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Childbearing increases the risk of weight gain and cardiometabolic disease. The reset hypothesis suggests that lactation has protective cardiometabolic effects in the mother. The hypothesis is based on observational studies and the possible interacting role of weight loss needs to be elucidated. To examine the individual and interaction effects of a breastfeeding promotion intervention (BPI) and dietary intervention for weight loss postpartum (Diet) on body weight and cardiometabolic risk factors at 6 mo postpartum. Pregnant women (n = 156) with a pre-pregnancy BMI of 25-35 kg/m2 were randomized to 4 groups in a 2x2 factorial design: BPI, Diet, both treatments or no treatment. BPI consisted of individual counseling by a lactation consultant during pregnancy, at childbirth, and thereafter monthly or more frequently based on individual needs. Diet was initiated at 11 wk postpartum. Body weight, body composition, waist- and hip circumference, markers of lipid and glucose metabolism and blood pressure were measured at 2 wk and 6 mo postpartum.We analyzed main and interaction effects using 2-way ANCOVA adjusted for baseline values. Among the participants attending both visits (n = 108), 99% practiced any breastfeeding at baseline and 97% at follow-up. The BPI did not affect rates of exclusive or partial breastfeeding, age at introduction of complementary foods or have main effects on body weight or cardiometabolic risk factors. There was a main effect of Diet reducing body weight, fat mass, fat-free mass, percent fat mass, waist- and hip circumference, fasting glucose and insulin (all p ≤ 0.03), with no interactions between the treatments. There were no effects of BPI on body weight or cardiometabolic risk factors at 6 mo postpartum. Diet caused weight loss and had favorable effects on risk factors for cardiovascular disease and type 2 diabetes. ClinicalTrials.gov (NCT03580057)
Øhman et al. (Tue,) studied this question.