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Frequency of Eating during Lactation and Postpartum Weight Loss: A Systematic Review
Steven Heymsfield, MD, Carol Boushey, PhD, MPH, RD, Heather Leidy, PhD, Richard Mattes, PhD, MPH, RD, Ronald Kleinman, MD, Emily Callahan, MS, Gisela Butera, MLIS, MEd, Nancy Terry, MS, MLS, and Julie Obbagy, PhD, RD.
Author Information and AffiliationsAlexandria (VA): USDA Nutrition Evidence Systematic Review; 2020 Jul.
TECHNICAL ABSTRACT
Background
- This important public health question was identified by the U.S. Departments of Agriculture (USDA) and Health and Human Services (HHS) to be examined by the 2020 Dietary Guidelines Advisory Committee.
- The 2020 Dietary Guidelines Advisory Committee, Frequency of Eating Subcommittee conducted a systematic review to answer this question with support from the Nutrition Evidence Systematic Review (NESR) team.
- The goal of this systematic review was to examine the following question: What is the relationship between the frequency of eating during lactation and postpartum weight loss?
Conclusion statement and grade
- Insufficient evidence is available to determine the relationship between the frequency of eating during lactation and postpartum weight loss. (Grade: Grade not assignable)
Methods
- A literature search was conducted using 4 databases (PubMed, Cochrane, Embase, and CINAHL) to identify articles that evaluated an intervention or exposure of the frequency of eating and the outcome of postpartum weight loss. A manual search was also conducted to identify articles that may not have been included in the electronic databases searched. Articles were screened by two authors independently for inclusion based on pre-determined criteria.
- Data extraction and risk of bias assessment were conducted for each included study, and both were checked for accuracy. The Committee qualitatively synthesized the body of evidence to inform development of a conclusion statement(s), and graded the strength of evidence using pre-established criteria for risk of bias, consistency, directness, precision, and generalizability.
Summary of the evidence
- Frequency of eating was defined as the number of daily eating occasions. An eating occasion was defined as an ingestive event (solid food or beverage, including water) that is either energy yielding or non-energy yielding.
- Postpartum weight loss was defined as a change in weight from baseline (postpartum) to a later time point during the postpartum period. Additionally, it could be postpartum weight retention, if gestational weight gain was controlled for in the analysis.
- This review included 1 prospective cohort study (using data from a multicomponent RCT) that met the inclusion criteria for this systematic review and was published within the date range of January 2000 and September 2019.
- The 1 included study did not report a significant association between a change in eating frequency and a change in weight from baseline over a 12-week follow-up.
- The study had several limitations, including:
- Key confounders were not accounted for.
- Data were from a multi-component randomized controlled trial that was not designed to test frequency of eating.
- One prospective cohort study with critical limitations was not sufficient to draw conclusions.
Contents
FUNDING SOURCE: United States Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Alexandria, VA
Suggested citation:
Heymsfield S, Boushey C, Leidy H, Mattes R, Kleinman R, Callahan E, Butera G, Terry N, Obbagy J. Frequency of Eating during Lactation and Postpartum Weight Loss: A Systematic Review. July 2020. U.S. Department of Agriculture, Food and Nutrition Service, Center for Nutrition Policy and Promotion, Nutrition Evidence Systematic Review. Available at: https://doi.org/10.52570/NESR.DGAC2020.SR0604.
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Related citation: Dietary Guidelines Advisory Committee. Scientific Report of the 2020 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Agriculture and the Secretary of Health and Human Services. July 2020. U.S. Department of Agriculture, Agricultural Research Service. Available at: https://doi.org/10.52570/DGAC2020.
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