Excessive Weight Gain Research Articles

Risk Factors for Incident Polycystic Ovary Syndrome Diagnosis.

Objective: While highly prevalent, risk factors for incident polycystic ovary syndrome (PCOS) are poorly delineated. Using a population-based cohort, we sought to identify predictors of incident PCOS diagnosis. Materials and Methods: A matched case-control analysis was completed utilizing patients enrolled in Kaiser Permanente Washington from 2006 to 2019. Inclusion criteria included female sex, age 16-40 years, and ≥3 years of prior enrollment with ≥1 health care encounter. PCOS cases were identified using International Classification of Diseases codes. For each incident case (n = 2,491), 5 patients without PCOS (n = 12,455) were matched based on birth year and enrollment status. Potential risk factors preceding diagnosis included family history of PCOS, premature menarche, parity, race, weight gain, obesity, valproate use, metabolic syndrome, epilepsy, prediabetes, and types 1 and 2 diabetes. Potential risk factors for incident PCOS diagnosis were assessed with univariate and multivariable conditional logistic regressions. Results: Mean age of PCOS cases was 26.9 years (SD 6.8). PCOS cases, compared with non-PCOS, were more frequently nulliparous (70.9% versus 62.4%) and in the 3 years prior to index date were more likely to have obesity (53.8% versus 20.7%), metabolic syndrome (14.5% versus 4.3%), prediabetes (7.4% versus 1.6%), and type 2 diabetes (4.1% versus 1.7%) (p < 0.001 for all comparisons). In multivariable models, factors associated with higher risk for incident PCOS included the following: obesity (compared with nonobese) Class I-II (body-mass index [BMI], 30-40 kg/m2; odds ratio [OR], 3.8; 95% confidence interval [CI], 3.4-4.2), Class III (BMI > 40 kg/m2; OR, 7.5, 95% CI, 6.5-8.7), weight gain (compared with weight loss or maintenance) of 1-10% (OR, 1.7, 95% CI, 1.3-2.1), 10-20% (OR, 1.9; 95% CI, 1.5-2.4), and >20% (OR, 2.6; 95% CI, 1.9-3.6), prediabetes (OR, 2.7; 95% CI, 2.1-3.4), and metabolic syndrome (OR, 1.8: 95% CI, 1.5-2.1). Conclusion: Excess weight gain, obesity, and metabolic dysfunction may play a key role in the ensuing phenotypic expression of PCOS. Treatment and prevention strategies targeted at preventing weight gain in early reproductive years may help reduce the risk of this syndrome.

Snacking motivations and behaviour in Australian adults: The role of personality traits

Snacking, namely, consuming food and beverages in-between main meals, especially snacks with a high fat, salt and/or sugar content, is a major contributor to excessive energy intake and long-term weight gain(1). There are many potential drivers of snacking behaviours, including physiological (e.g., hunger) as well as social, psychological, and emotional reasons(2). Individual differences, such as personality traits, have been linked to unhealthy snacking. Nevertheless, it is important to examine the potential explanatory pathways, such as motivations for snacking and habit strength, that may explain this relationship between personality and snacking. This cross-sectional study investigated the associations between personality traits, habit strength, motivations for snacking, and snacking behaviour, including choice and consumption. Participants were n = 230 Australian adults (female: n = 164; 71.3%) aged 18-77 years old (M = 34 years, SD = 13.4) who completed an online survey. The survey included assessments of personality traits (The Big Five Inventory 2), habit strength (the Self-Report Habit Index), motivations for snacking (The Eating Motivation Survey), momentary snack food choice (Snack Preference Task), and habitual snack food consumption (Snack Frequency Questionnaire). Overall, the most frequently selected motivations for snacking were ‘liking’, ‘convenience’, and ‘habit’. Correlation analyses were conducted to examine the relationship between motivations for snacking and snacking behaviour. We found that health motivation for snacking was negatively correlated with momentary choice (r = -.042, p &lt;.01) and habitual consumption (r = -.033, p &lt;.01) of unhealthy snack foods and beverages. Hierarchical multiple regression analyses were used to examine whether habit strength and the Big Five personality traits predicted both motivations for snacking and snacking behaviours after controlling for demographic variables. For health motivations for snacking, habit strength (beta = −0.15, p = .025), openness (beta = 0.50, p = .003, and conscientiousness (beta = 0.58, p = .001) were significant predictors. For momentary choice of unhealthy snacks, health motivation (beta = −4.35, p = .004), pleasure (beta = 3.53, p = .029), and visual appeal (beta = 5.29, p &lt;.001) were significant predictors. For habitual consumption of unhealthy snacks, health motivation (beta = −5.39, p = .001), habit strength (beta = 2.89, p = .045) and neuroticism (beta = 5.16, p = .045) were significant predictors. These findings indicate that health motivation for snacking predicts both momentary snack preference and habitual snack food consumption. Moreover, personality traits may be linked with habitual unhealthy snacking behaviour via their association with specific motivations for snacking. Overall, these findings suggest that health promotion messages focusing on health motivation may be important for increasing healthier momentary and habitual snack choices to improve dietary intake and support weight management.

Evidence based lifestyle interventions in Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common endocrine condition which affects up to 13% of reproductive-aged women and is associated with reproductive, metabolic and psychological features. Women with PCOS have a higher prevalence of longitudinal weight gain in population-based cohort studies compared to women without PCOS. On meta-analysis, women with PCOS also have an increased prevalence of overweight, obesity and central obesity, compared with controls. PCOS is therefore associated with an elevated prevalence of overweight and obesity which further worsen metabolic, reproductive and psychological dysfunction. Given the association between overweight and obesity and metabolic, reproductive and psychological dysfunction in women, weight management is a logical treatment strategy. This can be defined as prevention of excess weight gain, achieving a modest weight loss and sustaining a reduced weight long-term. This is best achieved through lifestyle management which traditionally refers to a complex multidisciplinary approach that combines dietary modification, physical activity and behavioural interventions. Lifestyle interventions and modest weight loss (5-10% of initial body weight) are associated with improvements in outcomes including central adiposity, hyperandrogenism, insulin resistance and cardiovascular risk factors. In PCOS specifically for dietary interventions, the majority of evidence indicates no differences between dietary approaches Lifestyle management advice should therefore follow general population guidance which states that lifestyle intervention can be achieved through a variety of dietary approaches providing these are tailored to dietary preferences and ensure the nutritional and health status of the individual patient with referral to a nutrition professional where possible. These recommendations are summarised in the 2023 International Evidence-based Guidelines on the Assessment and Management of PCOS. 1 These guidelines are now being translated and implemented internationally.

Factors Influencing Weight Management in Pregnant Women with Overweight or Obesity: A Meta-Synthesis of Qualitative Studies

BackgroundOverweight and obesity have multiple negative consequences for the health of both the mother and the child. Interventions to prevent excessive weight gain during pregnancy have had varying success, and the proportion of pregnant women who exceed national guidelines for weight gain continues to increase. ObjectiveTo investigate the influence of factors on weight management among pregnant women with overweight or obesity. MethodsThis meta-synthesis of qualitative studies involved searching databases PubMed, Embase, Cochrane, Scopus, and Web of Science. The databases were searched on October 4, 2022, and the search was updated on April 21, 2023. The screening of titles, abstracts, and full texts was conducted utilizing Covidence software. The quality assessment of the articles was performed using the Critical Appraisal Skills Programme checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement was used to enhance transparency in reporting. A meta-aggregation approach was used to guide the data extraction and synthesis. ResultsA total of 46 studies with appropriate Critical Appraisal Skills Programme scores were included for qualitative synthesis. Findings were extracted and integrated into 4 themes: psychological factors (personally driven negative emotions and society-driven negative emotions), social factors (societal attitudes and beliefs and social support resources), factors related to education and counseling (information provision and communication), and factors associated with effective care (provided care components and the method of providing effective care). ConclusionsTo improve weight management during pregnancy, health care providers should provide tailored and individualized recommendations that take into consideration the factors influencing these women.

Central inhibition of HDAC6 re-sensitizes leptin signaling during obesity to induce profound weight loss

Leptin resistance during excess weight gain significantly contributes to the recidivism of obesity to leptin-based pharmacological therapies. The mechanisms underlying the inhibition of leptin receptor (LepR) signaling during obesity are still elusive. Here, we report that histone deacetylase 6 (HDAC6) interacts with LepR, reducing the latter's activity, and that pharmacological inhibition of HDAC6 activity disrupts this interaction and augments leptin signaling. Treatment of diet-induced obese mice with blood-brain barrier (BBB)-permeable HDAC6 inhibitors profoundly reduces food intake and leads to potent weight loss without affecting the muscle mass. Genetic depletion of Hdac6 in Agouti-related protein (AgRP)-expressing neurons or administration with BBB-impermeable HDAC6 inhibitors results in a lack of such anti-obesity effect. Together, these findings represent the first report describing a mechanistically validated and pharmaceutically tractable therapeutic approach to directly increase LepR activity as well as identifying centrally but not peripherally acting HDAC6 inhibitors as potent leptin sensitizers and anti-obesity agents.

Substance P Concentration in Gestational Diabetes and Excessive Gestational Weight Gain and Its Impact on Neonatal Anthropometry.

Fetal programming is a process initiated by intrauterine conditions, leaving a lasting impact on the offspring's health, whether they manifest immediately or later in life. It is believed that children born to mothers with gestational diabetes mellitus (GDM) and excessive gestational weight gain (EGWG) may be at an increased risk of developing type 2 diabetes mellitus (T2DM) and obesity later in their adult lives. Substance P is a neurotransmitter associated with obesity development and impairment of insulin signaling. Dysregulation of substance P could lead to several pregnancy pathologies, such as preeclampsia and preterm birth. Our study aimed to compare substance P concentrations in serum and umbilical cord blood in patients with GDM, EGWG, and healthy women with a family history of gestational weight gain. Substance P levels in umbilical cord blood were significantly higher in the GDM group compared to the EGWG and control groups. Substance P levels in serum and umbilical cord blood were positively correlated in all groups and the GDM group. A very interesting direction for future research is the relationship between the concentration of substance P in newborns of diabetic mothers and the occurrence of respiratory distress syndrome as a complication of impaired surfactant synthesis. To our knowledge, it is the first study assessing substance P concentration in GDM and EGWG patients.

The impact of low-energy, partially hydrolysed enteral formula on gastrointestinal symptoms and weight in children with neurological impairment: a multicentre retrospective study.

Neurological impairment (NI) relates to disorders of the central nervous system. The specific aetiology of NI varies but includes genetic, congenital abnormalities or brain injury. In children with severe NI, feeding impairments can lead to undernutrition, and some children require a feeding tube. Although tube feeding improves overall nutritional status, it has also been associated with excess body fat. Commercially available enteral formulas that are low in energy, hydrolysed and nutritionally adequate for protein and micronutrients are available to mitigate gastrointestinal symptoms and obesity. This is a retrospective multicentre study of children who attended NI clinics between January 2022 and July 2023. Data were collected before and 1 month after receiving a low-energy, partially hydrolysed enteral formula (0.6 kcal/mL) on demographic data (age, sex, ethnicity and NI diagnosis), anthropometric measurements (weight, height, weight-for-age Z-score, height-for-age Z-score, body mass index [BMI] Z-score) and feed regimen (feed volume, total fluids and type of formula/supplements). Dietitians collected data on 28 children, the median age was 7 years (interquartile range [IQR] 3, 8). The most frequently recorded NI was cerebral palsy, in 13 of 28 children (48%). Before the formula switch, the most frequently reported gastrointestinal symptom was constipation, in 13 of 28 children. Within 1 month of switching to a low-energy, hydrolysed formula, 10 of the 13 (77%) children reported an improvement in constipation. Before the formula switch, all 28 children were experiencing excessive weight gain. After the formula was switched to low-energy, hydrolysed formula, dietitians reported that 20 of the 28 (76%) children's weight either stabilised or reduced after 1 month. There was no statistically significant difference in weight-for-age Z-score or BMI Z-scores postswitch of formula (p-value 0.1 and 0.09, respectively). Fibre intake increased significantly from 3.3 to 8.1 g/day (p-value < 0.01) after formula switch. The number of children whose feed regimens were simplified after switching to a low-energy, partially hydrolysed formula was 24 of 28 (91%). Children with an NI who have gastrointestinal symptoms may benefit from a low-energy, hydrolysed enteral formula to maximise feed tolerance and promote healthy weight gain. In addition, changing to a low-energy, hydrolysed formula may simplify feed regimens by eliminating the need for additional electrolytes, multivitamins and fluid boluses. Healthcare professionals should be knowledgeable about the effectiveness and availability of a low-energy, hydrolysed formula.

Mindfulness meditation modulates stress-eating and its neural correlates

Stress-related overeating can lead to excessive weight gain, increasing the risk of metabolic and cardiovascular disease. Mindfulness meditation has been demonstrated to reduce stress and increase interoceptive awareness and could, therefore, be an effective intervention for stress-related overeating behavior. To investigate the effects of mindfulness meditation on stress-eating behavior, meditation-naïve individuals with a tendency to stress-eat (N = 66) participated in either a 31-day, web-based mindfulness meditation training or a health training condition. Behavioral and resting-state fMRI data were acquired before and after the intervention. Mindfulness meditation training, in comparison to health training, was found to significantly increase mindfulness while simultaneously reducing stress- and emotional-eating tendencies as well as food cravings. These behavioral results were accompanied by functional connectivity changes between the hypothalamus, reward regions, and several areas of the default mode network in addition to changes observed between the insula and somatosensory areas. Additional changes between seed regions (i.e., hypothalamus and insula) and brain areas attributed to emotion regulation, awareness, attention, and sensory integration were observed. Notably, these changes in functional connectivity correlated with behavioral changes, thereby providing insight into the underlying neural mechanisms of the effects of mindfulness on stress-eating.Clinical trial on the ISRCTN registry: trial ID ISRCTN12901054

Weight as an indicator of enclosure suitability in Livingstone's fruit bats (Pteropus livingstonii).

Obesity is common in zoo animals, and both dietary management and the provision of adequate opportunities for exercise are needed to tackle it. We used 30 years of records from Jersey Zoo to compare the weight and forearm length of wild and captive-born Livingstone's fruit bats (Pteropus livingstonii), and to assess the impact on weight of enclosure space. The mean capture weight of wild-caught male Livingstone's bats was 657 g, significantly higher than that of females (544 g). In both wild and captive-born bats, males had significantly longer forearms than females, but there was no effect of birth location. Males weighed more in the mating season than at other times of year. Both sexes gained more weight during development if born in enclosures that restricted flight rather than a large aviary; this was particularly noticeable in females. After reaching maturity at 3 years, weights of bats born in restricted enclosures continued to increase, reached a peak of over 1000 g at 8-10 years, and then declined in both sexes. The weight of bats born in the aviary remained more stable after the age of three. Like wild bats, adult females born in the aviary weighed less than males. However, females born in restricted enclosures weighed more than males born in the same enclosures. Enclosure designs that maximize opportunities for flight can limit excessive weight gain in captive fruit bats and may therefore improve fitness and health, essential in planning for future reintroduction programs.

Interactive effects and relative contribution of prepregnancy overweight and obesity, excessive gestational weight gain and gestational diabetes mellitus to macrosomia: A retrospective cohort in Fujian, China

AimTo conduct a retrospective cohort study to investigate the association between prepregnancy overweight and obesity, excessive gestational weight gain (GWG), gestational diabetes mellitus (GDM) and macrosomia, both individually and in combination. MethodsBinary logistic regression was used to analyse the effects of overweight and obesity, excessive GWG and GDM on macrosomia, both separately and in combination. The interaction effects between prepregnancy overweight and obesity, excessive GWG and GDM were tested. The population attributable fraction (PAF) was calculated separately when interaction terms were significant. ResultsWhen analysed separately, prepregnancy overweight and obesity, excessive GWG and GDM increased the risk of macrosomia significantly. The pairwise interactions of each pair of risk factors or all three risk factors on macrosomia appear to be greater than any of them individually. Prepregnancy overweight and obesity contributed the least (5.69%) to macrosomia, while GDM contributed the most (8.5%). The PAF values for prepregnancy overweight and obesity/GDM, excessive GWG/GDM, and prepregnancy overweight and obesity/excessive GWG were 13.6%, 16.25% and 14.45%, respectively, and the total PAF for all three risk factors was 22.63%. ConclusionsPrepregnancy overweight and obesity, excessive GWG and GDM were associated with newborn macrosomia.

Analysis of the Effects of Maternal Body Mass Index and Gestational Weight Gain on Maternal and Neonatal Outcomes in Twin Pregnancy

Objective: To investigate the effects of maternal body mass index (BMI) and gestational weight gain on maternal and neonatal outcomes in twin pregnancies. Methods: Five hundred cases of twin pregnancies were divided into a low body weight group (68 cases), a normal weight group (355 cases), an overweight group (65 cases), and an obesity group (12 cases) according to the World Health Organization (WHO) Body Mass Index (BMI) classification guidelines Results: Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight. The higher the BMI before pregnancy, the higher the incidence of excessive weight gain during pregnancy. The incidences of gestational diabetes mellitus (GDM) and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain (P &lt; 0.05). The incidences of gestational hypertension, preeclampsia, and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain (P &lt; 0.05). The incidence of neonatal birth weight, fetal distress, and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups (P &lt; 0.05). The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers (P &lt; 0.05). Conclusion: Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy. Therefore, for women with twin pregnancies, weight management is crucial to ensure maternal and infant health.

Pregnant women's dietary patterns and knowledge of gestational weight gain: A cross-sectional study.

Excess gestational weight gain (GWG) is a risk factor for various unfavorable maternal and neonatal outcomes that may be preventable. Maintaining a healthy lifestyle while pregnant can help prevent uncontrollable weight gain. The aim of this study was to assess pregnant women's knowledge on weight, GWG, diet, and knowledge of obesity-related complications among women who seek care at our semi-urban, regional setting. A prospective observational study was conducted at the prenatal clinic at Kalafong Academic Hospital. Prospective participants completed a questionnaire on their perception of GWG, attitudes toward GWG, knowledge of GWG, associated complications of obesity, and food choices. Data analysis was performed using SAS version 9.4. The majority of the 500 individuals were overweight or obese prior to pregnancy. By the end of the third trimester, this increased by 10.1% (n = 420; 86.1%). Nearly half (n = 240; 48.78%) of the overweight and obese women underestimated their weight. Only 26.53% (n = 26) of women who checked their body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) gained weight according to recommendations. However, less than half (n = 96; 30.5%) gained weight within the recommended range, despite the fact that the majority of them (n = 315; 64%) were aware of the harmful effects of obesity on the cardiovascular system and the effects of high calories on weight gain (n = 321; 65%). Despite basic knowledge of the impact of high-caloric intake on weight gain and cardiovascular complications, less than half of the study population gained weight within the recommended range.

Abstract 2197: Weight history and colorectal cancer risk in the Cancer Prevention Study-3 cohort

Abstract While the link between obesity and colorectal carcinogenesis is established, limited evidence suggests that early-life overweight/obesity may be an important consideration, particularly in the development of early-onset colorectal cancer (CRC). Using data from the American Cancer Society’s Cancer Prevention Study-3 (CPS-3), we investigated the association of body weight across the life course and risk of CRC. From 2006-13, over 300,000 participants (ages 30-65) enrolled in the CPS-3 cohort and provided a baseline waist circumference (WC) measure, self-reported baseline weight and height, weight at age 18, and weight at each decade of adulthood (20s to current age). Body shape phenotype (apple, pear, other) was self-reported in 2015. Excess body mass index (BMI)-years was calculated by subtracting a reference BMI of 25 from the reported BMI for each decade of life and aggregating excess BMI for the reported years of life. Through 2018, 424 incident cases of colorectal cancer were reported, of which 94 were younger than 50 years. Associations of BMI measures and WC with incident CRC were estimated using multivariable-adjusted Cox proportional hazards regression and stratified by sex and body shape. After exclusions (n=248,804), 78% of participants were women, 85% were non-Hispanic white, 69% were never smokers, and 8% had a family history of CRC. The mean baseline age was 47.8 (women) and 48.5 (men) years. The mean baseline BMI, WC, and age 18 BMI were 27.6 kg/m2, 91.9 cm, and 21.7 kg/m2, respectively, among women and 28.3 kg/m2, 103.8 cm, and 23.1 kg/m2, respectively, among men. Baseline BMI was associated with 8% higher CRC risk (95% confidence interval (CI) 0.99-1.18) per 5 kg/m2 increase. However, apple body shape was associated with higher CRC risk (hazard ratio (HR) per 5 kg/m2 BMI = 1.18, 95% CI 1.02-1.38). WC was associated with higher CRC risk (HR 1.08, 95% CI 1.01-1.15) per 10 cm increase, and the association was higher for apple body shape (HR 1.14, 95% CI 1.01-1.28). BMI at age 18 was associated with 17% higher CRC risk (95% CI 1.03-1.32) per 5 kg/m2 increase, and the association was higher for apple body shape (HR 1.36, 95% CI 1.12-1.65). Associations for non-apple body shapes were not statistically significant across all exposures. For early-onset CRC, associations with baseline BMI, WC, and age 18 BMI were suggestive of higher risk but not statistically significant. Participants in the highest category of excess BMI-years (women ≥35, men ≥81) relative to those in the lowest had 56% higher risk of overall CRC (95% CI 1.19-2.05), but the association with early-onset CRC was not statistically significant (HR 1.92, 95% CI 0.90-4.07). These findings suggest that while obesity is associated with higher CRC risk, excess weight gain around the waist and at younger ages may be of importance. Studies are needed to confirm these findings and further investigate the potential role of early-life obesity in the development of early-onset CRC. Citation Format: Caroline Y. Um, Christina C. Newton, Aparna Parikh, Marjorie L. McCullough, Alpa V. Patel. Weight history and colorectal cancer risk in the Cancer Prevention Study-3 cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2197.

Exploring the relationships between pre-pregnancy BMI, gestational weight gain, and nutritional intake: a real-world investigation in Shandong, China.

This study investigated the associations between gestational weight gain (GWG), pre-pregnancy body mass index (BMI), and prenatal diet quality in pregnant women from Shandong, China. We analyzed a sample of 532 early-stage pregnant women registered at an outpatient clinic. Diet quality was evaluated using the Chinese Healthy Dietary Index for Pregnancy (CHDI-P), encompassing three dimensions: diversity, adequacy, and limitation, with an overall score out of 100. Dietary intake was documented via 24-h dietary recalls spanning three consecutive days and subsequently translated to a CHDI-P score. At the time of enrollment, BMI was measured on-site and classified as underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Pregnant women were also categorized into inadequate, adequate, and excessive weight gain groups based on their GWG. We employed a Tukey-adjusted generalized linear model to compare the CHDI-P scores between the pre-pregnancy BMI groups and GWG groups. The results revealed that the underweight group had significantly higher total scores and limitation total scores on the CHDI-P (p < 0.001). Conversely, the overweight and obese groups were more susceptible to suboptimal dietary quality. Notably, the inadequate weight gain group displayed significantly elevated food adequacy scores compared to the other two groups (p < 0.05). This indicates that greater GWGs do not necessarily align with principles of adequate nutrition.

Regional variation in weight change after the transition to dolutegravir in Uganda and South Africa.

People with HIV (PWH) on integrase inhibitor-based regimens may be at risk of excess weight gain, but it is unclear if this risk is consistent across settings. We assessed weight change over 48 weeks among PWH who were transitioned to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD). We conducted a prospective cohort study at public-sector HIV clinics in Uganda and South Africa. Eligible participants were adults who were transitioned to TLD. Weight was measured at enrollment, 24-, and 48-weeks post TLD transition. Our outcomes were weight change, change in waist circumference, and clinically significant weight gain, defined as ≥10% increase in weight from baseline, over 48 weeks. We used linear mixed-effects regression models, adjusted for demographic factors, to estimate weight gain and identify risk factors. Weight data were available for 428 participants in Uganda and 367 in South Africa. The mean weight change was 0.6 kg [95% CI: 0.1-1.0] in Uganda and 2.9 kg [2.3-3.4] in South Africa ( P < 0.001). The mean change in waist circumference was 0.8 cm [95% CI: 0.0-1.5]) in Uganda and 2.3 cm [95% CI: 1.4-3.2] in South Africa ( P = 0.012). Clinically significant weight gain occurred in 9.8% [7.0-12.6] of participants in Uganda and 18.0% [14.1-21.9] in South Africa ( P < 0.001). After adjustment, PWH gained significantly less weight in Uganda than in South Africa. PWH in South Africa experienced significantly greater weight gain and increases in waist circumference compared to Uganda. Strategies to address weight gain in PWH should be carefully considered and may vary by region.

DSOG Guideline Bulletin: Vegetarian and vegan diets during pregnancy

Vegetarian and vegan diets are becoming increasingly common among Danish women of reproductive age. We reviewed the available literature via PubMed and concluded that varied and well-balanced vegetarian and vegan diets are safe and sufficient during pregnancy and lactation, provided that dietary supplements for folate, vitamin B12, and vitamin D are taken regularly. Additionally, it is important to ensure adequate intake of calcium, protein, and iron. Protein requirements may be higher for vegetarians and especially for vegans, though evidence is limited regarding the recommendation for increased protein intake if the diet is exclusively plant-based. Routine blood tests are not recommended unless there has been insufficient supplementation leading up to or during pregnancy, or if symptoms suggest a deficiency. We found no evidence to support supplementation with docosahexaenoic acid (DHA). There is no indication of an increased risk of malformations for pregnant Danish women on a vegetarian or vegan diet compared to omnivores. The risk of delivering small for gestational age and low birthweight infants (&lt;2500 grams) may be increased, but the evidence is conflicting and of poor quality. Vegetarian and vegan diets may offer benefits, such as a lower risk of excessive gestational weight gain and women consuming the lowest amounts of meat have a significantly lower risk of gestational diabetes. Vegans may face a lower risk of having large for gestational age infants. Vegetarian and vegan lifestyles are also compatible with breastfeeding, and provided women take the recommended supplements, there is no difference in the micronutrient content of the breast milk of vegetarian/vegan women compared to that of omnivores. Children of vegans and vegetarians with limited or no consumption of milk products or eggs are recommended to breastfeed or receive baby formula for at least the first two years of life.

Association between spexin, nutritional status of pregnant women with excessive gestational weight gain, and newborn weight: A cross-sectional study

Association between spexin, nutritional status of pregnant women with excessive gestational weight gain, and newborn weight: A cross-sectional study

The impact of self-monitoring physical and mental health via an mHealth application on postpartum weight retention: Data from the INTER-ACT RCT.

Postpartum weight retention (PPWR) has many health risks. Digital self-monitoring of weight can potentially make postpartum weight management easier. We aim to test to what extent the self-monitoring of weight, steps and mental health through an mHealth application increases postpartum weight loss and reduces the odds of substantial PPWR (≥5 kg). Participants were mothers in the intervention arm of the INTER-ACT multicenter randomized controlled trial (RCT), an inter-pregnancy lifestyle intervention among mothers with excessive gestational weight gain. Participants (n=288) had access to an mHealth application to log their weight, steps and mental health between 6 weeks and 6 months postpartum. A linear multiple regression model and a logistic regression model were run to test to what extent self-monitoring via the app increases postpartum weight loss and reduces the risk of substantial PPWR. Women who logged their weight more often lost more weight (B=0.03, β=0.26, CIB =[0.01,0.05], P<0.01), and had reduced odds of substantive PPWR (OR=0.99, CIOR =[0.98, 0.999], P<.05). Mental health logging reduced the odds of substantive PPWR (OR=0.98, CIOR =[0.97, 1.00], P<0.05), but was unrelated to the amount of weight loss. Steps logging was unrelated to either weight loss or substantive PPWR. Mothers with excessive gestational weight gain can benefit from app-based lifestyle interventions to reduce PPWR by self-monitoring their weight. More attention to mental health in PPWR interventions is needed.

Telehealth for healthy gestational weight gain among overweight pregnant women: A systematic review

Introduction: Excessive Gestational Weight Gain (GWG) is associated with various complications during pregnancy and childbirth. In contrast, digital interventions like telehealth offer cost-effective solutions with broader accessibility. Therefore, our outcomes are to analyze the effectiveness of telehealth interventions for healthy GWG among overweight and obese pregnant women and to know which features are needed in telehealth for healthier GWG.Methods: We undertook a systematic review to address the objectives mentioned above. Initially, we employed the keywords telehealth, pregnant women, and overweight, which were subsequently refined using Medical Subject Headings provided by the National Center for Biotechnology Information. To identify relevant articles, we searched six databases—Scopus, SAGE Journals, Web of Science, PubMed, ScienceDirect, and ProQuest.Results: We included 15 articles in this review according to the criteria. Eleven papers show a positive effect of telehealth in promoting healthy GWG. Telehealth encompasses various functionalities, such as providing information, push notifications, self-monitoring, and feedback features related to gestational weight gain (GWG), maintaining a healthy diet, engaging in physical activity, receiving reminders, managing stress, and setting goals. On the other hand, four papers show no significant difference between telehealth and regular interventions.Conclusions: Telehealth is alternatively effective to use as an additional intervention to promote healthier GWG in overweight pregnant women. Keywords: gestational weight gain; overweight; pregnant women; telemedicine

An umbrella review of systematic reviews on interventions of physical activity before pregnancy, during pregnancy, andpostpartum to control and/or reduce weight gain.

The increasing prevalence of overweight and obesity worldwide represents a (chronic) complex public health problem. This is also seen among women of childbearing age despite increased efforts to promote physical activity (PA) interventions. Excessive gestational weight gain (GWG) is associated with negative health outcomes for both mothers and offspring. To summarize current systematic reviews (SRs) on PA interventions during pregnancy and postpartum to prevent excessive GWG and identify the most effective approaches. A literature search was conducted on major electronic databases (MEDLINE/Pubmed, Cochrane, Web of Science, Epistemonikos) from inception to March 2023. This study included SRs and meta-analyses of studies involving women aged 18 years or older from diverse ethnic backgrounds, who were either in the preconception period, pregnant, or within 1 year postpartum and who had no contraindications for exercise. Women with chronic diseases, such as pre-existing diabetes (type 1 or type 2) were excluded. Two reviewers extracted data from selected studies assessing the impact of PA in preconception, pregnancy, and postpartum. Methodologic quality was assessed with the AMSTAR-2 tool. A narrative summary of results addresses relationships between PA and weight before, during, and after pregnancy, informing future research priorities for preventing excessive weight gain. This study is registered on PROSPERO (CRD420233946666). Out of 892 identified articles, 25 studies were included after removing duplicates, unrelated titles, and screening titles and abstracts for eligibility. The results demonstrate that PA can help prevent excessive GWG and postpartum weight retention. Structured and supervised moderate-intensity exercise, at least twice a week, and each session lasting a minimum of 35 min seems to provide the greatest benefits. Women who comply with the PA program and recommendations are more likely to achieve adequate GWG and return to their pre-pregnancy body mass index after delivery. Further research is warranted to explore how preconception PA influences pregnancy and postpartum outcomes given the absence of identified preconception-focused interventions.