Texts sent to help pregnant women manage weight

Could a text message as direct as "Eat your veggies today?" help pregnant women control their weight gain?

To find out, nutritional sciences professor Christine Olson in the College of Human Ecology and colleagues are using a five-year, $4.6 million grant from the National Institutes of Health to study whether cell phone text messages and other electronic communication tools can help prevent pregnant women ages 18-35 from gaining excess weight.

Starting in February, they will recruit 3,500 Rochester-area pregnant women of different weight categories. The study will include the Web site, eMoms Roc, where mothers-to-be can track their weight gain during and after their pregnancies and access resources to help reach their goals.

"Pregnancy is a critical period for many women when it comes to maintaining a healthy weight," Olson said. "Gaining more than the recommended weight during pregnancy is strongly related to being heavier after having a baby. It also increases her child's risk of being overweight."

Olson and her collaborators -- communication professors Geri Gay and Jeff Niederdeppe, professor and statistician Robert Strawderman and University of Rochester researchers -- seek to nudge women at risk of surplus weight gain toward healthier behaviors. The women will receive periodic text messages and e-mail reminders to eat nutritious meals and exercise regularly to prevent gaining too much weight.

"Weight gain has a way of sneaking up on pregnant women, and after the baby comes, life is very busy," Olson said. "It can be hard to live a healthy lifestyle. Our goal is to provide the tools and information to make it easier and to do this 24/7 using electronic communication technologies."

The study builds on a successful behavioral intervention project that Olson led in Cooperstown, N.Y., a decade ago that used printed newsletters and postcards to reach out to pregnant women. It was especially effective at helping low-income mothers maintain a healthy weight.

Adding too many pounds during pregnancy -- and failing to shed the baby weight after the birth -- can predispose a woman to a lifetime of weight and health issues. Olson noted a Swedish study that found the effects of excessive weight gain in young pregnant women remained 15 years later.

Unfortunately, some women may follow the conventional wisdom that pregnancy is a time to discard their earlier healthy lifestyles, making it more difficult to manage their weight. "For years, women have been told that pregnancy is a time to eat for two and not pay attention to their weight," Olson said. "There is also this myth that pregnant women should abandon their exercise routines and take it easy. That's not the case, and these myths can set women up to gain too much."

The study is funded by the National Heart, Lung and Blood Institute and the National Institute of Child Health and Human Development.

Such national media outlets as The New York Times, Chicago Tribune and Baltimore Sun have lined up in the past year to talk with nutrition professor Kathy Rasmussen, one of the world's foremost experts of nutrition and weight loss during and after pregnancy.

Rasmussen has conducted some of the most far-reaching reviews of clinical data on weight gain during pregnancy, postpartum weight loss and breastfeeding, including a study of 35,000 Danish women that found that the more a mother breastfeeds, the less weight she retains six months after birth. And Rasmussen chaired the U.S. Institute of Medicine's committee on weight gain during pregnancy, which published the new report in 2009 "Weight Gain During Pregnancy: Reexamining the Guidelines."

In the report, Rasmussen and her colleagues found that how much weight women gain during pregnancy and their starting weight at conception can affect their health and that of their babies. The new guidelines add a recommendation for obese women (based on their body mass index) that limits their gain to 11 to 20 pounds during pregnancy. Guidelines for normal-weight women are to gain 25 to 35 pounds during pregnancy.

"We're concerned with the mother and the infant because they are both affected by the mother's weight gain during pregnancy," Rasmussen said. "One of the challenges is how to encourage women to follow these guidelines."

Ted Boscia is assistant director of communications at the College of Human Ecology.

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