Department of Nutrition-Public Health Medicine, LFoRCe, Catholic University Leuven, Leuven, Belgium.
Am J Clin Nutr. 2010 Feb;91(2):373-80. doi: 10.3945/ajcn.2009.28166. Epub 2009 Dec 2.
Maternal obesity and excessive gestational weight gain (GWG) are major short- and long-term risk factors for maternal and fetal complications.
The objective was to study whether a lifestyle intervention based on a brochure or on active education can improve dietary habits, increase physical activity (PA), and reduce GWG in obese pregnant women.
In this randomized controlled trial, 195 white, obese pregnant women [age: 29 + or - 4 y; body mass index (in kg/m(2)); 33.6 + or - 4.2] were randomly assigned into 3 groups: a group that received nutritional advice from a brochure, a group that received the brochure and lifestyle education by a nutritionist, and a control group. Nutritional habits were evaluated every trimester through 7-d food records. PA was evaluated with the Baecke questionnaire.
Energy intake did not change during pregnancy and was comparable in all groups. Fat intake, specifically saturated fat intake, decreased and protein intake increased from the first to the third trimester in the passive and active groups compared with an opposite change in the control group. Calcium intake and vegetable consumption increased during pregnancy in all groups. PA decreased in all groups, especially in the third trimester. No significant differences in GWG and obstetrical or neonatal outcome could be observed between the groups.
Both lifestyle interventions improved the nutritional habits of obese women during pregnancy. Neither PA nor GWG was affected.
母体肥胖和妊娠期间体重过度增加是母婴并发症的短期和长期主要危险因素。
本研究旨在探讨基于宣传册的生活方式干预或基于主动教育是否可以改善饮食习惯、增加身体活动(PA)并减少肥胖孕妇的妊娠体重增加。
在这项随机对照试验中,195 名白人肥胖孕妇(年龄:29+/-4 岁;体重指数(kg/m2);33.6+/-4.2)被随机分为 3 组:一组接受宣传册的营养建议,一组接受营养师的宣传册和生活方式教育,一组为对照组。通过 7 天的食物记录,每三个月评估一次营养习惯。通过 Baecke 问卷评估 PA。
妊娠期间能量摄入没有变化,且各组间无差异。与对照组相反,在被动组和主动组中,脂肪摄入量(特别是饱和脂肪摄入量)从第一孕期到第三孕期减少,蛋白质摄入量增加。钙摄入量和蔬菜摄入量在所有组中均在妊娠期间增加。所有组的 PA 均下降,尤其是在第三孕期。各组之间的妊娠体重增加和产科或新生儿结局均无显著差异。
两种生活方式干预均改善了肥胖孕妇的妊娠期间营养习惯。PA 和妊娠体重增加均不受影响。