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The study objective was to (1) compare, through a randomised pilot intervention study, the effects of a standard health app and an enhanced health app, with evidence-based information regarding healthy lifestyle, on gestational weight gain, diet quality and physical activity in pregnant women. The sub-objectives were to (2) characterise app use and users among pregnant women and to (3) compare, in the overall sample regardless of the intervention, whether the frequency of the health app use has an effect on the change in gestational weight, diet quality and physical activity. Women recruited through social media announcements (n 1038) were asked to record their lifestyle habits in the app from early pregnancy to delivery. Self-reported weight, diet quality and physical activity were assessed in early and late pregnancy with validated online questionnaires. No benefits of the enhanced app use were shown on the lifestyle habits. Nevertheless, frequent app users (use ≥ 4·7 weeks) in the enhanced app group had a higher physical activity level in late pregnancy compared with those in the standard app group. Overall, extensive variation was found in the number of recordings (median 59, interquartile range 19–294) and duration of app use (median 4·7, interquartile range 1·1–15·6 weeks). Frequent app users had higher education level, underweight/normal weight, better diet quality and were non-smokers, married and primipara more likely than occasional app users/non-users. Physical activity among app users decreased less compared with non-users over the pregnancy course, indicating that app use could motivate to maintain physical activity during pregnancy.
To develop and evaluate a stand-alone Elementary School-aged Children’s Index of Diet Quality (ES-CIDQ).
In this cross-sectional study, children filled in a food frequency questionnaire (FFQ) with twenty-nine multiple-item questions on the consumption of foods, portion sizes and eating frequency and a 5-d food diary. Nutrient intakes were calculated with nutrient analysis software. FFQ questions best reflecting a health-promoting diet with reference to dietary recommendations were identified by correlations, logistic regression modelling and receiver-operating characteristics curve analysis.
Southwest and Eastern Finland.
Healthy elementary school-aged volunteers [n 266, mean (sd) age 9·7 (1·7) years] were recruited between March 2017 and February 2018.
A set of questions was identified from the FFQ that best depicted the children’s diet quality as defined in the dietary recommendations. These fifteen questions were scored and formulated into a stand-alone index as a continuous index score (range 0–16·5 points) and a two-category score: good and poor diet quality. The cut-off score of six points for a good diet quality had a sensitivity of 0·60 and a specificity of 0·78. Children with a good diet quality (49·8 % of the children) had higher intakes of protein, dietary fibre, and several vitamins and minerals, and lower intakes of sucrose, total fat, SFA and cholesterol compared to children with a poor diet quality.
The developed short stand-alone index depicted diet quality as defined in the dietary recommendations. Thus, ES-CIDQ may be used for assessing diet quality in Finnish elementary school-aged children in school health care and nutrition research.
We evaluated the effects of fish oil and/or probiotic supplementation in a randomised placebo-controlled intervention pilot trial on gestational weight gain (GWG) and body composition. Additionally, the influence of gestational diabetes (GDM) on GWG and body composition was assessed. We randomised 439 overweight women into intervention groups: fish oil + placebo, probiotics + placebo, fish oil + probiotics and placebo + placebo (fish oil: 1·9 g DHA and 0·22 g EPA and probiotics: Lactobacillus rhamnosus HN001 and Bifidobacterium animalis ssp. lactis 420, 1010 colony-forming units each). GDM was diagnosed with oral glucose tolerance test. Body composition was measured with air displacement plethysmography at randomisation (mean 13·9) and in late pregnancy (mean 35·2 gestational weeks). Intervention did not influence mean GWG or change in body fat mass/percentage (P > 0·17). Body composition in early pregnancy did not differ between the women who did or did not develop GDM (adjusted P > 0·23). Compared with the normoglycaemic women (n 278), women diagnosed with GDM (n 119) gained less weight (7·7 (sd 0·4) v. 9·3 (sd 0·4) kg, adjusted mean difference −1·66 (95 % CI −2·52, −0·80) and fat mass (0·4 (sd 0·4) v. 1·8 (sd 0·3) kg, adjusted mean difference −1·43 (95 % CI −2·19, −0·67) during the follow-up. In conclusion, adiposity of pregnant overweight women was not affected by supplementation with fish oil and/or probiotics, nor did it predict the development of GDM. However, adiposity was reduced in women with GDM compared with normoglycaemic women irrespective of the dietary intervention.
Gestational diabetes (GDM) is a serious condition predisposing both the mother and child to health complications. Key means for treatment are lifestyle related, primarily adherence to a healthy diet and increase in physical activity. The aim of the study was to evaluate dietary quality and physical activity in early pregnancy of women reporting history of GDM compared to healthy women participating in a population-based study. Pregnant women were enrolled to the study by announcements in social media. The interested women (n = 1034) filled in an electronic questionnaire on their background data, validated Index of Diet Quality (IDQ) and index of leisure-time physical activity (MET-index) in early pregnancy. The protocol was approved by the Ethics Committee of the University of Turku, Finland. The study population characteristics were representative of the Finnish pregnant women as compared with values reported in national perinatal statistics, except for overrepresentation of primiparas (54% compared to 41%) and underrepresentation of smokers during pregnancy (2.2% compared to 13%). Of the multiparas, 18.3% reported having been diagnosed with GDM in a previous pregnancy, which is in accordance to that in the general population (19%). Having a history of GDM was not reflected in the dietary quality in the present pregnancy. The IDQ score of the women with history of GDM (adj. mean 9.5) did not differ from those with no history (adj. mean 9.3, NS). When evaluating the categorized values, 45.8% of the women with the history of GDM and 45.4% of those without had a good dietary quality (IDQ score 10 or above). Similarly, the MET-index of the women with history of GDM (4.8 hrs/wk) did not differ from that of the women with no history (4.8 hrs/wk). Also, the categorized MET-index did not differ between the groups. The physical activity level of the women with history of GDM was light in the majority (52%) of the women, moderate in 41% and vigorous in 7%. Despite the known risks that GDM induces to health of the pregnant women and their babies, the dietary quality and physical activity of the women with a history of GDM did not differ from that of the women who were not previously affected. The results indicate that new means are needed alongside with the traditional counselling practices to motivate healthy lifestyle changes in pregnant women, particularly those at risk for recurrent GDM.
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