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Title: Breastfeeding and obesity among Kuwaiti preschool children.
Author: Al-Qaoud N; Prakash P
Source: Medical Principles and Practice. 2009;18(2):111-7.
Abstract: OBJECTIVES: To determine if breastfeeding and its duration are associated with a reduced risk of obesity among Kuwaiti preschool children. SUBJECTS AND METHODS: The sample consisted of 2,291 (1,092 males and 1,199 females) preschool children (3-6 years of age) and their mothers. The data were collected from September 2003 to June 2004. Height and weight measurements were used for defining weight status while other data were collected by questionnaire. RESULTS: There was no significant association of breastfeeding or its duration with either overweight or obesity among preschool children after adjusting for effects of the confounders. The child's gender, age and birth weight were the significant factors influencing current weight. Girls were at 32% higher risk of becoming obese than boys. Children aged 4-5 years were at nearly 3 times higher risk of overweight and obesity than children of less than 4 years. Children with higher birth weight (>or=4 kg) had double the risk of obesity than those of normal birth weight (>or=2.5 to <4.0 kg). Maternal obesity was a strong predictor of obesity in the children. A child with an obese mother had nearly 2 times higher risk of being overweight (BMI between the 85th the 95th percentiles) and 3 times of being obese (BMI >or=95th percentile) compared to a child born to a mother with a normal body weight. CONCLUSION: Breastfeeding and its duration are not associated with obesity status. However, there is a positive association between child and maternal obesity.
Language: English
Keywords:
KUWAIT | RESEARCH REPORT | PREVALENCE | CHILDREN | BREASTFEEDING | OBESITY | BODY WEIGHT | CHILD HEALTH | Middle East | Developed Countries | Measurement | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Infant Nutrition | Nutrition | Health | Physiology | Biology
Document Number: 341031

Title: Effectiveness of a community-based intervention to improve nutrition in young children in Senegal: a difference in difference analysis.
Author: Alderman H; Ndiaye B; Linnemayr S; Ka A; Rokx C; Dieng K; Mulder-Sibanda M
Source: Public Health Nutrition. 2009 May;12(5):667-73.
Abstract: There are few studies of community growth promotion as a means of addressing malnutrition that are based on longitudinal analysis of large-scale programmes with adequate controls to construct a counterfactual. The current study uses a difference in difference comparison of cohorts to assess the impact on the proportion of underweight children who lived in villages receiving services provided by the Senegal Nutrition Enhancement Project between 2004 and 2006. The project, designed to extend nutrition and growth promotion intervention into rural areas through non-governmental organisation service providers, significantly lowered the risk of a child having a weight more than 2 sd below international norms. The odds ratio of being underweight for children in programme villages after introduction of the intervention was 0.83 (95% CI 0.686, 1.000), after controlling for regional trends and village and household characteristics. Most measured aspects of health care and health seeking behaviour improved in the treatment relative to the control.
Language: English
Keywords:
SENEGAL | RESEARCH REPORT | COHORT ANALYSIS | RURAL POPULATION | CHILD NUTRITION | INTERVENTIONS | NUTRITION PROGRAMS | PROGRAM EFFECTIVENESS | BODY WEIGHT | COMMUNITY HEALTH SERVICES | PROMOTION | BEHAVIOR CHANGE | GROWTH | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Research Methodology | Population Characteristics | Demographic Factors | Population | Nutrition | Health | Programs | Organization and Administration | Primary Health Care | Health Services | Delivery of Health Care | Program Evaluation | Physiology | Biology | Marketing | Economic Factors | Behavior | Child Development
Document Number: 342116

Title: The use of home-based therapy with ready-to-use therapeutic food to treat malnutrition in a rural area during a food crisis.
Author: Amthor RE; Cole SM; Manary MJ
Source: Journal of the American Dietetic Association. 2009 Mar;109(3):464-7.
Abstract: When the international community declared a famine in Malawi in January of 2006, emergency food aid reached only populations with pre-existing health care services. To treat the widespread childhood malnutrition in Machinga district, a rural area lacking health care facilities, in February 2006 five outpatient therapeutic programs were implemented that utilized home-based therapy and ready-to-use therapeutic food. Children with severe malnutrition, defined as the presence of edema and/or a weight-for-height less than 70% of the reference standard, were enrolled in the program. Two senior clinical nurses trained village health aides in each of the five communities. Children visited the health aides biweekly. During the visits, health aides collected demographic and anthropometric information and distributed a 2-week supply of ready-to-use therapeutic food, providing 175 kcal/kg/d. Treatment continued for 8 weeks; children were discharged before 8 weeks if they reached a weight-for-height more than 100% of the reference standard, or required admission to the hospital due to systemic infection or recurrence of edema. Of the 826 children enrolled, 775 (93.7%) recovered, 13 (1.8%) remained malnourished, 30 (3.6%) defaulted, and 8 (0.9%) died. Mean weight gained was 2.7+/-3.7 g/kg/d, height gained 0.3+/-0.9 mm/d, and mid-upper arm circumference gained 0.2+/-0.3 mm/d. Home-based therapy with ready-to-use therapeutic food administered by village health aides is an effective approach to treating malnutrition during food crises in areas lacking health services.
Language: English
Keywords:
DEVELOPING COUNTRIES | MALAWI | RESEARCH REPORT | RURAL AREAS | COMMUNITY | CHILDREN | FAMINE | FOOD SECURITY | NUTRITION DISORDERS | ANTHROPOMETRY | BODY WEIGHT | BODY HEIGHT | MALNUTRITION | HOME CARE | TREATMENT | Africa, Southern | Africa, Sub Saharan | Africa | Geographic Factors | Population | Residence Characteristics | Population Distribution | Youth | Age Factors | Population Characteristics | Demographic Factors | Food Supply | Natural Resources | Environment | Diseases | Measurement | Research Methodology | Physiology | Biology | Care and Support | Health Services | Delivery of Health Care | Health | Medical Procedures | Medicine
Document Number: 330803

Peer Reviewed

Title: Changes in weight, total fat, percent body fat, and central-to-peripheral fat ratio associated with injectable and oral contraceptive use.
Author: Berenson AB; Rahman M
Source: American Journal of Obstetrics and Gynecology. 2009 Mar;200(3):329.e1-8.
Abstract: OBJECTIVE: The purpose of this study was to determine changes in bodyweight and composition that result from hormonal contraception. STUDY DESIGN: Dual-energy x-ray absorptiometry was performed at baseline and every 6 months for 3 years for 703 women (African American, 200; white, 247; Hispanic, 256) who were beginning the use of oral contraception (OC; n = 245), depot medroxyprogesterone acetate (DMPA; n = 240), or nonhormonal contraception (NH; n = 218). DMPA discontinuers were observed for up to 2 years to examine the reversibility of the observed changes. RESULTS: Over 36 months, DMPA users increased their weight (+5.1 kg), body fat (+4.1 kg), percent body fat (+3.4%), and central-to-peripheral fat ratio (+0.1) more than OC and NH users (P < .01). OC use did not cause weight gain. After DMPA discontinuation, NH users lost 0.42 kg in 6 months; OC users gained 0.43 kg in 6 months. CONCLUSION: Bodyweight and fat significantly increase with the use of DMPA. After discontinuation of DMPA, some decrease in bodyweight and fat occurs when NH is used.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | WOMEN | ORAL CONTRACEPTIVES | BODY WEIGHT | MEDROXYPROGESTERONE ACETATE | CONTRACEPTIVE USAGE | LIPIDS | Developed Countries | North America | Americas | Studies | Research Methodology | Demographic Factors | Population | Contraceptive Methods | Contraception | Family Planning | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 330467

Peer Reviewed

Title: Comparison of CD4 cell count, viral load, and other markers for the prediction of mortality among HIV-1-infected Kenyan pregnant women.
Author: Brown ER; Otieno P; Mbori-Ngacha DA; Farquhar C; Obimbo EM; Nduati R; Overbaugh J; John-Stewart GC
Source: Journal of Infectious Diseases. 2009 May 1;199(9):1292-300.
Abstract: BACKGROUND: There are limited data regarding the relative merits of biomarkers as predictors of mortality or time to initiation of antiretroviral therapy (ART). METHODS: We evaluated the usefulness of the CD4 cell count, CD4 cell percentage (CD4%), human immunodeficiency virus type 1 (HIV-1) load, total lymphocyte count (TLC), body mass index (BMI), and hemoglobin measured at 32 weeks' gestation as predictors of mortality in a cohort of HIV-1-infected women in Nairobi, Kenya. Sensitivity, specificity, positive predictive value (PPV), and area under the receiver operating characteristic (ROC) curve (AUC) were determined for each biomarker separately, as well as for the CD4 cell count and the HIV-1 load combined. RESULTS: Among 489 women with 10,150 person-months of follow-up, mortality rates at 1 and 2 years postpartum were 2.1% (95% confidence interval [CI], 0.7%-3.4%) and 5.5% (95% CI, 3.0%-8.0%), respectively. CD4 cell count and CD4% had the highest AUC value (>0.9). BMI, TLC, and hemoglobin were each associated with but poorly predictive of mortality (PPV, <7%). The HIV-1 load did not predict mortality beyond the CD4 cell count. CONCLUSIONS: The CD4 cell count and CD4% measured during pregnancy were both useful predictors of mortality among pregnant women. TLC, BMI, and hemoglobin had a limited predictive value, and the HIV-1 load did not predict mortality any better than did the CD4 cell count alone.
Language: English
Keywords:
KENYA | RESEARCH REPORT | COHORT ANALYSIS | PERSONS LIVING WITH HIV/AIDS | PREGNANT WOMEN | IMMUNOLOGIC FACTORS | BODY WEIGHT | HEMOGLOBIN LEVEL | RISK FACTORS | AIDS | MORTALITY | ANTIRETROVIRAL THERAPY | TIME FACTORS | Africa, Eastern | Africa, Sub Saharan | Africa | Developing Countries | Research Methodology | HIV Infections | Viral Diseases | Diseases | Population Characteristics | Demographic Factors | Population | Immunity | Immune System | Physiology | Biology | Hemic System | Health | Population Dynamics | HIV
Document Number: 342360

Peer Reviewed

Title: Association between efficacy and body weight or body mass index for two low-dose oral contraceptives.
Author: Burkman RT; Fisher AC; Wan GJ; Barnowski CE; LaGuardia KD
Source: Contraception. 2009 Jun;79(6):424-7.
Abstract: BACKGROUND: This analysis investigated the association of oral contraceptive efficacy with body weight and body mass index (BMI) for hypothesis-generating purposes. STUDY DESIGN: Data were from a randomized, parallel-group trial of 180/215/250 mcg of norgestimate (NGM)/25 mcg of ethinyl estradiol (EE) (given to 1671 women) and 1 mg of norethindrone acetate (NETA)/20 mcg of EE (given to 1139 women). Pregnancies were evaluated across BMI deciles and by BMI and body weight dichotomies. A Pearl index was calculated for each treatment group. The relative risk (RR) of pregnancy was calculated with a Cox proportional hazards model. RESULTS: The Pearl index for women who received NGM/EE was 2.36 [95% confidence interval (CI)=1.33-3.40]; for those who received NETA/EE, the Pearl index was 3.29 (95% CI=1.81-4.77). Consistent, weak positive associations between weight and pregnancy risk were found. Overall, for women with a BMI >or=25 kg/m(2) (compared with women with a BMI <25 kg/m(2)), the RR of pregnancy was 1.84 (95% CI=0.98-3.45); that for women who received NGM/EE was 1.39 (95% CI=0.57-3.40), whereas that for women who received NETA/EE was 2.49 (95% CI=1.01-6.13). For women with a body weight >or=70 kg (compared with women with a body weight <70 kg), the RR was 1.25 (95% CI=0.63-2.46); that for women who received NGM/EE was 1.41 (95% CI=0.56-3.54), whereas that for women who received NETA/EE was 1.12 (95% CI=0.40-3.12). CONCLUSION: Women in the higher body weight or BMI category showed a small increase in the risk of pregnancy with these oral contraceptives, but this increase was not statistically significant overall or for either formulation studied.
Language: English
Keywords:
UNITED STATES OF AMERICA | RESEARCH REPORT | CLINICAL RESEARCH | COMPARATIVE STUDIES | WOMEN | CONTRACEPTIVE EFFECTIVENESS | BODY WEIGHT | NORGESTIMATE | ETHINYL ESTRADIOL | ORAL CONTRACEPTIVES, COMBINED | NORETHINDRONE ACETATE | ADMINISTRATION AND DOSAGE | Developed Countries | North America | Americas | Research Methodology | Studies | Demographic Factors | Population | Contraception | Family Planning | Physiology | Biology | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Oral Contraceptives | Contraceptive Methods | Norethindrone | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 341104

Peer Reviewed

Title: A visual dosing aid for first-line pediatric antiretroviral treatment in resource-poor settings.
Author: Callens SF; Westreich D; Kitetele F; Lusiama J; Shabani N; Belhorn T; Colebunders R; Behets F; Van Rie A
Source: Journal of Tropical Pediatrics. 2009 Apr;55(2):135-7.
Abstract: The visual dosing aid (VDA) was developed to facilitate dosing calculations in response to children's; growth and weight during antiretroviral treatment. The theoretical accuracy of the VDA was assessed using anthropometric data from 55 children receiving care in the USA and 324 children in the Democratic Republic of the Congo. The VDA dose was similar to the WHO recommended dose. A potentially significant relative dosing difference of >or=20% occurred in <3% of children for NVP, AZT and d4T, but was observed in 20% for 3TC, overdosing being more frequent. The VDA compared well with generic pediatric fixed dose combination tablets. Results did not differ between sites. The VDA enables accurate dosing of pediatric ART in distinct populations and could facilitate roll-out of pediatric ART in resource-poor settings.
Language: English
Keywords:
DEMOCRATIC REPUBLIC OF THE CONGO | RESEARCH REPORT | CHILDREN | ANTIRETROVIRAL DRUGS | ANTIRETROVIRAL THERAPY | TREATMENT | ADMINISTRATION AND DOSAGE | BODY WEIGHT | Developing Countries | Africa, Central | Africa, Sub Saharan | Africa | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | HIV | HIV Infections | Viral Diseases | Diseases | Drugs | Physiology | Biology
Document Number: 331199

9.
Title: Evolution of the nourishing condition on children submitted to additional feeding program in county of state of Sao Paulo, Brazil. Evolucao do estado nutricional de criancas submetidas a um programa de suplementacao alimentar em municipio do estado de Sao Paulo.
Author: Carvalho LG; Saldiva SR; da Costa Rosa TE; Lei DL
Source: Revista de Nutricao / Brazilian Journal of Nutrition. 2009 Mar-Apr;22(2):207-217.
Abstract: The objective of this study was to assess the impact of the Program Incentive to Fight Nutritional Deficiencies in the city of Assis, state of Sao Paulo. Methods A total of 132 children under 24 months who participated in the Program Incentive to Fight Nutritional Deficiencies for one year were followed. Their nutritional status was determined by comparing their weight-for-age in z-scores at baseline and after 2, 6, 9 and 12 months of follow-up to that of the reference population median given by the National Center for Health Statistics. Results Most (70%) of the children were classified as undernourished or at risk or malnutrition when they joined the Program Incentive to Fight Nutritional Deficiencies. After 12 months in the program, 64% of the children presented an increase in their weight-for-age z-score. Analysis of the mean weight-for-age z-score variation over time, according to age group and nutritional status at baseline, showed that children under 12 months of age had a significant increase in weight-for-age z-score. Conclusion Malnourished children under one year of age were the ones who benefited most from the Program Incentive to Fight Nutritional Deficiencies.
Language: Portuguese
Keywords:
BRAZIL | RESEARCH REPORT | DATA ANALYSIS | CHILDREN | DEFICIENCY DISEASES | NUTRITION DISORDERS | MALNUTRITION | NUTRITION INDEXES | INFANT NUTRITION | BODY WEIGHT | IMPACT | NUTRITION PROGRAMS | PROGRAM EVALUATION | South America, Eastern | South America | Latin America | Americas | Developing Countries | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Diseases | Nutrition | Health | Physiology | Biology | Communication | Primary Health Care | Health Services | Delivery of Health Care | Programs | Organization and Administration
Document Number: 340199

10.

Title: An assessment of the effectiveness of growth monitoring and promotion practices in the Lusaka district of Zambia.
Author: Charlton KE; Kawana BM; Hendricks MK
Source: Nutrition. 2009 Oct;25(10):1035-46.
Abstract: OBJECTIVE: We evaluated the effectiveness of the growth monitoring and promotion (GMP) program in Zambia. METHODS: A 3-mo prospective study of growth outcomes was undertaken at randomly selected health facilities and community posts within the Lusaka district. Children <2 y old (n=698) were purposively sampled from three health facilities (n=459) and four community posts (n=77) where health workers had undergone training in GMP and three health facilities where staff had not received training (n=162). Qualitative data on knowledge, attitudes, and practices of GMP were collected from health facility managers (n=6), health workers (n=35), and mothers whose children attended all follow-up visits (n=27). RESULTS: Anthropometric status of children in all groups deteriorated, with children at community posts having the worst outcomes (change in weight-for-age Z-score -0.8+/-0.7), followed by trained (-0.5+/-0.6) and untrained (-0.3+/-0.47; P<0.05) health facilities. A similar trend was seen for weight for length. The overall dropout rate was 74.1%. Weight-for-age Z-scores were higher at 1- and 2-mo follow-up visits for children who did not complete the study at trained health facilities and community posts compared with those who remained in the study. Mothers/caregivers identified GMP as important in attending the under-five clinic, associated their child's weight with overall health status, and expressed a willingness to comply with health workers' advice. However, health care providers were poorly motivated, inadequately supervised, and demonstrated poor practices. CONCLUSIONS: The GMP program in Lusaka is functioning suboptimally, even in facilities with trained staff.
Language: English
Keywords:
ZAMBIA | RESEARCH REPORT | MONITORING | CHILDREN | GROWTH | CHILD DEVELOPMENT | BODY WEIGHT | ANTHROPOMETRY | PROMOTION | PROGRAM EFFECTIVENESS | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Evaluation | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Biology | Physiology | Measurement | Research Methodology | Marketing | Economic Factors | Program Evaluation | Programs | Organization and Administration
Document Number: 342875

11.

Peer Reviewed

Title: Progestogen-only contraceptive use in obese women.
Author: Curtis KM; Ravi A; Gaffield ML
Source: Contraception. 2009 Oct;80(4):346-54.
Abstract: BACKGROUND: The objective of this systematic review is to determine whether obese women who use progestogen-only contraceptives are more likely to experience weight gain or serious adverse events as compared to nonobese users. STUDY DESIGN: We searched PubMed for all articles (in all languages) published in peer-reviewed journals from database inception through October 2008, for evidence relevant to obesity and progestogen-only contraceptives. We used standard abstract forms and grading systems to summarize and assess the quality of the evidence. RESULTS: From 579 articles, we identified nine studies fitting our selection criteria. Evidence from five studies suggests that among adult women, baseline weight or body mass index is not associated with weight gain among depot medroxyprogesterone acetate (DMPA) users (Level II-2, Fair). Evidence from three studies suggests that among adolescent women, overweight or obese DMPA users may gain more weight than normal weight DMPA users or overweight/obese nonusers (Level II-2, Fair). Evidence from one small study of Norplant users showed no differences in weight gain by baseline weight (Level II-3, Poor). We did not identify studies of other progestogen-only contraceptive methods that examined weight change by baseline weight, nor did we identify studies that reported on any serious adverse events by baseline weight. CONCLUSIONS: Adolescent DMPA users who are obese may gain more weight than normal weight users. This observation was not seen in adult DMPA users or adolescent Norplant users.
Language: English
Keywords:
GLOBAL | LITERATURE REVIEW | ADULTS | ADOLESCENTS, FEMALE | CONTRACEPTIVE AGENTS, PROGESTIN | PROGESTERONE | DEPO-PROVERA | CONTRACEPTIVE IMPLANTS | CONTRACEPTIVE AGENTS, SIDE EFFECTS | OBESITY | BODY WEIGHT | Age Factors | Population Characteristics | Demographic Factors | Population | Adolescents | Youth | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Progestational Hormones | Hormones | Endocrine System | Physiology | Biology | Medroxyprogesterone Acetate | Contraceptive Methods
Document Number: 342772

12.
Title: Mainstreaming early and exclusive breastfeeding for improving child survival.
Author: Dadhich JP; Agarwal RK
Source: Indian Pediatrics. 2009 Jan;46(1):11-7.
Abstract: India is home to maximum number of under-five deaths and underweight children in the world. In 2006, for the first time, the number of children in the world dying before their fifth birthday fell below 10 million, to 9.7 million annually. South Asia's contribution to this figure was 3.1 million out of which 2.1 million deaths occurred in India i.e., 21 percent of the global burden of under five deaths. Most of these deaths occur during the neonatal period. A reduction in the number of deaths among the under-five children reflects the country's progress on the fourth Millennium Development Goal (MDG 4). About 55 million, or one-third of the world's underweight children under the age of five years, live in India. Malnutrition has been estimated to be an underlying cause of up to 50-60 percent of under five deaths. The number of young underweight children reflects the country's progress on the first Millennium Development Goal (MDG 1), which deals with eradication of extreme poverty and hunger. In India, the average annual rate of decline in malnutrition has been around 0.9% since 1990. Considerably accelerated progress is needed for India to meet its MDG target of halving the percentage of underweight children by 2015. Despite breastfeeding's numerous recognized advantages, early and exclusive breastfeeding rates in most states of the India are low. There are many gaps in policy and programs related to infant and young child feeding in India. The big challenge is how to mainstream IYCF counseling and support interventions to help women to succeed both in early and exclusive breastfeeding. The rationale for supporting a major program to protect, promote and support breastfeeding action, backed by a budgetary support, is compelling for our country. Child health and development policies should urgently address this major concern.
Language: English
Keywords:
INDIA | RECOMMENDATIONS | HEALTH SURVEYS | MOTHERS | INFANT | BREASTFEEDING, EXCLUSIVE | CHILD SURVIVAL | MALNUTRITION | BODY WEIGHT | TIME FACTORS | POSTPARTUM PROGRAMS | LONGTERM EFFECTS | INTELLIGENCE | HIV PREVENTION | PREVENTION OF MOTHER-TO-CHILD TRANSMISSION | Asia, Southern | Asia | Developing Countries | Health | Parents | Family Relationships | Family Characteristics | Family and Household | Sociocultural Factors | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Breastfeeding | Infant Nutrition | Nutrition | Survivorship | Length of Life | Mortality | Population Dynamics | Nutrition Disorders | Diseases | Physiology | Biology | Family Planning Programs | Family Planning | Personality | Psychological Factors | Behavior | HIV Infections | Viral Diseases | Disease Transmission Control | Prevention and Control
Document Number: 331250

13.

Peer Reviewed

Title: Oral contraceptive effectiveness according to body mass index, weight, age, and other factors.
Author: Dinger JC; Cronin M; Mohner S; Schellschmidt I; Minh TD; Westhoff C
Source: American Journal of Obstetrics and Gynecology. 2009 May 28;
Abstract: OBJECTIVE: The purpose of this study was to assess the use-effectiveness of oral contraceptives (OCs) in Europe according to body mass index (BMI), weight, age, and other factors. STUDY DESIGN: In a planned secondary analysis, we used data from the European Active Surveillance Study on Oral Contraceptives, which was a prospective active cohort surveillance study of 59,510 OC users, to assess the effectiveness of OCs overall and by BMI, weight, age, duration of use, ethinylestradiol dose, regimen type, starting/switching status, and parity. Self-reported unplanned pregnancies during OC use were confirmed by interview. RESULTS: An analysis of OC effectiveness (112,659 women-years of exposure and 545 unplanned pregnancies) found little variation in effectiveness by BMI/weight. Failure rates decreased after 30 years of age and with an increasing duration of use. CONCLUSION: OC users in Europe reported high contraceptive effectiveness with "typical use." Failure rates decreased with age and duration ofuse. BMI and weight had little, if any, influence on effectiveness.
Language: English
Keywords:
EUROPE | RESEARCH REPORT | COHORT ANALYSIS | WOMEN | CONTRACEPTIVE USAGE | CONTRACEPTIVE EFFECTIVENESS | BODY WEIGHT | AGE FACTORS | Developed Countries | Research Methodology | Demographic Factors | Population | Contraception | Family Planning | Physiology | Biology | Population Characteristics
Document Number: 341572

14.
Title: [Efficacy and safety of drospirenone-ethinylestradiol on contraception in healthy chinese women: a multicenter randomized controlled trial]
Author: Fan GS; Bian ML; Cheng LN; Cao XM; Huang ZR; Han ZY; Jing XP; Li J; Wu SY; Xiong CL; Xiong ZA; Yue TF
Source: Zhonghua Fu Chan Ke Za Zhi. 2009 Jan;44(1):38-44.
Abstract: OBJECTIVE: To evaluate the contraception efficacy, mode of bleeding, side effects and other positive effects of drospirenone-ethinylestradiol (Yasmin) in healthy Chinese women. METHODS: This was a multicenter, randomized, control study of 768 healthy Chinese women who consulted about contraception. The subjects were randomized into Yasmin group (30 microg ethinylestradiol plus 3 mg drospirenone, 573 cases) or desogestrel group (30 microg ethinylestradiol plus 150 microg desogestrel, 195 cases) with the ratio of 3:1. Each individual was treated for 13 cycles. Further visits were required at cycle 4, cycle 7, cycle 10 and cycle 13 of treatment Weight, height, body mass index were evaluated at each visit. The menstrual distress questionnaire (MDQ) was given to the women at baseline, visit 3 (cycle 7) and visit 5 (after cycle 13). RESULTS: The values of basal features were similar between two groups (P > 0.05). The Pearl index (method failure) of Yasmin was 0. 208/hundred women year which was lower than that of desogestrel (0. 601/hundred women year). The mode of bleeding was similar between two groups after trial without showing any significant difference. According to MDQ subscale, the improvement of water retention and increasing appetite during inter-menstrual period and water retention and general well-being during menstrual period in the Yasmin group (-0.297, -0.057, 0.033, 0.150 respectively) was more obvious than that in the desogestrel group (-0.108, 0.023, 0.231, -0.023 respectively) with a significant difference (P < 0.05). Some other values which improved in both two groups, especially the improvement of breast tenderness and pain and skin abnormality in Yasmin group (18.0%, 89/494; 12.6%, 62/494) was more distinct than that in desogestrel group (11.3%, 19/168; 5.4%, 9/168). The mean weight increased in desogestrel group (0.57 kg) while it decreased in Yasmin group (-0.28 kg) with a significant difference (P < 0.01). CONCLUSIONS: Both Yasmin and desogestrel have good efficacy on contraception and similar modes of menstrual bleeding. Yasmin is better than desogestrel in terms of weight control and premenstrual syndrome of oral contraceptive.
Language: Chinese
Keywords:
CHINA | RESEARCH REPORT | WOMEN | PEARL'S FORMULA | BODY WEIGHT | BODY HEIGHT | MENSTRUATION DISORDERS | DESOGESTREL | ETHINYL ESTRADIOL | TREATMENT | TESTING | Asia, Eastern | Asia | Developing Countries | Demographic Factors | Population | Contraceptive Use-Effectiveness | Contraceptive Effectiveness | Contraception | Family Planning | Physiology | Biology | Diseases | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraceptive Agents, Estrogen | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Measurement | Research Methodology
Document Number: 341804

15.

Title: Nutritional recovery in HIV-infected and HIV-uninfected children with severe acute malnutrition.
Author: Fergusson P; Chinkhumba J; Grijalva-Eternod C; Banda T; Mkangama C; Tomkins A
Source: Archives of Disease in Childhood. 2009 Jul;94(7):512-6.
Abstract: OBJECTIVE: Few studies have reported on nutritional recovery, survival and growth among severely malnourished children with HIV. This study explores nutritional recovery in HIV-infected and HIV-uninfected children during inpatient nutrition rehabilitation and 4 months of follow-up. DESIGN: Prospective cohort study. SETTING: Lilongwe district, Malawi. MAIN OUTCOME MEASURES: Weight gain, anthropometrics. RESULTS: In our sample of 454 children with severe acute malnutrition (SAM), 17.4% (n = 79) of children were HIV infected. None of the children were on antiretroviral therapy upon admission. Among the HIV-infected children, 35.4% (28/79) died, compared with 10.4% (39/375) in HIV-uninfected children (p<0.001). All children who survived achieved nutritional recovery (>85% weight for height and no oedema), regardless of HIV status. HIV-infected children had similar weight gain to HIV-uninfected children (8.9 vs 8.0 g/kg/d, not significant (NS)). Mean increases in z-scores for both subscapular (2.72 vs 2.69, NS) and triceps (1.26 vs 1.48, NS) skinfolds were similar between HIV-infected and HIV-uninfected children, respectively, during nutrition rehabilitation. 362 children were followed for 4 months, at which time mean weight for height z-score was similar in HIV-infected and HIV-uninfected children (-0.85 vs -0.64, NS). CONCLUSIONS: HIV-infected children with SAM have higher mortality rates than HIV-uninfected children. Among those who survive, however, nutritional recovery is similar in HIV-infected and HIV-uninfected children.
Language: English
Keywords:
MALAWI | RESEARCH REPORT | PROSPECTIVE STUDIES | CHILDREN | HIV INFECTIONS | MALNUTRITION | CASE FATALITY RATE | GROWTH | ANTHROPOMETRY | BODY WEIGHT | Africa, Southern | Africa, Sub Saharan | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Nutrition Disorders | Death Rate | Mortality | Population Dynamics | Child Development | Biology | Measurement | Physiology
Document Number: 342645

16.

17.

Title: Use of combined oral contraceptives alters metabolic determinants and genetic regulation of C-reactive protein. The Cardiovascular Risk in Young Finns Study.
Author: Haarala A; Eklund C; Pessi T; Lehtimaki T; Huupponen R; Jula A; Viikari J; Raitakari O; Hurme M
Source: Scandinavian Journal of Clinical and Laboratory Investigation. 2009;69(2):168-74.
Abstract: BACKGROUND: Use of combined oral contraceptives (COCs) is known to increase concentrations of C-reactive protein (CRP), an important predictor of cardiovascular disease. The inflammatory nature of the disease is well acknowledged. The aim of this study was to find out whether the metabolic, lifestyle and genetic determinants of CRP differ between women who use COCs and those who do not use any hormonal contraceptives (non-users). MATERIAL AND METHODS: A total of 1,257 women (24-39 years) participated in the ongoing Cardiovascular Risk in Young Finns Study, a population based cross-sectional follow-up study. Use of hormonal contraceptives was determined by questionnaire. Plasma CRP and other cardiovascular risk factors were measured; five CRP gene polymorphisms were genotyped (-717A>G, -286C>T>A, +1059G>C, +1444C>T and +1846G>A) and CRP haplotypes were constructed. RESULTS: Multivariate regression analysis revealed that BMI and leptin were the main determinants of CRP in non-users, whereas in COC users the main determinants were BMI, leptin and triglycerides. The median CRP and triglyceride values were significantly higher in COC users than in non-users. The correlations between triglyceride and CRP were tested separately in different COC users in accordance with progestagen content and dosage, the analysis revealing significant association only in women using a high dosage of progestagen or cyproterone. The haplotypes of CRP gene had no significant association with CRP concentration in COC users, while independent effects on CRP were found in non-users. CONCLUSION: Our study suggests that use of COCs alters the metabolic determinants and genetic regulation of CRP.
Language: English
Keywords:
FINLAND | RESEARCH REPORT | WOMEN | YOUTH | CONTRACEPTIVE AGENTS, PROGESTIN | BODY WEIGHT | CARDIOVASCULAR EFFECTS | METABOLIC EFFECTS | Developed Countries | Europe, Northern | Europe | Demographic Factors | Population | Age Factors | Population Characteristics | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Physiology | Biology
Document Number: 341244

18.

Title: [Weight gain due to hormonal contraception: myth or truth?] Gewichtsveranderung unter hormonalen Kontrazeptiva: Mythos oder Wahrheit?
Author: Hani D; Imthurn B; Merki-Feld GS
Source: Gynakologisch - Geburtshilfliche Rundschau. 2009;49(2):87-93.
Abstract: Weight gain is one of the side effects often attributed to the use of hormonal contraception. Concern about weight gain can hinder particularly young women to use a safe contraceptive method or may be a reason for early discontinuation. In the following review, we present studies examining the influence of different contraceptive methods on weight change and discuss the results and methodological problems. During use of hormonal contraceptives, weight fluctuates by about 3 kg over an observation interval from 6 to 24 months. Only in a subgroup of Depo Provera users is the increase in weight higher: the proportion of women gaining >3 kg/year is higher compared with the other hormonal contraceptives. Interestingly users of intrauterine devices experience a weight gain too, which is approximately double that of the average female population. The age-associated weight gain has been described to be 0.1 kg/m(2) annually, corresponding to about 300 g/year.
Language: German
Keywords:
RESEARCH REPORT | RESEARCH METHODOLOGY | WOMEN | BODY WEIGHT | ORAL CONTRACEPTIVES, SIDE EFFECTS | Demographic Factors | Population | Physiology | Biology | Contraceptive Safety | Safety | Public Health | Health
Document Number: 330951

19.
Title: Paediatric antiretroviral therapy outcomes under HIV hospice care in South Africa.
Author: Harding R; Brits H; Penfold S
Source: International Journal of Palliative Nursing. 2009 Mar;15(3):142-5.
Abstract: AIM: This study aims to evaluate outcomes of children with advanced HIV disease who are initiated on antiretroviral therapy under multiprofessional specialist paediatric hospice care. DESIGN: A retrospective cohort file review methodology was undertaken in a specialist paediatric hospice in South Africa. METHODS: Antiretroviral therapy was initiated for children with a CD4% of less than 15% (for children under 6 years of age) or a CD4 count under 200 for children over 6 years of age. According to the World Health Organization Europe (2007) staging criteria, all children were stage 3/4 HIV disease. Multiprofessional staff provided daily tailored assessment and care. Each child was followed for 6 months. Data on mortality, CD4 count, CD4 percentage, body weight, and viral load were measured at initiation and a follow-up after 6 months. FINDINGS: Of the 37 children initiated on ART therapy, 31 I survived at 6 months. From a baseline of mean body weight 13.3 kg, there was an average of 3.2 kg increase (P < 0.001). Mean CD4 counts more than doubled (P < 0.001), with a mean increase of 467 cells per mm3 blood. Mean CD4 percentages increased from 13.6-19.4% (P < 0.001).Viral load decreased significantly from a median 271000 copies per mm3 blood to a median of 25 (imputed value for undetectable viral load) (P < 0.001). Twenty-three children had an undetectable viral load. CONCLUSION: For children with advanced HIV disease, who are least likely to access or respond to treatment, this study demonstrates a novel approach to managing care successfully.
Language: English
Keywords:
SOUTH AFRICA | RESEARCH REPORT | RETROSPECTIVE STUDIES | COHORT ANALYSIS | CHILDREN | PERSONS LIVING WITH HIV/AIDS | ANTIRETROVIRAL THERAPY | CARE AND SUPPORT | BODY WEIGHT | IMMUNOLOGIC FACTORS | MORTALITY | Developing Countries | Africa, Southern | Africa, Sub Saharan | Africa | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | HIV Infections | Viral Diseases | Diseases | HIV | Health Services | Delivery of Health Care | Health | Physiology | Biology | Immunity | Immune System | Population Dynamics
Document Number: 342153

20.

Title: Bone Accretion in Adolescents Using the Combined Estrogen and Progestin Transdermal Contraceptive Method Ortho Evra: A Pilot Study.
Author: Harel Z; Riggs S; Vaz R; Flanagan P; Harel D; Machan JT
Source: Journal of Pediatric and Adolescent Gynecology. 2009 Jul 30;
Abstract: OBJECTIVE: To date, there are no data regarding the effect of the transdermal combined estrogen and progestin contraceptive Ortho Evra on bone mineral content (BMC) and bone mineral density (BMD). We examined the effects of transdermally delivered ethinyl estradiol and norelgestromin on whole body (WB) BMC and BMD of the hip and lumbar spine (LS) of adolescent girls. METHODS: In a matched case-control study, girls (n=5) who applied Ortho Evra for days 1-21 followed by days 22-28 free of medication for 13 cycles (about 12 months) were compared with 5 age- and ethnicity-matched control girls. Evaluations of calcium intake; bone-protective physical activity; bone densitometry (DXA, QDR 4500A, Hologic); bone formation markers serum osteocalcin (OC) and bone-specific alkaline phosphatase (BAP); bone resorption marker urinary N-telopeptide (uNTX); insulin growth factor-1 (IGF-1); and sex hormone binding globulin (SHBG) were carried out at initiation, 6 months, and 12 months. Changes from baseline were compared using mixed models, adjusting for follow-up comparisons using the Holm Test (sequential Bonferroni). RESULTS: There were no significant differences (SD) between groups at baseline in age, gynecologic age, WBBMC, hip BMD, and LSBMD. Girls on Ortho Evra did not change significantly in WBBMC (12-month mean increase 0.2% +/- 0.8%), whereas controls did (3.9% +/- 1.8%, P Language: English
Keywords:
UNITED STATES OF AMERICA | RHODE ISLAND | RESEARCH REPORT | CONTROL GROUPS | ADOLESCENTS, FEMALE | CONTRACEPTIVE AGENTS, ESTROGEN | LOW-DOSE PROGESTINS | BIODEGRADABLE DELIVERY SYSTEMS | ETHINYL ESTRADIOL | CONTRACEPTIVE AGENTS, SIDE EFFECTS | SKELETAL EFFECTS | BODY WEIGHT | Developed Countries | North America | Americas | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Agents, Progestin | Contraceptive Methods | Physiology | Biology
Document Number: 342419

21.

Peer Reviewed

Title: Intergenerational effect of weight gain in childhood on offspring birthweight.
Author: Horta BL; Gigante DP; Osmond C; Barros FC; Victora CG
Source: International Journal of Epidemiology. 2009 Jun;38(3):724-32.
Abstract: BACKGROUND: Some studies suggest that weight gain in childhood may increase the risk of chronic diseases in adulthood, and recent studies have noticed that the timing of weight gain may be related to its long-term consequence. However, weight gain in childhood has clear short-term benefits, and the literature on the pro and cons of weight gain in childhood is limited. METHODS: In 1982, all 5914 hospital births (over 99% of all deliveries) occurring in Pelotas, Southern Brazil, were identified and studied prospectively on several occasions. In 2004-05, we attempted to trace the whole cohort and information on offspring birthweight was collected. Conditional growth modelling was used to assess the association between offspring birthweight and weight gain from birth to 20 months, and from 20 to 42 months. RESULTS: In 2004-05, we interviewed 4297 subjects, with a follow-up rate of 77.4%. This manuscript includes data from 848 women who had already delivered a child and 525 men who were fathers at the mean age of 23 years. Maternal birthweight, weight and length for age Z-score at 20 months of age were positively associated with next-generation birthweight, whereas paternal variables were not related to the outcome. Conditional growth modelling analyses showed that women whose weight gain in the first 20 months of life was faster than predicted had heavier babies, whereas paternal weight gain was not associated. The association was strongest for mothers whose birthweight for gestational age was in the lowest tertile. CONCLUSION: Maternal, but not paternal birthweight and weight gain in early childhood are positively associated with next-generation birthweight.
Language: English
Keywords:
BRAZIL | RESEARCH REPORT | INTERVIEWS | CHILDREN | BODY WEIGHT | POPULATION GENETICS | HEREDITARY DISEASES | OBESITY | BIRTH WEIGHT | South America, Eastern | South America | Latin America | Americas | Developing Countries | Data Collection | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Physiology | Biology | Genetics | Diseases
Document Number: 342506

22.

Peer Reviewed

Title: Effect of preventive supplementation with ready-to-use therapeutic food on the nutritional status, mortality, and morbidity of children aged 6 to 60 months in Niger: a cluster randomized trial.
Author: Isanaka S; Nombela N; Djibo A; Poupard M; Van Beckhoven D; Gaboulaud V; Guerin PJ; Grais RF
Source: JAMA. 2009 Jan 21;301(3):277-85.
Abstract: CONTEXT: Ready-to-use therapeutic foods (RUTFs) are an important component of effective outpatient treatment of severe wasting. However, their effectiveness in the population-based prevention of moderate and severe wasting has not been evaluated. OBJECTIVE: To evaluate the effect of a 3-month distribution of RUTF on the nutritional status, mortality, and morbidity of children aged 6 to 60 months in Niger. DESIGN, SETTING, AND PARTICIPANTS: A cluster randomized trial of 12 villages in Maradi, Niger. Six villages were randomized to intervention and 6 to no intervention. All children in the study villages aged 6 to 60 months were eligible for recruitment. INTERVENTION: Children with weight-for-height 80% or more of the National Center for Health Statistics reference median in the 6 intervention villages received a monthly distribution of 1 packet per day of RUTF (92 g [500 kcal/d]) from August to October 2006. Children in the 6 nonintervention villages received no preventive supplementation. Active surveillance for conditions requiring medical or nutritional treatment was conducted monthly in all 12 study villages from August 2006 to March 2007. MAIN OUTCOME MEASURES: Changes in weight-for-height z score (WHZ) according to the World Health Organization Child Growth Standards and incidence of wasting (WHZ <-2) over 8 months of follow-up. RESULTS: The number of children with height and weight measurements in August, October, December, and February was 3166, 3110, 2936, and 3026, respectively. The WHZ difference between the intervention and nonintervention groups was -0.10 z (95% confidence interval [CI], -0.23 to 0.03) at baseline and 0.12 z (95% CI, 0.02 to 0.21) after 8 months of follow-up. The adjusted effect of the intervention on WHZ from baseline to the end of follow-up was thus 0.22 z (95% CI, 0.13 to 0.30). The absolute rate of wasting and severe wasting, respectively, was 0.17 events per child-year (140 events/841 child-years) and 0.03 events per child-year (29 events/943 child-years) in the intervention villages, compared with 0.26 events per child-year (233 events/895 child-years) and 0.07 events per child-year (71 events/1029 child-years) in the nonintervention villages. The intervention thus resulted in a 36% (95% CI, 17% to 50%; P < .001) reduction in the incidence of wasting and a 58% (95% CI, 43% to 68%; P < .001) reduction in the incidence of severe wasting. There was no reduction in mortality, with a mortality rate of 0.007 deaths per child-year (7 deaths/986 child-years) in the intervention villages and 0.016 deaths per child-year (18 deaths/1099 child-years) in the nonintervention villages (adjusted hazard ratio, 0.51; 95% CI, 0.25 to 1.05). CONCLUSION: Short-term supplementation of nonmalnourished children with RUTF reduced the decline in WHZ and the incidence of wasting and severe wasting over 8 months. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT00682708.
Language: English
Keywords:
NIGER | RESEARCH REPORT | CLINICAL TRIALS | EPIDEMIOLOGIC METHODS | CHILDREN | FOOD SUPPLEMENTATION | CHILD MORTALITY | CHILD SURVIVAL | CHILD NUTRITION | PREVENTIVE HEALTH CARE | DISTRIBUTIONAL ACTIVITIES | BODY WEIGHT | GROWTH | MALNUTRITION | PREVALENCE | Developing Countries | Africa, Western | Africa, Sub Saharan | Africa | Clinical Research | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Nutrition Programs | Primary Health Care | Health Services | Delivery of Health Care | Health | Mortality | Population Dynamics | Survivorship | Length of Life | Nutrition | Program Activities | Programs | Organization and Administration | Physiology | Biology | Child Development | Nutrition Disorders | Diseases | Measurement
Document Number: 330049

23.

Title: Patterns of postnatal growth in HIV-infected and HIV-exposed children.
Author: Isanaka S; Duggan C; Fawzi WW
Source: Nutrition Reviews. 2009 Jun;67(6):343-59.
Abstract: HIV infection can contribute to disturbances in both linear growth and weight gain in early childhood, with disturbances often apparent as early as 3 months of age. There is little evidence for a difference in the early growth of HIV-exposed but uninfected children compared to healthy controls. Owing to the close association of growth with immune function and clinical progression, an understanding of growth patterns may be an important tool to ensure the provision of appropriate care to HIV-infected and exposed children. Timely growth monitoring may be used to improve the clinical course and quality of life of these children.
Language: English
Keywords:
AFRICA, SUB SAHARAN | RESEARCH REPORT | LONGITUDINAL STUDIES | CHILDREN | PERSONS LIVING WITH HIV/AIDS | EXPOSURE | HIV INFECTIONS | GROWTH | CHILD DEVELOPMENT | QUALITY OF LIFE | MONITORING | BODY WEIGHT | Africa | Developing Countries | Studies | Research Methodology | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Viral Diseases | Diseases | Risk Factors | Health | Biology | Social Welfare | Economic Factors | Evaluation | Physiology
Document Number: 342157

24.
Title: Metabolic profile and sex hormone binding globulin (SHBG) in different reproductive phases of Czech women and their relations to weight, body composition and fat distribution.
Author: KOSKOVA I; PETRASEK R; VONDRA K; DUSKOVA M; STARKA L
Source: Physiological Research / Academia Scientiarum Bohemoslovaca. 2009;58(3):393-402.
Abstract: In our study, 213 healthy Czech women aged 20 to 65 years were examined and divided into fully reproductive, premenopausal, menopausal and postmenopausal groups. In all subjects body composition was determined by classical anthropometry and metabolic profile was assessed. A total of 146 subjects completed 3-year longitudinal study. Total and LDL cholesterol increased and ratio HDL/total cholesterol decreased with age (p<0.001), most significantly in menopause. Triacylglycerols increased only up to menopause. HDL had a very slight trend to decrease in menopause and postmenopause. Fasting blood glucose level increased progressively (p<0.001), in postmenopause frequently exceeded normal range. Higher BMI, total fat mass and central fat indices were associated with higher total and LDL cholesterol, triacylglycerols, C-peptide, insulin and fasting blood glucose level (p<0.001; fasting blood glucose level to waist-to-hip ratio: p<0.01) and lower HDL cholesterol (p<0.001). Higher C-peptide and insulin were associated with lower HDL cholesterol and higher triacylglycerols (p<0.001). Fasting glucose correlated with LDL cholesterol (p<0.01). Higher SHBG was associated with higher HDL and lower LDL cholesterol (p<0.001). Hormone replacement treatment was related to lower fasting blood glucose level in postmenopausal women (p<0.01). Oral contraception is suggestive of a positive influence on lipid spectrum by increasing the ratio HDL/total cholesterol. Markers of lipid and carbohydrate metabolism are not only age-related, but they are also related to BMI, total fat mass and central fat indices. Therefore, preventive programs should be focused above all on menopausal women.
Language: English
Keywords:
CZECHOSLOVAKIA | RESEARCH REPORT | LONGITUDINAL STUDIES | WOMEN | CARBOHYDRATE METABOLIC EFFECTS | LIPID METABOLIC EFFECTS | CHOLESTEROL | BODY WEIGHT | ANTHROPOMETRY | AGE FACTORS | MENOPAUSE | ORAL CONTRACEPTIVES | HORMONE REPLACEMENT THERAPY | Europe, Central | Europe | Developing Countries | Studies | Research Methodology | Demographic Factors | Population | Metabolic Effects | Physiology | Biology | Lipids | Measurement | Population Characteristics | Reproduction | Contraceptive Methods | Contraception | Family Planning | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health
Document Number: 342621

25.

Title: Maternal weight and lean body mass may influence the lactation-related bone changes in young undernourished Indian women.
Author: Kulkarni B; Shatrugna V; Nagalla B; Ajeya Kumar P; Usha Rani K; Chandrakala Omkar A
Source: British Journal of Nutrition. 2009 May;101(10):1527-33.
Abstract: Lactation is known to be associated with a transient loss of bone mineral density (BMD) during 3-6 months post-partum. Bone changes during lactation in women consuming low dietary calcium are not sufficiently studied. The present longitudinal study examined the BMD changes during lactation in undernourished women and the relationship of bone changes to the nutritional status. Whole-body bone mineral content and BMD at hip, lumbar spine and forearm were assessed using dual-energy X-ray absorptiometry in thirty-six lactating women from the low socio-economic group at four time points -- within 1 month after delivery (baseline), and at 6, 12 and 18 months after delivery. Maternal body composition and biochemical parameters of bone metabolism were estimated at the same time. It was observed that femoral neck BMD reduced by 4.6 % at 6 months, but recovery to the baseline was incomplete at 18 months with a deficit of 2 %. Hip BMD reduction at 6 months was transient. Lumbar spine BMD did not show significant loss at 6 months and BMD increased by 3.6 and 6.3 % at 12 and 18 months, respectively. Regression analyses indicated that baseline lean mass was the most important determinant of bone preservation at femoral neck, hip as well as whole body, whereas baseline body weight was the most important determinant of per cent gain in lumbar spine. Maternal nutritional status as indicated by body weight and lean mass appears to influence the lactation-related BMD changes in undernourished women from the low socio-economic group in India.
Language: English
Keywords:
INDIA | RESEARCH REPORT | LONGITUDINAL STUDIES | LOW INCOME POPULATION | POSTPARTUM WOMEN | BODY WEIGHT | LACTATION | MALNUTRITION | DIET | SKELETAL EFFECTS | SERUM CALCIUM LEVEL | Asia, Southern | Asia | Developing Countries | Studies | Research Methodology | Social Class | Socioeconomic Status | Socioeconomic Factors | Economic Factors | Puerperium | Reproduction | Physiology | Biology | Maternal Physiology | Nutrition Disorders | Diseases | Nutrition | Health | Hemic System
Document Number: 342007

26.

Title: Maternal mid-pregnancy serum triglyceride levels and neonatal birth weight.
Author: Kushtagi P; Arvapally S
Source: International Journal of Gynaecology and Obstetrics. 2009 Mar 25;
Abstract: Although disturbances in maternal glucose metabolism and resultant fetal hyperinsulinemia are known to significantly impact fetal overgrowth, it has been suggested that other fuels such as lipids and amino acids may be the determinants of fetal growth in nondiabetics. Maternal serum lipid levels increase in mid to late pregnancy; and in women with gestational diabetes, elevated triglycerides were significantly associated with birth weight corrected for gestational age. Although the role of maternal hyperlipidemia in fetal growth is not known, maternal fasting serum triglyceride levels at 24 to 32 weeks of pregnancy were shown to be significantly and positively associated with neonatal weight at term, independent of maternal prepregnancy obesity, weight gain during pregnancy, or mid-pregnancy plasma glucose levels (either fasting or postprandial) in Japanese and white women. The aim of the present study was to determine the relationship between maternal mid-pregnancy serum lipid levels and neonatal birth weight in our region. (excerpt)
Language: English
Keywords:
INDIA | RESEARCH REPORT | CLINICAL RESEARCH | WOMEN IN DEVELOPMENT | PREGNANT WOMEN | INFANT | BIRTH WEIGHT | PREGNANCY, SECOND TRIMESTER | LIPIDS | LIPID METABOLIC EFFECTS | MATERNAL NUTRITION | CHOLESTEROL | GLUCOSE METABOLISM EFFECTS | BODY WEIGHT | Asia, Southern | Asia | Developing Countries | Research Methodology | Economic Development | Economic Factors | Population Characteristics | Demographic Factors | Population | Youth | Age Factors | Physiology | Biology | Pregnancy | Reproduction | Nutrition | Health | Carbohydrate Metabolic Effects | Metabolic Effects
Document Number: 341469

27.

Peer Reviewed

Title: Oral contraception usage in relation to bone mineral density and bone turnover in adolescent girls.
Author: Lattakova M; Borovsky M; Payer J; Killinger Z
Source: European Journal of Contraception and Reproductive Health Care. 2009 Jun;14(3):207-14.
Abstract: OBJECTIVES: To compare the effect of a low-dose oral contraceptive (OC) containing 30 microg ethinyloestradiol (EE) with that of an ultra-low-dose OC containing 15 microg EE on bone turnover and BMD in healthy adolescent women and, in addition, to ascertain the influence of body mass index (BMI) and exercise on these indices of bone metabolism. METHODS: We recruited to the study 92 healthy girls aged between 16 and 19. They were divided into three groups. Participants in the first two groups used an OC with either 15 or 30 microg ethinyloestradiol (EE), whereas those in the third group used no hormonal contraception. Bone mineral density (BMD) and bone turnover markers were measured before and after 12 months of treatment. RESULTS: The BMD values of the total hip in females using the OC containing 30 microg EE was 0.912 g/cm(2) at baseline and 0.918 g/cm(2) after one year; in females using the OC containing 15 microg EE the corresponding values were 0.888 g/cm(2) and 0.895 g/cm(2) whereas in females who used no contraception BMD values were 0.942 g/cm(2) and 0.949 g/cm(2), respectively. The changes were statistically insignificant. Levels of osteocalcin and CTX had decreased after one year in all groups, but not statistically significantly so. CONCLUSION: Low dose and ultra-low dose oral contraceptives did not significantly differ in their effects on bone mineral density or bone turnover markers in adolescent girls aged 16-19.
Language: English
Keywords:
SLOVAKIA | RESEARCH REPORT | CONTROL GROUPS | ADOLESCENTS, FEMALE | ORAL CONTRACEPTIVES, LOW-DOSE | ADMINISTRATION AND DOSAGE | SKELETAL EFFECTS | ETHINYL ESTRADIOL | BODY WEIGHT | FITNESS | Developing Countries | Europe, Central | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Oral Contraceptives | Contraceptive Methods | Contraception | Family Planning | Drugs | Treatment | Medical Procedures | Medicine | Health Services | Delivery of Health Care | Health | Physiology | Biology | Contraceptive Agents, Estrogen | Contraceptive Agents, Female | Contraceptive Agents
Document Number: 341800

28.

Peer Reviewed

Title: Adrenal glucocorticoid and androgen precursor dissociation in anorexia nervosa.
Author: Lawson EA; Misra M; Meenaghan E; Rosenblum L; Donoho DA; Herzog D; Klibanski A; Miller KK
Source: Journal of Clinical Endocrinology and Metabolism. 2009 Apr;94(4):1367-71.
Abstract: CONTEXT: Anorexia nervosa is characterized by hypogonadism and relative hypercortisolemia. We have demonstrated that free testosterone levels are low in women with anorexia nervosa, with the lowest levels in those receiving oral contraceptives (OCPs), and that dehydroepiandrosterone (DHEA) sulfate is reduced only in those receiving OCPs. OBJECTIVE: The aim of the study was to determine whether adrenal steroidogenesis dysregulation contributes to decreased androgen levels in anorexia nervosa. Design and Setting: We conducted a cross-sectional study in a General Clinical Research Center. STUDY PARTICIPANTS: We studied 20 women with anorexia nervosa [10 women with anorexia nervosa receiving OCPs (AN+E) and 10 not receiving OCPs (AN-E)] and 20 healthy controls [10 healthy controls receiving OCPs (HC+E) and 10 not receiving OCPs (HC-E)]. MAIN OUTCOME MEASURES: We measured DHEA and cortisol levels in response to 250-microg cosyntropin stimulation after 1-mg overnight dexamethasone suppression. RESULTS: Mean basal and stimulated, peak stimulated, and area under the curve (AUC) cortisol levels were higher in AN-E than HC-E, but mean basal and stimulated, peak and AUC DHEA were comparable. Mean AUC and peak cortisol were higher and DHEA AUC was lower in AN+E than AN-E. However, after controlling for cortisol binding globulin levels, peak and AUC cortisol were comparable between AN+E and AN-E. After controlling for albumin levels, AUC DHEA was comparable between AN+E and AN-E. CONCLUSIONS: Adrenal glucocorticoid and androgen precursor secretion are dissociated in anorexia nervosa, with relative hypercortisolemia and a preservation of DHEA secretion. Reduced DHEA response to cosyntropin in women receiving OCPs is attributable to decreased albumin levels. In the setting of relative hypercortisolemia, reduced adrenal androgen precursor secretion is not a mechanism underlying low testosterone levels in anorexia nervosa.
Language: English
Keywords:
MASSACHUSETTS | RESEARCH REPORT | CLINICAL RESEARCH | CROSS SECTIONAL ANALYSIS | CASE CONTROL STUDIES | WOMEN | DEFICIENCY DISEASES | BODY WEIGHT | TESTOSTERONE | ORAL CONTRACEPTIVES, SIDE EFFECTS | DEHYDROEPIANDROSTERONE | ANDROGENS | DEXAMETHASONE ACETATE | United States of America | North America | Americas | Developed Countries | Research Methodology | Studies | Demographic Factors | Population | Nutrition Disorders | Diseases | Physiology | Biology | Hormones | Endocrine System | Contraceptive Safety | Safety | Public Health | Health
Document Number: 341132

29.

Peer Reviewed

Title: Early weight gain predicting later weight gain among depot medroxyprogesterone acetate users.
Author: Le YC; Rahman M; Berenson AB
Source: Obstetrics and Gynecology. 2009 Aug;114(2 Pt 1):279-84.
Abstract: OBJECTIVE:: To examine if early weight gain in depot medroxyprogesterone acetate (DMPA) users predicts continued excessive weight gain and to identify risk factors of early weight gain in DMPA users. METHODS:: Depot medroxyprogesterone acetate users (N=240) were assessed before initiating contraception and every 3 months for 36 months. Early weight gain was defined as more than 5% baseline weight gain within 6 months of DMPA use. Mean weight gain at 6-month intervals was estimated based on early weight gain status (at or below 5% gain compared with above 5% gain). Multiple logistic and mixed-model regression analyses were used. RESULTS:: About one-fourth of DMPA users had early weight gain. The mean weight gain of the at or below 5% group and above 5% group was 0.63 kg and 8.04 kg, 1.48 kg and 10.86 kg, and 2.49 kg and 11.08 kg after 12, 24, and 36 months (P<.001 at all observations), respectively. Early weight gainers also had a much steeper slope of weight gain over time than the regular weight gainers (0.35 kg/month compared with 0.08 kg/month, P<.001). Risk factors for early weight gain were body mass index less than 30 (odds ratio [OR] 4.00, 95% confidence interval [CI] 1.513-10.455), parity (OR 2.23, 95% CI:1.040-4.761), and self-reported increased appetite after 6 months of DMPA use (OR 3.06, 95% CI 1.505-6.214). CONCLUSION:: Most DMPA users who gain excessive weight experience more than a 5% weight increase within 6 months. These data help physicians predict who is at risk of excessive gain and counsel them appropriately. LEVEL OF EVIDENCE:: II.
Language: English
Keywords:
UNITED STATES OF AMERICA | TEXAS | RESEARCH REPORT | WOMEN | MEDROXYPROGESTERONE ACETATE | ORAL CONTRACEPTIVES, SIDE EFFECTS | BODY WEIGHT | RISK FACTORS | Developed Countries | North America | Americas | Demographic Factors | Population | Contraceptive Agents, Progestin | Contraceptive Agents, Female | Contraceptive Agents | Contraception | Family Planning | Contraceptive Safety | Safety | Public Health | Health | Physiology | Biology
Document Number: 342271

30.

Peer Reviewed

Title: Contraceptive use and pregnancy outcome in three generations of Swedish female teenagers from the same urban population.
Author: Lindh I; Blohm F; Andersson-Ellstrom A; Milsom I
Source: Contraception. 2009 Aug;80(2):163-9.
Abstract: BACKGROUND: The primary objective of the study was to describe contraceptive use, reasons for discontinuation of contraception and pregnancy outcome in three generations of female teenagers over a period of 20 years. The secondary objective was to describe the relationship between contraception, smoking, body mass index (BMI) and socioeconomic status (SES). STUDY DESIGN: A cross-sectional comparison of 19-year-old women born in 1962, 1972 and 1982 and living in the city of Gothenburg, Sweden, in 1981, 1991 and 2001 was conducted. Contraceptive use, pregnancy outcome, smoking and weight/height were assessed by a postal questionnaire. RESULTS: Current contraceptive use was unchanged between the 62 (60%) and 72 cohorts (62%) but had increased (p<.01) in the 82 cohort (78%); there was no difference in contraceptive use between SES groups at any time. Condom use alone increased over time (p<.01), and the use of oral contraception and a condom together had increased in the 72 and 82 cohorts compared to the 62 cohort (p<.01). Reasons given for using and discontinuing oral contraceptives in three generations of teenagers were studied over 20 years. In addition to contraception, oral contraception was used to reduce dysmenorrhea and heavy bleeding. Discontinuation due to bleeding disturbances decreased (p<.01) over time, whereas discontinuation due to mental side effects increased (p<.01). The percentage of women who had been pregnant at < or =19 years of age in the 82 cohort (7%) was lower (p<.01) than in the 1962 (11%) and 1972 (13%) cohorts. However, there was a successive increase (p<.001) in the percentage of women who had been pregnant more than once at < or =19 years of age (1962/1972/1982: pregnant more than once, 8%/21%/31%). Smoking decreased over time (p<.01) and was no longer related to SES in the 82 cohort. BMI increased (p<.01) over time. There was no difference in BMI between SES groups in the 62 and 72 cohorts but was higher in the low-SES group in the 82 cohort compared to the middle (p<.01) and high (p<.05) SES groups. CONCLUSIONS: Contraceptive use was higher in the 82 cohort where there was a corresponding reduction in the percentage of women who had been pregnant at < or =19 years of age compared with the 62 and 72 cohorts. Discontinuation of oral contraception due to mental side effects increased over time. The prevalence of smoking decreased and BMI increased, and there were changes in smoking prevalence and BMI in the different SES groups over time.
Language: English
Keywords:
SWEDEN | RESEARCH REPORT | COHORT ANALYSIS | ADOLESCENTS, FEMALE | URBAN POPULATION | CONTRACEPTIVE USAGE | CONTRACEPTION TERMINATION | PREGNANCY OUTCOMES | TOBACCO USE | BODY WEIGHT | OBESITY | SOCIOECONOMIC STATUS | Developed Countries | Europe, Northern | Europe | Research Methodology | Adolescents | Youth | Age Factors | Population Characteristics | Demographic Factors | Population | Contraception | Family Planning | Pregnancy | Reproduction | Behavior | Physiology | Biology | Socioeconomic Factors | Economic Factors
Document Number: 342305


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