Page 79 - Pro-active Management of Women’s Health after Cardiometabolic Complicated Pregnancies

Intervention Description
heart rate 4 times per week during 10 wk. Initial exercise session 15 min. The following sessions increased by 2 min/d until women were exercising with their target heart rate for 45 min.
Same as Lovelady, 2000155
D: Aimed at 35% energy deficit. Diets were individually tailored and food was provided in preweighted amounts.
D+E: Aimed at 35% net energy deficit, 60% by dietary restriction and 40% by additional exercise. Exercise was prescribed in terms of a target heart rate range (50%- 70% of maximal heart rate) and total time. Exercise sessions were self-supervised. Energy expended in exercise (based on heart rate monitoring) was checked every 1-3d during the intervention period, and the prescription was adjusted as necessary.
C: Asked to maintain their weight during the intervention by maintaining their usual diet and activity patterns.
Diet: Eight healthy-eating classes to reduce total caloric intake, increase in fruit and vegetable consumption. In the classes, women were taught practical skills shown to facilitate weight loss, including making choices that decrease consumption of high-fat, high-sugar foods and beverages; learning appropriate portion sizes; cooking easy, low-fat meals; making appropriate choices at fast- food restaurants; and avoiding over-eating in stressful situations. Participants were provided with a study notebook with exercises and recipes.
Ten physical activity classes: increasing physical activity to the recommended 30 min a day, 5 times a wk. Counseling sessions by a trained counselor: every 6 wk, lasting 20 min each, delivered primary over the phone, but occasionally in person. Consistent with motivational interviewing, the counselor utilized reflective listening techniques, self-motivational statements, and change talk to elicit participants’ personal behavioral goals and troubleshoot barriers to achieving them. Participants
Mean baseline Weight in kg (SD)
I: 75.9 (9.8) C: 77.2 (8.3)
D: 68.3 (10.2) D+E: 69.0 (12.8)
C: 68.5 (8.5)
Weight Loss
Women in the intervention group lost significantly more weight (4.8 [1.6] kg) than women in the control group (0.8 [1.8] kg), (p<0.001)
Women in the D group had lost 1.9 kg, and women in the D+E group lost 1.9 kg at follow-up, while the women in the C group had lost 0.2 kg (p < 0.00001)
3.1 Effect of Postpartum Lifestyle Interventions| 77
I: 88.7 (18.8) C: 88.4 (18.5)
Mean weight at follow-up in I group was 87.8(20.7) kg, and in the C- group 88.1 (20.2) kg. Mean weight loss was 0.9 (5.1) kg in the I group and 0.4 (4.9) kg in the C group; this difference was NS. There was a positive association between classes attended and weight loss (p=0.01). There were no significant differences between the 2 groups in other measures of weight change, including return to pre-pregnancy weight and percent weight loss.
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