A Mobile App Lifestyle Intervention to Improve Healthy Nutrition in Women Before and During Early Pregnancy: Single-Center Randomized Controlled Trial

Abstract

Background Unhealthy nutrition contributes to the worldwide rising prevalence of noncommunicable diseases. As most adverse reproductive outcomes originate during the periconception period, effective interventions targeting this period are needed. Therefore, we developed the lifestyle intervention Smarter Pregnancy to empower women to adapt a healthy diet prior to conception and during early pregnancy and performed a randomized controlled trial. Objective The objectives of this trial were to investigate compliance and effectiveness in women using the Smarter Pregnancy program. Methods Women aged between 18 and 45 years who were contemplating pregnancy or <13 weeks pregnant and their male partners living in the urban area of Rotterdam, the Netherlands, were eligible for participation. After baseline screening, the intervention group received personal online coaching based on identified inadequate intakes of vegetables, fruits, and folic acid supplements. The sum of these risk factors was used as a dietary risk score (DRS), ranging from 0 (healthy) to 9 (unhealthy). The control group did not receive coaching. We applied an intention-to-treat principle and used a multivariable linear regression model to evaluate the change in DRS after 24 weeks. Compliance was defined as the percentage of women who completed the screening questionnaire at 24 weeks. Results Of women recruited, 81.2% (177/218) completed the program (intervention: 91/218, 83.5%; control: 86/218, 78.9%; P=.95). After 24 weeks, the reduction in DRS of women in the intervention group was significantly larger than in the control group (β=.75, 95% CI 0.18-1.34). This reduction was mainly due to increased vegetable intake (β=.55, 95% CI 0.25-0.86). Conclusions The high compliance and the larger improvements in nutritional behaviors, especially vegetable intake, in women in the intervention group emphasizes the effectiveness of empowering women by using the lifestyle change intervention Smarter Pregnancy. Trial Registration Netherlands Trial Register: NL3927; https://www.trialregister.nl/trial/3927 International Registered Report Identifier (IRRID) RR2-10.1186/s12884-017-1228-5

Development of a Lifestyle Intervention Program to Support Preconception, Pregnant and Postnatal Women Who are Overweight or Obese: A Qualitative Study

“…This may stem from insu cient guidance on healthy lifestyle behaviors applicable to the local context (13,16,25). Addressing these through education will enable participants to perceive value in optimizing health for themselves and their children in the longrun, while providing practical suggestions that are culturally convenient, so women can act (41). These form the considerations in designing an educational package as part of a lifestyle intervention program, aligned with our ndings in this study.…”

Development of a Lifestyle Intervention Program for Overweight or Obese Preconception, Pregnant and Postnatal Women: a Qualitative Study

“…This may stem from insu cient guidance on healthy lifestyle behaviors applicable to the local context [13,16,25]. Addressing these through education will enable participants to perceive value in optimizing health for themselves and their children in the long-run, while providing practical suggestions that are culturally convenient, so women can act [41]. These form the considerations in designing an educational package as part of a lifestyle intervention program, aligned with our ndings in this study.…”

A Remote Nutritional Intervention to Change the Dietary Habits of Patients Undergoing Ablation of Atrial Fibrillation: Randomized Controlled Trial

“…Similar results were found in the PREDIMED study after 1 year of face-to-face intervention [ 40 , 41 ]. Moreover, previous online intervention studies found an increase in the intake of fruit and vegetables [ 22 , 46 ]. Other authors have reported a significant increase in the consumption of total fat and different fatty acids after different online interventions [ 47 , 48 ].…”