title: Metabolic risk profile among overweight and obese lactating women in Sweden.
abstract: BACKGROUND
  Obesity and cardiovascular diseases are increasing globally and any association between reproduction and these conditions is of concern. Unfortunately, little is known about normal levels of metabolic risk factors in women of different body mass index throughout the reproductive cycle. This study is one of the first to describe the metabolic risk profile of lactating overweight or obese women at 8-12 weeks postpartum.
  
  
  METHODS
  During 2007-2009, 66 overweight or obese Swedish lactating women without known diseases underwent detailed measurements of their metabolic profiles, dietary intake and general health before entering a lifestyle intervention trial. Baseline measurements took place between 8-12 wk postpartum. Almost all women were exclusively breastfeeding their term infants.
  
  
  RESULTS
  The women were regarded as healthy, as reflected in the absence of diagnosed diseases, their own perceptions and in normal hemoglobin, albumin and fasting plasma glucose values. Four women were diagnosed with metabolic syndrome. In these cases, underlying conditions included large waist circumference, low HDL cholesterol values, high triglyceride values and relatively high blood pressure. The metabolic profile differed between overweight and obese women; obese women had significantly higher levels of fasting insulin (p = 0.017), borderline higher HOMA values (p = 0.057) and significantly higher triglyceride values (p = 0.029), as well as larger waist and hip circumferences (p<0.001 and p<0.001). However, no significant differences between overweight and obese women were detected for LDL or total cholesterol levels. Overweight and obese women reported similar total energy and macronutrient intakes, but obese women tended to be less physically active (p = 0.081).
  
  
  CONCLUSIONS
  Among generally healthy lactating women, obesity as compared to overweight is associated with increased metabolic risk. This cut-off is thus important also in the early postpartum period, and obesity among these women should warrant proper health investigation. Macronutrient intake did not differ between the groups and, hence, cannot explain these differences.
  
  
  BACKGROUND
  ClinicalTrials.gov Identifier: NCT01343238.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. anna.winkvist@nutrition.gu.se
authors.forename: Anna
authors.initials: A
authors.lastname: Winkvist
authors.forename: Fredrik
authors.initials: F
authors.lastname: Bertz
authors.forename: Lars
authors.initials: L
authors.lastname: Ellegård
authors.forename: Ingvar
authors.initials: I
authors.lastname: Bosaeus
authors.forename: Hilde K
authors.initials: HK
authors.lastname: Brekke
mesh_terms: D000328:Adult; D005260:Female; D006262:Health; D006801:Humans; D007223:Infant; D007774:Lactation; D008019:Life Style; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism; D055432:Metabolomics; D009765:Obesity / Q000453:epidemiology* / Q000378:metabolism*; D049590:Postpartum Period; D012307:Risk Factors