JOURNAL OF THE AMERICAN DIETETIC ASSOCIATION Durham HA, et al, J Am Diet Assoc. 2011; 111 (January). Comparison of Dietary Intake of Overweight Postpartum Mothers Practicing Breastfeeding or Formula Feeding Holiday A. Durham PhD, RD: Louisiana State University Cheryl A. Lovelady PhD, MPH, RD, FADA: University North Carolina at Greensboro Rebecca J. N. Brouwer MS: Duke University Medical Center (DUMC) Katrina M. Krause MS: DUMC Truls Østbye PhD, MD: DUMC
Comparison of Dietary Intake of Overweight Postpartum Mothers Practicing Breastfeeding or Formula Feeding Holiday A. Durham PhD, RD: Louisiana State University Cheryl A. Lovelady PhD, MPH, RD, FADA: University North Carolina at Greensboro - PowerPoint PPT Presentation
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JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al, J Am Diet Assoc. 2011; 111 (January).
Comparison of Dietary Intake of Overweight Postpartum
Mothers Practicing Breastfeeding or Formula Feeding
Holiday A. Durham PhD, RD: Louisiana State University
Cheryl A. Lovelady PhD, MPH, RD, FADA: University North Carolina at Greensboro
Rebecca J. N. Brouwer MS: Duke University Medical Center (DUMC)
Katrina M. Krause MS: DUMC
Truls Østbye PhD, MD: DUMC
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Rates of overweight & obesity in childbearing years
The postpartum period is a critical time for weight-management interventions because weight retention and weight gain in this period are significant predictors of long-term obesity 2,3.
In 2007-2008,
percentage of women
ages 20-39 years who
were overweight or obese 1
1. National Center for Health Statistics. Health, United States, 2008. With Chartbook. Hyattsville, Maryland: 2009. Web site. http://www.cdc.gov/nchs/data/hus/hus08.pdf. Published March 2009. Updated August 2009. Accessed September 1, 2009. 2. Gunderson EP, Abrams B. Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiol Rev. 2000;22:261-74.3. Rooney BL, Schauberger CW. Excess pregnancy weight gain and long-term obesity: one decade later. Obstet Gynecol. 2002;100:245-52.
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al. J Am Diet Assoc. 2011; 111 (January).
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Objectives
• Compare nutrient, meal and snack intakes, food group servings and prevalence of dieting among fully breastfeeding, mixed breast and formula feeding, and formula feeding, overweight and obese women.
• Compare nutrient intakes and food group servings to the Dietary Reference Intake and MyPyramid recommendations, respectively.
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
• Infant feeding practices, demographic information, and dietary information were collected on 450 women between six and nine weeks postpartum.
• Two 24-hour dietary recalls were completed by phone, using Nutrition Data Systems for Research1,2.
1. Nutrition Coordinating Center, University of Minnesota. Nutrition Data System (NDS). NDS-R[5.0]. 2004. Minneapolis, MN, University of Minnesota. 2. Nutrition Coordinating Center, University of Minnesota. Nutrition Data System (NDS). NDS-R[2005]. 2005. Minneapolis, MN, University of Minnesota.
Study Design
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Comparison of energy intake and supplement use of women fully breastfeeding (FB), mixed feeding
(MF) or formula feeding (FF)FB (n=160) MF (n= 128) FF (n=162)
a, b, c Groups with different letters are significantly different, P ≤ 0.001* Significantly different between groups, Chi-square, P ≤ 0.05.
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Percentage of women consuming less than the Estimated Average Requirement (EAR)
Total Vitamin A
Vitamin E
Vitamin C
Total Folate
percentage percentage
percentage percentage
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
% < EAR is the percentage of group whose intake was below the Estimated Average Requirements.
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Percentage of women consuming less than the Adequate Intakes (AI)
Calcium
percentage
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
% < AI is the percentage of group whose intake was below the Adequate Intake recommendation.
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
*p= 0.06
* p < 0.01
* p < 0.01
percentage
* Significantly different between groups, Chi-square, P ≤ 0.05.
The majority of women (n=399) reported consuming dinner on both days, with no differences between groups.
Percentage of fully breastfeeding, mixed feeding or formula feeding women
consuming meals and snacks on both days
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Recommended food group servings based on MyPyramid1 guidelines for reference participants who represents the average Active Mother’s Postpartum participant (sedentary, 165 cm, 89 kg, 31 years old, with a 2 month old baby, who was either FB, MF, or FF).
Groups with different letters are significantly different, P ≤ 0.001 (when adjusted for group differences in participant characteristics: pre-pregnancy BMI, race, age, education, income, marital status). 1U.S. Department of Agriculture. MyPyramid. 2007. Web site. http://www.MyPyramid.com. Published October 2007. Updated March 2009.
Breastfeeding (BF), mixed feeding (MF) and formula feeding (FF) women did not meet MyPyramid1 recommendations for any food group
Food Groups
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
b
aa
b
a, b
a
food groups
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al. J Am Diet Assoc. 2011; 111 (January).
Groups with different letters are significantly different, P ≤ 0.001 (when adjusted for group differences in participant characteristics: pre-pregnancy BMI, race, age, education, income, marital status).
food groups
aa
b
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Comparison of beverage and dessert intake among fully breastfeeding, mixed
feeding or formula feeding women
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Summary
Comparison of dietary intake of overweight postpartum mothers practicing breastfeeding or formula feeding
Formula feeding women: • Consumed less energy, servings of grains, and desserts• More likely to diet• Less likely to consume a multivitamin supplement
Breastfeeding women:• Consumed more energy and more refined grains and desserts• Snacked more frequently
All groups were at risk for inadequate intake of vitamins A, C, E, and folate.
In addition, the intakes of vitamin D and calcium were low in all groups.
All groups did not consume the recommended servings of any of the MyPyramidfood groups.
Serum Vitamin C (mg/dl) by Salad Intake
JOURNAL OFTHE AMERICAN DIETETICASSOCIATION
Durham HA, et al.J Am Diet Assoc. 2011; 111 (January).
Conclusion
Decrease
• Refined grains
• Regular soda
• Sweetened beverages
• Desserts
To help increase intakes of nutrients that are lacking in the diet and promote postpartum weight loss, dietitians should encourage women to: