***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 pilot , among women with gestational diabetes mellitus ( GDM ) , the feasibility of a prenatal/postpartum intervention to modify diet and physical activity similar to the Diabetes Prevention Program . The intervention was delivered by telephone , and support for breastfeeding was addressed . RESEARCH DESIGN AND METHODS The goal was to help women return to their prepregnancy weight , if it was normal , or achieve a 5 % reduction from prepregnancy weight if overweight . Eligible participants were identified shortly after a GDM diagnosis ; 83.8 % consented to be r and omly assigned to intervention or usual medical care ( 96 and 101 women , respectively ) . The retention was 85.2 % at 12 months postpartum . RESULTS The proportion of women who reached the postpartum weight goal was higher , although not statistically significant , in the intervention condition than among usual care ( 37.5 vs. 21.4 % , absolute difference 16.1 % , P = 0.07 ) . The intervention was more effective among women who did not exceed the recommended gestational weight gain ( difference in the proportion of women meeting the weight goals : 22.5 % , P = 0.04 ) . The intervention condition decreased dietary fat intake more than the usual care ( condition difference in the mean change in percent of calories from fat : −3.6 % , P = 0.002 ) and increased breastfeeding , although not significantly ( condition difference in proportion : 15.0 % , P = 0.09 ) . No differences in postpartum physical activity were observed between conditions . CONCLUSIONS This study suggests that a lifestyle intervention that starts during pregnancy and continues postpartum is feasible and may prevent pregnancy weight retention and help overweight women lose weight . Strategies to help postpartum women overcome barriers to increasing physical activity are needed Objectives . To compare a walking exercise to a stretching exercise during pregnancy in high-risk women who were sedentary and had previously experienced preeclampsia . Methods . A r and omized clinical trial of the effects of the two types of physical exercises was conducted between November 2001 and July 2006 in Washtenaw County , Michigan . Both groups engaged in the assigned exercise five times a week until the end of pregnancy . Results . Women were r and omized to either the walking group ( n = 41 ) or the stretching group ( n = 38 ) . The walkers exercised an average of 36 ( SD , 6 ) minutes at 18 weeks gestation , 34 ( SD , 7 ) minutes at 28 weeks gestation , and 31 ( SD , 12 ) minutes at the last week of the intervention . On average , they exercised within target heart rate ranges 35 % ( SD , 32 % ) at 18 weeks gestation , 22 % ( SD , 25 % ) at 28 weeks gestation , and 17 % ( SD , 25 % ) at the last week of the intervention . The stretching group engaged in stretching exercises following a 40-minutes videotape . On average , the walking group exercised 4 ( SD , 1 ) times a week at 18 weeks gestation , 4 ( SD , 1 ) time a week at 28 weeks gestation , and 3 ( SD , 1 ) times a week at the last week of the intervention . Equally on average , the stretching group exercised 4 ( SD , 2 ) times a week at 18 weeks gestation , 5 ( SD , 1 ) times a week at 28 weeks gestation , and 3 ( SD , 1 ) times a week at the last week of the intervention . No difference between groups was observed , but both exercised significantly less frequently over the time ( p < 0.0001 ) . Together , participants reported average 7,040 ( SD , 2,612 ) steps at the beginning and 5,711 ( SD , 2,739 ) steps at the end of the study . The walkers tracked an average 8,501 ( SE , 778 ) steps a day at 20 weeks gestation and 7,418 ( SE , 788 ) steps at 34 weeks gestation ( n.s . ) . The stretchers tracked an average 6,189 ( SE , 704 ) steps at 20 weeks gestation and 4,848 ( SE , 452 ) steps at 34 weeks gestation ( p < 0.05 ) . The incidence of preeclampsia was 14.6 % ( 95 % CI , 5.6 to 29.2 ) among the walkers and 2.6 % ( 95 % CI ; 0.07 to 13.8 ) among the stretchers . The incidence of gestational hypertension was 22 % ( 95 % C.I. , 8.7 to 35.2 ) for the walkers and 40 % ( 95 % CI , 23.2 to 55.8 ) for the stretchers . The mean transferrin level , an antioxidant marker , was significantly higher in the stretching group mean ( 412 mg/dL , 95%CI , 389 to 435 ) than the walkers at the time of labor ( mean = 368 mg/dL , 95%CI , 346 to 391 ) ( p < 0.05 ) . No significant group differences were observed in birth outcomes . Conclusion . Regular stretching exercises may promote endogenous antioxidants among women at risk for preeclampsia 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 Low-income , multi-ethnic women are at elevated risk for obesity and chronic diseases , yet influences at different levels may act as barriers to changing risk behaviors . Following the birth of a child , childrearing and social isolation can exacerbate these influences . The social ecological framework integrates behavior-change strategies at different levels , providing a strong theoretical base for developing interventions in this high-risk population . The primary purpose of this r and omized controlled trial is to test the efficacy of an educational model delivered by community-based paraprofessionals in improving diet , activity and weight loss  among new mothers over a 12-month postpartum period and a 6-month maintenance period . This model fosters institutional change to support behavior changes influenced at intrapersonal and interpersonal levels , through collaboration with federal programs for low-income families : the Special Supplemental Food Program for Women , Infants and Children ( WIC ) , and the Exp and ed Food and Nutrition Education Program ( EFNEP ) . Participants are r and omized to the Usual Care , e.g. WIC nutrition and breastfeeding education , or Enhanced EFNEP intervention arm , consisting of Usual WIC Care plus a sustained , multi-component intervention including home visits , group classes and monthly telephone counseling . If shown to be efficacious , this program will be readily sustainable through existing federal agencies Background : Sedentary mothers are important to reach with physical activity promotion . Purpose : This study pilot tested “ Moms on the Move ” a Transtheoretical Model (TTM)-derived physical activity ( PA ) intervention for low-income mothers enrolled in the Women , Infants , and Children ( WIC ) program . Method : Sedentary mothers ( N = 44 ) were r and omized to ( a ) Moms on the Move ( PA intervention ) or ( b ) counseling on self-breast examination ( control ) . Pre- and posttest measurement ( baseline and 2 weeks after the 8-week interventions ) included ( a ) stage of PA behavior change , ( b ) PA behavior , ( c ) selected TTM constructs , and ( d ) social support . Pre- and posidifference scores , chi-square , and one-way analyses of variance ( ANOVAs ) were used . Results : The experimental group progressed in stage of change more than control , x2(1 , N = 44)=20.50 , p < .001 . The experimental group had greater PA behavior : weekly minutes of PA , F(l , 42 ) = 46.85 , p < .001 ; daily energy expenditure ( EE ) , F(1 , 42 ) = 23.01,p < .001 ; and weekly moderate PA EE , F(1 , 42 ) = 32.63 , p < .001 . Experimental subgroup ( n = 11 ) step counts increased pre-post , t(l 0)=6.16,p7lt;. 001 . AnANOVA showed that the experimental group had greater improvements in all TTM constructs and social support , ps < .001 . Conclusions : WIC mothers are at risk for sedentary living and have not been targeted for  PA behavior change using a provider-counseled approach . Although further testing is needed , Moms on the Move appears to be efficacious The Internet has the potential for delivering innovative , interactive physical activity ( PA ) interventions to large numbers of people . This study was design ed to test the efficacy of an Internet intervention that consisted of a Web site plus 12 weekly e-mail tip sheets , compared with a waiting list control group . The Internet intervention was theory based and emphasized clear , graphical presentation of PA information . Sixty-five ( 30 intervention and 35 control ) sedentary adult employees of several large hospitals ( 9 men and 56 women ) were r and omly assigned to 1 of the 2 study arms . Of the 65 participants , 57 completed the 1-month follow-up , and 52 completed the 3-month follow-up . At both 1 and 3 months , those in the intervention group were significantly more likely to have progressed in stage of motivational readiness for PA than participants in the control group : 1 month , χ2(1 , N=52 ) = 4.05 , p > .05 ; 3 months , χ2(1 , N = 52 ) = 6.45 , p > .01 . We hypothesized that at 1 and 3 months , the intervention group would exhibit significant increases relative to the control group on the number of minutes of moderate activity . At the 1-month assessment , the intervention group did exhibit significant increases , relative to the control group in moderate minutes , F(1 , 54 ) = 5.79 , p > .05 ; however , at the 3-month assessment this difference was no longer significant . In addition , secondary analyses were conducted to examine total number of minutes of walking reported . At 1 month , the intervention group did exhibit significant increases , relative to the control group , in walking minutes , F(1 , 54 ) = 12.1 , p > .001 . At the 3-month assessment , amount of time spent in walking activity continued to be significantly higher for the intervention group compared with the control group , F(1 , 48 ) = 5.2 , p > .05 . These findings show that a theoretically based PA Web site and weekly e-mail tip sheets can have a short-term impact on PA motivation and behavior both at 1 and 3 months . As Internet access increases , and as b and with and other technical attributes of this medium improve , Web site delivered health behavior interventions will become increasingly useful in public health promotion Background Realizing the importance of regular physical activity , particularly in the prevention of chronic diseases and unhealthy weight gain , it is important to study how physical activity changes during and after pregnancy using prospect i ve study design s. The aim of this study was to describe the mode , duration , intensity , and changes in physical activity  during pregnancy through one year postpartum among a cohort of women . Methods This study was part of the third Pregnancy , Infection and Nutrition Postpartum Study at the University of North Carolina Hospitals . A cohort of 471 women was followed at 17 - 22 and 27 - 30 weeks ' gestation and at 3 and 12 months postpartum . The participants reported the  mode , frequency , duration , and intensity of all physical activities that increased their breathing and heart rate in the past week . Results Overall physical activity for the cohort decreased from 17 - 22 weeks to 27 - 30 weeks of gestation , but rebounded up at 3 months postpartum and remained stable at 12 months postpartum . The mean MET h/wk values for each time point were 24.7 ( st and ard deviation , SD 26.8 ) , 19.1 ( SD 18.9 ) ,  
    Output:
    
Although the interventions included a variety of strategies and techniques , none were uniquely associated with positive outcomes .
Overall , this review suggests that little is known about the efficacy of interventions for physical activity during pregnancy .