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减轻超重孕妇压力和暴饮暴食的新型干预措施:一项可行性研究。

Novel Interventions to Reduce Stress and Overeating in Overweight Pregnant Women: A Feasibility Study.

作者信息

Laraia B A, Adler N E, Coleman-Phox K, Vieten C, Mellin L, Kristeller J L, Thomas M, Stotland N E, Lustig R H, Dallman M F, Hecht F M, Bush N R, de Groat C L, Epel E

机构信息

Public Health Nutrition, School of Public Health, University of California, Berkeley, 207-B University Hall, #7360, Berkeley, CA, 94720-7360, USA.

Department of Psychiatry, UCSF School of Medicine, 3333 Calif. St, Laurel Heights, San Francisco, CA, 94118, USA.

出版信息

Matern Child Health J. 2018 May;22(5):670-678. doi: 10.1007/s10995-018-2435-z.

Abstract

Background High stress and depression during pregnancy are risk factors for worsened health trajectories for both mother and offspring. This is also true for pre-pregnancy obesity and excessive gestational weight gain. Reducing stress and depression may be one path to prevent excessive caloric intake and gestational weight gain. Study Purpose We tested the feasibility of two novel interventions aimed at reducing stress and overeating during pregnancy. Reflecting different theoretical underpinnings, the interventions target different mechanisms. Mindful Moms Training (MMT) uses mindfulness to improve awareness and acceptance of experiences and promote conscious rather than automatic behavior choices. Emotional Brain Training (EBT) uses active coping to change perceptions of negative experience and promote positive affective states. Methods Forty-six overweight/obese low-income women were assigned to either MMT (n = 24) or EBT (n = 22) for an 8-week feasibility study. Pre-post changes in perceived stress, eating and presumed mechanisms were assessed. Results Women reported high levels of stress at baseline. Both interventions were well attended and demonstrated clinically significant pre-post reductions in stress, depressive symptoms, and improved eating behaviors. MMT significantly decreased experiential avoidance, whereas EBT significantly increased positive reappraisal; these changes were marginally significantly different by group. Conclusions This feasibility study found that both interventions promoted meaningful reductions in stress and depressive symptoms and improved reported eating behaviors in a high-risk group of pregnant women. Each intervention has a potentially different pathway-acceptance for MMT and reappraisal for EBT. Larger studies are needed to test efficacy on longer term reductions in stress and overeating.

摘要

背景

孕期的高压力和抑郁是母亲和后代健康轨迹恶化的风险因素。孕前肥胖和孕期体重过度增加也是如此。减轻压力和抑郁可能是预防热量摄入过多和孕期体重增加的一条途径。研究目的:我们测试了两种旨在减少孕期压力和暴饮暴食的新型干预措施的可行性。这两种干预措施基于不同的理论基础,针对不同的机制。正念妈妈训练(MMT)运用正念来提高对体验的意识和接受度,并促进有意识而非自动的行为选择。情绪脑训练(EBT)运用积极应对方式来改变对负面体验的认知,并促进积极的情感状态。方法:46名超重/肥胖的低收入女性被分配到MMT组(n = 24)或EBT组(n = 22),进行为期8周的可行性研究。评估了感知压力、饮食及假定机制的前后变化。结果:女性在基线时报告有高水平的压力。两种干预措施的参与度都很高,并且在前后对比中显示出压力、抑郁症状有临床上显著的降低,饮食行为也有所改善。MMT显著降低了体验性回避,而EBT显著增加了积极重新评价;两组之间的这些变化在边缘上有显著差异。结论:这项可行性研究发现,两种干预措施都能使高危孕妇群体的压力和抑郁症状显著减轻,并改善报告的饮食行为。每种干预措施都有潜在的不同途径——MMT是接受,EBT是重新评价。需要更大规模的研究来测试其对长期减轻压力和暴饮暴食的疗效。

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