Dataset Information

The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials.

ABSTRACT:

Objective

To review the effectiveness of physical activity (PA) and PA plus diet interventions in managing weight among overweight or obese (OW/OB) pregnant or postpartum women.

Methods

Four databases were searched for randomized controlled studies published between January 2000 and December 2011 that reported weight change outcomes of PA interventions in OW/OB pregnant or postpartum women. PA alone as well as PA plus diet interventions were included.

Results

Of 681 abstracts identified, 11 were included (7 trials with pregnant women and 4 trials with postpartum women). Overall, we found that PA interventions were effective for OW/OB pregnant as well as postpartum women. On average, pregnant women in the intervention groups gained 0.91kg less (95% CI: -1.76, -0.06) compared with those in the usual care groups. Postpartum women in the intervention groups significantly lost more body weight (-1.22kg; 95% CI: -1.89, -0.56) than those in the control groups. In the subgroup analyses by PA intervention types, supervised PA plus diet interventions were the most effective.

Conclusions

PA plus diet interventions may require more than advice; supervised PA programs or personalized prescription/goals are needed to prevent excessive weight gain for OW/OB pregnant women and excessive weight retention for OW/OB postpartum women.

SUBMITTER: Choi J

PROVIDER: S-EPMC3670949 | biostudies-literature | 2013 Jun

REPOSITORIES: biostudies-literature

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Publications

The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials.

Choi JiWon J Fukuoka Yoshimi Y Lee Ji Hyeon JH

Preventive medicine 20130226 6

<h4>Objective</h4>To review the effectiveness of physical activity (PA) and PA plus diet interventions in managing weight among overweight or obese (OW/OB) pregnant or postpartum women.<h4>Methods</h4>Four databases were searched for randomized controlled studies published between January 2000 and December 2011 that reported weight change outcomes of PA interventions in OW/OB pregnant or postpartum women. PA alone as well as PA plus diet interventions were included.<h4>Results</h4>Of 681 abstrac ...[more]

PMID: 23480971

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Project description:BACKGROUND:Interventions to promote a healthy diet, physical activity, and weight management during pregnancy are increasingly embracing digital technologies. Although some interventions have combined digital with interpersonal (face-to-face or telephone) delivery, others have relied exclusively on digital delivery. Exclusively digital interventions have the advantages of greater cost-effectiveness and broader reach and as such can be a valuable resource for health care providers. OBJECTIVE:This systematic review aims to focus on exclusively digital interventions to determine their effectiveness, identify behavior change techniques (BCTs), and investigate user engagement. METHODS:A total of 6 databases (Medical Literature Analysis and Retrieval System Online [MEDLINE], Excerpta Medica dataBASE [EMBASE], PsycINFO, Cumulated Index to Nursing and Allied Health Literature [CINAHL] Plus, Web of Science, and ProQuest) were searched for randomized controlled trials or pilot control trials of exclusively digital interventions to encourage healthy eating, physical activity, or appropriate weight gain during pregnancy. The outcome measures were gestational weight gain (GWG) and changes in physical activity and dietary behaviors. Study quality was assessed using the Cochrane Risk of Bias tool 2.0. Where possible, pooled effect sizes were calculated using a random effects meta-analysis. RESULTS:In total, 11 studies met the inclusion criteria. The risk of bias was mostly high (n=5) or moderate (n=3). Of the 11 studies, 6 reported on GWG as the primary outcome, 4 of which also measured changes in physical activity and dietary behaviors, and 5 studies focused either on dietary behaviors only (n=2) or physical activity only (n=3). The meta-analyses showed no significant benefit of interventions on total GWG for either intention-to-treat data (-0.28 kg; 95% CI -1.43 to 0.87) or per-protocol data (-0.65 kg; 95% CI -1.98 to 0.67). Substantial heterogeneity in outcome measures of change in dietary behaviors and physical activity precluded further meta-analyses. BCT coding identified 7 BCTs that were common to all effective interventions. Effective interventions averaged over twice as many BCTs from the goals and planning, and feedback and monitoring domains as ineffective interventions. Data from the 6 studies reporting on user engagement indicated a positive association between high engagement with key BCTs and greater intervention effectiveness. Interventions using proactive messaging and feedback appeared to have higher levels of engagement. CONCLUSIONS:In contrast to interpersonal interventions, there is little evidence of the effectiveness of exclusively digital interventions to encourage a healthy diet, physical activity, or weight management during pregnancy. In this review, effective interventions used proactive messaging, such as reminders to engage in BCTs, feedback on progress, or tips, suggesting that interactivity may drive engagement and lead to greater effectiveness. Given the benefits of cost and reach of digital interventions, further research is needed to understand how to use advancing technologies to enhance user engagement and improve effectiveness.

Project description:ContextThe prevalence of severe obesity is increasing markedly, as is prevalence of comorbid conditions such as hypertension and type 2 diabetes mellitus; however, apart from bariatric surgery and pharmacotherapy, few clinical trials have evaluated the treatment of severe obesity.ObjectiveTo determine the efficacy of a weight loss and physical activity intervention on the adverse health risks of severe obesity.Design, setting, and participantsSingle-blind randomized trial conducted from February 2007 through April 2010 at the University of Pittsburgh. Participants were 130 (37% African American) severely obese (class II or III) adult participants without diabetes recruited from the community.InterventionsOne-year intensive lifestyle intervention consisting of diet and physical activity. One group (initial physical activity) was randomized to diet and physical activity for the entire 12 months; the other group (delayed physical activity) had the identical dietary intervention but with physical activity delayed for 6 months.Main outcome measuresChanges in weight. Secondary outcomes were additional components comprising cardiometabolic risk, including waist circumference, abdominal adipose tissue, and hepatic fat content.ResultsOf 130 participants randomized, 101 (78%) completed the 12-month follow-up assessments. Although both intervention groups lost a significant amount of weight at 6 months, the initial-activity group lost significantly more weight in the first 6 months compared with the delayed-activity group (10.9 kg [95% confidence interval {CI}, 9.1-12.7] vs 8.2 kg [95% CI, 6.4-9.9], P = .02 for group × time interaction). Weight loss at 12 months, however, was similar in the 2 groups (12.1 kg [95% CI, 10.0-14.2] vs 9.9 kg [95% CI, 8.0-11.7], P = .25 for group × time interaction). Waist circumference, visceral abdominal fat, hepatic fat content, blood pressure, and insulin resistance were all reduced in both groups. The addition of physical activity promoted greater reductions in waist circumference and hepatic fat content.ConclusionAmong patients with severe obesity, a lifestyle intervention involving diet combined with initial or delayed initiation of physical activity resulted in clinically significant weight loss and favorable changes in cardiometabolic risk factors.Trial registrationclinicaltrials.gov Identifier: NCT00712127.

Dataset Information

The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials.

Objective

Methods

Results

Conclusions

Publications

The effects of physical activity and physical activity plus diet interventions on body weight in overweight or obese women who are pregnant or in postpartum: a systematic review and meta-analysis of randomized controlled trials.

Similar Datasets

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