Review: dietary restriction, with or without aerobic exercise, promotes weight loss in postpartum women

Weaver, Kathryn
January 2008
Evidence Based Nursing;Jan2008, Vol. 11 Issue 1, p14
Academic Journal
QUESTION Are diet and/or exercise effective for weight reduction in postpartum women? METHODS Data sources: Cochrane Pregnancy and Childbirth Group's Trial Register (including searches of Cochrane Central Register of Controlled Trials, Medline, 30 journals, and proceedings of major conferences) (September 2006), LILACS (2006), reference lists, and experts. Study selection and assessment: randomised controlled trials (RCTs) and quasi-randomised trials that evaluated interventions involving diet (advice, counselling, or prescription of a calorie-restricted diet) and/or exercise (counselling or structured programmes) in postpartum women (≤ 12 mo after birth of a healthy singleton term infant) ≥18 years of age who were overweight, obese, or had gained excessive weight during pregnancy. Excluded were studies involving women who were underweight before pregnancy, exercise interventions for pelvic or back pain or urinary incontinence, or interventions combined with medication. 6 RCTs (n=245) met the selection criteria; duration of the intervention ranged from 11 days to 11 months. Quality of individual trials was assessed based on allocation concealment, completeness of follow-up, and blinding of outcome assessors. Outcomes: body weight, percentage body fat, fat-free mass, cardiorespiratory fitness, milk volume, and infant growth. MAIN RESULTS Dietary restriction reduced body weight more than usual care (table) but also reduced fat-free mass; groups did not differ for change in percentage body fat. Supervised aerobic exercise did not increase weight loss more than usual care (table) but did increase cardiorespiratory fitness (2 RCTs, n = 53); groups did not differ for change in percentage body fat or fat-free mass. Dietary restriction plus aerobic exercise reduced body weight more than usual care (table) and increased the proportion of women who returned to prepregnancy weight (2 RCTs, n = 102) or achieved a healthy weight (2 RCTs, n = 63). The combined intervention also reduced percentage body fat (3 RCTs, n= 107) and improved cardiorespiratory fitness (2 RCTs, n = 63); groups did not differ for change in fat-free mass. Dietary restriction plus aerobic exercise did not increase weight loss more than dietary restriction alone (table) but prevented the loss of fat-free mass; groups did not differ for change in percentage body fat. No intervention was found to have a negative effect on milk production or infant growth. CONCLUSIONS Dietary restriction, with or without an aerobic exercise programme, promotes weight loss in postpartum women. The combination of dieting and exercise improves cardio-respiratory fitness and preserves fat-free mass.


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