title: Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program.
abstract: BACKGROUND
  Postpartum weight retention is a risk factor for long-term weight gain. Encouraging new mothers to consume a healthy diet may result in weight loss.
  
  
  OBJECTIVE
  To assess predictors of diet quality during the early postpartum period; to determine whether diet quality, energy intake, and lactation status predicted weight change from 5 to 15 months postpartum; and to determine whether an intervention improved diet quality, reduced energy intake, and achieved greater weight loss compared with usual care.
  
  
  METHODS
  Randomized clinical trial (KAN-DO: Kids and Adults Now-Defeat Obesity), a family- and home-based, 10-month, behavioral intervention to prevent childhood obesity, with secondary aims to improve diet and physical activity habits of mothers to promote postpartum weight loss.
  
  
  METHODS
  Overweight/obese, postpartum women (n=400), recruited from 14 counties in the Piedmont region of North Carolina.
  
  
  METHODS
  Eight education kits, each mailed monthly; motivational counseling; and one group class.
  
  
  METHODS
  Anthropometric measurements and 24-hour dietary recalls collected at baseline (approximately 5 months postpartum) and follow-up (approximately 10 months later). Diet quality was determined using the Healthy Eating Index-2005 (HEI-2005).
  
  
  METHODS
  Descriptive statistics, χ(2), analysis of variance, bi- and multivariate analyses were used.
  
  
  RESULTS
  At baseline, mothers consumed a low-quality diet (HEI-2005 score=64.4 ± 11.4). Breastfeeding and income were positive, significant predictors of diet quality, whereas body mass index was a negative predictor. Diet quality did not predict weight change. However, total energy intake, not working outside of the home, and breastfeeding duration/intensity were negative predictors of weight loss. There were no significant differences in changes in diet quality, decreases in energy intake, or weight loss between the intervention (2.3 ± 5.4 kg) and control (1.5 ± 4.7 kg) arms.
  
  
  CONCLUSIONS
  The family-based intervention did not promote postpartum weight loss. Reducing energy intake, rather than improving diet quality, should be the focus of weight-loss interventions for overweight/obese postpartum women.
authors.affiliation: Department of Nutrition, The University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA.
authors.forename: Gina A
authors.initials: GA
authors.lastname: Wiltheiss
authors.forename: Cheryl A
authors.initials: CA
authors.lastname: Lovelady
authors.forename: Deborah G
authors.initials: DG
authors.lastname: West
authors.forename: Rebecca J N
authors.initials: RJ
authors.lastname: Brouwer
authors.forename: Katrina M
authors.initials: KM
authors.lastname: Krause
authors.forename: Truls
authors.initials: T
authors.lastname: Østbye
mesh_terms: D000328:Adult; D001942:Breast Feeding / Q000706:statistics & numerical data; D004032:Diet / Q000592:standards*; D004038:Diet, Reducing; D002149:Energy Intake; D015444:Exercise; D005247:Feeding Behavior; D005260:Female; D006801:Humans; D007182:Income; D009035:Mothers; D009657:North Carolina / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy; D050177:Overweight / Q000453:epidemiology / Q000517:prevention & control / Q000628:therapy*; D049590:Postpartum Period; D015397:Program Evaluation; D012307:Risk Factors; D012959:Socioeconomic Factors; D015430:Weight Gain; D015431:Weight Loss