Weight management in postpartum women - An Indian perspective.

BACKGROUND AND AIMS: This narrative review is intended to present an evidence and opinion-based weight management module for Indian postpartum women to be used by clinicians. MATERIAL AND METHODS: Electronic databases such as PubMed and Google Scholar were accessed to extract relevant studies to derive evidence-based information. The reference list of the extracted studies was also checked to obtain further relevant articles. The opinion-based information was achieved from the consensus among the gynaecologists, nutritionists and doctors from Medicine according to their practical experiences in real time. In this review, we have used the term "postpartum" to represent the time period of two years after delivery. RESULTS: A postpartum weight management module consisting of information about diet, physical activity, sleep and breastfeeding was devised to be used in regular clinical practice, particularly in the Indian settings. CONCLUSION: Postpartum women deal with various unique challenges as compared to other population groups. Individualised weight management strategies should be adopted to facilitate sustainable postpartum weight management.

Lifestyle Intervention Framework for Obese Patients with Non-alcoholic Fatty Liver Disease - a Tool for Health Professionals in Resource Constraint Settings.

Purpose Non-alcoholic fatty liver disease (NAFLD), is recognized as a health care burden worldwide. Lifestyle modification remains the first line of treatment. However, the real challenge is ensuring the patient's adherence to lifestyle modification measures, especially in hospitals with resource-limited settings. Methods We developed a six-month-long, dietitian-led, hospital-based, lifestyle intervention framework for obese NAFLD patients and evaluated its content. Literature review, interviews, and discussions with 10 health experts (general physicians, dietitians/nutritionists, gastroenterologists, and a clinical psychologist) and 45 NAFLD patients (35 in Phase I and 10 in Phase II) in a tertiary hospital of India were carried out. Results The lifestyle intervention framework has unique features, such as an intensive nature to ensure adherence, a comprehensive educational format with clear guidelines, the customization of a prescription as per individual patient requirements, and a holistic approach to inculcate self-monitoring and behavioral change in NAFLD patients. Conclusion Health professionals worldwide can use this lifestyle intervention framework to develop counseling interventions for better adherence among obese NAFLD patients.

Dietary nutrients and insulin resistance in urban Asian Indian adolescents and young adults.

BACKGROUND: Asian Indians have a high prevalence of insulin resistance that may underlie their higher tendency to develop type 2 diabetes mellitus and early-onset atherosclerosis. OBJECTIVE: To investigate the relationship between dietary nutrients and insulin resistance in Asian Indian adolescents and young adults. DESIGN: Dietary nutrient intake values (24-hour dietary recall and monthly consumption data) and fasting serum insulin levels were studied in 352 (311 males and 41 females) healthy adolescents and young adults (mean age 18.0 +/- 2.3 years; range 14-25 years). Bivariate and multivariate logistic regression analyses were performed with hyperinsulinemia as the outcome variable and various dietary nutrients and anthropometric variables as covariates. RESULTS: Mean fasting serum insulin levels were 107.4 +/- 35.0 pmol/l (36.5-230.4 pmol/l). The intake of polyunsaturated fatty acids (PUFAs) was higher, saturated fat and the omega-6 to omega-3 PUFA ratio were in the upper limit, and omega-3 PUFAs (% caloric intake, En) were lower than the recommended dietary allowance for Asian Indians. The PUFAs (% En), BMI, percent body fat and waist circumference were significantly higher in the hyperinsulinemic group compared with the normoinsulinemic group (p = 0.021, 0.0021, 0.0006, and 0.0041, respectively). Multiple regression analysis showed that the lowest tertile of omega-6 (< 3% En) PUFA intake [adjusted OR (95% CI) = 0.3 (0.1-0.7)] and BMI [adjusted OR (95% CI) = 2.9 (1.4-6.0)] were the significant independent predictors of fasting hyperinsulinemia. CONCLUSION: For prevention and amelioration of insulin resistance in Asian Indian adolescents and young adults, it is prudent to have normal BMI and low intake of omega-6 PUFAs.