Be Healthy in Pregnancy (BHIP): A Randomized Controlled Trial of Nutrition and Exercise Intervention from Early Pregnancy to Achieve Recommended Gestational Weight Gain

doi:10.3390/nu14040810

Paper

Be Healthy in Pregnancy (BHIP): A Randomized Controlled Trial of Nutrition and Exercise Intervention from Early Pregnancy to Achieve Recommended Gestational Weight Gain

Published Feb 1, 2022 · S. Atkinson, Atherai Maran, Kendra Dempsey

Nutrients

Q1 SJR score

23

Citations

1

Influential Citations

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Abstract

A randomized two-arm prospective superiority trial tested the efficacy of a novel structured and monitored nutrition (bi-weekly counselling for individualized energy and high dairy protein diet) and exercise program (walking goal of 10,000 steps/day) (intervention) compared to usual care (control) in pregnant women to achieve gestational weight gain (GWG) within current recommendations. Women recruited in communities in southern Ontario, Canada were randomized at 12–17 weeks gestation with stratification by site and pre-pregnancy BMI to intervention (n = 119) or control (n = 122). The primary outcome was the proportion of women who achieved GWG within the Institute of Medicine recommendations. Although the intervention compared to control group was more likely to achieve GWG within recommendations (OR = 1.51; 95% CI (0.81, 2.80)) and total GWG was lower by 1.45 kg (95% CI: (−11.9, 8.88)) neither reached statistical significance. The intervention group achieved significantly higher protein intake at 26–28 week (mean difference (MD); 15.0 g/day; 95% CI (8.1, 21.9)) and 36–38 week gestation (MD = 15.2 g/day; 95% CI (9.4, 21.1)) and higher healthy diet scores (22.5 ± 6.9 vs. 18.7 ± 8.5, p < 0.005) but step counts were similar averaging 6335 steps/day. Pregnancy and infant birth outcomes were similar between groups. While the structured and monitored nutrition with counselling improved diet quality and protein intake and may have benefited GWG, the exercise goal of 10,000 steps/day was unachievable. The results can inform future recommendations for diet and physical activity in pregnancy.

RCT

Very Rigorous Journal

Study Snapshot

The structured and monitored nutrition with counselling improved diet quality and protein intake, but the exercise goal of 10,000 steps/day was unachievable for most pregnant women.

PopulationOlder adults (50-71 years)

Sample size24

MethodsObservational

OutcomesBody Mass Index projections

ResultsSocial networks mitigate obesity in older groups.

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Be Healthy in Pregnancy (BHIP): A Randomized Controlled Trial of Nutrition and Exercise Intervention from Early Pregnancy to Achieve Recommended Gestational Weight Gain

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References

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Antenatal interventions for women with obesity should stratify outcomes by obesity severity, resulting in better pregnancy outcomes and lower gestational weight gain.

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New evidence has emerged since the 2009 IOM/NRC gestational weight gain recommendations, and new interventions show promise for women with overweight and obesity, but more research is needed to update these recommendations.

A Randomised Trial to Optimise Gestational Weight Gain and Improve Maternal and Infant Health Outcomes through Antenatal Dietary, Lifestyle and Exercise Advice: The OPTIMISE Randomised Trial

Optimal gestational weight gain through dietary, lifestyle, and exercise advice in pregnant women with normal BMI did not significantly impact pregnancy and birth outcomes.

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Postpartum women experience complex body image relationships, barriers to healthy habits, and lack of guidance on weight management, healthy eating, and exercise.

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Greater stepping intensity is associated with lower mortality rates in older women, but these associations are attenuated when accounting for daily steps.

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A multi-component behavioral intervention with a Registered Dietitian Nutritionist significantly improved adherence to the 2009 Institute of Medicine weight-gain guidelines in pregnant women.

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Structured diet and exercise guidance in pregnancy to improve health in women and their offspring: study protocol for the Be Healthy in Pregnancy (BHIP) randomized controlled trial

A structured Nutrition + Exercise intervention during pregnancy may improve women's likelihood of achieving recommended gestational weight gain and offspring's bone health at birth and six months postpartum.

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Prenatal physical activity is recommended for all women without contraindications, promoting maternal, fetal, and neonatal health, with moderate benefits and no harms identified.

Citations

Investigating discrepancies in findings between rigorous randomized trials and meta-analyses evaluating pregnancy interventions to limit gestational weight gain.

Diet and physical activity interventions for pregnant women with a BMI 18.5 kg/m2 show little impact on gestational weight gain and clinical outcomes.

Adaptive changes in multiple aspects of emotion regulation in the offspring of pregnant persons receiving a diet-and-exercise intervention relative to usual pregnancy care: A randomized controlled trial.

The Be Healthy in Pregnancy (BHIP) prenatal diet-and-exercise intervention improves offspring emotion regulation, reducing behavioral problems and impulsivity.

The Influence of Exercise and BMI on Food Choices During Pregnancy

Overweight/obese pregnant women who exercise during pregnancy tend to eat more nutrient-dense foods, compared to those who do not exercise.

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Dairy's complex matrix effects, including calcium, proteins, vitamins, and fatty acids, play a crucial role in maintaining bone health and preventing osteoporosis.

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Physical activity during pregnancy reduces the risk of gestational hypertension and positively affects systolic and diastolic blood pressure levels, improving maternal health.

Influence of Physical Activity during Pregnancy on Neonatal Complications: Systematic Review and Meta-Analysis

Physical activity during pregnancy may help reduce the risk of neonatal complications-related NICU admissions and improve Apgar scores.