Objective To evaluate any association between obesity in middle age, measured by body mass index and skinfold thickness, and risk of dementia later in life.

Central obesity in midlife increases risk of dementia independent of diabetes and cardiovascular comorbidities. Fifty percent of adults have central obesity; therefore, mechanisms linking central obesity to dementia need to be unveiled.

OBJECTIVE To estimate the relationship between the rate of gestational weight gain before the 50-g, 1-hour oral glucose challenge test screening for gestational diabetes mellitus (GDM) and subsequent risk of GDM. METHODS We conducted a nested case–control study (345 women with GDM and 800 women in the control group) within a multiethnic cohort of women delivering between 1996 and 1998 who were screened for GDM at 24–28 weeks of gestation. GDM was diagnosed according to the National Diabetes Data Group plasma glucose cut-offs for the 100-g, 3-hour oral glucose tolerance test. Women’s plasma glucose levels, weights, and covariate data were obtained by medical record chart review. RESULTS After adjusting for age at delivery, race/ethnicity, parity, and prepregnancy body mass index, the risk of GDM increased with increasing rates of gestational weight gain. Compared with the lowest tertile of rate of gestational weight gain (less than 0.27 kg/week [less than 0.60 lb/wk]), a rate of weight gain from 0.27–0.40 kg/wk (0.60–0.88 lb/wk) and 0.41 kg/wk (0.89 lb/wk) or more, were associated with increased risks of GDM (odds ratio 1.43, 95% confidence interval 0.96–2.14; and odds ratio 1.74, 95% confidence interval 1.16–2.60, respectively). The association between the rate of gestational weight gain and GDM was primarily attributed to increased weight gain in the first trimester. The association was stronger in overweight or obese and nonwhite women. CONCLUSION High rates of gestational weight gain, especially early in pregnancy, may increase a woman’s risk of GDM. Gestational weight gain during early pregnancy may represent a modifiable risk factor for GDM and needs more attention from health care providers. LEVEL OF EVIDENCE II

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The childbearing years are an important life stage for women that may result in substantial weight gain leading to the development of obesity. When compared with other age groups, US women aged 35 to 44 years have experienced the greatest increase in obesity prevalence in the past 45 years. 1 Furthermore, 45% of women begin pregnancy overweight or obese, up from 24% in 1983. 2 Gestational weight gain is also higher than ever before, with 43% of pregnant women gaining more than is recommended. 2 Maternal overweight and obesity is the most common high-risk obstetric condition and is associated gestational diabetes mellitus, hypertensive disorders, and newborn macrosomia, among other perinatal complications. 3 Women who are already over-weight or obese before a first pregnancy tend to retain or gain more weight after pregnancy than average weight women 4-7 despite larger newborns 8 and wider variability in gestational weight gain. Weight gain before, during, and after pregnancy not only affects the current pregnancy but may also be a primary contributor to the future development of obesity in women during midlife and beyond. [9][10][11] Two types of prospective study designs have examined persistent weight changes related to pregnancy in women: (1) pregnancy cohort studies using self-reported pre-pregnancy weight, and (2) longitudinal cohorts of women of reproductive age that measured weights before and after pregnancies and controlled for secular trends by accounting for weight gain in non-parous women. The pregnancy cohort studies rely almost exclusively on self-report of pregravid weight, and estimates of postpartum weight retention may be inflated by weight gain from secular trends. 4, 5 , 12 Moreover, pregnancy cohort studies have rarely obtained serial measurements of postpartum weight to differentiate net retention of gestational weight gain from subsequent post-partum weight gain or loss. By contrast, studies focusing on women of reproductive age more accurately estimate weight gain related to childbearing because body weight is measured before and after pregnancy. In addition, these studies remove weight gain due to secular trends and aging by estimating net weight gain for parous women relative to non-parous or nulliparous women during the same time interval.Three outcome measures have been examined: (1) average weight change (retension), (2) substantial postpartum weight retention (ie, >=5 kg above pregravid weight), and (3) the incidence of overweight or obesity after pregnancy (body mass index [BMI] >26). Mean weight change or "retention" from preconception to postpartum is subject to high interindividual variability. Substantial weight retention (>=5 kg above pregravid weight) at 1 to 2 years postpartum may be a more useful clinical measure for identifying women who experience NIH Public Access The evidence 13,[17][18][19] consistently shows that excessive gestational weight gain contributes to higher postpartum body weight; however, higher maternal body size before pregnancy and biologic factors are...

Daily sleep duration of less than 12 hours during infancy appears to be a risk factor for overweight and adiposity in preschool-aged children.

Mustillo et al. | Peer Reviewed | Research and Practice | 2125 RESEARCH AND PRACTICE  Objectives. We examined the effects of self-reported experiences of racial discrimination on Black-White differences in preterm (less than 37 weeks gestation) and low-birthweight (less than 2500 g) deliveries.Methods. Using logistic regression models, we analyzed data on 352 births among women enrolled in the Coronary Artery Risk Development in Young Adults Study.Results. Among Black women, 50% of those with preterm deliveries and 61% of those with low-birthweight infants reported having experienced racial discrimination in at least 3 situations; among White women, the corresponding percentages were 5% and 0%. The unadjusted odds ratio for preterm delivery among Black versus White women was 2.54 (95% confidence interval [CI] = 1.33, 4.85), but this value decreased to 1.88 (95% CI = 0.85, 4.12) after adjustment for experiences of racial discrimination and to 1.11 (95% CI = 0.51, 2.41) after additional adjustment for alcohol and tobacco use, depression, education, and income. The corresponding odds ratios for low birthweight were 4.24 (95% CI=1.31, 13.67), 2.11 (95% CI = 0.75, 5.93), and 2.43 (95% CI = 0.79, 7.42).Conclusions. Self-reported experiences of racial discrimination were associated with preterm and low-birthweight deliveries, and such experiences may contribute to Black-White disparities in perinatal outcomes. (Am J Public Health.