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产后减肥干预的两年随访:一项随机对照试验的结果。

Two-year follow-up of a postpartum weight loss intervention: Results from a randomized controlled trial.

机构信息

Department of Internal Medicine and Clinical Nutrition, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

出版信息

Matern Child Nutr. 2018 Apr;14(2):e12539. doi: 10.1111/mcn.12539. Epub 2017 Oct 6.

Abstract

We recently reported that a 12-week diet intervention among postpartum women produced a weight loss of 12% after 1 year, compared to 5% in controls. Here, we present 2-year results after 1 year of unsupervised follow-up. In total, 110 women with a self-reported body mass index of ≥27 kg/m at 6-15-week postpartum were randomized to diet group (D-group) or control group (C-group). D-group received a 12-week diet intervention by a dietitian followed by monthly e-mails up to the 1-year follow-up. C-group received a brochure on healthy eating. No contact was provided from 1 to 2 years to either group. Eighty-nine women (81%) completed the 2-year follow-up. Median (1st; 3rd quartile) weight change from 0 to 2 years was -6.9 (-11.0; -2.2) kg in D-group and -4.3 (-8.7; -0.2) kg in C-group. There was no group by time interaction at 2 years (p = .082); however, when women with a new pregnancy between 1 and 2 years were excluded, the interaction became significant (-8.2 vs. -4.6 kg, p = .038). From 1 to 2 years, women in D- and C-group gained 2.5 ± 5.0 kg and 1.1 ± 4.4 kg, respectively (p = .186). Women who gained weight from 1 to 2 years reported a decrease in self-weighing frequency compared to women who maintained or lost weight (p = .008). Both groups achieved clinically relevant 2-year weight loss, but the significant between-group-difference observed at 1 year was not maintained at 2 years in the main analysis. However, when women with a new pregnancy between 1 and 2 years were excluded, a significant weight loss effect was observed also at 2 years.

摘要

我们最近报道,在产后女性中进行 12 周的饮食干预,1 年后体重减轻 12%,而对照组为 5%。在这里,我们报告了 1 年未监督随访后的 2 年结果。共有 110 名产后 6-15 周自我报告体重指数≥27kg/m2的女性被随机分配到饮食组(D 组)或对照组(C 组)。D 组接受营养师的 12 周饮食干预,然后在 1 年随访期间每月通过电子邮件进行跟进。C 组收到了一本关于健康饮食的小册子。在 1 至 2 年内,两组均未进行任何联系。89 名女性(81%)完成了 2 年随访。从 0 到 2 年的体重中位数(第 1 个;第 3 个四分位数)变化为 D 组-6.9kg(-11.0;-2.2)kg,C 组-4.3kg(-8.7;-0.2)kg。2 年时组间无时间交互作用(p=0.082);然而,当排除 1 至 2 年内再次怀孕的女性时,交互作用变得显著(-8.2 与-4.6kg,p=0.038)。从 1 年到 2 年,D 组和 C 组的女性体重分别增加了 2.5±5.0kg 和 1.1±4.4kg(p=0.186)。与保持或减轻体重的女性相比,体重增加的女性自我称重的频率下降(p=0.008)。两组均实现了临床相关的 2 年体重减轻,但在主要分析中,1 年时观察到的显著组间差异在 2 年时并未维持。然而,当排除 1 至 2 年内再次怀孕的女性时,也观察到 2 年时体重减轻的显著效果。

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