Overweight, Obesity, and Neighborhood Characteristics among Postpartum Latinas

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Abstract

Background. Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in Latinas. Design and Methods. Madres para la Salud (Mothers for Health) is a 12-month prospective, randomized controlled trial exploring a social support intervention with moderate-intensity physical activity to effect changes in body fat, systemic and fat tissue inflammation, and depression symptoms in sedentary postpartum Latinas. This paper describes the initial body composition of the sample, social support, and neighborhood contextual correlations of overweight and obese Latina mothers within the first 6 months after birth. Results. The mean body mass index was 29.68 with 38.56% bioelectrical impedence analysis for body fat. Elements of the environment (e.g., opportunities to walk) received middle or high scores. Access to healthy food was positively related to favorability of the walking environment. Waist-to-hip ratio was uncorrelated with other obesity-related indices. Conclusions. The body adiposity of these Latina mothers was coupled with low levels of social support from family and friends and neighborhood characteristics that were unfavorable to walking.

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Most cited references 45

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Resistance to insulin-stimulated glucose uptake is present in the majority of patients with impaired glucose tolerance (IGT) or non-insulin-dependent diabetes mellitus (NIDDM) and in approximately 25% of nonobese individuals with normal oral glucose tolerance. In these conditions, deterioration of glucose tolerance can only be prevented if the beta-cell is able to increase its insulin secretory response and maintain a state of chronic hyperinsulinemia. When this goal cannot be achieved, gross decompensation of glucose homeostasis occurs. The relationship between insulin resistance, plasma insulin level, and glucose intolerance is mediated to a significant degree by changes in ambient plasma free-fatty acid (FFA) concentration. Patients with NIDDM are also resistant to insulin suppression of plasma FFA concentration, but plasma FFA concentrations can be reduced by relatively small increments in insulin concentration. Consequently, elevations of circulating plasma FFA concentration can be prevented if large amounts of insulin can be secreted. If hyperinsulinemia cannot be maintained, plasma FFA concentration will not be suppressed normally, and the resulting increase in plasma FFA concentration will lead to increased hepatic glucose production. Because these events take place in individuals who are quite resistant to insulin-stimulated glucose uptake, it is apparent that even small increases in hepatic glucose production are likely to lead to significant fasting hyperglycemia under these conditions. Although hyperinsulinemia may prevent frank decompensation of glucose homeostasis in insulin-resistant individuals, this compensatory response of the endocrine pancreas is not without its price. Patients with hypertension, treated or untreated, are insulin resistant, hyperglycemic, and hyperinsulinemic. In addition, a direct relationship between plasma insulin concentration and blood pressure has been noted. Hypertension can also be produced in normal rats when they are fed a fructose-enriched diet, an intervention that also leads to the development of insulin resistance and hyperinsulinemia. The development of hypertension in normal rats by an experimental manipulation known to induce insulin resistance and hyperinsulinemia provides further support for the view that the relationship between the three variables may be a causal one.(ABSTRACT TRUNCATED AT 400 WORDS)

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Author and article information

Journal

Journal ID (nlm-ta): J Obes

Journal ID (iso-abbrev): J Obes

Journal ID (publisher-id): JOBES

Title: Journal of Obesity

Publisher: Hindawi Publishing Corporation

ISSN (Print): 2090-0708

ISSN (Electronic): 2090-0716

Publication date (Print): 2013

Publication date (Electronic): 6 February 2013

Volume: 2013

Electronic Location Identifier: 916468

Affiliations

¹College of Nursing and Health Innovation, Arizona State University, 500 N. 3rd Street, MC 3020, Phoenix, AZ 85004, USA

²Phoenix Veterans Affairs Health Care System, 650 E. Indian School Road, Building 21, Room 147, Phoenix, AZ 85012, USA

³Department of Obstetrics and Gynecology, Maricopa Integrated Health System, 2525 East Roosevelt Street, Phoenix, AZ 85008, USA

Author notes

*Colleen Keller: colleen.keller@ 123456asu.edu

Academic Editor: Nangel M. Lindberg

Article

DOI: 10.1155/2013/916468

PMC ID: 3580903

PubMed ID: 23476752

SO-VID: 16e7b5d2-9f7b-4776-849d-20c644107f43

License:

This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.