Changing diet and physical activity to reduce gestational weight gain: a meta-analysis
Changing diet and physical activity to reduce gestational weight gain: a meta-analysis
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DOI：
10.1111/j.1467-789x.2011.00884.x
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发表时间：
2011-07-01
期刊：
影响因子：
8.9
通讯作者：
Croker, H.
中科院分区：
文献类型：
--
作者：
Gardner, B.;Wardle, J.;Croker, H.
过多的妊娠体重增加与不良的孕产妇和儿童健康结局有关。干预开发人员认为，在怀孕期间采用更健康的饮食和增加体力活动可以限制体重增加，但对这些干预措施的评估得出了喜忧参半的结果。最近对这些文献的回顾还没有确定有效干预的定义特征。我们系统地回顾了10项已发表的旨在通过改变饮食或体力活动来减少妊娠体重增加的干预对照试验。对样本的特征、干预内容和实施方式以及方法进行了分类。Meta分析显示，总体而言，饮食和体力活动的改变在减少妊娠体重增加方面是有效的，但结果存在相当大的异质性。我们的分析指出了干预设计、内容、实施和评估的样本特征和方面，这些方面在不同的研究中有所不同，并可能解释有效性的差异。未能评估行为或其心理决定因素的变化，以及对干预内容的报告不足，可能会模糊对影响体重变化的过程的识别。这限制了我们辨别积极干预因素的能力。我们建议更系统地设计、评估和报告基于行为的妊娠体重减轻干预措施，以建立在行为科学的基础上的见解。
Excessive pregnancy weight gain is associated with adverse maternal and child health outcomes. Intervention developers have assumed that adopting a healthier diet and increasing physical activity in pregnancy can limit weight gain, but evaluations of such interventions have yielded mixed results. Recent reviews of this literature have not identified defining characteristics of effective interventions. We systematically reviewed 10 published controlled trials of interventions that aimed to reduce gestational weight gain through changes in diet or physical activity. Characteristics of the sample, intervention content and delivery, and methodology were categorized. Meta-analysis showed that, overall, diet and physical activity change was effective in reducing gestational weight gain, but there was considerable heterogeneity in outcomes. Our analysis points to sample characteristics and aspects of intervention design, content, delivery and evaluation which differ between studies and may explain variation in effectiveness. Failure to evaluate changes in behaviour or its psychological determinants, and under-reporting of intervention content, may obscure identification of the processes by which weight change is effected. This limits our ability to discern active intervention ingredients. We suggest that behaviour-based gestational weight gain reduction interventions be more systematically designed, evaluated and reported to build on insights from behavioural science.