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OBJECTIVES: To describe the development, implementation and lessons learned of lifestyle intervention to promote appropriate gestational weight gain among Hispanic pregnant women. DESIGN: The intervention was informed by an empowerment oriented theoretical framework, and targeted women in the Pregnancy and Early Life Improvement Study. METHODS: The nutrition component consisted of recommendations for total calories, food quantity and improving carbohydrate and fat quality. We provided brown rice, omega-3 rich vegetable oil and spread, and water monthly. The physical activity focused on limiting sedentary behavior and promoting regular movement. The intervention was delivered through individual and group sessions and phone calls. Participants set their own goals, which were closely monitored. The intervention was evaluated extracting data from participant's record (attendance, goals, and challenges) and using a questionnaire. RESULTS: Participants were from underserved communities with economic, time, cultural and social barriers for engaging in lifestyle interventions. Modifications were done to facilitate participation, such as coordinating sessions with prenatal appointments and reducing group size and duration of sessions. Weekly text messages were added to reinforce the intervention. The main goal chosen by participants was reduction of sweetened beverages. The greatest challenges were replacing white rice with brown rice and improving physical activity. Participants suggested conducting sessions near their community and using social media as a motivation tool. Main outcomes results will be published elsewhere. CONCLUSION: We identified barriers to delivering the lifestyle intervention, mainly related to group session's participation. Sessions should be conducted in the community, using text messages and social media as reinforcement.
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OBJECTIVE: Obesity is a public health problem in Puerto Rico. Dietary patterns that include high intakes of energy and sweetened drinks and low consumption of fruits, vegetables and fiber are associated with obesity. The aim of this study is to relate dietary patterns with body composition in obese subjects. METHODS: Dietary patterns were evaluated using 3-day food records. Body composition was assessed by body weight, hip and waist circumferences and % body fat, and then used to classify subjects by obesity stages using BMI and by low or high risk using WHR or % body fat. The resulting comparison groups were associated with energy, macronutrients, fruits, vegetables, fiber, and sweetened drinks intake and with meal energy density and meal frequency intake. Kruskal Wallis and Mann Whitney tests were used to compare groups and Spearman correlations were used for continuous variables. RESULTS: Thirty subjects completed the study. By BMI, 30% were obese type I, 33% type II and 37% type III; by WHR, 43% were low risk and 57% high risk; by % body fat, all were high risk. Dietary patterns were similar between groups. WHR was positively correlated with fiber consumption (r = 0.42; p < 0.05) and CHO intake (r = 0.35; p = 0.057). CONCLUSION: In this pilot study, dietary patterns appeared similar between groups and sound with nutritional recommendations; however, we observed a poor quality of the diet due to very low intakes of fruits, vegetables and fiber and high intakes of sweetened drinks.
Assuntos
Composição Corporal , Dieta , Obesidade , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Porto Rico , Adulto JovemRESUMO
OBJECTIVE: Epidemiologic studies have shown that a high calcium intake is related to lower body weight, fat, and serum lipids in obese individuals. However, clinical studies have shown inconclusive results. The present study was conducted to determine if dairy or calcium supplementation alters body composition or serum lipids in Puerto Rican obese adults without dietary energy restriction or exercise. METHODS: A 21-wk randomized clinical trial was conducted in 30 obese adults, aged 21-50 y, with usual calcium intakes <700 mg/d. Subjects were randomly assigned to the following: high dairy (â¼ 1300 mg/d of calcium from dairy products by substituting foods); high calcium (â¼ 1300 mg/d of calcium; â¼ 700 mg/d from diet and 600 mg/d from a supplement); or placebo. Subjects were asked to continue their established dietary intake (except for the high dairy group) and their physical activity during the study. Body weight was measured monthly; body fat, bone, and serum lipids (total cholesterol, high-density lipoprotein, low-density lipoprotein, and triacylglycerol) were measured at baseline and at 21 wk. Pairwise differences in study endpoints among the groups were assessed using ANOVA and post-hoc analysis. RESULTS: Grand mean calcium intake was 1200 ± 370 (median 1187) mg/d in the high dairy group, 1171 ± 265 (median 1165) mg/d in the high calcium group, and 668 ± 273 (median 691) mg/d in the control group, which was significantly lower compared to the two treatment groups (P < 0.001). There were no significant group effects in any of the outcome variables. CONCLUSION: A high dairy or calcium diet alone did not alter body composition or serum lipids profile in a sample of Puerto Rican obese adults.