Systematic review of the effect of individual and combined nutrition and exercise interventions on weight, adiposity and metabolic outcomes after delivery: evidence for developing behavioral guidelines for post-partum weight control

BMC Pregnancy and Childbirth

Wanda K Nicholson²  Rachel Peragallo-Urrutia¹  Alexander Arkin Berger³ 

[1] Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, 321 South Columbia Street, Chapel Hill, NC, USA;Diabetes and Obesity Core, Center for Women’s Health Research, University of North Carolina School of Medicine, 3027 Old Clinic Building, CB # 7570, Chapel Hill, NC, USA;Public Health Leadership Program, University of North Carolina Gillings Global School of Public Health, 135 Dauer Drive, Chapel Hill, NC, USA

关键词: Randomized trials;    Post-partum weight retention;    Obesity;    Systematic review;   

Others  :  1125485
DOI  :  10.1186/1471-2393-14-319

 received in 2013-12-10, accepted in 2014-08-17,  发布年份 2014

【 摘 要 】

Background

Post-partum weight retention contributes to the risk of chronic obesity and metabolic alterations. We conducted a systematic review of randomized controlled trials (RCTs) on the effect of post-partum nutrition and exercise interventions on weight loss and metabolic outcomes. DATA SOURCES: Four electronic databases were searched from inception to January, 2012. Two investigators reviewed titles and abstracts, performed data abstraction on full articles and assessed study quality.

Methods

We included RCTs comparing nutrition, exercise or combined nutrition and exercise interventions with a control condition. Thirteen studies met our inclusion criteria (N = 1,310 participants). Data were abstracted on study characteristics, intervention components, enrollment period, and length of follow-up. Outcomes of interest included weight, adiposity, cardio-metabolic measures (glucose, lipids) and obesity-related inflammatory markers.

Results

Nine trials compared combined interventions to standard post-partum care; three trials assessed the effect of exercise interventions, one trial evaluated a nutrition-only intervention. Four good quality RCTs on combined interventions had inconsistent findings, with the larger RCT (N = 450) reporting no difference in weight between groups. Four fair-to good quality RCTs reported greater weight loss in the combined intervention group vs. standard care, ranging from 0.17 kg to 4.9 kg. Results from exercise only interventions were inconclusive. Evidence for nutrition only interventions was insufficient. There was insufficient evidence for the effect of post-partum interventions on metabolic risk factors and inflammatory biomarkers.

Conclusions

Combined nutrition and exercise interventions can achieve weight loss, but evidence is limited due to a small number of trials and limitations in study design.

【 授权许可】

   
2014 Berger et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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