Applied nutritional investigation Association between prepregnancy obesity and metabolic risk in Chilean premenopausal women 10 y postpartum Maria Luisa Garmendia Ph.D. a, * , Carolina Zamudio M.Sc. a , Marcela Araya Ph.D. b , Juliana Kain M.Sc. a a Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile b Faculty of Medicine, Department of Women and New Born Health Promotion, University of Chile, Santiago, Chile article info Article history: Received 14 November 2016 Accepted 5 January 2017 Keywords: Obesity Overweight Gestational weight gain Metabolic syndrome Pregnancy abstract Objectives: One of every four pregnant women in Chile is obese. Gestational obesity is associated with maternal metabolic complications in pregnancy (e.g., gestational diabetes, preeclampsia), but to our knowledge, there is little evidence on relationships with future metabolic risk. The aim of this study was to evaluate the association between prepregnancy obesity (prepregnancy body mass index 30 kg/m 2 ) or excessive gestational weight gain (GWG; according to the 2009 recommen- dations from the Institute of Medicine), and maternal metabolic complications 10 y postpartum in premenopausal Chilean women. Methods: A prospective study was conducted. In 2006, 1067 Chilean mothers of children born in 2002dparticipants of the GOCS (Growth and Obesity Cohort Study)dwere recruited. Mothers completed a questionnaire concerning sociodemographic, anthropometric, and pregnancy char- acteristics. Of the sample, 402 women were randomly selected to participate in a study related to the determinants of breast cancer risk in 2012. At follow-up, anthropometry, blood pressure, and fasting labs were measured. Complete data was available for 366 women. Results: Thirty-two percent of mothers had prepregnancy overweight/obesity and 39.1% had excessive GWG. In adjusted models, prepregnancy obesity was positively associated with increased insulin resistance (odds ratio [OR], 18; 95% confidence interval [CI], 5.2–62.7), metabolic syndrome (OR, 3.3; 95% CI, 1.3–8.3), and hyperglycemia (OR, 3; 95% CI, 1.1–8.6). Prepregnancy overweight/ obesity was associated with increased risk for insulin resistance, metabolic syndrome, abdominal obesity, low high-density lipoprotein cholesterol, and hypertriglyceridemia (P < 0.05). Excessive GWG was not associated with metabolic risk in the main model but was found to be positively associated in models with correction of weight by possible recall bias. Conclusions: Gestational obesity was associated with maternal metabolic alterations 10 y post- partum. Prevention strategies for chronic diseases should consider prepregnancy obesity as a modifiable risk factor for future metabolic health. Ó 2017 Elsevier Inc. All rights reserved. Introduction Obesity is considered a worldwide epidemic. Every year, approximately 2.6 million people die as a result of excess weight, which disproportionally affects women [1,2]. In 2010, the Chilean Ministry of Health estimated that 31% of women between the ages of 15 and 44 y were overweight and 20% were obese [3]. Additionally, the prevalence of overweight/- obesity among pregnant women who are beneficiaries of the Chilean public health system reached 59% in 2013, with one of every four women considered obese [4]. Prepregnancy obesity (prepregnancy body mass index [BMI] 30 kg/m 2 ) or excessive gestational weight gain (GWG; above recommendations established by the Institute of Medicine [IOM]) [5] are the most important factors in Western societies related to peri- natal outcomes as gestational diabetes, preeclampsia, or macrosomia [5–9]. This work was supported by FONDECYT 1130277, 11100238, and 1120326. MLG and CZ designed the research, analyzed the data, and wrote the manuscript. The authors were final reviewers for scientific content and they all read and approved the final manuscript. The authors have no conflicts of interest to declare. * Corresponding author. Tel.: þ56 229 781 402; fax: þ56 229 781 400. E-mail addresses: mgarmend@gmail.com, mgarmendia@inta.uchile.cl (M. L. Garmendia). http://dx.doi.org/10.1016/j.nut.2017.01.003 0899-9007/Ó 2017 Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Nutrition journal homepage: www.nutritionjrnl.com Nutrition 38 (2017) 20–27