Page 75 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

Intervention Description
High-protein (HP) diet: protein intake above or equal to 1.2 g per kg per day of body weight.
Low-protein (LP) diet: protein intake below 1.2 g per kg per day of body weight.
Regular supervised aerobic exercise (at a level of 60%- 70% of the heart rate reserve) for 45 min/d, 5d/wk for 12 wk. Individually tailored exercise sessions. The program began with 20-min sessions, with 5-min increments every 3 d until the woman could complete 45 min of continuous exercise at the target heart rate.
Individual counseling on diet and physical activity delivered by a public health nurse. Five visits at 2, 3, 5, 6, and 10 mo pp. Counseling was based on the theoretical models of Laitakari and Asikainen173, PRECEDE-PROCEED174 and Stages of Change175. Individual physical activity counseling consisted of one primary counseling session (20-30 min) at the 2 mo pp and 4 booster sessions (10-15 min) at 3, 5, 6 and 10 mo pp. An individual weekly physical activity plan was composed, adherence to this plan was assessed and the plan was revised if needed. Also: option to attend supervised group exercise sessions, developed specifically for pp women, held once a week for 45-60 min.
The dietary counseling consisted of one primary counseling session (20-30 min) at 3 mo pp and 3 booster sessions (10 min) at 5, 6 and 10 mo pp. After comparing the personal habits to the recommendations, the public health nurse and the participant discussed the need for dietary changes, as
Mean baseline Weight in kg (SD)
HP: 59.4 (10.4) LP: 67.9 (11.6)
Weight Loss
At 6 mo pp, women with and HP diet lost more body weight than women with an LP diet 1.69 (3.7) vs 0.77 (4.3) kg (p=0.08).
Mean difference in body weight loss form baseline to 9 mo pp between the HP and LP groups was 0.84 kg (p=0.17).
Women with an HP diet lost more (324 [0.06] g) per mo than women with a LP diet (P<0.00001).
At 12-14wk pp, women in the intervention group lost 0.60 kg, while women in the control group lost 1.00 kg.
At 18-20 wk pp both women in the intervention group and in the control group had lost 1.60 kg Differences between the intervention group and the control group at both time points were NS.
Of the women in the I group, 50% (n=23) returned to their pre- pregnancy weight at follow-up (weight retention ≤ 0 kg), while 30% (n=11) of the women in the C group did (p=0.06). OR 3.89 (95% CI: 1.16- 13.04, p=0.03).
Mean weight retention in the I group (1.8 [4.3] kg) was not significantly different from weight retention in the C group (1.0 [4.4] kg)
3.1 Effect of Postpartum Lifestyle Interventions| 73
I: 67.3 C: 67.0
I: 67.1 (11.1) C: (64.7 (7.8) Weight retention (kg): I: 4.3 (4.0)
C: 4.2 (3.9)
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