Lifestyle Intervention on Diet and Weight Gain in Pregnant Women Under a Randomized Controlled Trial Editorial comment

Excessive gestational weight gain ( EGWG) during pregnancy increases the risk of fetal macrosomia, maternal overweight status, and postpartum weight retention. Its prevention potentially improves maternal and neonatal outcomes. Important contributing factors to EGWG include excessive caloric intake and inadequate levels of physical activity. A number of studies have examined the effects of lifestyle intervention ( dietary intervention with or without increased physical activity) on the prevalence of EGWG, but the results have been mixed. This prospective, randomized, controlled trial tested the hypothesis that use of a community- based exercise and dietary intervention program during pregnancy can improve dietary habits, increase physical activity, and reduce EGWG in an urban population of pregnant women. The intervention group included nondiabetic pregnant volunteers who underwent a program, including community- based group exercise sessions, instructed home exercise, diet, and counseling between 20 and 36 weeks of gestation. The control group included pregnant women receiving standard prenatal care, with no exercise instruction or dietary intervention. Physical activity and food intake in both groups were assessed by surveys at enrollment and 2 months after the enrollment. The primary study outcome measure was the prevalence of EGWG in the 2 groups. The participants who completed the study included 88 women in the control group and 102 in the intervention group. The daily intake of calories, fat, saturated fat, and cholesterol was significantly lower at 2 months after enrollment among women in the intervention group than in the control group ( P < 0.01). Two months after the enrollment, the levels of physical activity were significantly higher in the intervention group compared with the control group ( P < 0.01). Participants in the lifestyle intervention group also had significantly lower prevalence of EGWG compared with those in the control group using the 2009 Institute of Medicine ( IOM) guidelines ( P < 0.01). These findings demonstrate that a community- based program of lifestyle intervention during pregnancy, including increased physical activity and improved dietary habits, can reduce the prevalence of EGWG in pregnant women.