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WEIGHT MANAGEMENT IN POSTPARTUM WOMEN: LESSONS LEARNED
Journal of the American Dietetic Association Online
Release 14 (2001), which differentiates between dietary folate and synthetic folic acid, was used to develop a telephone-administered, 142-item food frequency questionnaire (FFQ) and portion size estimate booklet to estimate and quantify dietary folate and folic acid intakes. Foods on the FFQ and accompanying survey included fortified foods and supplements, which were used to evaluate the impact of fortification and supplementation on women of childbearing age obtaining 400 µg of folic acid daily, the Dietary Reference Intake (DRI) for folate. Generation of 660 telephone numbers through random-digit-dialing resulted in the selection of 27 nonpregnant participants aged 18 to 50 years, English or Spanish-speaking, and living in an east coast city and county. Mean estimated intake of dietary folate and folic acid from fortified foods were 300.34±143.91 µg and 194.37±88.16 µg, respectively. Twelve subjects met the DRI from fortification and supplementation, but only one met the recommendation from foods. One-way analysis of variance and linear regression revealed statistically significant relationships between intakes of folic acid fortified foods and education (P=.019) and income (P=.012), and between having a college education and meeting the DRI (P=.031). Only seven participants understood the importance of periconceptional folic acid in the prevention of neural tube defects (NTDs). Differentiating between dietary folate and folic acid is essential in estimating intakes for women of childbearing age and for the development of nutrition education programs aimed at the prevention of NTDs. This research was funded by a grant from the March of Dimes Foundation. TITLE: THE KNOWLEDGE OF PREGNANT WOMEN CONCERNING THE CONSUMPTION OF ALCOHOL AND PREGNANCY AUTHOR(S): S.J. Wheeler, Intern, L.H. Clemens, Ed.D., R.D., D.R.Crase, Ph.D., B.M. Egan, M.S., R. D., L.D.N, The University of Memphis LEARNING OUTCOME: To determine what pregnant women know about the consumption of alcohol and pregnancy and where they are getting their information. TEXT: Alcohol intake during pregnancy is associated with severe problems including physical anomalies and cognitive deficits. Despite negative effects some women continue to drink during pregnancy. In this study 148 pregnant women between the ages of 17-40 completed a questionnaire to determine alcohol habits pre-pregnancy and during pregnancy, feelings towards alcohol during pregnancy, and sources of information related to alcohol and pregnancy. The subjects were gathered on a volunteer basis from Women, Infant, & Children clinics and pregnancy planning classes throughout the Memphis area. 41.2% of the subjects did not consume alcohol prior to pregnancy. Of the 58.1% of women that reported consuming alcohol prior to pregnancy, 7% reported consuming beer, 1.2% reported consuming liquor, and 14% reported consuming wine during pregnancy. The majority of the subjects felt that beer, wine, and liquor were harmful. The top three sources cited by pregnant women for information concerning alcohol and pregnancy were not professional sources. 50.7% of the subjects reported that neither their doctor nor anyone at their obstetrician's office spoke to them about alcohol consumption during pregnancy. This study found that it is important to find out why pregnant women are looking to popular media for credible information about alcohol and pregnancy and why doctors are not speaking to their patients about this potentially hazardous subject. TITLE: WEIGHT MANAGEMENT IN POSTPARTUM WOMEN: LESSONS LEARNED
http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (3 of 117) [3/21/2008 8:45:18 AM]
Journal of the American Dietetic Association Online
AUTHOR(S): D. A. Krummel, PhD, RD, LD, West Virginia University School of Medicine for the MOMS Investigative Team LEARNING OUTCOME: To discuss lessons learned in an obesity prevention trial in low-income women. TEXT: The Mothers' Overweight Management Study was a randomized, controlled trial to compare the effectiveness of facilitated group discussions on weight management in postpartum women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Women (>18 years) with a child under the age of two were recruited (n=150) and then randomized to the self or peer group. Both groups had one goal-setting session with a dietitian and follow-up via newsletters. In addition, the peer group participated in 10 monthly group discussions facilitated by a dietitian. Lessons learned in these areas will be presented: baseline data, exposure, effectiveness, retention, and successes. Recruiting, tracking, and following this group of women created many challenges which will be discussed along with strategies for improvement. Attendance at group discussions was less than optimal with a mean of 4 sessions. Of the 43 inconsistent attendees, 26 (60%) were interviewed by telephone. The main reason for nonattendance was change in job schedule (44%). Meeting with the dietitian produced better attendance and satisfaction with goal-setting (p<.01). At one-year follow-up, 40% of the women had lost weight, 25% had maintained their weight, and 35% gained weight (more than 5 pounds). The mean weight gain was 3.5 pounds (range up to 33 pounds). Steps on a pedometer were negatively correlated (r=–.32, p < .002) with final weight. As expected, women doing more steps each day had lower weights. Our findings underscore the need for developing effective interventions in this population at high risk for becoming obese. (NIH, NICHD Grant RO1HD39102). TITLE: MOBILIZATION OF A COMMUNITY BASED CHILDHOOD OBESITY TASK FORCE AUTHOR(S): B.H. Yager, MEd RD, P.B. Paviour, MS CHES; Thomas Jefferson Health District, Charlottesville, Virginia LEARNING OUTCOME: Identify community level childhood obesity prevention policies and interventions, and describe mobilizing projects for a community task force to assure community participation in support of healthy eating and physical activity. TEXT: The Thomas Jefferson Health District of the Virginia Department of Health recognized that effective responses to childhood overweight required a community-wide rather than single agency effort. In September of 1999 the district dietitian and health educator initiated a task force of community, health care, education, recreation, and human service organization members to address childhood overweight and obesity. First year objectives were to:
1. Identify factors contributing to obesity among District (Charlottesville City; Albemarle, Fluvanna, Greene, Louisa, Nelson counties) children; 2. Identify community level policies and interventions with the potential to prevent childhood obesity, and to promote healthful lifestyles; 3. Plan for implementing and evaluating proposed policies or interventions. http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (4 of 117) [3/21/2008 8:45:18 AM]
Release 14 (2001), which differentiates between dietary folate and synthetic folic acid, was used to develop a telephone-administered, 142-item food frequency questionnaire (FFQ) and portion size estimate booklet to estimate and quantify dietary folate and folic acid intakes. Foods on the FFQ and accompanying survey included fortified foods and supplements, which were used to evaluate the impact of fortification and supplementation on women of childbearing age obtaining 400 µg of folic acid daily, the Dietary Reference Intake (DRI) for folate. Generation of 660 telephone numbers through random-digit-dialing resulted in the selection of 27 nonpregnant participants aged 18 to 50 years, English or Spanish-speaking, and living in an east coast city and county. Mean estimated intake of dietary folate and folic acid from fortified foods were 300.34±143.91 µg and 194.37±88.16 µg, respectively. Twelve subjects met the DRI from fortification and supplementation, but only one met the recommendation from foods. One-way analysis of variance and linear regression revealed statistically significant relationships between intakes of folic acid fortified foods and education (P=.019) and income (P=.012), and between having a college education and meeting the DRI (P=.031). Only seven participants understood the importance of periconceptional folic acid in the prevention of neural tube defects (NTDs). Differentiating between dietary folate and folic acid is essential in estimating intakes for women of childbearing age and for the development of nutrition education programs aimed at the prevention of NTDs. This research was funded by a grant from the March of Dimes Foundation. TITLE: THE KNOWLEDGE OF PREGNANT WOMEN CONCERNING THE CONSUMPTION OF ALCOHOL AND PREGNANCY AUTHOR(S): S.J. Wheeler, Intern, L.H. Clemens, Ed.D., R.D., D.R.Crase, Ph.D., B.M. Egan, M.S., R. D., L.D.N, The University of Memphis LEARNING OUTCOME: To determine what pregnant women know about the consumption of alcohol and pregnancy and where they are getting their information. TEXT: Alcohol intake during pregnancy is associated with severe problems including physical anomalies and cognitive deficits. Despite negative effects some women continue to drink during pregnancy. In this study 148 pregnant women between the ages of 17-40 completed a questionnaire to determine alcohol habits pre-pregnancy and during pregnancy, feelings towards alcohol during pregnancy, and sources of information related to alcohol and pregnancy. The subjects were gathered on a volunteer basis from Women, Infant, & Children clinics and pregnancy planning classes throughout the Memphis area. 41.2% of the subjects did not consume alcohol prior to pregnancy. Of the 58.1% of women that reported consuming alcohol prior to pregnancy, 7% reported consuming beer, 1.2% reported consuming liquor, and 14% reported consuming wine during pregnancy. The majority of the subjects felt that beer, wine, and liquor were harmful. The top three sources cited by pregnant women for information concerning alcohol and pregnancy were not professional sources. 50.7% of the subjects reported that neither their doctor nor anyone at their obstetrician's office spoke to them about alcohol consumption during pregnancy. This study found that it is important to find out why pregnant women are looking to popular media for credible information about alcohol and pregnancy and why doctors are not speaking to their patients about this potentially hazardous subject. TITLE: WEIGHT MANAGEMENT IN POSTPARTUM WOMEN: LESSONS LEARNED
http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (3 of 117) [3/21/2008 8:45:18 AM]
Journal of the American Dietetic Association Online
AUTHOR(S): D. A. Krummel, PhD, RD, LD, West Virginia University School of Medicine for the MOMS Investigative Team LEARNING OUTCOME: To discuss lessons learned in an obesity prevention trial in low-income women. TEXT: The Mothers' Overweight Management Study was a randomized, controlled trial to compare the effectiveness of facilitated group discussions on weight management in postpartum women who participated in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Women (>18 years) with a child under the age of two were recruited (n=150) and then randomized to the self or peer group. Both groups had one goal-setting session with a dietitian and follow-up via newsletters. In addition, the peer group participated in 10 monthly group discussions facilitated by a dietitian. Lessons learned in these areas will be presented: baseline data, exposure, effectiveness, retention, and successes. Recruiting, tracking, and following this group of women created many challenges which will be discussed along with strategies for improvement. Attendance at group discussions was less than optimal with a mean of 4 sessions. Of the 43 inconsistent attendees, 26 (60%) were interviewed by telephone. The main reason for nonattendance was change in job schedule (44%). Meeting with the dietitian produced better attendance and satisfaction with goal-setting (p<.01). At one-year follow-up, 40% of the women had lost weight, 25% had maintained their weight, and 35% gained weight (more than 5 pounds). The mean weight gain was 3.5 pounds (range up to 33 pounds). Steps on a pedometer were negatively correlated (r=–.32, p < .002) with final weight. As expected, women doing more steps each day had lower weights. Our findings underscore the need for developing effective interventions in this population at high risk for becoming obese. (NIH, NICHD Grant RO1HD39102). TITLE: MOBILIZATION OF A COMMUNITY BASED CHILDHOOD OBESITY TASK FORCE AUTHOR(S): B.H. Yager, MEd RD, P.B. Paviour, MS CHES; Thomas Jefferson Health District, Charlottesville, Virginia LEARNING OUTCOME: Identify community level childhood obesity prevention policies and interventions, and describe mobilizing projects for a community task force to assure community participation in support of healthy eating and physical activity. TEXT: The Thomas Jefferson Health District of the Virginia Department of Health recognized that effective responses to childhood overweight required a community-wide rather than single agency effort. In September of 1999 the district dietitian and health educator initiated a task force of community, health care, education, recreation, and human service organization members to address childhood overweight and obesity. First year objectives were to:
1. Identify factors contributing to obesity among District (Charlottesville City; Albemarle, Fluvanna, Greene, Louisa, Nelson counties) children; 2. Identify community level policies and interventions with the potential to prevent childhood obesity, and to promote healthful lifestyles; 3. Plan for implementing and evaluating proposed policies or interventions. http://www2.us.elsevierhealth.com/inst/serve?article=jjada0310309ab01&arttype=full (4 of 117) [3/21/2008 8:45:18 AM]