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Randomized Controlled Trial
. 2018 Nov 7;13(11):e0206888.
doi: 10.1371/journal.pone.0206888. eCollection 2018.

Effects of a preconception lifestyle intervention in obese infertile women on diet and physical activity; A secondary analysis of a randomized controlled trial

Affiliations
Randomized Controlled Trial

Effects of a preconception lifestyle intervention in obese infertile women on diet and physical activity; A secondary analysis of a randomized controlled trial

Tessa M van Elten et al. PLoS One. .

Abstract

Background: Lifestyle changes are notoriously difficult. Since women who intend to become pregnant are more susceptible to lifestyle advice, interventions during this time window might be more effective than interventions during any other period in life. We here report the effects of the first large preconception lifestyle intervention RCT on diet and physical activity in obese infertile women.

Methods: In total, 577 women were randomized between a six-month lifestyle intervention program (intervention group; N = 290) or prompt infertility treatment (control group; N = 287). Self-reported dietary behaviors and physical activity were assessed at baseline, three, six and twelve months after randomization. Mixed models were used to analyze differences between groups.

Results: Compared to the control group, the intervention group reduced their intake of sugary drinks at three months (-0.5 glasses/day [95% C.I. = -0.9;-0.2]), of savory snacks at three (-2.4 handful/week [-3.4;-1.4]) and at six months (-1.4 handful/week [-2.6;-0.2]), and of sweet snacks at three (-2.2 portion/week [-3.3;-1.0]) and twelve months after randomization (-1.9 portion/week [-3.5;-0.4]). Also, the intervention group was more moderate to vigorous physically active at three months after randomization compared to the control group (169.0 minutes/week [6.0; 332.1]).

Conclusion: Our study showed that obese infertile women who followed a six-month preconception lifestyle intervention program decreased their intake of high caloric snacks and beverages, and increased their physical activity. These changes in lifestyle may not only improve women's health but their offspring's health too.

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Conflict of interest statement

The authors have read the journal's policy and the authors of this manuscript have the following competing interests: The department of Obstetrics and Gynaecology of the UMCG received an unrestricted educational grant from Ferring pharmaceuticals BV, The Netherlands, outside the submitted work (Prof. Dr. A. Hoek). Prof. Dr. B.W. Mol is supported by a NHMRC Practitioner Fellowship (GNT1082548) and reports consultancy for ObsEva, Merck Merck KGaA and Guerbet. This does not alter our adherence to PLOS ONE policies on sharing data and materials. All other authors declare that they have no competing interests.

Figures

Fig 1
Fig 1. Flow diagram LIFEstyle study for diet and physical activity data.
FFQ = Food Frequency Questionnaire; SQUASH = Short QUestionnaire to ASsess Health-enhancing physical activity; mo. = months.
Fig 2
Fig 2. Estimated marginal means for diet and physical activity corrected for baseline, education level, pregnancy and smoking.
Marginal means were estimated by mixed model analysis and time was added as a categorical variable into the model. Time points are at baseline, three months, six months and twelve months after randomization in both groups; MVPA = moderate to vigorous physical activity; min/week = minutes per week; * P<0.05, ** P<0.001.

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