Becoming a parent: A systematic review and meta-analysis of changes in BMI, diet, and physical activity

Obesity prevalence rises fastest during young adulthood when weight, diet, and physical activity may be influenced by life events, including becoming a parent, but the impact is uncertain. We searched six electronic databases to July 2019 for longitudinal studies (both sexes) aged 15 to 35 years with a prospective pre-pregnancy/parenthood and post-delivery outcome. Of 11 studies (across 15 papers), six studies (women only) were eligible for meta-analysis of the difference in change in body mass index (BMI; kg/m(2)) between remaining without children and becoming a parent. Mean (+/- SD) BMI gain for non-mothers was 2.8 +/- 1.3 kg/m(2) (similar to 7.5 kg for 164-cm woman) over 5.6 +/- 3.1 years; 12.3% of baseline BMI (22.8 +/- 2.5 kg/m(2)). Becoming a mother was associated with an additional BMI increase of 0.47 +/- 0.26 kg/m(2) (similar to 1.3 kg), 4.3% of baseline BMI (22.8 +/- 5.6 kg/m(2)); the one study including men reported no difference in change. Physical activity results were equivocal; 2/4 studies (women) and 2/2 (men) showed a greater decline in parents versus non-parents; diet (three studies) varied by dietary measure, mostly indicating no difference. Becoming a mother is associated with 17% greater absolute BMI gain than remaining childless. Motherhood BMI gain is additional to an alarming BMI increase among young women, highlighting the need for obesity prevention among all young women, including mothers.