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Objective Large for gestational age infants are at increased risk of childhood obesity and maternal nutrition impacts birthweight. The aim of this study was to assess the impact of a maternal low glycaemic index ( GI) diet on neonatal anthropometry. Methods The ROLO (Randomised Control Trial of Low Glycaemic Index Diet in Pregnancy) study was a randomized controlled trial to assess the impact of a low GI diet versus usual diet on birthweight. It took place in a tertiary maternity hospital in Ireland and women were randomized to receive either a low GI diet or no dietary intervention from early pregnancy to term. Two hundred sixty-five neonates had anthropometric measurements on day 1-2 of life, 126 in the intervention group and 139 in the control group. Measurements included birthweight, length and circumferences of the head, chest, abdominal, thigh and mid-upper arm. A subgroup of 219 (82%) neonates also had skin-fold measurements. Results Neonates whose mothers had a low GI diet in pregnancy had lower thigh circumference (15.9 ± 1.7 cm vs. 16.6 ± 1.5 cm, P = 0.04). There was no difference between the intervention and control groups in head, chest abdominal or mid-upper arm circumferences. No difference was noted between the two groups for any skin-fold measurements (subscapular, thigh, biceps and triceps). Conclusion Neonatal thigh circumference was altered by maternal low GI diet in pregnancy. These findings suggest that maternal low GI diet is safe in pregnancy and may positively impact infant adiposity. [ABSTRACT FROM AUTHOR]

Aim: To quantify the effects of hormone-replacement therapy (HRT) on components of the metabolic syndrome in postmenopausal women. Methods: Comprehensive searches of electronic databases were performed from April 1966 to October 2004. We included randomized controlled trials that were of at least 8 weeks duration and evaluated the effect of HRT on metabolic, inflammatory or thrombotic components. Insulin resistance was calculated by homeostasis model assessment (HOMA-IR). Subgroup analysis evaluated the effects for transdermal and oral treatment and for diabetic and non-diabetic women. Results: Pooled results of 107 trials showed that HRT reduced abdominal fat [−6.8% (CI, −11.8 to −1.9%)], HOMA-IR [−12.9% (CI, −17.1 to −8.6%)] and new-onset diabetes [relative risk 0.7 (CI, 0.6–0.9)] in women without diabetes. In women with diabetes, HRT reduced fasting glucose [−11.5% (CI, −18.0 to −5.1%)] and HOMA-IR [−35.8% (CI, −51.7 to −19.8%)]. HRT also reduced low-density lipoprotein/high-density lipoprotein cholesterol ratio [−15.7% (CI, −18.0 to −13.5%)], lipoprotein(a) [Lp(a)] [−25.0% [CI, −32.9 to −17.1%)], mean blood pressure [−1.7% (CI, −2.9 to −0.5%)], E-selectin [−17.3% (CI, −22.4 to −12.1%)], fibrinogen [−5.5% (CI, −7.8 to −3.2%)] and plasminogen activator inhibitor-1 [−25.1% (CI, −33.6 to −15.5%)]. Oral agents produced larger beneficial effects than transdermal agents, but increased C-reactive protein (CRP) [37.6% (CI, 17.4–61.3%)] and decreased protein S [−8.6% CI, −13.1 to −4.1%)], while transdermal agents had no effect. Conclusions: HRT reduces abdominal obesity, insulin resistance, new-onset diabetes, lipids, blood pressure, adhesion molecules and procoagulant factors in women without diabetes and reduced insulin resistance and fasting glucose in women with diabetes. Oral agents adversely affected CRP and protein S, while transdermal agents had no effects. [ABSTRACT FROM AUTHOR]

Objective: To describe how primary care clinicians can detect an eating disorder and identify and manage the associated medical complications.Design: A review of literature from 1994 to 1999 identified by a MEDLINE search on epidemiology, diagnosis, and therapy of eating disorders, including anorexia nervosa and bulimia nervosa.Measurements and Main Results: Detection requires awareness of risk factors for, and symptoms and signs of, anorexia nervosa (e.g., participation in activities valuing thinness, family history of an eating disorder, amenorrhea, lanugo hair) and bulimia nervosa (e.g., unsuccessful attempts at weight loss, history of childhood sexual abuse, family history of depression, erosion of tooth enamel from vomiting, partoid gland swelling, and gastroesophageal reflux). Providers must also remain alert for disordered eating in female athletes (the female athlete triad) and disordered eating in diabetics. Treatment requires a multidisciplinary team including a primary care practitioner, nutritionist, and mental health professional. The role of the primary care practitioner is to help determine the need for hospitalization and to manage medical complications (e.g., arrhythmias, refeeding syndrome, osteoporosis, and electrolyte abnormalities such as hypokalemia).Conclusion: Primary care providers have an important role in detecting and managing eating disorders. [ABSTRACT FROM AUTHOR]

Background Although colorectal cancer (CRC) screening is widely recommended, screening rates remain low. Workplace interventions have the potential to increase rates of screening. Aims To evaluate the impact of a workplace CRC screening program targeting active duty and retired firefighters. Methods A letter, a fecal immunochemical test (FIT) kit and a survey were mailed to all active duty and retired San Francisco firefighters aged 40 and older during 2008–09. The survey included questions about CRC risk factors and prior CRC screening tests. The primary outcome was return of the completed FIT. Results FIT kits and surveys were sent to 1203 firefighters. In total, 445 individuals (37%) completed the survey, and 400 (33%) completed the FIT. Forty-five per cent of respondents had had a stool test for blood at some time, although few (8%) had had it within the past year. Thirty-six per cent of respondents said they had had a sigmoidoscopy at some time, although only 15% had had it within the past 5 years and 37% within the past 10 years. Among those aged 50 and older, 59% had had a test for colon cancer at some time. Conclusions A workplace intervention can increase CRC screening rates in firefighters. Future studies should focus on the long-term sustainability of this type of program. [ABSTRACT FROM PUBLISHER]

Answers a question on the beneficial effect of hormone replacement therapy in young postmenopausal women. Research showing cardiovascular or cancer related death rates were not affected by HRT in women 60 and older; Assertion that estrogen replacement in women under 60 is associated with a net decrease in overall mortality; Reference to published research.

Objective: To assess the evidence that lipid lowering prevents coronary heart disease (CHD) events in women.Data Sources: English-language literature assessing the effects of cholesterol lowering with dietary and/or drug interventions as primary or secondary prevention on CHD events in women.Main Outcome Measures: Coronary heart disease and total mortality were the primary outcomes assessed. Angiographic regression of coronary atherosclerosis was a secondary outcome. STUDY SELECTION, DATA EXTRACTION, AND DATA SYNTHESIS: All nine of the identified studies that met the criteria were included. Relative risks for CHD and total mortality were calculated from available data. Summary relative risks were calculated using meta-analytic techniques.Conclusions: There is no evidence from primary prevention trials that cholesterol lowering affects total mortality in healthy women, although the available data are limited. Limited evidence suggests that treatment of hypercholesterolemia in women with coronary disease may decrease CHD mortality. Future research should address the role of dietary and other nondrug treatment of hypercholesterolemia in women at high risk for CHD. [ABSTRACT FROM AUTHOR]

Objective: To describe patterns of physical activity and to determine factors associated with engaging in regular exercise, especially walking, in elderly white women.Design: Cross-sectional study of 9,442 independently living elderly white women aged 65 years and over participating in the Study of Osteoporotic Fractures.Measurements and Main Results: We studied the association between lifestyle habits, social factors, health status and self-reported physical activity (assessed by modified Paffenbarger scale) during the past twelve months. Walking was the most common form of exercise: 4,837 (51%) women reported doing so a mean of 12 (SD = 10) blocks per day, 3.9 (SD = 2.9) times per week. Other common activities were gardening (35%), swimming (16%), and bicycling (13%). Less than a third of women reported engaging in medium- or high-intensity exercise in the past year. In a multivariate age-adjusted analysis, factors independently (P < .01) associated with walking for exercise included greater than high school education (52% vs 48%), history of physical activity for exercise at ages 30 years (51% vs 46%) and 50 years (51% vs 45%), and stronger social network (51% vs 47%). Women who were current smokers, obese, or depressed were less likely to take walks for exercise. Marital status, self-reported arthritis, current estrogen use, and a history of falls in the past year were not independently associated with taking walks for exercise.Conclusions: In this healthy cohort, walking for exercise is associated with other positive health behaviors. Given the mounting evidence about the health benefits of walking, and since many of these community dwelling women can and do walk for exercise, but rarely engage in other common prescribed physical activities, clinicians might best focus their efforts on encouraging walking. [ABSTRACT FROM AUTHOR]

Discusses abstracts of research articles on women's health, published as of November 2000. Coronary heart disease; Osteoporosis; Prevention of breast cancer; Hormone replacement therapy; Oral contraceptives.

A review of the article "Factors associated with maternal mortality at advanced maternal age: a population-based case-control study" by S.J. McCall and colleagues, which appeared in "BJOG: An International Journal of Obstetrics and Gynaecology" on 13 July 2016 is presented.