The maternal diet influences the long-term health status of both mother and offspring. The current study aimed to compare dietary intakes of pregnant women compared to food and nutrient recommendations in the Australian Guide to Healthy Eating (AGHE) and Nutrient Reference Values (NRVs). Usual dietary intake was assessed in a sample of women in their 3rd trimester of pregnancy attending antenatal outpatient clinics at John Hunter Hospital, Newcastle, New South Wales (NSW). Dietary intake was measured using the Australian Eating Survey, a validated, semi-quantitative 120-item food frequency questionnaire. Daily food group servings and nutrient intakes were compared to AGHE and NRV targets. Of 534 women participating, none met the AGHE recommendations for all food groups. Highest adherence was for fruit serves (38%), and lowest for breads and cereals (0.6%). Only four women met the pregnancy NRVs for folate, iron, calcium, zinc and fibre from food alone. Current dietary intakes of Australian women during pregnancy do not align with national nutrition guidelines. This highlights the importance of routine vitamin and mineral supplementation during pregnancy, as intakes from diet alone may commonly be inadequate. Future revisions of dietary guidelines and pregnancy nutrition recommendations should consider current dietary patterns. Pregnant women currently need more support to optimise food and nutrient intakes.
Cardiovascular disease, especially coronary heart disease and cerebrovascular disease, is a leading cause of mortality and morbidity in women globally. The development of cardiometabolic conditions in pregnancy, such as gestational diabetes mellitus and hypertensive disorders of pregnancy, portend an increased risk of future cardiovascular disease in women. Pregnancy therefore represents a unique opportunity to detect and manage risk factors, prior to the development of cardiovascular sequelae. Risk prediction models for gestational diabetes mellitus and hypertensive disorders of pregnancy can help identify at-risk women in early pregnancy, allowing timely intervention to mitigate both short- and long-term adverse outcomes. In this narrative review, we outline the shared pathophysiological pathways for gestational diabetes mellitus and hypertensive disorders of pregnancy, summarise contemporary risk prediction models and candidate predictors for these conditions, and discuss the utility of these models in clinical application.
Background and aimsOver seven million women die from cardiovascular disease (CVD) annually. While lifestyle modification is recommended for CVD prevention, there are no systematic reviews evaluating the effectiveness of interventions targeted to women. The primary aim of this systematic review is to determine the efficacy of primary and secondary CVD prevention interventions targeting lifestyle risk factors in women.MethodsSix electronic databases were searched up to January 2022. Eligible studies included randomized controlled trials of primary or secondary CVD prevention interventions targeting CVD lifestyle risk factors (diet, physical activity, sedentary behavior, smoking, alcohol, sleep, and weight management) in women (≥18 years) that reported CVD risk markers or lifestyle risk factors. Meta-analyses were conducted on CVD risk markers and body mass index (BMI), and the level of evidence was applied to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) criteria and reported.ResultsThirty-five RCTs were included (24 primary and 11 secondary prevention). Meta-analyses demonstrated that lifestyle CVD prevention interventions achieved statistically significant reductions in BMI at ≤ 6 months (0.95 kg/m2, 95% CI = 0.54 to 1.35, p < 0.0001), 12 months (0.61 kg/m2, 95% CI = 0.07 to 1.16, p = 0.03) and >12 months (0.58 kg/m2, 95% CI = 0.01 to 1.16, p = 0.05), and systolic blood pressure (mmHg) at ≤ 6 months (3.51, p < 0.001).ConclusionsLifestyle interventions are important for the prevention of CVD in women, specifically to reduce systolic blood pressure in the short term (≤ 6 months) and BMI long term (>12 months).Systematic review registrationhttps://osf.io/bkwqm, identifier: osf-registrations-bkwqm-v1.
Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in women. Hypertensive disorders of pregnancy (HDP) affect 5–10% of pregnancies worldwide, and are an independent risk factor for CVD. A greater understanding of the rates of modifiable CVD risk factors in women with a history of HDP can inform CVD prevention priorities in this group. The aim of this study was to understand the rates of individual and multiple modifiable risk factors for CVD (body mass index, fruit and vegetable intake, physical activity, sitting time, smoking, alcohol consumption and depressive symptoms) among women with a history of HDP, and assess whether they differ to women without a history of HDP. This study is a cross-sectional analysis of self-reported data collected for the Australian Longitudinal Study of Women’s Health (ALSWH). The sample included 5820 women aged 32–37 years old, who completed survey 7 of the ALSWH in 2015. Women with a history of HDP had a higher multiple CVD modifiable risk factor score compared to those without HDP (mean (SD): 2.3 (1.4) vs. 2.0 (1.3); p < 0.01). HDP history was significantly associated with a higher body mass index (p < 0.01), high-risk alcohol consumption (p = 0.04) and more depressive symptoms (p < 0.01). Understanding that women with a history of HDP have higher CVD risk factors, specifically body mass index, alcohol consumption and depressive symptoms, allows clinicians to provide appropriate and tailored CVD interventions for this group of women.
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