74 Participants Needed

Dietary Intervention for Postpartum Weight Retention

(PADaWL Trial)

Recruiting at 1 trial location
AP
SK
CM
Overseen ByChothika Mekonnen, BS
Age: 18 - 65
Sex: Female
Trial Phase: Academic
Sponsor: Tripler Army Medical Center
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

Pregnancy and delivery are major stressors on the female body and contribute significantly to permanent weight gain and associated morbidity in women. This can profoundly affect the ability of active duty (AD) women to advance in their career. The first 12 weeks postpartum are the time period during which the most significant weight loss occurs and is critical in achieving a healthy weight in the first year postpartum. Many factors contribute to effective weight loss in this period among which the most critical are diet, exercise, and sleep. Breast feeding and depression may also affect weight changes postpartum. Research has shown diet to likely be the most crucial of these factors.The PADaWL study is designed as a randomized controlled trial to assess the effects of dietary intervention on weight and physical fitness versus routine postpartum care in the first year postpartum. Subjects will be primiparous AD women from any military service recruited in the obstetric clinic in the third trimester of pregnancy at Tripler Army Medical Center. Data will collected in an ambi-directional fashion with pre-pregnancy physical fitness data, demographic and pregnancy data collected at time of enrollment. Subjects will be randomized to receive intensive virtual sessions with a dietician vs routine postpartum care for the first 12 months postpartum. We will utilize a biometric device to monitor activity levels and sleep, web-based diaries to monitor breast feeding and diet, and validated questionnaires to evaluate depression as well as diet and sleep. Subjects will be monitored weekly for the first 12 weeks postpartum and will then be further evaluated at 6, 9 and 12 months postpartum.Primary outcome is weight at 12weeks postpartum and whether subjects have achieved military standards. Secondary outcome will be weight at 12 months postpartum and whether subject has achieved weight and fitness standards. The study intends to collect large amounts of data, and we intend to analyze which factors may be contributing to weight retention postpartum.This study should provide an accurate assessment of the effects of pregnancy on AD women. It should generate a clean and accurate dataset on which multiple follow-on studies can be performed and provide data for designing further intervention studies in postpartum women. The results of this study should also be able to assist in developing policy and guidance concerning AD women and pregnancy.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It focuses on diet and exercise for postpartum weight loss.

Is nutritional counseling safe for humans?

Nutritional counseling, often combined with cognitive-behavioral therapy, is generally safe and has been used effectively to help modify dietary habits and manage weight in various conditions, including postpartum weight retention and eating disorders.12345

How does the treatment of dietary counseling for postpartum weight retention differ from other treatments?

Dietary counseling for postpartum weight retention is unique because it focuses on modifying eating behaviors through personalized nutritional advice, often using approaches like the DASH diet, which is designed for gradual and healthy weight loss. Unlike other treatments that may involve medication or more generalized advice, this approach is tailored to individual needs and emphasizes adherence to a healthy dietary pattern.26789

What data supports the effectiveness of the treatment Counseling with goal of modifying eating behaviors, Dietary Counseling, Nutritional Counseling, Behavioral Therapy for Eating Behaviors?

Research shows that patient-centered counseling and cognitive-behavioral therapy (CBT) are effective in helping people stick to healthy eating plans and change their eating habits. These approaches have been successful in managing weight and improving health in conditions like type 2 diabetes, suggesting they could also help with postpartum weight retention.13101112

Who Is on the Research Team?

AP

Alan P Gehrich, MD

Principal Investigator

Tripler Army Medical Center

Are You a Good Fit for This Trial?

This trial is for active duty women from any military service who are experiencing their first pregnancy, have a BMI under 30 in the first trimester, and plan to remain on active duty for at least 18 months post-delivery. They must not be planning another pregnancy within that time and should stay on Oahu for at least 12 months after giving birth.

Inclusion Criteria

Not planning short interval pregnancy within 18 months of delivery
Active Duty from any service - Army, Navy, Air Force, Marine, Coast Guard
Any type of delivery (spontaneous vaginal delivery, operative vaginal delivery, cesarean delivery)
See 9 more

Exclusion Criteria

My newborn was in the NICU for more than 2 weeks.
No physical fitness test for record in the year prior to pregnancy
Delivery before 36 weeks
See 6 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks
1 visit (in-person)

Enrollment

Eligible participants meet with the research team, provide consent, and are randomized into study groups

1 week
1 visit (in-person)

Treatment

Participants receive dietary intervention and monitoring of diet, exercise, and sleep for the first 12 months postpartum

12 months
Weekly virtual sessions for the first 12 weeks, then at 6, 9, and 12 months

Intensive Data Collection

Intensive data collection on diet, activity, and sleep using biometric devices and web-based diaries

12 weeks
Weekly data submission

Follow-up

Participants are monitored for weight and fitness outcomes at 6, 9, and 12 months postpartum

12 months
3 visits (virtual)

What Are the Treatments Tested in This Trial?

Interventions

  • Counseling with goal of modifying eating behaviors
Trial Overview The study tests if counseling with a dietician can help new mothers return to pre-pregnancy weight and meet military fitness standards faster than usual care. Participants will get weekly virtual sessions with a dietician for the first year postpartum, alongside monitoring of activity levels, sleep, breastfeeding habits, diet, and depression.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Active Control
Group I: Intervention Arm 2Experimental Treatment1 Intervention
Women in this arm will not have dietary counseling but will have close supervision of diet, exercise and sleep.
Group II: Intervention Arm 1Experimental Treatment1 Intervention
Women in this arm will undergone dietary counseling in the first year postpartum in addition to close supervision of diet, exercise, and sleep.
Group III: ControlActive Control1 Intervention
Women in this arm will undergo routine postpartum care.

Find a Clinic Near You

Who Is Running the Clinical Trial?

Tripler Army Medical Center

Lead Sponsor

Trials
23
Recruited
27,900+

Published Research Related to This Trial

The patient-centered counseling model improves long-term dietary adherence by personalizing interventions based on individual patient needs and stages of change.
This model includes a 4-step counseling process that helps nutrition professionals effectively support patients in following nutrition care plans and dietary guidelines.
Facilitating dietary change: the patient-centered counseling model.Rosal, MC., Ebbeling, CB., Lofgren, I., et al.[2022]
A systematic review of 214 articles identified strong evidence supporting the use of cognitive behavioral therapy (CBT) combined with behavioral theories to effectively change dietary habits and reduce risks for conditions like type 2 diabetes, particularly in patients undergoing intensive CBT for 6 to 12 months.
Motivational interviewing emerged as a highly effective counseling strategy, especially when paired with CBT, while strategies like financial rewards were found to be ineffective, highlighting the importance of goal setting and social support in nutrition counseling.
State of the evidence regarding behavior change theories and strategies in nutrition counseling to facilitate health and food behavior change.Spahn, JM., Reeves, RS., Keim, KS., et al.[2022]
Manual-based cognitive-behavioral therapy (CBT) and nutritional counseling both aim to eliminate unhealthy eating patterns, but require specialized training in behavior change that many nutritionists and mental health professionals may lack.
Nutritional rehabilitation programs can enhance CBT by specifically targeting the appetitive and metabolic abnormalities seen in eating disorders like bulimia nervosa and binge eating disorder, potentially leading to better treatment outcomes.
Cognitive-behavioral therapy and nutritional counseling in the treatment of bulimia nervosa and binge eating.Latner, JD., Wilson, GT.[2019]

Citations

Facilitating dietary change: the patient-centered counseling model. [2022]
State of the evidence regarding behavior change theories and strategies in nutrition counseling to facilitate health and food behavior change. [2022]
Cognitive-behavioral therapy and nutritional counseling in the treatment of bulimia nervosa and binge eating. [2019]
[Strategies in practical nutrition counseling]. [2009]
[Importance of nutritional counseling and dietary fiber content on glycemic control in type 2 diabetic patients under intensive educational intervention]. [2019]
A pilot intervention to reduce postpartum weight retention at primary health care in Brazil. [2022]
Effects of behavioral and pharmacological weight loss programs on nutrient intake. [2018]
Cognitive-behavioral approaches in the management of obesity. [2018]
Effect of the e-health supported INTER-ACT lifestyle intervention on postpartum weight retention and body composition, and associations with lifestyle behavior: A randomized controlled trial. [2022]
A Stepwise Approach to Prescribe Dietary Advice for Weight Management in Postpartum and Midlife Women. [2023]
11.United Statespubmed.ncbi.nlm.nih.gov
Effects of a lifestyle intervention on postpartum weight retention among women with elevated weight. [2022]
12.United Statespubmed.ncbi.nlm.nih.gov
Diets and eating disorders: implications for the breastfeeding mother. [2015]
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