WASHINGTON -- A low-cost intervention promoting the benefits of walking helped Hispanic mothers return to their prepregnancy weight within 6 months of delivery, with many showing a net weight loss, researchers said here.
"The study showed that the moms not only walked more, but they walked more with the children, their baby, and their partner," Diana Ramos, MD, MPH, director of reproductive health at the Los Angeles County Department of Health and a co-author of the study, told MedPage Today in an interview at the National Hispanic Medical Association annual conference. "So the mom changes the whole tone of family activities."
The study, presented as a poster at the meeting, was led by the health department's Lonnie Resser, MPH.
In the U.S., 23% of total births are to Hispanic women and 51% of Hispanic women are overweight or obese before pregnancy, the authors noted in their poster. And in Los Angeles County, 58% of the approximately 133,000 births are to Hispanic women; overweight and obesity affects both the women and their children.
To see whether encouraging walking postpartum would help combat the problem, the investigators enrolled 39 women at 2 weeks postpartum. Participants received one weekly text message, as well as an online lesson promoting the benefits of walking, for 6 months. The lessons also included goals in terms of minutes to walk per day, while the text messages included both reminders and motivation. Participant progress was addressed with monthly questionnaires.
Prior to becoming pregnant, 56% of participants were obese or overweight; none were underweight.
The researchers accommodated both English- and Spanish-speakers in their study, with 56% of the texts and lessons in English, and 44% in Spanish.
At the end of 6 months, study participants had lost an average of 107.5% of the weight they had gained during their pregnancy, the researchers found (P<0.05). In addition, the percentage of participants walking an average of 30 minutes a day, 5 days a week rose from 41% at baseline to 65%, and 97% of participants said they planned to continue with the walks after the study concluded.
Initially, the program gave pedometers to the new mothers and tracked their steps, "but what ended up happening is that they lost the pedometer ... so it was just easier to track time," said Ramos. "So we did the average estimate of the number of steps a person takes in 15 minutes and just guesstimated [from there]."
The researchers also had to remind moms that walking inside the house also counted as walking, not just walking outside, she added.
The study is part of a larger effort by the health department -- known as Choose Health LA Moms -- to get more new mothers to do three things to promote health and weight loss: walk, breastfeed, and drink water, Ramos explained. That program includes text messages and education in all three areas.
"Normally if they're going to get back to their pre-pregnancy weight, it takes 2 years; our moms participating in the program got back to their pre-pregnancy weight in 12 weeks," she said.
The mothers who are immediately postpartum receive motivation and education on breastfeeding. "We encourage them, 'Yes, you have enough breast milk,' because many times moms think 'I don't have enough breast milk; the baby is crying' when it may not be that they're hungry, it may be gas or other issues," said Ramos.
The nice thing about the program -- which is free to participants -- is that all of the interventions are free or low-cost, she said. "If you think about it, the Affordable Care Act already pays for breastfeeding support; it pays for breast pumps and all the equipment needed, so it's something that is already available to them. Water is low-cost, and walking is low-cost too."
Women who do all three interventions are the most successful at losing weight, she said. The program did get some pushback from critics who pointed out that it requires a cellphone, "but if you look at all of the data, 95% of women who are less than 29 years old send about 108 text messages a day. This is how they communicate," she said. "And then they get all their information online."
The department would welcome anyone who wants to replicate the program elsewhere, she said. "We've had several states call us and say, 'How can we replicate your program? Because the outcomes are amazing.'"
The authors disclosed no relevant relationships with industry.
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