title: Diet and exercise interventions among overweight and obese lactating women: randomized trial of effects on cardiovascular risk factors.
abstract: OBJECTIVE
  To examine the effects of Diet (D) and Exercise (E) interventions on cardiovascular fitness, waist circumference, blood lipids, glucose metabolism, inflammation markers, insulin-like growth factor 1 (IGF-1) and blood pressure in overweight and obese lactating women.
  
  
  METHODS
  At 10-14 wk postpartum, 68 Swedish women with a self-reported pre-pregnancy BMI of 25-35 kg/m(2) were randomized to a 12-wk behavior modification treatment with D, E, both or control using a 2×2 factorial design. The goal of D treatment was to reduce body weight by 0.5 kg/wk, accomplished by decreasing energy intake by 500 kcal/d and monitoring weight loss through self-weighing. The goal of E treatment was to perform 4 45-min walks per wk at 60-70% of max heart-rate using a heart-rate monitor. Effects were measured 12 wk and 1 y after randomization. General Linear Modeling was used to study main and interaction effects adjusted for baseline values of dependent variable.
  
  
  RESULTS
  There was a significant main effect of the D treatment, decreasing waist circumference (P = 0.001), total cholesterol (P = 0.007), LDL-cholesterol (P = 0.003) and fasting insulin (P = 0.042), at the end of the 12-wk treatment. The decreased waist circumference (P<0.001) and insulin (P = 0.024) was sustained and HDL-cholesterol increased (P = 0.005) at the 1-y follow-up. No effects from the E treatment or any interaction effects were observed.
  
  
  CONCLUSIONS
  Dietary behavior modification that produced sustained weight loss among overweight and obese lactating women also improved risk factors for cardiovascular disease and type 2 diabetes. This intervention may not only reduce weight-related risks with future pregnancies but also long-term risk for metabolic disease.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT01343238.
authors: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors: Hilde K
authors: HK
authors: Brekke
authors: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors: Fredrik
authors: F
authors: Bertz
authors: Division of Nutritional Sciences, Cornell University, Ithaca, New York, United State of America.
authors: Kathleen M
authors: KM
authors: Rasmussen
authors: Department of Clinical Nutrition, Sahlgrenska University Hospital, Gothenburg, Sweden.
authors: Ingvar
authors: I
authors: Bosaeus
authors: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors: Lars
authors: L
authors: Ellegård
authors: Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors: Anna
authors: A
authors: Winkvist
mesh_terms: D000328:Adult; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000503:physiopathology / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000517:prevention & control; D004038:Diet, Reducing; D015444:Exercise / Q000502:physiology; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D015438:Health Behavior; D006801:Humans; D007774:Lactation / Q000502:physiology*; D008019:Life Style; D008055:Lipids / Q000097:blood; D009765:Obesity / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*; D050177:Overweight / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*; D012307:Risk Factors; D016896:Treatment Outcome; D055105:Waist Circumference / Q000502:physiology*; D015431:Weight Loss / Q000502:physiology
chemical_list: D008055:Lipids