Effect of transition cow health and estrous expression detected by an automated activity monitoring system within 60 days in milk on reproductive performance of lactating Holstein cows.

The objective of this observational study was to evaluate the association of transition cow health and estrous expression, detected by an automated activity monitoring system (Smarttag Neck, Nedap Livestock Management), with reproductive performance in lactating Holstein cows. A total of 3,750 lactating Holstein cows (1,563 primiparous cows and 2,187 multiparous cows) from a commercial dairy farm in Slovakia calving from January 2020 until July 2021 were enrolled on an ongoing basis. Activity data were recorded from d 7 until d 60 postpartum. Within this observational period, cows were classified into 3 categories: (1) no estrus event (Estrus0), (2) 1 estrus event (Estrus1), or (3) 2 or more estrus events (Estrus2+). Transition cow health was assessed by farm personnel within the first 30 d in milk (DIM) using standard operating procedures. Generalized linear mixed models were used to analyze continuous and categorical data. Cox proportional hazard models were used for time to event data. The overall prevalence of anestrus was 20.8%. Multiparous cows had a greater risk for anestrus compared with primiparous cows [odds ratio (OR) = 1.4]. Cows with stillbirth (OR = 1.76), retained placenta (OR = 2.19), puerperal metritis (OR = 1.48), or subclinical ketosis (OR = 1.51) had a greater risk for anestrus. In addition, cows calving in summer (OR = 0.82), autumn (OR = 0.38), or winter (OR = 0.56) had a higher incidence of anestrus than cows calving in spring. Estrous expression from d 7 until d 60 postpartum was associated with estrous duration (DU) and estrous intensity at first artificial insemination (AI). Cows in Estrus0 had the shortest DU at first postpartum AI (9.4 ± 0.18 h) compared with cows in Estrus1 (10.5 ± 0.13 h) and Estrus2+ (11.4 ± 0.12 h). Cows in Estrus2+ had a longer DU at first postpartum AI compared with cows in Estrus1. For Estrus0, Estrus1, and Estrus2+ cows, pregnancy per AI at first service was 42.5%, 50.9%, and 55.4%, respectively. Estrous expression from d 7 until d 60 postpartum was associated with time to first AI and time to pregnancy. Compared with Estrus0 cows, Estrus1 [hazard ratio (HR) = 1.43] and Estrus2+ cows (HR = 1.62) had an increased hazard of being inseminated within 100 DIM. Compared with Estrus2+, Estrus1 cows had a reduced hazard of being inseminated within 100 DIM (HR = 0.89). Compared with Estrus0 cows, Estrus1 (HR = 1.24) and Estrus2+ cows (HR = 1.46) had an increased hazard of becoming pregnant within 200 DIM. Median DIM to pregnancy were 121, 96, and 92 for Estrus0, Estrus1, and Estrus2+ cows, respectively. In conclusion, cows with transition cow disorders (i.e., stillbirth, retained placenta, puerperal metritis, or subclinical ketosis) had a greater chance for anestrus compared with healthy cows. Cows in Estrus0 had reduced estrous expression at first AI and inferior reproductive performance compared with cows that displayed estrous activity from d 7 until d 60.

Retenção de peso pós-parto em mulheres assistidas no serviço público de saúde: estudo de coorte / Retención de peso posparto en mujeres asistidas en el servicio de salud pública: estudio de cohorte / Postpartum weight retention in women assisted in the public health service: cohort study

Objetivo analisar a retenção de peso pós-parto em mulheres assistidas no serviço público de saúde em um município do Sul do Brasil. Método estudo de coorte realizado com 85 puérperas. Dados socioeconômicos, obstétricos, antropométricos, hábitos alimentares, atividade física, amamentação e fatores emocionais foram coletados mediante entrevista em dois momentos: no hospital, no puerpério imediato; e no domicílio, seis meses após o parto. Na análise, utilizou-se estatística descritiva e inferencial. Resultados a incidência da retenção de peso pós-parto maior que 1 kg foi de 54,1%, associada ao ganho de peso gestacional excessivo (68,4%), estado nutricional eutrófico/baixo peso no início da gestação (65,8%) e excesso de peso seis meses pós-parto (61,8%). Mulheres que não amamentaram exclusivamente até seis meses retiveram mais peso. A prevalência de insatisfação corporal foi alta (82,4%). Conclusão os fatores de risco para retenção de peso pós-parto foram estado nutricional eutrófico pré-gestacional e ganho de peso excessivo na gestação

Objetivo analizar la retención de peso posparto en mujeres atendidas en el servicio público de salud en un municipio del sur de Brasil. Método estudio de cohorte realizado con 85 puérperas. Los datos socioeconómicos, obstétricos, antropométricos, hábitos alimenticios, actividad física, lactancia materna y factores emocionales fueron recolectados a través de entrevistas en dos momentos: en el hospital, en el puerperio inmediato; y en casa, seis meses después del parto. En el análisis se utilizó estadística descriptiva e inferencial Resultados la incidencia de retención de peso posparto mayor de 1 kg fue de 54,1%, asociada a aumento excesivo de peso gestacional (68,4%), estado nutricional eutrófico/bajo peso al inicio del embarazo (65,8%) y sobrepeso seis meses postparto (61,8%). Las mujeres que no amamantaron exclusivamente hasta seis meses retuvieron más peso. La prevalencia de insatisfacción corporal fue alta (82,4%). Conclusión los factores de riesgo para la retención de peso posparto fueron el estado nutricional eutrófico pre-gestacional y el aumento de peso excesivo durante el embarazo.

Objective to analyze postpartum weight retention in women assisted in the public health service in a municipality in southern Brazil. Method cohort study conducted with 85 puerperal women. Socioeconomic, obstetric, anthropometric data, eating habits, physical activity, breastfeeding and emotional factors were collected through interviews in two moments: in the hospital, in the immediate puerperium; and at home, six months after delivery. Descriptive and inferential statistics were used in the analysis. Results the incidence of postpartum weight retention greater than 1 kg was 54.1%, associated with excessive gestational weight gain (68.4%), eutrophic nutritional status/low weight at the beginning of pregnancy (65.8%) and overweight six months postpartum (61.8%). Women who did not breastfeed exclusively up to six months retained more weight. The prevalence of body dissatisfaction was high (82.4%). Conclusion the risk factors for postpartum weight retention were pre-gestational eutrophic nutritional status and excessive weight gain during pregnancy.

Pregnancy rest-activity patterns are related to salivary cortisol rhythms and maternal-fetal health indicators in women from a disadvantaged population.

Irregular rest-activity patterns can disrupt metabolic and hormonal physiology and potentially lead to disease. Little is known regarding rest-activity patterns during gestation and their association with hormonal rhythms and health in pregnant women. We conducted a pilot study to determine if 24 h rest-activity was related to saliva cortisol rhythms and maternal-fetal health in an economically disadvantaged population. Primiparous women wore a wrist actigraphy device for a week to record activity during gestational weeks 22 (G22; n = 50) and 32 (G32; n = 46) and postpartum week one (PPW1; n = 39). Participants collected saliva samples every 4 hr over a 24 hr period during G22 (n = 22), G32 (n = 20) and 24-48 hr postnatal (n = 20), and cortisol concentrations were measured with ELISA. Circadian rhythmicity was assessed using autocorrelation coefficient (r24) and cosinor analysis. Blood glucose levels, body mass index (BMI), gestational disease data, and gestational age of infant at birth were abstracted from medical charts. Time of cortisol peak (acrophase) during G22 was related with acrophase of activity (r = 0.66; p = 0.001) and blood glucose levels (r = 0.58; p = 0.006). During G22, minutes of wake after sleep onset was positively related to cortisol mesor and AUC (p <0.05). Rest-activity r24, R2, and mesor during G32 were positively (p<0.05) associated with gestational age of infant at birth. Across all three time points r24 of activity was related with cortisol amplitude (r = 0.33; p = 0.01). Findings support a relationship between rest-activity patterns and saliva cortisol rhythms during pregnancy. The association of less robust activity rhythms with earlier gestational age of infant at birth indicates a potential link between circadian system disruption and maternal-fetal health outcomes.

Systematic review of effectiveness and cost-effectiveness of lifestyle interventions to improve clinical diabetes outcome measures in women with a history of GDM.

OBJECTIVE: Lifestyle interventions have been shown to be both effective and cost-effective in reducing diabetes and metabolic risk in high-risk populations. We systematically reviewed the effectiveness and cost-effectiveness of lifestyle interventions on anthropometric, glycemic and cardiovascular outcomes in women with previous gestational diabetes mellitus (GDM). METHOD: Relevant randomized control trials (RCT) were identified by searching multiple electronic databases through 20th June 2018. Data were pooled using random-effects models. The review protocol was registered on the PROSPERO international prospective register of systematic reviews (PROSPERO 2016: CRD42018108870). RESULTS: Twenty-one studies met the inclusion criteria and 16 studies with outcome data were analyzed in the meta-analysis. No RCT studies included cost-effectiveness data on lifestyle interventions. The pooled estimate for postpartum weight showed a significant mean reduction in the intervention arm (-1.8 kg [95% CI: -2.9, -0.6; p = 0.002; I2 = 92.2%; p < 0.05]). Further, the effect of lifestyle intervention on weight change was significantly greater in studies of longer duration. Most of the other endpoints had modest improvements but only anthropometric endpoints were statistically significant. However, there was high heterogeneity between the studies. CONCLUSIONS: Lifestyle interventions showed statistically and clinically significant improvements in anthropometric outcomes. However, more research is needed to explore lifestyle effects on glycemic and cardiovascular risk factors and to establish cost-effectiveness. Methodologically sound, large scale studies on diverse ethnicities and with longer follow-up would establish the real effect of lifestyle interventions to reduce diabetes risk in women with previous GDM.

Effect of rumen-protected branched-chain amino acid supplementation on production- and energy-related metabolites during the first 35 days in milk in Holstein dairy cows.

Essential AA are critical for multiple physiological processes. Branched-chain AA (BCAA) supplementation has beneficial effects on body weight, lipogenesis, and insulin resistance in several species. The BCAA are used for milk and body protein synthesis as well as being oxidized by the tricarboxylic acid cycle to produce ATP during catabolic states. The objective was to evaluate the effect of rumen-protected BCAA (375 g of 27% l-Leu, 85 g of 48% l-Ile, and 91 g of 67% l-Val) with or without propylene glycol (PG) oral administration on milk production, dry matter intake, nonesterified fatty acids, ß-hydroxybutyrate, and plasma urea nitrogen during the first 35 d in milk (DIM) in dairy cattle. Multiparous Holstein cows were enrolled in blocks of three 28 d before expected calving and assigned randomly to either the control or 1 of 2 treatments. The control (n = 26) received 200 g/d of dry molasses, the BCAA treatment (n = 23) received BCAA mixed with 200 g/d of dry molasses from calving until 35 DIM, and the BCAA plus PG (BCAAPG) treatment (n = 25) received BCAA mixed with 200 g/d of dry molasses from calving until 35 DIM plus 300 mL of PG once daily from calving until 7 DIM. Postpartum, dry matter intake least squares means (LSM; 95% confidence interval) were 20.7 (19.9, 21.7), 21.3 (20.4, 22.3), and 21.9 (20.9, 22.8) kg for control, BCAA, and BCAAPG, respectively. Milk yield (1-35 DIM) LSM were 41.7 (39.4, 44.0), 42.7 (40.3, 45.0), and 43.7 (41.4, 46.0) kg for control, BCAA, and BCAAPG, respectively. Energy-corrected milk LSM were 50.3 (46.8, 53.7), 52.4 (48.9, 55.8), and 52.9 (49.5, 56.4) kg for control, BCAA, and BCAAPG, respectively. Milk urea nitrogen LSM in milk for control, BCAA, and BCAAPG were 8.60 (8.02, 9.22), 9.70 (9.01, 10.45), and 9.75 (9.08, 10.47) mg/dL. Plasma urea nitrogen concentrations LSM for control, BCAA, and BCAAPG were 8.3 (7.7, 8.9), 10.1 (9.4, 10.9), and 9.6 (9.4, 10.3) mg/dL, respectively. The numbers of plasma samples classified as hyperketonemia were 77, 44, and 57 in control, BCAA, and BCAAPG, respectively. The BCAA supplementation increased plasma urea nitrogen and milk urea nitrogen, free valine concentration in plasma, and decreased hyperketonemia events during the postpartum period.

The use of whole body calorimetry to compare measured versus predicted energy expenditure in postpartum women.

BACKGROUND: Accurate assessment of energy expenditure may support weight-management recommendations. Measuring energy expenditure for each postpartum woman is unfeasible; therefore, accurate predictive equations are needed. OBJECTIVES: This study compared measured with predicted resting energy expenditure (REE) and total energy expenditure (TEE) in postpartum women. METHODS: This was a longitudinal observational study. REE was measured at 3 mo postpartum (n = 52) and 9 mo postpartum (n = 49), whereas TEE was measured once at 9 mo postpartum (n = 43) by whole body calorimetry (WBC). Measured REE (REEWBC) was compared with 17 predictive equations; measured TEE plus breast milk energy output (ERWBC) was compared with the estimated energy requirements/Dietary Reference Intakes equation (EERDRI). Fat and fat-free mass were measured by dual-energy X-ray absorptiometry. Group-level agreement was assessed by the Pearson correlation, paired t test, and Bland-Altman (bias) analyses. Individual-level accuracy was assessed with the use of Bland-Altman limits of agreement, and by the percentage of women with predicted energy expenditure within 10% of measured values ("accuracy"). RESULTS: The cohort was primarily Caucasian (90%). At a group level, the best equation predicting REEWBC was the DRI at 3 mo postpartum (-7 kcal, -0.1%; absolute and percentage bias, respectively), and the Harris-Benedict at 9 mo postpartum (-17 kcal, -0.5%). At an individual level, the Food and Agriculture Organization/World Health Organization/United Nations University (FAO/WHO/UNU) height and weight equation was the most accurate at 3 mo postpartum (100% accuracy) and 9 mo postpartum (98% accuracy), with the smallest limits of agreement. Equations including body composition variables were not more accurate. Compared with ERWBC, EERDRI bias was -36 kcal, with inaccurate predictions in 33% of women. CONCLUSIONS: Many REE predictive equations were accurate for group assessment, with the FAO/WHO/UNU height and weight equation having the highest accuracy for individuals. EERDRI performed well at a group level, but inaccurately for 33% of women. A greater understanding of the physiology driving energy expenditure in the postpartum period is needed to better predict TEE and ultimately guide effective weight-management recommendations.

Postpartum assessment of the beta cell function and insulin resistance for Chinese women with previous gestational diabetes mellitus.

Gestational diabetes mellitus (GDM) imparts a high risk of developing postpartum diabetes and is considered to be an early stage of type 2 diabetes mellitus (T2DM). In this study, a 75-g oral glucose tolerance test was performed on 472 women with GDM at 6-8 weeks after delivery. The clinical and metabolic characteristics were compared between the patients with normal glucose tolerance (NGT) and abnormal glucose metabolism (AGM). These data were then compared between pre-diabetic and diabetic patients. A total of 37.7% of the women with GDM continued to have abnormal glucose levels after delivery. Compared with the women who reverted to normal, HOMA-IR was significantly higher in AGM. A multiple stepwise regression analysis revealed that age, the postpartum body mass index (BMI), low density lipoprotein-cholesterol (LDL-C), 2 h glucose load plasma glucose (2 h PG), triglycerides (TG), hemoglobin A1c (HbA1c), 1 h glucose load plasma insulin (INS) level, and 2 h INS level were independent risk factors for the development of insulin resistance after delivery. This study has identified a high prevalence of AGM after GDM. Insulin resistance appears to be the major contributor. Any treatment to reduce the postpartum BMI and lipids level may be beneficial to decrease insulin resistance.

An assessment of hair cortisol among postpartum Brazilian mothers and infants from a high-risk community in São Paulo: Intra-individual stability and association in mother-infant dyads.

This study examined maternal-infant synchrony of hair cortisol at 12 months after birth and the intra-individual stability of maternal hair cortisol in the postpartum period. Participants were selected from an ongoing São Paulo birth cohort project, where families are considered to be "high-risk" due to their chronic stress experiences, with the majority living in slums (favelas). Cortisol was collected through 3-cm segments of hair samples, with values representing approximate levels of cortisol from 9 to 12 months for mothers and children and 6 to 12 months for mothers. Maternal and infant cortisol values reflecting chronic stress 9-12 months after birth were highly correlated (r = .61, p < .001); earlier maternal cortisol levels (6-9 months) and child cortisol levels at 9-12 months (r = .51, p < .001) were also correlated. Maternal cortisol values showed stability over time (r = .79, p < .001). These maternal-infant correlations are high compared to the existing literature on hair cortisol in other mother-child dyads, suggesting stronger synchrony under high-risk contexts where families are faced with challenging circumstances.

Intra-Individual Consistency in Endocrine Profiles Across Successive Pregnancies.

CONTEXT: It is yet unknown how similar women's hormone levels are during successive pregnancies, and very little is known about the degree to which siblings experience similar prenatal environments. Given the importance of understanding how women's reproductive life histories exert cumulative effects on health via hormone exposure, and the importance of understanding how fetal programming via endocrine signaling affects sibling trait concordance, here, we address this important lacuna in the literature. OBJECTIVE: This study aimed to investigate how consistent women's hormone profiles are across two successive pregnancies. DESIGN AND MAIN OUTCOME MEASURES: This longitudinal, prospective study followed a cohort of 28 women across two pregnancies (PREG 1 and PREG 2). Women's circulating hormone levels were assessed from blood samples at 25, 31, and 37 weeks' gestation for adrenocorticotropic hormone (ACTH), placental corticotropin-releasing hormone (pCRH), cortisol, estradiol, and progesterone. ACTH and cortisol levels were assessed 3 months postpartum. Research questions include: Are hormone levels in PREG 2 significantly different from levels in PREG 1? What proportion of variance in PREG 2 hormone levels is attributable to variance in PREG 1 levels? Are hormone levels more stable between PREG 1 and PREG 2 compared with postpartum phases following these pregnancies? Is pCRH, which is completely placentally derived, less similar than other hormones across successive pregnancies? PARTICIPANTS AND SETTING: Pregnant women attended study visits at a university psychobiology laboratory in Southern California. RESULTS AND CONCLUSIONS: Comparisons of hormone concentrations across women's successive pregnancies via paired t test revealed substantial consistency from one pregnancy to another, with only significant differences between pregnancies for pCRH. Regressions revealed substantial predictability from one pregnancy to another, with between 17-56% of PREG 2 variances accounted for by PREG 1 values. Women exhibited lower degrees of consistency and predictability in hormone levels across postpartum phases compared with gestational concentrations. This is the first study to describe maternal and placental hormone levels across successive pregnancies.

Effects of dry period length on milk production, body condition, metabolites, and hepatic glucose metabolism in dairy cows.

Dry period (DP) length affects energy metabolism around calving in dairy cows as well as milk production in the subsequent lactation. The aim of the study was to investigate milk production, body condition, metabolic adaptation, and hepatic gene expression of gluconeogenic enzymes in Holstein cows (>10,000 kg milk/305 d) with 28- (n=18), 56- (n=18), and 90-d DP (n=22) length (treatment groups) in a commercial farm. Cows were fed total mixed rations ad libitum adjusted for far-off (not for 28-d DP) and close-up DP and lactation. Milk yield was recorded daily and body condition score (BCS), back fat thickness (BFT), and body weight (BW) were determined at dry off, 1 wk before expected and after calving, and on wk 2, 4, and 8 postpartum (pp). Blood samples were taken on d -56, -28, -7, 1, 7, 14, 28, and 56 relative to calving to measure plasma concentrations of metabolites and hormones. Liver biopsies (n=11 per treatment) were taken on d -10 and 10 relative to calving to determine glycogen and total liver fat concentration (LFC) and to quantify mRNA levels of pyruvate carboxylase (PC), cytosolic phosphoenolpyruvate carboxykinase, and glucose-6-phosphatase. Time course of milk yield during first 8 wk in lactation differed among treatment. Milk protein content was higher in 28-d than in 90-d DP cows. Milk fat to protein ratio was highest and milk urea was lowest in 90-d DP cows. Differences in BW, BFT, and BCS were predominantly seen before calving with greatest BW, BFT, and BCS in 90-d DP cows. Plasma concentrations of NEFA and BHBA were elevated during the transition period in all cows, and the greatest increase pp was seen in 90-d DP cows. Plasma glucose concentration decreased around calving and was greater in 28-d than in 90-d DP cows. Dry period length also affected plasma concentrations of urea, cholesterol, aspartate transaminase, and glutamate dehydrogenase. Plasma insulin concentration decreased around calving in all cows, but insulin concentration pp was greater in 28-d than in 56-d DP cows. Hepatic glycogen concentration decreased and LFC increased after calving in all cows, and LFC was greater pp in 90-d DP than in 28-d DP cows. Hepatic PC mRNA abundance pp tended to increase most in 90-d DP cows. Changes on glucose metabolism were more balanced in cows with a reduced DP, whereas cows with extended DP and elevated body condition indicated greatest metabolic changes according to lipid and glucose metabolism during the transition period.

Zinc in plasma and breast milk in adolescents and adults in pregnancy and pospartum: a cohort study in Uruguay.

OBJECTIVE: To assess if age is a risk factor for low zinc nutritional status in pregnancy, postpartum and in breast milk concentration, and the association between mother zinc plasma level with zinc milk concentration. DESIGN: Cohort study comparing adolescents with adult women, with < 14 weeks of gestation at first prenatal care. Socio demographic and plasma zinc data were collected at that moment and at postpartum time (4 + 1 month). Milk zinc concentrations were also measured at 4 th month postpartum. SETTING: Women were recruited from 16 public primary health care services in Uruguay Subjects: 151 adolescents and 161 adult women. RESULTS: Adolescent average plasma zinc at < 14 weeks of gestation was 84.4 ± 3.6 ug /dl and did not differ significantly from that for adult women (85.2 ± 13.6 ug/dl). Prevalence of hypozincemia was relatively low with but with no difference by age (14.6% in adolescents and 12.3% in adults). Zinc concentrations in breast milk were similar for adolescents, 1.24 mg. /L (CI 1.06 to 1.44) and adult women, 1.27 mg./L (CI .1.0-1.46). There was no correlation between plasma zinc and breast milk zinc concentrations in adults and a weak correlation in adolescents (- 0.27, P <0.05). CONCLUSIONS: Prevalence of hypozincemia in pregnancy was relatively low but similar in adolescents and adult women. Neither pregnancy nor age had negative consequences over postpartum plasma zinc, nor over breast milk zinc concentrations. No correlation was found between mother s plasma zinc and breast milk levels.

Objetivo: Evaluar la edad como factor de riego para el déficit nutricional de zinc en el embarazo y en el posparto y la correlación entre la concentración de zinc plasmático y de la leche materna. Diseño: Estudio de cohorte de 151 embarazadas adolescentes y 161 adultas con < 14 semanas de gestación al primer control prenatal, seleccionadas en 16 centros públicos de salud de primer nivel de atención de Uruguay. Se obtuvieron datos socio demográficos y se determinó zinc plasmático al primer control prenatal y 4 meses posparto (± 1 mes). En el último control se midió también la concentración de zinc en la leche materna. Resultados: La media de concentración de zinc plasmático a las 14 semanas de gestación fue 84.4 ± 3.6 ug. /dl sin diferencias significativas con las adultas (85.2 ± 13.6 ug/dl). La prevalencia de hipozincemia fue relativamente baja, sin diferencias entre los grupos (14.6% en adolescentes y 12.3% en adultas). La concentración de zinc en la leche materna fue similar en adolescentes y adultas (1.2 CI 1.1-1.4 mg. /L en el grupo total). No se encontró correlación entre el nivel plasmático de zinc materno y la concentración en la leche en adultas y una débil correlación en el grupo de adolescentes (-0.27, P <0.05). Conclusión: La prevalencia de hipozincemia en el embarazo es relativamente baja y similar entre adultas y adolescentes. No se observó relación entre la edad materna y los niveles plasmáticos de zinc post parto en la madre ni en la leche materna. La concentración de zinc plasmático materno no se correlacionó con el zinc en la leche materna.

Assessment of phytochemical content in human milk during different stages of lactation.

OBJECTIVE: The present study reports the presence of several carotenoids and flavonoids in human milk samples. METHODS: Samples were collected from 17 women who delivered healthy term babies (≥ 37 wk of gestation) at 1-, 4-, and 13-wk postpartum intervals. RESULTS: Epicatechin (63.7-828.5 nmol/L), epicatechin gallate (55.7-645.6 nmol/L), epigallocatechin gallate (215.1-2364.7 nmol/L), naringenin (64.1-722.0 nmol/L), kaempferol (7.8-71.4 nmol/L), hesperetin (74.8-1603.1 nmol/L), and quercetin (32.5-108.6 nmol/L) were present in human milk samples with high inter-/intraindividual variability. With the exception of kaempferol, the mean flavonoid content in human milk was not statistically different among lactation stages. In contrast, carotenoids α-carotene (59.0-23.2 nmol/L), ß-carotene (164.3-88.0 nmol/L), α-cryptoxanthin (30.6-13.5 nmol/L), ß-cryptoxanthin (57.4-24.8 nmol/L), zeaxanthin (46.3-21.4 nmol/L), lutein (121.2-56.4 nmol/L), and lycopene (119.9-49.5 nmol/L) significantly decreased from weeks 1 to 13 of lactation. CONCLUSION: The observed differences in the relative concentrations of the two phytochemical classes in human milk may be a result of several factors, including dietary exposure, stability in the milk matrix, efficiency of absorption/metabolism, and transfer from plasma to human milk. These data support the notion that flavonoids, as with carotenoids, are dietary phytochemicals present in human milk and potentially available to breast-fed infants.

Pregnancy-related changes in activity energy expenditure and resting metabolic rate in Switzerland.

BACKGROUND/OBJECTIVES: To measure resting metabolic rate (RMR), activity energy expenditure (AEE), total energy expenditure (TEE) and physical activity pattern, that is, duration and intensity (in metabolic equivalents, METs) of activities performed in late pregnancy compared with postpartum in healthy, well-nourished women living in Switzerland. SUBJECTS/METHODS: Weight, height, RMR, AEE, TEE and physical activity patterns were measured longitudinally in 27 healthy women aged 23-40 years at 38.2+/-1.5 weeks of gestation and 40.0+/-7.2 weeks postpartum. RESULTS: The RMR during late pregnancy was 7480 kJ per day, that is, 1320+/-760 kJ per day (21.4%) higher than the postpartum RMR (P<0.001). Absolute changes in RMR were positively correlated with the corresponding changes in body weight (r=0.61, P<0.001). RMR per kg body weight was similar in late pregnancy vs postpartum (P=0.28). AEE per kg during pregnancy and postpartum was 40+/-13 and 50+/-20 kJ/kg, respectively (P=0.001). There were significant differences in daily time spent at METs<1.5 (1067 vs 998 min, P=0.045), at 2.5< or =METs <3.0 (58 vs 82 min, P=0.002) and METs> or =6 (1 vs 6 min, P=0.014) during pregnancy and postpartum, respectively. CONCLUSIONS: Energy expenditure in healthy women living in Switzerland increases in pregnancy compared with the postpartum state. Additional energy expenditure is primarily attributed to an increase in RMR, which is partly compensated by a decrease in AEE. The decrease in physical activity-related energy costs is achieved by selecting less demanding activities and should be taken into account when defining extra energy requirements for late pregnancy in Switzerland.

Risk assessment of postpartum uterine disease and consequences of puerperal metritis for subsequent metabolic status, reproduction and milk yield in dairy cows.

The objective of this study was to determine some metabolic and other factors predicting the risk of postpartum uterine disease (PUD), and the effects of puerperal metritis (PM) on metabolic status, reproduction and milk yield were analysed. A total of 105 Holstein-Friesian cows were included, and sampled on day < -14 prepartum and days 4, 10-14, 28-35 and 56-63 postpartum for metabolic tests. From day 4 the development of PUD, and from days 28-35 the ovarian activity was monitored. When grade > or = 1 + ketonuria was present on day 4 postpartum, this indicated a higher probability of PUD [odds ratio (OR) 2.64; P < 0.05] including PM occurring on days 10-14 (OR: 2.65; P < 0.05). Plasma nonesterified fatty acid (NEFA) concentrations > 0.200 mmol/l on days < -14 prepartum indicated a higher risk of uterine diseases (OR: 3.44; P < 0.05). The odds of PUD increased, depending on whether a body condition score (BCS) loss of > or = 1.0 occurred between days < -14 and 28-35 (OR: 2.82; P < 0.05), between days < -14 and 10-14 (OR: 4.79; P < 0.01) or between days 10-14 and 28-35 (OR: 10.81; P < 0.01). PM was more probable (OR: 27.3; P < 0.001) in cows with retained placenta. The risk of uterine diseases was lower in multiparous than in primiparous cows (OR: 0.29; P < 0.01). PM increased the risk of ovarian inactivity between days 28 and 35 (OR: 2.83; P < 0.05). Cows affected with PM (PM+ cows) showed lower milk production on day 4 (kg; P < 0.05) and lower milk production (P < 0.05), milk fat and milk protein production (kg; P < 0.01; P < 0.01) in the first 100 days of lactation than did PM-cows.

Diurnal salivary cortisol levels in postpartum mothers as a function of infant feeding choice and parity.

Daily stress and sleep deprivation can influence the diurnal pattern of cortisol, which normally consists of high morning levels and a gradual decline throughout the day. While most individuals have consistent declining cortisol concentrations over days, others display either flat or inconsistent profiles. Postpartum mothers experience considerable home demands and sleep deprivation, yet, breastfeeding mothers perceive lower stress and reduced negative mood states compared to bottlefeeders. On the other hand, multiparity (having more than one child) is associated with reduced steepness in diurnal cortisol decline. Interestingly, no study to date has investigated the diurnal cortisol pattern and its stability across days in postpartum women as a function of their choice of infant feeding and parity. In this study, we measured salivary cortisol at four different time points during the day, on two non-consecutive days in first-time (primiparous) and second-time (multiparous) mothers at 5-20 weeks postpartum who were exclusively breastfeeding or bottlefeeding, and in non-postpartum mothers of young children (1-6 years). Among multiparous mothers, we found that cortisol levels in those who were bottlefeeding were higher than in breastfeeding mothers at both awakening and 1600 h. This effect remained significant after controlling for individual differences related to infant feeding choice, such as estradiol levels, education and income. No effect of infant feeding choice on cortisol concentrations was observed in primiparous mothers. While a consistent decline across days was common, some mothers presented a flat or inconsistent profile, a profile that was not associated with infant feeding choice or parity. Importantly, mothers with consistent declining profiles had the highest household income. Our findings suggest that although breastfeeding might promote a tighter regulation of diurnal basal cortisol secretion, in particular for multiparous mothers who are likely to be exposed to greater home demands and maternal responsibilities, some aspects of socioeconomic status such as income can also play a significant role in the stability of diurnal cortisol secretion across days.

Assessment of early postpartum reproductive performance in two high producing Estonian dairy herds.

Early postpartum (6 weeks) ovarian activity, hormonal profiles, uterine involution, uterine infections, serum electrolytes, glucose, milk acetoacetate and blood urea nitrogen (BUN) levels were studied in 2 Estonian high producing dairy herd with annual milk production of 7688 (Farm A) and 9425 (Farm B). From each farm 10 cows, with normal calving performance were used. Blood samples for the hormonal (PGF2alpha-metabolite, progesterone) analyses were withdrawn. On day 25 PP blood serum samples were taken for the evaluation of metabolic/electrolyte status. On the same day estimation of milk acetoacetate values was done. The ultrasound (US) was started on day 7 PP and was performed every 3rd day until the end of experiment. Uterine content, follicular activity and sizes of the largest follicle and corpus luteum were monitored and measured. Vaginal discharge and uterine tone were recorded during the rectal palpation. Each animal in the study was sampled for bacteriological examination using endometrial biopsies once a week. Two types of PGF2alpha-metabolite patterns were detected: elevated levels during 14 days PP, then decline to the basal level and then a second small elevation at the time of final elimination of the bacteria from the uterus: or elevated levels during first 7 days PP, then decline to the basal level and a second small elevation before the final elimination of bacteria. Endometritis was diagnosed in 5 cows in farm A and in 3 cows in farm B respectively. In farm A, 5 cows out of 10 ovulated during experimental period and in 1 cow cystic ovaries were found. In farm B, 3 cows out of 10 ovulated. In 3 cows cystic ovaries were found. Altogether 40% of cows had their first ovulation during the experimental period. Three cows in farm A and 5 cows in farm B were totally bacteria negative during the experimental period. The most frequent bacteria found were A. pyogenes, Streptococcus spp., E. coli., F. necrophorum and Bacteroides spp. The highest incidence of bacteriological species was found during the first 3 weeks in both farms. All animals were free from bacteria after 5th week PP in farm A and after 4th week in farm B respectively. Serum electrolytes and glucose levels were found to be within the reference limits for the cows in both farms. No significant difference was found between farms (p > 0.05). Low phosphorus levels were found in both farms. Significant difference (p < 0.05) was found in BUN levels between farms. In both farms milk acetoacetate values were staying within the reference range given for the used test (< 100 micromol/l). The uterine involution and bacterial elimination in the investigated cows could consider as normal but more profound metabolic studies could be needed to find reasons for later resumption of ovarian activity. Some recommendations to changing feeding regimes and strategies should also be given.

Changes in energy expenditure, anthropometry, and energy intake during the course of pregnancy and lactation in well-nourished Indian women.

Basal metabolic rate (BMR), thermic effect of a meal (TEM), anthropometry, and dietary intakes were measured in 18 control subjects; 18 pregnant women at 12, 24, and 34 wk gestation; and in 17 of these women at 12 and 24 wk postpartum, to uncover any metabolic economy associated with either pregnancy or lactation. Results indicated that the BMR and TEM were not associated with any energy saving either during pregnancy or lactation. Mean weight gain from 12 wk gestation to term was 11.4 +/- 3.7 kg; mean birth weight of the infants was 3.06 +/- 0.41 kg. Estimated gain in adipose tissue and fat mass were 3.1 +/- 3.6 and 2.5 +/- 2.9 kg, respectively. Energy cost of pregnancy was estimated to be 303 +/- 171 MJ. The cumulative increase in energy intake over the last two trimesters of pregnancy was 290 +/- 280 MJ, meeting a large part of the total estimated cost of pregnancy. Weight gained by infants who were exclusively breast-fed from birth to 12 wk of age was used as a proxy indicator of adequate lactational performance. The extra energy required during lactation appeared to have been met largely by increases in energy intake, rather than by any metabolic economy or increase in fat mobilization.

PIP: Researchers compared data on 18 nonpregnant, nonlactating staff and students (controls) with data on 18 pregnant women at 12, 24, and 34 weeks gestation and on 17 of these women at 12 and 24 weeks postpartum to determine any changes in maternal energy metabolism during pregnancy and lactation. All controls and cases were healthy and recruited at St. John's Medical College and Hospital in Bangalore, India. They had unlimited access to food. Mean birth weight stood at 3.06 kg. Pregnant women gained, on average, 11.4 kg between 12 weeks gestation and term. They also gained 3.1 kg of adipose tissue and 2.5 kg in fat mass during the same period. The total energy cost of pregnancy was 303 MJ. Pregnant women experienced a cumulative increase in energy intake over the last trimesters of pregnancy of 290 MJ, satisfying a considerable part of the total estimated cost of pregnancy. Neither the basal metabolic rate nor the thermic effect of a meal were related to any energy saving during pregnancy or lactation. Energy intake was significantly higher than that of controls at 24 and 34 weeks gestation (9.01 and 9.33 vs 7.58 MJ/d) and at 12 and 24 weeks postpartum (9.6 and 9.09 vs. 7.58 MJ/d) (p 0.05). The proxy indicator of adequate lactational performance was weight gain of infant between birth and 12 weeks. At 12 weeks, the body weights were similar to the 50th percentile of the NCHS weight-for-age. These findings suggest that increases in energy intake met the need for extra energy needed during lactation and that metabolic economy and increase in fat mobilization did not occur.

Energy cost of physical activity throughout pregnancy and the first year postpartum in Dutch women with sedentary lifestyles.

Basal metabolic rate (BMR), activity pattern, and energy costs of some daily activities were measured in 25 Dutch women throughout pregnancy and the first year postpartum. Physical activity index (PAI), which refers to daily energy expenditure expressed as a multiple of BMR, was calculated from activity-pattern data and activity costs. Mean PAIs (+/- SD) throughout pregnancy, during the first 6 mo postpartum, and at 1 y postpartum were 1.48 +/- 0.08, 1.49 +/- 0.07, and 1.53 +/- 0.10 X BMR, respectively. Because measured BMR at 1 y postpartum was 1440 +/- 168 kcal/d, costs for physical activity in pregnancy and the first 6 mo postpartum were, respectively, approximately 70 and approximately 50 kcal/d lower than at 1 y postpartum. For women with sedentary lifestyles the energy saved during pregnancy and lactation because of decreased physical activity and decreased costs of activities will be limited.

Body fat mass and basal metabolic rate in Dutch women before, during, and after pregnancy: a reappraisal of energy cost of pregnancy.

Body weight, fat mass, and basal metabolic rate were measured longitudinally from early pregnancy until 2 mo postpartum in 57 healthy Dutch women; 23 of whom were also studied before pregnancy. Weight gain over pregnancy was 11.8 +/- 3.7 kg and weight gain from 12 wk gestation to delivery was 10.3 +/- 3.8 kg. Birth weights and placental weights were 3458 +/- 527 and 657 +/- 114 g, respectively. Gain in maternal fat stores over pregnancy was 2.0 +/- 2.6 kg and difference in fat mass from 12 wk gestation to 5 wk postpartum was 1.2 +/- 2.2 kg. The energy equivalent of the gain in fat stores, including costs of synthesizing, can be estimated as 22,000 kcal. The cumulative increment in basal metabolism over pregnancy was 34,350 +/- 30,000 kcal. When the energy equivalent of the gain in tissue other than fat stores is assumed to be approximately 11,750 kcal, total energy cost of pregnancy is at 68,100 +/- 38,560 kcal.