A comparison of Mediterranean-style and MyPyramid diets on weight loss and inflammatory biomarkers in postpartum breastfeeding women.

BACKGROUND: Of postpartum women, 15%-20% retain ≥ 5 kg of their gestational weight gain, increasing risk for adult weight gain. Postpartum women are also in a persistent elevated inflammatory state. Both factors could increase the risk of obesity-related chronic disease. We hypothesized that breastfeeding women randomized to a Mediterranean-style (MED) diet for 4 months would demonstrate significantly greater reductions in body weight, body fat, and inflammation than women randomized to the U.S. Department of Agriculture's (USDA) MyPyramid diet for Pregnancy and Breastfeeding (comparison diet). METHODS: A randomized, controlled dietary intervention trial was conducted in 129 overweight (body mass index [BMI] 27.2 ± 4.9 kg/m(2)), mostly exclusively breastfeeding (73.6%) women who were a mean 17.5 weeks postpartum. Dietary change was assessed using a validated Food Frequency Questionnaire (FFQ) before and after intervention as well as plasma fatty acid measures (gas chromatography/flame ionization detector [GC/FID]). Anthropometric measurements and biomarkers of inflammation, tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6), also were assessed at baseline and 4 months via enzyme-linked immunosorbent assay (ELISA). RESULTS: Participants in both diet groups demonstrated significant (p<0.001) reductions in body weight (-2.3 ± 3.4 kg and -3.1 ± 3.4 kg for the MED and comparison diets, respectively) and significant (p ≤ 0.002) reductions in all other anthropometric measurements; no significant between-group differences were shown as hypothesized. A significant decrease in TNF-α but not IL-6 was also demonstrated in both diet groups, with no significant between-group difference. CONCLUSIONS: Both diets support the promotion of postpartum weight loss and reduction in inflammation (TNF-α) in breastfeeding women.

Increasing the vegetable intake dose is associated with a rise in plasma carotenoids without modifying oxidative stress or inflammation in overweight or obese postmenopausal women.

The optimal amount of vegetable consumption required to reduce chronic disease risk is widely debated. Intervention trials evaluating biological activity of vegetables at various doses are limited. We conducted a 3-dose, crossover feeding trial to test the hypothesis that vegetable intake is associated in a dose-dependent manner with increased plasma carotenoids and subsequently reduced oxidative stress and inflammation in 49 overweight, postmenopausal women. Participants were assigned in random order to 2 (130 g), 5 (287 g), and 10 (614 g) daily servings of fresh, greenhouse-grown vegetables for 3-wk intervals with a 4-wk washout period between treatments. Plasma total carotenoids significantly increased from 1.63 to 2.07 µmol/L with a dose of 2 vegetable servings, from 1.49 to 2.84 µmol/L with a dose of 5 vegetable servings, and from 1.40 to 4.42 µmol/L with a dose of 10 vegetable servings (pre-post paired ttests, all P < 0.001). The change during each feeding period increased with each dose level (P < 0.001). Urine concentrations of 8-isoprostane F2α, hexanoyl lysine, and serum high sensitivity C-reactive protein were not affected by any administered vegetable dose. In this variable-dose vegetable study, a dose-response for plasma carotenoids was demonstrated without significant change in oxidative stress and inflammation in overweight, postmenopausal women.

Recruitment of lactating women into a randomized dietary intervention: successful strategies and factors promoting enrollment and retention.

INTRODUCTION: Recruitment and retention of lactating women require unique strategies to prevent high attrition. The purpose of this report is to identify successful recruitment strategies and evaluate demographic and lifestyle characteristics associated with study completion. METHODS: A randomized, controlled trial was initiated to test the hypothesis that lactating women adhering to a Mediterranean diet will show a significant reduction in anthropometric measurements as compared to lactating women randomized to the USDA's MyPyramid diet for Pregnancy and Breastfeeding (control diet). Measurements were collected at baseline, 2 months, and 4 months. Recruitment methods and baseline characteristics of completers and non-completers are described. RESULTS: The largest percentage of women, 24.8%, were recruited from a local parenting magazine, 20.9% from Craig's List, 20.2% from local hospitals, and 34.1% from various other sources. At baseline, women (n = 129) were mostly Non-Hispanic (75.2%), average age 29.7 years, BMI averaged 27.2 kg/m(2), waist:hip ratio 0.84 cm (SD: 0.07), and body fat averaged 30.8%. Approximately 72% were exclusively breastfeeding, a mean 17.5 weeks postpartum, and 69.0% had a college degree. Non-completers were more likely to have supplemented with formula at baseline as compared to completers (P<0.001). No other characteristics were significantly associated with attrition. CONCLUSION: Researchers conducting studies with lactating women may consider "exclusive breastfeeding" as a study inclusion criterion to prevent high attrition rates or include additional breastfeeding support to study participants.