Adherence of pregnant women to Nordic dietary guidelines in relation to postpartum weight retention: results from the Norwegian Mother and Child Cohort Study.
Pregnancy is a major life event for women and often connected with changes in diet and lifestyle and natural gestational weight gain. However, excessive weight gain during pregnancy may lead to postpartum weight retention and add to the burden of increasing obesity prevalence. Therefore, it is of interest to examine whether adherence to nutrient recommendations or food-based guidelines is associated with postpartum weight retention 6 months after birth.
This analysis is based on data from the Norwegian Mother and Child Cohort Study (MoBa) conducted by the Norwegian Institute of Public Health. Diet during the first 4-5 months of pregnancy was assessed by a food-frequency questionnaire and maternal weight before pregnancy as well as in the postpartum period was assessed by questionnaires. Two Healthy Eating Index (HEI) scores were applied to measure compliance with either the official Norwegian food-based guidelines (HEI-NFG) or the Nordic Nutrition Recommendations (HEI-NNR) during pregnancy. The considered outcome, i.e. weight retention 6 months after birth, was modelled in two ways: continuously (in kg) and categorically (risk of substantial postpartum weight retention, i.e. =?5% gain to pre-pregnancy weight). Associations between the HEI-NFG and HEI-NNR score with postpartum weight retention on the continuous scale were estimated by linear regression models. Relationships of both HEI scores with the categorical outcome variable were evaluated using logistic regression.
In the continuous model without adjustment for gestational weight gain (GWG), the HEI-NFG score but not the HEI-NNR score was inversely related to postpartum weight retention. However, after additional adjustment for GWG as potential intermediate the HEI-NFG score was marginally inversely and the HEI-NNR score was inversely associated with postpartum weight retention. In the categorical model, both HEI scores were inversely related with risk of substantial postpartum weight retention, independent of adjustment for GWG.
Higher adherence to either the official Norwegian food guidelines or possibly also to Nordic Nutrition Recommendations during pregnancy appears to be associated with lower postpartum weight retention.
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National dietary guidelines are intended to promote primary prevention of lifestyle-related diseases, but little is known about their effectiveness in prevention of stroke.
We used the Danish cohort Diet, Cancer and Health (n = 57 053) to investigate whether adherence to the Danish food-based dietary guidelines was associated with risk of stroke. Adherence was assessed by the Danish Dietary Guidelines Index, score 0 [no adherence] to 6 [complete adherence]. Cox proportional hazards models were used to estimate adjusted hazard ratios and 95% confidence intervals for stroke and subtypes of stroke in men and women separately.
Incident stroke was determined in 1357 men and 900 women during follow-up (median 12.5 years and 13.0 years, respectively). A higher Danish Dietary Guidelines Index score was inversely associated with total stroke in men but not in women. In men, a high Index score (=4) was also inversely associated with total ischemic stroke (hazard ratio 0.75, 95% confidence interval 0.65-0.86), large-artery atherosclerosis (hazard ratio 0.63, 95% confidence interval 0.44-0.92) and small artery occlusion (hazard ratio 0.68, 95% confidence interval 0.54-0.84) compared to a low Index score (
Adherence to the New Nordic Diet during pregnancy and subsequent maternal weight development: a study conducted in the Norwegian Mother and Child Cohort Study (MoBa).
The rising prevalence of overweight and obesity is a worldwide public health challenge. Pregnancy and beyond is a potentially important window for future weight gain in women. We investigated associations between maternal adherence to the New Nordic diet (NND) during pregnancy and maternal BMI trajectories from delivery to 8 years post delivery. Data are from the Norwegian Mother and Child Cohort. Pregnant women from all of Norway were recruited between 1999 and 2008, and 55 056 are included in the present analysis. A previously constructed diet score, NND, was used to assess adherence to the diet. The score favours intake of Nordic fruits, root vegetables, cabbages, potatoes, oatmeal porridge, whole grains, wild fish, game, berries, milk and water. Linear spline multi-level models were used to estimate the association. We found that women with higher adherence to the NND pattern during pregnancy had on average lower post-partum BMI trajectories and slightly less weight gain up to 8 years post delivery compared with the lower NND adherers. These associations remained after adjustment for physical activity, education, maternal age, smoking and parity (mean diff at delivery (high v. low adherers): -0·3 kg/m2; 95 % CI -0·4, -0·2; mean diff at 8 years: -0·5 kg/m2; 95 % CI -0·6, -0·4), and were not explained by differences in energy intake or by exclusive breast-feeding duration. Similar patterns of associations were seen with trajectories of overweight/obesity as the outcome. In conclusion, our findings suggest that the NND may have beneficial properties to long-term weight regulation among women post-partum.
The article describes the after-school (AS) snacking pattern of young Canadians and its relationship with the amount of energy consumed daily and at dinner.
We analyzed cross-sectional dietary data, measured by 24h recall, from 9,131 children and adolescents aged 4 to 18 years from the Canadian Community Health Survey, cycle 2.2 (2004). We evaluated AS snack intake; i.e., foods consumed Monday to Friday between 3:00 and 6:00 pm, excluding lunch and dinner. We also assessed the consumption frequency of AS snack items, the energy provided by AS snacks and total daily energy intake (TDEI) by age group and sex.
Approximately 63% of respondents consumed AS snacks. AS snacks provided on average 1212[95%CI,1157-1268] kJ (290[95%CI,276-303] kcal), representing 13[95%CI,12-13]% of TDEI. Youth who consumed AS snacks contributing 1-418 kJ (1-99 kcal) reported lower TDEI than those who consumed no snack. Among AS snack consumers, TDEI was higher in groups consuming the highest amount of energy from AS snacks. Fruits were among the most frequently consumed food categories. However, the largest energy contributors were mostly foods that may be energy-dense and nutrient-poor, such as cookies, sugar-sweetened beverages and sweets.
Considering that the majority of children and adolescents consumed AS snacks, that these snacks provided about 13% of their TDEI, and that the majority of the most frequently consumed snacks were generally energy-dense, nutrient-poor foods, the AS time period presents an opportunity to promote healthy eating in order to improve diet quality and potentially influence TDEI among Canadian children and adolescents.
Centre for Indigenous Peoples' Nutrition and Environment and School of Dietetics and Human Nutrition, McGill University, Macdonald Campus, Ste-Anne-de-Bellevue, QC. grace.egeland@mcgill.ca
BACKGROUND: Inuit traditional food provides ample amounts of preformed vitamin A. However, the dietary transition away from traditional food raises concerns regarding dietary adequacy. Vitamin A is an essential nutrient with inadequate and excessive exposures having adverse effects. OBJECTIVE: To evaluate total dietary vitamin A intake for Canadian Inuit from market food and traditional food sources and to evaluate retinol concentrations in liver and blubber. METHODS: Dietary surveys were conducted in 18 communities representing 5 Inuit regions, and traditional food items were evaluated for nutrient content. RESULTS: Among those 15-40 years of age, 68% of men and 60% of women had a dietary vitamin A intake below the estimated average requirement (EAR) for retinol activity equivalents (RAE)/day. Among those over 40 years of age, only 11 % of men and 15% of women had a dietary vitamin A intake below the EAR. Young Inuit men had a relative risk of 6.2 (95% CI= 4.5-8.4), and young Inuit women had a relative risk of 4.0 (95% CI= 3.1-5.0) for dietary inadequacy compared to the older Inuit men and women, respectively. The median retinol content of liver of ringed seal, caribou, and fish were comparable to levels observed in market food liver. Liver was less frequently consumed by those 15-40 years of age than among older Inuit. DISCUSSION: Sub-optimal vitamin A intake is the predominant nutritional concern rather than excessive exposures. Public health education campaigns are needed to improve vitamin A intake among the younger generations of Inuit men and women.
OBJECTIVES: A significant fraction of the Alaska Native population appears to be shifting from a primarily subsistence-based diet to a market-based diet; therefore, the ability to link diet pattern to disease risk has become increasingly important to predicting public health needs. Our research aims to develop the use of stable isotope ratios as diet pattern biomarkers, based on naturally-occurring isotopic differences in the elemental composition of subsistence and non-subsistence foods. These differences are reflected in human blood, hair and fingernail isotope signatures. STUDY DESIGN: In this preliminary study, we investigate the potential for 13C and 15N to serve as dietary biomarkers for age-related dietary differences in a subset of participants involved with a long-term study initiated by the Center for Alaska Native Health Research (CANHR) at the University of Alaska Fairbanks (UAF). METHODS: We measured delta13C and delta15N in red blood cells collected from 12 "elder" participants (age 60+ yrs) and 14 younger participants (age 14-19 yrs). Samples were evenly divided between males and females, and between two villages sampled in 2004. We also sampled market and subsistence foods in Fairbanks, AK, as an indicator of the isotopic differences likely to be observed in village foods. RESULTS: Elders were significantly enriched in 15N, but depleted in 13C, relative to younger participants. These differences are consistent with increased intake of marine subsistence in elders, and of certain market foods in younger participants. However, elders were considerably more variable in delta15N, suggesting greater differences among individuals in their usual intake. CONCLUSIONS: Overall we find that RBC stable isotope signatures exhibit variation consistent with previously documented dietary patterns in Alaska Natives, and we describe future directions for developing these biomarkers for diet pattern monitoring.
The nutrient intake for 86 male myocardial infarction patients was calculated from data based on the interview methods studied both one and two years after infarction. The dietary history method resulted in systematically higher mean daily intakes than the other methods. The differences in mean intakes calculated from the recall methods were, in general, rather small. The agreement, measured by the intraclass correlation coefficient, varied from 0.42 to 0.69. The pattern of mean differences between methods was consistent one and two years after infarction.
In an ongoing study of the hypothesised association between consumption of fish contaminated with persistent organochlorine compounds and low birth weight, a relevant measure of exposure is the accumulated fish consumption over long time periods. An issue of concern in this study is the quality of the retrospective exposure assessments. The present investigation was undertaken to determine the agreement between reported fish consumption in two interviews with approximately one year in between. in order to evaluate its impact on the effect estimates. The agreement decreased with increasing retrospective time interval between interview and focused time period of fish consumption. Furthermore, the exposure assessments based on the two interviews led to considerably different effect estimates.
To study the association between alcohol consumption and risk of benign proliferative epithelial disorders (BPED) of the breast (conditions which are thought to have premalignant potential).
Case-cohort study.
The study was undertaken within the 56,537 women in the Canadian National Breast Screening Study (NBSS) who completed self-administered dietary questionnaires. (The NBSS is a randomized controlled trial of screening for breast cancer in women aged 40-59 years at recruitment.)
The study subjects were the 657 women in the dietary cohort who were diagnosed with biopsy-confirmed incident BPED. For comparative purposes, a subcohort consisting of a random sample of 5681 women was selected from the full dietary cohort. After exclusions for various reasons, the analyses were based on 557 cases and 5028 non-cases.
When compared to non-drinkers, rate ratios (95% CI) for those consuming > 0 and 10 and 20 and 30 g day(-1) were 0.35 (0.27-0.45), 0.26 (0.18-0.39), 0.29 (0.18-0.48), and 0.23 (0.13-0.40), respectively (the associated P value for the trend was 0.089). Similar findings were obtained from analyses conducted separately in the screened and control arms of the NBSS, in premenopausal and postmenopausal women, and for non-atypical and atypical forms of BPED, and there was little difference between the results for screen-detected and interval-detected BPED.
Alcohol consumption was associated with a non-dose-dependent reduction in risk of BPED.
Division of Nutritional Epidemiology, Institute for Environmental Medicine, Karolinska Institutet, Box 210, 171 77, Stockholm, Sweden. holly.harris@ki.se
Alcohol intake has consistently been associated with increased breast cancer incidence in epidemiological studies. However, the relation between alcohol and survival after breast cancer diagnosis is less clear.
We investigated whether alcohol intake was associated with survival among 3146 women diagnosed with invasive breast cancer in the Swedish Mammography Cohort. Alcohol consumption was estimated using a food frequency questionnaire. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (95% CIs).
From 1987 to 2008 there were 385 breast cancer-specific deaths and 860 total deaths. No significant association was observed between alcohol intake and breast cancer-specific survival. Women who consumed 10 g per day (corresponding to approximately 0.75 to 1 drinks) or more of alcohol had an adjusted HR (95% CI) of breast cancer-specific death of 1.36 (0.82-2.26;p(trend)=0.47) compared with non-drinkers. A significant inverse association was observed between alcohol and non-breast cancer deaths. Those who consumed 3.4-9.9 g per day of alcohol had a 33% lower risk of death compared with non-drinkers (95% CI 0.50-0.90;p(trend)=0.04).
Our findings suggest that alcohol intake up to approximately one small drink per day does not negatively impact breast cancer-specific survival and a half drink per day is associated with a decreased risk of mortality from other causes.
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