Effects of lifestyle intervention on dietary intake, physical activity level, and gestational weight gain in pregnant women with different pre-pregnancy Body Mass Index in a randomized control trial

Amy Leung Hui, Lisa Back, Sora Ludwig, Phillip Gardiner, Gustaaf Sevenhuysen, Heather J Dean, Elisabeth Sellers, Jonathan McGavock, Margaret Morris, Depeng Jiang, Garry X Shen, Amy Leung Hui, Lisa Back, Sora Ludwig, Phillip Gardiner, Gustaaf Sevenhuysen, Heather J Dean, Elisabeth Sellers, Jonathan McGavock, Margaret Morris, Depeng Jiang, Garry X Shen

Abstract

Background: The objectives of this study were to assess the efficacy of lifestyle intervention on gestational weight gain in pregnant women with normal and above normal body mass index (BMI) in a randomized controlled trial.

Methods: A total of 116 pregnant women (<20 weeks of pregnancy) without diabetes were enrolled and 113 pregnant women completed the program. Participants were randomized into intervention and control groups. Women in the intervention group received weekly trainer-led group exercise sessions, instructed home exercise for 3-5-times/week during 20-36 weeks of gestation, and dietary counseling twice during pregnancy. Participants in the control group did not receive the intervention. All participants completed a physical activity questionnaire and a 3-day food record at enrolment and 2 months after enrolment.

Results: The participants in the intervention group with normal pre-pregnancy BMI (≤24.9 kg/M2, n = 30) had lower gestational weight gain (GWG), offspring birth weight and excessive gestational weight gain (EGWG) on pregnancy weight gain compared to the control group (n = 27, p < 0.05). Those weight related-changes were not detected between the intervention (n = 27) and control group (n = 29) in the above normal pre-pregnancy BMI participants. Intervention reduced total calorie, total fat, saturated fat and cholesterol intake were detected in women with normal or above normal pre-pregnancy BMI compared to the control group (p < 0.05 or 0.01). Increased physical activity and reduced carbohydrate intake were detected in women with normal (p < 0.05), but not above normal, pre-pregnancy BMI at 2 months after the onset of the intervention compared to the control group.

Conclusion: The results of the present study demonstrated that the lifestyle intervention program decreased EGWG, GWG, offspring birth weight in pregnant women with normal, but not above normal, pre-pregnancy BMI, which was associated with increased physical activity and decreased carbohydrate intake.

Trial registration: NCT00486629.

Figures

Figure 1
Figure 1
Consort flow chart of the study.
Figure 2
Figure 2
Effect of lifestyle intervention on physical activity index levels in pregnant women with normal or above normal pre-pregnancy BMI at base line and 2 months after enrolment. Upper: normal pre-pregnancy BMI (control n = 27, intervention n = 30); bottom: above normal pre-pregnancy BMI (control n = 29, intervention n = 27). Values were expressed in mean ± SD. **: p < 0.01 versus control group with corresponding pre-pregnancy BMI.

References

    1. Canada H. Canadian Guidelines for Body Weight Classification in Adults (Catalogue H49-179) 2003.
    1. Canadian Institute for Health Information . Improving the Health of Canadians. 2004.
    1. Gilmore J. Body mass index and health. Health Rep Summer. 1999;11:31–43 (Eng).
    1. Lau DC, Douketis JD, Morrison KM, Hramiak IM, Sharma AM, Ur E. Canadian clinical practice guidelines on the management and prevention of obesity in adults and children [summary] CMAJ. 2006;2007(176):S1–S13.
    1. Tjepkema M, Shields M. Canadian community health survey - Measured obesity: adult obesity in Canada. Ottawa, ON: Statistics CanadA; 2005.
    1. Public Health Agency of Canada . The Canadian Maternity Experiences Survey. 2006.
    1. Rasmussen KM, Yaktine AL. Weight Gain during Pregnancy: Reexamining the Guidelines. Washington, D.C: Institute of Medicine and National Research Council of the National Academies. The National Academies Press; 2009.
    1. ACOG: Committee opinion: weight gain during pregnancy. Number 548, Jan. 2013.
    1. Health Canada: Prenatal Nutrition Guidelines for Health Professionals: Gestational Weight Gain.
    1. Borberg C, Gillmer MD, Brunner EJ, Gunn PJ, Oakley NW, Beard RW. Obesity in pregnancy: the effect of dietary advice. Diabetes Care. 1980;3:476–481. doi: 10.2337/diacare.3.3.476.
    1. Olson CM, Strawderman MS, Reed RG. Efficacy of an intervention to prevent excessive gestational weight gain. Am J Obstet Gynecol. 2004;191:530–536. doi: 10.1016/j.ajog.2004.01.027.
    1. Claesson IM, Sydsjo G, Brynhildsen J, Cedergren M, Jeppsson A, Nyström F, Sydsjö A, Josefsson A. Weight gain restriction for obese pregnant women: a case-control intervention study. BJOG. 2008;115:44–50. doi: 10.1111/j.1471-0528.2007.01531.x.
    1. Wolff S, Legarth J, Vangsgaard K, Toubro S, Astrup A. A randomized trial of the effects of dietary counseling on gestational weight gain and glucose metabolism in obese pregnant women. Int J Obes (Lond) 2008;32:495–501. doi: 10.1038/sj.ijo.0803710.
    1. Asbee SM, Jenkins TR, Butler JR, White J, Elliot M, Rutledge A. Preventing excessive weight gain during pregnancy through dietary and lifestyle counseling: a randomized controlled trial. Obstet Gynecol. 2009;113(2 Pt 1):305–312. doi: 10.1097/AOG.0b013e318195baef.
    1. Mottola MF, Giroux I, Gratton R, Hammond JA, Hanley A, Harris S, McManus R, Davenport MH, Sopper MM. Nutrition and exercise prevent excess weight gain in overweight pregnant women. Med Sci Sports Exerc. 2010;42:265–272. doi: 10.1249/MSS.0b013e3181b5419a.
    1. Polley BA, Wing RR, Sims CJ. Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes Relat Metab Disord. 2002;26:1494–1502. doi: 10.1038/sj.ijo.0802130.
    1. Gray-Donald K, Robinson E, Collier A, David K, Renaud L, Rodrigues S. Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. CMAJ. 2000;163:1247–1251.
    1. Guelinckx I, Devlieger R, Mullie P, Vansant G. Effect of lifestyle intervention on dietary habits, physical activity, and gestational weight gain in obese pregnant women: a randomized controlled trial. Am J Clin Nutr. 2010;91:373–380. doi: 10.3945/ajcn.2009.28166.
    1. Hui A, Back L, Ludwig S, Gardiner P, Sevenhuysen G, Dean H, Sellers E, McGavock J, Morris M, Bruce S, Murray R, Shen GX. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a randomised controlled trial. BJOG. 2012;119:70–77. doi: 10.1111/j.1471-0528.2011.03184.x.
    1. Hui A, Ludwig S, Gardiner P, Sevenhuysen G, Murray R, Morris M, Shen GX. Report of a pilot study on community - based exercise and dietary intervention during pregnancy. Can J Diabetes. 2006;31:169–175.
    1. Sevenhuysen GP, Gross U. Documenting the reasons people have for choosing their food. Asia Pac J Clin Nutr. 2003;12:30–37.
    1. Shuaibi AM, Sevenhuysen GP, House JD. Validation of a food choice map with a 3-day food record and serum values to assess folate and vitamin B-12 intake in college-aged women. J Am Diet Assoc. 2008;108:2041–2050. doi: 10.1016/j.jada.2008.09.002.
    1. Institute of Medicine . Dietary Reference Intakes: The Essential Guide to Nutrient Requirements. 2006.
    1. Canada H. Prenatal Nutrition Guidelines for Health Professionals: gestational weight gain. 2010.
    1. Canada H. Prenatal Nutrition Guidelines for Health Professionals - Background on Canada's Food Guide. 2009.
    1. Canadian Diabetes Association, Clinical Practice Guidelines Committee, Canadian Diabetes Association 2008 Clinical Practice Guidelines for the Prevention and Management of Diabetes in Canada. Can J Diabetes Care. 2008;32:S1:171.
    1. Williams RL, Creasy RK, Cunningham GC, Hawes WE, Norris FD, Tashiro M. Fetal growth and perinatal viability in California. Obstet Gynecol. 1982;59:624–632.
    1. Mottola MF, Davenport MH, Brun CR, Inglis SD, Charlesworth S, Sopper MM. Vo2 peak prediction and exercise prescription for pregnant women. Med Sci Sports Exerc. 2006;38:1389–1395. doi: 10.1249/01.mss.0000228940.09411.9c.
    1. Gibson RS. Priniciples of Nutritional Assessment. New York: Oxford University Press; 1990.
    1. Garriguet D. Under-reporting of energy intake in the Canadian Community Health Survey. Health Rep. 2008;19:37–45.
Pre-publication history
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Source: PubMed

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