Metabolic Health and Heterogenous Outcomes of Prenatal Interventions: A Secondary Analysis of a Randomized Clinical Trial.

Importance: Prenatal intensive behavioral therapy (IBT) interventions that promote adequate gestational weight gain (GWG) have had variable and mostly modest effects on clinically relevant maternal and infant outcomes. It is unknown whether different maternal obesity metabolic phenotypes underlie the heterogeneity in response.

Objective: To examine GWG, adverse perinatal outcomes, substrate changes, and differential changes in each in a prenatal IBT intervention conducted among pregnant individuals with 2 identified obesity phenotypes.

Effect of caloric restriction on organ size and its contribution to metabolic adaptation: an ancillary analysis of CALERIE 2.

Caloric restriction (CR) can enhance human health, though underlying mechanisms, particularly related to energy expenditure, remain unclear. This ancillary investigation of the only randomized controlled trial of long-term CR in normal-weight adults, aimed to quantify metabolic adaptation following weight loss by assessing changes in energy-expending tissues and organs using magnetic resonance imaging (MRI). Participants in the CR group were prescribed 24-month 25% CR causing a ~ 13% weight loss at 12 months followed by 12 month weight maintenance, whereas the control group maintained ad libitum food intake throughout.

Exploring Individual Factors Affecting Endothelial Function Response Variability in Aging: Implications for Precision Nutrition.

Aging is a major non-modifiable risk factor for cardiovascular disease (CVD), in part due to its detrimental effects on vascular endothelial function. Dietary interventions, including those rich in plant-based components or following dietary patterns such as the Mediterranean Diet, have been shown to improve endothelial function in older adults, assessed via brachial artery flow-mediated dilation (FMD). However, it is well recognized that FMD responses to dietary interventions often show considerable variability among individuals.

An eHealth Intervention in Pregnancy on Maternal Body Composition and Subsequent Perinatal Outcomes: A Randomized Trial.

Objective: To examine the effects of a pragmatic multicomponent eHealth intervention in pregnancy on body composition changes and subsequent associations with perinatal outcomes.

Methods: Pregnant individuals (n = 351) enrolled in Louisiana's Women, Infants, and Children program were randomly assigned to a multicomponent eHealth Intervention or Usual Care. Fat percentage, fat mass, and fat-free mass were assessed using bioelectrical impedance at trimester-specific study visits.

Precision nutrition for cardiometabolic diseases.

Precision nutrition is a vibrant and rapidly evolving field of scientific research and innovation with the potential to deliver health, societal and economic benefits by improving healthcare delivery and policies. Advances in deep phenotyping technologies, digital tools and artificial intelligence have made possible early proof-of-concept research that expands the understanding of within- and between-person variability in responses to diet. These studies illustrate the promise of precision nutrition to complement the traditional 'one size fits all' dietary guidelines, which, while considering broad life-stage and disease-specific nutritional requirements, often lack the granularity to account fully for individual variations in nutritional needs and dietary responses.

Trends in adverse pregnancy outcomes in Louisiana, 2017 to 2022.

Natural disasters can lead to more adverse pregnancy outcomes (APO). It is unclear if the extended COVID-19 pandemic has impacted APOs and pre-existing conditions among perinatal populations with increased risk of severe maternal morbidity and mortality.A retrospective chart review was conducted of hospital records and birth certificates in the largest birth hospital in Louisiana from 2017 to 2022.

The effect of a leptin phenotype on weight change and energy expenditure responses to acute and prolonged energetic stressors.

Leptin is a hormone produced by adipocytes that plays a crucial role in regulating energy homeostasis and body mass. Despite its close correlation with body fat, up to ∼40% of variation in plasma leptin concentration remains unexplained, allowing for the classification of a distinct "leptin phenotype." This leptin phenotype-characterized by either relatively high or relatively low leptin concentration relative to an individual's level of body fat-presents an intriguing opportunity to test whether relatively higher (compared with lower) leptin concentrations differentially affect energy expenditure, metabolic adaptation, and susceptibility to weight change in response to energy balance perturbations.

Estimating energy requirements from Dietary Reference Intakes for pregnant people with obesity using wearables.

Objective: Estimating physical activity levels (PAL) is difficult outside of the laboratory, and patient-reported PAL are often overestimated. Herein, we determine the importance of selecting the correct PAL when computing estimated energy requirements (EER) to determine gestational weight gain (GWG). Then, we examine whether data from a wearable can be used to select PAL and predict EER.

Validation of a novel approach to assess metabolic flexibility to a high-fat meal in a whole-body room calorimeter.

Objective: Metabolic inflexibility to Western high-fat diets may contribute to the obesity epidemic. However, validated methods for assessing metabolic flexibility (MetFlex) to high-fat meals are currently lacking. The purpose of this study was to evaluate the reliability of a novel approach for determining MetFlex to a high-fat meal and to compare it with the gold standard for measuring MetFlex to high-carbohydrate loads.

Values, principles and research priorities for the implementation of type 2 diabetes prevention after gestational diabetes: A global consensus from Asia, Africa, Americas, Europe and Oceania.

Aims: The implementation of type 2 diabetes prevention after gestational diabetes (GDM) is poor despite research evidence on efficacy. This is limited by the lack of knowledge of the priorities in real-world settings from the perspectives of local clinicians and women with lived experiences, particularly those from underserved populations. We report here a global consensus on the values, principles, and research priorities for the implementation of type 2 diabetes prevention in individuals after gestational diabetes (GDM), from the perspectives of clinicians and women from Asia, Africa, Oceania, the Americas, and Europe.

Protocol for a randomised controlled trial of a weight maintenance intervention to promote fat loss in pregnant individuals with obesity.

Introduction: In pregnancy, people with obesity or excess adiposity are prone to excess gestational weight gain (GWG) and have the highest risks for multiple maternal morbidities. Epidemiological studies suggest that the lowest incidence of adverse maternal and infant outcomes occurs with GWG lower than current recommendations (<5 kg) and with gestational weight maintenance, resulting in fat mass loss, in those with obesity. Data from randomised clinical trials are needed to evaluate the efficacy of a fat mass loss intervention on pregnancy outcomes.

Effects of Infant Formula Supplemented With Prebiotics on the Gut Microbiome, Gut Environment, Growth Parameters, and Safety and Tolerance: A Systematic Review and Meta-Analysis.

Context: Prebiotics are often added to infant formulas to mimic the benefits of oligosaccharides found in human milk.

Objective: This systematic review and meta-analysis evaluated the effects of prebiotic-supplemented cow's milk-based formula on the gut microbiota, gut environment, growth parameters, and safety and tolerance in infants ≤6 months old, compared with a standard formula or human milk comparator.

Data Sources: Searches were performed in the PubMed, Embase, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses databases.

Predictive equation derived from 6,497 doubly labelled water measurements enables the detection of erroneous self-reported energy intake.

Nutritional epidemiology aims to link dietary exposures to chronic disease, but the instruments for evaluating dietary intake are inaccurate. One way to identify unreliable data and the sources of errors is to compare estimated intakes with the total energy expenditure (TEE). In this study, we used the International Atomic Energy Agency Doubly Labeled Water Database to derive a predictive equation for TEE using 6,497 measures of TEE in individuals aged 4 to 96 years.

Racial disparities in gestational weight gain and adverse pregnancy outcomes among Black and White pregnant people with obesity.

Objective: This study of pregnant people with obesity examined two aims in testing the hypothesis that the COVID-19 pandemic widened racial disparity in maternal health in high-risk pregnancies; it compared by race both (1) gestational weight gain (GWG) patterns and (2) patterns of preexisting conditions and adverse pregnancy outcomes.

Methods: This retrospective chart review included birth certificate and delivery records from a large women's specialty hospital in Louisiana between 2018 and 2022. Differences in preexisting conditions, GWG, and adverse pregnancy outcomes were explored across early-, peak-, and late-pandemic periods using log-linear regression and robust Poisson models.

Changes in insulin sensitivity and gut peptides 8 and 52 weeks after bariatric surgery or low-calorie diet.

The endocrine consequences of weight loss by bariatric surgery (BS) and caloric restriction are not fully understood but contribute to variable improvements in insulin sensitivity and cardiometabolic health. This study compared changes in insulin sensitivity and plasma concentrations of gut peptides 8 weeks and 1 year after BS and a low-calorie diet (LCD). Nineteen female patients with obesity self-selected BS (gastric bypass [n = 5] or sleeve gastrectomy [n = 7]) or LCD (n = 7) in this parallel-arm, prospective observational study.

The role of government assistance, housing, and employment on postpartum maternal health across income and race: a mixed methods study.

Background: Stressful large-scale events, such as the COVID-19 pandemic and natural disasters, impact birthing individuals' postpartum experiences and their mental health. Resultant changes in government assistance, housing, and employment may further exacerbate these impacts, with differences experienced by varying income levels and races. This study aimed to examine maternal depression and anxiety in postpartum individuals by income and race during a stressful large-scale event, and the mediating role of government assistance, housing, and employment.

Metabolic scaling, energy allocation tradeoffs, and the evolution of humans' unique metabolism.

All organisms use limited energy to grow, survive, and reproduce, necessitating energy allocation tradeoffs, but there is debate over how selection impacted metabolic budgets and tradeoffs in primates, including humans. Here, we develop a method to compare metabolic rates as quotients of observed relative to expected values for mammals corrected for size, body composition, environmental temperature, and phylogenetic relatedness. Contrary to previous analyses, these quotients reveal that nonhuman primates have total metabolic rates expected for similar-sized mammals in similar environments.

Energy expenditure, metabolic adaptation, physical activity and energy intake following weight loss: comparison between bariatric surgery and low-calorie diet.

Objective: Bariatric surgery remains the most effective treatment to achieve substantial weight loss; however, total daily energy expenditure and physical activity changes in response to such interventions have been seldom explored.

Methods: In this prospective observational study, total daily energy expenditure (TDEE) using doubly labeled water and physical activity (SenseWear armband) was assessed in 17 females (mean ± SD: 48.6 ± 9.

Early Life Energy Balance: The Development of Infant Energy Expenditure and Intake in the Context of Obesity.

Purpose Of Review: This review aims to provide a summary of the current knowledge on measurement tools and most recent evidence for prenatal and postnatal modulators of energy balance in young infants.

Recent Findings: The prevention of pediatric obesity depends upon curating the perfect imbalance of energy intake to energy expenditure, taking into consideration the energy needs for healthy growth. We summarize the recent evidence for the programming of fetal and infant metabolism influenced by maternal preconception health, prenatal metabolic milieu, and physical activity behaviors.

Calculation and Comparison of Step Guidelines for Preschooler Physical Activity While Indoors.

Objectives: Preschooler physical activity (PA) is vital for growth and development. The World Health Organization PA guidelines state preschoolers should achieve ≥ 180 min/day of Total PA (TPA) of which ≥ 60 min is moderate-to-vigorous PA (MVPA). A step/day recommendation to match these guidelines may be a more practical metric for caregivers to promote PA.

Prediction of individual weight loss using supervised learning: findings from the CALERIE 2 study.

Background: Predicting individual weight loss (WL) responses to lifestyle interventions is challenging but might help practitioners and clinicians select the most promising approach for each individual.

Objective: The primary aim of this study was to develop machine learning (ML) models to predict individual WL responses using only variables known before starting the intervention. In addition, we used ML to identify pre-intervention variables influencing the individual WL response.

Precision Interventions Targeting the Maternal Metabolic Milieu for Healthy Pregnancies in Obesity.

Purpose Of Review: Entering pregnancy with obesity increases the risk of adverse health outcomes for parent and child. As such, research interventions are largely focused on limiting excess gestational weight gain during pregnancy, especially in those with obesity. Yet, while many lifestyle interventions are successful in reducing GWG, few affect pregnancy outcomes.

Effects of the Menstrual Cycle and Hormonal Contraceptive Use on Metabolic Outcomes, Strength Performance, and Recovery: A Narrative Review.

The effects of female sex hormones on optimal performance have been increasingly recognized as an important consideration in exercise and sport science research. This narrative review explores the findings of studies evaluating the effects of menstrual cycle phase in eumenorrheic women and the use of hormonal contraception (oral contraceptives and hormonal intrauterine devices) on metabolism, muscular strength, and recovery in active females. Ovarian hormones are known to influence metabolism because estrogen is a master regulator of bioenergetics.