This trial is to assess the feasibility of a larger, definitive RCT and determine the clinical effectiveness of an NHS 1:1 programme versus a modified programme with a low carbohydrate dietary intervention (as per Feinman and colleagues classification) with telehealth, physical activity and enhanced behaviour change on specified health outcomes amongst post-partum women living with obesity
For individuals living with obesity, the post-partum period is currently the initial, optimal timeframe for weight management. Many women reconceive during the post-partum phase, increasing the risk of between-pregnancy bodyweight retention and even gain. Consequentially, many re-enter subsequent pregnancies with a higher BMI often associated with unfavourable obstetric outcome and further cyclical perpetuation. Health behaviour change is an important facet within weight management interventions and delivery may be enhanced by digital technologies, for example, telehealth. Short messaging service (SMS) may be used to enhance communication between patients and practitioner and is relatively inexpensive to use. Low carbohydrate diets continue to gain traction however research is arguably confounded by the lack of a universally agreed definition and classification. Feinman and colleagues (2015) propose intermediary categories. The experimental arm of this trial will be encouraged to adopt a non-ketogenic LCD as per Feinman.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
NONE
Enrollment
3
Adapted NHS 1:1 weight management programme with a low carbohydrate dietary focus, incorporating enhanced behaviour change via telehealth, step count and pedometer
NHS 1:1 weight management programme
Astley Ainslie Hospital
Edinburgh, United Kingdom
Change in Bodyweight (Kilograms)
Bodyweight measured by the CI or self-reported
Time frame: Proposed 0,3,6,8 months
Change in Body composition (Fat mass/fat free mass)
Medical grade
Time frame: Proposed 0,3,6,8 months
Change in Waist circumference (Centimetres)
SECA Ergonomic measuring tape
Time frame: Proposed 0,3,6,8 months
Change in systolic and diastolic Blood pressure
Standard technique
Time frame: Proposed 0,3,6,8 months
Change in Physical activity levels
Level of physical activity (minutes) and step count from pedometer data
Time frame: Proposed 0,3,6,8 months
Change in emotional eating using the Weight loss Readiness Test II
Incidence of emotional eating (if present) determined by change score. Increased score is less favourable
Time frame: 0,3,6,8 months
Change in hunger and eating cues using the Weight loss Readiness Test II
Hunger and eating cues determined by change score. Increased score is less favourable
Time frame: 0,3,6,8 months
Change in psychological distress (if present) using the Clinical Outcomes in Routine Evaluation-10 screening tool
Measured using the Clinical Outcomes in Routine Evaluation-10 tool using change scores. An increased score is less favourable
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Time frame: Baseline, post-intervention at 3 months
Change in Quality of life
Measured using the World Health Organisation Quality of life (BREF) tool. A lower score is less favourable
Time frame: Proposed 0,3,6,8 months
Food frequency questionnaire
Standard validated tool
Time frame: Baseline
Diet quality
Diet quality measured using a 3 day unweighed food diary
Time frame: Proposed 0,3,6,8 months