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Exploring Sociocultural Factors During Pregnancy and Postpartum among African-immigrant Women within the Context of a Community-Based Organization
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Abstracts / Can J Diabetes 39 (2015) S21eS22
737161 g/day, which equated to an estimated energy cost of 622136 kcal/day. Conclusions: Postpartum women exceeded DRI recommendations for carbohydrate and protein, but not for fat. Breastfeeding was an important component of estimated energy expenditure.
T3.4 Metabolite Profiling in Diet-Induced Maternally Obese Rats Identifies Putative Metabolic Pathways Involved in Developmental Programming of Obesity HEATHER A. PAUL*, MARC R. BOMHOF, HANS J. VOGEL, RAYLENE A. REIMER University of Calgary, Calgary, AB, Canada Obesity is a multifactorial disease that presents a global health concern. Offspring exposed to an adverse early environment are more susceptible to developing obesity later in life, an effect known as developmental programming. However, the exact mechanisms are not fully established. Our aim was to identify the maternal metabolic environment that contributes to this programming in the context of diet-induced obesity using serum proton nuclear magnetic resonance (1H-NMR) spectroscopy metabolomics. Diet-induced obese female Sprague-Dawley rats were mated and fed a high-fat/sucrose diet through pregnancy and lactation (n¼14). A lean reference group (n¼14) consumed control diet (AIN-93) throughout. Maternal blood was collected for serum metabolomics pre-pregnancy, on gestation d14, and lactation d19. Metabolite profiles were analyzed using multivariate OPLS-DA modeling. Body weight was measured weekly and body composition analyzed at weaning via dual-energy X-ray absorptiometry (DXA). Obese dams were heavier than lean dams at conception and throughout pregnancy and lactation (p<0.001), and their offspring weighed more at birth and at weaning (p<0.001). Both obese dams and their offspring had higher body fat percent at weaning (p<0.001). Metabolomic analysis indicated that maternal metabolic profiles in obese and lean dams were distinct at all time points, though were most similar during gestation. In particular, obese dams showed increased fatty acid breakdown after obesity induction and at lactation, but not during gestation, and had decreased methionine levels during pregnancy and lactation. In conclusion, 1H-NMR metabolomic analysis of maternal serum provides insight into the metabolic pathways involved in detrimental programming of offspring in the presence of maternal obesity.
T3.5 Abdominal Adiposity, Adiponectin and Markers of Insulin Resistance in Early Pregnancy LEANNE R. DE SOUZA*1, 2, ALISON PARK 1, 2, RAVI RETNAKARAN 1, 3, PHIL W. CONNELLY 1, 2, JOEL G. RAY 1, 2 1 University of Toronto, Toronto, ON, Canada 2 St. Michael’s Hospital, Toronto, ON, Canada 3 Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada Background: Hypoadiponectinemia is associated with gestational diabetes mellitus and predicts postpartum insulin resistance (IR) and type 2 diabetes. The contribution of first-trimester abdominal adiposity and IR to early pregnancy hypoadiponectinemia remains unclear. Objective: To assess the association between first-trimester abdominal adiposity and IR with early pregnancy adiponectin.
Methods: We completed a prospective cohort study of 79 pregnant women. Abdominal adipose tissue depth was measured by ultrasonography at 11-14 weeks’ gestation, at the time of routine fetal nuchal translucency assessment. Adiponectin was subsequently measured during a 2-hour 75-g oral glucose tolerance test at 16-22 weeks’ gestation. Insulin resistance was estimated by the homeostatic model assessment of insulin resistance (HOMA-IR) as well as by the Insulin Sensitivity Index (ISI). Results: After adjusting for maternal age, parity, ethnicity, prepregnancy BMI, and family history of diabetes, peripheral insulin sensitivity explained 32% (95% CI 0.12 to 0.52) of the variance in adiponectin, while total adipose tissue (TAT) depth and subcutaneous adipose tissue (SAT) depth each explained 24% (95% CI 0.06 to 0.42) and 20% (95% CI 0.05 to 0.35) respectively. Visceral adipose tissue depth and pre-pregnancy BMI were not significantly associated with early pregnancy adiponectin. A 1-cm increase in either SAT depth or TAT depth resulted in 8% (95% CI 3% to 13%) and 6% reductions in adiponectin (95% CI 1% to 10%) respectively. Conclusions: Measurement of maternal adipose tissue depth at the time of routine first-trimester ultrasonography may detect early pregnancy IR and maternal hypoadiponectinemia.
T3.6 Exploring Sociocultural Factors During Pregnancy and Postpartum among African-immigrant Women within the Context of a Community-Based Organization MAIRA QUINTANILHA*, JESSICA THOMPSON, RHONDA C. BELL, MARIA MAYAN University of Alberta, Edmonton, AB, Canada Purpose: Low socioeconomic status, language difficulties and sociocultural barriers can negatively affect many aspects of a healthy pregnancy, including dietary practices. The purpose of this study was to investigate immigrant women’s pregnancy and postpartum experiences in Edmonton, Alberta while receiving support from a community-based organization (CBO). Methods: Using a community-based research approach, a focused ethnography was conducted with African-immigrant women (i.e., refugees and non-refugees) who participated in a prenatal/ postnatal group offered through Multicultural Health Brokers Co-operative (MCHB). Data was generated using focus groups and direct observations, and analyzed through qualitative content analysis. Results: Various life adversities (e.g., poverty), in the absence of women’s family circle created a sense of isolation and increased stress, which were heightened by pregnancy and postpartum. African-immigrant women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy. This included nutritious foods, physical activity opportunities, and adequate time for rest. Once in Canada, without sufficient social support, it becomes extremely challenging to be healthy during pregnancy and postpartum. However, women described that services and supports offered through MCHB (e.g., childcare, cooking classes) facilitated a healthy pregnancy and postpartum. Conclusion: CBOs appear to foster a sense of kinship women often miss when they immigrate to a new country and become pregnant. Policies that support CBOs, and ensure adequate funding, will enable continuing services that can assist immigrant women in being healthier during pregnancy and postpartum in Canada.
Abstracts / Can J Diabetes 39 (2015) S21eS22
737161 g/day, which equated to an estimated energy cost of 622136 kcal/day. Conclusions: Postpartum women exceeded DRI recommendations for carbohydrate and protein, but not for fat. Breastfeeding was an important component of estimated energy expenditure.
T3.4 Metabolite Profiling in Diet-Induced Maternally Obese Rats Identifies Putative Metabolic Pathways Involved in Developmental Programming of Obesity HEATHER A. PAUL*, MARC R. BOMHOF, HANS J. VOGEL, RAYLENE A. REIMER University of Calgary, Calgary, AB, Canada Obesity is a multifactorial disease that presents a global health concern. Offspring exposed to an adverse early environment are more susceptible to developing obesity later in life, an effect known as developmental programming. However, the exact mechanisms are not fully established. Our aim was to identify the maternal metabolic environment that contributes to this programming in the context of diet-induced obesity using serum proton nuclear magnetic resonance (1H-NMR) spectroscopy metabolomics. Diet-induced obese female Sprague-Dawley rats were mated and fed a high-fat/sucrose diet through pregnancy and lactation (n¼14). A lean reference group (n¼14) consumed control diet (AIN-93) throughout. Maternal blood was collected for serum metabolomics pre-pregnancy, on gestation d14, and lactation d19. Metabolite profiles were analyzed using multivariate OPLS-DA modeling. Body weight was measured weekly and body composition analyzed at weaning via dual-energy X-ray absorptiometry (DXA). Obese dams were heavier than lean dams at conception and throughout pregnancy and lactation (p<0.001), and their offspring weighed more at birth and at weaning (p<0.001). Both obese dams and their offspring had higher body fat percent at weaning (p<0.001). Metabolomic analysis indicated that maternal metabolic profiles in obese and lean dams were distinct at all time points, though were most similar during gestation. In particular, obese dams showed increased fatty acid breakdown after obesity induction and at lactation, but not during gestation, and had decreased methionine levels during pregnancy and lactation. In conclusion, 1H-NMR metabolomic analysis of maternal serum provides insight into the metabolic pathways involved in detrimental programming of offspring in the presence of maternal obesity.
T3.5 Abdominal Adiposity, Adiponectin and Markers of Insulin Resistance in Early Pregnancy LEANNE R. DE SOUZA*1, 2, ALISON PARK 1, 2, RAVI RETNAKARAN 1, 3, PHIL W. CONNELLY 1, 2, JOEL G. RAY 1, 2 1 University of Toronto, Toronto, ON, Canada 2 St. Michael’s Hospital, Toronto, ON, Canada 3 Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada Background: Hypoadiponectinemia is associated with gestational diabetes mellitus and predicts postpartum insulin resistance (IR) and type 2 diabetes. The contribution of first-trimester abdominal adiposity and IR to early pregnancy hypoadiponectinemia remains unclear. Objective: To assess the association between first-trimester abdominal adiposity and IR with early pregnancy adiponectin.
Methods: We completed a prospective cohort study of 79 pregnant women. Abdominal adipose tissue depth was measured by ultrasonography at 11-14 weeks’ gestation, at the time of routine fetal nuchal translucency assessment. Adiponectin was subsequently measured during a 2-hour 75-g oral glucose tolerance test at 16-22 weeks’ gestation. Insulin resistance was estimated by the homeostatic model assessment of insulin resistance (HOMA-IR) as well as by the Insulin Sensitivity Index (ISI). Results: After adjusting for maternal age, parity, ethnicity, prepregnancy BMI, and family history of diabetes, peripheral insulin sensitivity explained 32% (95% CI 0.12 to 0.52) of the variance in adiponectin, while total adipose tissue (TAT) depth and subcutaneous adipose tissue (SAT) depth each explained 24% (95% CI 0.06 to 0.42) and 20% (95% CI 0.05 to 0.35) respectively. Visceral adipose tissue depth and pre-pregnancy BMI were not significantly associated with early pregnancy adiponectin. A 1-cm increase in either SAT depth or TAT depth resulted in 8% (95% CI 3% to 13%) and 6% reductions in adiponectin (95% CI 1% to 10%) respectively. Conclusions: Measurement of maternal adipose tissue depth at the time of routine first-trimester ultrasonography may detect early pregnancy IR and maternal hypoadiponectinemia.
T3.6 Exploring Sociocultural Factors During Pregnancy and Postpartum among African-immigrant Women within the Context of a Community-Based Organization MAIRA QUINTANILHA*, JESSICA THOMPSON, RHONDA C. BELL, MARIA MAYAN University of Alberta, Edmonton, AB, Canada Purpose: Low socioeconomic status, language difficulties and sociocultural barriers can negatively affect many aspects of a healthy pregnancy, including dietary practices. The purpose of this study was to investigate immigrant women’s pregnancy and postpartum experiences in Edmonton, Alberta while receiving support from a community-based organization (CBO). Methods: Using a community-based research approach, a focused ethnography was conducted with African-immigrant women (i.e., refugees and non-refugees) who participated in a prenatal/ postnatal group offered through Multicultural Health Brokers Co-operative (MCHB). Data was generated using focus groups and direct observations, and analyzed through qualitative content analysis. Results: Various life adversities (e.g., poverty), in the absence of women’s family circle created a sense of isolation and increased stress, which were heightened by pregnancy and postpartum. African-immigrant women discussed that in their home countries regardless of their socioeconomic status they felt supported in pregnancy and postpartum as their kinship provided them with “everything they needed” to be healthy. This included nutritious foods, physical activity opportunities, and adequate time for rest. Once in Canada, without sufficient social support, it becomes extremely challenging to be healthy during pregnancy and postpartum. However, women described that services and supports offered through MCHB (e.g., childcare, cooking classes) facilitated a healthy pregnancy and postpartum. Conclusion: CBOs appear to foster a sense of kinship women often miss when they immigrate to a new country and become pregnant. Policies that support CBOs, and ensure adequate funding, will enable continuing services that can assist immigrant women in being healthier during pregnancy and postpartum in Canada.