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Volume 37, Issue 3, Pages 173-180 (September 2009)


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Active Mothers Postpartum: A Randomized Controlled Weight-Loss Intervention Trial

Truls Østbye, MD, PhDafgCorresponding Author Informationemail address, Katrina M. Krause, MAa, Cheryl A. Lovelady, PhD, RDf, Miriam C. Morey, PhDbe, Lori A. Bastian, MD, MPHbe, Bercedis L. Peterson, PhDc, Geeta K. Swamy, MDd, Rebecca J.N. Brouwer, MSa, Colleen M. McBride, PhDh

published online 13 July 2009.

Background

Pregnancy may contribute to overweight and obesity.

Purpose

The primary objective of Active Mothers Postpartum was to promote a reduction in BMI through 24-months postpartum via sustainable lifestyle changes.

Design

Behavioral intervention RCT to enhance postpartum weight loss.

Setting/participants

A total of 450 overweight or obese women, enrolled 6-weeks postpartum, were recruited through obstetrics clinics and community posters in the Durham NC area.

Intervention

Intervention participants were offered eight healthy-eating classes, ten physical-activity classes, and six telephone-counseling sessions over 9 months.

Main outcome measures

Changes from baseline (6-weeks postpartum) to 1-month post-intervention (12-months postpartum) in: (1) diet (caloric intake, calories from fat, intake of certain foods); (2) physical activity (self-reported physical activity, television time); and (3) weight (collected 2004–2007, analyzed 2007–2008).

Results

Mean weight loss was 0.90 kg (±5.1 kg) in the intervention group and 0.36 kg (±4.9 kg) in the control group; this difference was not significant. There were also no significant group differences in improvement of diet or increased physical activity. In secondary analyses, there was a positive bivariate relationship between classes attended and weight loss (p=0.01).

Conclusions

There were no significant differences among the arms in diet, physical activity, or weight change. Home-based interventions via mail, telephone, or Internet/e-mail may be more feasible and successful in this population. The postpartum period is an important phase in women's lives with regard to weight retention, but engaging them during this busy period remains a challenge.

Trial registration

NCT00212251.

a Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina

b Department of Medicine, Duke University Medical Center, Durham, North Carolina

c Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina

d Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, North Carolina

e Durham Veteran's Affairs Medical Center, Durham, North Carolina

f Department of Nutrition, University of North Carolina at Greensboro, Greensboro, North Carolina

g Duke-NUS Graduate Medical School, Singapore

h National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland

Corresponding Author InformationAddress correspondence and reprint requests to: Truls Østbye, MD, PhD, Department of Community and Family Medicine, Box 104006, Duke University Medical Center, Durham NC 27710

 The full text of this article is available via AJPM Online at www.ajpm-online.net.

PII: S0749-3797(09)00378-X

doi:10.1016/j.amepre.2009.05.016


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