human
***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 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 Promotoras from the communities in which interventions are implemented can be effective contributors to validity and fidelity efforts . This article describes a 48-week r and omized controlled trial Madres para la Salud ( Mothers for Health ) and illustrates the use of promotoras as collaborative members of the research team to contribute to attaining integrative validity and treatment fidelity . Madres para la Salud implements a culturally tailored physical activity program to effect changes in body fat , systemic and fat tissue inflammation , and depression symptoms . The significance of Madres para la Salud treatment validity and fidelity processes includes cultural tailoring of a social support intervention , and a promotora model to incorporate initial and ongoing fidelity monitoring Background Mother 's physical activity levels are relatively low , while their energy consumption is generally high result ing in 58 % of Australian women over the age of 18 years being overweight or obese . This study aims to confirm if a low-cost , accessible playgroup based intervention program can improve the dietary and physical activity behaviours of mothers with young children . Methods / Design The current study is a r and omized controlled trial lifestyle ( nutrition and physical activity ) intervention for mothers with children aged between 0 to 5 years attending playgroups in Perth , Western Australia . Nine-hundred participants will be recruited and r and omly assigned to the intervention ( n = 450 ) and control ( n = 450 ) groups . The study is based on the Social Cognitive Theory ( SCT ) and the Transtheoretical Model ( TTM ) , and the Precede-Proceed Framework incorporating goal setting , motivational interviewing , social support and self-efficacy . The six month intervention will include multiple strategies and re sources to ensure the engagement and retention of participants . The main strategy is home based and will include a specially design ed booklet with dietary and physical activity information , a muscle strength and flexibility exercise chart , a nutrition label reading shopping list and menu planner . The home based strategy will be supported by face-to-face dietary and physical activity workshops in the playgroup setting , posted and emailed bi-monthly newsletters , and monthly Short Message Service ( SMS ) reminders via mobile phones . Participants in the control group receive no intervention material s. Outcome measures will be assessed using data that will be collected at baseline , six months and 12 months from participants in the control and intervention groups . Discussion This trial will add to the evidence base on the recruitment , retention and the impact of community based dietary and physical activity interventions for mothers with young children . Trial Registration Australian and New Zeal and Clinical Trials Registry 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 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 : 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 BACKGROUND Limiting postpartum weight retention is important for preventing adult obesity , but the effect of weight loss on lactation has not been studied adequately . OBJECTIVE We evaluated whether weight loss by dieting , with or without aerobic exercise , adversely affects lactation performance . DESIGN At 12+/-4 wk postpartum , exclusively breast-feeding women were r and omly assigned for 11 d to a diet group ( 35 % energy deficit ; n = 22 ) , a diet plus exercise group ( 35 % net energy deficit ; n = 22 ) , or a control group ( n = 23 ) . Milk volume , composition , and energy output ; maternal weight , body composition , and plasma prolactin concentration ; and infant weight were measured before and after the intervention . RESULTS Weight loss averaged 1.9 , 1.6 , and 0.2 kg in the diet , diet + exercise , and control groups , respectively ( P < 0.0001 ) and was composed of 67 % fat in the diet group and nearly 100 % fat in the diet + exercise group . Change in milk volume , composition , and energy output and infant weight did not differ significantly among groups . However , there was a significant interaction between group and baseline percentage body fat : in the diet group only , milk energy output increased in fatter women and decreased in leaner women . The plasma prolactin concentration was higher in the diet and diet + exercise groups than in the control group . CONCLUSIONS Short-term weight loss ( approximately 1 kg/wk ) through a combination of dieting and aerobic exercise appears safe for breast-feeding mothers and is preferable to weight loss achieved primarily by dieting because the latter reduces maternal lean body mass . Longer-term studies are needed to confirm these findings To assess the feasibility of a pediatric primary care based intervention to promote healthful behaviors among 0–6 month old infants and their mothers . We enrolled  two intervention practice s ( 60 mother-infant pairs ) and one usual care control practice ( 24 pairs ) in a non-r and omized controlled trial . We completed visits and interviews with 80 ( 95 % ) pairs at birth and 6 months . The intervention included ( 1 ) brief focused negotiation by pediatricians , ( 2 ) motivational counseling by a health educator , and ( 3 ) group parenting workshops . We evaluated the intervention effects on infant feeding , sleep duration , TV viewing , and mothers ’ responsiveness to satiety cues . Maternal behavioral targets included postpartum diet , physical activity , TV and sleep . At 6 months , fewer intervention than control infants had been introduced to solid foods ( 57 % vs. 82 % ; P = 0.04 ) , and intervention infants viewed less TV ( mean 1.2 vs. 1.5 h/d ; P = 0.07 ) . Compared to control infants , intervention infants had larger increases in their nocturnal sleep duration from baseline to follow up ( mean increase 1.9 vs. 1.3 h/d ; P = 0.05 ) ; larger reductions in settling time ( mean reduction −0.70 vs. −0.10 h 
    Output:
    
agent
***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 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 Promotoras from the communities in which interventions are implemented can be effective contributors to validity and fidelity efforts . This article describes a 48-week r and omized controlled trial Madres para la Salud ( Mothers for Health ) and illustrates the use of promotoras as collaborative members of the research team to contribute to attaining integrative validity and treatment fidelity . Madres para la Salud implements a culturally tailored physical activity program to effect changes in body fat , systemic and fat tissue inflammation , and depression symptoms . The significance of Madres para la Salud treatment validity and fidelity processes includes cultural tailoring of a social support intervention , and a promotora model to incorporate initial and ongoing fidelity monitoring Background Mother 's physical activity levels are relatively low , while their energy consumption is generally high result ing in 58 % of Australian women over the age of 18 years being overweight or obese . This study aims to confirm if a low-cost , accessible playgroup based intervention program can improve the dietary and physical activity behaviours of mothers with young children . Methods / Design The current study is a r and omized controlled trial lifestyle ( nutrition and physical activity ) intervention for mothers with children aged between 0 to 5 years attending playgroups in Perth , Western Australia . Nine-hundred participants will be recruited and r and omly assigned to the intervention ( n = 450 ) and control ( n = 450 ) groups . The study is based on the Social Cognitive Theory ( SCT ) and the Transtheoretical Model ( TTM ) , and the Precede-Proceed Framework incorporating goal setting , motivational interviewing , social support and self-efficacy . The six month intervention will include multiple strategies and re sources to ensure the engagement and retention of participants . The main strategy is home based and will include a specially design ed booklet with dietary and physical activity information , a muscle strength and flexibility exercise chart , a nutrition label reading shopping list and menu planner . The home based strategy will be supported by face-to-face dietary and physical activity workshops in the playgroup setting , posted and emailed bi-monthly newsletters , and monthly Short Message Service ( SMS ) reminders via mobile phones . Participants in the control group receive no intervention material s. Outcome measures will be assessed using data that will be collected at baseline , six months and 12 months from participants in the control and intervention groups . Discussion This trial will add to the evidence base on the recruitment , retention and the impact of community based dietary and physical activity interventions for mothers with young children . Trial Registration Australian and New Zeal and Clinical Trials Registry 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 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 : 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 BACKGROUND Limiting postpartum weight retention is important for preventing adult obesity , but the effect of weight loss on lactation has not been studied adequately . OBJECTIVE We evaluated whether weight loss by dieting , with or without aerobic exercise , adversely affects lactation performance . DESIGN At 12+/-4 wk postpartum , exclusively breast-feeding women were r and omly assigned for 11 d to a diet group ( 35 % energy deficit ; n = 22 ) , a diet plus exercise group ( 35 % net energy deficit ; n = 22 ) , or a control group ( n = 23 ) . Milk volume , composition , and energy output ; maternal weight , body composition , and plasma prolactin concentration ; and infant weight were measured before and after the intervention . RESULTS Weight loss averaged 1.9 , 1.6 , and 0.2 kg in the diet , diet + exercise , and control groups , respectively ( P < 0.0001 ) and was composed of 67 % fat in the diet group and nearly 100 % fat in the diet + exercise group . Change in milk volume , composition , and energy output and infant weight did not differ significantly among groups . However , there was a significant interaction between group and baseline percentage body fat : in the diet group only , milk energy output increased in fatter women and decreased in leaner women . The plasma prolactin concentration was higher in the diet and diet + exercise groups than in the control group . CONCLUSIONS Short-term weight loss ( approximately 1 kg/wk ) through a combination of dieting and aerobic exercise appears safe for breast-feeding mothers and is preferable to weight loss achieved primarily by dieting because the latter reduces maternal lean body mass . Longer-term studies are needed to confirm these findings To assess the feasibility of a pediatric primary care based intervention to promote healthful behaviors among 0–6 month old infants and their mothers . We enrolled  two intervention practice s ( 60 mother-infant pairs ) and one usual care control practice ( 24 pairs ) in a non-r and omized controlled trial . We completed visits and interviews with 80 ( 95 % ) pairs at birth and 6 months . The intervention included ( 1 ) brief focused negotiation by pediatricians , ( 2 ) motivational counseling by a health educator , and ( 3 ) group parenting workshops . We evaluated the intervention effects on infant feeding , sleep duration , TV viewing , and mothers ’ responsiveness to satiety cues . Maternal behavioral targets included postpartum diet , physical activity , TV and sleep . At 6 months , fewer intervention than control infants had been introduced to solid foods ( 57 % vs. 82 % ; P = 0.04 ) , and intervention infants viewed less TV ( mean 1.2 vs. 1.5 h/d ; P = 0.07 ) . Compared to control infants , intervention infants had larger increases in their nocturnal sleep duration from baseline to follow up ( mean increase 1.9 vs. 1.3 h/d ; P = 0.05 ) ; larger reductions in settling time ( mean reduction −0.70 vs. −0.10 h 
    Output:
    