Nutrition and exercise in overweight and obese postpartum women

Trajectory of weight changes in the first 6 weeks postpartum

OBJECTIVE

To determine the trajectory of postpartum weight changes and to examine associations between weight change in the first 6 weeks postpartum and demographic, clinical, psychosocial, and behavioral variables.

DESIGN

Prospective, longitudinal design.

SETTING

Community hospital and university research setting.

PARTICIPANTS

26 low-income women (9 White, 8 Black, and 9 Hispanic) with uncomplicated term pregnancies.

MAIN OUTCOME MEASURE

Body mass index measured weekly.

RESULTS

Among White women, body mass index decreased significantly for the first 3 weeks of the postpartum period. Black women experienced a significant reduction in body mass index for only the first 2 postpartum weeks. Similarly, the postpartum body mass index decreased for the first 2 weeks for Hispanic women. Prepregnancy body mass index and gestational weight gain each had a significant positive effect on postpartum body mass index. Perception of social support at 4 weeks had a significant positive effect on postpartum body mass index in Black women.

CONCLUSIONS

The trajectory of weight change was nonlinear with large initial weight losses during the first 2 to 3 weeks postpartum followed by weight plateaus for the remainder of the first 6 weeks postpartum.

Compliance with dietary guidelines and relationship to psychosocial factors in low-income women in late postpartum

OBJECTIVES

The goals were to evaluate compliance with the Dietary Guidelines among low-income women during late postpartum and to examine the relationship between psychosocial variables and dietary compliance.

SUBJECTS/SETTING

Participants were 146 triethnic, low-income women who were recruited 0 to 1 days after childbirth and who visited a clinic site at 1 year postpartum.

DESIGN

At 1 year postpartum, multiple psychosocial characteristics were measured, and food choices and nutrient intakes were assessed via a validated food frequency questionnaire. Dietary guidelines index scores and measures of adherence to dietary recommendations were computed.

STATISTICAL ANALYSES PERFORMED

Descriptive statistics, analysis of variance with post-hoc Scheffe tests, chi 2 with follow-up tests of independent proportions, and Pearson correlation coefficients were utilized.

RESULTS

For dietary compliance, 60% had adequate intakes of meat, but less than 30% met recommendations for grains, vegetables, fruits, dairy foods, total fat, and added sugar. Healthful weights (body mass index <25) were observed in 37% of women. Those in the highest tertile of dietary compliance had a more positive body image than those in the lowest tertile, and less neglect of self-care, weight-related distress, stress, depressive symptoms, and perceived barriers to weight loss ( P <.05). Dietary compliance and psychosocial scale scores did not vary by ethnicity.

CONCLUSIONS

Adherence to dietary guidelines was limited in the low-income, postpartum women. Psychosocial variables, such as neglect of self-care, weight-related distress, negative body image, stress, and depressive symptoms were associated with less healthful diets and lifestyle in late postpartum. Programs that target diet-related behavior change in low-income women might be improved by inclusion of psychosocial assessment and counseling components.

Nursing research on physical activity: a feminist critique

Studies on physical activity have rarely included women as research participants, and have been mainly conducted among Western populations. In this paper, nursing research on women's physical activity is analyzed and critiqued using a feminist perspective that respects and values women's own experiences and their diversities. An extensive literature search was conducted using computerized data retrieval systems and 47 empirical studies published in nursing literature were selected and analyzed. The critique is presented with three main themes emerged from the analysis: (a) "without considering women's own experiences"; (b) "implicit androcentric and ethnocentric assumptions"; (c) "without meaningful interactions". Based on the analysis, future directions for nursing research on physical activity are proposed.

Rediscovering the "M" in "MCH": maternal health promotion after childbirth

Although maternal mortality is not a major health concern in the United States, evidence is accruing that after 6 weeks postpartum mothers continue to face mental and physical health, lifestyle, and parenting concerns. Exemplar areas for enhanced maternal health promotion after childbirth include (a) lifestyle changes in exercise, nutrition, and smoking, and (b) psychosocial well-being, particularly mood and body image. Research on health of women after childbirth supports rethinking the scope and duration of maternal health promotion.