High Risk Of Non-communicable Diseases Research Articles

Spatial variation of zero fruits/vegetables consumption and associated factors among children aged 6–23 months in Ethiopia: geographical weighted regression analysis

BackgroundAfter 6 months, nutrient-dense, varied diets containing fruits and vegetables are crucial to supplement breastfeeding. Like many other low-income countries, Ethiopia has very low FV consumption. Zero vegetable or fruit (ZVF) consumption has been shown to significantly raise the risk of non-communicable diseases and has been ranked among the top 10 risk factors for mortality. And it is associated with poor health, an increased risk of obesity, and a higher risk of non-communicable diseases. Thus, this study’s goal was to investigate the spatial distribution of ZVF consumption and its spatial determinants among children aged 6–23 months in Ethiopia.MethodsA cross-sectional study design was employed. A total of 1,489 weighted samples were included from kids’ datasets from the 2019 Ethiopian mini-demographic and health survey. STATA version 16, ArcGIS version 10.8, Kuldorff’s SaTScan version 9.6, and MGWR version 2.0 software were used for analysis. Spatial regression analyses (geographical weighted regression and ordinary least squares analysis) were conducted. Models were compared using AICc and adjusted R2. A p-value of less than 0.05 was used to declare statistically significant spatial predictors, and the corresponding local coefficients were mapped.ResultsThe spatial distribution of ZVF consumption among children aged 6–23 months was non-random in Ethiopia. Spatial scan analysis revealed a total of 120 significant clusters. Maternal education, wealth status, age of the child, place of delivery, number of under-five children in the house, and current pregnancy status were significant predictors of the spatial variation of ZVF consumption.ConclusionSignificant geographic variation in ZVF consumption was found in this study throughout Ethiopia’s regions. Significant predictors of the spatial variation in ZVF consumption were maternal education, wealth status, child age, place of delivery, number of under-five children in the home, and status as a pregnant woman at the time of birth. Therefore, in order to improve children’s adequate consumption of fruit and vegetables, area-based interventions that can consider these significant factors into account are needed.

Consumption of ultra-processed foods and relationship with sodium and potassium excretion: a cross-sectional study

Introduction: Higher consumption of ultra-processed foods (UPF) had been associated with higher risk of non-communicable diseases (NCD) and NCD-promoting nutrient profile such as high sodium content and low potassium content. The objective of the study was to evaluate the level of food processing according to the NOVA classification and its relationship with sodium and potassium intake estimated by 24-hour urinary excretion. Methods: This is a cross-sectional study. Data collection included 107 workers from a public university (51.4% female; mean age 47 years) participating in an iMC Salt clinical trial). A 24-hour urinary collection was used to estimate sodium and potassium intake, validated by the creatinine coefficient. The corresponding 24-hour dietary recall was used to assess food intake and foods were categorized using the NOVA classification according to the degree and purpose of processing, into four groups. Nutri-score was also used to categorize UPF and provide more information about the nutritional quality of products. Results: The largest energy contribution came from the group of unprocessed or minimally processed foods (51.6%), followed by UPF (24%), processed foods (21.8%) and processed culinary ingredients (2.6%). Individuals with the lowest caloric contribution of the consumption of UPF had higher average values of potassium (K) intake (1438 vs 1136 mg/1000kcal; p=0.007), as individuals with the highest weight contribution of the consumption of unprocessed or minimally processed foods (1434 vs 1109 mg/1000kcal; p=0.010). For sodium (Na) intake no significant results were found between individuals with the lowest and the highest consumption of each NOVA group. Conclusions: Higher consumption of fresh or minimally processed foods and lower UPF intake were associated with higher K intake values. On the other hand, higher UPF intake was not associated with higher Na intake values. Funding: This work was supported by Fundação para a Ciência e Tecnologia by Grant POCI-01-0145-FEDER-029269) and by the European Regional Development Fund (ERDF) through NORTE 2020 (Northern Regional Operational Program 2014/2020) - NORTE-01-0145-FEDER-072687.

Gender differences in changes in alcohol consumption achieved by free provision of non-alcoholic beverages: a secondary analysis of a randomized controlled trial

BackgroundWe recently demonstrated that a 12-week intervention consisting of the provision of free non-alcoholic beverages reduced alcohol consumption in excessive drinkers for 8 weeks after the intervention. However, gender differences in this effect were not explored. Thus, this secondary analysis investigated gender differences in the influence of non-alcoholic beverage provision on alcohol consumption.MethodsIndividuals who frequently drank excessively (at least 40 g/day in men and 20 g/day in women) and who were not diagnosed with alcoholism were recruited. Participants were randomized into the intervention or control group by simple randomization using a random number table. In the intervention group, free non-alcoholic beverages were provided once every 4 weeks for 12 weeks (three times in total). The consumption of alcoholic and non-alcoholic beverages was calculated based on a drinking diary submitted with the previous 4 weeks’ of data. In this study, we compared the longitudinal changes in alcohol consumption between genders in both groups.ResultsThe provision of non-alcoholic beverages significantly reduced alcohol consumption in both genders; however, significant differences in alcohol consumption between the control and intervention groups were observed only in men. The average alcohol consumption during the intervention fell below the level associated with a high risk of non-communicable diseases in men (32.7 g/day), but not in women (24.8 g/day). Correlation coefficient analysis showed that replacing alcoholic beverages with the provided non-alcoholic beverages resulted in different drinking patterns according to gender. The percent changes in the consumption of alcoholic and non-alcoholic beverages relative to baseline levels did not differ between genders.ConclusionsOur results suggest that the provision of non-alcoholic beverages reduced alcohol consumption irrespective of gender. Of note, providing non-alcoholic beverages might be particularly useful for reducing high-risk alcohol consumption in male excessive drinkers.Trial registrationUMIN UMIN000047949. Registered 4 June 2022.

Dietary Protein Intake, Health-related Quality of Life and Sleep Quality of Malaysians

Introduction: The Malaysian Adult Nutrition Survey and National Health and Morbidity Surveys revealed a significant shift in protein intake with increased meat and seafood consumption. Concomitantly, non-communicable diseases (NCD) increased and were linked to poor health-related quality of life (HRQoL) and sleep quality. Protein intake, particularly from the animal source, is a modifiable nutrition parameter affecting HRQoL and sleep quality. This study investigated the association between different animal proteins, HRQoL and sleep quality in the Malaysian population. Methods: One hundred and fifty Malaysian adults were recruited and subjected to validated questionnaires to assess their protein intake, HRQoL and sleep quality. Additionally, their BMI and waist circumference were measured. Associations between all study parameters were analyzed. Results: There was no statistically significant association between protein intake, BMI, and waist circumference. Increased diet of white meat and seafood was linked to a lower risk of NCDs, improved overall HRQoL, and better sleep quality. Contrastingly, increased red meat consumption was associated with a higher risk of NCDs, poor physical and social function, and worsening sleep quality. Conclusion: The type of animal dietary protein consumed, as well as the frequency with which white and red meat, and seafood are consumed, can all have an effect on HRQoL and sleep quality. More research is needed to evaluate the impact of protein intake levels on HRQoL and sleep quality, including understanding the physiological processes involved. These data will be able to assist health professionals in personalised nutritional and patient management.

Relationship between Serum Homocysteine Concentration and Dietary Factors in Young Japanese Women.

Homocysteine is a methionine metabolism intermediate and its increased blood levels are associated with a higher risk of noncommunicable diseases. Reportedly, blood homocysteine levels increase with inadequate folate, vitamin B6, and vitamin B12 intake; however, its relationship with dietary factors other than these three vitamins remains unknown. Thus, we investigated the relationship of homocysteine with other nutrient intake. We performed a dietary survey on 227 young women using a food record with approximate amounts for 7 consecutive days in conjunction with digital imaging. We collected early morning fasting blood samples the day after the dietary survey was completed and analyzed the serum homocysteine levels. We observed that the serum homocysteine concentrations were significantly negatively associated with soluble, insoluble, and total fiber intake. In addition, participants with high fruit and mushroom intake displayed lower serum homocysteine concentrations, suggesting dietary fiber involvement from these foods. However, we observed no serum homocysteine concentration-related association with cereals and vegetables (well-documented dietary fiber sources) or with fruits and mushrooms. In conclusion, fiber quality-related differences could thus be caused by different sources, including antioxidant components such as fruit polyphenols and mushroom antioxidant and anti-inflammatory factors.

The cytokine profile in obesity and asthma in children

Background. Childhood obesity is one of the pressing problems in modern healthcare, since it is associated with a high risk of non-communicable diseases, such as bronchial asthma (BA). The aim. To determine the features of cytokine profiles in children with and without BA, depending on body weight and visceral fat area.Materials and methods. At the first stage, 506 Tomsk schoolchildren underwent anthropometry with the calculation of the body mass index (BMI) and measurement of the visceral fat area (VFA) using the InBody 770 analyzer. Fiftyone (51) children from the first stage were included in the second clinical and diagnostic stage. The children were divided into four clinical groups: “Obesity” (n = 17), “Visceral Obesity” (n = 7), “Asthma” (n = 15), and “Healthy Children” (n = 12). In all study participants, the levels of interleukin (IL)-6, IL-8, IL-4, IL-10, and immunoglobulin (Ig) E in the blood serum were determined by the multiplex assay (MagPix and Luminex 200 c analyzers). Statistical data analysis was carried out using the Statistica 10.0 software package and the 4.2.2 version of R.Results. The levels of IL-10 in the “Asthma” (p < 0.006) and “Obesity” (p < 0.008) groups were significantly higher than in the “Visceral Obesity” group. Significantly higher levels of IL-8 were found in patients with asthma (p < 0.003) and obesity (p < 0.003) compared to the “Visceral Obesity” group. Higher concentrations of IL-6 were found in the “Asthma” (p < 0.001) and “Obesity” (p < 0.028) groups compared to the “Visceral Obesity” group.Conclusion. Similar upward changes in IL-6, IL-8, and IL-10 in children with asthma and obesity without a history of asthma may explain the contribution of obesity to a risk of asthma in children, possibly through excessive production of these proinflammatory cytokines that contribute to the implementation of Th2-mediated allergic inflammation.

Prevalence and risk factors associated with non-communicable diseases among employees in a university setting: A cross-sectional study

BackgroundGlobally, around 41 million people die due to non-communicable diseases (NCDs) which accounts for more than 75% of global deaths. The major NCDs, namely, Cardiovascular diseases, Cancers, Respiratory diseases and Diabetes accounts for 80% of deaths in the world. This is one of the major public health concerns in low and middle-income countries like India. The present study aims to study the prevalence and risk factors associated with Non-Communicable Diseases among employees in a university setting in Gujarat. MethodsPrimary data was collected through a structural questionnaire with the guidelines given by WHO STEP-wise approach to NCDs. There was total 1025 participants in the study. Bivariate and logistics regression were used to show the prevalence and the influence of risk factors of NCDs with the help of STATA 14 software. ResultsPrevalence of NCDs among the university employees was 10.15%. The prevalence of diabetes (DM), cardio vascular diseases (CVDs) and hypertension were 7.2%, 3.2% and 17% respectively. Having family history of chronic diseases (OR: 2.17; 95% CI:1.39–3.41) and >50 years of age (OR:3.47; 95% CI:1.19–10.14) were 2.17 and 3.47 times at higher risk of NCDs. Moreover obesity (OR: 8.34; 95% CI: 1.12–9.42), unhealthy waist-hip-ratio and hypertension (OR: 1.85; 95% CI:1.15–2.96) increase the risk of such diseases. ConclusionThe study recommends to focus on employees who have history of chronic diseases in their families and encourage people and households to reduce the risk of NCDs through changes in lifestyle, namely physical activity and improvement in substance abuse behaviour.

THE LIFESTYLE PATTERN & PREVALENCE OF OBESITY AND OVERWEIGHT AMONG THE ADOLESCENTS OF BHOPAL CITY, MADHYA PRADESH, CENTRAL INDIA

Introduction: Adolescence means “grow to maturity”. It is derived from the Latin verb Adolescere. This is a period of life between childhood and adulthood during which growth and development occur. The trend of consumption of fast food increases worldwide and in India fast food production and consumption are high. Physical inactivity is associated with a high risk of non-communicable diseases. In India non-communicable diseases like metabolic syndrome are growing fast currently. Methods: It was a cross-sectional study. Sampling was done by using Systematic multistage random sampling. By using the formula N= Z2 PQ/ d2, the Sample size was calculated as 322. 536 adolescents of age (13-17 years) group were enrolled from the four schools in a different quadrant of Bhopal city. Results: In the present study 35.26% (189) adolescents were boys and 64.74% (347) were girls. In this study Prevalence of overweight/pre-obese in boys was found at 8.06% & in Girls, it was 12.17%. Whereas the prevalence of obesity in boys was found 1.45% and in girls, it was 3.7%.Conclusion: Adolescents who spent leisure time on television or computer/internet were found overweight and obese relative to those who spend less time. The prevalence of overweight and obesity was found less in adolescents who were highly active as per the physical activity index as compared to those who were less active

Missing data and other challenges in assessing inappropriate marketing of baby foods in the Russian Federation: a cross-sectional study

ObjectivesWe used the WHO draft nutrient profile model (NPM) to evaluate baby foods targeted at infants and young children (IYC) aged 6–36 months in the Russian Federation to assess their...

Tobacco Use and Cessation among a Nationally Representative Sample of Men in India, 2019-2021.

Tobacco users are exposed to a higher risk of noncommunicable diseases, leading to premature mortality and disability-adjusted life years (DALYs). The future prediction indicates that tobacco-related mortality and morbidity rates will substantially increase in coming years. The study is aimed at assessing the prevalence of tobacco consumption and cessation attempts for different tobacco products among adult men in India. The study utilized information from India's latest National Family Health Survey-5 (NFHS-5) data which was conducted during 2019-21, including 988,713 adult men aged 15 years and above and 93,144 men aged 15-49. Results suggest that 38 percent of men consume tobacco, including 29% in urban and 43% in rural areas. Among the men aged 35-49 years, the odds were significantly higher for consuming any form of tobacco (AOR: 7.36, CI: 6.72-8.05), smoking cigarettes (AOR: 2.56, CI: 2.23-2.94), and smoking bidi (AOR: 7.12, CI: 4.75-8.82) as compared to those aged 15-19. The application of multilevel model indicates that tobacco usages are not evenly distributed. In addition, there is maximum clustering of tobacco usages found around household level factors. Further, 30% of men aged 35-49 years attempted to stop consuming tobacco. Though 27% of men tried to quit tobacco in the last 12 months and 69% of men are exposed to secondhand smoke, 51% of men who received advice for quitting tobacco and visited the hospital in the last 12 months belong to the lowest wealth quintile. These findings prioritize promoting awareness about adverse effects of tobacco use, especially in rural areas, and capacitate them to adopt cessation efforts so that those who want to quit may be successful in their efforts. In addition, the health system's response to the tobacco epidemic in the country should be strengthened by training of service providers to promote cessation efforts through appropriate counselling of all the patients visiting them in the context of tobacco use in any form as key drivers of the increasing burden of noncommunicable diseases (NCDs) in the country.

Characteristics of participants who take up screening tests for diabetes and lipid disorders: a systematic review

ObjectivesTo perform a systematic review on the characteristics of participants who attended screening programmes with blood glucose tests, lipid profiles or a combination of them, respectively.DesignSystematic review following the Meta-analysis...

Sugar-Sweetened Beverage Consumption in Adults: Evidence from a National Health Survey in Peru.

High consumption of sugar-sweetened beverages (SSB) is associated with a high risk of non-communicable diseases. Evidence of SSB consumption is needed to inform SSB-related policies, especially in countries with a high consumption, such as Peru. Using data from Peru’s National Health Survey conducted in 2017–2018, the consumption of homemade and ready-to-drink SSB was estimated from a single 24 h dietary recall, accounting for socio-demographic and health-related variables. Regression models were fitted to assess which variables were linked to a high/low SSB consumption. There were 913 people and mean age was 37.7 years (95% confidence interval (CI): 36.9–38.6). Mean consumption (8 oz servings/day) of homemade SSB (1.2) doubled that of ready-to-drink SSB (0.5). The intake of homemade and ready-to-drink SSB was higher in men (1.3 and 0.7) than women (1.1 and 0.3). The intake of ready-to-drink SSB was higher in urban (0.6) compared to rural (0.2) populations. People aware of having diabetes had a lower consumption of both ready-to-drink (0.9 vs. 0.4) and homemade SSB (1.3 vs. 0.8) than those unaware of having diabetes. Male sex and living in urban locations were associated with higher ready-to-drink SSB intake. Older age was associated with a higher intake of homemade SSB. Amongst Peruvian adults, the consumption of SSB products (particularly homemade) remains high. Population-wide interventions should also aim to improve awareness of the nutritional components of homemade beverages.

Determinants of Non Communicable Diseases: A Mixed-method Study on Its Prevalence and Perceptions among Rural Population of Muchisa, West Bengal

Introduction: Most people with Non Communicable Diseases (NCDs) are unaware of the problem because it usually does not have any signs or symptoms in the initial stages. The measures for prevention of NCDs are not well known to the rural population which results in a huge burden on the health system. Aim: To estimate the burden of NCDs, and its risk factors among the rural population residing in a village of Budge Budge II block, West Bengal. Also to explore their perceptions regarding determinants, complications and prevention of NCDs, and to look for the association of NCDs with the risk factors and sociodemographic characteristics. Materials and Methods: An observational study, with crosssectional design using mixed methods approach, was conducted on 160 residents of Muchisa, from December 2020 to March 2021. A predesigned, pretested and structured schedule, prepared on the basis of World Health Organization (WHO) STEPS framework, was used to assess the presence NCD and associated risk factors in the study population. Focused group discussion guide was employed to inquire about their perceptions. The participants were selected through cluster random sampling. The data were explored using Pearson’s Chi-square test, logistic regression and thematic analysis. A p-value of <0.05 was considered significant. Results: Mean age of the participants was 45.0±16.8 years, and 69.4% participants were females. Total 75% of the participants suffered from at least one NCD. All the participants had at least one risk factor for NCD. Age group of 40-59 years (p-value <0.001) and 60 years or above (p-value=0.002), female gender (p-valu=0.009), and preschool education or below (p-value=0.006) were associated with a higher risk of NCD. Qualitative data analysis revealed that lifestyle modification was not perceived to be effective against NCDs. Conclusion: Socio-demographic factors, like age, gender and education have a bearing on the risk of developing NCD. Lack of awareness about the prevention of NCDs is the challenge in addressing the problem.

Health and well-being in small island communities: a cross-sectional study in the Solomon Islands

ObjectivesThis study explored the health problems of inhabitants of small South Pacific Islands under the influence of climate change, focusing on three communities in the Solomon Islands.DesignCross-sectional study of the...

Smoking and obesity among long-haul truck drivers in France.

INTRODUCTIONThis study examines the health status of long-haul truck drivers (LHTDs) and more specifically smoking and obesity, in France.METHODSA total of 373 French and other LHTDs were randomly interviewed at six highway rest stops. Variables recorded were self-reported sociodemographic characteristics (age, gender, marital status, and nationality), behavioral variables (consumption of sodas, daily exercise, smoking status), weight and height. Body mass index (BMI) was also calculated. Statistical analysis was conducted using chi-squared analysis and multiple logistic ordinal regression models (MLR) were developed.RESULTSThe mean age was 43.4 and the largest proportion (41.2%) of respondents were aged 40–50 years. Most respondents were French (70.3%), married (73.8%) and did not report having an active exercise routine (66.0%). Almost two-thirds of the drivers consumed daily 1–2 sodas (34.2%) or 3–4 sodas (33.2%). Based on the BMI, respondents were divided into normal (34.3%), overweight (39.8%), obese (19.5%) or morbidly obese (9.4%) categories. The mean BMI was 27.9 kg/m2 and 51.1% of LHTDs were current or active smokers. MLR analysis revealed that French LHTDs were more likely (OR=3.04; 95% CI: 1.62–5.69) to have a normal BMI compared to other drivers. Smokers were significantly more likely than non-smokers (OR=2.12; 95% CI: 1.26–3.58) to have an above normal BMI.CONCLUSIONSThese results confirm that French and other LHTDs are at high risk of non-communicable diseases. They also highlight the need to address the health risks associated with smoking and obesity among LHTDs using multifaceted strategies.

Symptoms and risk of obstructive sleep apnea in the Mongolian population: A nation-wide analysis from the non-timeline study

The prevalence of obesity is dramatically increasing in Mongolia. Obese people have a higher risk for non-communicable diseases and Obstructive Sleep Apnea (OSA) syndrome. There is no data on the prevalence of OSA in the Mongolian population.

Diet or exercise: The role of diet and/or exercise on changes of pro-inflammatory markers during a weight loss program in adult women with overweight.

Obesity is associated with increased inflammation leading to a higher risk for non-communicable diseases. There was a controversy about whether exercise has a better influence on reducing inflammation during a lifestyle modification program among individuals with obesity. The objective of this study was to evaluate whether exercise could provide a benefit in reducing inflammatory markers in the context of a weight loss program. This is an experimental study with control. Subjects were pre-menopausal adult women with overweight and assigned for low-calorie diet only (LCD) or low-calorie diet and exercise (LCDex) without randomization. We compared the effect of LCDex (n=36) and LCD (n=36) on inflammation markers (leptin and interleukin 6/IL6) for 8 weeks. We showed that after the weight loss program, there was a significant increase in IL6 (p=0.009) but no changes in leptin (p=0.760) concentration in both groups. There were no difference in changes of IL6 between LCDex and LCD (p=0.483). A weight loss program was associated with increased inflammation. Among premenopausal women with overweight, a combination of LCD with exercise does not provide a greater benefit in reducing inflammation than those with LCD alone. KE/0700/06/2018.

Severe acute malnutrition in childhood, chronic diseases, and human capital in adulthood in the Democratic Republic of Congo: the Lwiro Cohort Study

ABSTRACTBackgroundLittle is known about the long-term outcome of children treated for severe acute malnutrition (SAM) after nutritional rehabilitation.ObjectivesTo explore the association between SAM in childhood, noncommunicable diseases (NCDs), and low human capital in adulthood.MethodsWe identified 524 adults (median age: 22 y) who were treated for SAM during childhood in Eastern Democratic Republic of Congo between 1988 and 2007. They were compared with 407 community unexposed age- and sex-matched subjects with no history of SAM. The variables of interest were cardiometabolic risk markers for NCDs and human capital. For the comparison, we used linear and logistic regressions to estimate the association between SAM in childhood and the risk of NCDs and ordinal logistic regression for the human capital.ResultsCompared with unexposed subjects, the exposed participants had a higher waist circumference [1.2 (0.02, 2.3) cm; P = 0.015], and a larger waist-to-height ratio [0.01 (0.01, 0.02) cm; P < 0.001]. On the other hand, they had a smaller hip circumference [−1.5 (−2.6, −0.5) cm; P = 0.021]. Regarding cardiometabolic markers for NCDs, apart from a higher glycated hemoglobin (HbA1c) [0.4 (0.2, 0.6); P < 0.001], no difference was observed in other cardiometabolic markers for NCD between the 2 groups. Compared with unexposed participants, exposed participants had a higher risk of metabolic syndrome (crude OR: 2.35; 95% CI: 1.22, 4.54; P = 0.010) and visceral obesity [adjusted OR: 1.44 (1.09, 1.89); P = 0.001]. The prevalence of hypertension, diabetes, overweight, and dyslipidaemia was similar in both groups. Last, the proportion of malnutrition survivors with higher socioeconomic status level was lower.ConclusionSAM during childhood was associated with a high risk of NCDs and lower human capital in adulthood. Thus, policymakers and funders seeking to fight the global spread of NCDs in adults in low-resource settings should consider the long-term benefit of reducing childhood SAM as a preventive measure to reduce the socioeconomic burden attributable to NCDs.

Body satisfaction of female staff members working in primary schools in Mangaung, Bloemfontein.

BackgroundThe role of psychosocial determinants of overweight and obesity is receiving attention in South African literature. South Africans tend to exhibit an inaccurate perception of their body weight.AimsThe purpose of this study was to determine levels of body satisfaction in female staff members working in primary schools in Mangaung, Bloemfontein.SettingMangaung is a peri-urban area in Bloemfontein in the Free State province of South Africa.MethodsFemale staff members over the age of 18 years were invited to participate in the study. Anthropometric measurements of weight and height were measured using standardised techniques to calculate body mass index (BMI). Waist circumference (WC) was measured as an indicator of risk for non-communicable diseases (NCDs). Weight satisfaction was measured using a structured, self-administered body satisfaction questionnaire.ResultsThe majority of the staff members (71.3%) were classified as obese (BMI > 30 kg/m2); similarly a majority of them were at a high risk of NCDs according to WC. A little over a third (34.8%) of the women perceived themselves to have a normal weight. The majority of the women who had no concern with their body image were obese (59.1%) and only 8.7% of the women in this study were markedly concerned with their body image. Of the 60.9% of women who reported having attempted to lose weight, 38.6% reported using exercise and 30.0% used water as a weight loss method.ConclusionWomen’s awareness of a healthy weight should be promoted if efforts to achieve weight loss are to be effective.

Associations of maternal dietary inflammatory potential and quality with offspring birth outcomes: An individual participant data pooled analysis of 7 European cohorts in the ALPHABET consortium.

BackgroundAdverse birth outcomes are major causes of morbidity and mortality during childhood and associate with a higher risk of noncommunicable diseases in adult life. Maternal periconception and antenatal nutrition, mostly focusing on single nutrients or foods, has been shown to influence infant birth outcomes. However, evidence on whole diet that considers complex nutrient and food interaction is rare and conflicting. We aim to elucidate the influence of whole-diet maternal dietary inflammatory potential and quality during periconceptional and antenatal periods on birth outcomes.Methods and findingsWe harmonized and pooled individual participant data (IPD) from up to 24,861 mother–child pairs in 7 European mother–offspring cohorts [cohort name, country (recruitment dates): ALSPAC, UK (1 April 1991 to 31 December 1992); EDEN, France (27 January 2003 to 6 March 2006); Generation R, the Netherlands (1 April 2002 to 31 January 2006); Lifeways, Ireland (2 October 2001 to 4 April 2003); REPRO_PL, Poland (18 September 2007 to 16 December 2011); ROLO, Ireland (1 January 2007 to 1 January 2011); SWS, United Kingdom (6 April 1998 to 17 December 2002)]. Maternal diets were assessed preconceptionally (n = 2 cohorts) and antenatally (n = 7 cohorts). Maternal dietary inflammatory potential and quality were ranked using the energy-adjusted Dietary Inflammatory Index (E-DII) and Dietary Approaches to Stop Hypertension (DASH) index, respectively. Primary outcomes were birth weight and gestational age at birth. Adverse birth outcomes, i.e., low birth weight (LBW), macrosomia, small-for-gestational-age (SGA), large-for-gestational-age (LGA), preterm and postterm births were defined according to standard clinical cutoffs. Associations of maternal E-DII and DASH scores with infant birth outcomes were assessed using cohort-specific multivariable regression analyses (adjusted for confounders including maternal education, ethnicity, prepregnancy body mass index (BMI), maternal height, parity, cigarettes smoking, and alcohol consumption), with subsequent random-effects meta-analyses.Overall, the study mothers had a mean ± SD age of 29.5 ± 4.9 y at delivery and a mean BMI of 23.3 ± 4.2 kg/m2. Higher pregnancy DASH score (higher dietary quality) was associated with higher birth weight [β(95% CI) = 18.5(5.7, 31.3) g per 1-SD higher DASH score; P value = 0.005] and head circumference [0.03(0.01, 0.06) cm; P value = 0.004], longer birth length [0.05(0.01, 0.10) cm; P value = 0.010], and lower risk of delivering LBW [odds ratio (OR) (95% CI) = 0.89(0.82, 0.95); P value = 0.001] and SGA [0.87(0.82, 0.94); P value < 0.001] infants. Higher maternal prepregnancy E-DII score (more pro-inflammatory diet) was associated with lower birth weight [β(95% CI) = −18.7(−34.8, −2.6) g per 1-SD higher E-DII score; P value = 0.023] and shorter birth length [−0.07(−0.14, −0.01) cm; P value = 0.031], whereas higher pregnancy E-DII score was associated with a shorter birth length [−0.06(−0.10, −0.01) cm; P value = 0.026] and higher risk of SGA [OR(95% CI) = 1.18(1.11, 1.26); P value < 0.001]. In male, but not female, infants higher maternal prepregnancy E-DII was associated with lower birth weight and head circumference, shorter birth length, and higher risk of SGA (P-for-sex-interaction = 0.029, 0.059, 0.104, and 0.075, respectively). No consistent associations were observed for maternal E-DII and DASH scores with gestational age, preterm and postterm birth, or macrosomia and LGA. Limitations of this study were that self-reported dietary data might have increased nondifferential measurement error and that causality cannot be claimed definitely with observational design.ConclusionsIn this cohort study, we observed that maternal diet that is of low quality and high inflammatory potential is associated with lower offspring birth size and higher risk of offspring being born SGA in this multicenter meta-analysis using harmonized IPD. Improving overall maternal dietary pattern based on predefined criteria may optimize fetal growth and avert substantial healthcare burden associated with adverse birth outcomes.