The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial

Dodd, Jodie M; Cramp, Courtney; Sui, Zhixian; Yelland, Lisa N; Deussen, Andrea R; Grivell, Rosalie M; Moran, Lisa J.; Crowther, Caroline A; Turnbull, Deborah; McPhee, Andrew J; Wittert, Gary; Owens, Julie A.; Robinson, Jeffrey S.

doi:10.1186/s12916-014-0161-y

Cited by 146 publications

(206 citation statements)

References 71 publications

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“…Recent intervention trials have successfully increased physical activity levels among obese pregnant women (Dodd et al, 2014;Poston et al, 2015). However, similar to the women in this study, others have identified a lack of advice and support with physical activity in pregnancy, and a particular concern around safety (Weir et al, 2010;Sui and Dodd, 2013;Padmanabhan et al, 2015), while receiving physical activity advice from health professionals is a key enabler to supporting physical activity (Sui and Dodd, 2013).…”

Section: Resultsmentioning

confidence: 51%

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

et al. 2017

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Objective: To understand the lived experiences and views of being referred to an antenatal dietetic service from the perspective of pregnant women with obesity.Design: A qualitative, interpretive approach using one-to-one in-depth interviews to explore the lived experience of pregnant women with obesity following referral to an antenatal dietetics service. Thematic content analysis was carried out by two researchers independently to develop data-driven themes.Setting: One NHS Trust maternity and dietetic services, North East England, UK Participants: Fifteen pregnant women with a booking body mass index ≥30kg/m 2 attending an obesity-specific antenatal dietetic service. All women were White, parity between 0-2, and BMI range 30-51kg/m 2 .Findings: Four themes were identified within this concept. 1) Women's overall experience of the service: experiences were predominately positive with only two negative cases identified.2) Process of referral: women placed importance on informative and in-person communication about the service, with health professionals, at the point of referral. 3) 2 Delivery of the service: dietitians were considered to be the experts and women wanted more frequent contact. 4) Content of the service: tailored advice enabled behaviour change, and women desired increased physical activity support and weight monitoring.Key conclusions: Women reported an overall positive experience and thought that dietitians were the expert health professionals to support them. Women in this study felt that tailoring advice specific to their personal circumstances helped them implement changes, and had a strong interest in the nutritional benefits for fetal development. Women considered weight monitoring to be a positive element of the service; however, further research is required given the limited and conflicting evidence-base.Implications for practice: It is important to incorporate women's experiences in the development and delivery of antenatal weight management services to facilitate personcentred care. Communication by health professionals at the point of referral is particularly important to provide accurate expectations of services and to reduce anxieties. Dietitians are considered to be appropriate experts to deliver these services, although they may need additional support to address women's physical activity needs in pregnancy.Keywords obesity, body mass index, dietetic, qualitative, experience, pregnancy IntroductionMaternal obesity (body mass index (BMI) ≥30kg/m 2 ) is increasing in prevalence internationally (Brynhildsen et al., 2006;Ray et al., 2007;Heslehurst et al., 2010;Fisher et al., 2013) and is associated with complex inequalities, including deprivation and ethnic minority groups (Heslehurst et al., 2010(Heslehurst et al., , 2012. There are significantly increased associations with adverse outcomes for women and babies including congenital anomalies, perinatal mortality, macrosomia, gestational diabetes, maternal infections and preterm birth (Heslehurst et al., 2008;Stothard et al., 2009;Tenn...

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Section: Resultsmentioning

confidence: 51%

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

et al. 2017

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“…In that survey, eating sufficient vegetables and fruit was the most frequently cited component of a healthy diet, followed by limiting fat intake, which is consistent with what our study showed for Australians during January and February. However, lack of knowledge around the health consequences of poor weight management, healthy eating, and safe exercise have been identified as barriers to weight management in other studies, such as a study of pregnant women who paradoxically had access to freely provided weight loss information (Sui et al, 2013;Dodd et al, 2014), suggesting a possible mismatch between what they required and what was supplied.…”

Section: Discussionmentioning

confidence: 99%

Gluttony and guilt: monthly trends in internet search query data are comparable with national-level energy intake and dieting behavior

2018

Self Cite

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Systems for monitoring population-level diet and nutritional intake have been considered insufficient across many countries. Recently, internet search query data have been used to examine spatial and temporal patterns of public behavior to inform publichealth campaigns, policies, and interventions. Seasonal trends in public interest in behavioral change associated with obesity have been documented using such data. However, it has not been validated whether search query data can be related to diet and nutritional intake at the population level. The purpose of this study was to investigate whether trends in search query data related to behavioral changes associated with obesity reflects population nutritional intake and dieting behavior. First, long-term (2004 to 2016) trends in Australian Google search behavior were examined for the terms "weight loss", "diet", and "fitness" to establish monthly patterns in relative search volume (RSV). Second, monthly total energy (kJ), macronutrient, and food intake of the Australian population, and the percentage of self-reported dieters, were quantified using data collected as part of a 2011-2012 national-level survey. The two independent data sets were then compared to ascertain similarities in trends. There were distinct patterns in RSV across months, which was significantly higher than the mean during January, and lower during December, for all search terms. The decline in RSV was not linear, however, as there were significantly lower RSVs for terms during May to July, and significantly higher from August to October. Likewise, nutritional data showed a seasonal pattern, with the energy intake of survey participants highest in December and lowest in February, and the percentage of self-reported dieters closely followed monthly patterns in RSV. The proportion of energy from protein was consistent across months examined; however, energy from lipid and carbohydrate + fiber, was variable between months. Likewise, consumption patterns of different food groups was variable across months. Our analysis suggests that search query data can be used to surveil and predict dietary behavior at the population level, which has implications for producing novel and contemporaneous health information and marketing strategies.

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“…The LIMIT trial from Australia (Dodd et al, 2014b) which recruited over 2000 overweight or obese women found that a lifestyle intervention which focused on diet and physical activity was associated with a reduction in number of macrosomic babies born to women allocated to the intervention, but as this was a prespecified secondary outcome, a chance finding cannot be ruled out. Reasons postulated for this difference included greater physical activity in the intervention arm and differences in dietary intake including a reduction in energy intake from saturated fat and an increase in dietary fibre (Dodd et al, 2014a). The results of recently completed trials of pregnancy weight management interventions in the UK are currently awaited.…”

mentioning

confidence: 97%

The challenge of obesity during pregnancy: When to intervene and what could work?

Bick

2015

Midwifery

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The effects of antenatal dietary and lifestyle advice for women who are overweight or obese on maternal diet and physical activity: the LIMIT randomised trial

Cited by 146 publications

References 71 publications

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

Lived experiences of routine antenatal dietetic services among women with obesity: A qualitative phenomenological study

Gluttony and guilt: monthly trends in internet search query data are comparable with national-level energy intake and dieting behavior

The challenge of obesity during pregnancy: When to intervene and what could work?

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