To investigate whether individual counselling on diet and physical activity during pregnancy can have positive effects on diet and leisure time physical activity (LTPA) and prevent excessive gestational weight gain.
A controlled trial.
Six maternity clinics in primary health care in Finland. The clinics were selected into three intervention and three control clinics.
Of the 132 pregnant primiparas, recruited by 15 public health nurses (PHN), 105 completed the study.
The intervention included individual counselling on diet and LTPA during five routine visits to a PHN until 37 weeks’ gestation; the controls received the standard maternity care.
The counselling did not affect the proportion of primiparas exceeding the weight gain recommendations or total LTPA when adjusted for confounders. The adjusted proportion of high-fibre bread of the total weekly amount of bread decreased more in the control group than in the intervention group (difference 11.8%-units, 95% confidence interval (CI) 0.6–23.1, P=0.04). The adjusted intake of vegetables, fruit and berries increased by 0.8 portions/day (95% CI 0.3–1.4, P=0.004) and dietary fibre by 3.6 g/day (95% CI 1.0–6.1, P=0.007) more in the intervention group than in the control group. There were no high birth weight babies (⩾4000 g) in the intervention group, but eight (15%) of them in the control group (P=0.006).
The counselling helped pregnant women to maintain the proportion of high-fibre bread and to increase vegetable, fruit and fibre intakes, but was unable to prevent excessive gestational weight gain.
This is a preview of subscription content
Subscribe to Journal
Get full journal access for 1 year
only $9.92 per issue
All prices are NET prices.
VAT will be added later in the checkout.
Tax calculation will be finalised during checkout.
Get time limited or full article access on ReadCube.
All prices are NET prices.
Abrams B, Altman SL, Pickett KE (2000). Pregnancy weight gain: still controversial. Am J Clin Nutr 71 (Suppl), 1233S–1241S.
Althuizen E, van Poppel MNM, Seidell JC, van der Wijden C, van Mechelen W (2006). Design of the New Life(style) study: a randomized controlled trial to optimise maternal weight development during pregnancy. BMC Public Health 6, 168. http://www.biomedcentral.com/1471-2458/6/168.
American College of Sports Medicine (ACSM) (1998). The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc 30, 975–991.
Artal R, O’Toole M (2003). Guidelines of the American College of Obstetricians and Gynecologist for exercise during pregnancy and the postpartum period. Br J Sports Med 37, 6–12.
Carmichael S, Abrams B, Selvin S (1997). The pattern of maternal weight gain in women with good pregnancy outcomes. Am J Public Health 87, 1984–1988.
Caulfield LE, Witter FR, Stoltzfus RJ (1996). Determinants of gestational weight gain outside the recommended ranges among black and white women. Obstet Gynecol 87, 760–766.
Cogswell ME, Scanlon KS, Fein SB, Schieve LA (1999). Medically advised, mother's personal target, and actual weight gain during pregnancy. Obstet Gynecol 94, 616–622.
Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE et al. (2003). International Physical Activity Questionnaire (IPAQ): 12-country reliability and validity. Med Sci Sports Exerc 35, 1381–1395.
Davies GAL, Wolfe LA, Mottola MF, MacKinnon C (2003). Exercise in pregnancy and the postpartum period. J Obstet Gynaecol Can 25, 516–522.
Gore SA, Brown DM, West DS (2003). The role of postpartum weight retention in obesity among women: a review of the evidence. Ann Behav Med 26, 149–159.
Gray-Donald K, Robinson E, Collier A, David K, Renaud L, Rodrigues S (2000). Intervening to reduce weight gain in pregnancy and gestational diabetes mellitus in Cree communities: an evaluation. Can Med Assoc J 163, 1247–1251.
Gunderson EP, Abrams B (2000). Epidemiology of gestational weight gain and body weight changes after pregnancy. Epidemiol Rev 22, 261–274.
Hasunen K, Kalavainen M, Keinonen H, Lagström H, Lyytikäinen A, Nurttila A et al. (2004). Lapsi, perhe ja ruoka. Imeväis-ja leikki-ikäisten lasten, odottavien ja imettävien äitien ravitsemussuositus [The Child, Family and Food. Nutrition recommendations for infants and children as well as pregnant and breastfeeding mothers (in Finnish with an English summary)]. Sosiaali-ja terveysministeriön julkaisuja vol. 11 Sosiaali- ja terveysministeriö, terveysosasto: Helsinki.
Helakorpi S, Patja K, Prättälä R, Uutela A (2005). Suomalaisen aikuisväestön terveyskäyttäytyminen ja terveys, kevät 2005 [Health behaviour and health among the Finnish adult population, spring 2005). (in Finnish with an English summary)]. Kansanterveyslaitoksen julkaisuja, B18/2005. Kansanterveyslaitos: Helsinki.
Institute of Medicine (1990). Nutrition during pregnancy, weight gain and nutrient supplements Report of the Subcommittee on Nutritional Status and Weight Gain during Pregnancy, Subcommittee on Dietary Intake and Nutrient Supplements during Pregnancy, Committee on Nutritional Status during Pregnancy and Lactation, Food and Nutrition Board National Academy Press: Washington, DC, 1–233.
Kinnunen TI, Luoto R, Gissler M, Hemminki E (2003). Pregnancy weight gain from 1960s to 2000 in Finland. Int J Obes 27, 1572–1577.
Kinnunen TI, Luoto R, Gissler M, Hemminki E, Hilakivi-Clarke L (2004). Pregnancy weight gain and breast cancer risk. BMC Women's health 4, 7. http://www.biomedcentral.com/content/pdf/1472-6874-4-7.pdf.
Laitakari J, Asikainen T-M (1998). How to promote physical activity through individual counseling – a proposal for a practical model of counseling on health-related physical activity. Patient Educ Couns 33 (Suppl), S13–S24.
Lederman SA (2001). Pregnancy weight gain and postpartum loss: avoiding obesity while optimizing the growth and development of the fetus. J Am Med Womens Assoc 56, 53–58.
Lederman SA, Paxton A, Heymsfield SB, Wang J, Thornton JC, Pieron Jr RN (1997). Body fat and water changes during pregnancy in women with different body weight and weight gain. Obstet Gynecol 90, 483–488.
Männistö S, Ovaskainen M-L, Valsta V (eds) (2003). Finravinto 2002-tutkimus. The National FINDIET 2002 Study. Kansanterveyslaitoksen julkaisuja, B3/2003. Kansanterveyslaitos: Helsinki.
National Research and Development Centre for Welfare and Health (STAKES) (2004) (unpublished data from the official birth register).
Nordic Council of Ministers (2004). Integrating Nutrition and Physical activity. Nordic Nutrition Recommendations 2004, 4th edn, Nord 2004:13 Nordic Council of Ministers: Copenhagen.
Öhlin A, Rössner S (1990). Maternal body weight development after pregnancy. Int J Obes 14, 159–173.
Olson CM, Strawderman MS (2003). Modifiable behavioral factors in a biopsychosocial model predict inadequate and excessive gestational weight gain. J Am Diet Assoc 103, 48–54.
Olson CM, Srawderman MS, Reed RG (2004). Efficacy of an intervention to prevent excessive gestational weight gain. Am J Obstet Gynecol 191, 530–536.
Pate RR, Pratt M, Blair SN, Haskell WL, Macera CA, Bouchard C (1995). Physical activity and public health. A recommendation from the Centers for Disease Control and Prevention and the American College of Sports Medicine. JAMA 273, 402–407.
Polley BA, Wing RR, Sims CJ (2002). Randomized controlled trial to prevent excessive weight gain in pregnant women. Int J Obes 26, 1494–1502.
Rowland ML (1990). Self-reported weight and height. Am J Clin Nutr 52, 1125–1133.
Siega-Riz AM, Adair LS, Hobel CJ, Institute of Medicine (1994). Maternal weight gain recommendations and pregnancy outcome in a predominantly Hispanic population. Obstet Gynecol 84, 565–573.
Siega-Riz AM, Evenson KR, Dole N (2004). Pregnancy-related weight gain – a link to obesity? Nutr Rev 7, S105–S111.
Viisainen K (ed) (1999). Seulontatutkimukset ja yhteistyö äitiyshuollossa, suositukset 1999. Stakes oppaita, vol. 34. Jyväskylä: Gummerus (in Finnish).
We thank the PHNs in the MCs for their valuable work throughout the study. We are also grateful to Katriina Ojala for planning the group exercise sessions. This study was supported by Doctoral Programs in Public Health (DPPH), Finland, and by grants from the National Institutes of Health in the US (1 U54 CA00100971, 5 RO1 CA89950 to Riitta Luoto and Leena Hilakivi-Clarke) and the Ministry of Education and the Ministry of Social Affairs and Health in Finland.
Contributors: TIK: study design, intervention protocols (especially dietary counselling), acquisition of data, analysis and interpretation of data and preparation of paper. MP: study design, intervention protocols, statistical methodology, analysis and interpretation of data and preparation of paper. MA: study design, intervention protocols (especially physical activity counselling), acquisition of data interpretation of data and preparation of paper. MF: study design, intervention protocols, interpretation of data and preparation of paper. LH-C: obtained funding, study design, interpretation of data and preparation of paper. EW: study design, interpretation of data and preparation of paper. RL: principal investigator, obtained funding, study concept and design, intervention protocols, interpretation of data and preparation of paper.
About this article
Cite this article
Kinnunen, T., Pasanen, M., Aittasalo, M. et al. Preventing excessive weight gain during pregnancy – a controlled trial in primary health care. Eur J Clin Nutr 61, 884–891 (2007). https://doi.org/10.1038/sj.ejcn.1602602
- weight gain
- physical activity
A longitudinal study on the relationship between mother’s personality trait and eating behaviors, food intake, maternal weight gain during pregnancy and neonatal birth weight
Nutrition Journal (2020)
Smart Phone APP to Restore Optimal Weight (SPAROW): protocol for a randomised controlled trial for women with recent gestational diabetes
BMC Public Health (2019)
Nature Reviews Endocrinology (2019)
Journal of Technology in Behavioral Science (2018)
Informing the development and uptake of a weight management intervention for preconception: a mixed-methods investigation of patient and provider perceptions
BMC Obesity (2017)