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Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Berit Lilienthal Heitmann, University of Copenhagen, Denmark
- Second opponent: Professor Nina Cecilie Øverby, University of Agder, Norway
- Third member and chair of the evaluation committee: Associate professor Anne-Marie Aas, Faculty of Medicine, University of Oslo
Chair of the Defence
Associate Professor Thomas Sæther, University of Oslo
Principal Supervisor
Professor Hilde Kristin Brekke, University of Oslo
Summary
After childbirth, both an increase in weight and a lower level of the "good" HDL cholesterol (HDL-C) may be mechanisms contributing to elevated maternal risk for cardiovascular disease (CVD) and type 2 diabetes (T2D). Weight loss in adults with overweight and obesity has been shown to increase HDL-C. Breastfeeding is associated to a more favourable risk profile for CVD and T2D, including a higher level of HDL-C, while it is more uncertain whether breastfeeding also contributes to weight loss. The aim of the thesis was to examine the effects of a dietary intervention, an exercise treatment, and a breastfeeding promotion intervention (BPI) in postpartum women with overweight and obesity.
A Swedish randomised controlled trial (RCT), the LEVA study, showed that lactating women with overweight and obesity before pregnancy lost 9% of their weight and improved their HDL-C and fasting insulin levels through a 12-week dietary program from 3 to 6 months after childbirth.
A secondary analysis of the LEVA study showed that the dietary program changed the distribution of HDL particle subclasses in a direction associated with lower risk of CVD. An exercise intervention, which showed no effect on weight, had a more limited effect on the HDL subclasses than the dietary program.
In a second RCT, the dietary program was tested in women postpartum with a higher body mass index than in the LEVA study. The program had a positive effect also among these women by reducing weight or preventing weight gain.
In a third RCT, the effects of a BPI and the dietary program were examined among postpartum women with overweight and obesity. At 6 months postpartum, almost all participants were breastfeeding. There were no effects of BPI, while the dietary program resulted in a reduction of weight and fasting glucose.
In summary, the dietary program led to weight reduction and other favourable effects on risk factors for HKS and T2D, which may improve the mothers' future health.
Additional information
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