scholarly journals The Role of Health Literacy in Postpartum Weight, Diet, and Physical Activity

2020 ◽  
Vol 9 (8) ◽  
pp. 2463
Author(s):  
Rhonda Garad ◽  
Crystal McPhee ◽  
Tze Lin Chai ◽  
Lisa Moran ◽  
Sharleen O’Reilly ◽  
...  

Background: Postpartum weight retention is a significant contributor to obesity in women, adverse perinatal events in subsequent pregnancies, and chronic disease risk. Health literacy is known to impact health behaviors. The study aimed to identify the health literacy domains utilized in postpartum weight management interventions and to determine their impact on weight, diet and physical activity in postpartum women. Methods: We searched MEDLINE, CINAHL, EMBASE, PSYCINFO, and EBM databases. We included random control trials of lifestyle intervention in postpartum women (within two years post-delivery) published up to 3 May 2019. Subgroup analyses were performed to determine the effect of health literacy domains on outcomes. Results: Out of 5000 studies, 33 studies (n = 3905) were included in the systematic review and meta-analysis. The health literacy domain self-care (skills and knowledge) was associated with a significant reduction in body weight (mean difference (MD) −2.46 kg; 95% confidence interval (CI) from −3.65 to −1.27) and increase in physical activity (standardized mean difference (SMD) 0.61; 95% CI 0.20 to 1.02). No other health literacy domain was associated with significant outcomes in weight, energy intake, or physical activity. Conclusions: Health literacy skills such as knowledge of self-care are effective in improving weight and in increasing physical activity in postpartum women. The efficacy of other health domains was not supported.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kailin Teh ◽  
Imm Pin Quek ◽  
Wern Ee Tang

Abstract Background A woman with a history of GDM has at least seven-fold increased lifetime risk of developing type 2 diabetes mellitus (T2DM), compared to women who have normoglycemic pregnancies. Postpartum lifestyle modification has been shown to reduce postpartum weight retention and prevent the progression to T2DM. The aim of this study was to explore the postpartum dietary and physical activity-related beliefs and behaviors among women in Singapore who had GDM in their most recent pregnancies. Methods Semi-structured in-depth interviews were conducted with 14 women, who were up to four months postpartum and had GDM in their most recent pregnancies. Interview data were analyzed using thematic analysis. Results Three themes were identified in the analysis: (1) risk perception and knowledge regarding future diabetes, (2) suboptimal diet and physical activity after delivery and (3) factors influencing the postpartum lifestyle. Conclusions The study findings provided useful information on the postpartum lifestyle beliefs and behaviors among women with a history of GDM. Most participants had low risk perception of future diabetes and their diet and physical activity after delivery were suboptimal due to various influences. These insights can be used to design tailored materials and programs to support women who have had GDM reduce their risk of developing future T2DM.


BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044200
Author(s):  
Fiona Jane Kinnear ◽  
Fiona E Lithander ◽  
Aidan Searle ◽  
Graham Bayly ◽  
Christina Wei ◽  
...  

ObjectiveFamilial hypercholesterolaemia (FH) elevates low-density lipoprotein cholesterol (LDL-C) and increases cardiovascular disease (CVD) risk. This study aimed to provide evidence for the feasibility of conducting a randomised controlled trial to evaluate the efficacy of an intervention designed to improve diet and physical activity in families with FH.DesignA parallel, randomised, waitlist-controlled, feasibility pilot trial.SettingThree outpatient lipid clinics in the UK.ParticipantsFamilies that comprised children (aged 10–18 years) and their parent with genetically diagnosed FH.InterventionFamilies were randomised to either 12-week usual care or intervention. The behavioural change intervention aimed to improve dietary, physical activity and sedentary behaviours. It was delivered to families by dietitians initially via a single face-to-face session and then by four telephone or email follow-up sessions.Outcome measuresFeasibility was assessed via measures related to recruitment, retention and intervention fidelity. Postintervention qualitative interviews were conducted to explore intervention acceptability. Behavioural (dietary intake, physical activity and sedentary time) and clinical (blood pressure, body composition and blood lipids) outcomes were collected at baseline and endpoint assessments to evaluate the intervention’s potential benefit.ResultsTwenty-one families (38% of those approached) were recruited which comprised 22 children and 17 adults with FH, and 97% of families completed the study. The intervention was implemented with high fidelity and the qualitative data revealed it was well accepted. Between-group differences at the endpoint assessment were indicative of the intervention’s potential for improving diet in children and adults. Evidence for potential benefits on physical activity and sedentary behaviours was less apparent. However, the intervention was associated with improvements in several CVD risk factors including LDL-C, with a within-group mean decrease of 8% (children) and 10% (adults).ConclusionsThe study’s recruitment, retention, acceptability and potential efficacy support the development of a definitive trial, subject to identified refinements.Trial registration numberISRCTN24880714.


2015 ◽  
Vol 11 (1) ◽  
pp. 31-40 ◽  
Author(s):  
Michelle F. Mottola

Maternal obesity is accelerating world-wide and may be partly due to excessive gestational weight gain (GWG) and weight retention so that women begin a subsequent pregnancy with extra weight. Excessive GWG has been linked to chronic disease risk in the mother and also to an unhealthy foetal environment with downstream consequences for offspring health with risk for childhood obesity. Weight control during pregnancy and prevention of excessive GWG is an important issue for both mother and developing child. A healthy lifestyle through healthy eating and physical activity are key to prevention. Weight management for non-pregnant individuals has been evaluated for over 30 years, and lessons learned may assist in planning interventions for preventing excessive GWG. Many systematic reviews and meta-analyses analyzing the same studies on GWG report very different results. Recently, 10 intervention trials to prevent excessive GWG were published and only 6 of them were successful. Significant association between maternal exercise and GWG guidelines were reported, however, “one size does not fit all”. The failed trials did not have extra faceto- face sessions, were educational based and adherence was <50%. Accountability, face-to-face exercise sessions, and pedometers may motivate pregnant women to increase step counts to 10,000, which, when combined with nutrition control, prevents excessive GWG. Community walking programs that include family members and children may assist pregnant women of all body mass index categories to overcome potential barriers to promote a healthy lifestyle that will benefit them and their families for weight control and prevention of future chronic disease risk.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e038625
Author(s):  
Joanna Goldthorpe ◽  
Tracy Epton ◽  
Chris Keyworth ◽  
Rachel Calam ◽  
Joanna Brooks ◽  
...  

ObjectivePrimary schools are crucial settings for early weight management interventions but effects on children’s weight are small and evidence shows that deficiencies in intervention implementation may be responsible. Very little is known about the roles of multiple stakeholders in the process of implementation. We used a multiple-stakeholder qualitative research approach to explore the implementation of an intervention developed to improve the diet and increase the levels of physical activity for children living in some of the most deprived areas of England.DesignFor this qualitative study, interviews and focus groups were carried out using semi-structured topic guides. Data were analysed thematically.SettingSeven primary schools (pupils aged 4 to 11) in Manchester, England.ParticipantsWe conducted 14 focus groups with children aged 5 to 10 years and interviews with 19 staff members and 17 parents.InterventionManchester Healthy Schools (MHS) is a multicomponent intervention, developed to improve diet and physical activity in schools with the aim of reducing and preventing childhood obesity.ResultsThree themes were developed from the data: common understandings of health and health behaviours; congruence and consistency of messages; negotiations of responsibility.ConclusionAll participant groups had a common conceptualisation of health as having physical and psychological components and that action could be taken in childhood to change behaviours that protect long-term health. When parents and staff felt a shared sense of responsibility for children’s health and levels of congruence between home and school norms around diet and physical activity were high, parents and children were more likely to accept the policies implemented as part of MHS. Effective two-way communication between home and school is therefore vital for successful implementation of this intervention.


2021 ◽  
Vol 46 (1) ◽  
pp. 77-85
Author(s):  
Brittany A. Matenchuk ◽  
Margie H. Davenport

Poor sleep in the postpartum is often treated as an unavoidable consequence of childbirth. This study aims to compare objective and subjective measures of sleep, explore the relationship between sleep and postpartum weight retention (PPWR), and investigate factors that may contribute to sleep quality in the postpartum period. In this cross-sectional cohort, PPWR, sleep quality (Pittsburgh Sleep Quality Index (PSQI)), and objective sleep and physical activity (accelerometry) were assessed in 109 women 0–52 weeks postpartum. Anthropometric and demographic data were collected. Gestational weight gain (GWG) was classified as inadequate, appropriate, or excessive according to Institute of Medicine guidelines. Average GWG (33.7 lbs) and PPWR (5.39 lbs) were not different between “good” (PSQI < 6) and “bad” (PSQI ≥ 6) sleepers. Following adjustment, mothers with excessive GWG who were “bad” sleepers had 5.26 higher odds of PPWR ≥ 10 lbs compared with all other combinations of GWG and PSQI. PSQI was not correlated with total sleep time (accelerometer-derived). Light activity and moderate-to-vigorous physical activity (MVPA) were associated with reduced odds of being a “bad” sleeper. The influence of GWG on PPWR was modified by postpartum sleep quality. Both light activity and meeting the MVPA guidelines in the postpartum were associated with higher sleep quality. Novelty Subjectively rated poor sleep may represent the number of awakenings and wake after sleep onset in postpartum women. Poor postpartum sleep quality increases excessive postpartum weight retention in women with excessive GWG. Women doing light-to-vigorous physical activity in the postpartum are less likely to experience poor sleep quality.


2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Tamara R. Cohen ◽  
Kristine G. Koski

Few studies have investigated if compliance with energy intakes, physical activity, and weight gain guidelines attenuate postpartum weight retention (PPWR) in mothers attending prenatal classes. We investigated whether (a) daily energy intakes within 300 kcal of estimated energy requirements (EERs), (b) walking more than 5000 steps/day, (c) targeting the recommended weight gain goals for prepregnancy BMI, and/or (d) achieving weekly or total gestational weight gain (GWG) recommendations minimized PPWR in 54 women attending prenatal classes in Montreal/Ottawa, Canada. Participants completed a validated pregnancy physical activity questionnaire (PPAQ), 3 telephone-validated 24-hr dietary recalls, and wore a pedometer for one week. PPWR was measured 6 weeks after delivery. Results showed that 72% had healthy prepregnancy BMIs. However, 52% consumed>300 kcal/day in excess of their EER, 54% exceeded recommended GWG, and more overweight (93%) than normal weight women (38%) cited nonrecommended GWG targets. Following delivery, 33% were classified as overweight, and 17% were obese. Multiple logistic regressions revealed that women targeting “recommended weight gain advice” were 3 times more likely to meet total GWG recommendations (OR: 3.2,P<0.05); women who complied with weekly GWG goals minimized PPWR (OR: 4.2,P<0.02). In conclusion, appropriate GWG targets, lower energy intakes, and physical activity should be emphasized in prenatal education programs.


2016 ◽  
Vol 11 (6) ◽  
pp. 501-510
Author(s):  
Rebecca A. Schlaff ◽  
Claudia Holzman ◽  
Kimberly S. Maier ◽  
Karin A. Pfieffer ◽  
James M. Pivarnik

Prospective studies examining postpartum weight retention (PPWR) in relation to the appropriateness of gestational weight gain (GWG) and leisure-time physical activity (LTPA) during pregnancy and postpartum are lacking. While utilizing varying estimates of prepregnancy weight, we sought to prospectively examine associations among the aforementioned variables. Our sample consisted of a subset of women from the Archive for Research on Child Health Study (n = 68). Prepregnancy weight was obtained via questionnaire and birth certificates. GWG (2 estimates) was calculated by subtracting prepregnancy weight estimates from weight at delivery and classified as “excess” or “not excess.” Pregnancy and postpartum LTPA were self-reported and dichotomized at recommended levels. Prepregnancy weight estimates were subtracted from self-reported postpartum weight to calculate 2 estimates of PPWR at 6 months. Linear regression was used to examine relationships among GWG and LTPA, and PPWR. Estimates of excess GWG were associated with increased PPWR (mean difference = 3.3-8.9 kg), even after adjustment for prepregnancy body mass index and breastfeeding. Meeting pregnancy and postpartum LTPA recommendations did not significantly predict PPWR. Our findings highlight the importance of encouraging appropriate GWG and provide insight into the impact varying estimates of prepregnancy weight may have when exploring associations among these variables.


2020 ◽  
Vol 4 (3) ◽  
pp. 1
Author(s):  
Lisiane Goetz ◽  
Renato C. Teixeira

The choices related to lifestyle habits, during the period of graduation at the university are decisive for the development of a healthy lifestyle and for combating the risk behaviors that lead to Chronic Non-communicable Diseases. This study aims to examine the relationship between a discipline focused on health literacy and the development of attitudinal components aimed at the competence of self-care and responsibility of pedagogy students, in relation to the choices that constitute their lifestyle. The investigation of this research indicates that the literacy and health promotion program developed during the Principles of Healthy Living for education students had a positive effect on the development of competence and responsibility for self-care in their lifestyle. Quantitative data were obtained using the socio-demographic questionnaire and validated scale of the Fantastic Lifestyle and the Global Physical Activity Questionnaire, at the beginning and end of the course. The results point to an improvement in lifestyle with an increase in the practice of recreational physical activity of vigorous intensity (p=0.0339) and in its frequency (p=0.0130). Still, there was a significant reduction in the level of physical inactivity (p=0.0451), in addition to the evident improvement in lifestyle (p=0.0196), with all participants grouped in the categories “Good”, “Very Good” and “Excellent” referring to lifestyle. This study showed that an approach to health education for university students is a positive initiative for teaching important skills to consolidate a healthy lifestyle.


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