Sara Lindberg, PhD, MPH (right), with Whitney Witt, PhD, MPH, and Dr. Cynthia Anderson, MD, MPH.
Affecting over 12.5 million children and nearly 40 million adults, obesity has more than exceeded epidemic proportions in the United States. With many prevention programs adopting the familiar, "eat less exercise more," mantra, the underlying societal, economic, and cultural complexities of the issue that continue to drive the epidemic are often overlooked.
One UW researcher has decided to address the issue further upstream in search of a more effective preventative solution.
Sara Lindberg, a scientist in the UW Department of Obstetrics & Gynecology's Center for Women's Health and Health Disparities Research, has applied her diverse expertise, which includes a PhD in Developmental Psychology and a Master's Degree in Public Health focusing on epidemiology, both from UW-Madison, toward investigating gestational weight gain—the amount of weight a woman gains during pregnancy.
"The research that is out there—including some of my own work—has pointed to weight gain during pregnancy as being important for childhood obesity," Lindberg said.
Long interested in the developmental origins of health and disease, Lindberg initially focused her research on gender development in children and socioeconomic disparities before developing an interest in the obesity prevention movement. Her subsequent collaboration with Dr. Cynthia Anderson, MD, a faculty member in the UW Department of Ob-Gyn and a fellow MPH, that led her to explore gestational weight gain and its potential for preventing obesity.
"[We] developed a project that alerts providers to talk to women during their prenatal visit about their weight gain, to give them guidance on what appropriate weight gain during their pregnancy would be, and to refer them for nutritional counseling ," Lindberg explained.
Maternal obesity and excessive weight gain during pregnancy pose risks of complications such as gestational diabetes, hypertension, and operative deliveries—all of which may immediately endanger both mother and child. Just as important are the impacts of these conditions on the nutritional environment that the developing fetus experiences in utero, which sets the stage for the child's future metabolism.
Because obese mothers tend to have higher levels of insulin, "bad" cholesterol, triglycerides, inflammatory markers, and leptin circulating in their blood, their children run a significantly higher lifelong risk of obesity and associated health problems like high blood pressure, insulin resistance, and diabetes.
Congenital abnormalities and neural tube defects in the fetus are outcomes that are relatively rare but serious.
It was this ground-breaking work on gestational weight-gain that earned Sara an appointment to the University of Wisconsin's Building Interdisciplinary Research Careers in Women's Health (BIRCWH, pronounced "birch") program, under the direction of Dr. Gloria Sarto, MD, PhD, UW Professor Emerita of Obstetrics & Gynecology. This National Institutes of Health-funded career development grant is given to research scientists who strive to address gender differences in health and disease and who will advance women's health research at several universities, including UW-Madison.
UW-Madison's BIRCWH program is unique in its focus on health disparities research, making Lindberg's work on the impacts of race and other socioeconomic factors on linkages between maternal obesity, gestational weight gain, and health outcomes a perfect fit.
"The training and mentoring I have received through the BIRCWH program have helped me blend my basic epidemiology work into translational health disparities research, allowing me to pursue population-based strategies to improve maternal and child health and to reduce disparities," Lindberg said.
While encouraging physicians to alert women about gestational weight gain is a good start, Lindberg and colleagues hope to extend their efforts to helping women actually achieve their weight gain goals during pregnancy.
"We are looking at additional clinical and community interventions to go beyond just the ‘best-practice alert,' to give them resources to achieve that goal, whether they be opportunities for exercise, nutrition programs, or social and economic support."