In the Journals Plus

Diabetes intervention plus home visits boosts weight loss in mothers with overweight, obesity

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April 11, 2018

Mothers with overweight or obesity assigned to a lifestyle intervention embedded in a home visitation program were more likely to achieve 5% weight loss vs. mothers assigned to standard home visits, according to trial results published in American Journal of Preventive Medicine.

“Pragmatic interventions embedded in home visiting organizations can enhance accessibility to lifestyle interventions and allow for ongoing contact and support for behavior change,” Debra Haire-Joshu, PhD, RN, the Joyce Wood professor at the Brown School, Washington University in St. Louis, and director of the Center for Diabetes Translation Research and the Center for Obesity Prevention and Policy Research, and colleagues wrote. “This also offers the opportunity to scale up effective interventions to maximize public health impact in preventing type 2 diabetes.”

Researchers analyzed data from 179 women with overweight or obesity aged 18 to 45 years with a minimum of one preschool-aged child participating in Parents as Teachers, a nationwide home visiting organization dedicated to educating families about child development before the child enters school. Researchers randomly assigned the women to either a usual care group (n = 97; mean baseline BMI 34.5 kg/m2) or an intervention group (n = 82; 34.4 kg/m2). The intervention group received the standard Parents as Teachers program with the addition of a lifestyle intervention program, Healthy Eating and Active Living Taught at Home, modeled on the Diabetes Prevention Program. Participants in both groups had similar baseline weight, waist circumference, blood pressure, diet and activity. Researchers measured participants’ weight at 12 and 24 months.

At 12 months, intervention participants lost a mean of 0.7 kg, whereas usual care participants gained a mean of 2.1 kg, for a between-group difference of 2.8 kg (P = .0006). By 24 months, the between-group difference grew to 4.7 kg, according to researchers. Furthermore, at 24 months, mothers assigned to the intervention group were more likely to achieve 5% weight loss vs. mothers assigned to usual care (26% vs. 11%; P = .01). Although usual care participants continued to gain weight, intervention participants maintained their weight loss (3.2 kg vs. –1.5 kg; P = .002).

“These results suggest an intervention that is low intensity, because it is embedded within the real-world practice of a parent education home visiting organization, can achieve clinically significant weight outcomes among overweight or obese women by 24 months,” the researchers wrote.

In a press release, Haire-Joshu said weight loss can seem like a daunting task.

“This is all about the prevention of weight gain,” Haire-Joshu said in the release. “Our end goal is to prevent diabetes, but framing the challenge as the prevention of weight gain can also be effective.” – by Melissa J. Webb

Disclosures: The authors report no relevant financial disclosures.