Supporting women of childbearing age in the prevention and treatment of overweight and obesity: a scoping review of randomized control trials of behavioral interventions

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Abstract

Background

Women of childbearing age are vulnerable to weight gain. This scoping review examines the extent and range of research undertaken to evaluate behavioral interventions to support women of childbearing age to prevent and treat overweight and obesity.

Methods

Eight electronic databases were searched for randomized controlled trials (RCT) or systematic reviews of RCTs until 31st January 2018. Eligible studies included women of childbearing age (aged 15–44 years), evaluated interventions promoting behavior change related to diet or physical activity to achieve weight gain prevention, weight loss or maintenance and reported weight-related outcomes.

Results

Ninety studies met the inclusion criteria (87 RCTs, 3 systematic reviews). Included studies were published from 1998 to 2018. The studies primarily focused on preventing excessive gestational weight gain ( n = 46 RCTs, n = 2 systematic reviews), preventing postpartum weight retention ( n = 18 RCTs) or a combination of the two ( n = 14 RCTs, n = 1 systematic review). The RCTs predominantly evaluated interventions that aimed to change both diet and physical activity behaviors ( n = 84) and were delivered in-person ( n = 85).

Conclusions

This scoping review identified an increasing volume of research over time undertaken to support women of childbearing age to prevent and treat overweight and obesity. It highlights, however, that little research is being undertaken to support the young adult female population unrelated to pregnancy or preconception.

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Most cited references 109

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Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

Emily Sonestedt, Kim Overvad (2016)

Summary Background Underweight and severe and morbid obesity are associated with highly elevated risks of adverse health outcomes. We estimated trends in mean body-mass index (BMI), which characterises its population distribution, and in the prevalences of a complete set of BMI categories for adults in all countries. Methods We analysed, with use of a consistent protocol, population-based studies that had measured height and weight in adults aged 18 years and older. We applied a Bayesian hierarchical model to these data to estimate trends from 1975 to 2014 in mean BMI and in the prevalences of BMI categories (<18·5 kg/m2 [underweight], 18·5 kg/m2 to <20 kg/m2, 20 kg/m2 to <25 kg/m2, 25 kg/m2 to <30 kg/m2, 30 kg/m2 to <35 kg/m2, 35 kg/m2 to <40 kg/m2, ≥40 kg/m2 [morbid obesity]), by sex in 200 countries and territories, organised in 21 regions. We calculated the posterior probability of meeting the target of halting by 2025 the rise in obesity at its 2010 levels, if post-2000 trends continue. Findings We used 1698 population-based data sources, with more than 19·2 million adult participants (9·9 million men and 9·3 million women) in 186 of 200 countries for which estimates were made. Global age-standardised mean BMI increased from 21·7 kg/m2 (95% credible interval 21·3–22·1) in 1975 to 24·2 kg/m2 (24·0–24·4) in 2014 in men, and from 22·1 kg/m2 (21·7–22·5) in 1975 to 24·4 kg/m2 (24·2–24·6) in 2014 in women. Regional mean BMIs in 2014 for men ranged from 21·4 kg/m2 in central Africa and south Asia to 29·2 kg/m2 (28·6–29·8) in Polynesia and Micronesia; for women the range was from 21·8 kg/m2 (21·4–22·3) in south Asia to 32·2 kg/m2 (31·5–32·8) in Polynesia and Micronesia. Over these four decades, age-standardised global prevalence of underweight decreased from 13·8% (10·5–17·4) to 8·8% (7·4–10·3) in men and from 14·6% (11·6–17·9) to 9·7% (8·3–11·1) in women. South Asia had the highest prevalence of underweight in 2014, 23·4% (17·8–29·2) in men and 24·0% (18·9–29·3) in women. Age-standardised prevalence of obesity increased from 3·2% (2·4–4·1) in 1975 to 10·8% (9·7–12·0) in 2014 in men, and from 6·4% (5·1–7·8) to 14·9% (13·6–16·1) in women. 2·3% (2·0–2·7) of the world’s men and 5·0% (4·4–5·6) of women were severely obese (ie, have BMI ≥35 kg/m2). Globally, prevalence of morbid obesity was 0·64% (0·46–0·86) in men and 1·6% (1·3–1·9) in women. Interpretation If post-2000 trends continue, the probability of meeting the global obesity target is virtually zero. Rather, if these trends continue, by 2025, global obesity prevalence will reach 18% in men and surpass 21% in women; severe obesity will surpass 6% in men and 9% in women. Nonetheless, underweight remains prevalent in the world’s poorest regions, especially in south Asia. Funding Wellcome Trust, Grand Challenges Canada.

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The levels of evidence and their role in evidence-based medicine.

Patricia B Burns, Rod J Rohrich, Kevin C Chung (2011)

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Pregnancy: a "teachable moment" for weight control and obesity prevention.

Suzanne Phelan (2010)

Excessive gestational weight gain has been shown to relate to high-postpartum weight retention and the development of overweight and obesity later in life. Because many women are concerned about the health of their babies during pregnancy and are in frequent contact with their healthcare providers, pregnancy may be an especially powerful "teachable moment" for the promotion of healthy eating and physical activity behaviors among women. Initial research suggests that helping women gain the recommended amount during pregnancy through healthy eating and physical activity could make a major contribution to the prevention of postpartum weight retention. However, more randomized controlled trials with larger sample sizes are needed to identify the most effective and disseminable intervention. Providers have the potential to prevent high postpartum weight retention and future obesity by monitoring weight gain during pregnancy and giving appropriate advice about recommended amounts of gestational weight gain. Copyright 2010 Mosby, Inc. All rights reserved.

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Author and article information

Contributors

Melinda J. Hutchesson:

ORCID: http://orcid.org/0000-0002-1851-0661

Melinda.hutchesson@newcastle.edu.au

Journal

Journal ID (nlm-ta): BMC Womens Health

Journal ID (iso-abbrev): BMC Womens Health

Title: BMC Women's Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1472-6874

Publication date (Electronic): 23 January 2020

Publication date PMC-release: 23 January 2020

Publication date Collection: 2020

Volume: 20

Electronic Location Identifier: 14

Affiliations

[1 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, School of Health Sciences, Faculty of Health and Medicine, and Priority Research Centre for Physical Activity and Nutrition, , University of Newcastle, ; University Drive, Callaghan, New South Wales Australia

[2 ]ISNI 0000 0001 0791 5666, GRID grid.4818.5, Division of Human Nutrition and Health, , Wageningen University, ; Wageningen, The Netherlands

[3 ]ISNI 0000 0004 1936 7857, GRID grid.1002.3, Monash Centre for Health Research and Implementation, , Monash University, ; Clayton, Victoria Australia

[4 ]ISNI 0000 0004 0437 5432, GRID grid.1022.1, School of Allied Health Science, , Griffith University, ; Gold Coast, Queensland Australia

[5 ]Hunter New England Population Health, Longworth Avenue, Wallsend, Australia

[6 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, School of Medicine and Public Health, , The University of Newcastle, ; Callaghan, Australia

[7 ]ISNI 0000 0000 8831 109X, GRID grid.266842.c, Priority Research Centre for Health Behaviour, , University of Newcastle, ; Callaghan, New South Wales Australia

[8 ]GRID grid.413648.c, Hunter Medical Research Institute, ; New Lambton Heights, NSW Australia

Author information

Melinda J. Hutchesson http://orcid.org/0000-0002-1851-0661

Article

Publisher ID: 882

DOI: 10.1186/s12905-020-0882-3

PMC ID: 6979060

PubMed ID: 31973716

SO-VID: 574a77e7-acf3-4b62-be64-2df58af3dcd6

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 21 May 2019

Date accepted : 10 January 2020

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: childbearing,women,obesity treatment,obesity prevention,scoping review

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ScienceOpen disciplines: Obstetrics & Gynecology

Keywords: childbearing, women, obesity treatment, obesity prevention, scoping review

Supporting women of childbearing age in the prevention and treatment of overweight and obesity: a scoping review of randomized control trials of behavioral interventions

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SDG 3: Good Health and Well-Being

Most cited references 109

Trends in adult body-mass index in 200 countries from 1975 to 2014: a pooled analysis of 1698 population-based measurement studies with 19·2 million participants

The levels of evidence and their role in evidence-based medicine.

Pregnancy: a "teachable moment" for weight control and obesity prevention.

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