title: Total energy expenditure (H218O), physical activity level and milk output of lactating rural Bangladeshi tea workers and nontea workers.
abstract: OBJECTIVE
  To assess the total daily energy expenditure (TDEE), milk output and physical activity level (PAL) of chronically malnourished lactating women using the doubly labelled water method (DLW).
  
  
  METHODS
  Prospective, longitudinal study designed to assess the extent of malnutrition and energetics of lactating tea workers and nontea workers.
  
  
  METHODS
  North-east Bangladesh on women working and living in the same tea estates.
  
  
  METHODS
  Of an original cohort of 150 lactating women, 30 were selected to participate in this study when they were at about 12 months postpartum. One mother subsequently dropped out.
  
  
  METHODS
  On day 1 each women provided a urine sample, was administered a dose of DLW and 6 h later provided another sample. Further urine samples were collected for 21 subsequent days. In addition, every 5 days the mother provided a milk sample and at the same time her baby provided a urine sample.
  
  
  RESULTS
  Mean (s.d.) BMI was 17.4 (1.63). Mean TDEE and PAL were significantly higher in workers than nonworkers (8.42 (1.38) and 6.83 (2.09) MJ/day, P = 0.02 and 1.92 (0.34) and 1.59 (0.44), P = 0.03, respectively). Mean milk output was similar in the two groups (672 (180) ml and 749 (189) ml in workers and nonworkers, respectively).
  
  
  CONCLUSIONS
  Based on international BMI cutoffs, 79% of mothers were suffering from some degree of chronic energy deficiency. A total of 35% of workers and 17% of nonworkers were engaged in strenuous physical activity. The mean milk output of both workers and nonworkers was not different and was high especially as most of the mothers were about 12 months postpartum. No relationship was found between menses return and any of the variables studied.
  
  
  BACKGROUND
  World Health Organization, Nestle Foundation, UNICEF.
authors.affiliation: Centre National de la Recherche Scientifique (CNRS) UPR 2147, Paris, France. rosetta@infobiogen.fr
authors.forename: L
authors.initials: L
authors.lastname: Rosetta
authors.forename: A
authors.initials: A
authors.lastname: Kurpad
authors.forename: C G N
authors.initials: CG
authors.lastname: Mascie-Taylor
authors.forename: P S
authors.initials: PS
authors.lastname: Shetty
mesh_terms: D000293:Adolescent; D000328:Adult; D000383:Agriculture / Q000706:statistics & numerical data*; D000704:Analysis of Variance; D001459:Bangladesh / Q000453:epidemiology; D015992:Body Mass Index; D015331:Cohort Studies; D003903:Deuterium; D004734:Energy Metabolism / Q000502:physiology*; D005260:Female; D006801:Humans; D007774:Lactation / Q000378:metabolism*; D008137:Longitudinal Studies; D044342:Malnutrition / Q000453:epidemiology / Q000378:metabolism / Q000652:urine; D008895:Milk, Human / Q000378:metabolism*; D009043:Motor Activity / Q000502:physiology*; D016272:Occupational Health; D011446:Prospective Studies; D012424:Rural Population / Q000706:statistics & numerical data*
chemical_list: D003903:Deuterium