Attenuation of maternal weight gain impacts infant birthweight: systematic review and meta-analysis.

Despite many interventions aiming to reduce excessive gestational weight gain (GWG), it is currently unclear the impact on infant anthropometric outcomes. The aim of this review was to evaluate offspring anthropometric outcomes in studies designed to reduce GWG. A systematic search of seven international databases, one clinical trial registry and three Chinese databases was conducted without date limits. Studies were categorised by intervention type: diet, physical activity (PA), lifestyle (diet + PA), other, gestational diabetes mellitus (GDM) (diet, PA, lifestyle, metformin and other). Meta-analyses were reported as weighted mean difference (WMD) for birthweight and birth length, and risk ratio (RR) for small for gestational age (SGA), large for gestational age (LGA), macrosomia and low birth weight (LBW). Collectively, interventions reduced birthweight, risk of macrosomia and LGA by 71 g (WMD: -70.67, 95% CI -101.90 to -39.43, P<0.001), 16% (RR: 0.84, 95% CI 0.73-0.98, P=0.026) and 19% (RR: 0.81, 95% CI 0.69-0.96, P=0.015), respectively. Diet interventions decreased birthweight and LGA by 99 g (WMD -98.80, 95% CI -178.85 to -18.76, P=0.016) and 65% (RR: 0.35, 95% CI 0.17-0.72, P=0.004). PA interventions reduced the risk of macrosomia by 51% (RR: 0.49, 95% CI 0.26-0.92, P=0.036). In women with GDM, diet and lifestyle interventions reduced birthweight by 211 and 296 g, respectively (WMD: -210.93, 95% CI -374.77 to -46.71, P=0.012 and WMD:-295.93, 95% CI -501.76 to -90.10, P=0.005, respectively). Interventions designed to reduce excessive GWG lead to a small reduction in infant birthweight and risk of macrosomia and LGA, without influencing the risk of adverse outcomes including LBW and SGA.

Beliefs and advice-seeking behaviours for fertility and pregnancy: a cross-sectional study of a global sample.

BACKGROUND: Pregnancy can motivate individuals to adopt lifestyle behaviours that protect the health of their offspring. The aims of the present study were to explore men's and women's beliefs about lifestyle, fertility and pregnancy, as well as where they seek advice. METHODS: Participants (2185 women and 221 men, six unspecified) from 104 countries completed a questionnaire that explored their beliefs about what was important for a healthy pregnancy and their advice-seeking behaviours. Recruitment was via a Massive Open Online Course entitled 'Food as Medicine', with food, nutrient and health content. Comparisons of categorical data were performed using a chi-squared test (P = 0.05). RESULTS: Eating a variety of fruits and vegetables and not smoking (both 93.7%) were the most frequently and equally ranked in the top-five factors for a healthy pregnancy. Taking prenatal supplements (26.8%) was considered to be less important. Participants in Westernised countries ranked not smoking or drinking alcohol as being significantly more important than those in other countries. Overall, doctors (47.7%) were the most common source of fertility and pregnancy advice. Larger proportions of those aged <40 years used the Internet (<40 years 44.1%, >40 years 18.2% χ2 = 152.7, P < 0.01) and social media (<40 years 16.1%, >40 years 3.6%; χ2 = 110.18, P < 0.01) for health information. CONCLUSIONS: There is disconnection between beliefs and actions regarding the lifestyle behaviours considered to be important for a healthy pregnancy, particularly nutrition. Pregnancy advice-seeking has evolved, with younger men and women utilising the Internet and social media. Health professionals must consider new communication strategies to deliver evidence-based lifestyle advice, particularly for younger men and women and where access to healthcare is limited.

Investigating the relationship between sleep and macronutrient intake in women of childbearing age.

BACKGROUND/OBJECTIVE: Reduced sleep is a strong and independent risk factor for weight gain and obesity. Maternal obesity preconception and throughout gestation can increase the risk of adverse pregnancy outcomes and impact on offspring health in later life. This study investigated the relationship between sleeping behaviour and macronutrient intake in childbearing aged women. SUBJECTS/METHODS: We used cross-sectional data from the Australian Longitudinal Study on Women's Health 1973-78 cohort, aged 31-36 years in 2009 (n=8200). Subjective sleeping behaviour was reported and macronutrient intake was measured using a validated food frequency questionnaire. Latent class analysis (LCA) was used to derive sleeping patterns. Multivariate regression analysis was used to investigate the relationships between sleep and macronutrient intake. RESULTS: LCA identified three sleep patterns: (LC1) average sleep (~8 h) with no adverse sleep-related symptoms (n=3570); (LC2) average sleep (~8 h) with sleeping difficulties and severe tiredness (n=2109); and (LC3) short sleep (~6 h) with sleeping difficulties and severe tiredness (n=915). In fully adjusted models, LC2 was inversely associated with percentage energy as protein (b=-0.24; P=0.01) and the protein-to-carbohydrate ratio (b=-0.01; P<0.05). LC3 was positively associated with percentage of energy as fat (b=0.29; P=0.01), saturated fat (b=0.24; P=<0.001) and monounsaturated fat (b=0.09; P=0.04). CONCLUSIONS: Sleeping behaviour patterns were associated with macronutrient intake in childbearing aged women. Improved sleep patterns, together with diet and physical activity strategies, may make it easier for women to achieve a balanced diet and optimise their weight status in preparation for pregnancy.

The association between portion size, nutrient intake and gestational weight gain: a secondary analysis in the WATCH study 2006/7.

BACKGROUND: Excessive gestational weight gain (GWG) is associated with adverse maternal-child health outcomes. Managing energy intake and GWG versus optimising nutrient intake can be challenging. The present study aimed to examine the relationships between dietary portion size, GWG and nutrient intakes during pregnancy. It is hypothesised that, after adjustment for potential confounders, portion size would be positively associated with both GWG and nutrient intakes during pregnancy. METHODS: Prospective data were obtained for 179 Australian women from the Women and Their Children's Health Study. A validated food frequency questionnaire was used at 18-24 and 36-40 weeks of gestation to quantify diet and portion size during the previous 3 months of pregnancy. Nutrient intakes were compared with Australian Nutrient Reference Values (NRVs). GWG was measured up to 36 weeks and compared with the Institute of Medicine weight gain recommendations (WtAdh). RESULTS: In multivariate regression models, portion size factor (PSF) was positively associated with GWG in women with high socio-economic status (SES; ß = 0.20, P = 0.04) and those with an overweight/obese pre-pregnancy body mass index (BMI) (ß = 0.28, P = 0.04). PSF uniquely accounted for 8.2% and 3.7% of the variability in GWG for women with high SES and overweight/obese pre-pregnancy BMIs, respectively. Nutrient intakes and PSF were similar regardless of WtAdh. Women achieved NRVs for calcium and zinc in all PSF categories. Most of the women with large PSF still failed to achieve the NRVs for folate (95.7%), iron (89.6%) and fibre (85.5%). CONCLUSIONS: All women require advice on quality food choices during pregnancy to optimise health outcomes. Targeting portion size alone is insufficient to manage GWG but may prove to be a valuable tool in pregnant women of high SES and/or those who are overweight/obese pre-pregnancy.

The weight of the pineal gland in malignancy.

A series of 150 pineal glands removed at routine postmortems in a general hospital have been examined. Statistical analysis of the weights of 147 of these glands from patients aged between 45 and 90 years, shows that the glands from patients dying of malignant disease are significantly lighter than those where the cause of death was non-malignant. These results are almost the exact reverse of those described recently in a similar series in America.After decalcification very little difference in the weight of the gland can be detected between the two groups and it would appear that the higher weight of the glands from non-malignant patients is due, at least in part, to the presence of a greater amount of mineral in these glands.