Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial.

OBJECTIVE: To examine the effect of an exercise and dietary intervention during pregnancy on excessive gestational weight gain (EGWG), dietary habit and physical activity in pregnant women. DESIGN: Randomised controlled trial. SETTING: Community-based study. POPULATION: Nondiabetic urban-living pregnant women (<26 weeks of gestation). METHODS: Participants in the intervention group were provided with community-based group exercise sessions, instructed home exercise and dietary counselling between 20 and 36 weeks of gestation. Participants in both groups received physical activity and food intake surveys at enrolment and 2 months after the enrolment. MAIN OUTCOME MEASURES: Prevalence of EGWG and measures of physical activity and food intakes between the two groups. RESULTS: A total of 190 pregnant women, 88 in the control group and 102 in the intervention group, completed the study. Decreased daily intakes of calorie, fat, saturated fat and cholesterol were detected in participants in the intervention group at 2 months after enrolment compared with the control group (P<0.01). Participants in the intervention group had higher physical activity 2 months after enrolment compared with the control group (P<0.01). The lifestyle intervention during pregnancy reduced the prevalence of EGWG in the intervention group compared with the control group (P<0.01) according to the guidelines of the Institute of Medicine. CONCLUSION: The findings suggest that lifestyle intervention during pregnancy increased physical activity, improved dietary habits and reduced EGWG in urban-living pregnant women.

Socio-demographic and geographic analysis of overweight and obesity in Canadian adults using the Canadian Community Health Survey (2005).

Using the 2005 Canadian Community Health Survey, this study examined how overweight and obesity in Canadian adults are distributed across socio-demographic and geographic groupings. Overweight and obesity prevalence were modeled against socio-demographic indicators using Poisson regression and were assessed geographically using choropleth maps. The Gini coefficient was used to assess the distribution of prevalence across risk groups. The potential impacts of high risk versus population-based prevention approaches on the population prevalence of obesity were also examined. Of adults aged 25 to 64 years, 17% were obese and 53% were overweight or obese, with the highest proportions observed in older age groups, among those who were physically inactive, white or non-immigrant, with low educational levels, and living in the prairie and east coast regions. Recalculation of obesity rates under the different prevention scenarios demonstrated that population-based approaches could achieve a four-fold greater decrease in obesity cases than high risk approaches, highlighting the need for broader population strategies for obesity prevention in Canada.

The Manitoba Nutrition Survey: fat consumption data.

A nutrition survey was conducted as part of a larger cardiovascular risk study undertaken by the Manitoba Heart Health Project. A representative group of Manitobans participated in the study, 68% of whom reported their food intake using a food frequency questionnaire. After verifying and merging data from the nutrition and risk factor questionnaires used in the survey, 2,115 were used in data analysis. Results are reported by gender for three age groups. The proportion of food energy derived from total fat varied between 35.3% for senior females and 40.2% for young males. Food of seniors contained a lower proportion of energy from fat than that of either of the two younger age groups. In all three age groups, men consumed diets with a higher proportion of fat than did women. People in regional centres and rural areas obtained higher proportions of energy from fat than did people in Winnipeg. Fat intake from butter, margarine or spreads eaten with bread and potatoes was high compared to the intake from other foods.

Nutrition related resource use in urban areas.

Current social organization of cities is unable to respond to increases in the population fast enough to ensure adequate physical and social functioning of all inhabitants. New social structures in the organization of cities is changing the situation of disadvantaged and malnourished people by changing their access to resources. Resources include a number of non-economic ones that can contribute to improve health and nutritional status. The use of these resources depends on individual choices by people. The nature of basic needs predisposes these choices to include ones that are economically irrational and an inefficient use of resources from economic standpoints. The combination of restricted access to resources and inherent inefficiencies in their use determine the health and nutritional situation of people. Indicators of change in the number of choices and the elasticities of benefits associated with them would recognise both the non-competitive and the market aspects of the new urban social organization. Indicators of the number and type of choices available to people, associated with the nutritional and health benefits derived from those choices may be tools for use in urban planning to support new initiatives for groups in fast growing areas where malnutrition is prevalent.

Determinants of plasma glucose level and diabetic status in a northern Canadian Indian population.

We conducted a cross-sectional survey of 704 Indians aged 20 to 64 years in six remote communities in northern Ontario and Manitoba to determine the factors associated with the fasting plasma glucose and glycosylated hemoglobin levels and diabetic status, defined by past history and current fasting plasma glucose level. Multivariate analyses for the 671 subjects with complete data showed that triglyceride level, age and body mass index (BMI) were significant predictors of the log fasting plasma glucose level and the log glycosylated hemoglobin level; for the latter, waist/hip ratio, history of diabetes mellitus among first-degree relatives and low level of education were additional predictors. Significant risk factors for diabetes as a dichotomous variable included triglyceride level, age, BMI and family history of diabetes. Although energy intake per unit of body weight was lower among subjects with diabetes than those without diabetes, possibly reflecting the lower physical activity level of diabetic subjects, the former consumed significantly more "calorie-adjusted" protein and less carbohydrate than the latter. The findings are consistent with studies in other populations. Further study is needed to determine the natural history of diabetes and its metabolic consequences and to assess the effect of dietary alteration and promotion of physical activity on the incidence of the disease.

Obesity in northern Canadian Indians: patterns, determinants, and consequences.

A survey of 704 adult Cree and Ojibwa Indians in northern Canada found that a large proportion of individuals in all age-sex groups was obese. Almost 90% of females aged 45-54 y had a body mass index (BMI) greater than or equal to 26. The obesity was primarily of the central type as gauged by skinfold thickness and girth ratios. Multivariate analyses showed that age, sex, smoking, alcohol use, marital status, and employment were associated with the levels of BMI and/or the sum of skinfold thicknesses. When three categories of BMI were compared, higher age-adjusted mean serum lipids, blood pressures, glucose, and glycosylated hemoglobin were observed in the obese subjects whereas total energy was decreased. Calorie-adjusted carbohydrate intake was higher in the obese subjects. BMI was an independent and significant predictor of both diabetic and hypertensive status. Obesity is a significant public health problem for Indians and poses particular risks for future chronic diseases.

Improving the nutritional impact of extension services in rural Africa.

PIP: Experience in nutrition interventions in Africa points to several design characteristics of field programs which could improve their effectiveness. Regular government extension services have the potential to reach large numbers of people, yet staff will require additional training to respond to the changing demands of field work. A new approach to obercome 2 implementation difficulties found in previous interventions has recently been formulated. The 1st difficulty addressed is that of reaching large enough numbers of people to affect the national prevalence of nutritional and other health problems. The 2nd is to present information that is directly relevant to the situation of people in different localities. The new approach to training rural extension workers has been developed by the Food and Agriculture Organization (FAO). The approach provides staff with information and managerial skills that are common to all extension work. The practical examples used to introduce these techniques illustrate nutritional problems that fieldworkers face and give a measure of confidence in finding solutions. The problems discussed include the adequacy of the techical information given during basic training; the need to understand the administrative aspects of a program or service, and the need to develop effective communication skills. It is intended that the fieldworker will be able to assess the situation in a locality and decide on appropriate action related to the nutritional problems identified. Subsequent action will always conform to the ministry's technical madate. The process of developing an understanding of the nutritional realities of a locality introduces a number of managerial techniques. These techniques for efficient management of field programs are explained and demonstrated during training, using examples that are nutritionally appropriate. In showing the step-by-step application of these techniques to nutritional activities, fieldworkers become familiar with nutritional terms. They also become confident in dealing with the nutritional implications of their work.^ieng

Development of salivary alpha-amylase in infants from birth to 5 months.

The alpha-amylase activity in whole saliva of two groups of infants was investigated from birth to 5 months at monthly intervals. Foods used in infant feeding as well as height and weight were recorded at each monthly collection period. alpha-Amylase activity was found to increase rapidly from low values at birth to approximately two-thirds of adult values by 3 months. Large variation in alpha-amylase activity, either per ml of saliva or per mg of protein, was recorded. No significant relationships of alpha-amylase activity with weight, weight for height, growth rate, or presence of starch-containing foods in the diet were found. Introduction of starch-containing food before 3 months of age would likely lead to inadequate hydrolization of starch in some infants.