Background: Excessive gestational weight gain (GWG) increases the risk of a number of adverse pregnancy outcomes and was recently identified as a potential risk factor for childhood obesity. It is therefore of interest whether GWG can be modified by an intervention combining dietary counseling and physical activity. Objective: The objective was to review published data on interventions to reduce GWG by modulating diet and physical activity during pregnancy. Design: We systematically reviewed 4 databases and bibliographies of various publications supplemented by a hand-search for relevant articles published in English or German and performed a metaanalysis to quantify the effect estimate by a random-effects model. Results: Four randomized controlled trials and 5 nonrandomized trials with a total of 1549 women enrolled were identified as being relevant. Meta-analyses of all 9 trials indicated a lower GWG in the intervention groups, with a standardized mean difference of 20.22 units (95% CI: 20.38, 20.05 units). We observed no indication for publication bias. Conclusions: Interventions based on physical activity and dietary counseling, usually combined with supplementary weight monitoring, appear to be successful in reducing GWG. The results are of particular interest with respect to the objective of preventing excessive GWG.Am J Clin Nutr 2010;92:678-87.

Background High gestational weight gain (GWG) has been found to be associated with a number of adverse perinatal and long-term outcomes.Objectives We aimed to perform a systematic review and metaanalysis to find out whether physical activity in pregnancy might help avoid high GWG.Search strategy A literature search in relevant databases and an additional search by hand through bibliographies of various publications were performed.Selection criteria We included randomised controlled trials on healthy women, with increased physical activity as the only intervention. GWG had to be documented for the intervention and control group separately.Data collection and analysis Two reviewers independently extracted data and performed quality assessment. Data from the included trials were combined using a random-effects model. The effect size was expressed as mean difference (MD).Main results Of 1380 studies identified, 12 trials met the inclusion criteria. In seven trials, GWG was lower in the exercise group compared with the control group, whereas five trials showed a lower GWG in the control groups. The meta-analysis resulted in an MD of GWG of )0.61 (95% CI: )1.17, )0.06), suggesting less GWG in the intervention groups compared with the control groups. We found no indication for publication bias or dose effects.Author's conclusions In summary, our analyses suggest that physical activity during pregnancy might be successful in restricting GWG.

Background: Gestational weight gain (GWG) above the recently recommended ranges is likely to be related to adverse pregnancy outcomes and therefore a challenge in industrialized countries. Aims: We conducted a systematic review on observational studies in order to gain more evidence on whether diets with lower caloric/protein content or other diets might be associated with lower GWG. Methods: We searched in MEDLINE and EMBASE for observational studies written in English or German reporting associations between diet and GWG in singleton pregnancies of healthy women in industrialized countries. Results: We identified 12 studies which met the inclusion criteria. Five studies suggested significant positive associations between energy intake and GWG, whereas three found no significant association. Further significant positive associations of GWG were reported with respect to protein intake, animal lipids, energy density and a number of different food servings per day, whereas intake of carbohydrates and vegetarian diet were associated with less GWG. Conclusions: We suggest that GWG might be reduced by lower energy intake in pregnancy.

We showed no evidence that proposed adverse effects of rapid growth regarding later overweight will be counterbalanced by beneficial effects on cognitive functions in non-SGA children.