Diet quality and weight change among overweight and obese postpartum women enrolled in a behavioral intervention program

"Many women enter pregnancy already overweight or obese, and then gain weight in excess of what is recommended by the Institute of Medicine. Evidence shows that excessive weight gain during pregnancy can lead to higher postpartum weight retention. And postpartum weight retention is a significant risk factor for long-term weight gain. The aims of the current study were related to diet quality during the postpartum period. The first aim was to determine predictors of diet quality during the early postpartum period; the second aim was to determine whether mothers in a behavioral intervention program significantly improved their diet quality, reduced energy intake, and lost more weight compared to participants in the control group; and the third aim was to determine if diet quality during the early postpartum period predicted weight change from 6 to 16 months postpartum for overweight and obese postpartum women. For the present study, data were used from 400 overweight/obese postpartum women enrolled in an intervention study that focused on reducing postpartum weight retention through healthier eating habits. Women randomized into the intervention group received monthly kits in the mail, motivational counseling, and were invited to attend one group educational session. Anthropometric measurements and 24-hour dietary recalls were collected at baseline and endpoint. Diet quality was analyzed using the Healthy Eating Index-2005 (HEI-2005). Results indicated a suboptimal diet quality for these participants at baseline, with an average HEI-2005 score of 64.4. Factors that significantly predicted diet quality at baseline were infant feeding status, income, and BMI (r2=0.20). After the intervention, both the intervention and control groups reported a decrease in energy intake (253 kcal and 236 kcal, respectively) and weight loss (1.9 (5.5) kg and 1.0 (5.3) kg, respectively). In addition, there were no significant differences in changes in diet quality between groups. Baseline dietary quality did not predict weight change from 6 to 16 months postpartum. However, total energy intake at baseline was a significant predictor of weight change, along with work status and breastfeeding duration/intensity. Total energy intake, rather than just diet quality, should be addressed in weight loss interventions for overweight/obese postpartum women."--Abstract from author supplied metadata.