scholarly journals A Promising Food-Coaching Intervention Program to Achieve Optimal Gestational Weight Gain in Overweight and Obese Pregnant Women: Pilot Randomized Controlled Trial of a Smartphone App (Preprint)

2018 ◽  
Author(s):  
Ling-Jun Li ◽  
Izzuddin M Aris ◽  
Wee Meng Han ◽  
Kok Hian Tan
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Real Time ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Smartphone App ◽  
Control Group ◽  
Gestational Weight ◽  
Randomized Controlled

BACKGROUND Traditional dietary recommendations for achieving optimal gestational weight gain are ineffective for pregnant women due to the lack of real-time communication and tedious consultation processes. OBJECTIVE In this pilot study, we aimed to determine the feasibility of a novel food-coaching smartphone app for controlling gestational weight gain and macronutrient intake among overweight and obese pregnant women. METHODS We designed a randomized controlled trial and recruited 30 overweight and obese pregnant women (1:1 ratio) during 18-20 weeks of gestation and followed them up after 4 and 8 weeks, respectively. Both groups received standard pregnancy dietary orientation at recruitment, while the intervention group received 8 weeks of real-time food coaching via a smartphone app. This food-coaching smartphone app (Glycoleap, Holmusk, Singapore) aimed to improve care and outcomes for people with diabetes. Pregnant women using this app were able to upload food images (eg, a picture of a meal, a drink, or a dessert) and received real-time and detailed food-coaching comments and guidance provided by professional dietitians during the day (8 AM to 8 PM). We recorded detailed characteristics during recruitment and examined anthropometry at all visits. We compared the mean differences of the 8-week gestational weight gain and macronutrient intake between the two groups. RESULTS Upon study completion, three subjects dropped out from the intervention, and one gave birth prematurely in the control group. The acceptance rate of the smartphone app was 90%. More participants achieved optimal gestational weight gain per week in the intervention group (8/12, 67%) than in the control group (5/14, 36%). After the 8-week intervention, women in the intervention group appeared to have lower gestational weight gain (mean difference=–0.08 kg; 95% CI –1.80 to 1.63) and cholesterol intake (mean difference=–31.73 mg; 95% CI –102.91 to 39.45) than those in the control group. CONCLUSIONS Our findings showed that this food-coaching smartphone app is feasible and favorable for weight gain control and cholesterol intake control among overweight and obese pregnant women. Although our results were not significant (perhaps, attributed to the small sample size), it provided proof of concept for the feasibility of applying such technology in future randomized controlled trials with a larger sample size, an earlier intervention onset, and a longer follow-up for overweight and obese pregnant women.

scholarly journals A Promising Food-Coaching Intervention Program to Achieve Optimal Gestational Weight Gain in Overweight and Obese Pregnant Women: Pilot Randomized Controlled Trial of a Smartphone App

10.2196/13013 ◽  
2019 ◽  
Vol 3 (4) ◽  
pp. e13013 ◽  
Author(s):  
Ling-Jun Li ◽  
Izzuddin M Aris ◽  
Wee Meng Han ◽  
Kok Hian Tan
Keyword(s):  
Weight Gain ◽  
Pregnant Women ◽  
Real Time ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Smartphone App ◽  
Control Group ◽  
Gestational Weight ◽  
Randomized Controlled

Background Traditional dietary recommendations for achieving optimal gestational weight gain are ineffective for pregnant women due to the lack of real-time communication and tedious consultation processes. Objective In this pilot study, we aimed to determine the feasibility of a novel food-coaching smartphone app for controlling gestational weight gain and macronutrient intake among overweight and obese pregnant women. Methods We designed a randomized controlled trial and recruited 30 overweight and obese pregnant women (1:1 ratio) during 18-20 weeks of gestation and followed them up after 4 and 8 weeks, respectively. Both groups received standard pregnancy dietary orientation at recruitment, while the intervention group received 8 weeks of real-time food coaching via a smartphone app. This food-coaching smartphone app (Glycoleap, Holmusk, Singapore) aimed to improve care and outcomes for people with diabetes. Pregnant women using this app were able to upload food images (eg, a picture of a meal, a drink, or a dessert) and received real-time and detailed food-coaching comments and guidance provided by professional dietitians during the day (8 AM to 8 PM). We recorded detailed characteristics during recruitment and examined anthropometry at all visits. We compared the mean differences of the 8-week gestational weight gain and macronutrient intake between the two groups. Results Upon study completion, three subjects dropped out from the intervention, and one gave birth prematurely in the control group. The acceptance rate of the smartphone app was 90%. More participants achieved optimal gestational weight gain per week in the intervention group (8/12, 67%) than in the control group (5/14, 36%). After the 8-week intervention, women in the intervention group appeared to have lower gestational weight gain (mean difference=–0.08 kg; 95% CI –1.80 to 1.63) and cholesterol intake (mean difference=–31.73 mg; 95% CI –102.91 to 39.45) than those in the control group. Conclusions Our findings showed that this food-coaching smartphone app is feasible and favorable for weight gain control and cholesterol intake control among overweight and obese pregnant women. Although our results were not significant (perhaps, attributed to the small sample size), it provided proof of concept for the feasibility of applying such technology in future randomized controlled trials with a larger sample size, an earlier intervention onset, and a longer follow-up for overweight and obese pregnant women.

scholarly journals A Smartphone App to Promote Healthy Weight Gain, Diet, and Physical Activity During Pregnancy (HealthyMoms): Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Pontus Henriksson ◽  
Johanna Sandborg ◽  
Marie Blomberg ◽  
Christina Alexandrou ◽  
Ralph Maddison ◽  
...  
Keyword(s):  
Physical Activity ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Intervention Group ◽  
Smartphone App ◽  
Healthy Weight ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Diet And Physical Activity

BACKGROUND Excessive gestational weight gain is common and associated with adverse outcomes both in the short and long term. Although traditional lifestyle-based interventions have shown to mitigate excess gestational weight gain, little is known about whether mobile Health (mHealth) apps can promote healthy weight gain, diet, and physical activity during pregnancy. OBJECTIVE The primary aim of the HealthyMoms trial is to determine the effectiveness of a smartphone app (HealthyMoms) for mitigating excess gestational weight gain during pregnancy. Secondary aims are to determine the effectiveness of the app on dietary habits, physical activity, body fatness, and glycemia during pregnancy. METHODS HealthyMoms is a two-arm randomized controlled trial. Women are being recruited at routine visits at the maternity clinics in Linköping, Norrköping and Motala, Sweden. Women are randomized to the control or intervention group (n=150 per group). All women will receive standard care, and women in the intervention group will also receive the HealthyMoms smartphone app. RESULTS Recruitment of participants to the trial was initiated in October 2017, and 190 women have so far completed the baseline measurement. The baseline measures are estimated to be finalized in December 2019, and the follow-up measures are estimated to be completed in June 2020. CONCLUSIONS This project will evaluate a novel smartphone app intervention integrated with existing maternity health care. If successful, it has great potential to be implemented nationally in order to promote healthy weight gain and health behaviors during pregnancy. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/13011

scholarly journals Optimizing Gestational Weight Gain With the Eating4Two Smartphone App: Protocol for a Randomized Controlled Trial (Preprint)

2018 ◽  
Author(s):  
Deborah Davis ◽  
Rachel Davey ◽  
Lauren T. Williams ◽  
Maralyn Foureur ◽  
Ellen Nohr ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Maternity Care ◽  
Controlled Trial ◽  
Smartphone App ◽  
Care Providers ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
In Pregnancy

BACKGROUND Approximately 50% of women gain excessive weight in pregnancy. Optimizing gestational weight gain is important for the short- and long-term health of the childbearing woman and her baby. Despite this, there is no recommendation for routine weighing in pregnancy, and weight is a topic that many maternity care providers avoid. Resource-intensive interventions have mainly targeted overweight and obese women with variable results. Few studies have examined the way that socioeconomic status might influence the effectiveness or acceptability of an intervention to participants. Given the scale of the problem of maternal weight gain, maternity services will be unlikely to sustain resource intensive interventions; therefore, innovative strategies are required to assist women to manage weight gain in pregnancy. OBJECTIVE The primary aim of the trial was to examine the effectiveness of the Eating4Two smartphone app in assisting women of all body mass index categories to optimize gestational weight gain. Secondary aims include comparing childbirth outcomes and satisfaction with antenatal care and examining the way that relative advantage and disadvantage might influence engagement with and acceptability of the intervention. METHODS This randomized controlled trial will randomize 1330 women to control or intervention groups in 3 regions of different socioeconomic status. Women will be recruited from clinical and social media sites. The intervention group will be provided with access to the Eating4Two mobile phone app which provides nutrition and dietary information specifically tailored for pregnancy, advice on food serving sizes, and a graph that illustrates women’s weight change in relation to the range recommended by the Institute of Medicine. Women will be encouraged to use the app to prompt conversations with their maternity care providers about weight gain in pregnancy. The control group will receive routine antenatal care. RESULTS Recruitment has commenced though the recruitment rate is slower than expected. Additional funds are required to employ research assistants and promote the study in an advertising campaign. CONCLUSION Feasibility testing highlighted the inadequacy of the original recruitment strategy and the need to provide the app in both major platforms (Android and iOS). Smartphone technologies may offer an effective alternative to resource intensive strategies for assisting women to optimize weight gain in pregnancy. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12617000169347; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371470 (Archived by WebCite at http://www.webcitation.org /6zDvgw5bo) REGISTERED REPORT IDENTIFIER RR1-10.2196/9920

The Effect of an Exercise Intervention on Gestational Weight Gain: The Behaviors Affecting Baby and You (B.A.B.Y.) Study: A Randomized Controlled Trial

2017 ◽  
Vol 32 (3) ◽  
pp. 736-744 ◽  
Author(s):  
Carrie Nobles ◽  
Bess H. Marcus ◽  
Edward J. Stanek ◽  
Barry Braun ◽  
Brian W. Whitcomb ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Gestational Weight Gain ◽  
Exercise Intervention ◽  
Controlled Trial ◽  
Intervention Group ◽  
Ethnically Diverse ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Meta Analyses

Purpose: To examine the effect of a prenatal exercise intervention on gestational weight gain (GWG) and to update meta-analyses. Design: Randomized controlled trial and meta-analysis. Setting: Obstetrical practices in a Western Massachusetts hospital. Patients: We analyzed 241 ethnically diverse pregnant participants at high risk for gestational diabetes in the Behaviors Affecting Baby and You (B.A.B.Y.) study. A total of 118 participants were randomized to an exercise intervention group and 123 to a comparison health and wellness intervention group. Intervention: A 12-week individually tailored, motivationally matched program designed to increase the compliance with guidelines for exercise during pregnancy (30 min/day). Measures: The GWG and compliance with 2009 Institute of Medicine (IOM) guidelines for GWG abstracted from medical records. Analysis: Unadjusted logistic regression, intent-to-treat. Results were added to the existing meta-analyses using a random effects model. Results: Women randomized to the exercise group had a lower mean GWG than the comparison group (−0.97 kg, P value = .39) and were less likely to exceed IOM guidelines (odds ratio = 0.69, 95% confidence interval [CI] 0.34-1.40), but results were not statistically significant. Meta-analyses yielded a −0.63 kg (95% CI −1.17 to −0.08, P = .02) reduction in GWG and a 20% reduction in odds of exceeding IOM guidelines (95% CI 0.73 to 0.89) for the exercise intervention. Conclusion: Findings from this randomized trial among ethnically diverse women contribute to the results of meta-analyses supporting exercise as a means of attenuating GWG.

scholarly journals A Randomized Controlled Trial to Evaluate the Effects of a Smartphone App-based Lifestyle Coaching Program on Gestational Weight Gain, Glycemic Control, Maternal and Neonatal Outcomes in Women with Gestational Diabetes: The SMART-GDM Study

2020 ◽  
Author(s):  
Tong Wei Yew ◽  
Claudia Chi ◽  
Shiao-Yng Chan ◽  
Rob M. van Dam ◽  
Clare Whitton ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Weight Gain ◽  
Glycemic Control ◽  
Gestational Weight Gain ◽  
Controlled Trial ◽  
Neonatal Outcomes ◽  
Smartphone App ◽  
Gestational Weight ◽  
Randomized Controlled ◽  
Maternal And Neonatal Outcomes

OBJECTIVE <p>SMART-GDM examined whether Habits-GDM, a smartphone app coaching program, can prevent excessive gestational weight gain (EGWG) and improve glycemic control, maternal and neonatal outcomes in gestational diabetes mellitus (GDM).</p> <p> </p> <p>RESEARCH DESIGN AND METHODS </p> <p>In this randomized controlled trial, women diagnosed with GDM between 12-30 weeks were randomly assigned usual care (Control) or additional support from Habits-GDM that integrated dietary, physical activity, weight and glucose monitoring (Intervention). The primary outcome was the proportion of participants with EGWG. Secondary outcomes included absolute gestational weight gain (GWG), glycemic control, and maternal, delivery and neonatal outcomes. </p> <p> </p> <p>RESULTS</p> <p>In total, 340 women were randomized (170 Intervention, 170 Control; mean age 32.0 years [SD 4.2]; mean BMI 25.6kg/m<sup>2</sup> [SD 5.6]). There were no statistically significant differences in the proportions of women with EGWG, absolute GWG, or maternal and delivery outcomes between experimental groups. Average glucose readings were lower in Intervention (mean difference -0.15mmol/L [95% CI -0.26; -0.03]; <i>P</i>=0.011), so were the proportions of glucose above targets (pre-meal 17.9% vs. 23.3%, OR=0.68 [95% CI 0.53; 0.87]; <i>P</i>=0.003; 2-hours post-meal 19.9% vs. 50%, OR=0.54 [95% CI 0.42; 0.70]; <i>P</i><0.001). When regarded as a composite (although not prespecified), the overall neonatal complications (including birth trauma, neonatal hypoglycemia, hyperbilirubinemia, respiratory distress, neonatal intensive care unit admission, perinatal death) were significantly lower in Intervention (38.1% vs. 53.7%, OR=0.53 [95% CI 0.34; 0.84]; <i>P</i>=0.006).</p> <p> </p> <p>CONCLUSIONS</p> <p>When added to usual care, Habits-GDM resulted in better maternal glycemic control and composite neonatal outcomes (non-prespecified), but did not reduce EGWG among women with GDM. </p>

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