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 methods 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. We updated this search on 5 December 2011 and added the results to the awaiting classification section. Selection criteria All published and unpublished randomised controlled trials (RCT) and quasi-randomised trials of diet or exercise or both, among women during the postpartum period.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 risk ratio for categorical data and mean difference (MD) for continuous data. Data were analysed with a fixed-effect model. A random-effects model was used in the presence of heterogeneity.

Targeting physical activity and nutrition interventions towards mothers with young children: a review on components that contribute to attendance and effectiveness

“…Preliminary findings of a recently published Cochrane review (16) extracted from six studies showed that among women recruited in the postpartum period (up to 12 months postpartum) a prescribed diet combined with structured exercise, or diet alone, compared with usual care, seemed to enhance weight loss (16) . However, this Cochrane review focused on the effect of a change in diet or exercise on change in weight without examining the factors that lead to behaviour change.…”

“…The main reasons for exclusion were lack of a control group; a different outcome measurement than physical activity or nutritional behaviour; or because mothers of children above 5 years of age were included in the study. Moreover, four review articles were found, all describing studies which mainly investigated the relationship between weight-related behaviours and weight only using prescribed diet or exercise with no attention for lifestyle change (16,(20)(21)(22) . Equally, two intervention studies were excluded for this reason.…”

“…However, this does not mean that there is no room left to improve nutritional behaviour among mothers. An unhealthy diet and a decrease in physical activity are both related to weight gain among mothers with young children (7,14,15) .Preliminary findings of a recently published Cochrane review (16) extracted from six studies showed that among women recruited in the postpartum period (up to 12 months postpartum) a prescribed diet combined with structured exercise, or diet alone, compared with usual care, seemed to enhance weight loss (16) . However, this Cochrane review focused on the effect of a change in diet or exercise on change in weight without examining the factors that lead to behaviour change.…”

Effect of breast-feeding on weight retention at 3 and 6 months postpartum: data from the North Carolina WIC Programme

“…Protective factors are less well studied, but include modifiable behavioural strategies such as healthy diet and physical activity (12)(13)(14)(15) and mode of infant feeding.…”

Tackling maternal obesity: Building an evidence base to reflect the complexity of lifestyle behaviour change

“…Evidence on postnatal interventions is developing, with systematic reviews reporting that interventions which combined diet and physical activity components were more likely to be successful (van der Pligt et al, 2013, Amorim et al, 2007. Vincze et al (2017) explored motivators for healthy eating and physical activity among women in Australia who had given birth in the previous five years.…”