Changes in Body Composition in Apparently Healthy Urban Indian Women Up to 3 Years Postpartum

Overview

Journal Indian J Endocrinol Metab

Specialty Endocrinology

Date 2015 Jul 17

PMID 26180762

Citations 3

Authors

Neha A Kajale

Anuradha V Khadilkar

Shashi A Chiplonkar

Vaman Khadilkar

Affiliations

Soon will be listed here.

Abstract

Introduction: Dietary and life style practices differ in postpartum (PP) and nonpregnant Indian women. Effect of these practices on postpartum weight retention (PPWR) and development of cardio-metabolic risk (CMR) has been scarcely studied in urban women. Aims of this study were to (i) compare anthropometry, biochemical parameters and body composition up to 3 years PP (ii) effect of PPWR, dietary fat intake and physical activity on CMR factors.

Methods:

Design: Cross-sectional, 300-fullterm, apparently healthy primi-parous women (28.6 ± 3.4 years) randomly selected. 128 women within 7-day of delivery (Group-A), 88 with 1-2 years (Group-B) and 84 with 3-4-year-old-children (Group-C) were studied. Anthropometry, sociodemographic status, physical activity, diet, clinical examination, biochemical tests, body composition, at total body (TB), by dual energy X-ray absorptiometry (GE-Lunar DPX) were collected.

Results: Women at 3-year PP showed higher weight retention (6.5[10] kg) than at 1-year (3.0[7] kg) (median [IQR]). Android fat % (central obesity) increased (P < 0.05) at 1-year PP (47 ± 10.0%) when compared to 1-week PP (44.3 ± 6.7%) and remained elevated at 3-year PP (45.6 ± 10.2%). Regression analysis revealed that at 1-year PP, increase in PPWR (Odd Ratio [OR] 1.8, 95% confidence interval [CI] = [1.2, 2.5], P < 0.001) and inactivity (OR 1.4, 95% CI= (0.97, 2.0), P < 0.1) were predictors for CMR. At 3-year PP, only PPWR was responsible for increase in CMR parameters (OR 1.6, 95% CI = (1.3, 2.3), P < 0.001) and not inactivity (P > 0.1).

Conclusion: Postdelivery, low physical activity and higher PPWR may increase CMR in Indian women.

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References

Chiplonkar S, Agte V, Tarwadi K, Paknikar K, Diwate U . Micronutrient deficiencies as predisposing factors for hypertension in lacto-vegetarian Indian adults. J Am Coll Nutr. 2004; 23(3):239-47. DOI: 10.1080/07315724.2004.10719367. View

Baker J, Gamborg M, Heitmann B, Lissner L, Sorensen T, Rasmussen K . Breastfeeding reduces postpartum weight retention. Am J Clin Nutr. 2008; 88(6):1543-51. DOI: 10.3945/ajcn.2008.26379. View

Hatsu I, McDougald D, Anderson A . Effect of infant feeding on maternal body composition. Int Breastfeed J. 2008; 3:18. PMC: 2519058. DOI: 10.1186/1746-4358-3-18. View

Lear S, Humphries K, Kohli S, Chockalingam A, Frohlich J, Birmingham C . Visceral adipose tissue accumulation differs according to ethnic background: results of the Multicultural Community Health Assessment Trial (M-CHAT). Am J Clin Nutr. 2007; 86(2):353-9. DOI: 10.1093/ajcn/86.2.353. View

Ostbye T, Peterson B, Krause K, Swamy G, Lovelady C . Predictors of postpartum weight change among overweight and obese women: results from the Active Mothers Postpartum study. J Womens Health (Larchmt). 2011; 21(2):215-22. PMC: 3525888. DOI: 10.1089/jwh.2011.2947. View

Kew S, Ye C, Hanley A, Connelly P, Sermer M, Zinman B . Cardiometabolic implications of postpartum weight changes in the first year after delivery. Diabetes Care. 2014; 37(7):1998-2006. DOI: 10.2337/dc14-0087. View

Motil K, Sheng H, Kertz B, Montandon C, Ellis K . Lean body mass of well-nourished women is preserved during lactation. Am J Clin Nutr. 1998; 67(2):292-300. DOI: 10.1093/ajcn/67.2.292. View

. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002; 106(25):3143-421. View

Wiklund P, Xu L, Wang Q, Mikkola T, Lyytikainen A, Volgyi E . Lactation is associated with greater maternal bone size and bone strength later in life. Osteoporos Int. 2011; 23(7):1939-45. DOI: 10.1007/s00198-011-1790-z. View

10.

Khadilkar A, Chiplonkar S, Pandit D, Kinare A, Khadilkar V . Metabolic risk factors and arterial stiffness in Indian children of parents with metabolic syndrome. J Am Coll Nutr. 2012; 31(1):54-62. DOI: 10.1080/07315724.2012.10720009. View

11.

Gunderson E, Sternfeld B, Wellons M, Whitmer R, Chiang V, Quesenberry Jr C . Childbearing may increase visceral adipose tissue independent of overall increase in body fat. Obesity (Silver Spring). 2008; 16(5):1078-84. PMC: 2952441. DOI: 10.1038/oby.2008.40. View

12.

Misra A, Wasir J, Pandey R . An evaluation of candidate definitions of the metabolic syndrome in adult Asian Indians. Diabetes Care. 2005; 28(2):398-403. DOI: 10.2337/diacare.28.2.398. View

13.

Chen L, Low Y, Fok D, Han W, Chong Y, Gluckman P . Dietary changes during pregnancy and the postpartum period in Singaporean Chinese, Malay and Indian women: the GUSTO birth cohort study. Public Health Nutr. 2013; 17(9):1930-8. PMC: 11108683. DOI: 10.1017/S1368980013001730. View

14.

Cho G, Yoon H, Kim E, Oh M, Seo H, Kim H . Postpartum changes in body composition. Obesity (Silver Spring). 2011; 19(12):2425-8. DOI: 10.1038/oby.2011.163. View

15.

Durham H, Morey M, Lovelady C, Namenek Brouwer R, Krause K, Ostbye T . Postpartum physical activity in overweight and obese women. J Phys Act Health. 2011; 8(7):988-93. PMC: 3613777. DOI: 10.1123/jpah.8.7.988. View

16.

Gunderson E . Childbearing and obesity in women: weight before, during, and after pregnancy. Obstet Gynecol Clin North Am. 2009; 36(2):317-32, ix. PMC: 2930888. DOI: 10.1016/j.ogc.2009.04.001. View

17.

Astrup A . Macronutrient balances and obesity: the role of diet and physical activity. Public Health Nutr. 1999; 2(3A):341-7. DOI: 10.1017/s1368980099000464. View

18.

Butte N, Hopkinson J . Body composition changes during lactation are highly variable among women. J Nutr. 1998; 128(2 Suppl):381S-385S. DOI: 10.1093/jn/128.2.381S. View

19.

Maddah M, Nikooyeh B . Weight retention from early pregnancy to three years postpartum: a study in Iranian women. Midwifery. 2008; 25(6):731-7. DOI: 10.1016/j.midw.2008.01.004. View

20.

Evenson K, Aytur S, Borodulin K . Physical activity beliefs, barriers, and enablers among postpartum women. J Womens Health (Larchmt). 2010; 18(12):1925-34. PMC: 2828187. DOI: 10.1089/jwh.2008.1309. View