Extended lifestyle intervention increased vegetable intake from 2.0 to 3.0 serves/day at 12 months postpartum compared to no significant change in usual care group (p = 0.001).
RCT (n=405)
Open-label (participants not blinded)
1:1:1 randomization stratified by hospital, parity and BMI
Yes
Do brief or extended lifestyle interventions improve dietary and physical activity outcomes in women post-hypertensive disorders of pregnancy?
Intensive lifestyle interventions, including telephone coaching, improve vegetable intake and nutrition awareness at 12 months in women with prior hypertensive disorders of pregnancy, which correlates with improved cardiometabolic measures.
Effect estimate: p = 0.001 for increase in vegetable intake in extended lifestyle group from 6 to 12 months
Absolute Event Rate: 3% vs 2%
p-value: p=0.001
Background/Objectives: Hypertensive disorders of pregnancy (HDP) increase the risk of cardiovascular disease (CVD), but few studies have explored the efficacy of lifestyle interventions to improve CVD risk post-HDP. This study compared the 6 month (6M) and 12 month (12M) dietary and physical activity outcomes of women post-HDP participating in one of three lifestyle interventions. Methods: This sub-study of the Blood Pressure Postpartum (BP2) randomised controlled trial included participants from six hospitals across Sydney, Australia, randomly assigned to one of three groups: Group 1 (usual care) received general postpartum health information; Group 2 (brief education) received usual care plus an individualised cardiovascular risk assessment and lifestyle counselling; Group 3 (extended lifestyle) received all Group 2 components plus enrolment in a six-month telephone coaching programme. Baseline and post-intervention data were collected at 6M and 12M, respectively. Diet and physical activity were assessed using the NSW Population Health Survey, alongside cardiometabolic measures. Results: Overall, 405 women provided complete 6M and 12M data (Group 1 n = 129, Group 2 n = 137, Group 3 n = 139). From 6M to 12M, Group 3 increased their vegetable serves/day (3.0 vs. 2.0, p = 0.001). No significant changes in fruit intake and physical activity levels were observed among groups. Groups 2 and 3 reported that nutritional information had a greater influence on their food choices at 12M (p = 0.010 and p < 0.001, respectively). At 12M, higher vegetable and fruit intake correlated with lower body mass index (BMI) (p = 0.006, p = 0.003) and waist circumference (p = 0.035, p = 0.014), and increased vigorous and strength exercise correlated with lower BMI (p = 0.005, p = 0.003) and waist circumference (p < 0.001, p < 0.001). Conclusions: Intensive lifestyle interventions improved vegetable intake and nutrition awareness in post-HDP women at 12M, holding promise for long-term cardiometabolic health benefits.
Zhang et al. (Thu,) conducted a rct in Women aged ≥18 years with hypertensive disorders of pregnancy (chronic hypertension, gestational hypertension, preeclampsia, or preeclampsia superimposed on chronic hypertension) at 6 months postpartum (n=405). Extended lifestyle intervention involving 6-month telephone coaching program vs. Optimised usual care with general health information; Brief education intervention with individual cardiovascular risk assessment and lifestyle counselling was evaluated on Lifestyle outcomes including vegetable serves/day, fruit serves/day, and time spent in physical activity per week at 12 months postpartum (p = 0.001 for increase in vegetable intake in extended lifestyle group from 6 to 12 months, p=0.001). Extended lifestyle intervention increased vegetable intake from 2.0 to 3.0 serves/day at 12 months postpartum compared to no significant change in usual care group (p = 0.001).