***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 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 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 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 Objective To examine factors in early life ( up to age 5 years ) that are associated with objective ly measured physical activity in 11 - 12 year olds . Design Prospect i ve cohort study . Setting Avon longitudinal study of parents and children , United Kingdom . Participants Children aged 11 - 12 years from the Avon longitudinal study of parents and children . Main outcome measure  Physical activity levels in counts per minute ( cpm )  and  minutes of moderate to vigorous physical activity for seven days measured with a uniaxial actigraph accelerometer . Results Valid actigraph data , defined as at least three days of physical activity for at least 10 hours a day , were collected from 5451 children . Several factors were associated with physical activity at ages 11 - 12 years . Regression coefficients are compared with the baseline of “ none ” for categorical variables : maternal brisk walking during pregnancy ( regression coefficient 5.0 , 95 % confidence interval −8.5 to 18.5 ; cpm for < 1 h/wk and ≥2 h/wk of physical activity 17.7 , 5.3 to 30.1 ) , maternal swimming during pregnancy ( 21.5 , 10.9 to 32.1 and cpm for < 1 h/wk and ≥2 h/wk of physical activity 24.2 , 7.8 to 40.7 ) ,  parents ’ physical activity when the child was aged 21 months  ( 28.5 , 15.2 to 41.8 and cpm of physical activity for either parent active and both parents active 33.5 , 17.8 to 49.3 ) , and parity assessed during pregnancy ( 2.9 , −7.6 to 13.4 and cpm of physical activity for 1 and ≥2 parity 21.2 , 7.1 to 35.3 ) . Conclusions Few factors in early life predicted later physical activity in 11 - 12 year olds .  Parents ’ physical activity during pregnancy and early in the child ’s life showed a modest association with physical activity of the child at age 11 - 12 years , suggesting that active parents tend to raise active children . Helping parents to increase their physical activity therefore may promote children ’s activity 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 Excessive gestational weight gain has been shown to relate to high-postpartum weight retention and the development of overweight and obesity later in life . Because many women are concerned about the health of their babies during pregnancy and are in frequent contact with their healthcare providers , pregnancy may be an especially powerful " teachable moment " for the promotion of healthy eating and physical activity behaviors among women . Initial research suggests that helping women gain the recommended amount during pregnancy through healthy eating and physical activity could make a major contribution to the prevention of postpartum weight retention . However , more r and omized controlled trials with larger sample sizes are needed to identify the most effective and disseminable intervention . Providers have the potential to prevent high postpartum weight retention and future obesity by monitoring weight gain during pregnancy and giving appropriate advice about recommended amounts of gestational weight gain BACKGROUND : The Institute of Medicine ( IOM ) recommends that normal‐weight women ( BMI ( body mass index ) of 19.8–26.0 ) gain 25–35 lb ( 11.4–15.9 kg ) during pregnancy , and that overweight women ( BMI of 26.1–29.0 ) gain 15–25 lbs ( 6.8–11.4 kg ) . A significant number of normal‐weight women and an even greater proportion of overweight women exceed these guidelines , which increases postpartum weight retention and may contribute to the development of obesity . OBJECTIVE : To determine whether a stepped care , behavioral intervention will decrease the percentage of women who gain more than the IOM recommendation . DESIGN : R and omized controlled trial comparing a stepped-care behavioral intervention with usual care .  Women ( n=120 ) who had a BMI > 19.8 , age>18 and < 20 weeks gestation were recruited from a hospital-based clinic serving low-income women and r and omized by race and BMI category to the intervention or control group . The intervention group received education about weight gain , healthy eating , and exercise and individual graphs of their weight gain . Those exceeding weight gain goals were given more intensive intervention . Women were followed through pregnancy to their first postpartum clinic visit . The main outcome measure was weight gain during pregnancy categorized as above the IOM recommendations vs below or within the IOM recommendations . RESULTS : The intervention significantly decreased the percentage of normal-weight women who exceeded the IOM recommendations ( 33 vs 58 % , P<0.05 ) . There was a non-significant ( P=0.09 ) effect in the opposite direction among overweight women ( 59 % of intervention and 32 % of control gained more than recommended ) . Postpartum weight retention was strongly related to weight gain during pregnancy ( r=0.89 ) . CONCLUSIONS : The intervention reduced excessive weight gain during pregnancy among normal weight women Objective : The objective of this study was to examine the relationship of sociodemographic and psychosocial characteristics and exercise prior to pregnancy to change in  physical activity ( PA )  during pregnancy . Methods : This study was part of the Bassett Mothers ' Health Project ( BMHP ) , a prospect i ve cohort study of women who enrolled for prenatal care in the Bassett Healthcare system between November 7 , 1994 , and November 15 , 1996 . Six hundred twenty-two women met the eligibility criteria and were enrolled in the study . Sociodemographic and psychosocial characteristics and exercise behavior were assessed prenatally using the medical record and an anonymous mailed question naire . Staged linear regression analysis was used to predict change in physical activity with the psychosocial and sociodemographic characteristics as the independent variables and prepregnancy exercise frequency as a control variable . Results : Women who were older , more educated , and had higher household incomes were more likely to exercise prior to pregnancy ( p < .05 ) . Change in PA  after becoming pregnant was associated with prepregnancy exercise frequency ( p < .001 ) . Women who exercised frequently moderated their activity , while sedentary women maintained or increased their PA after becoming pregnant . Exercise self-efficacy ( the belief in one 's ability to exercise regularly ) and body mass index ( BMI ) were positive predictors of change in PA  ( p < .05 ) , while prepregnancy exercise frequency remained significant as a control variable . Conclusion : Interventions that aim to help women maintain or increase their  PA  during the perinatal period should be design ed to increase exercise self-efficacy OBJECTIVE To examine the feasibility of an individualized exercise program to prevent  gestational diabetes mellitus ( GDM ) in obese pregnant women . RESEARCH DESIGN 
    Output:
    
AND IMPLICATION S Physical activity interventions incorporating behaviour change techniques help reduce the decline in PA throughout pregnancy .
Range of behaviour change techniques can be implemented to reduce this decline including goals and planning , shaping knowledge and comparison of outcomes .