Association between food intake and obesity in pregnant women living with and without HIV in Cape Town, South Africa: a prospective cohort study

Abstract Background Although global nutrition/dietary transition resulting from industrialisation and urbanisation has been identified as a major contributor to widespread trends of obesity, there is limited data in pregnant women, including those living with HIV in South Africa. We examined food-based dietary intake in pregnant women with and without HIV at first antenatal care (ANC) visit, and associations with maternal overweight/obesity and gestational weight gain (GWG). Methods In an urban South African community, consecutive women living with (n = 479) and without (n = 510) HIV were enrolled and prospectively followed to delivery. Interviewer-administered non-quantitative food frequency questionnaire was used to assess dietary intake (starch, protein, dairy, fruits, vegetables, legumes, oils/fats) at enrolment. Associations with maternal body mass index (BMI) and GWG were examined using logistic regression models. Results Among women (median age 29 years, IQR 25–34), the prevalence of obesity (BMI ≥ 30 kg/m2) at first ANC was 43% and that of excessive GWG (per IOM guidelines) was 37% overall; HIV prevalence was 48%. In women without HIV, consumption of potato (any preparation) (aOR 1.98, 95% CI 1.02–3.84) and pumpkin/butternut (aOR 2.13, 95% CI 1.29–3.49) for 1–3 days a week increased the odds of overweight/obesity compared to not consuming any; milk in tea/coffee (aOR 6.04, 95% CI 1.37–26.50) increased the odds of excessive GWG. Consumption of eggs (any) (aOR 0.52, 95% CI 0.32–0.86) for 1–3 days a week reduced the odds of overweight/obesity while peanut and nuts consumption for 4–7 days a week reduced the odds (aOR 0.34, 95% CI 0.14–0.80) of excessive GWG. In women with HIV, consumption of milk/yoghurt/maas to drink/on cereals (aOR 0.35, 95% CI 0.18–0.68), tomato (raw/cooked) (aOR 0.50, 95% CI 0.30–0.84), green beans (aOR 0.41, 95% CI 0.20–0.86), mixed vegetables (aOR 0.49, 95% CI 0.29–0.84) and legumes e.g. baked beans, lentils (aOR 0.50, 95% CI 0.28–0.86) for 4–7 days a week reduced the odds of overweight/obesity; tomato (raw/cooked) (aOR 0.48, 95% CI 0.24–0.96) and mixed vegetables (aOR 0.38, 95% CI 0.18–0.78) also reduced the odds of excessive GWG. Conclusions Diet modification may promote healthy weight in pregnant women living with and without HIV.

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Patterns of SES Health Disparities Among Older Adults in Three Upper Middle- and Two High-Income Countries

The Journals of Gerontology Series B ◽

10.1093/geronb/gby050 ◽

2018 ◽

Vol 74 (6) ◽

pp. e25-e37 ◽

Cited By ~ 1

Author(s):

Mary McEniry ◽

Rafael Samper-Ternent ◽

Carmen Elisa Flórez ◽

Renata Pardo ◽

Carlos Cano-Gutierrez

Keyword(s):

South Africa ◽

Older Adults ◽

Health Behaviors ◽

Chronic Conditions ◽

High Income ◽

Middle Income ◽

Logistic Regression Models ◽

Prevalence Of Obesity ◽

Obesity Hypertension ◽

Health Gradient

Abstract Objectives To examine the socioeconomic status (SES) health gradient for obesity, diabetes, and hypertension within a diverse group of health outcomes and behaviors among older adults (60+) in upper middle-income countries benchmarked with high-income countries. Method We used data from three upper middle-income settings (Colombia-SABE-Bogotá, Mexico-SAGE, and South Africa-SAGE) and two high-income countries (England-ELSA and US-HRS) to estimate logistic regression models using age, gender, and education to predict health and health behaviors. Results The sharpest gradients appear in middle-income settings but follow expected patterns found in high-income countries for poor self-reported health, functionality, cognitive impairment, and depression. However, weaker gradients appear for obesity, hypertension, diabetes, and other chronic conditions in Colombia and Mexico and the gradient reverses in South Africa. Strong disparities exist in risky health behaviors and in early nutritional status in the middle-income settings. Discussion Rapid demographic and nutritional transitions, urbanization, poor early life conditions, social mobility, negative health behavior, and unique country circumstances provide a useful framework for understanding the SES health gradient in middle-income settings. In contrast with high-income countries, the increasing prevalence of obesity, an important risk factor for chronic conditions and other aspects of health, may ultimately change the SES gradient for diseases in the future.

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Dietary intake and food sources of choline in pregnant women in bloemfontein, South Africa

Clinical Nutrition ESPEN ◽

10.1016/j.clnesp.2020.09.659 ◽

2020 ◽

Vol 40 ◽

pp. 625-626

Author(s):

L. Robb ◽

G. Joubert ◽

M. Jordaan ◽

J. Osei Ngounda ◽

C. Walsh

Keyword(s):

South Africa ◽

Dietary Intake ◽

Pregnant Women ◽

Food Sources

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Dietary Intake and Beliefs of Pregnant Women with Gestational Diabetes in Cape Town, South Africa

Nutrients ◽

10.3390/nu10091183 ◽

2018 ◽

Vol 10 (9) ◽

pp. 1183 ◽

Cited By ~ 5

Author(s):

Stephanie M. Krige ◽

Sharmilah Booley ◽

Naomi S. Levitt ◽

Tawanda Chivese ◽

Katherine Murphy ◽

...

Keyword(s):

South Africa ◽

Gestational Diabetes ◽

Dietary Intake ◽

Pregnant Women ◽

Fruits And Vegetables ◽

Sugar Content ◽

Cape Town ◽

Cross Sectional Study ◽

Cross Sectional ◽

Nutritional Guidelines

This study investigated the dietary intake of pregnant women with gestational diabetes mellitus (GDM) and their beliefs relating to the consumption of fruits and vegetables (F&V) and sugary foods and drinks. A cross-sectional study was conducted on 239 pregnant women with GDM in Cape Town. Dietary intake was assessed using a quantified Food Frequency Questionnaire and beliefs relating to food choices were assessed using the Theory of Planned Behaviour (TPB). The mean energy intake was 7268 KJ, carbohydrate was 220 (±104.5) g, protein 60.3 (±27.5) g and fat 67.7 (±44.2) g. The macronutrient distribution was 55% carbohydrates, 14.5% protein and 30.5% fat of total energy. The majority of the sample had inadequate intakes of vitamin D (87.4%), folate (96.5%) and iron (91.3%). The median (IQR) amount of added table sugar and sugar sweetened beverages (SSBs) was 4.0 (0.00–12.5) g and 17.9 (0.0–132.8) mL per day, respectively. Only 31.4% met the recommendation (400 g per day) for F&V. Beliefs that it was not easy to exclude sugary foods/drinks and that knowing how to control cravings for sugary foods/drinks are areas to target messages on the sugar content of SSBs. In conclusion, the dietary intake of these women was not optimal and fell short of several nutritional guidelines for pregnant women with hyperglycaemia. The strongly held beliefs regarding sugary foods/drinks may contribute to poor adherence to nutritional guidelines among pregnant women with GDM in South Africa.

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Association Between Mode of Delivery and Body Mass Index at 4-5 Years in White British and Pakistani Children: the Born in Bradford Birth Cohort

10.21203/rs.3.rs-117961/v1 ◽

2020 ◽

Author(s):

Eleanor Ralphs ◽

Lucy Pembrey ◽

Jane West ◽

Gillian Santorelli

Keyword(s):

Pregnant Women ◽

Vaginal Delivery ◽

Regression Models ◽

Mode Of Delivery ◽

Multivariable Analysis ◽

Royal Infirmary ◽

Healthy Weight ◽

Linear Regression Models ◽

Logistic Regression Models ◽

Born In Bradford

Abstract Background Globally, it is becoming more common for pregnant women to deliver by caesarean section (CS). In 2012, 21% of births in the UK were CS, surpassing the recommended prevalence of 15%. Concerns have been raised regarding potential unknown consequences of this mode of delivery.Childhood adiposity is also an increasing concern. Previous research provides inconsistent conclusions on the association between CS and childhood adiposity. More studies are needed to investigate the consequences of CS in different populations and ethnicities. Therefore, this study investigates the association between mode of delivery and BMI, in children of 4-5 years and if this differs between White British (WB) and Pakistani ethnicities, in Bradford UK.Methods Data were obtained from the Born in Bradford (BiB) cohort, which recruited pregnant women at the Bradford Royal Infirmary, between 2007-2010. For these analyses, a sub-sample (n=6410) of the BiB cohort (n=13858) was used. Linear regression models determined the association between mode of delivery (vaginal or CS) and BMI z-scores at 4-5 years. Children were categorised as underweight/healthy weight, overweight and obese, and logistic regression models determined the odds of adiposity. Effect modification by ethnicity was also explored.Results Multivariable analysis found no evidence for a difference in BMI z-score between children of CS and vaginal delivery (0.005 kg/m2, 95% CI= -0.062–0.072, p=0.88). Neither was there evidence of CS affecting the odds of being overweight (OR=1.05, 95% CI=0.86–1.28, p=0.65), or obese (OR=0.98, 95% CI=0.74–1.29, p=0.87). There was no evidence that ethnicity was an effect modifier of these associations (p=0.97). Conclusion Having CS, compared to a vaginal delivery, was not associated with greater adiposity in children of 4-5 years in this population. Concerns over CS increasing adiposity in children are not supported by the findings reported here using the BiB study population, of both WB and Pakistani families.

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Micronutrient Status and Dietary Intake of Iron, Vitamin A, Iodine, Folate and Zinc in Women of Reproductive Age and Pregnant Women in Ethiopia, Kenya, Nigeria and South Africa: A Systematic Review of Data from 2005 to 2015

Nutrients ◽

10.3390/nu9101096 ◽

2017 ◽

Vol 9 (10) ◽

pp. 1096 ◽

Cited By ~ 44

Author(s):

Rajwinder Harika ◽

Mieke Faber ◽

Folake Samuel ◽

Judith Kimiywe ◽

Afework Mulugeta ◽

...

Keyword(s):

South Africa ◽

Systematic Review ◽

Vitamin A ◽

Dietary Intake ◽

Pregnant Women ◽

Reproductive Age ◽

Women Of Reproductive Age ◽

Micronutrient Status

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Faculty Opinions recommendation of Burden of tuberculosis in HIV-positive pregnant women in Cape Town, South Africa.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733487840.793550301 ◽

2018 ◽

Author(s):

Anthony Harries ◽

Kudakwashe C Takarinda

Keyword(s):

South Africa ◽

Pregnant Women ◽

Cape Town ◽

Hiv Positive

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Dietary and serum vitamin D and preeclampsia risk in Chinese pregnant women: a matched case–control study

British Journal Of Nutrition ◽

10.1017/s0007114521002956 ◽

2021 ◽

pp. 1-26

Author(s):

Xue-min Huang ◽

Yan-hua Liu ◽

Han Zhang ◽

Yuan Cao ◽

Wei-feng Dou ◽

...

Keyword(s):

Vitamin D ◽

Dietary Intake ◽

Pregnant Women ◽

Case Control Study ◽

Serum Levels ◽

Case Control ◽

Serum Concentrations ◽

Matched Case ◽

Matched Case Control Study ◽

Control Study

Abstract The effect of vitamin D (VD) on the risk of preeclampsia (PE) is uncertain. Few of previous studies focused on the relationship between dietary VD intake and PE risk. Therefore, we conducted this 1:1 matched case-control study to explore the association of dietary VD intake and serum VD concentrations with PE risk in Chinese pregnant women. A total of 440 pairs of participants were recruited during March 2016 to June 2019. Dietary information was obtained using a 78-item semi-quantitative food frequency questionnaire. Serum concentrations of 25(OH)D2 and 25(OH)D3 were measured by liquid chromatography–tandem mass spectrometry. Multivariate conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Restricted cubic splines (RCS) were plotted to evaluate the dose-response relationship of dietary VD intake and serum VD concentrations with PE risk. Compared with the lowest quartile, the ORs of the highest quartile were 0.45 (95%CI: 0.29-0.71, Ptrend = 0.001) for VD dietary intake and 0.26 (95%CI: 0.11-0.60, Ptrend = 0.003) for serum levels after adjusting for confounders. In addition, the RCS analysis suggested a reverse J-shaped relationship between dietary VD intake and PE risk (P-nonlinearity = 0.02). A similar association was also found between serum concentrations of total 25(OH)D and PE risk (P-nonlinearity = 0.02). In conclusion, this study provides evidence that higher dietary intake and serum levels of VD are associated with the lower risk of PE in Chinese pregnant women.

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Time trends in socio-economic, urban-rural and regional disparities in prevalence of obesity among non-pregnant women in Lesotho: evidence from Lesotho demographic and health surveys (2004–2014)

BMC Public Health ◽

10.1186/s12889-021-10571-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Betregiorgis Zegeye ◽

Gebretsadik Shibre ◽

Gashaw Garedew Woldeamanuel

Keyword(s):

Pregnant Women ◽

Health Surveys ◽

Educational Inequality ◽

Statistical Significance ◽

World Health ◽

Demographic And Health Surveys ◽

Obesity Prevalence ◽

Urban Rural ◽

Prevalence Of Obesity ◽

Health Organization

Abstract Background The growing rates of obesity in developing countries are alarming. There is a paucity of evidence about disparities of obesity in Lesotho. This study examined socioeconomic and area-based inequalities in obesity among non-pregnant women in Lesotho. Methods Data were extracted from the 2004, 2009 and 2014 Lesotho Demographic and Health Surveys (LDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. Obesity prevalence was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, simple and complex as well as relative and absolute summary measures were calculated. A 95% confidence interval was used to measure statistical significance of findings. Results We noticed substantial wealth-driven (D = -21.10, 95% CI; − 25.94, − 16.26), subnational region (PAR = -11.82, 95%CI; − 16.09, − 7.55) and urban-rural (− 9.82, 95% CI; − 13.65, − 5.99) inequalities in obesity prevalence without the inequalities improved over time in all the studied years. However, we did not identify educational inequality in obesity. Conclusions Wealth-driven and geographical inequalities was identified in Lesotho in all the studied time periods while education related inequalities did not appear during the same time period. All population groups in the country need to be reached with interventions to reduce the burden of obesity in the country.

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