(15-10-12) Diet and exercise weight-loss trial in lactating overweight and obese women

1,2,3
1. Fredrik Bertz,
2. Hilde K Brekke,
3. Lars Elleg?rd,
4. Kathleen M Rasmussen,
5. Margareta Wennergren, and
6. Anna Winkvist
+Author Affiliations
+Author Notes
1From the Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden (FB, HKB, LE, and AW); the Division of Nutritional Sciences, Cornell University, Ithaca, NY (KMR); and the Department of Obstetrics and Gynecology, Sahlgrenska University Hospital, Gothenburg, Sweden (MW).
2 Supported by The Swedish Research Council (project grant K2009-70X-21091-01-3; primary investigator: AW) and the Swedish Council for Working Life and Social Research (project grant 2006-0339; primary investigator: AW).
↵3 Address correspondence to F Bertz, Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Box 459, SE-405 30, Gothenburg, Sweden. E-mail: [email protected].

Abstract
Background: Current evidence suggests a combined treatment of postpartum weight loss of diet and exercise. However, to our knowledge, neither their separate and interactive effects nor long-term outcomes have been evaluated.
Objective: We evaluated whether a 12-wk dietary behavior modification (D) treatment to decrease energy intake, physical exercise behavior modification (E) treatment to implement moderate aerobic exercise, or combined dietary and physical exercise behavior modification (DE) treatment compared with control (usual care) (C) reduces body weight in lactating women measured at the end of treatment and at a 1-y follow-up 9 mo after treatment termination.
Design: At 10?14 wk postpartum, 68 lactating Swedish women with a prepregnancy BMI (in kg/m2) of 25?35 were randomly assigned to D, E, DE, or C groups. Measurements were made at baseline, after the intervention, and again at a 1-y follow-up 9 mo later. A 2 ? 2 factorial approach was used to analyze main and interaction effects of treatments.
Results: Weight changes after the intervention and 1-y follow-up were −8.3 ? 4.2 and −10.2 ? 5.7 kg, respectively, in the D group; −2.4 ? 3.2 and −2.7 ? 5.9 kg, respectively, in the E group; −6.9 ? 3.0 and −7.3 ? 6.3 kg, respectively, in the DE group; and −0.8 ? 3.0 and −0.9 ? 6.6 kg, respectively, in the C group. The main effects of D treatment, but not of E treatment, on weight were significant at both times (P < 0.001).
Conclusions: Dietary treatment provided clinically relevant weight loss in lactating postpartum women, which was sustained at 9 mo after treatment. The combined treatment did not yield significant weight or body-composition changes beyond those of dietary treatment alone. This trial was registered at clinicaltrials.gov as

Source: Am J Clin Nutr October 2012vol. 96 no. 4 698-705

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