Repeated measurements of energy intake, energy expenditure and energy balance in lactating Bangladeshi mothers

Objective: To examine changes in energetic parameters and nutritional statu s of chronically malnourished lactating women over a period of 13 months po stpartum. Design: A study of 15 lactating Bangladeshi mothers, of whom eight were tea pluckers and seven housewives, was conducted over a 13 months period from the birth of the child. Anthropometric measurements and body composition we re determined on five occasions (at 3.5, 5.5, 7.5, 10 and 13 months) and en ergy expenditure (heart rate monitoring method), and energy intake (3-day w eighing) on three occasions at 3.5, 10 and 13 months. Results: The mothers, all of whom were of low BMI (range 14.9-18.1 kg/m(2) at the end of the study) undertook high levels of physical activity (plucke rs more so than housewives). There was evidence of weight loss over the 13 months, particularly between the fourth and sixth months postpartum, mainly due to a significant decrease in fat-free mass. Food intake and expenditur e were higher in pluckers than housewives but energy balance was not signif icantly different, although workers were, on average, in negative balance o n all three occasions. Food intake was based on cereals and fat deficient. Conclusions: A Bangladeshi sample of breast-feeding mothers studied over 13 months postpartum showed evidence of chronic malnutrition with women livin g on very low fat diets. All mothers, either housewives or tea pluckers wer e involved in energy demanding activities. There was a general tendency tow ards negative energy balance. Mothers lost weight, mainly fat-free mass ove r the study period.