Effect of Breakfast Intake on Body Mass Index of Females at One Year after Delivery in Alexandria

Abstract

BACKGROUND: Addressing different risk factors among postpartum females may help reduce weight retention and prevent intergenerational obesity. The objective of this study was to assess factors that might affect BMI of females at one year after delivery in Alexandria in the period between January 2014 and ended in October 2014. Methods: The study is a case control study comprised a total of 200 females at one year after delivery who attended the family health centers in Alexandria in 2014;100 females at one year after delivery with BMI >25 and 100 females at one year after delivery with normal BMI. The target population was interviewed to collect the study data through the use of pre-designed questionnaire sheet which included socio-demographic data, dietary behavior data, breastfeeding data, contraceptive use data, gestational weight gain data GWG and height and weight measurement to determine their (BMI). RESULTS: There was significant association between gestational duration gestational (c²= 4.700, p = 0.030), birth interval (c²= 14.831, p < 0.001), caesarean section (c²= 6.876, p = 0.009) and GWG and postpartum BMI (t = 2.480, p = 0.014). Moreover, there was significant association between breastfeeding and postpartum BMI (c²= 5.604, p = 0.018). Those who didn't breastfeed their infant had 2.4 times greater risk for increasing postpartum BMI than those who breastfed their infant as recommended (OR = 2.44). Females who gave formula feeding to their infants without breastfeeding had four times greater risk for increasing postpartum BMI than those who breast feed their infants (OR = 4.054). Females who breastfed their infants for less than 6 months had ten and half times greater risk for increasing postpartum BMI than those who breastfed their infants for more than 6 months (OR = 10.5). Those who introduced complementary food from two to less than 4 months had an increase in postpartum BMI. Those who began weaning before 4 months had an increase in postpartum BMI.  Additionally, there was significant association between type of contraception methods and postpartum BMI. (c²= 17.999, p = 0.001). Females who used combined contraceptive pills had about 3 times greater risk for increasing postpartum BMI than females who used other methods of contraception (OR = 2.92). Females who used hormonal contraception had 2.3 times greater risk for increasing postpartum BMI than females who did not use hormonal contraception (OR = 2.39). Furthermore, there was significant association between breakfast consumption and postpartum BMI (c²= 10.889, p = 0.028). Women who skipped breakfast all through the week had 3.3 times greater risk for increasing postpartum BMI than females who regularly ate breakfast (OR = 3.324). Conclusions: increase postpartum BMI is multi-factorial problem. Giving birth to third child, short gestational duration, short birth interval, caesarean section, high GWG, giving formula feeding without breastfeeding, breastfeeding less than 6 months, introducing complementary food from two to less than 4 months, introducing more than one food item, weaning before 4 months, using combined contraceptive pills, hormonal contraception, skipping breakfast,  and consumption of 2-4 cups of water  per day. Interventions to control these factors are recommended in order to prevent an increase in the postpartum BMI.