Onderzoek

Excess weight before, during and after pregnancy entails several maternal and infant adverse health outcomes. Lifestyle factors such as energy intake, eating behavior, physical activity and sedentary behavior are important contributors to maternal perinatal weight changes. The aim of the current thesis was to investigate lifestyle behaviors, weight and body composition up to one year postpartum after a pregnancy with excessive gestational weight gain, and the effect of a lifestyle intervention on these factors.

A systematic literature review showed that several links between eating behaviors and perinatal weight were previously established. Research on eating behaviors in relation to postpartum weight is scarce, although the postpartum period emerges as a potentially important period to target eating behaviors for the reduction of postpartum weight retention.

Analyses showed that sedentary time, emotional eating, and uncontrolled eating are related to postpartum weight and body composition up to 1 year after delivery in women with preceding excessive gestational weight gain. Restrained eating, energy intake and physical activity were not found to play a role in the evolution of weight and body composition up to 1 year after delivery.

Phase angle is an indicator for nutritional status and fitness. Phase angle values were explored during the first year after delivery and found a small increase in phase angle values between 6 weeks and 12 months postpartum from 5.8 to 6.0 degrees, which indicates an improving health status. The implication of these phase angle values on the longer term need to be further elucidated, for example whether phase angle in early postpartum is predictive of maternal health outcomes on the long term.

A postpartum blended lifestyle intervention effectively increased restrained eating, decreased uncontrolled eating and decreased energy intake. The intervention did not affect emotional eating, physical activity and sedentary time. Nor did the intervention affect postpartum weight retention, fat percentage and waist circumference.

These findings can guide future postpartum lifestyle intervention efforts. In addition to healthy eating and physical activity, eating behaviors should be targeted in future weight management efforts. The long-term effects of the postpartum lifestyle intervention, in terms of maternal health and weight as well as complications in a subsequent pregnancy, should be investigated.