Can gestational weight gain be modified by increasing physical activity and diet counseling? A meta-analysis of interventional trials

Abstract

Background: Excessive gestational weight gain (GWG) increases the risk of a number of adverse pregnancy outcomes and was recently identified as a potential risk factor for childhood obesity. It is therefore of interest whether GWG can be modified by an intervention combining dietary counseling and physical activity. Objective: The objective was to review published data on interventions to reduce GWG by modulating diet and physical activity during pregnancy. Design: We systematically reviewed 4 databases and bibliographies of various publications supplemented by a hand-search for relevant articles published in English or German and performed a metaanalysis to quantify the effect estimate by a random-effects model. Results: Four randomized controlled trials and 5 nonrandomized trials with a total of 1549 women enrolled were identified as being relevant. Meta-analyses of all 9 trials indicated a lower GWG in the intervention groups, with a standardized mean difference of 20.22 units (95% CI: 20.38, 20.05 units). We observed no indication for publication bias. Conclusions: Interventions based on physical activity and dietary counseling, usually combined with supplementary weight monitoring, appear to be successful in reducing GWG. The results are of particular interest with respect to the objective of preventing excessive GWG.Am J Clin Nutr 2010;92:678-87.

Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy

“…A meta-analysis of randomized controlled trials, focusing on diet and physical activity during pregnancy as intervention, showed that interventions may be effective to control weight gain during pregnancy (40). However, as maternal overweight and obesity are strongly associated with shortterm and long-term adverse consequences, future preventive strategies should also focus on prepregnancy overweight and obesity.…”

Late pregnancy reversal from excessive gestational weight gain lowers risk of childhood overweight-A cohort study

“…Interventions based on increasing physical activity (17,18); dietary advice (19); or by a combination of physical activity, supplementary weight monitoring, and nutritional counselling have been shown to be effective in reducing total GWG (20). A recent meta-analyses suggested that dietary measures might be most effective (21).…”

Exercise Guidelines for Women with Gestational Diabetes

“…Lifestyle intervention studies also showed successful results with respect to the prevention of excessive GWG. Two reports using meta-analyses of intervention trials showed that exercise programs, combined with or without nutrition counselling, helps to limit GWG (Streuling et al, 2010a;Streuling et al, 2010b). Interventions that combined exercise and dietary counseling were found to be more successful in limiting GWG, with an average reduction of GWG of 1.2 kg (p=0.01) found in the intervention groups compared to the control groups (Streuling et al, 2010b).…”

“…Two reports using meta-analyses of intervention trials showed that exercise programs, combined with or without nutrition counselling, helps to limit GWG (Streuling et al, 2010a;Streuling et al, 2010b). Interventions that combined exercise and dietary counseling were found to be more successful in limiting GWG, with an average reduction of GWG of 1.2 kg (p=0.01) found in the intervention groups compared to the control groups (Streuling et al, 2010b). Three studies found significant lower GWG in the exercise plus nutrition intervention group compared with the control groups (Asbee et al, 2009;Claesson et al, 2008;Shirazian et al, 2010), 3 studies found a non significant trend in lower GWG in the intervention group compared with the control group (Gray-Donald et al, 2000;Guelinckx et al, 2010;Olson et al, 2004) and three found no significant results (Hui et www.intechopen.com al., 2006;Kinnunen et al, 2007;Polley et al, 2002).…”