Dietary patterns in obese pregnant women; influence of a behavioral intervention of diet and physical activity in the UPBEAT randomized controlled trial

International Journal of Behavioral Nutrition and Physical Activity

Research

Suzanne Barr¹  Louise M. Goff²  Thomas A. Sanders²  Lucilla Poston³  Nashita Patel³  Paul T. Seed³  Annette L. Briley³  Angela C. Flynn⁴  Eugene Oteng-Ntim⁵  Jane Wardle⁶  Naveed Sattar⁷  Ruth Bell⁸  Sian M. Robinson⁹  Keith M. Godfrey⁹  Scott M. Nelson^1,10 

[1] Department of Cardiovascular Medicine, Imperial College London, London, UK;Division of Diabetes and Nutritional Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, London, UK;Division of Women’s Health, King’s College London, 10th Floor North Wing, St. Thomas’ Hospital, London, UK;Division of Women’s Health, King’s College London, 10th Floor North Wing, St. Thomas’ Hospital, London, UK;Division of Diabetes and Nutritional Sciences, King’s College London, Franklin-Wilkins Building, 150 Stamford Street, London, UK;Guys and St Thomas’ NHS Foundation Trust, Westminster Bridge Road, London, UK;Health Behaviour Research Centre, Institute of Epidemiology and Health, University College London, 1-19 Torrington Place, London, UK;Institute of Cardiovascular and Medical Sciences, RC214 Level C2, British Heart Foundation Glasgow Cardiovascular Research Centre, University of Glasgow, Glasgow, UK;Institute of Health & Society Newcastle University, UK Baddiley-Clark Building Richardson Road, Newcastle upon Tyne, UK;MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Mailpoint 95, Southampton, UK;School of Medicine, University of Glasgow, New Lister Building, Glasgow Royal Infirmary, Glasgow, UK;

关键词: Dietary patterns;    Obesity;    Pregnancy;    Gestational diabetes;   

DOI  :  10.1186/s12966-016-0450-2

 received in 2016-09-05, accepted in 2016-11-21,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundUnderstanding dietary patterns in obese pregnant women will inform future intervention strategies to improve pregnancy outcomes and the health of the child. The aim of this study was to investigate the effect of a behavioral intervention of diet and physical activity advice on dietary patterns in obese pregnant woman participating in the UPBEAT study, and to explore associations of dietary patterns with pregnancy outcomes.MethodsIn the UPBEAT randomized controlled trial, pregnant obese women from eight UK multi-ethnic, inner-city populations were randomly assigned to receive a diet/physical activity intervention or standard antenatal care. The dietary intervention aimed to reduce glycemic load and saturated fat intake. Diet was assessed using a food frequency questionnaire (FFQ) at baseline (15+0-18+6 weeks’ gestation), post intervention (27+0-28+6 weeks) and in late pregnancy (34+0-36+0 weeks). Dietary patterns were characterized using factor analysis of the baseline FFQ data, and changes compared in the control and intervention arms. Patterns were related to pregnancy outcomes in the combined control/intervention cohort (n = 1023).ResultsFour distinct baseline dietary patterns were defined; Fruit and vegetables, African/Caribbean, Processed, and Snacks, which were differently associated with social and demographic factors. The UPBEAT intervention significantly reduced the Processed (−0.14; 95% CI −0.19, −0.08, P <0.0001) and Snacks (−0.24; 95% CI −0.31, −0.17, P <0.0001) pattern scores. In the adjusted model, baseline scores for the African/Caribbean (quartile 4 compared with quartile 1: OR = 2.46; 95% CI 1.41, 4.30) and Processed (quartile 4 compared with quartile 1: OR = 2.05; 95% CI 1.23, 3.41) patterns in the entire cohort were associated with increased risk of gestational diabetes.ConclusionsIn a diverse cohort of obese pregnant women an intensive dietary intervention improved Processed and Snack dietary pattern scores. African/Caribbean and Processed patterns were associated with an increased risk of gestational diabetes, and provide potential targets for future interventions.Trial registrationCurrent controlled trials; ISRCTN89971375

【 授权许可】

CC BY   
© The Author(s). 2016