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1.
J Clin Densitom ; 2021 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-34479797

RESUMO

Infancy is a period of rapid bone growth and mineral accretion; nonetheless, reference data remain scarce for this age group. The purpose of this report is to generate reference data for bone mass in breastfed vitamin D replete infants and investigate patterns of bone mineral accretion and sex differences. This is a secondary analysis from a double-blinded randomized controlled trial (NCT00381914). Healthy term breastfed (exclusively or mixed) infants were randomized to different doses of oral vitamin D supplementation (400-1600 IU/d) and followed prospectively from 1 to 12 mo. Plasma 25-hydroxyvitamin D (LC-MS/MS), bone mineral content (BMC; whole body (WB) and lumbar spine (LS)) and bone mineral density (BMD; LS) were measured at 1, 3, 6, 9, and 12 mo by dual-energy x-ray absorptiometry (Hologic Discovery 4500A) with no effect of supplementation on bone outcomes. For the purpose of this analysis, 63 infants with adequate plasma 25-hydroxyvitamin D ≥ 50 nmol/L at baseline, were included. Differences over time and between sexes were tested using mixed model repeated measures ANOVA. Infants (31 males, 32 females) were 39.5 ± 1.1 wk gestational age at birth and appropriate for gestational age. WB BMC, LS BMC, and LS BMD increased by 143.2%, 116.8%, and 31.1% respectively across infancy. WB BMC was higher (4.2% - 9.4%; p = 0.03) in males than in females across the study. After adjusting WB BMC for weight, length or head BMC, sex differences were not evident. LS BMC and LS BMD did not vary by sex. LS BMD growth charts for both sexes combined, were generated using LMS chartmaker. WB BMC more than doubles during the first year of life confirming the importance of skeletal growth and the need for age-specific reference data in infancy. Sex differences in BMC, if any, are mostly driven by differences in body size.

2.
Nutrients ; 13(9)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34579165

RESUMO

PURPOSE: To assess relationships between diet quality and areal bone mineral density (aBMD) in youth with healthy weight, obesity, and type 2 diabetes (T2D). METHODS: We performed a secondary analysis of cross-sectional data from youth (55% African American, 70% female) ages 10-23 years with T2D (n = 90), obesity (BMI > 95th; n = 128), or healthy weight (BMI < 85th; n = 197). Whole body (less head) areal bone mineral density (aBMD) was assessed by dual-energy X-ray absorptiometry (DXA). aBMD was expressed as age-, sex-, and ancestry-specific standard deviation scores (Z-scores). Whole body aBMD Z-scores were adjusted for height-for-age Z-score. Diet was assessed via three-day diaries, and the Healthy Eating Index (HEI) was computed. Total HEI score and HEI subcomponent scores were compared across groups, and associations with aBMD Z-scores were assessed via linear regression adjusted for group, age, sex, and ancestry. RESULTS: Mean HEI was similar between the healthy weight, obesity, and T2D groups. Several HEI sub-components differed between groups, including meats and beans, total vegetables, milk, saturated fat, sodium, oils, and empty calories. The obesity and T2D group had significantly greater aBMD Z-scores compared to the healthy weight group. Multiple linear regression analyses revealed a significant positive association between HEI and aBMD Z-score (p < 0.05). The HEI sub-components for whole grains (p = 0.052) and empty calories (p < 0.05) were positively associated with aBMD Z-score. CONCLUSIONS: Individuals that followed a dietary pattern more closely aligned with the Dietary Guidelines for Americans had greater bone density. Since few studies have investigated the role of diet on bone in youth with obesity-related conditions, additional research is required among these populations.

3.
J Strength Cond Res ; 35(9): 2572-2578, 2021 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-34431484

RESUMO

ABSTRACT: Fields, JB, Merigan, JM, Gallo, S, White, JB, and Jones, MT. External and internal load measures during preseason training in men collegiate soccer athletes. J Strength Cond Res 35(9): 2572-2578, 2021-Collegiate athletes are exposed to high volume loads during preseason training. Monitoring training load can inform training and recovery periods. Therefore, the purpose was to examine changes in and bidirectional relationship between external and internal load metrics in men collegiate soccer athletes (n = 20; age, 20 ± 1 year). Internal load measures of heart rate variability (HRV), salivary testosterone (T) and cortisol (C), and self-assessment wellness and ratings of perceived exertion scales were collected daily. External load measures of total distance, player load, high-speed distance, high inertial movement analysis, and repeated high-intensity efforts were collected in each training session using global positioning system/global navigation satellite system technology. A 1-way analysis of variance determined weekly changes in external load, physiological, hormonal, and subjective self-assessment measures of internal load. Bidirectional prediction of external load markers and self-assessment measures on physiological and hormonal markers of internal load were assessed by hierarchical linear regression models (p < 0.05). External load measures, C, energy, sleep, and rate of perceived exertion (RPE) decreased (p < 0.01), whereas T, T:C ratio, anger, depression, and vigor increased (p < 0.01) from week 1 to week 2. Morning C positively predicted afternoon external load and post-training RPE (p < 0.05); T:C ratio negatively predicted afternoon external load and post-training RPE (p < 0.05); and morning HRV negatively predicted post-training RPE (p = 0.031). Despite reduced hormonal stress and external load across weeks, negative perceptions of fatigue increased, suggesting fatigue patterns may have a delayed response. Load may have a more belated, chronic effect on perceptions of fatigue, whereas hormonal changes may be more immediate and sensitive to change. Practitioners may wish to use a variety of external and internal load measures to understand athletes' stress responses to training.


Assuntos
Futebol , Adulto , Atletas , Fadiga , Frequência Cardíaca , Humanos , Masculino , Esforço Físico , Adulto Jovem
4.
J Strength Cond Res ; 35(5): 1182-1186, 2021 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33677459

RESUMO

ABSTRACT: Fields, JB, Lameira, DM, Short, JL, Merrigan, JM, Gallo, S, White, JB, and Jones, MT. Relationship between external load and self-reported wellness measures across a collegiate men's soccer preseason. J Strength Cond Res 35(5): 1182-1186, 2021-Monitoring athlete training load is important to training programming and can help balance training and recovery periods. Furthermore, psychological factors can affect athlete's performance. Therefore, the purpose was to examine the relationship between external load and self-reported wellness measures during soccer preseason. Collegiate men soccer athletes (n = 20; mean ± SD age: 20.3 ± 0.9 years; body mass: 77.9 ± 6.8 kg; body height: 178.87 ± 7.18cm; body fat: 10.0 ± 5.0%; V̇o2max: 65.39 ± 7.61ml·kg-1·min-1) participated. Likert scale self-assessments of fatigue, soreness, sleep, stress, and energy were collected daily in conjunction with the Brief Assessment of Mood (vigor, depression, anger, fatigue, and confusion). Total distance (TD), player load (PL), high-speed distance (HSD, >13 mph [5.8 m·s-1]), high inertial movement analysis (IMA, >3.5 m·s-2), and repeated high-intensity efforts (RHIEs) were collected in each training session using positional monitoring (global positioning system/global navigation satellite system [GPS/GNSS]) technology. Session rate of perceived exertion (sRPE) was determined from athlete's post-training rating (Borg CR-10 Scale) and time of training session. Multilevel models revealed the bidirectional prediction of load markers on fatigue, soreness, sleep, energy, and sRPE (p < 0.05). Morning ratings of soreness and fatigue were predicted by previous afternoon's practice measures of TD, PL, HSD, IMA, RHIE, and sRPE. Morning soreness and fatigue negatively predicted that day's afternoon practice TD, PL, HSD, IMA, RHIE, and sRPE. Morning ratings of negative mood were positively predicted by previous day's afternoon practice HSD. In addition, negative morning mood states inversely predicted HSD (p = 0.011), TD (p = 0.002), and PL (p < 0.001) for that day's afternoon practice. Using self-reported wellness measures with GPS/GNSS technology may enhance the understanding of training responses and inform program development.


Assuntos
Condicionamento Físico Humano , Futebol , Adulto , Atletas , Fadiga , Humanos , Masculino , Esforço Físico , Autorrelato , Adulto Jovem
5.
Sports (Basel) ; 9(2)2021 Feb 11.
Artigo em Inglês | MEDLINE | ID: mdl-33670086

RESUMO

Low-income Latino children are at high risk for obesity and associated comorbidities. Considering the health benefits of proper sleep habits and physical activity, understanding the patterns, or the relationship between these modifiable factors may help guide intervention strategies to improve overall health in this population. Thus, the purpose was to investigate bidirectional associations between physical activity and sleep among Latino children who are overweight/obese. Twenty-three children (boys, 70%; overweight, 17%; obese, 83%) (age 7.9 ± 1.4 years) wore activity monitors on their wrist for 6 consecutive days (comprising 138 total observations). Hierarchical linear modeling evaluated temporal associations between physical activity (light physical activity, LPA; moderate to vigorous activity, MVPA) and sleep (duration and efficiency). Although there was no association between MVPA and sleep (p > 0.05), daytime LPA was negatively associated with sleep duration that night (estimate ± SE = -10.77 ± 5.26; p = 0.04), and nighttime sleep efficiency was positively associated with LPA the next day (estimate ± SE = 13.29 ± 6.16; p = 0.03). In conclusion, increased LPA may decrease sleep duration that night, but increasing sleep efficiency may increase LPA the following day. Although further investigation is required, these results suggest that improving sleep efficiency may increase the level of physical activity reached among Latino children who are overweight/obese.

6.
Gastroenterol Clin North Am ; 50(1): 113-125, 2021 03.
Artigo em Inglês | MEDLINE | ID: mdl-33518158

RESUMO

Obesity affects 2 of 5 Americans, and nearly 1 of 10 is considered severely obese, with the greatest risk of morbidity and mortality. A reduction in body weight of 2% to 5% can lead to improvements in cardiovascular health, with weight loss maintenance associated with the best health outcomes. Lifestyle interventions that focus on changes in diet and physical activity behaviors are best to maintain weight loss. This article provides a review of the treatment of adult obesity with a focus on dietary interventions.

7.
J Transcult Nurs ; 32(6): 697-706, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33375879

RESUMO

INTRODUCTION: Second-generation Arab Americans may be at risk for poor cardiovascular health behaviors, but these behaviors are poorly understood. The purpose of this study was to examine the effects of acculturative stress and psychological flexibility on cardiovascular health behaviors among second-generation Arab Americans. METHOD: In a cross-sectional study, survey data were collected in 2018 at local mosques, churches, and a university campus. Cardiovascular health behaviors were measured with a questionnaire based on the American Heart Association Life's Simple 7. Acculturative stress and psychological flexibility were assessed using reliable and valid measures. RESULTS: Participants (n = 325) with higher acculturative stress were significantly more likely to report intermediate overall cardiovascular health behaviors (p = .01) and poor to intermediate diet (p = .00). Psychological flexibility partially mediated poor/intermediate smoking (p = .02) and intermediate diet (p = .00) scores. DISCUSSION: Nurses may consider the role of acculturation when designing culturally sensitive interventions to promote cardiovascular health in second-generation populations.

8.
Int J Exerc Sci ; 13(3): 488-500, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32509118

RESUMO

Given the high prevalence of obesity in Latino children and potential health risks, the purpose of this study was to: 1) evaluate relationships among metabolic-risk, fitness, and body fatness; 2) determine sex differences in cardio-metabolic risk factors and fitness of obese children of Latino descent. Sixty children (boys, n = 39, 7.8 ± 1.5 years; girls, n = 21, 7.2 ± 1.5 years; body mass index, 97.8 ± 2.5th percentile) completed assessments of height, weight, and body fat, prior to fasted blood draws and a battery of fitness tests. Cardio-metabolic markers were analyzed, and a metabolic risk score created. Correlations and regression analyses evaluated the relationships among body fatness, metabolic-risk, and fitness. Independent samples t-tests determined sex differences (p < 0.05). Body fat related negatively to lower body power (p < 0.016), but positively to upper body power (p = 0.049). After controlling for age and sex, body fat (p < 0.001) was a positive predictor of variance in metabolic-risk scores, (R2 = 0.39, p < 0.001). Further, the association between body fat and metabolic-risk was not moderated by sex. Metabolic-risk scores and body fat were similar for both sexes, but boys performed better on muscular fitness tests, even after accounting for fat free mass (p < 0.05). Higher body fatness in obese Latino children may result in greater metabolic-risk and difficulty performing weight-bearing tasks. Therefore, culturally adapted weight management programs should employ a multifaceted approach to improve metabolic-risk and fitness.

9.
Nutrients ; 12(2)2020 Jan 31.
Artigo em Inglês | MEDLINE | ID: mdl-32023809

RESUMO

Vitamin D may play a role in performance and injury risk, yet the required supplementation dosage for collegiate athletes is unclear. The objective of this study was to define the dosage of vitamin D3 supplementation required to beneficially affect serum 25-hydroxyvitamin D (25(OH)D) among a sample of collegiate basketball athletes. This was a quasi-experimental trial, participants were allocated to one of three groups of vitamin D3 daily at the beginning of pre-season training and dependent upon their baseline vitamin D status as follows: insufficient (<75 nmol/L) to 10,000 IU, sufficient (75-125 nmol/L) to 5000 IU and optimal (>125 nmol/L) to no supplementation. Follow-up assessments were completed ~ 5 months later in post season. The majority (n = 13) were allocated to 10,000 IU vs. n = 5 to 5000 IU and n = 2 to no supplementation. The 10,000 IU group showed the greatest change (35.0 ± 27.0 nmol/L) vs. the 5000 IU group (-9.3 ± 9.6 nmol/L) and no supplementation group (-41.6 ± 11.7 nmol/L, p < 0.01). Only 1 participant reached optimal status in the 10,000 IU group. In conclusion, a daily dosage of 10,000 IU vitamin D3 supplementation mitigated the high prevalence of vitamin D deficiency among collegiate basketball players but was insufficient for all to reach sufficient levels.


Assuntos
Basquetebol/fisiologia , Colecalciferol/administração & dosagem , Suplementos Nutricionais , Deficiência de Vitamina D/terapia , Vitamina D/análogos & derivados , Atletas , Feminino , Humanos , Masculino , Ensaios Clínicos Controlados não Aleatórios como Assunto , Prevalência , Estudantes/estatística & dados numéricos , Resultado do Tratamento , Estados Unidos , Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia , Adulto Jovem
10.
J Acad Nutr Diet ; 120(10): 1730-1744, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32037271

RESUMO

Malnutrition during the critical period of pregnancy has significant health outcomes for both the mother and her offspring. Medical nutrition therapy (MNT) by a registered dietitian nutritionist (RDN) may help mitigate negative health effects, although studies that support the role of the RDN have not been comprehensively evaluated. The objective was to explore the health effects of MNT by an RDN on maternal and infant outcomes in pregnant women with malnutrition. A systematic review of studies published between 2000 and 2014 that incorporated MNT by an RDN during pregnancy were retrieved from a PubMed search, using criteria established by the Academy of Nutrition and Dietetics Evidence Analysis Process. Among 94 identified studies, five controlled trials met the inclusion criteria. The initial search was extended to include one study published between 2014 and 2019. Outcomes included maternal gestational weight gain, maternal markers of glycemic control, maternal complications such as hypertension, incidence of caesarean section, infant birth weight both in grams and in clinical categories, infant gestational age, and infant complications. There was good/strong evidence that MNT by an RDN decreased gestational weight gain, although there was no effect on maternal complications, caesarean section deliveries, and gestational age among women with mixed body mass index status or those who were overweight/obese. The evidence was deemed fair in support of an effect on glycemic control, infant birth weight, and infant complications. The heterogeneity in the results are due to the variation among populations studied, types of interventions, and inconsistency among outcomes. In addition, the training and educational requirements of the RDN or the international equivalent may vary widely across the four countries in which studies were conducted. There was good evidence for MNT by an RDN during pregnancy on improving gestational weight gain among overweight/obese women. To better support the role of MNT by an RDN in the health care of pregnant women, research that clearly identifies the role of the RDN in the intervention, includes a control group, and studies more heterogeneous populations is needed.


Assuntos
Desnutrição/terapia , Terapia Nutricional/métodos , Nutricionistas , Complicações na Gravidez/terapia , Resultado do Tratamento , Peso ao Nascer , Cesárea/estatística & dados numéricos , Medicina Baseada em Evidências , Feminino , Idade Gestacional , Controle Glicêmico/estatística & dados numéricos , Humanos , Recém-Nascido , Desnutrição/complicações , Gravidez , Complicações na Gravidez/epidemiologia , Nascimento Prematuro/epidemiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Ganho de Peso
11.
J Clin Densitom ; 23(2): 264-270, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-30196053

RESUMO

BACKGROUND: A leaner body phenotype in infancy plays an important role in the early life prevention of obesity. However, there is a dearth of reference data for body composition in infancy. This study aimed to create a normative reference dataset for lean (LM) and fat (FM) mass and accretion rates in healthy infants. METHODS: Healthy term-born infants (35 boys; 35 girls) were studied at ≤ 1, 3, 6, 9, and 12 mo of age for growth and compared to World Health Organization standards. LM (g) and FM (g) were measured using DXA (APEX version 13.3:3, Hologic 4500A) in infant whole-body mode. Sex specific reference curves were generated using the LMS method (LMSchartmaker, Medical Research Council, UK). RESULTS: Infants were predominantly white (82.9%), breastfed (98.4% ≥ 3 mo), and grew in length and weight within World Health Organization Z-score ranges for normal growth across infancy. LM accretion was 327.4 ± 12.5 g/mo representing 95% increment in LM. Boys had more LM compared to girls at 12 mo (7807.4 ± 1114.0 vs 6817.4 ± 1016.1 g; p = 0.008). FM accretion was 114.3 ± 12.0 g/mo representing 114% increment in FM with no difference between the sexes. CONCLUSIONS: This data, which is based on a healthy sample of infants, characterizes LM and FM accretion during the first year of life and will aid in the interpretation of body composition.

12.
J Am Coll Nutr ; 39(2): 112-121, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-31322483

RESUMO

Objective: The aim was to evaluate differences in nutritional intake of calcium, vitamin D, and phosphorus; serologic indices of these nutrients; and bone health among adults with and without probable, undiagnosed celiac disease (CD).Method: Cross-sectional data from What We Eat in America and the National Health and Nutrition Examination Survey 2009-2014 including self-reported dietary and supplement intake from one day of 24-hour recalls, serologic indicators, and dual x-ray absorptiometry scans were analyzed in adults with probable undiagnosed CD, who tested positive on the immunoglobulin A endomysial antibody assay (n = 48) and controls (n = 13,634). Statistical analysis included multiple linear regression modeling controlled for age, sex, race/ethnicity, energy intake, and poverty income ratio.Results: The prevalence of probable undiagnosed CD was 1 in 285. Probable CD status was associated with a 251.6 mg (95% confidence interval [CI], 72.3-432.9) higher daily total calcium intake. The total dietary and supplement intake of those with probable CD was significantly higher in calcium density (103.4 mg/1,000 kcal; 95% CI, 25.6-181.1) and phosphorus density (46.7 mg/1,000 kcal; 95% CI, 3.1-90.3). Probable CD status was associated with higher dairy consumption by 0.7 cups per day (95% CI, 0.2-1.2) and higher serum phosphorus concentrations (4.0 mg/dL vs 3.8 mg/dL, p = 0.011). No differences in serum calcium, vitamin D, or alkaline phosphatase levels were observed between groups. Probable CD status was also associated with a -0.1 g/cm2 (95% CI, -0.2 to -0.0) lower femur bone mineral density (BMD) and a -0.1 g/cm2 (95% CI, -0.1 to -0.0) lower femoral neck BMD. No differences in total spine BMD were observed.Conclusions: Adults with probable undiagnosed CD had lower bone density than adults without CD, despite also reporting higher total calcium intake and nutritional density of both calcium and phosphorus.


Assuntos
Densidade Óssea , Cálcio na Dieta/administração & dosagem , Doença Celíaca/fisiopatologia , Inquéritos Nutricionais , Fósforo na Dieta/administração & dosagem , Vitamina D/administração & dosagem , Adulto , Doença Celíaca/diagnóstico , Doença Celíaca/epidemiologia , Estudos Transversais , Laticínios , Dieta , Suplementos Nutricionais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estado Nutricional/fisiologia , Fósforo/sangue , Estados Unidos/epidemiologia
13.
J Acad Nutr Diet ; 120(5): 898-924.e4, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-31669079

RESUMO

BACKGROUND: Given the high rates of vitamin D deficiency among pregnant women and possible effects on offspring health, a systematic review on this topic was conducted to help inform future practice guidelines. OBJECTIVE: To evaluate associations between maternal vitamin D supplementation, maternal 25-hydroxyvitamin D (25(OH)D) concentrations, and health outcomes. METHODS: A PubMed literature search was conducted to identify studies that examined the health effects of vitamin D supplementation during pregnancy on maternal and infant health outcomes published from 2000 to 2016. Among 976 identified publications, 20 randomized clinical trials met the inclusion criteria. The initial search was extended to include five studies published between July 2016 and September 2018. MAIN OUTCOME MEASURES: Maternal and infant 25(OH)D concentrations, gestational diabetes, preeclampsia or gestational hypertension, cesarean section, maternal parathyroid hormone and calcium concentrations, and infant gestational age, birth weight, and birth length. STATISTICAL ANALYSES: Mean differences, odds ratios, and 95% CIs were calculated, only for the initial search, using separate random-effects meta-analyses for each outcome. RESULTS: Evidence was good or strong that maternal vitamin D supplementation significantly increased maternal (13 studies, n=18, mean difference, 14.1 ng/mL [35.2 nmol/L]; 95% CI=9.6-18.6 ng/mL [24.0-46.4 nmol/L]) and infant (nine studies, n=12; 9.7, 5.2, 14.2 ng/mL [24.2, 12.9, 35.5 nmol/L]) 25(OH)D concentrations, although heterogeneity was significant (I2=95.9% and I2=97.4, respectively, P<0.001). Evidence was fair that vitamin D supplementation significantly decreases maternal homeostatic model assessment-insulin resistance (five studies, n=7; -1.1, -1.5, -0.7) and increases infant birth weight (nine studies, n=11, 114.2, 63.4, 165.1 g), both had insignificant heterogeneity. A null effect of maternal supplementation on other maternal (preeclampsia, cesarean section) and infant (gestational age, birth length) outcomes was found. CONCLUSIONS: Results show vitamin D supplementation during pregnancy improves maternal and infant 25(OH)D concentrations and may play a role in maternal insulin resistance and fetal growth. To further inform practice and policies on the amount of vitamin D, which supports a healthy pregnancy, high quality dose-response randomized clinical trials, which assess pregnancy-specific 25(OH)D thresholds, and appropriately powered clinical outcomes are needed.


Assuntos
Suplementos Nutricionais , Complicações na Gravidez/terapia , Cuidado Pré-Natal/métodos , Deficiência de Vitamina D/terapia , Vitamina D/administração & dosagem , Adulto , Feminino , Humanos , Recém-Nascido , Fenômenos Fisiológicos da Nutrição Materna , Gravidez , Complicações na Gravidez/sangue , Resultado da Gravidez , Resultado do Tratamento , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D/sangue , Adulto Jovem
14.
J Nutr Educ Behav ; 52(1): 55-63, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31706793

RESUMO

OBJECTIVE: To determine the feasibility of a pediatric weight management program for low-income Latino families. METHODS: A pretest-posttest pilot study was conducted among 60 Latino children, aged 4-9, who were overweight/obese (body mass index-for-age ≥85th percentile). The 10-week group-based community program addressed diet, exercise, and behavior modification. Demand was assessed through recruitment and attendance, acceptability using postintervention surveys with participants, and limited efficacy testing of participant anthropometrics and cardiometabolic markers. RESULTS: Overall 65% of families were retained for follow-up. All families reported feeling more confident in making healthier food choices and would participate in the program again. Pre/post intervention testing found statistically significant decreases (P < .05) in body mass index for age z score, waist circumference, and % body fat. CONCLUSIONS AND IMPLICATIONS: This culturally adapted group intervention for Latino families was acceptable and shows promise for improved health status, although it needs to be replicated with a larger group and longer follow-up.


Assuntos
Hispano-Americanos , Obesidade Pediátrica/terapia , Programas de Redução de Peso/métodos , Índice de Massa Corporal , Criança , Dietoterapia , Terapia por Exercício , Família , Estudos de Viabilidade , Feminino , Humanos , Masculino , Projetos Piloto , Circunferência da Cintura
15.
Sports (Basel) ; 7(11)2019 Nov 18.
Artigo em Inglês | MEDLINE | ID: mdl-31752086

RESUMO

Vitamin D plays a key role in bone health, musculoskeletal function, and sport performance. Collegiate athletes competing in indoor sports may be at greater risk of vitamin D deficiency due to limited outdoor time. Therefore, the purpose was to assess 25-hydroxyvitamin D (25(OH)D) concentrations among collegiate men and women basketball (MBB, WBB) athletes. National Collegiate Athletic Association Division I men (MBB, n = 11) and women (WBB, n = 9) were tested during the off-season (T1; July) and pre-season (T2; October). Measurements included serum 25(OH)D; skin pigmentation, bone mineral density, and daily sun exposure (self-reported). Paired t-tests determined changes in 25(OH)D by sport-season and sex. Pearson correlations examined relationships between outcome variables. MBB athletes (mean ± SD; 19.6 ± 1.3 years) showed a reduction in 25(OH)D (T1: 64.53 nmol·L-1 ± 11.96) (T2: 56.11 nmol·L-1 ± 7.90) (p = 0.001). WBB (20.1 ± 1.1 years) had no change in 25(OH)D (T1: 99.07 nmol·L-1 ± 49.94. T2: 97.56 nmol·L-1 ± 36.47, p = 0.848). A positive association between 25(OH)D and skin pigmentation was observed (r = 0.47, p = 0.038). 25(OH)D was inversely correlated with lean body mass (LBM), body mass (BM), and bone mineral density (BMD), while a positive association was seen between 25(OH)D and skin pigmentation. In summary, 25(OH)D insufficiency was prevalent amongst male collegiate basketball athletes, with 25(OH)D levels being lower in the pre-season (October) than the off-season (July). Furthermore, darker skin pigmentation significantly correlated with 25(OH)D, indicating that individuals with darker skin tones may be at a greater risk of insufficiency/deficiency. More research is needed to examine the relationships between 25(OH)D and bone health in athletes.

16.
J Midwifery Womens Health ; 64(6): 725-733, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31469235

RESUMO

INTRODUCTION: Breastfeeding rates among women participating in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) are lower compared with those of nonparticipants. The objective of this study was to assess racial and ethnic differences in self-reported reasons for breastfeeding cessation during the first year postpartum. METHODS: This was a secondary analysis of data from women participating in the WIC Infant and Toddler Feeding Practices Study-2. Women specified reasons that influenced their decision to stop breastfeeding during telephone interviews between 1 and 13 months postpartum. Logistic regression models for each racial and ethnic group explored the effects of sociodemographic variables on each reason. RESULTS: The sample for this analysis included 4095 women (34.1% non-Hispanic white, 25.5% non-Hispanic black, and 40.4% Hispanic). Across all race and ethnic groups, food security status was a predictor of some but not all reasons for breastfeeding cessation. Compared with their counterparts who were food secure, white women with low food security and black women with very low food security were more likely (odds ratio [OR], 1.86; 95% CI, 1.04-3.35 and OR, 1.86; 95% CI, 1.19-2.90, respectively) to stop breastfeeding because they wanted or needed someone else to feed their infants. Hispanic women with very low food security were more likely to stop breastfeeding because they felt they did not have enough milk. Compared with their multiparous counterparts, primiparous black and white women were almost twice as likely to stop breastfeeding because of trouble sucking or latching. Hispanic and black women born outside the United States had significantly higher odds of breastfeeding cessation because of the infant losing interest compared with US-born women. Education and marital status significantly predicted reasons for breastfeeding cessation among Hispanic and white women. DISCUSSION: Among women participating in WIC, food security, parity, country of birth, education, and marital status were significant predictors of reasons for breastfeeding cessation across racial and /ethnic groups. Incorporating these findings in education, counseling, and interventions may help overcome breastfeeding barriers.


Assuntos
Aleitamento Materno/etnologia , Grupos Étnicos/estatística & dados numéricos , Disparidades em Assistência à Saúde/etnologia , Comportamento Materno/etnologia , Serviços de Saúde Materna/organização & administração , Relações Mãe-Filho/etnologia , Adulto , Atitude Frente a Saúde , Feminino , Comportamentos Relacionados com a Saúde/etnologia , Disparidades nos Níveis de Saúde , Humanos , Lactente , Recém-Nascido , Estados Unidos
17.
Res Nurs Health ; 42(4): 264-272, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31119757

RESUMO

High prevalence rates of both Vitamin B12 insufficiency and depressive symptoms exist in pregnant women. Although the association between depressive symptoms and certain nutrient deficiencies like iron, folate, or Vitamin B12 has been established, the specific relationship between low-normal serum Vitamin B12 levels and depressive symptoms in pregnant women in the United States has not been studied closely. Using 2005-2006 National Health and Nutrition Examination Survey data, a secondary analysis was conducted to examine the association between low-normal serum Vitamin B12 level and depression, as measured by a score of 10 or higher on the Patient Health Questionnaire-9, in pregnant women (N = 174). In bivariate regression models, Vitamin B12 level, experiencing poverty, and pre-pregnancy body mass index (BMI) were significant predictors of depression. In multivariate logistic regression models, pregnant women with low-normal serum Vitamin B12 levels (OR = 3.82, 95% CI [1.10-13.31], p < 0.04) were 3.82 times more likely to experience depression, controlling for sociodemographic characteristics, pre-pregnancy BMI, and the biomarkers hemoglobin and folate. Identifying and treating pregnant women with low-normal Vitamin B12 levels may enhance prenatal depression management.


Assuntos
Transtorno Depressivo/etiologia , Complicações na Gravidez/etiologia , Deficiência de Vitamina B 12/complicações , Vitamina B 12/sangue , Adulto , Transtorno Depressivo/epidemiologia , Feminino , Humanos , Inquéritos Nutricionais , Gravidez , Complicações na Gravidez/epidemiologia , Gestantes , Prevalência , Estados Unidos/epidemiologia , Deficiência de Vitamina B 12/epidemiologia
18.
J Acad Nutr Diet ; 119(11): 1921-1943, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31040070

RESUMO

BACKGROUND: While obesity presents specific acute and long-term risks to the pregnant woman and her offspring, the effects of bariatric surgery on pregnancy outcomes are undetermined. OBJECTIVE: A systematic review was performed according to the Academy of Nutrition and Dietetics Evidence Analysis Library process to determine the effects of bariatric surgery on both maternal and infant health outcomes of pregnancy. DESIGN: A comprehensive literature search of PubMed was conducted to identify studies published from years 2000 to 2015 that examined the health effects of pregnancy after bariatric surgery. Experimental studies and observational studies with a control group were included. MAIN OUTCOME MEASURES: Outcomes of interest were gestational weight gain, maternal complications (ie, gestational diabetes, pre-eclampsia, eclampsia, hypertension, and postpartum hemorrhage), miscarriage and/or stillbirth, cesarean section, birth weight in grams, birth weight in categories (ie, macrosomia, low birth weight, small for gestational age, and large for gestational age), gestational age and preterm birth, infant illness and complications (ie, perinatal death, admission to neonatal intensive care unit, neonatal illness, and congenital malformation rates), and Apgar scores. RESULTS: Thirteen of 246 studies were included. Compared to body mass index-matched controls without surgery, bariatric surgery before pregnancy reduced infant birth weight in grams, with no effect on total maternal gestational weight gain or Apgar scores. Surgery did not increase risk of adverse outcomes, such as miscarriage and/or stillbirth, preterm birth, or infant complications. Effects of surgery on maternal complications, infant birth weight categories, and surgical delivery rates were inconsistent. CONCLUSIONS: Bariatric surgery is a successful treatment of maternal obesity, but certain surgery-specific risks may exist. More data are needed to determine clinical guidelines. The long-term effects of surgery on pregnancy outcomes are unknown.


Assuntos
Cirurgia Bariátrica/efeitos adversos , Obesidade/cirurgia , Complicações na Gravidez/epidemiologia , Resultado da Gravidez , Adulto , Índice de Apgar , Peso ao Nascer , Cesárea/estatística & dados numéricos , Feminino , Idade Gestacional , Humanos , Recém-Nascido , Gravidez , Nascimento Prematuro/epidemiologia , Ganho de Peso
19.
Public Health Nutr ; 22(9): 1667-1674, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30803466

RESUMO

OBJECTIVE: To describe infant feeding practices and predictors of exclusive breast-feeding among women attending a local Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) programme. DESIGN: Cross-sectional survey. Outcomes included reported infant feeding practices at 3 and 6 months, timing and reasons for introduction of formula. Descriptive statistics, χ 2 tests and logistic regression were used describe the sample and explore relationships between variables. SETTING: Loudoun County, VA, USA. SUBJECTS: A sample of 190 predominantly Hispanic women attending local WIC clinics. RESULTS: Overall, 84 % of women reported ever breast-feeding and 61 % of infants received formula in the first few days of life. Mothers who reported on infant feeding practices were less likely to exclusively breast-feed (34 v. 45 %) and more likely to provide mixed feeding (50 v. 20 %) at 3 months compared with 6 months, respectively. Significant (P<0·05) predictors of exclusive breast-feeding at 3 months included setting an exclusive breast-feeding goal and completing some high school (compared with completing high school or more). Only education remained a significant predictor of exclusive breast-feeding at 6 months. CONCLUSIONS: A high proportion of women reported giving formula in the first few days of life and many changed from mixed to exclusive breast-feeding or formula by 6 months, suggesting possibly modifiable factors. Further investigation can help drive direct service- as well as policy and systems-based interventions to improve exclusive breast-feeding.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Adulto , Estudos Transversais , Demografia , Feminino , Humanos , Lactente , Fórmulas Infantis , Fenômenos Fisiológicos da Nutrição do Lactente , Modelos Logísticos , Mães , Adulto Jovem
20.
J Pediatr Endocrinol Metab ; 29(6): 709-14, 2016 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-26812861

RESUMO

BACKGROUND: Ionized calcium (iCa) is believed to be the principle determinant of parathyroid hormone concentration (PTH). However, previous studies contained few infants. METHODS: This ancillary study from our vitamin D3 dose-response trial in healthy, breastfed infants measured calcium, phosphorus, PTH and 25(OH)D (25-hydroxyvitamin D) at 1, 2, 3, 6, 9 and 12 months of age. The relationship between iCa and PTH was assessed by Pearson correlation and a mixed effects regression model to account for repeated measures. RESULTS: No significant correlations were observed between iCa and PTH at individual visits (p>0.2). After accounting for repeated measures, PTH decreased with increasing iCa (slope -5.25; 95% confidence intervals (CI) -8.78 to -1.73), decreased with increasing 25(OH)D (slope -0.006; 95% CI -0.009 to -0.002, and increased with later visits (6-12 months, p<0.001), CONCLUSIONS: We observed a weak negative relationship between iCa and PTH and an increase with age consistent with physiologic maturation.


Assuntos
Cálcio/sangue , Hormônio Paratireóideo/sangue , Fatores Etários , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos
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