title: Dietary patterns in association with postpartum weight retention.
abstract: BACKGROUND
  Postpartum weight retention (PPWR) can contribute to obesity development in women of reproductive age. Few studies have examined the association between postnatal diet and PPWR.
  
  
  OBJECTIVE
  We examined both PPWR and substantial PPWR (≥4.55 kg) in association with the following dietary patterns: the alternate Mediterranean Diet Score (aMED) and the Alternative Healthy Eating Index-2010 (AHEI-2010).
  
  
  METHODS
  Women (n = 1136) in the Infant Feeding Practices Study II (2005-2007) self-reported their prepregnancy and postpartum weights at ~4, 7, 10, and 14 mo. Dietary patterns were calculated from a food-frequency questionnaire administered ~4 mo postpartum. Linear mixed models and generalized estimating equations for repeated measurements were used to examine PPWR and substantial PPWR, respectively, in association with the dietary patterns with adjustment for energy intake, breastfeeding, age, education, smoking, and marital status.
  
  
  RESULTS
  At 14 mo postpartum, the mean (±SD) PPWR was 1.1 ± 6.7 kg, and 22.4% of women had substantial PPWR. Although the change in PPWR over time seemed to differ by diet quality 4-7 mo postpartum, no differences were ultimately observed in the total mean PPWR or probability of substantial PPWR across aMED and AHEI-2010 categories during the rest of the follow-up (P > 0.12). Instead, PPWR and substantial PPWR were associated with total energy intake (at ~7-14 mo postpartum: 0.97 kg/1000 kcal (95% CI: 0.40, 1.55 kg/1000 kcal); OR: 1.25/1000 kcal (95% CI: 1.03, 1.52/1000 kcal), respectively].
  
  
  CONCLUSIONS
  Postpartum diet quality assessed by 2 patterns was not associated with weight retention. Total energy intake, regardless of the diet composition, plays a more important role in weight retention.
authors.affiliation: Division of Epidemiology, Statistics, and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors.forename: Nansi S
authors.initials: NS
authors.lastname: Boghossian
authors.forename: Edwina H
authors.initials: EH
authors.lastname: Yeung
authors.forename: Leah M
authors.initials: LM
authors.lastname: Lipsky
authors.forename: Anna K
authors.initials: AK
authors.lastname: Poon
authors.forename: Paul S
authors.initials: PS
authors.lastname: Albert
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001835:Body Weight; D001942:Breast Feeding; D038441:Diet, Mediterranean; D002149:Energy Intake; D005247:Feeding Behavior; D005260:Female; D058870:Food, Organic; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D015999:Multivariate Analysis; D015596:Nutrition Assessment; D010349:Patient Compliance; D049590:Postpartum Period; D015203:Reproducibility of Results; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors; D055815:Young Adult