Energy intake, energy expenditure, and body composition of poor rural Philippine women throughout the first 6 mo of lactation

Abstract

Between 6 and 30 wk postpartum, body weight and body-fat mass of 40 healthy, rural, lactating Filipino women decreased by 1.5 (P < 0.05) and 0.7 kg (P < 0.05), respectively. Energy intake decreased slightly (NS) from 8.84 +/- 2.05 MJ/d (2113 +/- 489 kcal/d; mean +/- SD) at 6 wk to 8.67 +/- 2.37 MJ/d (2073 +/- 566 kcal/d) at 30 wk. Basal metabolic rate (BMR) remained unchanged throughout lactation, and physical-activity level increased significantly (P < 0.05) from 1.61 +/- 0.17 x BMR at 6 wk to 1.97 +/- 0.18 x BMR at 30 wk. Energy intakes at 6 and 30 wk of lactation were 1.02 and 0.77 MJ/d (244 and 185 kcal/d) higher (P < 0.05), respectively, than in early pregnancy. At ages 1-6 mo, mean weights and lengths of mainly breast-fed infants had Z scores between 0 and -1. By using the growth patterns of the breast-fed infants as proxy indicators for adequacy of lactational performance, this study suggests that present recommended energy intakes for lactation are too high for healthy Filipino women who show adequate lactational performance.

Energy intake and expenditure of free-living, lactating Colombian women in an urban setting

“…Alternatively, the differences observed were small enough that sample sizes of n ¼ 229 for both LACT and NPNL women would be required to show a significance at 80% power. This finding of a non-significant tendency for BMR to be higher in lactating women is in agreement with the majority of studies in both developing (Schutz et al, 1980;Singh et al, 1989;Guillermo-Tuazon et al, 1992;Madhavapeddi & Rao, 1992), and developed countries (Goldberg et al, 1991;Illingworth et al, 1986).…”

“…For example, lactating women in India, 1 -6 months pp (Madhavapeddi & Rao, 1992;Piers et al, 1995), and in Bangladesh, 2 -8 months pp (Rashid & Ulijaszek 1999), as well as food supplemented women in the Gambia, 3 -9 months pp (Lawrence et al, 1986) were essentially weight stable showing changes in body weight of less than 0.7 kg. In contrast, studies of lactating women in the Philippines, 1-8 months pp (Guillermo-Tuazon et al, 1992), as well as those in Europe (Forsum, et al, 1992;Sadurkis et al, 1988;van Raaij et al, 1991) reported weight losses of 1.3 -1.4 kg in lactating women 1 -7 months pp. In the latter, the possibility that some of the weight loss was due to dieting cannot be discounted.…”

Repeated measurements of energy intake, energy expenditure and energy balance in lactating Bangladeshi mothers

“…Recently, attention has focussed on lactating women and a number of studies have investigated their energy expenditure and body composition (Goldberg et al, 1991;Adair & Popkin, 1992;Forsum et al, 1992;Guillermo-Tuazon et al, 1992;Piers et al, 1995;Dewey, 1998;Butte et al, 1997Butte et al, ,1999Krebs et al, 1997;Motil et al, 1998;Spurr et al, 1998). However there have been few longitudinal studies beyond 6 months post-partum (cf Lawrence et al, 1986) and most of the subjects were well-nourished mothers (van Raaij et al, 1990;Adair & Popkin, 1992;Motil et al, 1998).…”

“…Weight loss of about 500 gamonth is usual during lactation and fat mass loss has been observed during lactation among tropical populations (Adair & Popkin, 1992;Guillermo-Tuazon et al, 1992) and among women from developed countries with maternal caloric restriction (Dewey, 1998). Furthermore, observed fat-mass losses during lactation are often substantially smaller than the supposed fat mobilization used in the calculations of recommendations (Butte et al, 1984;.…”

“…Evidence for energy-sparing mechanisms is con¯icting. Some authors reported a lower BMR (Guillermo-Tuazon et al, 1992) or an increased muscular ef®ciency (Spurr et al, 1998), while other studies did not show any energetic adaptation as a response to an energy de®cit (Frigerio et al, 1991;Beall et al, 1996;Butte et al, 1997;Ferro-Luzzi et al, 1997). Recently Shetty (1999) has questioned the metabolic adaptation of undernourished people.…”