rebound weight gain had a significantly higher frequency of the Gly16 allele for the beta2-adrenoceptor polymorphism compared to subjects who had a 24-month maintenance of weight loss. Subjects carrying the Gly16 allele also had significantly higher plasma NE, leptin, and body fat mass levels and a greater waist-to-hip ratio both at entry and throughout the study. A high initial degree of body fat mass and high plasma NE levels as determined by the Gly16 allele for the beta2-adrenoceptor polymorphisms predict those individuals who will have rebound weight gain after their initial successful weight loss.

  15. Clinical Assessment of Weight Gain with Atypical Antipsychotics - Blonanserin vs Amisulpride

    PubMed Central

    Raveesh, BN; Parashivamurthy, BM; Kumar, MS Narendra; Majgi, Sumanth Mallikarjuna; Nagesh, HN

    2015-01-01

    Background Atypical antipsychotics appear to have the greatest potential to induce weight gain. Antipsychotic-induced weight gain is the one of main cause of non-compliance and discontinuation of treatment, often resulting in the relapse of psychosis. Objective To compare the weight gain between amisulpride and blonanserin treatment, in persons with psychosis. Materials and Methods Fifty six subjects with psychosis attending psychiatry department at KR Hospital, Mysore were randomized into two equal groups. After obtaining informed consent, subjects of group I received amisulpride tablets 200 mg BD, and group II received blonanserin tablets 4 mg BD, for eight weeks. Body weight, Body Mass Index (BMI) and Waist Hip Ratio (WHR) were measured at baseline, 4 weeks and 8 weeks. Results The mean weight gain with amisulpride at 4 weeks was 2.73 kg (5.21%) and at 8 weeks was 4.34 kg (8.28%) from the baseline. The mean weight gain with blonanserin at 4 weeks was 1.77 kg (3.46%) and at 8 weeks was 3.46 kg (6.75%) from the baseline. The mean BMI increase at 8 weeks with amisulpride was 1.66 ± 0.56 and with blonanserin was 1.34 ± 0.77. The mean WHR increase at 8 weeks with amisulpride was 0.036 ± 0.026 and with blonanserin was 0.029 ± 0.020. There was statistically significant increase in weight, BMI and WHR associated with both blonanserin and amisulpride at 8 weeks. But there was no statistically significant difference in those parameters between blonanserin and amisulpride, at eight weeks. Conclusion Even though there was no significant difference in the weight gain caused by blonanserin, in comparison with amisulpride, both these drugs individually caused significant weight gain at 8 weeks, which is in contrast with the earlier studies, which needs to be further evaluated. PMID:26266134

  16. Clinical risk factors for weight gain during psychopharmacologic treatment of depression: results from 2 large German observational studies.

    PubMed

    Kloiber, Stefan; Domschke, Katharina; Ising, Marcus; Arolt, Volker; Baune, Bernhard T; Holsboer, Florian; Lucae, Susanne

    2015-06-01

    Weight gain during psychopharmacologic treatment has considerable impact on the clinical management of depression, treatment continuation, and risk for metabolic disorders. As no profound clinical risk factors have been identified so far, the aim of our analyses was to determine clinical risk factors associated with short-term weight development in 2 large observational psychopharmacologic treatment studies for major depression. Clinical variables at baseline (age, gender, depression psychopathology, anthropometry, disease history, and disease entity) were analyzed for association with percent change in body mass index (BMI; normal range, 18.5 to 25 kg/m(2)) during 5 weeks of naturalistic psychopharmacologic treatment in patients who had a depressive episode as single depressive episode, in the course of recurrent unipolar depression or bipolar disorder according to DSM-IV criteria. 703 patients participated in the Munich Antidepressant Response Signature (MARS) project, an ongoing study since 2002, and 214 patients participated in a study conducted at the University of Muenster from 2004 to 2006 in Germany. Lower BMI, weight-increasing side effects of medication, severity of depression, and psychotic symptoms could be identified as clinical risk factors associated with elevated weight gain during the initial treatment phase of 5 weeks in both studies. Based on these results, a composite risk score for weight gain consisting of BMI ≤ 25 kg/m(2), Hamilton Depression Rating Scale (17-item) score > 20, presence of psychotic symptoms, and administration of psychopharmacologic medication with potential weight-gaining side effects was highly discriminative for mean weight gain (F4,909 = 26.77, P = 5.14E-21) during short-term psychopharmacologic treatment. On the basis of our results, depressed patients with low to normal BMI, severe depression, or psychotic symptoms should be considered at higher risk for weight gain during acute antidepressant treatment. We introduce a new risk score that might be considered in psychopharmacologic decisions for the prevention of weight gain and resulting metabolic disorders. © Copyright 2015 Physicians Postgraduate Press, Inc.

  17. Longitudinal changes in infant body composition: association with childhood obesity.

    PubMed

    Koontz, M B; Gunzler, D D; Presley, L; Catalano, P M

    2014-12-01

    Rapid weight gain in infancy has been established as a risk factor for the development of later obesity. We aimed to investigate the role of changes in infant body composition (assessed via total body electrical conductivity) on the development of overweight/obesity in mid-childhood. Fifty-three term infants were evaluated at birth, three times during infancy and in mid-childhood. Logistic regression was used to determine associations between rates of total weight gain, fat mass gain and lean mass gain during infancy and later overweight/obesity (defined as body mass index [BMI] ≥85th percentile), adjusted for birth weight and parent education. At follow-up (age 9.0 ± 1.8 years), 30% were overweight/obese. More rapid total weight gain from 0 to 4 months was associated with twofold odds (odds ratio [OR] 1.98, 95% confidence interval [CI] 1.05-3.74, P = 0.04) of overweight/obesity in mid-childhood. From 0 to 8 months, more rapid weight gain was associated with nearly fivefold odds (OR 4.76, 95% CI 1.05-21.5, P = 0.04), and more rapid fat mass gain was associated with eightfold odds (OR 8.03, 95% CI 1.11-58.2, P = 0.04) of later overweight/obesity. This exploratory study suggests that rapid weight gain, especially fat mass gain, in earlier infancy predisposes to mid-childhood overweight/obesity. © 2014 World Obesity.

  18. Maternal feeding practices predict weight gain and obesogenic eating behaviors in young children: a prospective study

    PubMed Central

    2013-01-01

    Background Maternal feeding practices have been proposed to play an important role in early child weight gain and obesogenic eating behaviors. However, to date longitudinal investigations in young children exploring these relationships have been lacking. The aim of the present study was to explore prospective relationships between maternal feeding practices, child weight gain and obesogenic eating behaviors in 2-year-old children. The competing hypothesis that child eating behaviors predict changes in maternal feeding practices was also examined. Methods A sample of 323 mother (mean age = 35 years, ± 0.37) and child dyads (mean age = 2.03 years, ± 0.37 at recruitment) were participants. Mothers completed a questionnaire assessing parental feeding practices and child eating behaviors at baseline and again one year later. Child BMI (predominantly objectively measured) was obtained at both time points. Results Increases in child BMI z-scores over the follow-up period were predicted by maternal instrumental feeding practices. Furthermore, restriction, emotional feeding, encouragement to eat, weight-based restriction and fat restriction were associated prospectively with the development of obesogenic eating behaviors in children including emotional eating, tendency to overeat and food approach behaviors (such as enjoyment of food and good appetite). Maternal monitoring, however, predicted decreases in food approach eating behaviors. Partial support was also observed for child eating behaviors predicting maternal feeding practices. Conclusions Maternal feeding practices play an important role in the development of weight gain and obesogenic eating behaviors in young children and are potential targets for effective prevention interventions aiming to decrease child obesity. PMID:23414332

  19. The efficacy of physiotherapy for the prevention and treatment of prenatal symptoms: a systematic review.

    PubMed

    Van Kampen, Marijke; Devoogdt, Nele; De Groef, An; Gielen, Annelies; Geraerts, Inge

    2015-11-01

    Several studies have described the evidence of prenatal physiotherapy for one symptom, but none has made an overview. We provided a systematic review on the effectiveness of prenatal physiotherapy. A full search was conducted in three electronic databases (Embase, PubMed/MEDLINE and PEDro), selecting randomized controlled trials concerning prenatal physiotherapy. Methodological quality was assessed using the PEDro scale. We identified 1,249 studies and after exclusions 54 studies were included concerning the evidence of prenatal physiotherapy. The majority of studies indicated a preventative effect for low back pain/pelvic girdle pain, weight gain, incontinence, and perineal massage. For leg edema, fear, and prenatal depression, the efficacy was only based on one study per symptom. No preventative effect was found for gestational diabetes, while literature concerning gestational hypertensive disorders was inconclusive. Regarding the treatment of low back pain/pelvic girdle pain and weight gain, most therapies reduced pain and weight respectively. Evidence regarding exercises for diabetes was contradictory and only minimally researched for incontinence. Foot massage and stockings reduced leg edema and leg symptoms respectively. Concerning gestational hypertensive disorders, perineal pain, fear, and prenatal depression no treatment studies were performed. The majority of studies indicated that prenatal physiotherapy played a preventative role for low back pain/pelvic girdle pain, weight gain, incontinence, and pelvic pain. Evidence for the remaining symptoms was inclusive or only minimally investigated. Regarding treatment, most studies indicated a reduction of low back pain/pelvic girdle pain, weight gain, incontinence, and the symptoms of leg edema.

  20. Hormonal Correlates of Clozapine-Induced Weight Gain in Psychotic Children: An Exploratory Study

    ERIC Educational Resources Information Center

    Sporn, Alexandra L.; Bobb, Aaron J.; Gogtay, Nitin; Stevens, Hanna; Greenstein, Deanna K.; Clasen, Liv S.; Tossell, Julia W.; Nugent, Thomas; Gochman, Peter A.; Sharp, Wendy S.; Mattai, Anand; Lenane, Marge C.; Yanovski, Jack A.; Rapoport, Judith L.

    2005-01-01

    Objective: Weight gain is a serious side effect of atypical antipsychotics, especially in childhood. In this study, the authors examined six weight gain-related hormones in patients with childhood-onset schizophrenia (COS) after 6 weeks of clozapine treatment. Method: Fasting serum samples for 24 patients with COS and 21 matched healthy controls…

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