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

Flynn, A. C. et al. (2016) 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, 13, 124. (doi:10.1186/s12966-016-0450-2) (PMID:27894316) (PMCID:PMC5126873)

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Abstract

Background: Understanding 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. Methods: In 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). Results: Four 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. Conclusions: In 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 registration: Current controlled trials; ISRCTN89971375

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Nelson, Professor Scott and Sattar, Professor Naveed
Authors: Flynn, A. C., Seed, P. T., Patel, N., Barr, S., Bell, R., Briley, A. L., Godfrey, K. M., Nelson, S. M., Oteng-Ntim, E., Robinson, S. M., Sanders, T. A., Sattar, N., Wardle, J., Poston, L., and Goff, L. M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:International Journal of Behavioral Nutrition and Physical Activity
Publisher:BioMed Central
ISSN:1479-5868
ISSN (Online):1479-5868
Copyright Holders:Copyright © 2016 The Authors
First Published:First published in International Journal of Behavioral Nutrition and Physical Activity 13: 124
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
509251Improving pregnancy outcome in obese women (UK Better Eating and Activity Trial - UPBEAT)Naveed SattarNational Institute for Health Research (NIHR)RP-PG-0407-10452RI CARDIOVASCULAR & MEDICAL SCIENCES
512251Improving Pregnancy Outcome in Obese Women - the UK Pregnancies: Better Eating and Activity Trial (UPBEAT)Scott NelsonScottish Executive Health Department (SEHHD-CSO)CZB/4/680MVLS MED - REPRODUCTIVE & MATERNAL MED