Preventing excessive gestational weight gain in obese women

怀孕期间低强度的生活方式干预可以防止过度妊娠体重增加， 体重正常的女性然而，预防肥胖妇女妊娠期体重过度增加已被证明， 更加困难.强化干预措施，包括规定特定的热量目标和均衡营养 已经显示出最有希望的，但是，类似于非怀孕人群，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 促进未怀孕的多民族人群坚持热量和体重目标。而且他们 在怀孕期间作为补充剂使用，以改善营养充足性，并证明是安全的 并导致改善的膳食摄入量。然而，迄今为止还没有研究评估这种方法作为一种手段， 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 多成分的生活方式干预，包括怀孕期间的部分代餐， 减少肥胖妇女的人数超过1OM建议的体重增加， 怀孕在这项双中心随机试验中，430名肥胖女性（50%为西班牙裔）将在中心内随机分配 和种族的人进行多组分生活方式改变治疗和部分膳食替代 方案（N = 215）或标准治疗（N = 215）。治疗将发生在怀孕期间，使用标准化的 我们以前工作的干预程序。所有妇女都将被招募和评估， 怀孕（10至16周）、妊娠30周、产后6个月和产后12个月 在分娩时和产后2个月时进行人体测量。我们相信这个项目是 重要的是，因为它涉及预防妊娠期体重过度增加及其相关的 对母亲和后代健康的不利影响。这项研究也是创新的;没有 随机对照试验评价部分进餐的行为生活方式干预的效果 替代计划，以促进健康的体重增加，在多种族肥胖妇女。

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.