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Kanneganti, Aishwarya
- Incidence and Risk Factors of Excess Gestational Weight Gain in Indian Women
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Authors
Affiliations
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
2 Department of Statistics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
2 Department of Statistics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 56, No 3 (2019), Pagination: 280-288Abstract
Excess Gestational Weight Gain (EGWG) increases risks of adverse obstetric outcomes, long-term obesity and metabolic disorders in mothers and children. The objective was to identify the incidence and risk factors of EGWG in the Indian context in order to develop effective preventative measures. A prospective cohort study was done to evaluate Gestational Weight Gain (GWG) in pregnant women who have completed a validated knowledge survey on GWG in 4 urban maternity tertiary centres and subsequently delivered at the same centres. Chi square test and Fisher’s exact test were used to identify risk factors associated with EGWG. 245 women completed the study. Gestational weight gain was classified as per the Institute of Medicine BMI-specific recommendations. Of the total women surveyed, 37.5% exceeded the GWG recommendation. The overweight and obese women constituted 50.2% of the entire population. In the overweight-obese category, 52% of women exceeded GWG recommendations. Risk factors for EGWG were high pre-pregnancy BMI (P<0.001), underestimation of pre-pregnancy weight category (P=0.003) and overestimation of GWG recommendations (P<0.001). In overweight-obese women, primiparity also increased risk of EGWG (P=0.04). Maternal age, education and perception of EGWG associated risks did not influence GWG. Ensuring women begin their pregnancies at a normal weight and provision of individualised GWG related counselling, either pre-conception or in the early stages of pregnancy may help foster appropriate weight gain in pregnancy. A modification in the current model of care involving detailed screening and nutritional counselling at the first visit itself could ensure effectiveness.
Keywords
Excess Gestational Weight Gain, Incidence, Risk Factors, Pregnancy, Obesity.
References
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- Knowledge of Diet and Lifestyle Measures for Hypertensive Disorders of Pregnancy
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Authors
Affiliations
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Hyderabad, Telangana - 500 001, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 1 (2020), Pagination: 52-62Abstract
Hypertensive Disorders of Pregnancy (HDP) pose significant risks to materno-fetal health. Appropriate knowledge of the condition ensures timely intervention. Dietary and lifestyle recommendations in HDP differ from those in the non-pregnant population. Salt restriction is not recommended and physical activity may be contraindicated. The aim of the study is to identify the knowledge of pregnant hypertensive Indian women about normal blood pressure in pregnancy, warning signs and complications of HDP and control measures. A cross sectional study was conducted in maternity centres using purposive convenience sampling and a structured questionnaire. Data was analysed using descriptive statistics. One hundred women completed the study. Sixty three per cent knew what constituted high blood pressure, 56% and 60% had a knowledge score of ≤ 50% for warning signs and complications of high blood pressure respectively. When questioned about control measures, women believed that dietary modifications (88%), physical activity (84%), bed rest (51%) and weight loss (44%) were important. With respect to knowledge of salt intake recommendations, 39% correctly identified the daily recommendation, 93% believed salt reduction is necessary and 21% believed salt elimination is required. Thirty nine per cent of women stated high calcium foods are beneficial for control. Post diagnosis, 80% and 38% reported salt reduction and use of low sodium salt, respectively. Traditional home remedies cited included bananas, spinach, curry leaf, garlic, barley water, flax seeds and beetischolar_main. In adequate awareness of HDP may delay necessary medical interventions. Misconceptions regarding salt restriction need to be addressed to prevent iodine deficiency disorders. Counseling regarding a healthy diet for HDP and risks associated with excess physical activity and strict bed rest need to be communicated more effectively.
Keywords
Hypertension, Pregnancy, Salt Restriction, Physical Activity, Knowledge.References
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- A Comparison of Macronutrient Intake and Anthropometric Profile between Male and Female Type 2 Diabetics
Abstract Views :193 |
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Authors
Aishwarya Kanneganti
1,
Mariam Hussain
1,
Ravalika Sri
1,
Rakesh Sahay
2,
Neelaveni Kudugunti
2,
Latha Sashi
1
Affiliations
1 Department of Nutrition, Fernandez Hospital Foundation, Bogulkunta, Hyderabad - 500 001, Telangana, IN
2 Department of Endocrinology, Osmania Medical College and General Hospital, Hyderabad, Andhra Pradesh, IN
1 Department of Nutrition, Fernandez Hospital Foundation, Bogulkunta, Hyderabad - 500 001, Telangana, IN
2 Department of Endocrinology, Osmania Medical College and General Hospital, Hyderabad, Andhra Pradesh, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 2 (2020), Pagination: 164-177Abstract
Medical nutrition therapy and weight management are vital for type 2 diabetes management. Obesity and truncal adiposity increase insulin resistance and predict progression and severity of diabetes. The objective was to identify macronutrient intake, assess body composition and associations between the two, among South Indians. A crosssectional observational study was conducted in the endocrinology OPD at a public hospital (n=88). Dietary intake was assessed by 24-hour recall, body composition using bioelectrical impedance, Waist Circumference (WC) and Waist-Hip Ratio (WHR) using standardized techniques. Mean calorie intake was 1956.52 ± 373.52 kcal and 1578.82 ± 256.64 kcal (p<0.001) in men and women respectively. Carbohydrate, protein and fat intakes were 59.55 ± 4.33, 11.44 ± 1.49 and 26.45 ± 4.67 % Total Energy (TE) in men and 56.12 ± 5.92, 10.54 ± 2.46 and 32.77 ± 5.2 4% TE in women. More women consumed inadequate protein, consumed > 30% TE from fat (p = 0.008) and were sedentary (p = 0.02). Per BMI, 40.9% were overweight and 34.1% obese. Majority were obese as per WC (87.5%) and WHR (93.2%). There were no significant differences between genders for fat and muscle mass. Of the total population, 3.4%, 34.1%, and 2.3% had normal total body fat, visceral fat and skeletal muscle mass respectively. Female diabetics are less likely to meet macronutrient and physical activity guidelines. Most exceed BMI have high body fat and truncal adiposity. Weight management, dietary intake and physical activity counselling may be a costeffective strategy in this population.Keywords
Diabetes Mellitus, Type 2 Diabetes, Body Composition, Waist Circumference, Waist-Hip Ratio, Obesity, Skeletal Muscle.References
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- Oral Hydration and Food During Labour - Is Restriction Necessary?
Abstract Views :267 |
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Authors
Affiliations
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Bogulkunta, Hyderabad, Telangana - 500 001, IN
1 Department of Clinical Nutrition and Dietetics, Fernandez Hospital Foundation, Bogulkunta, Hyderabad, Telangana - 500 001, IN
Source
The Indian Journal of Nutrition and Dietetics, Vol 57, No 4 (2020), Pagination: 450-458Abstract
Hospital labour room policies restrict oral intake of women in labour to clear liquids, due to fears of pulmonary aspiration in cases of emergency C-sections under general anesthesia. Professional organizations have provided varying recommendations for oral intake in labour with some advocating clear fluids alone, which are unlikely to meet the 50-100 kcal/hour energy requirements of labour; and others recommending ad-lib intake. The objective was to explore intra partum food choices and compare the effect of ad-lib oral calorific clear fluid intake vs solids and calorific clear liquids on obstetric and neonatal outcomes. A prospective observational study was conducted in low-risk pregnant women >18 years of age with 36+ gestational age in the labour wards of urban maternity tertiary centres in Hyderabad (N=211). Women were given the option of eating and drinking from a standardised low residue menu. 72.2, 22.4 and 5.38 % of the women consumed liquids, a combination of liquids and solids, and fasted respectively. Women consuming solids and fluids consumed 350.5 ± 171.9 kcal whereas those consuming only calorific clear liquids consumed 168.35 ± 106.2 kcal during the intra partum period (p<0.001). No significant differences were observed in obstetric or neonatal outcomes between groups. Eating during labour is safe in low-risk pregnancies and women who consume both solids and liquids are able to meet the calorie requirements of labour. Obstetricians should give women greater freedom in their choice of oral intake.Keywords
Parturition, Obstetric, Labour, Complications, Neonate.References
- American College of Nurse Midwives, Providing oral nutrition to women in labor. J. Midwifery. Women’s Healt., 2016, 61, 528-534. doi: 10.1111/jmwh.12515
- Committee on Obstetric Practice and American College of Obstetricians and Gynecologists. ACOG Committee Opinion No. 441: oral intake during labor. Obstet. Gynecol., 2009, 114, 714.
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- World Health Organization. WHO recommendations on intrapartum care for a positive childbirth experience. World Health Organization, 2018.
- American College of Nurse Midwives, Providing Oral Nutrition to Women in Labor. J. Midwifery. Women’s Healt., 2016, 61, 528-534. doi: 10.1111/jmwh.12515
- Singata, M., Tranmer, J. and Gyte, G.M. Restricting oral fluid and food intake during labour. Cochrane Database. Systemat. Rev., 2010, 20, 3930.
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