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Participant engagement with a text message delivered intervention for weight loss and maintenance of weight loss in the postpartum period
- Caroline McGirr, Dunla Gallagher, Rooney Ciara, Stephan Dombrowsk, Annie Anderson, Christopher Cardwell, Caroline Free, Pat Doddinott, Valerie Holmes, Emma McIntosh, Camilla Somers, Jayne Woodside, Ian Young, Frank Kee, Michelle McKinley
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E88
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Introduction: Postpartum weight management is difficult for many mothers due to the demands of parenthood. Women have highlighted a need for support but experience barriers to engaging with lifestyle interventions hence more adaptable approaches are required. This work examined participants’ engagement with a 12-month, theory-based, automated, text message (SMS) delivered, intervention supporting postpartum weight management.
Methods: SMS content was informed by: 1) the ‘Health Action Process Approach’ (HAPA)1; 2) behaviour change techniques associated with effectiveness in weight management interventions2; 3) women's accounts of postpartum weight-related experiences; and 4) personal and public involvement. A two-arm pilot RCT recruited women within two years postpartum, with a BMI ≥ 25 kg/m2, through community sources and social media. Women were randomised via a secure remote system to receive the intervention or an active control delivering child development messages. Participants received 353 messages during the 12 month intervention. Two-way messages were used to assess engagement: 50 messages prompted women to respond with their weight; 36 interactive messages requested participants’ to respond ‘Yes/No’ to a question which then triggered a feedback message. Participant engagement with two-way messages was calculated as a percentage of replies sent by women and was categorised as ‘high’ or ‘low’ according to the median number of replies sent. Weight was measured at 0, 3, 6, 9 and 12 months.
Results: 51 of 100 women recruited were randomised to receive the intervention. In months 0–6, (47%) and (95%) of participants responded to the weight messages and the ‘Yes/No’ messages respectively. In months 7–12, the responses were (77%) and (86%) respectively. Participants who were high engagers with weight messages had greater mean weight loss compared with low engagers at all time points: at 12 months high engagers (n = 18) lost -2.66 kg and had a reduction in waist circumference at 12 months of -8.9 cm, compared to changes in low engagers (n = 18) of -0.84 kg and -3.6 cm. Likewise, high engagers with ‘Yes/No’ messages had greater mean weight loss compared with low engagers at all time points: at 12 months high engagers (n = 16) lost -2.87 kg and had a reduction in waist circumference of -9.4 cm, compared to changes in low engagers (n = 20) of -0.86 kg and -3.6 cm.
Discussion: The use of two-way text messages was a useful way to encourage engagement with this SMS-delivered intervention. Higher engagement resulted in more weight loss compared to low engagement.
Maternal vitamin D and neonatal anthropometrics and markers of neonatal glycaemia: Belfast Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study
- Claire Casey, Ann McGinty, Valerie A. Holmes, Chris C. Patterson, Ian S. Young, David R. McCance
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- Journal:
- British Journal of Nutrition / Volume 120 / Issue 1 / 14 July 2018
- Published online by Cambridge University Press:
- 25 June 2018, pp. 74-80
- Print publication:
- 14 July 2018
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Vitamin D deficiency is a common occurrence globally, and particularly so in pregnancy. There is conflicting evidence regarding the role of vitamin D during pregnancy in non-skeletal health outcomes for both the mother and the neonate. The aim of this study was to investigate the associations of maternal total 25-hydroxy vitamin D (25OHD) with neonatal anthropometrics and markers of neonatal glycaemia in the Belfast centre of the Hyperglycemia and Adverse Pregnancy Outcome (HAPO) study. Serological samples (n 1585) were obtained from pregnant women in the Royal Jubilee Maternity Hospital, Belfast, Northern Ireland, between 24 and 32 weeks’ gestation as part of the HAPO study. 25OHD concentrations were measured by liquid chromatography tandem-MS. Cord blood and neonatal anthropometric measurements were obtained within 72 h of birth. Statistical analysis was performed. After adjustment for confounders, birth weight standard deviation scores (SDS) and birth length SDS were significantly associated with maternal total 25OHD. A doubling of maternal 25OHD at 28 weeks’ gestation was associated with mean birth weight SDS and mean birth length SDS higher by 0·05 and 0·07, respectively (both, P=0·03). There were no significant associations with maternal 25OHD and other measures of neonatal anthropometrics or markers of neonatal glycaemia. In conclusion, maternal total 25OHD during pregnancy was independently associated with several neonatal anthropometric measurements; however, this association was relatively weak.
Use of vitamin D supplements during infancy in an international feeding trial
- Eveliina Lehtonen, Anne Ormisson, Anita Nucci, David Cuthbertson, Susa Sorkio, Mila Hyytinen, Kirsi Alahuhta, Carol Berseth, Marja Salonen, Shayne Taback, Margaret Franciscus, Teba González-Frutos, Tuuli E Korhonen, Margaret L Lawson, Dorothy J Becker, Jeffrey P Krischer, Mikael Knip, Suvi M Virtanen, , Thomas Mandrup-Poulsen, Elias Arjas, Åke Lernmark, Barbara Schmidt, Jeffrey P. Krischer, Hans K. Åkerblom, Mila Hyytinen, Mikael Knip, Katriina Koski, Matti Koski, Eeva Pajakkala, Marja Salonen, David Cuthbertson, Jeffrey P. Krischer, Linda Shanker, Brenda Bradley, Hans-Michael Dosch, John Dupré, William Fraser, Margaret Lawson, Jeffrey L. Mahon, Mathew Sermer, Shayne P. Taback, Dorothy Becker, Margaret Franciscus, Anita Nucci, Jerry Palmer, Minna Pekkala, Suvi M. Virtanen, Jacki Catteau, Neville Howard, Patricia Crock, Maria Craig, Cheril L. Clarson, Lynda Bere, David Thompson, Daniel Metzger, Colleen Marshall, Jennifer Kwan, David K. Stephure, Daniele Pacaud, Wendy Schwarz, Rose Girgis, Marilyn Thompson, Shayne P. Taback, Daniel Catte, Margaret L. Lawson, Brenda Bradley, Denis Daneman, Mathew Sermer, Mary-Jean Martin, Valérie Morin, Lyne Frenette, Suzanne Ferland, Susan Sanderson, Kathy Heath, Céline Huot, Monique Gonthier, Maryse Thibeault, Laurent Legault, Diane Laforte, Elizabeth A. Cummings, Karen Scott, Tracey Bridger, Cheryl Crummell, Robyn Houlden, Adriana Breen, George Carson, Sheila Kelly, Koravangattu Sankaran, Marie Penner, Richard A. White, Nancy King, James Popkin, Laurie Robson, Eva Al Taji, Irena Aldhoon, Pavla Mendlova, Jan Vavrinec, Jan Vosahlo, Ludmila Brazdova, Jitrenka Venhacova, Petra Venhacova, Adam Cipra, Zdenka Tomsikova, Petra Krckova, Pavla Gogelova, Ülle Einberg, Mall-Anne Riikjärv, Anne Ormisson, Vallo Tillmann, Päivi Kleemola, Anna Parkkola, Heli Suomalainen, Anna-Liisa Järvenpää, Anu-Maaria Hämälainen, Hannu Haavisto, Sirpa Tenhola, Pentti Lautala, Pia Salonen, Susanna Aspholm, Heli Siljander, Carita Holm, Samuli Ylitalo, Raisa Lounamaa, Anja Nuuja, Timo Talvitie, Kaija Lindström, Hanna Huopio, Jouni Pesola, Riitta Veijola, Päivi Tapanainen, Abram Alar, Paavo Korpela, Marja-Liisa Käär, Taina Mustila, Ritva Virransalo, Päivi Nykänen, Bärbel Aschemeier, Thomas Danne, Olga Kordonouri, Dóra Krikovszky, László Madácsy, Yeganeh Manon Khazrai, Ernesto Maddaloni, Paolo Pozzilli, Carla Mannu, Marco Songini, Carine de Beaufort, Ulrike Schierloh, Jan Bruining, Margriet Bisschoff, Aleksander Basiak, Renata Wasikowa, Marta Ciechanowska, Grazyna Deja, Przemyslawa Jarosz-Chobot, Agnieszka Szadkowska, Katarzyna Cypryk, Malgorzata Zawodniak-Szalapska, Luis Castano, Teba Gonzalez Frutos, Mirentxu Oyarzabal, Manuel Serrano-Ríos, María Teresa Martínez-Larrad, Federico Gustavo Hawkins, Dolores Rodriguez Arnau, Johnny Ludvigsson, Malgorzata Smolinska Konefal, Ragnar Hanas, Bengt Lindblad, Nils-Osten Nilsson, Hans Fors, Maria Nordwall, Agne Lindh, Hans Edenwall, Jan Aman, Calle Johansson, Margrit Gadient, Eugen Schoenle, Dorothy Becker, Ashi Daftary, Margaret Franciscus, Carol Gilmour, Jerry Palmer, Rachel Taculad, Marilyn Tanner-Blasiar, Neil White, Uday Devaskar, Heather Horowitz, Lisa Rogers, Roxana Colon, Teresa Frazer, Jose Torres, Robin Goland, Ellen Greenberg, Maudene Nelson, Holly Schachner, Barney Softness, Jorma Ilonen, Massimo Trucco, Lynn Nichol, Erkki Savilahti, Taina Härkönen, Mikael Knip, Outi Vaarala, Kristiina Luopajärvi, Hans-Michael Dosch
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- Journal:
- Public Health Nutrition / Volume 17 / Issue 4 / April 2014
- Published online by Cambridge University Press:
- 24 June 2013, pp. 810-822
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Objective
To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial.
DesignLongitudinal study.
SettingInformation about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months.
SubjectsInfants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia.
ResultsDaily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements.
ConclusionsMost of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.
Association between breast-feeding and anthropometry and CVD risk factor status in adolescence and young adulthood: the Young Hearts Project, Northern Ireland
- Valerie A Holmes, Chris Cardwell, Michelle C McKinley, Ian S Young, Liam J Murray, Colin A Boreham, Jayne V Woodside
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- Journal:
- Public Health Nutrition / Volume 13 / Issue 6 / June 2010
- Published online by Cambridge University Press:
- 07 October 2009, pp. 771-778
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Objective
To examine the association between breast-feeding and blood pressure, anthropometry and plasma lipid profile in both adolescence and young adulthood.
DesignLongitudinal study of biological and behavioural risk factors for CVD.
SettingThe Young Hearts Project, Northern Ireland.
SubjectsSchoolchildren aged 12 years and 15 years who participated in a cross-sectional study of lifestyle and health, and who were followed up as young adults aged 20–25 years.
ResultsThere was no significant difference in height, weight, BMI, skinfold thickness measurements, blood pressure or plasma lipid profile in adolescents who had been breast-fed compared with those who had not been breast-fed. However, by the time these adolescents had reached adulthood, those who had been breast-fed were significantly taller than those who had not been breast-fed (standing height, P = 0·013; leg length, P = 0·035). Specifically, the breast-fed group was on average taller by 1·7 cm (95 % CI 0·4, 3·0 cm) and had longer legs by 1·0 cm (95 % CI 0·1, 1·9 cm). There was no significant difference in other anthropometric measures, blood pressure or plasma lipid profile in adults who had been breast-fed compared with those who had not been breast-fed.
ConclusionsCompared with those who had not been breast-fed, individuals who had been breast-fed were taller in adulthood. Given the known association of increased adult height with improved life expectancy, the results from the present study support a beneficial effect of breast-feeding.
Vitamin D deficiency and insufficiency in pregnant women: a longitudinal study
- Valerie A. Holmes, Maria S. Barnes, H. Denis Alexander, Peter McFaul, Julie M. W. Wallace
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- Journal:
- British Journal of Nutrition / Volume 102 / Issue 6 / 28 September 2009
- Published online by Cambridge University Press:
- 31 March 2009, pp. 876-881
- Print publication:
- 28 September 2009
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Maternal vitamin D insufficiency is associated with childhood rickets and longer-term problems including schizophrenia and type 1 diabetes. Whilst maternal vitamin D insufficiency is common in mothers with highly pigmented skin, little is known about vitamin D status of Caucasian pregnant women. The aim was to investigate vitamin D status in healthy Caucasian pregnant women and a group of age-matched non-pregnant controls living at 54–55°N. In a longitudinal study, plasma 25-hydroxyvitamin D (25(OH)D) was assessed in ninety-nine pregnant women at 12, 20 and 35 weeks of gestation, and in thirty-eight non-pregnant women sampled concurrently. Plasma 25(OH)D concentrations were lower in pregnant women compared to non-pregnant women (P < 0·0001). Of the pregnant women, 35, 44 and 16 % were classified as vitamin D deficient (25(OH)D < 25 nmol/l), and 96, 96 and 75 % were classified as vitamin D insufficient (25(OH)D < 50 nmol/l) at 12, 20 and 35 weeks gestation, respectively. Vitamin D status was higher in pregnant women who reported taking multivitamin supplements at 12 (P < 0·0001), 20 (P = 0·001) and 35 (P = 0·001) weeks gestation than in non-supplement users. Vitamin D insufficiency is evident in pregnant women living at 54–55°N. Women reporting use of vitamin D-containing supplements had higher vitamin D status, however, vitamin D insufficiency was still evident even in the face of supplement use. Given the potential consequences of hypovitaminosis D on health outcomes, vitamin D supplementation, perhaps at higher doses than currently available, is needed to improve maternal vitamin D nutriture.
ENSO and variability of the Antarctic Peninsula pelagic marine ecosystem
- Valerie J. Loeb, Eileen E. Hofmann, John M. Klinck, Osmund Holm-Hansen, Warren B. White
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- Journal:
- Antarctic Science / Volume 21 / Issue 2 / April 2009
- Published online by Cambridge University Press:
- 19 November 2008, pp. 135-148
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The West Antarctic Peninsula region is an important source of Antarctic krill (Euphausia superba) in the Southern Ocean. From 1980–2004 abundance and concentration of phytoplankton and zooplankton, krill reproductive and recruitment success and seasonal sea ice extent here were significantly correlated with the atmospheric Southern Oscillation Index and exhibited three- to five-year frequencies characteristic of El Niño–Southern Oscillation (ENSO) variability. This linkage was associated with movements of the Southern Antarctic Circumpolar Current Front and Boundary, a changing influence of Antarctic Circumpolar Current and Weddell Sea waters, and eastward versus westward flow and mixing processes that are consistent with forcing by the Antarctic Dipole high-latitude climate mode. Identification of hydrographic processes underlying ecosystem variability presented here were derived primarily from multi-disciplinary data collected during 1990–2004, a period with relatively stable year-to-year sea ice conditions. These results differ from the overwhelming importance of seasonal sea ice development previously established using 1980–1996 data, a period marked by a major decrease in sea ice from the Antarctic Peninsula region in the late 1980s. These newer results reveal the more subtle consequences of ENSO variability on biological responses. They highlight the necessity of internally consistent long-term multidisciplinary datasets for understanding ecosystem variability and ultimately for establishing well-founded ecosystem management. Furthermore, natural environmental variability associated with interannual- and decadal-scale changes in ENSO forcing must be considered when assessing impacts of climate warming in the Antarctic Peninsula–Weddell Sea region.
Could antioxidant supplementation prevent pre-eclampsia?
- Valerie A. Holmes, David R. McCance
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- Journal:
- Proceedings of the Nutrition Society / Volume 64 / Issue 4 / November 2005
- Published online by Cambridge University Press:
- 07 March 2007, pp. 491-501
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Pre-eclampsia is a disorder characterised by pregnancy-induced hypertension and new-onset proteinuria occurring in the second half of pregnancy. Worldwide, approximately 2–3% of all pregnant women develop pre-eclampsia. The condition is a major cause of maternal and fetal morbidity and mortality. Abnormal placentation is an important predisposing factor for pre-eclampsia, while endothelial activation appears to be central to the pathophysiological changes, possibly indicative of a two-stage disorder characterised by reduced placental perfusion and a maternal syndrome. There is increasing evidence that pre-eclampsia is associated with both increased oxidative stress and reduced antioxidant defences, which has led to the hypothesis that oxidative stress may play an important role in the pathogenesis of pre-eclampsia, perhaps acting as the link in a two-stage model of pre-eclampsia. In support of this hypothesis a small, but important, preliminary study has shown a highly significant (P = 0.02) reduction in the incidence of pre-eclampsia in women at risk who were taking a supplement of vitamins C and E from mid-pregnancy. Furthermore, these findings support the hypothesis that oxidative stress is at least partly responsible for the endothelial dysfunction of pre-eclampsia. Several larger multicentre trials are currently underway to evaluate the efficacy, safety and cost benefits of antioxidant supplementation during pregnancy for the prevention of pre-eclampsia in both low- and high-risk women, including women with diabetes. The results of these trials are awaited with interest.
Changes in haemostasis during normal pregnancy: does homocysteine play a role in maintaining homeostasis?
- Valerie A. Holmes
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- Journal:
- Proceedings of the Nutrition Society / Volume 62 / Issue 2 / May 2003
- Published online by Cambridge University Press:
- 05 March 2007, pp. 479-493
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Homocysteine, derived from the demethylation of the ammo acid methionine, is either further catabolised by trans-sulfuration to cysteine or remethylated to methionine. Remethylation to methionine requires the cofactors, folate and vitamin B12. Folate is an effective homocysteine-lowering agent and, thus, homocysteine and folate status are inversely related. Hyperhomocysteinaemia is a strong independent risk factor for venous thromboembolism (VTE) and is associated with adverse pregnancy outcomes such as pre-eclampsia, placental abruption, early pregnancy loss and neural-tube defects. Pregnancy is a risk factor for VTE as a result of prothrombotic changes in levels of haemostatic factors. However, despite this hypercoagulable state, the incidence of pregnancy-associated VTE is relatively low. Hyperhomocysteinaemia is associated with abnormalities in markers of coagulation activation, and recent research suggests that folic acid supplementation, as well as lowering homocysteine, lowers markers of coagulation activation and increases levels of coagulation inhibitors. Tissue factor (TF) is the initiator of blood coagulation in vivo, and homocysteine induces TF expression in vitro. During pregnancy, monocyte TF expression is lower than that in the non-pregnant state, and this lowering of TF may act to counterbalance increases in coagulation activation. Furthermore, despite a high folate requirement, several studies have reported that homocysteine is lower in normal pregnancy than in the non-pregnant state. Although the exact mechanism of homocysteine lowering during pregnancy is unclear, one possible outcome of lower homocysteine may be the protection of women from pregnancy complications and VTE, and thus lower homocysteine may contribute to maintaining homeostasis in haemostasis.
10 - Discrimination of Fluid Seeps on the Convergent Oregon Continental Margin with GLORIA Imagery
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- By Bobb Carson, Department of Earth and Environmental Sciences, Lehigh University, Bethlehem, Pennsylvania, Valerie Paskevich, U.S. Geological Survey, Branch of Atlantic Marine Geology, Woods Hole, Massachusetts, Erol Seke, Department of Electrical Engineering and Computer Science, Lehigh University, Bethlehem, Pennsylvania, Mark L. Holmes, U.S. Geological Survey, Branch of Pacific Marine Geology, University of Washington, Seattle, Washington
- Edited by James V. Gardner, United States Geological Survey, California, Michael E. Field, United States Geological Survey, California, David C. Twichell
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- Book:
- Geology of the United States' Seafloor
- Published online:
- 25 January 2010
- Print publication:
- 13 August 1996, pp 169-180
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Summary
Abstract
Diagenetic carbonate cements and gas hydrates occur at or near the seafloor where pore fluids seep from continental margins. Because these deposits have acoustic impedances that differ significantly from those of hemipelagic deposits, they can be mapped with sidescan sonar if topographic effects (that affect backscattering angle and amplitude) are removed. We have made this topographic correction, using registered GLORIA and SeaBeam data, for a portion of the Oregon continental slope. Comparison of the processed images with local structure indicates that focused fluid expulsion is controlled by faults, but not all faults are active flow paths. Incipient thrust faults in Cascadia Basin just seaward of the base of the slope and an out-of-sequence thrust fault in the Pliocene section of the lower slope apparently channel fluids rapidly to the surface. Near-surface gas hydrates are inferred in the former location and known to precipitate very near the seafloor in the latter. In contrast, the frontal thrust fault that dips landward to the décollement at the toe of the slope shows no evidence of diagenesis associated with focused fluid flow. Instead, pore waters at the décollement may laterally migrate in this region to transverse strike-slip faults that define the northern and southern boundaries of the frontal thrust sheet. Preliminary flow measurements at vent sites, hydrogeologic tests, and thermal anomalies at Ocean Drilling Program (ODP) Site 892 suggest that near-surface formation of gas hydrates is associated with active, rapid fluid discharge. Carbonate cements may reflect slower seepage or relict deposits.