4. Discussion
obesity, 3rd-trimester, weight loss
OBESITY, SECONDARY
This secondary analysis has provided novel data on postnatal diet, PA, and weight change among a highly deprived population of women living with obesity in the UK. This population had a suboptimal dietary intake, particularly regarding fruit and vegetables, unrefined breakfast cereals, fish, and oily fish, which did not meet national recommendations. Additionally, guideline recommendations are to limit the consumption of red meat and processed meat and fish, with no more than 70 g/day, whereas the median intake in this population was higher than these recommendations at most postnatal time points. Light-intensity PA contributed most to overall EE across all time points, whereas guideline recommendations are for at least 150 min/week of moderate-intensity PA. Overall, most EE was from the household/care PA domain, suggesting this might be an area for interventions to focus on, for example, supporting women to increase the intensity of activity in domains they are already participating in. There was a pattern towards weight loss across all postnatal time points when compared with 1st- and 3rd-trimester weights, with the greatest weight loss observed at 3-months postnatal and among women whose GWG was not excessive. Interventions could focus on limiting GWG as part of a preconception strategy for subsequent pregnancies and supporting women to maintain early postnatal weight loss from three months and throughout the 12-months.There is little existing evidence exploring postnatal diets of women in the UK. However, the findings in this study are similar to international studies in both the USA [Furthermore, Stephenson et al. [There is a lack of research in the UK focusing on women living with obesity in the postnatal period to compare our findings with. However, our findings are similar to those reported in the general postnatal populations. Our study showed increasing median EE over the postnatal period, and an Australian cross-sectional study also showed that sitting time was highest and PA levels lowest in the first six months postnatal, increasing significantly between 6–12 months [In our study, there was an overall pattern for weight loss in the postnatal period compared with booking or 3rd-trimester weights, and 60% of women had postnatal weights lower than their booking weight. These patterns are similar to a secondary analysis of the UK UPBEAT trial in women with obesity, which showed 52% had a lower weight at 6-months postnatal than in their 1st-trimester [In our study, we could not explore postnatal behaviour and weight change patterns according to breastfeeding status as planned due to too few women breastfeeding. At 3-months postnatal, only 20% were breastfeeding, and 27% at 6-months, lower than the population average outlined in the latest UK-wide infant feeding survey (34% at 6-months) [