Diet or exercise, or both, for weight reduction in women after childbirth

Amanda Rodrigues Amorim Adegboye; Yvonne M. Linne; Paulo Mauricio C. Lourenço

doi:10.1002/14651858.CD005627.pub3

Diet or exercise, or both, for weight reduction in women after childbirth

Amanda Rodrigues Amorim Adegboye
, Yvonne M. Linne
, Paulo Mauricio C. Lourenço

Karolinska University Hospital
Karolinska Institutet
Rio de Janeiro State University

Research output: Contribution to journal › Review article › peer-review

116 Citations (Scopus)

Abstract

Background: Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated.

Objectives: The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes.

Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006) and LILACS. We scanned secondary references and contacted experts in the field.

Selection criteria: All published and unpublished randomised controlled trials (RCT) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period.

Data collection and analysis: Three review authors independently assessed trial quality and extracted data. Results are presented using relative risk for categorical data and weighted mean difference (WMD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity.

Main results: Six trials involving 245 women were included. Women who exercised did not lose significantly more weight than women in the usual care group (one trial; n = 33; WMD 0.00 kg; 95% confidence interval (CI) -8.63 to 8.63). Women who took part in a diet (one trial; n = 45; WMD -1.70 kg; 95% CI -2.08 to -1.32), or diet plus exercise programme (four trials; n = 169; WMD -2.89 kg; 95% CI -4.83 to -0.95), lost significantly more weight than women in the usual care. There was no difference in the magnitude of weight loss between diet and diet plus exercise group (one trial; n = 43; WMD 0.30 kg; 95% CI -0.60 to 0.66). The interventions seemed not to affect breastfeeding performance adversely.

Authors' conclusions: Preliminary evidence from this review suggests that dieting and exercise together appear to be more effective than diet alone at helping women to lose weight after childbirth, because the former improves maternal cardiorespiratory fitness level and preserves fat-free mass, while diet alone reduces fat-free mass. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby. Due to insufficient available data, additional research, with larger sample size, is needed to confirm the results.

Original language	English
Article number	CD005627
Journal	Cochrane Database of Systematic Reviews
Volume	2013
Issue number	7
DOIs	https://doi.org/10.1002/14651858.CD005627.pub3 https://doi.org/10.1002/14651858.CD005627.pub2
Publication status	Published - 23 Jul 2013

Funding

Supported by the Medical Research Coun cil (Ref GO701771) and NHS Research Scotland (NRS) through NHS Tayside. No mention of any research pro tocol published a priori. The characteristics of participants were not significantly different between groups at baseline Randomisation using a random-number table. Allocation using sealed, opaque envelopes (information not published) Supported by a grant (HD 24112) from the National Institutes of Health. Study guided by a research protocol and previous validation studies. The characteristics of participants were not significantly different between groups at baseline Supported by a grant (R18-DK067334) from the National Institute of Diabetes and Digestive and Kidney Diseases and a grant from the Kaiser Garfield Foundation. No mention of any research protocol published a priori. The characteristics of participants were slightly different between groups at baseline Supported by a grant from the Nation- alScienceCouncil,Taiwan (NSC 93-2314- B-182-079). No mention of any research protocol published a priori. The characteristics of participants were not significantly different between groups at baseline Some outcomes of relevance were not de scribed (e.g. weight loss) Supported by a Research Incentive Grant awarded by Boston College. No mention of any research protocol published a priori. The characteristics of participants were not significantly different between groups at baseline Supported by the NIH, NICHD, R01, D39102 grant to DK. To guide interven tion development, 8 focus groups (n = 38 women) of women, who were WIC participants but not eligible for the study, were held prior to the intervention. The characteristics of participants were not significantly different between groups at baseline for the entire population (n = 151). However, participants and drop outs were slightly different Supported by a Pilot Feasibility Grant from the Obesity Nutrition Research Center (DK46204). No mention of any research protocol published a priori. The intervention group was significantly older and had a greater percentage of married women, compared to control group Supported by grants from the National Institutes of Health (HD 34222) and the North Carolina Agricultural Research Service. No mention of any research protocol published a priori. The characteristics of participants were not significantly different between groups at baseline Randomised controlled trial. The randomisation was stratified by parity because loss of bone density during lactation may be different between primiparous and multiparous women 20 healthy (free from chronic disease), non-smoking, sedentary, exclusively breastfeeding women with a BMI of 25-30 kg/m2 at 3 weeks postpartum. Supported by a grant from the North Car olina Agricultural Research Service. No mention of any research protocol published a priori. The characteristics of participants were not significantly different between groups at baseline Supported by NIH grant (HD 24112). No mention of any research protocol published a priori. But the study seems to be guided by a previous short-term intervention study in lactating women. The characteristics of participants were not significantly different between groups at baseline Study supported by the American Heart Association Heartland Affiliate, award 0051330Z. No mention of any research protocol published a priori. The characteristics of participants were not significantly different between groups at baseline

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 3 Good Health and Well-being

ASJC Scopus subject areas

Pharmacology (medical)

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Cite this

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title = "Diet or exercise, or both, for weight reduction in women after childbirth",

abstract = "Background: Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. Objectives: The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006) and LILACS. We scanned secondary references and contacted experts in the field. Selection criteria: All published and unpublished randomised controlled trials (RCT) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period. Data collection and analysis: Three review authors independently assessed trial quality and extracted data. Results are presented using relative risk for categorical data and weighted mean difference (WMD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity. Main results: Six trials involving 245 women were included. Women who exercised did not lose significantly more weight than women in the usual care group (one trial; n = 33; WMD 0.00 kg; 95\% confidence interval (CI) -8.63 to 8.63). Women who took part in a diet (one trial; n = 45; WMD -1.70 kg; 95\% CI -2.08 to -1.32), or diet plus exercise programme (four trials; n = 169; WMD -2.89 kg; 95\% CI -4.83 to -0.95), lost significantly more weight than women in the usual care. There was no difference in the magnitude of weight loss between diet and diet plus exercise group (one trial; n = 43; WMD 0.30 kg; 95\% CI -0.60 to 0.66). The interventions seemed not to affect breastfeeding performance adversely. Authors' conclusions: Preliminary evidence from this review suggests that dieting and exercise together appear to be more effective than diet alone at helping women to lose weight after childbirth, because the former improves maternal cardiorespiratory fitness level and preserves fat-free mass, while diet alone reduces fat-free mass. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby. Due to insufficient available data, additional research, with larger sample size, is needed to confirm the results.",

author = "\{Rodrigues Amorim Adegboye\}, Amanda and Linne, \{Yvonne M.\} and Louren{\c c}o, \{Paulo Mauricio C.\}",

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doi = "10.1002/14651858.CD005627.pub3",

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AU - Rodrigues Amorim Adegboye, Amanda

AU - Linne, Yvonne M.

AU - Lourenço, Paulo Mauricio C.

PY - 2013/7/23

Y1 - 2013/7/23

N2 - Background: Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. Objectives: The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006) and LILACS. We scanned secondary references and contacted experts in the field. Selection criteria: All published and unpublished randomised controlled trials (RCT) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period. Data collection and analysis: Three review authors independently assessed trial quality and extracted data. Results are presented using relative risk for categorical data and weighted mean difference (WMD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity. Main results: Six trials involving 245 women were included. Women who exercised did not lose significantly more weight than women in the usual care group (one trial; n = 33; WMD 0.00 kg; 95% confidence interval (CI) -8.63 to 8.63). Women who took part in a diet (one trial; n = 45; WMD -1.70 kg; 95% CI -2.08 to -1.32), or diet plus exercise programme (four trials; n = 169; WMD -2.89 kg; 95% CI -4.83 to -0.95), lost significantly more weight than women in the usual care. There was no difference in the magnitude of weight loss between diet and diet plus exercise group (one trial; n = 43; WMD 0.30 kg; 95% CI -0.60 to 0.66). The interventions seemed not to affect breastfeeding performance adversely. Authors' conclusions: Preliminary evidence from this review suggests that dieting and exercise together appear to be more effective than diet alone at helping women to lose weight after childbirth, because the former improves maternal cardiorespiratory fitness level and preserves fat-free mass, while diet alone reduces fat-free mass. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby. Due to insufficient available data, additional research, with larger sample size, is needed to confirm the results.

AB - Background: Weight retention after pregnancy may contribute to obesity. It is known that diet and exercise are recommended components of any weight loss programme in the general population. However, strategies to achieve healthy body weight among postpartum women have not been adequately evaluated. Objectives: The objectives of this review were to evaluate the effect of diet, exercise or both for weight reduction in women after childbirth, and to assess the impact of these interventions on maternal body composition, cardiorespiratory fitness, breastfeeding performance and other child and maternal outcomes. Search strategy: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (September 2006) and LILACS. We scanned secondary references and contacted experts in the field. Selection criteria: All published and unpublished randomised controlled trials (RCT) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period. Data collection and analysis: Three review authors independently assessed trial quality and extracted data. Results are presented using relative risk for categorical data and weighted mean difference (WMD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity. Main results: Six trials involving 245 women were included. Women who exercised did not lose significantly more weight than women in the usual care group (one trial; n = 33; WMD 0.00 kg; 95% confidence interval (CI) -8.63 to 8.63). Women who took part in a diet (one trial; n = 45; WMD -1.70 kg; 95% CI -2.08 to -1.32), or diet plus exercise programme (four trials; n = 169; WMD -2.89 kg; 95% CI -4.83 to -0.95), lost significantly more weight than women in the usual care. There was no difference in the magnitude of weight loss between diet and diet plus exercise group (one trial; n = 43; WMD 0.30 kg; 95% CI -0.60 to 0.66). The interventions seemed not to affect breastfeeding performance adversely. Authors' conclusions: Preliminary evidence from this review suggests that dieting and exercise together appear to be more effective than diet alone at helping women to lose weight after childbirth, because the former improves maternal cardiorespiratory fitness level and preserves fat-free mass, while diet alone reduces fat-free mass. For women who are breastfeeding, more evidence is required to confirm whether diet or exercise, or both, is not detrimental for either mother or baby. Due to insufficient available data, additional research, with larger sample size, is needed to confirm the results.

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SN - 1361-6137

VL - 2013

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

IS - 7

M1 - CD005627

ER -

Diet or exercise, or both, for weight reduction in women after childbirth

Abstract

Funding

UN SDGs

ASJC Scopus subject areas

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