Today, I'd like to share another study from the June/July 2016 issue of Nursing for Women's Health. Here Purnell and MacKenzie provide an excellent article which offers CEs to nurses, addressing the prevalence of obesity. "Research from the last two decades has established that the prenatal environment plays a key role in programming lifelong endocrine and cardiac patterns related to body composition, fat metabolism and storage, and the regulation of glucose," (p 290). The intergenerational cycle of obesity is partly to blame for the dramatic rise in young child and adolescent obesity, causing health problems with cardiometabolic dysfunction. The authors explain the intergenerational cycle as, "A woman's adiposity not only affects her children directly, but it also affects grandchildren and future descendants as her children's propensity for adiposity and metabolic dysfunction is passed on to their children," (p 290).
Discussed in this article are several factors affecting obesity, including diet, physical activity, and breastfeeding. The maternal diet affects fetal metabolic outcomes directly as well as maternal glucose levels and weight gain. "Maternal diets high in fructose and/or fat have been shown to increase fetal mortality and fetal adiposity...and low in zinc and B12 have been associated with increased body weight, hyperinsulinemia, leptin resistance, and dyslipidemia in offspring," (p 292).
Physical activity and exercise can affect weight gained during pregnancy, reduces the risk of gestational diabetes, LGA and SGA birth weights, and improves fetal cardiac autonomic control and long term cardiovascular outcomes.
Breastfeeding is highly promoted as "...the most effective and least expensive intervention that is associated with a decreased risk of obesity in later life," (p 294). In their discussion of the postnatal period, Purnell and MacKenzie make the following statements:
"The focus on breastfeeding remains a priority early in the prenatal period. To enhance breastfeeding, nurses should advocate for Baby-Friendly hospital systems with active support for breastfeeding and for the availability of lactation rooms in workplaces and public buildings to facilitate breastfeeding for women during the postnatal period. Particular attention should be paid to women when they return to the workforce, because this time period is know to be associated with breastfeeding cessation," (p 295).
Purnell, M. C. and MacKenzie, M. A. (2016). The intergenerational cycle of obesity and its implications for nursing care of childbearing women. Nursing for Women's Health; 20(3):289. http://dx.doi.org/10.1016/j.nwh.2016.03.003
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