2 results
The predictors of interpregnancy change in body mass index
- Ciara Reynolds, Brendan Egan, Eimer O'Malley, Sharon Sheehan, Michael Turner
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E444
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Introduction
Pregnancy is a time when weight increases as part of a physiological process to aid fetal growth. However, when excess weight is gained during pregnancy, and retained thereafter, the risk of obesity in the future increases. Increasing BMI between pregnancies and maternal obesity are associated with several adverse pregnancy outcomes. Although the risks of increasing BMI on future pregnancies is well defined, the predictors of this weight gain are not. This study aimed to investigate the predictors of interpregnancy BMI change.
Materials and methodsThis study was conducted in one of Europe's largest maternity hospitals delivering approximately 8000 infants per annum. Women's sociodemographic and clinical data were self-reported at the first antenatal visit and computerised to an electronic recording system by trained midwives. Weight and height were measured at the first antenatal visits of both pregnancies, and body mass index was calculated. Data was extracted and analysed for women who delivered their first and second singleton infants between 2009–2018.
ResultsA total of 12,056 women delivered their first and second baby over the 10-year period. The mean interval between pregnancies was 32.3months (SD15.9) and the median BMI change was 0.6units (IQR1.3). From the first to the second pregnancy the rate of obesity increased from 11.6% to 16.0%. Between pregnancies 46.1% of women maintained their BMI (-1 to + 1units), 13.3% lost > 1 BMI unit(s), whereas 15.5% gained 1–2unit(s), 9.9% gained 2–3units and 12.0% gained > 3units. Overall, 5.8% became obese by the second pregnancy. On multinomial regression analysis, having a pregnancy interval of > 3years (aOR2.1, 95%CI 1.9–2.5, p < 0.001), artificial feeding after the first pregnancy (aOR1.8, 1.5–2.0, p < 0.001), postnatal depression after the first pregnancy (aOR1.6, 1.3–2.1, p < 0.001) and taking prescribed anxiolytics or antidepressants (aOR1.6, 1.1–2.5, p = 0.013) were predictors of gaining > 3 BMI units between pregnancies after adjusting for maternal occupation and age. The predictors of becoming obese in the second pregnancy also included a pregnancy interval of > 3years (aOR1.5, 1.2–1.8, p < 0.001), artificial feeding after the first pregnancy (aOR2.1, 1.8–2.6, p < 0.001), postnatal depression after the first pregnancy (aOR1.7, 1.2–2.3, p = 0.001) and taking prescribed anxiolytics or antidepressants (aOR1.8, 1.1–3.1, p = 0.016) following the same adjustments.
ConclusionLonger pregnancy interval, not breastfeeding and psychological health disorders are predictors of BMI increase between pregnancies and becoming obese in the second pregnancy. Interventions provided following women's first delivery should aim to promote breastfeeding, manage weight and improve mental health.
Prevalence of sarcopenia in community-dwelling older adults in Ireland: comparison of EWGSOP1 and EWGSOP2 definitions
- Caoileann Murphy, Aoibheann McMorrow, Ellen Flanagan, Helen Cummins, Sinead McCarthy, Maureen McGowan, Sheena Rafferty, Brendan Egan, Giuseppe De Vito, Clare Corish, Helen Roche
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- Journal:
- Proceedings of the Nutrition Society / Volume 79 / Issue OCE2 / 2020
- Published online by Cambridge University Press:
- 10 June 2020, E161
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Sarcopenia is a muscle disease rooted in adverse muscle changes that accrue across a lifetime. It is an independent risk factor for numerous adverse health outcomes. In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a definition for the identification of people with sarcopenia (EWGSOP1). In 2018, this definition was updated based on the newest evidence (EWGSOP2), with the focus now on low muscle strength rather than low muscle quantity as the key characteristic of sarcopenia. In addition, EWGSOP2 provides clear cut-off points for measurements of variables that identify sarcopenia. The aim of this study was to determine the prevalence of sarcopenia among community-dwelling older adults in Ireland for the first time and to assess agreement between the EWGSOP1 and EWGSOP2 definitions. In a cross-sectional analysis, 490 community-dwelling adults (age 78.4 ± 8.0 y, body mass index 27.6 ± 5.1 kg/m2) were assessed. Skeletal muscle mass was estimated using bioelectrical impedance analysis, muscle strength was measured via handgrip dynamometry and physical performance via the Short Physical Performance Battery. Sarcopenia was defined according to both the 2010 criteria (EWGSOP1) and the updated 2018 criteria (EWGSOP2). Using the EWGSOP1 criteria, the prevalence of sarcopenia was 7.1% (2.6% sarcopenia, 4.5% severe sarcopenia) and 3.6% were classified as pre-sarcopenic (low muscle mass without a decrement in strength or physical performance). Using the EWGSOP2 criteria, the prevalence of sarcopenia was 5.5% (1.6% sarcopenia, 3.9% severe sarcopenia) and 23.4 % were classified as having low strength but without a decrement in muscle mass. Five of the participants who were classified as sarcopenic (2 sarcopenia, 3 severe sarcopenia) by EWGSOP1 were classified as “normal” using the EWGSOP2 criteria. In conclusion, the prevalence of sarcopenia in community-dwelling older adults in Ireland is in line with the prevalence reported in other European countries using the EWGSOP1 criteria (3.3–11.4 %). To our knowledge this is the first study to compare the prevalence based on the EWGSOP1 and the EWGSOP2 criteria. We report a slightly lower prevalence using the EWGSOP2 definition compared to the EWGSOP1 definition. Importantly however, in contrast to EWGSOP1, the EWGSOP2 definition identified a substantial proportion of older adults with poor strength in the absence of overt sarcopenia (23.4%). These older adults represent a group who would benefit from further clinical investigation and intervention.