Optimizing weight gain in pregnancy to prevent obesity in women and children

Pregnancy is now considered to be an important risk factor for new or persistent obesity among women during the childbearing years. High gestational weight gain is the strongest predictor of maternal overweight or obesity following pregnancy. A growing body of evidence also suggests that both high and low gestational weight gains are independently associated with an increased risk of childhood obesity, suggesting that influences occurring very early in life are contributing to obesity onset. In response to these data, the US Institute of Medicine (IOM) revised gestational weight gain guidelines in 2009 for the first time in nearly two decades. However, less than one third of pregnant women achieve guideline-recommended gains, with the majority gaining above IOM recommended levels. To date, interventions to optimize pregnancy weight gains have had mixed success. In this paper, we summarize the evidence from human and animal studies linking over-nutrition and under-nutrition in pregnancy to maternal and child obesity. In addition, we discuss published trials and ongoing interventions to achieve appropriate gestational weight gain as a strategy for obesity prevention in women and their children.

Maternal feeding practices predict weight gain and obesogenic eating behaviours in young children : a prospective study

Background Maternal feeding practices have been proposed to play an important role in early child weight gain and obesogenic eating behariours. However, to date longitudinal investigations in young children exploring these relationships have been lacking. The aim of the present study was to explore prospective relationships between maternal feeding practices, child weight gain and obesogenic eating behaviours in 2-year-old children. The competing hypothesis that child eating behaviours predict changes in maternal feeding practices was also examined.

Methods A sample of 323 mother (mean age = 35 years, + 0.37) and child dyads (mean age = 2.03 years, + 0.37 at recruitment) were participants. Mothers completed a questionnaire assessing parental feeding practices and child eating behaviours at baseline and again one year later. Child BMI (predominantly objectively measured) was obtained at both time points.

Results Increases in child BMI z-scores over the follow-up period were predicted by maternal instrumental feeding practices. Furthermore, restriction, emotional feeding, encouragement to eat, weight-based restriction and fat restriction were associated prospectively with the development of obesogenic eating behaviours in children including emotional eating, tendency to overeat and food approach behaviours (such as enjoyment of food and good appetite). Maternal monitoring, however, predicted decreases in food approach eating behaviours. Partial support was also observed for child eating behaviours predicting maternal feeding practices.

Conclusions Maternal feeding practices play an important role in the development of weight gain and obesogenic eating behaviours in young children and are potential targets for effective prevention interventions aiming to decrease child obesity.

A simple-to-use calculator for determining the total solar heat gain of a glazing system

Architects and designers could readily use a quick and easy tool to determine the solar heat gains of their selected glazing systems for particular orientations, tilts and climate data. Speedy results under variable solar angles and degree of irradiance would be welcomed by most. Furthermore, a newly proposed program should utilise the outputs of existing glazing tools and their standard information, such as the use of U-values and Solar Heat Gain Coefficients (SHGC’s) as generated for numerous glazing configurations by the well-known program WINDOW 6.0 (LBNL, 2001). The results of this tool provide interior glass surface temperature and transmitted solar radiation which link into comfort analysis inputs required by the ASHRAE Thermal Comfort Tool –V2 (ASHRAE, 2011). This tool is a simple-to-use calculator providing the total solar heat gain of a glazing system exposed to various angles of solar incidence. Given basic climate (solar) data, as well as the orientation of the glazing under consideration the solar heat gain can be calculated. The calculation incorporates the Solar Heat Gain Coefficient function produced for the glazing system under various angles of solar incidence WINDOW 6.0 (LBNL, 2001). The significance of this work rests in providing an orientation-based heat transfer calculator through an easy-to-use tool (using Microsoft EXCEL) for user inputs of climate and Solar Heat Gain Coefficient (WINDOW-6) data. We address the factors to be considered such as solar position and the incident angles to the horizontal and the window surface, and the fact that the solar heat gain coefficient is a function of the angle of incidence. We also discuss the effect of the diffuse components of radiation from the sky and those from ground surface reflection, which require refinement of the calculation methods. The calculator is implemented in an Excel workbook allowing the user to input a dataset and immediately produce the resulting solar gain. We compare this calculated total solar heat gain with measurements from a test facility described elsewhere in this conference (Luther et.al., 2012).

Interventions designed to limit gestational weight gain: a systematic review of theory and meta-analysis of intervention components

Limiting gestational weight gain (GWG) to recommended levels is important to optimize health outcomes for mother and baby. Surprisingly, a recent review revealed that theory-based interventions to limit GWG were less effective than interventions that did not report a theory-base; however, strict criteria were used to identify theory-informed studies. We extended this review and others by systematically evaluating the theories of behaviour change informing GWG interventions using a generalized health psychology perspective, and meta-analysing behaviour change techniques reported in the interventions. Interventions designed to limit GWG were searched for using health, nursing and psychology databases. Papers reporting an underpinning theory were identified and the CALO-RE taxonomy was used to determine individual behaviour change techniques. Nineteen studies were identified for inclusion. Eight studies were informed by a behaviour change theory; six reported favourable effects on GWG. Overall, studies based on theory were as effective as non–theory-based studies at limiting GWG. Furthermore, the provision of information, motivational interviewing, behavioural self-monitoring and providing rewards contingent on successful behaviour appear to be key strategies when intervening in GWG. Combining these behaviour change techniques with dietary interventions may be most effective. Future research should focus on determining the exact combination of behaviour change techniques, or which underpinning theories, are most useful for limiting GWG.

An ultra low power OTA with improved unity gain bandwidth product

An operational transconductance amplifier (OTA) using dynamic threshold MOS (DTMOS) and hybrid compensation technique is presented in this paper. The proposed topology is based on a bulk and gate driven input differential pair. Two separate capacitors are employed for the OTA compensation where one of them is used in a signal path and the other one in a non-signal path. The circuit is designed in the 0.18μm CMOS TSMC technology. The proposed design technique shows remarkable enhancement in unity gain-bandwidth and also in DC gain compared to the bulk driven input differential pair OTAs. The Hspice simulation results show that the amplifier has a 92dB open-loop DC gain and a unity gain-bandwidth of 135kHz while operating at 0.4V supply voltage. The total power consumption is as low as 386nW which makes it suitable for low-power bio-medical and bio-implantable applications.

Psychosocial stress is positively associated with body mass index gain over 5 years : evidence from the longitudinal AusDiab study

Objective
Emerging evidence suggests that psychosocial stress may influence weight gain. The relationship between stress and weight change and whether this was influenced by demographic and behavioral factors was explored.

Design and Methods
A total of 5,118 participants of AusDiab were prospectively followed from 2000 to 2005. The relationship between stress at baseline and BMI change was assessed using linear regression.

Results
Among those who maintained/gained weight, individuals with high levels of perceived stress at baseline experienced a 0.20 kg/m2 (95% CI: 0.07-0.33) greater mean change in BMI compared with those with low stress. Additionally, individuals who experienced 2 or ≥3 stressful life events had a 0.13 kg/m2 (0.00-0.26) and 0.26 kg/m2 (0.14-0.38) greater increase in BMI compared with people with none. These relationships differed by age, smoking, and baseline BMI. Further, those with multiple sources of stressors were at the greatest risk of weight gain.

Conclusion
Psychosocial stress, including both perceived stress and life events stress, was positively associated with weight gain but not weight loss. These associations varied by age, smoking, obesity, and multiple sources of stressors. Future treatment and interventions for overweight and obese people should consider the psychosocial factors that may influence weight gain.