Effect of the e-health supported INTER-ACT lifestyle intervention on postpartum weight retention and body composition, and associations with lifestyle behavior: A randomized controlled trial

Abstract

We investigated whether a postpartum lifestyle intervention reduced postpartum weight retention (PPWR) and improved body composition, and whether improved lifestyle was associated with less PPWR and improved body composition. A total of 1075 women with excessive gestational weight gain were randomized into the inter-vention (N = 551) or control (N = 524) group. A completion rate of 76% was reached. Anthropometrics and lifestyle data were collected at 6 weeks and 6 months postpartum. The e-health supported intervention consisted of 4 face-to-face coaching's, focusing on nutrition, exercise and mental wellbeing and using motivational interviewing and behavior change techniques. In the intervention group we observed; larger decrease in weight in women who reduced their energy intake (mean +/- SD: 3.1 +/- 4.2 kg vs. 2.2 +/- 3.8 kg, P = 0.05) and decreased uncontrolled eating (3.5 +/- 4.2 kg vs. 1.9 +/- 3.7 kg, P <= 0.001) by the end of the intervention; larger decrease in fat percentage in women who reduced energy intake (2.3% +/- 2.9 vs. 1.4% +/- 2.7, P = 0.01), enhanced restrained eating (2.2% +/- 3 vs. 1.4% +/- 2.6, P = 0.02) and decreased uncontrolled eating (2.3% +/- 2.9 vs. 1.5% +/- 2.7, P = 0.01) and larger decrease in waist circumference in women who reduced energy intake (4.6 cm +/- 4.8 vs. 3.3 cm +/- 4.7, P = 0.01), enhanced restrained eating (4.5 cm +/- 4.8 vs. 3.4 cm +/- 4.8, P = 0.05) and decreased uncon-trolled eating (4.7 cm +/- 4.8 vs. 3.3 cm +/- 4.8, P = 0.006), compared to those who did not. Improved energy intake, restrained eating and uncontrolled eating behavior were associated with more favorable outcomes in weight and body composition. ClinicalTrials.gov identifier:NCT02989142.