Table 1 Characteristics of 13 RCTs of postpartum nutrition, exercise and combined interventions

Nutrition and Exercise Interventions

Bertz, 2012, Sweden, in-person [30]

Intervention (I): 3 intervention arms and 1 control arm (D) dietary modifications reduce caloric intake by 500Kcal/day; (E): exercise only- exercise to achieve 45 min brisk walk 4d/week; (DE): combined diet and exercise; Control (C): Usual care

10-14 weeks postpartum; 12 weeks

63 lactating, overweight/obese primiparous; N = 68

33

Swedish

Good

Colleran, 2012,US, in-person [32]

Intervention (I): postpartum counseling on diet and exercise plus on-line resources; Control (C): Usual care + diet and nutrition print handouts

4-6 weeks;16 weeks

31 women, ≥23 years and < 37 years, singleton pregnancy

31

NR

Fair-to-good

(−5.8 ± 3.5 kg) (7%) compared with the C (−1.6 ± 5.4 kg) (3%) (P = 0.03).

Leermakers 1998, US, in-person [31]

Intervention (I): Correspondence lessons, group sessions and telephone follow-up Control (C): Usual care + informational brochure

8 mos; 6 mos

Non-lactating postpartum women; N = 90

31

3% non-white

Fair-to-good

O’Toole, 2003 US, in-person [36]

I: Structured diet + exercise with weekly in-person sessions x 12 wks, bi-weekly sessions x 8 wks, and monthly sessions up to 1-year

6 wks-6 mos; 6–10 mos

Postpartum women who were overweight or obese prior to pregnancy; N = 40

31

1 AA

Good

C: One in-person session followed by self-directed program

Craigie 2011, United Kingdom, in-person [28]

I: Information pamphlet + two face to face counseling sessions, with telephone follow-up for reinforcement and resources C: Information pamphlet

6-18 mos; 3 mos

Low income, overweight and obese postpartum women; N = 52

30

3 non-white participants

Fair

Huang, 2011, Taiwan, in-person [25]

I: Individualized dietary and physical activity plans, including 6 pregnancy sessions and 3 postpartum sessions C: Usual care

1 day; 6 mos

Pregnant and postpartum women Taiwanese women; 1 day postpartum; N = 189

32

Taiwanese

Fair-to-good

Lovelady 2000, US, in-person [37]

I: Caloric restriction and exercise intervention, including 4 exercise sessions, lasting 43 minutes with goal of 65-80% heart rate C: Usual care

5 wks; 2.5 mos

Overweight postpartum women with BMI 25–30 kg/m2, exclusively breastfeeding; N = 40

32

3.5% AA

Fair-to-good

Ostbye, 2009, US, in-person [29]

I: 8 healthy eating classes, 10 physical activity classes and 6 telephone counseling sessions over 9 mos. C: Usual care

2 mos; 9 mos

Overweight or obese postpartum women; N = 450

31

I: 45% AA

Good

C:45% AA

Davenport, 2011, US, in-person [33]

I: Diet + low intensity exercise

8 wks; 4 mos

Overweight or obese women who retained > 5 kg after delivery; N = 60

33

Intervention groups: 85-90% white

Fair-to-good

I: Diet + moderate intensity exercise

No AA

C: Historical controls matched for age, BMI, and parity

Other race: NR

Exercise-only Interventions

Zourladani, 2011, Greece [15]

I: Instructor led 1-hour exercise class with aerobic activity and strength training 3 times per wk for 12 wks.

4-6 wks; 3 mos

Primiparous postpartum women; N = 40

31

Greek

Fair

C: No intervention

Maturi, 2011, Iran [14]

Tailored pedometer-based walking program with baseline counseling session, cell phone and text reminders and telephone feedback; C: Usual Care

6wks-6mos; 3 mos

Lactating, normal or overweight postpartum women; N = 66

25

Iranian

Fair-to-poor

Dewey, 1994, US [34]

I: Individually tailored and supervised aerobic activity to achieve 60-70% heart rate reserve. 45 min-5 times a wk

6-8 wks; 3 mos

Exclusively breastfeeding postpartum women; N = 33

30

No AA

Fair-to-good

C: No intervention

Nutrition-only Interventions

Krummel, 2010, US [23]

I: Counseling with dietitian, and 10 facilitated discussion groups, monthly personalized feedback on self-monitoring records

30 wks; 12 mos

Postpartum women enrolled in WIC; N = 151

27

10% non-white;

Fair-to-poor

C: Self directed