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Randomized Controlled Trial
. 2014 Feb 7;9(2):e88250.
doi: 10.1371/journal.pone.0088250. eCollection 2014.

Diet and exercise interventions among overweight and obese lactating women: randomized trial of effects on cardiovascular risk factors

Hilde K Brekke  1 , Fredrik Bertz  1 , Kathleen M Rasmussen  2 , Ingvar Bosaeus  3 , Lars Ellegård  1 , Anna Winkvist  1
Affiliations
Randomized Controlled Trial

Diet and exercise interventions among overweight and obese lactating women: randomized trial of effects on cardiovascular risk factors

Hilde K Brekke et al. PLoS One. .

Abstract

Objective: To examine the effects of Diet (D) and Exercise (E) interventions on cardiovascular fitness, waist circumference, blood lipids, glucose metabolism, inflammation markers, insulin-like growth factor 1 (IGF-1) and blood pressure in overweight and obese lactating women.

Methods: At 10-14 wk postpartum, 68 Swedish women with a self-reported pre-pregnancy BMI of 25-35 kg/m(2) were randomized to a 12-wk behavior modification treatment with D, E, both or control using a 2×2 factorial design. The goal of D treatment was to reduce body weight by 0.5 kg/wk, accomplished by decreasing energy intake by 500 kcal/d and monitoring weight loss through self-weighing. The goal of E treatment was to perform 4 45-min walks per wk at 60-70% of max heart-rate using a heart-rate monitor. Effects were measured 12 wk and 1 y after randomization. General Linear Modeling was used to study main and interaction effects adjusted for baseline values of dependent variable.

Results: There was a significant main effect of the D treatment, decreasing waist circumference (P = 0.001), total cholesterol (P = 0.007), LDL-cholesterol (P = 0.003) and fasting insulin (P = 0.042), at the end of the 12-wk treatment. The decreased waist circumference (P<0.001) and insulin (P = 0.024) was sustained and HDL-cholesterol increased (P = 0.005) at the 1-y follow-up. No effects from the E treatment or any interaction effects were observed.

Conclusions: Dietary behavior modification that produced sustained weight loss among overweight and obese lactating women also improved risk factors for cardiovascular disease and type 2 diabetes. This intervention may not only reduce weight-related risks with future pregnancies but also long-term risk for metabolic disease.

Trial registration: ClinicalTrials.gov NCT01343238.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Subject-flow diagram of the LEVA trial.
C denotes control, D dietary behavior modification, E exercise behavior modification, and DE combined dietary plus exercise behavior modification.
Figure 2
Figure 2. Effect of interventions on change in LDL-cholesterol (panel A) and HDL-cholesterol (panel B).
No statistical comparisons were made between groups as shown in the figures. C denotes control, D dietary behavior modification, E exercise behavior modification, and DE combined dietary plus exercise behavior modification.
See this image and copyright information in PMC

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