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Objective: To study whether the dietary patterns of Finnish pregnant women are associated with their weight gain rate during pregnancy. Design: A validated 181-item FFQ was applied retrospectively to assess the diet during the eighth month of pregnancy, and maternal height and maternal weight at first and last antenatal visits were recalled. Information on sociodemographic characteristics, parity and smoking of the pregnant women was obtained by a structured questionnaire and from the Finnish Birth Registry. Principal components analysis was used to identify dietary patterns that described the diet of pregnant women based on their food consumption profile. Setting: Finland. Subjects: Subjects consisted of 3360 women who had newly delivered in 1997-2002 and whose baby carried human leucocyte antigen-conferred susceptibility to type 1 diabetes in two university hospital regions, Oulu and Tampere, in Finland. Results: Out of seven dietary patterns identified, the 'fast food' pattern was positively associated (b 5 0?010, SE 5 0?003, P 5 0?004) and the 'alcohol and butter' pattern was inversely associated (b 5 -0?010, SE 5 0?003, P , 0?0001) with weight gain rate (kg/week) during pregnancy after adjusting for potential dietary, perinatal and sociodemographic confounding factors. Both of the dietary pattern associations demonstrated dose dependency. Conclusions: Pregnant women should be guided to have a well-planned, balanced, healthy diet during pregnancy in order to avoid rapid gestational weight gain. The association between diet, health and maternal weight gain of the women who consumed alcohol during pregnancy should be studied further.

These observations indicate that an early exposure to cow's milk formula-feeding and rapid growth in infancy are independent risk factors of childhood type 1 diabetes.

ObjectivesTo evaluate effectiveness of a structured one-to-one behaviour change programme on weight loss in obese and overweight individuals.DesignRandomised controlled trial.Setting23 general practices in Camden, London.Participants381 adults with body mass index ≥25 kg/m2 randomly assigned to intervention (n=191) or control (n=190) group.InterventionsA structured one-to-one programme, delivered over 14 visits during 12 months by trained advisors in three primary care centres compared with usual care in general practice.Outcome measuresChanges in weight, per cent body fat, waist circumference, blood pressure and heart rate between baseline and 12 months.Results217/381 (57.0%) participants were assessed at 12 months: missing values were imputed. The difference in mean weight change between the intervention and control groups was not statistically significant (0.70 kg (0.67 to 2.17, p=0.35)), although a higher proportion of the intervention group (32.7%) than the control group (20.4%) lost 5% or more of their baseline weight (OR: 1.80 (1.02 to 3.18, p=0.04)). The intervention group achieved a lower mean heart rate (mean difference 3.68 beats per minute (0.31 to 7.04, p=0.03)) than the control group. Participants in the intervention group reported higher satisfaction and more positive experiences of their care compared with the control group.ConclusionsAlthough there is no significant difference in mean weight loss between the intervention and control groups, trained non-specialist advisors can deliver a structured programme and achieve clinically beneficial weight loss in some patients in primary care. The intervention group also reported a higher level of satisfaction with the support received. Primary care interventions are unlikely to be sufficient to tackle the obesity epidemic and effective population-wide measures are also necessary.Clinical trial registration numberTrial registrationClincaltrials.gov NCT00891943.