Effect of a lifestyle intervention in obese infertile women on cardiometabolic health and quality of life: A randomized controlled trial

Abstract

BackgroundThe prevalence of obesity, an important cardiometabolic risk factor, is rising in women. Lifestyle improvements are the first step in treatment of obesity, but the success depends on factors like timing and motivation. Women are especially receptive to advice about lifestyle before and during pregnancy. Therefore, we hypothesize that the pre-pregnancy period provides the perfect window of opportunity to improve cardiometabolic health and quality of life of obese infertile women, by means of a lifestyle intervention.Methods and findingsBetween 2009–2012, 577 infertile women between 18 and 39 years of age, with a Body Mass Index of ≥ 29 kg/m2, were randomized to a six month lifestyle intervention preceding infertility treatment, or to direct infertility treatment. The goal of the intervention was 5–10% weight loss or a BMI < 29 kg/m2. Cardiometabolic outcomes included weight, waist- and hip circumference, body mass index, systolic and diastolic blood pressure, fasting glucose and insulin, HOMA-IR, hs-CRP, lipids and metabolic syndrome. All outcomes were measured by research nurses at randomization, 3 and 6 months. Self-reported quality of life was also measured at 12 months. Three participants withdrew their informed consent, and 63 participants discontinued the intervention program. Intention to treat analysis was conducted. Mixed effects regression models analyses were performed. Results are displayed as estimated mean differences between intervention and control group. Weight (-3.1 kg 95% CI: -4.0 to -2.2 kg; P < .001), waist circumference (-2.4 cm 95% CI: -3.6 to -1.1 cm; P < .001), hip circumference (-3.0 95% CI: -4.2 to -1.9 cm; P < .001), BMI (-1.2 kg/m2 95% CI: -1.5 to -0.8 kg/m2; P < .001), systolic blood pressure (-2.8 mmHg 95% CI: -5.0 to -0.7 mmHg; P = .01) and HOMA-IR (-0.5 95% CI: -0.8 to -0.1; P = .01) were lower in the intervention group compared to controls. Hs-CRP and lipids did not differ between groups. The odds ratio for metabolic syndrome in the intervention group was 0.53 (95% CI: 0.33 to 0.85; P < .01) compared to controls. Physical QoL scores were higher in the lifestyle intervention group (2.2 95% CI: 0.9 to 3.5; P = .001) while mental QoL scores did not differ.ConclusionsIn obese infertile women, a lifestyle intervention prior to infertility treatment improves cardiometabolic health and self-reported physical quality of life (LIFEstyle study: Netherlands Trial Register: NTR1530).

Effects of maternal lifestyle interventions on child neurobehavioral development: Follow‐up of randomized controlled trials

“…In the present study, we conducted a planned follow-up (van de Beek, Hoek, Painter et al, 2018) of two randomized controlled trials (RCTs) of maternal lifestyle interventions before and during pregnancy in obese women on child neurobehavioral development at the age of 3 to 6 years. We hypothesized that the benefits of the lifestyle interventions were extended from the mothers (van Dammen, Wekker, van Oers et al, 2018;Koivusalo, Rono, Klemetti et al, 2016;Mutsaerts, van Oers, Groen et al, 2016) to the children.…”

A lifestyle intervention improves sexual function of women with obesity and infertility: A 5 year follow-up of a RCT

“…We have previously reported on the LIFEstyle study, a Randomized Controlled Trial (RCT) in which women with obesity and infertility were allocated to a six month lifestyle intervention or infertility care as usual [ 38 ]. This intervention led to weight loss, improved cardiometabolic health by halving the odds of metabolic syndrome and improved physical quality of life [ 30 , 39 ]. Due to these effects that are associated with sexual function, we hypothesized that a lifestyle intervention in women with obesity and infertility would improve sexual function.…”

Asociación de un índice de estilos de vida saludable con factores de riesgo cardiovascular en población chilena

“…Diversos estudios han respaldado la importancia de un estilo de vida saludable en la prevención de enfermedades cardiometabólicas [27][28][29] , una menor cantidad de estudios han analizado el efecto combinado de múltiples componentes del estilo de vida sobre la salud 30 . A pesar que en este estudio no observó cambios significativos en el SM, Soto-Prieto y cols.…”