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Diet and Weight Gain

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A special issue of Nutrients (ISSN 2072-6643).

Deadline for manuscript submissions: closed (31 March 2019) | Viewed by 74085

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Special Issue Editors

Prof. Dr. Margaret Allman-Farinelli

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Guest Editor

Faculty of Medicine and Health, Charles Perkins Centre, The University of Sydney, Sydney, NSW 2006, Australia
Interests: obesity prevention; diet; health promotion; public health; chronic diseases; prevention of malnutrition; food and beverage intake
Special Issues, Collections and Topics in MDPI journals

Dr. Cheryce Harrison

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Guest Editor

Monash Centre for Health Research and Implementation, School of Public Health and Preventative Medicine, Monash University, Melbourne 3004, Australia
Interests: obesity prevention; women’s health; pregnancy; physical activity; lifestyle change; implementation

Special Issue Information

Dear Colleagues,

Modifiable lifestyle factors, including diet and physical activity, and their impact on obesity present a major public health burden. While weight gain can be a problem at all stages of the lifecycle, younger adults are a high risk group and the weight gain trajectory during this time contributes to the accelerated development of obesity and associated risk factors. Males aged 20 to 24 years experience the highest increases in body mass index each year and young reproductive age women present the population group at highest risk of progressive weight gain. Furthermore:

Preconception, women are a large, diverse population who do not identify themselves as a distinct high-risk group or at a specific life stage. Coupled with limited research and awareness, over 50% of women are falling pregnant while overweight or obese and there is a need to address modifiable lifestyle factors including optimal diet, physical inactivity and smoking, alcohol and folate consumption.
Pregnancy presents a critical window for excessive weight gain: 50-60% of women gain above international Institute Of Medicine gestational weight gain (GWG) recommendations with every kilo gained above guidelines linked to ~10% increase in adverse outcomes. Risks are exacerbated in the presence of pre-existing obesity.
Postpartum, women retain ~2-5kg with excessive GWG a strong predictor for future maternal obesity and offspring impacts are significant: children are three times more likely to develop obesity later in life when the GWG exceeds the guidelines, independent of maternal BMI.

Strategies to generate knowledge and the public health impact for the prevention of weight gain in these critical windows offer potential for major benefits to reproductive, cardio-metabolic and psychological health in young men and women and their families.

This Special Issue of Nutrients welcomes the submission of manuscripts describing either original research, narrative reviews or systematic reviews and meta-analyses.

Potential topics may include, but are not limited to:

Interventions evaluating diet for improved health outcomes in adolescents and younger adults, especially women of reproductive age
Nutrition in adolescents, men and reproductive-aged women across preconception, pregnancy and postpartum
Diet quality of adolescents and adults
Determinants of poor nutrition in children, adolescents and adults
Role modelling and nutrition in mothers and fathers
Systematic reviews and meta-analyses of studies of the impact of diet on weight gain and health outcomes in adolescents and adults
Systematic reviews and meta-analyses of interventions to optimise diet in chidren, men and women of reproductive age for improved health outcomes.

While there is special interest in younger people, submissions regarding older age groups such as menopausal women are welcome.

Prof. Margaret A. Allman-Farinelli
Dr. Cheryce Harrison
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Nutrients is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

Weight gain
Obesity
Diet
Lifestyle
Preconception
Pregnancy
Postpartum
Young adult
Adolescent

Published Papers (8 papers)

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Research

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12 pages, 230 KiB

Open AccessArticle

Preconception Health Attitudes and Behaviours of Women: A Qualitative Investigation

by Nadia N. Khan, Jacqueline A. Boyle, Adina Y. Lang and Cheryce L. Harrison

Nutrients 2019, 11(7), 1490; https://doi.org/10.3390/nu11071490 - 29 Jun 2019

Cited by 45 | Viewed by 6612

Abstract

The preconception period is a critical window in which maternal health can profoundly affect both individual and intergenerational health. Despite its importance, little information about women’s preconception health attitudes, behaviours and information preferences exists, yet these details are vital to inform targeted health communication. Semi-structured interviews were conducted to explore women’s attitudes to preconception health (areas of importance, support sources, enablers and barriers), behaviours (information seeking and health actions taken) and information preferences. Interviews were transcribed, coded and thematically analysed. Fifteen women participated (n = 7 preconception, n = 7 pregnant and n = 1 postpartum). Women perceived optimising lifestyle behaviours including a healthy diet, regular physical activity, reducing alcohol intake and pre-pregnancy vitamin supplementation as important preconception health actions to adopt. Few women acknowledged the importance of formal preconception health checks and screening with health professionals. Barriers to achieving health behaviour change included anxiety, stress and challenges obtaining reputable information. Participants reported a lack of preconception information about supplementation requirements, safe foods and exercise recommendations. Information preferences included the internet or their general practitioner. Whilst women predominantly prioritised optimising diet and physical activity prior to pregnancy, there appeared to be limited awareness of preconception health checks and screening, highlighting a need for broader awareness of overall preconception health and wellbeing. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

12 pages, 222 KiB

Open AccessArticle

Barriers and Facilitators to Weight and Lifestyle Management in Women with Polycystic Ovary Syndrome: General Practitioners’ Perspectives

by Alexis Arasu, Lisa J Moran, Tracy Robinson, Jacqueline Boyle and Siew Lim

Nutrients 2019, 11(5), 1024; https://doi.org/10.3390/nu11051024 - 07 May 2019

Cited by 17 | Viewed by 5125

Abstract

Background: Weight and lifestyle management is advocated as the first-line treatment for polycystic ovary syndrome (PCOS) by evidence-based guidelines. Current literature describes both systems- and individual-related challenges that general practitioners (GPs) face when attempting to implement guideline recommendations for lifestyle management into clinical practice for the general population. The GPs’ perspective in relation to weight and lifestyle advice for PCOS has not been captured. Methods: Fifteen GPs were recruited to take part in semi-structured interviews. NVIVO software was used for qualitative analysis. Results: We report that GPs unanimously acknowledge the importance of weight and lifestyle management in PCOS. Practice was influenced by both systems-related and individual-related facilitators and barriers. Individual-related barriers include perceived lack of patient motivation for weight loss, time pressures, lack of financial reimbursement, and weight management being professionally unrewarding. System-related barriers include costs of accessing allied health professionals and unavailability of allied health professionals in certain locations. Individual-related facilitators include motivated patient subgroups such as those trying to get pregnant and specific communication techniques such as motivational interviewing. System-related facilitators include the GP’s role in chronic disease management. Conclusions: This study contributes to the understanding of barriers and facilitators that could be addressed to optimize weight and lifestyle management in women with PCOS in primary care. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

13 pages, 389 KiB

Open AccessArticle

Weight Change and Cardiometabolic Outcomes in Postpartum Women with History of Gestational Diabetes

by Siew Lim, Vincent L. Versace, Sharleen O’Reilly, Edward Janus and James Dunbar

Nutrients 2019, 11(4), 922; https://doi.org/10.3390/nu11040922 - 24 Apr 2019

Cited by 8 | Viewed by 4334

Abstract

Weight gain after childbirth is a significant risk factor for type 2 diabetes (T2DM) development after gestational diabetes mellitus (GDM). The level of weight loss achieved in diabetes prevention programs for women after GDM is often low but its effects on the cardiometabolic risk are not known. In a secondary analysis of a diabetes prevention program in postpartum women with history of gestational diabetes, we evaluated the effect of weight change on the cardiometabolic outcomes at 1-year follow-up. Of the 284 women randomized to the intervention arm, 206 with the final outcome measurements were included in the analyses. Participants were categorized into weight loss (>2 kg, n = 74), weight stable (±2 kg, n = 74) or weight gain (>2 kg, n = 58) groups. The weight loss group had significantly greater decrease in glycated hemoglobin (HbA1c) than the weight gain group (−0.1 + 0.4% vs. 0 + 0.4%, p = 0.049). The weight loss group had significantly greater decrease in total cholesterol and low-density lipoprotein cholesterol cholesterol than the other two groups (p < 0.05). The weight gain group had significantly greater increase in triglyceride and triglyceride:high-density lipoprotein cholesterol ratio compare with the other groups (p < 0.01). Overall, a small amount of weight loss and prevention of further weight gain was beneficial to the cardiometabolic outcomes of postpartum women after GDM. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

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13 pages, 278 KiB

Open AccessArticle

Preconception Lifestyle and Weight-Related Behaviors by Maternal Body Mass Index: A Cross-Sectional Study of Pregnant Women

by Adina Y. Lang, Cheryce L. Harrison and Jacqueline A. Boyle

Nutrients 2019, 11(4), 759; https://doi.org/10.3390/nu11040759 - 31 Mar 2019

Cited by 10 | Viewed by 4114

Abstract

Obesity is a rising global health challenge, particularly for reproductive-aged women. Our cross-sectional study of pregnant women (n = 223) examined associations between preconception body mass index (BMI) and socio-demographics, weight perceptions and lifestyle behaviors. Over half of women were overweight (33.2%) or obese (22.0%), 49.6% of which perceived their weight as normal. High proportions of women reported planning their pregnancies (70.0%) and were actively trying to lose or maintain their weight preconception (72.7%). Weight management approaches varied from reducing discretionary foods (63.7%) to professional support (8.1%). Obese women had significantly greater odds of reducing discretionary foods (odds ratio (OR) = 6.69 95% confidence interval (CI) 2.13–21.00, p = 0.001) and using structured diets (adjusted odds ratio (AOR) = 9.13 95% CI 2.90–28.81, p < 0.001) compared to normal-weight women. After adjusting for socio-demographics, compared to normal-weight women, overweight (AOR = 5.24 95% CI 2.19–12.56, p < 0.001) and obese (AOR = 2.85 95% CI 1.06–7.67, p = 0.04) women had significantly increased odds of exercising for weight management and significantly lower odds of taking folic-acid preconception (overweight: AOR = 0.40 95% CI 0.18–0.90, p = 0.01, obese: AOR = 0.38 95% CI 0.16–0.91, p = 0.03). Large proportions of women planning a pregnancy have an overweight/obese BMI, with associated suboptimal health behaviors and reduced health professional engagement preconception. Further research exploring women’s perspectives regarding preconception lifestyles is needed to inform effective preconception health promotion strategies. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

13 pages, 262 KiB

Open AccessArticle

Predictors of Lifestyle Intervention Attrition or Weight Loss Success in Women with Polycystic Ovary Syndrome Who Are Overweight or Obese

by Lisa J. Moran, Manny Noakes, Peter Clifton, Jon Buckley, Grant Brinkworth, Rebecca Thomson and Robert J. Norman

Nutrients 2019, 11(3), 492; https://doi.org/10.3390/nu11030492 - 26 Feb 2019

Cited by 34 | Viewed by 7460

Abstract

Background/objectives: Polycystic ovary syndrome (PCOS) is a common condition in reproductive-aged women. Weight management is a first-line treatment for PCOS according to international evidence-based guidelines. However, the factors associated with attrition or success in weight loss interventions are not known for women with PCOS. The objective of this study was to identify characteristics associated with attrition and weight loss success in women with PCOS and overweight or obesity undergoing weight loss interventions. Methods: Four randomised controlled clinical weight loss trials comprising energy restricted diets and/or exercise interventions of 2–8 months duration. The interventions were conducted over 2001–2007 in outpatient clinical research centres with n = 221 premenopausal women with PCOS and overweight/obesity recruited through community advertisement. The main outcome measures were attrition and ≥5% weight loss at 2 months and study completion. Results: Weight loss was 5.7 ± 2.9 kg at 2 months and 7.4 ± 5.3 kg after study completion (p < 0.001). Attrition was 47.1% and ≥5% weight loss occurred in 62.5% and 62.7% of women at 2 months and study completion respectively. Baseline depressive symptoms (OR 1.07 95% CI 0.88, 0.96, p = 0.032) and lower appointment attendance by 2 months (OR 0.92 95% CI 0.88, 0.96, p < 0.001) were independently associated with attrition. Lower appointment attendance over the whole study was independently associated with not achieving ≥5% weight loss at study completion (OR 0.95 95% CI 0.92, 0.99, p = 0.020). Conclusions: Despite high attrition, successful weight loss was achieved by 63% of women with PCOS in a clinical research setting. Higher baseline depressive symptoms were associated with greater attrition and higher appointment attendance was associated with lower attrition and greater weight loss success. These finding have implications for development of successful weight management programs in PCOS. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

17 pages, 517 KiB

Open AccessArticle

Diet Quality in a Weight Gain Prevention Trial of Reproductive Aged Women: A Secondary Analysis of a Cluster Randomized Controlled Trial

by Julie C. Martin, Lisa J. Moran, Helena J. Teede, Sanjeeva Ranasinha, Catherine B. Lombard and Cheryce L. Harrison

Nutrients 2019, 11(1), 49; https://doi.org/10.3390/nu11010049 - 27 Dec 2018

Cited by 11 | Viewed by 3725

Abstract

Reproductive-aged women are at high risk for obesity development. Limited research exploring weight gain prevention initiatives and associated modifiable risk factors, including diet quality exists. In a secondary analysis of a 12 month, cluster randomized controlled trial for weight gain prevention in reproductive-aged women, we evaluated change in diet quality, macronutrient and micronutrient intake, predictors of change and associations with weight change at follow-up. Forty-one rural towns in Victoria, Australia were randomized to a healthy lifestyle intervention (n = 21) or control (n = 20). Women aged 18–50, of any body mass index and without conditions known to affect weight, were recruited. Diet quality was assessed by the Dietary Guideline Index (DGI) and energy, macronutrient, and micronutrient intake as well as anthropometrics (weight; kg) were measured at baseline and 12 months. Results were adjusted for group (intervention/control), town cluster, and baseline values of interest. Of 409 women with matched data at baseline and follow-up, 220 women were included for final analysis after accounting for plausible energy intake. At 12 months, diet quality had improved by 6.2% following the intervention, compared to no change observed in the controls (p < 0.001). Significant association was found between a change in weight and a change in diet quality score over time β −0.66 (95%CI −1.2, −0.12) p = 0.02. The percentage of energy from protein (%) 0.009 (95%CI 0.002, 0.15) p = 0.01 and glycemic index −1.2 (95%CI −2.1, −0.24) p = 0.02 were also improved following the intervention, compared to the control group. Overall, a low-intensity lifestyle intervention effectively improves diet quality, with associated weight gain preventions, in women of reproductive age. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

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Review

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20 pages, 361 KiB

Open AccessReview

Macronutrient and Micronutrient Intake during Pregnancy: An Overview of Recent Evidence

by Aya Mousa, Amreen Naqash and Siew Lim

Nutrients 2019, 11(2), 443; https://doi.org/10.3390/nu11020443 - 20 Feb 2019

Cited by 239 | Viewed by 36907

Abstract

Nutritional status during pregnancy can have a significant impact on maternal and neonatal health outcomes. Requirements for macronutrients such as energy and protein increase during pregnancy to maintain maternal homeostasis while supporting foetal growth. Energy restriction can limit gestational weight gain in women with obesity; however, there is insufficient evidence to support energy restriction during pregnancy. In undernourished women, balanced energy/protein supplementation may increase birthweight whereas high protein supplementation could have adverse effects on foetal growth. Modulating carbohydrate intake via a reduced glycaemic index or glycaemic load diet may prevent gestational diabetes and large-for-gestational-age infants. Certain micronutrients are also vital for improving pregnancy outcomes, including folic acid to prevent neural tube defects and iodine to prevent cretinism. Newly published studies support the use of calcium supplementation to prevent hypertensive disorders of pregnancy, particularly in women at high risk or with low dietary calcium intake. Although gaps in knowledge remain, research linking nutrition during pregnancy to maternofoetal outcomes has made dramatic advances over the last few years. In this review, we provide an overview of the most recent evidence pertaining to macronutrient and micronutrient requirements during pregnancy, the risks and consequences of deficiencies and the effects of supplementation on pregnancy outcomes. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

17 pages, 505 KiB

Open AccessReview

Dietary Energy Density and Its Association with Overweight or Obesity in Adolescents: A Systematic Review of Observational Studies

by Andrea Arango-Angarita, Sonia Rodríguez-Ramírez, Lluis Serra-Majem and Teresa Shamah-Levy

Nutrients 2018, 10(11), 1612; https://doi.org/10.3390/nu10111612 - 01 Nov 2018

Cited by 10 | Viewed by 4424

Abstract

Dietary energy density (DED) has been identified as a crucial dietary factor in body weight control, in that higher DED has been associated with weight gain. To our knowledge, no review studies have explained this association specifically in adolescents. The aim of this study was to describe the association of DED with overweight or obesity (OW/O) in adolescents, as derived from observational studies. We conducted a systematic search of the MEDLINE/PubMed and Science Direct databases, including studies published between January 2000 and December 2017. We selected the studies that included adolescents (aged 10–19 years) and contained DED-related information and anthropometric measurements of OW/O. From 1149 candidate studies, 30 were selected, though only 12 met all the inclusion criteria. Of these, only four found a positive association between DED and certain OW/O indicators, six found no association and two showed an inverse association with weight gain. These studies differed in several aspects such as design, DED calculation method and dietary assessment tool, leading to inconsistent results. Methodological differences found among the examined studies did not allow us to establish a clear conclusion of this association. Evidence in adolescents was also poor. New, standardized methodological approaches should be considered in future studies. Full article

(This article belongs to the Special Issue Diet and Weight Gain)

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