Hostname: page-component-cd9895bd7-hc48f Total loading time: 0 Render date: 2024-12-17T14:19:30.548Z Has data issue: false hasContentIssue false

Effect of a diet intervention during pregnancy on dietary behavior in the randomized controlled Norwegian Fit for Delivery study

Published online by Cambridge University Press:  16 June 2016

E. R. Hillesund*
Affiliation:
Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
E. Bere
Affiliation:
Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
L. R. Sagedal
Affiliation:
Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Kristiansand, Norway Department of Research, Sørlandet Hospital HF, Kristiansand, Norway
I. Vistad
Affiliation:
Department of Obstetrics and Gynecology, Sørlandet Hospital HF, Kristiansand, Norway Department of Research, Sørlandet Hospital HF, Kristiansand, Norway
N. C. Øverby
Affiliation:
Department of Public Health, Sports and Nutrition, University of Agder, Kristiansand, Norway
*
*Address for correspondence: E. R. Hillesund, Department of Public Health, Sports and Nutrition, University of Agder, Serviceboks 422, 4604 Kristiansand, Norway. (Email elisabet.r.hillesund@uia.no)

Abstract

A mother’s diet during pregnancy has the potential to influence both her own and her child’s short- and long-term health. This paper reports the effects of a randomized controlled diet intervention during pregnancy on dietary behavior post-intervention as reported in late pregnancy. The diet intervention was part of a lifestyle intervention targeting both diet and physical activity behaviors among nulliparous women participating in the randomized controlled Norwegian Fit for Delivery study (NFFD). Eligible women were enrolled in early pregnancy from eight healthcare clinics in southern Norway between 2009 and 2013. The diet intervention was based on 10 dietary recommendations that were conveyed during two counseling sessions by phone and in a pamphlet describing the recommendations and their simplified rationale. A diet score was constructed from a 43-item food frequency questionnaire (FFQ) and used to assess intervention effect on dietary behavior (score range 0–10). Between-group dietary differences post-intervention were estimated with analysis of covariance, with adjustment for baseline diet. A total of 508 women completed the FFQ both at baseline and post-intervention. There were no between-group differences in diet score and subscales at baseline. Post-intervention, the intervention group had higher overall diet score (control: 4.61, intervention: 5.04, P=0.013) and favorable dietary behavior in seven of the 10 dietary domains: ‘consumption of water relative to total beverage consumption’ (P=0.002), ‘having vegetables with dinner’ (P=0.027), ‘choosing fruits and vegetables for between-meal snacks’ (P=0.023), ‘buying small portion sizes of unhealthy foods’ (P=0.010), ‘limiting sugar intake’ (P=0.005), ‘avoiding eating beyond satiety’ (P=0.009) and ‘reading food labels’ (P=0.011). The NFFD diet intervention improved dietary behavior. Potential long-term clinical influence in mother and child will be investigated in further studies.

Type
Original Article
Copyright
© Cambridge University Press and the International Society for Developmental Origins of Health and Disease 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1. Lim, SS, Vos, T, Flaxman, AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012; 380, 22242260.Google Scholar
2. Hanson, MA, Gluckman, PD. Developmental origins of health and disease – global public health implications. Best Pract Res Clin Obstet Gynaecol. 2015; 29, 2431.Google Scholar
3. Barker, D, Barker, M, Fleming, T, Lampl, M. Developmental biology: support mothers to secure future public health. Nature. 2013; 504, 209211.Google Scholar
4. Alfaradhi, MZ, Ozanne, SE. Developmental programming in response to maternal overnutrition. Front Genet. 2011; 2, 27.CrossRefGoogle ScholarPubMed
5. Barker, DJP, Lampl, M, Roseboom, T, Winder, N. Resource allocation in utero and health in later life. Placenta. 2012; 33(Suppl. 2), e30e34.Google Scholar
6. Hanson, M, Godfrey, KM, Lillycrop, KA, Burdge, GC, Gluckman, PD. Developmental plasticity and developmental origins of non-communicable disease: theoretical considerations and epigenetic mechanisms. Prog Biophys Mol Biol. 2011; 106, 272280.Google Scholar
7. Barker, DJP, Thornburg, KL. The obstetric origins of health for a lifetime. Clin Obstet Gynecol. 2013; 56, 511519.Google Scholar
8. Catalano, P, deMouzon, SH. Maternal obesity and metabolic risk to the offspring: why lifestyle interventions may have not achieved the desired outcomes. Int J Obes. 2015; 39, 642649.Google Scholar
9. Rasmussen, KM, Catalano, PM, Yaktine, AL. New guidelines for weight gain during pregnancy: what obstetrician/gynecologists should know. Curr Opin Obstet Gynecol. 2009; 21, 521526.Google Scholar
10. Rasmussen, KM, Yaktine, AL, eds. Weight Gain During Pregnancy: Reexamining the Guidelines. 2009. The National Academies Press: Washington, DC.Google Scholar
11. von Ruesten, A, Brantsæter, AL, Haugen, M, et al. Adherence of pregnant women to Nordic dietary guidelines in relation to postpartum weight retention: results from the Norwegian Mother and Child Cohort Study. BMC Public Health. 2014; 14, 7586.Google Scholar
12. Haugen, M, Brantsæter, AL, Winkvist, A, et al. Associations of pre-pregnancy body mass index and gestational weight gain with pregnancy outcome and postpartum weight retention: a prospective observational cohort study. BMC Pregnancy Childbirth. 2014; 14, 201.Google Scholar
13. Thangaratinam, S, Rogozinska, E, Jolly, K, et al. Effects of interventions in pregnancy on maternal weight and obstetric outcomes: meta-analysis of randomised evidence. BMJ. 2012; 344, e2088.Google Scholar
14. Dodd, JM, Turnbull, D, McPhee, AJ, et al. Antenatal lifestyle advice for women who are overweight or obese: LIMIT randomised trial. BMJ. 2014; 348, 11.Google Scholar
15. Poston, L, Bell, R, Croker, H, et al. Effect of a behavioural intervention in obese pregnant women (the UPBEAT study): a multicentre, randomised controlled trial. Lancet Diabetes Endocrinol. 2015; 3, 767777.CrossRefGoogle ScholarPubMed
16. Muktabhant, B, Lumbiganon, P, Ngamjarus, C, Dowswell, T. Interventions for preventing excessive weight gain during pregnancy. Cochrane Database Syst Rev. 2012; 4, CD007145.Google Scholar
17. Muktabhant, B, Lawrie, TA, Lumbiganon, P, Laopaiboon, M. Diet or exercise, or both, for preventing excessive weight gain in pregnancy. Cochrane Database Syst Rev. 2015; 6, CD007145.Google Scholar
18. Tobias, DB, Bao, W. Diet during pregnancy and gestational weight gain. Curr Nutr Rep. 2014; 3, 289297.Google Scholar
19. Sagedal, LR, Øverby, NC, Bere, E, et al. Lifestyle intervention to limit gestational weight gain: the Norwegian Fit for Delivery randomised controlled trial. BJOG: An International Journal Of Obstetrics And Gynaecology, 2016; doi:10.1111/1471-0528.13862.Google Scholar
20. Sagedal, LR, Overby, NC, Lohne-Seiler, H, et al. Study protocol: fit for delivery – can a lifestyle intervention in pregnancy result in measurable health benefits for mothers and newborns? A randomised controlled trial. BMC Public Health. 2013; 13, 132. doi:10.1186/1471-2458-13-132.Google Scholar
21. Overby, NC, Hillesund, ER, Sagedal, LR, Vistad, I, Bere, E. The Fit for Delivery study: rationale for the recommendations and test-retest reliability of a dietary score measuring adherence to 10 specific recommendations for prevention of excessive weight gain during pregnancy. Matern Child Nutr. 2015; 11, 2032.Google Scholar
22. Twisk, J, Proper, K. Evaluation of the results of a randomised controlled trial: how to define changes between baseline and follow-up. J Clin Epidemiol. 2004; 57, 223228.Google Scholar
23. Hanson, MA, Gluckman, PD. Early developmental conditioning of later health and disease: physiology or pathophysiology? Physiol Rev. 2014; 94, 10271076.CrossRefGoogle ScholarPubMed
24. Hanson, MA, Bardsley, A, De-Regil, LM, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: ‘Think Nutrition First’. Int J Gynaecol Obstet. 2015; 131(Suppl. 4), S213S213.Google Scholar
25. Moses, RG, Casey, SA, Quinn, EG, et al. Pregnancy and Glycemic Index Outcomes study: effects of low glycemic index compared with conventional dietary advice on selected pregnancy outcomes. Am J Clin Nutr. 2014; 99, 517523.Google Scholar
26. Gresham, E, Byles, JE, Bisquera, A, Hure, AJ. Effects of dietary interventions on neonatal and infant outcomes: a systematic review and meta-analysis. Am J Clin Nutr. 2014; 100, 12981321.Google Scholar
27. Hu, FB. Dietary pattern analysis: a new direction in nutritional epidemiology. Curr Opin Lipidol. 2002; 13, 39.Google Scholar
28. van de Mortel, T. Faking it: social desirability response bias in self-report research. Aust J Adv Nurs. 2008; 25, 4048.Google Scholar