***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: Background Postnatal women ( < 12 months postpartum ) are at increased risk of physical inactivity . Purpose To evaluate the efficacy and feasibility of a theory-based physical activity ( PA ) intervention delivered to postnatal women primarily via mobile telephone short message service ( SMS ) . Methods Eighty-eight women were r and omized to the intervention ( n = 45 ) or minimal contact control ( n = 43 ) condition . The 12-week intervention consisted of a face-to-face PA goal - setting consultation , a goal - setting magnet , three to five personally tailored SMS/week and a nominated support person who received two SMS per week . SMS content targeted constructs of social cognitive theory . Frequency ( days/week ) and duration ( min/week ) of PA participation and walking for exercise  were assessed via self-report at baseline , 6 and 13 weeks . Results Intervention participants increased PA frequency by 1.82 days/week ( SE ± 0.18 ) by 13 weeks ( F(2,85 ) = 4.46 , p = 0.038 ) and walking for exercise frequency by 1.08 days/week ( SE ± 0.24 ) by 13 weeks ( F(2,85 ) = 5.38 , p = 0.02 ) . Positive trends were observed for duration ( min/week ) of PA and walking for exercise . Conclusions Intervention exposure result ed in increased frequency of PA and walking for exercise in postnatal women Background Recent studies have shown the potential of Web-based interventions for changing dietary and physical activity ( PA ) behavior . However , the pathways of these changes are not clear . In addition , nonusage poses a threat to these interventions . Little is known of characteristics of participants that predict usage . Objective In this study we investigated the users and effect of the Healthy Weight Assistant ( HWA )  , a Web-based intervention aim ed at healthy dietary and PA behavior . We investigated the value of a proposed framework ( including social and economic factors , condition-related factors , patient-related factors , reasons for use , and satisfaction ) to predict which participants are users and which participants are nonusers . Additionally , we investigated the effectiveness of the HWA on the primary outcomes , self-reported dietary and physical activity behavior . Methods Our design was a two-armed r and omized controlled trial that compared the HWA with a waiting list control condition . A total of 150 participants were allocated to the waiting list group , and 147 participants were allocated to the intervention group .  Online question naires were filled out before the intervention period started and after the intervention period of 12 weeks . After the intervention period , respondents in the waiting list group could use the intervention . Objective usage data was obtained from the application itself . Results In the intervention group , 64 % ( 81/147 ) of respondents used the HWA at least once and were categorized as “ users . ” Of these , 49 % ( 40/81 ) used the application only once . Increased age and not having a chronic condition increased the odds of having used the HWA ( age : beta = 0.04 , P = .02 ; chronic condition : beta = 2.24 , P = .003 ) . Within the intervention group , users scored better on dietary behavior and on knowledge about healthy behavior than nonusers ( self-reported diet : χ2 2 = 8.4 , P = .02 ; knowledge : F1,125 = 4.194 , P = .04 ) . Furthermore , users underestimated their behavior more often than nonusers , and nonusers overestimated their behavior more often than users ( insight into dietary behavior : χ2 2 = 8.2 , P = .02 ) . Intention-to-treat analyses showed no meaningful significant effects of the intervention . Exploratory analyses of differences between pretest and posttest scores of users , nonusers , and the control group showed that on dietary behavior only the nonusers significantly improved ( effect size r = −.23 , P = .03 ) , while on physical activity behavior only the users significantly improved ( effect size r = −.17 , P = .03 ) . Conclusions Respondents did not use the application as intended . From the proposed framework , a social and economic factor ( age ) and a condition-related factor ( chronic condition ) predicted usage . Moreover , users were healthier and more knowledgeable about healthy behavior than nonusers . We found no apparent effects of the intervention , although exploratory analyses showed that choosing to use or not to use the intervention led to different outcomes . Combined with the differences between groups at baseline , this seems to imply that these groups are truly different and should be treated as separate entities . Trial registration Trial ID number : IS RCT N42687923 ; http://www.controlled-trials.com/IS RCT N42687923/ ( Archived by WebCite at http://www.webcitation.org/5xnGmvQ9Y The aim of this study was to evaluate dietary changes during and after a dietary treatment shown to result in significant and sustained weight loss  among lactating overweight and obese women . This is crucial before clinical implementation . Data were collected from the LEVA ( in Swedish : Livsstil för Effektiv Viktminskning under Amning [ Lifestyle for Effective Weight Loss During Lactation ] ) r and omized controlled factorial trial with a 12-week intervention and a 1-year follow up . At 10 to 14 weeks postpartum , 68 lactating Swedish women with a prepregnancy body mass index ( calculated as kg/m(2 ) ) of 25 to 35 were r and omized to structured dietary treatment , physical exercise treatment , combined treatment , or usual care ( controls ) for a 12-week intervention , with a 1-year follow-up . Dietary intake was assessed with 4-day weighed dietary records .  Recruitment took place between 2007 and 2010 . The main outcome measures were changes in macro- and micronutrient intake from baseline to 12 weeks and 1 year . Main and interaction effects of the treatments were analyzed by a 2 × 2 factorial approach using a General Linear Model adjusted for relevant covariates ( baseline intake and estimated underreporting ) . It was found that at baseline , the women had an intake of fat and sucrose above , and an intake of total carbohydrates and fiber below , recommended levels . At 12 weeks and 1 year , the dietary treatment led to reduced intake of energy ( P<0.001 and P=0.005 , respectively ) , fat ( both P values < 0.001 ) , and sucrose ( P<0.001 and P=0.050 ) . At 12 weeks , total carbohydrates were reduced ( P<0.001 ) . A majority of women in all groups reported low intakes of vitamin D , folate , and /or iron . In conclusion , a novel dietary treatment led to reduced intake of fat and carbohydrates . Diet composition changed to decreased proportions of fat and sucrose , and increased proportions of complex carbohydrates , protein and fiber . Weight loss through dietary treatment was achieved with a diet in line with macronutrient recommendations Background Weight gain during the childbearing years and failure to lose pregnancy weight after birth contribute to the development of obesity in postpartum Latinas . Methods Madres para la Salud [ Mothers for Health ] was a 12-month , r and omized controlled trial exploring a social support intervention with moderate-intensity physical activity ( PA ) seeking to effect changes in body fat , fat tissue inflammation , and depression symptoms in sedentary postpartum Latinas . This report describes the efficacy of the Madres intervention . Results The results show that while social support increased during the active intervention delivery , it declined to pre-intervention levels by the end of the intervention . There were significant achievements in aerobic and total steps across the 12 months of the intervention , and declines in body adiposity assessed with bioelectric impedance . Conclusions Social support from family and friends mediated increases in aerobic PA result ing in decrease in percent body fat . Trial registration Clinical Trials.gov Identifier : NCT01908959 OBJECTIVE To examine the feasibility , acceptability , and initial efficacy of a  technology-based weight loss intervention for urban , low-income mothers . METHODS Eighteen obese , ethnic minority , socioeconomically disadvantaged mothers in the first year after childbirth were r and omly assigned to either : 1 ) technology-based intervention , which included empirically supported behavior-change strategies , daily skills , and self-monitoring text messages with personalized feedback , biweekly counseling calls from a health coach , and access to a Facebook support group , or 2 ) usual-care control . RESULTS After 14 weeks of treatment , the technology-based intervention participants had significantly greater weight loss ( -2.9 ± 3.6 kg ) than usual care ( 0.5 ± 2.3 kg ; adjusted mean difference : -3.2 kg , 95 % confidence interval -6.2 to -0.1 kg , P = .04 ) . One-third of intervention participants ( 3 of 9 ) and no control participants lost > 5 % of their initial body weight at follow up . CONCLUSIONS AND IMPLICATION S Results suggest the potential for using technology to deliver a postpartum weight loss intervention among low-income racial/ethnic minorities OBJECTIVE Optimizing gestational weight gain ( GWG ) in early pregnancy is of clinical and public health importance , especially in higher risk pregnancies . DESIGN AND METHODS In a robustly design ed , r and omized controlled trial , 228 pregnant women at risk of developing gestational diabetes mellitus ( GDM ) were allocated to either control ( written health information only ) or intervention ( four-session lifestyle program ) . All women received st and ard maternal care . Measures were completed at 12 - 15 and 26 - 28 weeks gestation . Measures included anthropometrics ( weight and height ) , physical activity ( pedometer and International Physical Activity Question naire ) , question naires ( risk perception ) , and GDM screening . RESULTS The mean ( SD ) age [ 31.7 ( 4.5 ) and 32.4 ( 4.7 ) years ] and body mass index [ BMI ; 30.3 ( 5.9 ) and 30.4 ( 5.6 ) kg/m(2 ) ] were similar between control and intervention groups , respectively . By 28 weeks , GWG was significantly different between control and intervention groups [ 6.9 ( 3.3 ) vs. 6.0 ( 2.8 ) kg , P < 0.05 ] . When stratified according to baseline BMI , overweight women in the control group gained significantly more weight compared to overweight women in the intervention group [ 7.8 ( 3.4 ) vs. 6.0 ( 2.2 ) kg , P < 0.05 ] , yet in obese women , GWG was similar in both groups . Physical activity levels declined by 28 weeks gestation overall ( P < 0.01 ) ; however , the intervention group retained a 20 % higher step count compared to controls [ 5,203 ( 3,368 ) vs. 4,140 ( 2,420 ) steps/day , P < 0.05 ] . Overall , GDM prevalence was 22.8 % [ Corrected ] , with a trend toward less cases in the intervention group ( P = 0.1 ) . CONCLUSIONS Results indicate that a low-intensity lifestyle intervention , integrated with antenatal care , optimizes healthy GWG and attenuates physical activity decline in early pregnancy . Efficacy in limiting weight gain was greatest in overweight women and in high-risk ethnically diverse women OBJECTIVE To determine if an interactive , computerized Video Doctor counseling tool improves self-reported diet and exercise in pregnant women . METHODS A r and omized trial comparing a Video Doctor intervention to usual care in ethnically diverse , low-income , English-speaking pregnant women was conducted . Brief messages about diet , exercise , and weight gain were delivered by an actor-portrayed Video Doctor twice during pregnancy . RESULTS In the  Video Doctor group ( n=158 ) , there were statistically significant increases from baseline in exercise ( + 28 min ) , intake of fruits and vegetables , whole grains , fish , avocado and nuts , and significant decreases in intake of sugary foods , refined grains , high fat meats , fried foods , solid fats , and fast food . In contrast , there were no changes from baseline for any of these outcomes in the usual care group ( n=163 ) . Nutrition knowledge improved significantly over time in both groups but more so in the Video Doctor group . Clinician-patient discussion s about these topics occurred significantly more frequently in the Video Doctor group . There was no difference in weight gain between groups . CONCLUSION A brief Video Doctor intervention can improve exercise and dietary behaviors in pregnant women . PRACTICE IMPLICATION S The Video Doctor can be integrated into prenatal care to assist clinicians with effective diet and exercise counseling BACKGROUND Behavioural interventions might improve clinical outcomes in pregnant women who are obese . We aim ed to investigate whether a complex intervention addressing diet and physical activity could reduce the incidence of gestational diabetes and large-for-gestational-age infants . METHODS The UK Pregnancies Better Eating and Activity Trial ( UPBEAT ) is a r and omised controlled trial done at antenatal clinics in eight hospitals in multi-ethnic , inner-city locations in the UK . We recruited pregnant women ( 15 - 18 weeks plus 6 days of gestation ) older than 16 years who were obese ( BMI ≥30 kg/m(2 ) ) . We r and omly assigned participants to either a behavioural intervention or st and ard antenatal care with an internet-based , computer-generated , r and omisation procedure , minimising by age , ethnic origin , centre , BMI , and par 
    Output:
    
The meta-analyses demonstrated a significant result for limiting gestational weight gain , losing postnatal weight in 1 - 2 months , increasing self-reported moderate and vigorous physical activity and reducing caloric intake using diet-related software .
Our review shows that an e-based lifestyle intervention is an acceptable approach .