Trajectory and determinants of change in lean soft tissue over the postpartum period

Abstract

The aim of this study was to characterise changes in lean soft tissue (LST) and examine the contributions of energy intake, physical activity and breast-feeding practices to LST changes at 3 and 9 months postpartum. We examined current weight, LST (via dual-energy X-ray absorptiometry), dietary intake (3-d food diary), physical activity (Baecke questionnaire) and breast-feeding practices (3-d breast-feeding diary) in forty-nine women aged 32·9 (sd 3·8) years. Changes in LST varied from -2·51 to +2·50 kg with twenty-nine women gaining LST (1·1 (sd 0·7) kg, P<0·001) and twenty women losing LST (-0·9 (sd 0·8) kg, P<0·001). Energy intake (133 (SD 42) v. 109 (SD 33) kJ/kg, P=0·019) and % kJ from fat at 3 months postpartum was higher in women who gained LST at 9 months postpartum (gained LST=34 (sd 5) % kJ; lost LST=29 (sd 4) % kJ, P=0·002). Women who gained LST reported breast-feeding their infants more frequently (gained LST=8 (sd 3) feeds/d; lost LST=5 (sd 1) feeds/d, P=0·014) and for more time per d (gained LST=115 (sd 78) min/d; lost LST=59 (sd 34) min/d, P=0·016) at 9 months postpartum. Energy intake and % kJ from fat at 3 months were significant predictors of LST gain (β=0·08 (se 0·04) and 0·24 (se 0·09), respectively). This suggests that gain in LST may be associated with more frequent and longer episodes of breast-feeding at 9 months postpartum as well as dietary intake early in the postpartum period.

Prospective associations between breast feeding, metabolic health, inflammation and bone density in women with prior gestational diabetes mellitus

“…Lean mass is associated with many health benefits, including increased metabolic rate, reduction in inflammatory markers, and increased BMD. 10 58 In our cohort, we found no relationship between breastfeeding and BMD at 1 year postpartum. Breastfeeding has been shown to reduce BMD, particularly within the first 6 months postpartum, but most studies show a full bone mass recovery afterwards.…”

“…There are conflicting data regarding its effect on body composition and BMD in the general population. [8][9][10][11][12][13] While an intervention to promote breastfeeding duration did not result in lower percentage of body fat in a large cluster-randomized trial, 14 one cohort study showed a beneficial association between breastfeeding and fat mass index (FMI) in women having had a child in the last 5 years 9 and two prospective studies suggested that exclusive breast feeding was associated with lower fat mass than mixed breastfeeding. 15 16 In addition, breastfeeding has been associated with a lower visceral adipose tissue in some studies.…”

“… 17–19 Although existing studies that investigated the relationship between breastfeeding duration and lean mass are limited, no significant relationships have been reported. 10 11 …”

<i>Linum usitatissimum</i> (Flaxseed) Oil during Postpartum Period Contributes to Lean Mass and Healthy Serum Lipid Profile in Rats

“…In this study, it is possible to ascribe the increase in body mass by a significantly high lean mass (P<0.05) in FO group vs. C group. However, it is possible to associate postpartum period with lean mass loss in humans as it depends on factors, such as exercise, lactation and diet [27,28]. A low amount of lean mass can contribute to an increase in body fat and obesity due to the decrease in energy metabolism.…”