Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility

Karsten, Matty D. A.; Oers, Anne M. van; Groen, Henk; Mutsaerts, Meike; Poppel, Mireille N. M. van; Geelen, Anouk; Beek, C. van de; Painter, Rebecca C.; Mol, Ben W.; Roseboom, Tessa J.; Hoek, Annemieke; Burggraaff, Jan M.; Kuchenbecker, Walter K. H.; Perquin, Denise A. M.; Koks, Carolien A.M.; Golde, R. van; Kaaijk, Eugenie M.; Schierbeek, Jaap M.; Oosterhuis, G. J. E.; Broekmans, Frank J.; Vogel, Niels E. A.; Lambalk, Cornelis B.; Veen, Fulco van der; Klijn, Nicole F.; Mercelina, Patricia E. A. M.; Kasteren, Y.M. van; Nap, Annemiek W.; Mulder, Robert J. A. B.; Gondrie, Ed T. C. M.; Bruin, Jan Peter de

doi:10.1007/s00394-018-1798-7

Cited by 21 publications

(11 citation statements)

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“…Individually macronutrient intake on itself is probably less informative than pre-pregnancy BMI as this is a representative measurement of not only dietary intake, but also dietary/lifestyle behaviour and physical activity. Out of the three variables found via Lasso regression, maternal BMI is the only modifiable factor and is subject of several lifestyle intervention studies for women during preconception and pregnancy [41][42][43][44][45]. Therefore, we performed subsequent analyses in cohort based BMI quintiles to understand to what extent possible associations could be attributed to specific groups of BMI, and also which group may potentially benefit the most from changes in diet and lifestyle.…”

Section: Plos Onementioning

confidence: 99%

Associations between preconception macronutrient intake and birth weight across strata of maternal BMI

et al. 2020

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Introduction Maternal nutrition during pregnancy is linked with birth outcomes including fetal growth, birth weight, congenital anomalies and long-term health through intra-uterine programming. However, a woman’s nutritional status before pregnancy is a strong determinant in early embryo-placental development, and subsequently outcomes for both mother and child. Therefore, the aim of this study was to investigate the association between dietary macronutrient intake in the preconception period with birth weight. Methods We studied a group of 1698 women from the Dutch Perined-Lifelines linked birth cohort with reliable detailed information on preconception dietary macronutrient intake (using a semi quantitative food frequency questionnaire) and data available on birth weight of the offspring. Birth weight was converted into gestational age adjusted z-scores, and macronutrient intake was adjusted for total energy intake using the nutrient residual method. Preconception BMI was converted into cohort-based quintiles. Multivariable linear regression was performed, adjusted for other macronutrients and covariates. Results Mean maternal age was 29.5 years (SD 3.9), preconception BMI: 24.7 kg/m2 (SD 4.2) and median daily energy intake was 1812 kcal (IQR 1544–2140). Mean birth weight was 3578 grams (SD 472). When adjusted for covariates, a significant association (adjusted z score [95% CI], P) between polysaccharides and birth weight was shown (0.08 [0.01–0.15], 0.03). When linear regression analyses were performed within cohort-based quintiles of maternal BMI, positive significant associations between total protein, animal protein, fat, total carbohydrates, mono-disaccharides and polysaccharides with birth weight were shown in the lowest quintile of BMI independent of energy intake, intake of other macronutrients and covariates. Conclusion Out of all macronutrients studied, polysaccharides showed the strongest association with birth weight, independent of energy intake and other covariates. Our study might suggest that specifically in women with low preconception BMI a larger amount of macronutrient intake was associated with increased birth weight. We recommend that any dietary assessment and advise during preconception should be customized to preconception weight status of the women.

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Section: Plos Onementioning

confidence: 99%

Associations between preconception macronutrient intake and birth weight across strata of maternal BMI

et al. 2020

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“…A recent study has shown that a higher body mass index is associated with hypertriglyceridemia [8] in PCOS patients, which is attributed to the obesity-induced change of adipokines, including tumor necrosis factor-alpha (TNFα), interleukin (IL)-6, and adiponectin [9]. The risk factors of PCOS are linked to a sedentary lifestyle and western-style eating habits, which can lead to fat accumulation, in turn, contributing to the recruitment of immune defense cells [10].…”

Section: Introductionmentioning

confidence: 99%

Immunophenotypic Profiles in Polycystic Ovary Syndrome

Pang

et al. 2020

Mediators of Inflammation

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Polycystic ovary syndrome (PCOS) a long-known endocrinopathy and one of the most common endocrine-reproductivemetabolic disorders in women, which can lead to infertility. Although the precise etiology remains unclear, PCOS is considered as a complex genetic trait, with a high degree of heterogeneity. Besides, hormones and immune cells, including both innate and adaptive immune cells, are reportedly a cross talk in PCOS. Chronic low-grade inflammation increases autoimmune disease risk. This proinflammatory condition may, in turn, affect vital physiological processes that ultimately cause infertility, such as ovulation failure and embryo implantation. Here, we review the accumulating evidence linking PCOS with inflammatory status providing an overview of the underlying hormone-mediated dysregulation of immune cells. We mainly focus on the correlational evidence of associations between immune status in women and the increased prevalence of PCOS, along with the specific changes in immune responses. Further recognition and exploration of these interactions may help elucidate PCOS pathophysiology and highlight targets for its treatment and prevention.

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“…A reason for this finding could be that during these first three months, participants had more close contact with the intervention nurse compared to the last three months of the intervention period (6 visits of which 4 face-to-face vs. 4 visits of which 2 face-to-face respectively). Women who attended a greater number of scheduled visits with the intervention nurse more often successfully lost ≥5% of their original bodyweight [ 29 ]. Therefore, it seems that the higher intensity of guidance in the first three months of the intervention program encouraged healthy changes in diet and physical activity.…”

Section: Discussionmentioning

confidence: 99%

Effects of a preconception lifestyle intervention in obese infertile women on diet and physical activity; A secondary analysis of a randomized controlled trial

et al. 2018

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BackgroundLifestyle changes are notoriously difficult. Since women who intend to become pregnant are more susceptible to lifestyle advice, interventions during this time window might be more effective than interventions during any other period in life. We here report the effects of the first large preconception lifestyle intervention RCT on diet and physical activity in obese infertile women.MethodsIn total, 577 women were randomized between a six-month lifestyle intervention program (intervention group; N = 290) or prompt infertility treatment (control group; N = 287). Self-reported dietary behaviors and physical activity were assessed at baseline, three, six and twelve months after randomization. Mixed models were used to analyze differences between groups.ResultsCompared to the control group, the intervention group reduced their intake of sugary drinks at three months (-0.5 glasses/day [95% C.I. = -0.9;-0.2]), of savory snacks at three (-2.4 handful/week [-3.4;-1.4]) and at six months (-1.4 handful/week [-2.6;-0.2]), and of sweet snacks at three (-2.2 portion/week [-3.3;-1.0]) and twelve months after randomization (-1.9 portion/week [-3.5;-0.4]). Also, the intervention group was more moderate to vigorous physically active at three months after randomization compared to the control group (169.0 minutes/week [6.0; 332.1]).ConclusionOur study showed that obese infertile women who followed a six-month preconception lifestyle intervention program decreased their intake of high caloric snacks and beverages, and increased their physical activity. These changes in lifestyle may not only improve women’s health but their offspring’s health too.

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Determinants of successful lifestyle change during a 6-month preconception lifestyle intervention in women with obesity and infertility

Cited by 21 publications

References 65 publications

Associations between preconception macronutrient intake and birth weight across strata of maternal BMI

Associations between preconception macronutrient intake and birth weight across strata of maternal BMI

Immunophenotypic Profiles in Polycystic Ovary Syndrome

Effects of a preconception lifestyle intervention in obese infertile women on diet and physical activity; A secondary analysis of a randomized controlled trial

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