Prevention of Postpartum Weight Retention

描述（由申请人提供）：肥胖已经达到流行病的程度，在美国是一个严重的公共卫生问题。治疗肥胖的努力只取得了适度的成功，人们的注意力已经转向预防体重增加，而不是治疗肥胖。虽然从怀孕前到产后一年平均体重增加2公斤，但大约25%的女性在此期间体重增加5公斤或更多。此外，最近的一项研究发现，在产后12个月保持大量体重（M= 4.8公斤）的正常体重妇女中，近44%的人在以后的生活中变得超重。因此，怀孕期间似乎是预防工作的重要时期。从怀孕前到怀孕后体重增加的最强预测因子是怀孕期间体重增加的幅度。医学研究所（IOM）制定了怀孕期间健康增重的具体建议。然而，超过三分之一的正常体重妇女和三分之二的超重妇女在怀孕期间的体重增加超过了建议的水平。因此，通过健康的饮食和体育活动帮助妇女在怀孕期间获得建议的体重，将对防止体重过重做出重大贡献。本研究的主要目的是确定怀孕期间的行为生活方式干预是否可以减少正常体重和超重妇女在怀孕期间体重增加超过IOM建议的数量。我们建议招募400名初产妇女，并随机分配这些妇女接受常规护理或干预，以促进怀孕期间健康的体重增加。干预组每周将收到教育材料，体重监测和反馈，以及支持性电话。所有女性从怀孕早期到产后1年都将被跟踪。我们认为这个项目意义重大，因为它涉及预防体重增加，这是一个主要的健康问题。这项研究也具有创新性；目前还没有足够有力的随机对照试验来评估怀孕期间行为生活方式干预对促进健康体重增加和防止产后持续体重潴留的影响。

DESCRIPTION (provided by applicant): Obesity has reached epidemic proportions and represents a serious public health problem in the United States. Efforts to treat obesity have been only moderately successful, and attention has shifted toward prevention of weight gain, rather than treatment of obesity. Although average weight gain from pre- pregnancy to one-year postpartum is 2 kg, approximately 25 percent of women gain 5 kg or more during this period. Moreover, a recent study found that nearly 44 percent of normal weight women who had retained significant amounts of weight (M= 4.8 kg) at 12 months postpartum became overweight later in life. Thus, the period surrounding pregnancy appears to be an important time for prevention efforts. The single strongest predictor of weight gain from pre-to post-pregnancy is the magnitude of weight gained during pregnancy. The Institute of Medicine (IOM) has formulated specific recommendations for healthy weight gain during pregnancy. However, more than one-third of normal weight women and two thirds of overweight women exceed recommended levels of weight gain during pregnancy. Thus, helping women gain the recommended amount during pregnancy through healthy eating and physical activity would make a major contribution to preventing excessive weight retention. The principal aim of this study is to determine whether behavioral lifestyle intervention during pregnancy can reduce the number of normal weight and overweight women who exceed the IOM recommendations for weight gain during pregnancy. We propose to recruit 400 primiparous women and randomly assign these women to receive usual care or Intervention to Promote Healthy Weight Gain During Pregnancy. The Intervention group will receive weekly educational materials, weight monitoring with feedback, and supportive phone calls. All women will be followed from early pregnancy to 1-year postpartum. We believe this project is significant because it deals with the prevention of weight gain, which is a major health problem. The study is also innovative; there have been no adequately powered randomized controlled trials evaluating the effects of a behavioral lifestyle intervention delivered during pregnancy to promote healthy weight gain and prevent sustained postpartum weight retention.