***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE to examine the effect of individual counselling on diet and physical activity from pregnancy to six months post partum , or from birth to six months post partum , on weight retention among Taiwanese women . DESIGN a r and omised controlled trial assigned participants to two experimental groups [ from pregnancy to six months post partum ( EP ) and from birth to six months post partum ( EPP ) ] and one comparison group . SETTING a 3900-bed medical centre in northern Taiwan with around 3000 births annually . PARTICIPANTS a sample of 189 women who had regular check-ups during pregnancy and gave birth at the medical centre . INTERVENTIONS the comparison group received the routine outpatient department obstetric educational programme . The EP group attended regularly scheduled clinic visits with individualised dietary and physical activity education plans from 16 gestational weeks to six months post partum , and received on brochure . The EPP group received the same educational intervention as the EP group from 24 - 48 hours after birth to six months post partum . MEASUREMENTS body weight , body mass index , health-promoting behaviour and psycho-social variables ( self-efficacy , body image , depression and social support ) . FINDINGS average gestational weight gain was 14.02 , 15.27 and 16.22 kg in the three EP , EPP and comparison groups respectively , and average weight retention at six months post partum was 2.34 , 4.06 and 5.08 kg in the three groups , respectively . KEY CONCLUSIONS a diet and physical activity intervention from pregnancy is effective for reducing post-pregnancy weight retention . IMPLICATION S FOR PRACTICE the findings of the present study should be taken into consideration when incorporating significant others and weight-loss maintenance strategies with interventions for a healthier family lifestyle Background To evaluate the effectiveness and safety of water aerobics during pregnancy . Methods A r and omized controlled trial carried out in 71 low-risk sedentary pregnant women , r and omly allocated to water aerobics or no physical exercise .  Maternal body composition and perinatal outcomes were evaluated . For statistical analysis Chi-square , Fisher 's or Student 's t-tests were applied . Risk ratios and their 95 % CI were estimated for main outcomes . Body composition was evaluated across time using MANOVA or Friedman multiple analysis . Results There were no significant differences between the groups regarding maternal weight gain , BMI or percentage of body fat during pregnancy . Incidence of preterm births ( RR = 0.84 ; 95%CI:0.28–2.53 ) , vaginal births ( RR = 1.24 ; 95%CI:0.73–2.09 ) , low birthweight ( RR = 1.30 ; 95%CI:0.61–2.79 ) and adequate weight for gestational age ( RR = 1.50 ; 95%CI:0.65–3.48 ) were also not significantly different between groups . There were no significant differences in systolic and diastolic blood pressure and heart rate between before and immediately after the water aerobics session . Conclusion Water aerobics for sedentary pregnant women proved to be safe and was not associated with any alteration in maternal body composition , type of delivery , preterm birth rate , neonatal well-being or weight Optimal strategies to prevent progression towards overt diabetes in women with recent gestational diabetes remain ill defined . We report a pilot study of a convenient , home based exercise program with telephone support , suited to the early post-partum period . Twenty eight women with recent gestational diabetes were enrolled at six weeks post-partum into a 12 week r and omised controlled trial of Usual Care ( n = 13 ) versus Supported Care ( individualised exercise program with regular telephone support ; n = 15 ) . Baseline characteristics ( Mean ± SD ) were : Age 33 ± 4 years ; Weight 80 ± 20 kg and Body Mass Index ( BMI ) 30.0 ± 9.7 kg/m2 . The primary outcome , planned physical activity { Median ( Range ) } , increased by 60 ( 0–540 ) mins/week in the SC group versus 0 ( 0–580 ) mins/week in the UC group ( P = 0.234 ) . Walking was the predominant physical activity . Body weight , BMI , waist circumference , % body fat , fasting glucose and insulin did not change significantly over time in either group . This intervention design ed to increase physical activity  in post-partum women with previous gestational diabetes proved feasible . However , no measurable improvement in metabolic or biometric parameters was observed over a three month period Pregnant women at risk for preeclampsia may benefit from the positive effects of exercise , but they may be unlikely to adhere to an exercise program . A r and omized trial was conducted with 124 sedentary pregnant women to compare the effects of walking exercise to a stretching exercise on adherence and on the preeclampsia risk factors of heart rate ( HR ) , blood pressure , and weight gain .  Walkers exercised less than stretchers both overall and as pregnancy advanced . HR and blood pressure were lower among stretchers than walkers , but weight gain did not differ between the groups . For sedentary pregnant women , a stretching exercise may be more effective than walking in mitigating the risk of preeclampsia due to higher adherence and possible cardiac-physiologic effects Please cite this paper as : Hui A , Back L , Ludwig S , Gardiner P , Sevenhuysen G , Dean H , Sellers E , McGavock J , Morris M , Bruce S , Murray R , Shen G. Lifestyle intervention on diet and exercise reduced excessive gestational weight gain in pregnant women under a r and omised controlled trial . BJOG 2012;119:70–77 AIM The significant deterioration of insulin sensitivity and glucose tolerance during pregnancy can have serious health implication s for both the pregnant woman and her baby . Although it is well established that regular exercise benefits insulin sensitivity in the nonpregnant population , the effect on glucose tolerance in obese pregnant women is not known . The purpose of this study was to investigate the effect of a supervised 10-week , home-based , exercise programme , beginning at week 18 of gestation , on glucose tolerance and aerobic fitness in previously sedentary obese women . METHODS Twelve sedentary obese women were r and omized into an exercise ( EX ; n=6 ) or control ( CON ; n=6 ) group at 18 weeks of gestation . Those r and omized to EX engaged in 10 weeks of supervised home-based exercise ( three sessions a week of stationary cycling ) , while those in the CON group maintained their usual daily activity . Their glucose and insulin responses to an oral glucose tolerance test ( OGTT ) , as well as their aerobic fitness , were assessed both pre- and postintervention . RESULTS Reduced glucose tolerance in the CON , but not EX , group was indicated by a tendency postintervention towards higher blood glucose levels at 1h of the OGTT ( P=0.072 ) . Furthermore , at 2h of the postintervention OGTT , blood glucose tended to remain elevated from baseline in the CON ( P=0.077 ) . There was also a trend towards increased fitness in the EX ( P=0.064 ) , but not the CON group . CONCLUSION Regular aerobic exercise begun during pregnancy may have favourable effects on glucose tolerance and fitness in obese women , and warrants further investigation in a larger sample population Flaws in the design , conduct , analysis , and reporting of r and omised trials can cause the effect of an intervention to be underestimated or overestimated . The Cochrane Collaboration ’s tool for assessing risk of bias aims to make the process clearer and more OBJECTIVE This paper describes the design and findings of a pilot Mothers In Motion ( P-MIM ) program . DESIGN A r and omized controlled trial that collected data via telephone interviews and finger stick at 3 time points : baseline and 2 and 8 months post-intervention . SETTING Three Special Supplemental Nutrition Program for Women , Infants , and Children ( WIC ) sites in southern Michigan . PARTICIPANTS One hundred and twenty nine overweight and obese African-American and white mothers , 18 - 34 years old . INTERVENTION The 10-week , theory-based , culturally sensitive intervention messages were delivered via a series of 5 chapters on a DVD and complemented by 5 peer support group teleconferences . MAIN OUTCOME MEASURES Dietary fat , fruit , and vegetable intake ; physical activity ; stress ; feelings ; body weight ; and blood glucose . ANALYSIS General linear mixed model was applied to assess treatment effects across 2 and 8 months post-intervention . RESULTS No significant effect sizes were found in primary and secondary outcome variables at 2 and 8 months post-intervention . However , changes in body weight and blood glucose showed apparent trends consistent with the study 's hypotheses . CONCLUSIONS AND IMPLICATION S The P-MIM showed promise for preventing weight gain in low-income overweight and obese women . However , a larger experimental trial is warranted to determine the effectiveness of this intervention Objective : We examined the effect of light intensity resistance exercise training performed during the second and third trimester of pregnancy on the  newborn 's birth size . We also studied the association between  maternal body weight prior to pregnancy and newborn 's birth size .  Design : R and omised controlled trial . Subjects : We r and omly assigned 160 sedentary gravidae to either a training ( n=80 ) or a control ( n=80 ) group . The training programme focused on light resistance and toning exercises ( three times per week , 35–40 min per session ) . We recorded the Apgar score , birth weight , birth length , and head circumference of the newborn , as well as gestational age at time of delivery from hospital perinatal records . We also measured maternal weight and height before parity and gestational weight gain . Results : Maternal characteristics neither differed between groups ( all P>0.1 ) nor newborn characteristics ( all P>0.1 ) . Maternal body weight was positively and significantly associated with newborn 's birth weight and length only in the control group ( β=19.20 and 0.065 , respectively , P<0.01 ) . Conclusion : Light intensity resistance training performed over the second and third trimester of pregnancy does not have a negative impact on the newborn 's body size or overall health . Exercise interventions might attenuate the adverse consequences of maternal body weight before pregnancy on the newborn 's birth size OBJECTIVE This study examines the effects of circuit-type resistance training on the need for insulin in women with gestational diabetes mellitus . STUDY DESIGN Thirty-two patients with gestational diabetes mellitus were r and omly assigned either to a group that was treated with diet alone or to a group that was treated with diet plus resistance exercise . RESULTS The number of women whose condition required insulin therapy was the same , regardless of treatment . However , a subgroup analysis that examined only overweight women ( prepregnant body mass index , > 25 kg/m(2 ) ) showed a lower incidence of insulin use in the diet-plus-exercise group ( P<.05 ) . Women in the diet-plus-exercise group were prescribed less insulin ( P<.05 ) and showed a longer delay from diagnosis to the initiation of insulin therapy ( P<.05 ) , compared with the diet-alone group . CONCLUSION Resistance exercise training may help to avoid insulin therapy for overweight women with gestational diabetes mellitus BACKGROUND Maternal obesity and excessive gestational weight gain ( GWG ) are major short- and long-term risk factors for maternal and fetal complications . OBJECTIVE The objective was to study whether a lifestyle intervention based on a brochure or on active education can improve dietary habits , increase physical activity ( PA ) , and reduce GWG in obese pregnant women . DESIGN In this r and omized controlled trial , 195 white , obese pregnant women [ age : 29 + or - 4 y ; body mass index ( in kg/m(2 ) ) ; 33.6 + or - 4.2 ] were r and omly assigned into 3 groups : a group that received nutritional advice from a brochure , a group that received the brochure and lifestyle education by a nutritionist , and a control group . Nutritional habits  were evaluated every trimester through 7-d food records . PA was evaluated with the Baecke question naire . RESULTS Energy intake did not change during pregnancy and was comparable in all groups . Fat intake , specifically saturated fat intake , decreased and protein intake increased from the first to the third trimester in the passive and active groups compared with an opposite change in the control group . Calcium intake and vegetable consumption increased during pregnancy in all groups . PA decreased in all groups , especially in the third trimester . No significant differences in GWG and obstetrical or neonatal outcome could be observed between the groups . CONCLUSIONS Both lifestyle interventions improved the nutritional habits of obese women during pregnancy . Neither PA nor GWG was affected Objective : To evaluate the effects of aerobic training on submaximal cardiorespiratory capacity in overweight pregnant women . Methods : We conducted a r and omized clinical trial in a referral center prenatal clinic during the period 2000–2002 . Of 132 overweight ( body mass index 26–31 kg/m2 ) but otherwise healthy volunteers , at 20 years of age or older , with gestational age of 20 weeks or less , and without diabetes or hypertension , 92 consented to participate and were r and omized . Intervention consisted of 3 one-hour aerobic exercise sessions per week ; the control group received weekly relaxation and focus group discussion s. The main outcome measure 
    Output:
    
Overall , we found that PA interventions were effective for OW/OB pregnant as well as postpartum women .
In the subgroup analyses by PA intervention types , supervised PA plus diet interventions were the most effective .
CONCLUSIONS PA plus diet interventions may require more than advice ; supervised PA programs or personalized prescription/ goals are needed to prevent excessive weight gain for OW/OB pregnant women and excessive weight retention for OW/OB postpartum women