Preventing excessive gestational weight gain in obese women

预防肥胖女性妊娠期体重过度增加

• 批准号: 8536037
• 负责人: Suzanne Phelan
• 金额: $ 5万
• 依托单位: CALIFORNIA POLY STATE U SAN LUIS OBISPO
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-23 至 2016-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8536037
• 关键词: Adherence; Affect; Age-Months; Apgar Score; Behavior; Behavior Therapy; Behavioral; Birth trauma; Blood Pressure; Body Image; Calories; Constipation; Cromolyn Sodium; Diet; Disinhibition; Eating; Environment; Equilibrium; Ethnic Origin; Exercise; Fasting; Fatty acid glycerol esters; Feedback; Food; Frequencies; Gestational Diabetes; Glucose; Goals; Health; Hispanics; Home environment; Incidence; Infant; Institute of Medicine (U.S.); Instruction; Insulin; Intake; Intervention; Length; Life Style; Lipids; Liquid substance; Low Birth Weight Infant; Measures; Modeling; Moods; Mothers; Not Hispanic or Latino; Nutritional; Obesity; Overweight; Participant; Physical activity; Physiological; Population; Postpartum Period; Pre-Eclampsia; Pregnancy; Prevention; Procedures; Publishing; Randomized; Randomized Controlled Trials; Recommendation; Recruitment Activity; Relative (related person); Research; Research Project Grants; Site; Testing; Time; Very Light Exercise; Weight; Weight Gain; Weight maintenance regimen; Woman; Work; base; fast food; good diet; improved; innovation; lifestyle intervention; meetings; nutrition; offspring; prevent; programs; psychosocial; randomized trial; restraint; sedentary; sound; standard care; sugar; sweetened beverage

Low-intensity lifestyle interventions during pregnancy can prevent excessive gestational weight gain in normal weight women. However, preventing excessive gestational weight gain in obese women has proven more difficult. Intensive interventions involving prescription of specific calorie goals and balanced nutrition have shown the most promise, but, similar to non-pregnant populations, promoting ongoing adherence to caloric prescription remains a significant challenge. Liquid meal-replacement products have been shown to promote adherence to calorie and weight goals in non-pregnant multiethnic populations. Moreover, they have been used during pregnancy as a supplement to improve nutritional adequacy and shown to be safe and to result in improved dietary intal<e. However, no study to date has evaluated this approach as a means to prevent excessive weight gain during pregnancy. The principal aim of this study is to determine whether a multi-component lifestyle intervention that incorporates partial meal replacements during pregnancy can reduce the number of obese women who exceed the lOM recommendations for weight gain during pregnancy. In this two-site randomized trial, 430 obese women, 50% Hispanic, will be randomized within site and ethnicity into either a multi-component lifestyle modification treatment with partial meal replacement program (N=215) or standard care (N=215). Treatment will occur during pregnancy, using standardized intervention procedures from our previous work. All women will be recruited and assessed early in pregnancy (between 10 and 16 weelis), at 30 weeks gestation, and at 6 months, and 12 months postpartum with anthropometric measures obtained at delivery and at 2 months postpartum. We believe this project is significant because it deals with the prevention of excessive gestational weight gain and its associated adverse maternal and offspring health consequences. The study is also innovative; there have been no randomized controlled trials evaluating the effects of a behavioral lifestyle intervention with partial meal replacement program to promote healthy weight gain in multiethnic obese women.

怀孕期间低强度的生活方式干预可以防止妊娠期体重过度增加 正常体重的女性。然而，事实证明，预防肥胖女性妊娠期体重过度增加是有效的。 更困难。强化干预措施，包括制定具体卡路里目标和均衡营养 已显示出最大的希望，但与非怀孕人群类似，促进持续坚持 热量处方仍然是一个重大挑战。液体代餐产品已被证明可以 促进非怀孕多种族人群遵守卡路里和体重目标。而且，他们 已在怀孕期间用作补充剂以改善营养充足性，并被证明是安全的 并导致膳食摄入量的改善<e。然而，迄今为止还没有研究评估这种方法作为一种手段 以防止怀孕期间体重过度增加。本研究的主要目的是确定是否 包括怀孕期间部分代餐在内的多成分生活方式干预可以 减少期间体重增加超过 LOM 建议的肥胖女性数量 怀孕。在这项两中心随机试验中，430 名肥胖女性（其中 50% 是西班牙裔）将在中心内进行随机分组 和种族进入多成分生活方式改变治疗和部分代餐 计划 (N=215) 或标准护理 (N=215)。治疗将在怀孕期间进行，使用标准化的 我们之前工作的干预程序。所有女性都将在早期被招募和评估 怀孕（10 至 16 周）、妊娠 30 周、产后 6 个月和 12 个月 并在分娩时和产后 2 个月进行人体测量。我们相信这个项目是 意义重大，因为它涉及预防妊娠期体重过度增加及其相关的 对孕产妇和后代健康造成不利影响。这项研究也具有创新性；没有 评估部分膳食行为生活方式干预效果的随机对照试验 促进多种族肥胖妇女健康体重增加的替代计划。