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Programming offspring behavior and metabolism through maternal high-fat diet
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showing an average methylation level higher than 10%. Among them, two (E2-F-CpG 3 and 4) were correlated with the mothers’ glucose levels (2-h post-OGTT) between 24 and 28 weeks of gestation (rs≤-0.30; p<0.01). Four other CpGs (C1-M-CpG 1 to 4) were correlated with mothers circulating adiponectin levels 24 hours post delivery (rs≤-0.33; p<0.05). These correlations were adjusted for first trimester BMI and weight gain during pregnancy. conclusions: Adiponectin DNA methylation profile shows adaptation to mothers’ blood glucose levels during pregnancy with the potential to induce transcription dysregulation. Those results support the hypothesis that epigenetics accounts for fetal programming. 31 Programming offspring behavior and metabolism through maternal high-fat diet L. Naef and C-D. Walker McGill University, Douglas Mental Health University Institute, Montreal, Quebec, Canada Introduction: Alterations in the nutritional and hormonal environment of developing young can predispose individuals to the development of obesity in adulthood. Our work focuses on the proximal and longterm consequences of these alterations on some of the brain systems implicated in the control of feeding and related behaviors, as well as the ability of metabolic hormones to modulate these brain circuits. Methods: Mother rats are maintained on either a control (5% fat) or a high-fat (30% fat) diet during the last week of gestation and throughout lactation, and all offspring are weaned onto the control diet until testing in adulthood. results: Augmenting the dams’ dietary fat content increases maternal milk fat and leptin concentrations, increases the adiposity of the pups and skews their hormonal profile towards significantly higher plasma leptin and glucocorticoid concentrations during the early postnatal period. These hormones target developing brain structures implicated in energy balance and reward. Consequently, as adults, high-fat exposed offspring display significant alterations in mesolimbic dopaminergic (DA) neurotransmission resulting in blunted locomotor and nucleus accumbens DA responses to amphetamine, but increased DA responses to stress. The behavioral consequences of these changes include increased motivation to work for fat pellets in an operant conditioning paradigm. conclusions: Our experiments demonstrate that increasing the fat content of the maternal diet has a significant impact on the nutritional and hormonal environment of developing young, alters brain circuits controlling feeding, and consequently favours behaviours associated with the development of obesity. 32 assessment of physical activity in pregnant obese women using the pregnancy physical activity questionnaire (PPaQ) and accelerometer N. Chandonnet1, D. Saey2, A. Dufresne1, J. Robitaille3, and I. Marc1 1 Paediatric department, Centre Mère-Enfant (CHUQ), CHUQ Research Center (CRCHUQ), Laval University, Québec City, Québec, Canada; 2 IUCPQ Research Center (CRIUCPQ), Laval University, Québec City, Québec, Canada; 3Nutrition and Food Science Department, Laval University, Québec City, Québec, Canada; Introduction: PPAQ is a validated tool available for the measure of physical activity (PA) during pregnancy. Validation of PPAQ in specific population, such as pregnant obese women, is required to assess the effect of PA on perinatal outcomes in this population. Objectives: To assess reliability and accuracy of a French version of the PPAQ in pregnant obese women. Methods: In this transversal study, pregnant obese women were equally recruited at the end of each trimester of pregnancy. They completed the
PPAQ twice, seven days apart, to recall PA in the last three months. Between the PPAQ assessments, they wore an accelerometer during seven consecutive days (Actigraph GT1M). results: 48 pregnant obese women (29.9±4.2 yrs, 34.8±5.1 kg/m2) participated to the study (n=17 at 14 weeks, n=16 at 26 weeks and n=15 at 36 weeks of gestational age). Intraclass correlation coefficients were 0.86 for total activity, 0.86 for moderate intensity, and 0.81 for vigorous intensity, and ranged from 0.59 for transportation activity to 0.97 for occupational activity. Spearman correlations between PPAQ and Freedson’s cut point were 0.26 for activity of >=light intensity, 0.30 for vigorous activity, 0.20 for moderate activity, and 0.19 for lightintensity activity. Correlations between PPAQ and accelerometer counts were 0.57 for activity of >=light intensity, 0.36 for vigorous activity, 0.47 for moderate activity, and 0.52 for light-intensity activity. conclusions: The French version of the PPAQ is reliable and accurate for the measure of PA of various intensities and types among pregnant obese women. 33 Improved weight management in primary care P. Brauer1, D. Royall2, J.J.M. Dwyer1, A.M. Edwards3, R. Goy1, T. Hussey4, N. Kates4, H. Smith5, and R. Kirkconnell5 1 Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada; 2Nutrition Research Consulting, Fergus, Ontario, Canada; 3Department of Computing and Communications Services, University of Guelph, Guelph, Ontario, Canada; 4Hamilton Family Health Team, Hamilton, Ontario; 5Guelph Family Health Team, Guelph, Ontario, Canada This program of work aimed to develop a flexible planning framework for action on obesity management in primary care. Three relevant planning models/frameworks were used to organize the work: the Chronic Care Model, the WHO planning framework for prevention of chronic disease, and the MRC (UK) guide to developing and evaluating complex interventions. The goal of the current funding was to identify and prioritize possible approaches that would be applicable to Canadian interprofessional primary care organizations. We first conducted a scoping review (2003-2009) for evidence of improved obesity management in primary care looking for innovations in “organization of care” from studies based on representative patient samples. Secondly, we conducted 11 focus groups with providers and patients in the Hamilton Family Health Team on ideas for new services. The final phase was to draft and review a planning framework with one interprofessional group of providers: 11 members of the Guelph Family Health Team. To facilitate decision-making, electronic meeting software was employed in a one-day face-to-face meeting, that include nominal group, free discussion and rating and ranking exercises. Evidence was widely scattered in diverse disease-focused studies, with few studies focusing on organization of care issues. Key themes from the focus groups for patient care included raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support. A draft planning framework was developed and priority areas for further development identified. A variety of techniques were used to integrate evidence and opinion in this developmental work. The resulting framework blends health promotion planning with traditional clinical care process models. Lessons learned in work to date provide guidance going forward in wider planned review and pilot testing. 34 Key learnings from a Provincial Health Organization’s experience in developing a Provincial Obesity Plan J.L. Nelson, C. Ellendt, J.J. Lovely, A. Estey, H. Toporowski, and A. Sharma Community & Rural / Primary Care & Chronic Disease Management, Alberta Health Services, Edmonton, Alberta, Canada
cANADIAN JoUrNAL oF DIAbEtEs
showing an average methylation level higher than 10%. Among them, two (E2-F-CpG 3 and 4) were correlated with the mothers’ glucose levels (2-h post-OGTT) between 24 and 28 weeks of gestation (rs≤-0.30; p<0.01). Four other CpGs (C1-M-CpG 1 to 4) were correlated with mothers circulating adiponectin levels 24 hours post delivery (rs≤-0.33; p<0.05). These correlations were adjusted for first trimester BMI and weight gain during pregnancy. conclusions: Adiponectin DNA methylation profile shows adaptation to mothers’ blood glucose levels during pregnancy with the potential to induce transcription dysregulation. Those results support the hypothesis that epigenetics accounts for fetal programming. 31 Programming offspring behavior and metabolism through maternal high-fat diet L. Naef and C-D. Walker McGill University, Douglas Mental Health University Institute, Montreal, Quebec, Canada Introduction: Alterations in the nutritional and hormonal environment of developing young can predispose individuals to the development of obesity in adulthood. Our work focuses on the proximal and longterm consequences of these alterations on some of the brain systems implicated in the control of feeding and related behaviors, as well as the ability of metabolic hormones to modulate these brain circuits. Methods: Mother rats are maintained on either a control (5% fat) or a high-fat (30% fat) diet during the last week of gestation and throughout lactation, and all offspring are weaned onto the control diet until testing in adulthood. results: Augmenting the dams’ dietary fat content increases maternal milk fat and leptin concentrations, increases the adiposity of the pups and skews their hormonal profile towards significantly higher plasma leptin and glucocorticoid concentrations during the early postnatal period. These hormones target developing brain structures implicated in energy balance and reward. Consequently, as adults, high-fat exposed offspring display significant alterations in mesolimbic dopaminergic (DA) neurotransmission resulting in blunted locomotor and nucleus accumbens DA responses to amphetamine, but increased DA responses to stress. The behavioral consequences of these changes include increased motivation to work for fat pellets in an operant conditioning paradigm. conclusions: Our experiments demonstrate that increasing the fat content of the maternal diet has a significant impact on the nutritional and hormonal environment of developing young, alters brain circuits controlling feeding, and consequently favours behaviours associated with the development of obesity. 32 assessment of physical activity in pregnant obese women using the pregnancy physical activity questionnaire (PPaQ) and accelerometer N. Chandonnet1, D. Saey2, A. Dufresne1, J. Robitaille3, and I. Marc1 1 Paediatric department, Centre Mère-Enfant (CHUQ), CHUQ Research Center (CRCHUQ), Laval University, Québec City, Québec, Canada; 2 IUCPQ Research Center (CRIUCPQ), Laval University, Québec City, Québec, Canada; 3Nutrition and Food Science Department, Laval University, Québec City, Québec, Canada; Introduction: PPAQ is a validated tool available for the measure of physical activity (PA) during pregnancy. Validation of PPAQ in specific population, such as pregnant obese women, is required to assess the effect of PA on perinatal outcomes in this population. Objectives: To assess reliability and accuracy of a French version of the PPAQ in pregnant obese women. Methods: In this transversal study, pregnant obese women were equally recruited at the end of each trimester of pregnancy. They completed the
PPAQ twice, seven days apart, to recall PA in the last three months. Between the PPAQ assessments, they wore an accelerometer during seven consecutive days (Actigraph GT1M). results: 48 pregnant obese women (29.9±4.2 yrs, 34.8±5.1 kg/m2) participated to the study (n=17 at 14 weeks, n=16 at 26 weeks and n=15 at 36 weeks of gestational age). Intraclass correlation coefficients were 0.86 for total activity, 0.86 for moderate intensity, and 0.81 for vigorous intensity, and ranged from 0.59 for transportation activity to 0.97 for occupational activity. Spearman correlations between PPAQ and Freedson’s cut point were 0.26 for activity of >=light intensity, 0.30 for vigorous activity, 0.20 for moderate activity, and 0.19 for lightintensity activity. Correlations between PPAQ and accelerometer counts were 0.57 for activity of >=light intensity, 0.36 for vigorous activity, 0.47 for moderate activity, and 0.52 for light-intensity activity. conclusions: The French version of the PPAQ is reliable and accurate for the measure of PA of various intensities and types among pregnant obese women. 33 Improved weight management in primary care P. Brauer1, D. Royall2, J.J.M. Dwyer1, A.M. Edwards3, R. Goy1, T. Hussey4, N. Kates4, H. Smith5, and R. Kirkconnell5 1 Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada; 2Nutrition Research Consulting, Fergus, Ontario, Canada; 3Department of Computing and Communications Services, University of Guelph, Guelph, Ontario, Canada; 4Hamilton Family Health Team, Hamilton, Ontario; 5Guelph Family Health Team, Guelph, Ontario, Canada This program of work aimed to develop a flexible planning framework for action on obesity management in primary care. Three relevant planning models/frameworks were used to organize the work: the Chronic Care Model, the WHO planning framework for prevention of chronic disease, and the MRC (UK) guide to developing and evaluating complex interventions. The goal of the current funding was to identify and prioritize possible approaches that would be applicable to Canadian interprofessional primary care organizations. We first conducted a scoping review (2003-2009) for evidence of improved obesity management in primary care looking for innovations in “organization of care” from studies based on representative patient samples. Secondly, we conducted 11 focus groups with providers and patients in the Hamilton Family Health Team on ideas for new services. The final phase was to draft and review a planning framework with one interprofessional group of providers: 11 members of the Guelph Family Health Team. To facilitate decision-making, electronic meeting software was employed in a one-day face-to-face meeting, that include nominal group, free discussion and rating and ranking exercises. Evidence was widely scattered in diverse disease-focused studies, with few studies focusing on organization of care issues. Key themes from the focus groups for patient care included raising awareness, screening, clinical care, skill building, ongoing support, and social/peer support. A draft planning framework was developed and priority areas for further development identified. A variety of techniques were used to integrate evidence and opinion in this developmental work. The resulting framework blends health promotion planning with traditional clinical care process models. Lessons learned in work to date provide guidance going forward in wider planned review and pilot testing. 34 Key learnings from a Provincial Health Organization’s experience in developing a Provincial Obesity Plan J.L. Nelson, C. Ellendt, J.J. Lovely, A. Estey, H. Toporowski, and A. Sharma Community & Rural / Primary Care & Chronic Disease Management, Alberta Health Services, Edmonton, Alberta, Canada