title: Diet and exercise weight-loss trial in lactating overweight and obese women.
abstract: BACKGROUND
  Current evidence suggests a combined treatment of postpartum weight loss of diet and exercise. However, to our knowledge, neither their separate and interactive effects nor long-term outcomes have been evaluated.
  
  
  OBJECTIVE
  We evaluated whether a 12-wk dietary behavior modification (D) treatment to decrease energy intake, physical exercise behavior modification (E) treatment to implement moderate aerobic exercise, or combined dietary and physical exercise behavior modification (DE) treatment compared with control (usual care) (C) reduces body weight in lactating women measured at the end of treatment and at a 1-y follow-up 9 mo after treatment termination.
  
  
  METHODS
  At 10-14 wk postpartum, 68 lactating Swedish women with a prepregnancy BMI (in kg/m²) of 25-35 were randomly assigned to D, E, DE, or C groups. Measurements were made at baseline, after the intervention, and again at a 1-y follow-up 9 mo later. A 2 × 2 factorial approach was used to analyze main and interaction effects of treatments.
  
  
  RESULTS
  Weight changes after the intervention and 1-y follow-up were -8.3 ± 4.2 and -10.2 ± 5.7 kg, respectively, in the D group; -2.4 ± 3.2 and -2.7 ± 5.9 kg, respectively, in the E group; -6.9 ± 3.0 and -7.3 ± 6.3 kg, respectively, in the DE group; and -0.8 ± 3.0 and -0.9 ± 6.6 kg, respectively, in the C group. The main effects of D treatment, but not of E treatment, on weight were significant at both times (P < 0.001).
  
  
  CONCLUSIONS
  Dietary treatment provided clinically relevant weight loss in lactating postpartum women, which was sustained at 9 mo after treatment. The combined treatment did not yield significant weight or body-composition changes beyond those of dietary treatment alone.
authors.affiliation: Department of Internal Medicine and Clinical Nutrition, University of Gothenburg, Gothenburg, Sweden. fredrik.bertz@nutrition.gu.se
authors.forename: Fredrik
authors.initials: F
authors.lastname: Bertz
authors.forename: Hilde K
authors.initials: HK
authors.lastname: Brekke
authors.forename: Lars
authors.initials: L
authors.lastname: Ellegård
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Rasmussen
authors.forename: Margareta
authors.initials: M
authors.lastname: Wennergren
authors.forename: Anna
authors.initials: A
authors.lastname: Winkvist
mesh_terms: D000328:Adult; D001521:Behavior Therapy; D001823:Body Composition; D015992:Body Mass Index; D015930:Diet Records; D004038:Diet, Reducing; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007774:Lactation; D009765:Obesity / Q000178:diet therapy / Q000517:prevention & control / Q000628:therapy*; D050177:Overweight / Q000178:diet therapy / Q000517:prevention & control / Q000628:therapy*; D010352:Patient Dropouts; D010353:Patient Education as Topic; D055502:Secondary Prevention; D013548:Sweden; D016138:Walking; D015431:Weight Loss