Excessive weight gain during pregnancy increases the risk of obesity in both mothers and babies. To avoid dangerous gestational weight gain, it is important to identify effective tools for behavior change.
"As we look to the future, digital behavioral nutrition interventions will become more widely used," said lead author Christine M. Olson, Ph.D., Division of Nutritional Sciences, Cornell University, Ithaca, NY, USA.
Pregnant women between 18 and 35 years of age were eligible to participate if they were healthy and had a normal to obese BMI. Additionally, they needed to be less than 20 weeks pregnant, available for follow-up appointments, planned to keep the baby, spoke English, and could be contacted by email. Once accepted into the study, the participants were separated into groups by income level and BMI. There were two intervention and one control groups.
Before starting the study, participants completed an online questionnaire to elicit psychosocial data including attitudes and beliefs; motivation; and environmental constraints including social, economic and personal barriers. Weight data were gathered through an audit of prenatal, labor and delivery, and postpartum medical records.
All groups were given access to a website featuring blogs, local resources, informative articles, frequently asked questions, and event reminders. The intervention groups were able to use additional tools including a weight gain tracker, as well as goal-setting tools for diet and physical activity. Goal suggestions were listed in a drop-down menu or participants could set a custom goal.
Of the nearly 900 women in the intervention group, slightly less than half of the participants started using the diet goal-setting tool with one third actually setting a goal and one fifth starting self-monitoring.
Women in the normal weight group who set two or more goals gained less weight than those who set fewer goals. This did not hold true for women in the higher BMI group. These women gained more than women who set fewer goals. Women in the normal weight group, who moved on to the self-monitoring step, also reduced their risk of excessive weight gain, but self-monitoring of diet did not help women who were overweight or obese. Nearly all women who set a goal selected a self-reward.
"The diet goal-setting tool appears to be an effective component of an online intervention for weight gain management for women who begin pregnancy with normal BMI. Although the tool was used more frequently by women who were overweight, it was not effective in reducing their risk of excessive weight gain," concluded Dr. Olson. "This group may need more personalized, face-to-face approaches to dietary change."
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