Effectiveness of a weight loss intervention in postpartum women: results from a randomized controlled trial in primary health care1

• Published in: The American journal of clinical nutrition 2016-08, Vol.104 (2), p.362-370
• Main Authors: Huseinovic, Ena, Bertz, Fredrik, Leu Agelii, Monica, Hellebö Johansson, Else, Winkvist, Anna, Brekke, Hilde Kristin
• Format: Article
• Language: English
• Subjects: diet intervention; obesity; postpartum; randomized controlled trial; weight loss
• ISSN: 0002-9165; 1938-3207
• DOI: 10.3945/ajcn.116.135673

Background: Reproduction has been identified as an important factor for long-term weight gain among women. A previous efficacy trial has successfully produced postpartum weight loss; however, the effectiveness of this intervention needs to be established. Objective: This study was designed to evaluate the short- and long-term effectiveness of a diet behavior modification treatment to produce weight loss in postpartum women within the primary health care setting in Sweden. Design: During 2011–2014, 110 women with a self-reported body mass index (BMI; in kg/m2) of ≥27 at 6–15 wk postpartum were randomly assigned to the diet behavior modification group (D group) or the control group (C group). Women randomly assigned to the D group (n = 54) received a structured 12-wk diet behavior modification treatment by a dietitian and were instructed to gradually implement a diet plan based on the Nordic Nutrition Recommendations and to self-weigh ≥3 times/wk. Women randomly assigned to the C group (n = 56) were given a brochure on healthy eating. The primary outcome was change in body weight after 12 wk and 1 y. The retention rate was 91% and 85% at 12 wk and 1 y, respectively. Results: At baseline, women had a median (1st, 3rd quartile) BMI of 31.0 (28.8, 33.6), and 84% were breastfeeding. After 12 wk, median weight change in the D group was −6.1 kg (−8.4, −3.2 kg) compared with −1.6 kg (−3.5, −0.4 kg) in the C group (P < 0.001). The difference was maintained at the 1-y follow-up for the D group, −10.0 kg (−11.7, −5.9 kg) compared with −4.3 kg (−10.2, −1.0 kg) in the C group (P = 0.004). In addition, the D group reduced BMI, waist circumference, hip circumference, and body fat percentage more than did the C group at both 12 wk and 1 y (all P < 0.05). Conclusion: A low-intensity diet treatment delivered by a dietitian within the primary health care setting can produce clinically relevant and sustainable weight loss in postpartum women with overweight and obesity. This trial was registered at clinicaltrials.gov as NCT01949558.