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Background: Inadequate and excessive gestational weight gain (GWG) are rising epidemiological health concerns, affecting a substantial proportion of pregnant women in high-income countries and contributing to a multitude of adverse maternal and infant health outcomes. The aim of this scoping review was to identify key structural vulnerability factors (SVFs) related to GWG, and to examine the extent, range, and nature of the existing literature to inform future research. Methods: Electronic searches were performed in October 2018 (updated in August 2019) in MEDLINE(R) ALL, EMBASE, PsycINFO, CINAHL, and Sociological Abstracts databases. Eligible studies had an observational design, had to be conducted before COVID-19, in a high-income country, have pregnant participants, and perform inferential statistics between an SVF and GWG. Results: Of the 157 included articles, the eight SVFs most commonly studied in association with GWG were race/ethnicity (n=91 articles), age (n=87), parity (n=48), education (n=44), income (n=39), marital status (n=28), immigration (n=19), and abuse (n=12). Substantial heterogeneity across study contexts, methodologies, populations, and findings was identified. Studies spanned 22 high-income countries, were predominantly conducted in the USA (77%), and most studies (60%) had a retrospective design. Race/ethnicity was the most extensively studied factor, covering the longest time period (since 1976) and having the largest sample size, and the second-highest proportion of studies reporting a significant relationship with GWG (79%), following immigration status (95%). Conclusions: Given the heterogeneity in findings across studies, adopting an intersectional approach may enhance our understanding of the complex interplay between SVFs and the social context in relation to GWG. This nuanced perspective is critical for informing future research and developing effective strategies to address the pervasive perinatal health challenges associated with inadequate and excessive GWG.

Alima, Perinatal Social Nutrition Centre, is an established community organization that adopts a perinatal social nutrition approach to provide multidimensional support to women living in vulnerable conditions, particularly those with a precarious migratory status. This study aims to (i) determine which maternal characteristics, pregnancy-related variables, and structural features of the Alima intervention are associated with breastfeeding; and (ii) examine whether the association between attending breastfeeding workshops and breastfeeding characteristics differ according to maternal factors. The Alima digital database was used to analyze data from women who received the perinatal intervention between 2013 and 2020. Infant feeding data were retrieved at 2 weeks postpartum (T0, n = 2925), 2 months postpartum (T2, n = 1475), and 4 months postpartum (T4, n = 890). Logistic regressions were used to estimate the odds of overall and exclusive breastfeeding depending on sociodemographic characteristics, pregnancy-related variables, and features of the intervention. The prevalence of overall and exclusive breastfeeding was, respectively, 96.1% and 60.7% at T0; 93.0% and 58.5% at T2; 83.0% and 48.4% at T4. Higher education, previous breastfeeding experience, and recent immigration were associated with a higher likelihood of breastfeeding at each time point. Breastfeeding workshop attendance was associated with a greater likelihood of overall and exclusive breastfeeding at T2 and T4, with a stronger effect among women aged 35 or less, those with lower education, and those with excessive gestational weight gain. In conclusion, the Alima intervention is associated with positive breastfeeding outcomes, especially among vulnerable women living with precarious migratory status in Canada. [ABSTRACT FROM AUTHOR]

Context Contrary to nutritional guidelines, accumulating evidence shows that pregnant women's energy intakes remain stable throughout trimesters. Although pregnant women may eat below their needs or underreport their energy intakes, it is also relevant to question how energy requirements – estimated through measurements of energy expenditure (EE) – change throughout pregnancy. Objective This review examined prospective studies that measured EE during pregnancy, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources PubMed/MEDLINE, Web of Science, Embase, and CINAHL databases were searched to identify relevant publications up to November 14, 2019. Study selection All studies that measured EE prospectively and objectively during pregnancy were included in this systematic review. Two authors independently screened 4852 references. A total of 32 studies were included in the final analysis. Data extraction One author extracted data and assessed the risk of bias and a second author did so for a random sample of studies (n = 7; 22%). Data analysis Increases in resting EE ranged from 0.5% to 18.3% (8–239 kcal), from 3.0% to 24.1% (45–327 kcal), and from 6.4% to 29.6% (93–416 kcal) between early and mid-, mid- and late, and early and late pregnancy, respectively. Increases in total EE ranged from 4.0% to 17.7% (84–363 kcal), from 0.2% to 30.2% (5–694 kcal), and from 7.9% to 33.2% (179–682 kcal) between early and mid-, mid- and late, and early and late pregnancy, respectively. Participants were mainly of normal weight, although many studies did not report important covariates such as prepregnancy body mass index and gestational weight gain adequacy. Conclusions Additional high-quality longitudinal studies (ie, with multiple objective measurements of EE in all periods of pregnancy while considering important confounding variables, like gestational weight gain) are required. [ABSTRACT FROM AUTHOR]

There is a lack of evidence pointing to specific dietary elements related to weight gain and obesity prevention in childhood and adulthood. Dietary intake and obesity are both inherited and culturally transmitted, but most prospective studies on the association between diet and weight status do not take genetics into consideration. The objective of this study was to document the association between dietary intake at 9 years and subsequent Body Mass Index (BMI) in adolescent monozygotic boy and girl twin pairs. This research used data from 152 twin pairs. Dietary data were collected from two 24-hour-recall interviews with a parent and the child aged 9 years. Height and weight were obtained when the twins were aged 9, 12, 13, and 14 years. Intrapair variability analysis was performed to identify dietary elements related to BMI changes in subsequent years. BMI-discordant monozygotic twin pairs were also identified to analyze the dietary constituents that may have generated the discordance. After eliminating potential confounding genetic factors, pre-adolescent boys who ate fewer grain products and fruit and consumed more high-fat meat and milk had higher BMIs during adolescence; pre-adolescent girls who consumed more grain products and high-fat meat and milk had higher BMIs during adolescence. Energy intake (EI) at 9 years was not related to BMI in subsequent years. Our study suggests that messages and interventions directed at obesity prevention could take advantage of sex-specific designs and‚ eventually‚ genetic information. [ABSTRACT FROM PUBLISHER]