Preventing excessive gestational weight gain in obese women

孕期低强度生活方式干预可预防孕期体重过度增加 体重正常的女性。然而，事实证明，防止肥胖女性的妊娠体重过度增加 更难了。集中干预措施，包括制定特定卡路里目标和平衡营养 显示出最大的希望，但与非怀孕人口类似，促进持续遵守 热量处方仍然是一个巨大的挑战。液体代餐产品已被证明是 在非怀孕的多民族人群中促进对卡路里和体重目标的遵守。此外，他们还 在怀孕期间被用作补充剂，以提高营养充分性，并被证明是安全的 并导致改善饮食，然而，到目前为止，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。这项研究的主要目的是确定一个 在怀孕期间包括部分膳食替代的多组分生活方式干预可以 减少超过LOM建议体重增加的肥胖女性的数量 怀孕了。在这项两个地点的随机试验中，430名肥胖妇女，50%是西班牙裔，将在地点内随机进行 和种族转变为多组分的生活方式改变治疗和部分膳食替代 方案(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 我们之前工作中的干预程序。所有妇女都将在#年初接受招募和评估。 怀孕(10至16周)，孕期30周，产后6个月和12个月 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，因为它涉及防止妊娠体重过度增加及其相关的 对母子健康造成不利影响。这项研究也是创新的；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 促进多民族肥胖妇女健康体重增加的替代计划。

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.