Pregnant Women Can Limit Weight Gain with Diet, Exercise, Mobile Apps

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Results from most extensive set of U.S. trials to target pregnancy weight gain in women who are overweight or have obesity -- published this week in Obesity journal
Released: Thursday, September 13, 2018

Baton Rouge, Louisiana -- A new group of National Institutes of Health-funded trials (LIFE-Moms) shows that pregnant women who are overweight or have obesity can safely limit the amount of weight they gain with diet and physical activity interventions. To achieve the greatest health gains, though, study results suggest that pregnant women may need to begin physical activity and diet changes before or immediately after they conceive.

LSU's Pennington Biomedical Research Center participated in the trials considered the most extensive set of U.S. trials to target pregnancy weight gain in moms who are overweight or have obesity. The LIFE-Moms trials included diverse socioeconomic groups, which means the findings can be generalized to a large population. The results will be published in the journal Obesity.

"Women affected by obesity have the most difficult time controlling their weight gain in pregnancy. Gaining too much weight is associated with many complications for not only the mother but her child as well," said Leanne Redman, PhD, professor and head of Pennington Biomedical's Reproductive Endocrinology & Women's Health Lab. "The LIFE-Moms trials hold promise for the importance of improving lifestyle habits such as eating a more healthful diet and avoiding sedentary behaviors to improved rates of weight gain in pregnancy."

The LIFE-Moms trials involved seven teams of investigators and 1,150 participants. Of those, 579 women had the lifestyle intervention while 571 had standard care. The trials ran from the second trimester to birth. Each trial offered a different lifestyle intervention, but all aimed to improve diet quality and reduce calories, increase physical activity, and incorporate behavior strategies such as self-monitoring.

Pennington Biomedical performed the only lifestyle intervention trial that used a mobile phone app to help women control pregnancy weight gain. Moms used the app, their mobile phone, a Bluetooth scale and activity monitors to interact with lifestyle coaches.

"Our study, Expecting Success, is important as researchers look to the next series of studies which will aim to reach larger numbers of women and probably remotely -- through smartphone or tablets since this avenue is considerably less costly to the health care system," Dr. Redman said.

Pennington Biomedical's app could easily be integrated into standard clinical practice, she said.

About 62 percent of the women in the intervention groups, versus 75 percent in the control groups, exceeded the National Academy of Medicine recommendations for pregnancy weight gain. The recommended weight gain is 15 to 25 pounds and 11 to 20 pounds with overweight or obese conditions are present, respectively, compared to 25 to 35 pounds for women who are of normal weight range.

The reduced weight gain -- about four pounds per woman -- did not lessen the number of obstetrical complications including cesarean sections, diabetes, hypertension, and preeclampsia, or change the average birth weight of the baby.

Dr. Redman said women may need to start changing their physical activity levels and their diets before or immediately after they conceive. "By the time these women enter their second trimester, it may be too late to lower the risk of obstetrical complications," Dr. Redman said.

In addition to Pennington Biomedical, clinical trials were conducted at Northwestern Medicine, California Polytechnic State University and Brown University, St. Luke's-Roosevelt Hospital and Columbia University, University of Puerto Rico, Washington University in St. Louis, and the Phoenix Indian Medical Center/National Institute of Diabetes and Digestive and Kidney Diseases-Phoenix.

LIFE-Moms was supported by the National Institutes of Health through The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK, U01 DK094418, U01 DK094463, U01 DK094416, 5U01 DK094466 (RCU)), The National Heart, Lung, and Blood Institute (NHLBI, U01 HL114344, U01 HL114377), and The Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD, U01 HD072834). In addition, the National Center for Complementary and Integrative Health (NCCIH), the NIH Office of Research in Women's Health (ORWH), the Office of Behavioral and Social Science Research (OBSSR), the NIH Office of Disease Prevention, the Indian Health Service and the Intramural Research Program of the NIDDK contributed support.

Additional support was received from the NIDDK Obesity Nutrition Research Centers (P30 DK026687, P30 DK072476, P30 DK56341), National Center for Advancing Translational Sciences Clinical and Translational Science Awards (U54 GM104940, U54 MD007587, UL1 RR024992), National Institute on Minority Health and Health Disparities (S21MD001830) and EXODIAB-Excellence of diabetes research in Sweden.

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The Pennington Biomedical Research Center is at the forefront of medical discovery as it relates to understanding the triggers of obesity, diabetes, cardiovascular disease, cancer and dementia. It is a campus of Louisiana State University and conducts basic, clinical and population research. The research enterprise at Pennington Biomedical includes approximately 58 faculty and more than 18 postdoctoral fellows who comprise a network of 40 laboratories supported by lab technicians, nurses, dietitians, and support personnel, and 13 highly specialized core service facilities. Pennington Biomedical's more than 450 employees perform research activities in state-of-the-art facilities on the 222-acre campus located in Baton Rouge, Louisiana.