Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes

To access publisher's full text version of this article, please click on the hyperlink in Additional Links field or click on the hyperlink at the top of the page marked Files. This article is open access.Awareness that maternal diet may influence the outcome of pregnancy as well as the long-term health of mother and child has increased in recent years. A new food frequency questionnaire (FFQ) was developed and validated specifically for the Norwegian Mother and Child Cohort Study (MoBa). The MoBa FFQ is a semi-quantitative tool which covers the average intake of food, beverages and dietary supplements during the first 4 to 5 months of pregnancy. It includes questions about intakes of 255 foods and dishes and was used from 2002 onwards. Data assessed by the MoBa FFQ is available for 87,700 pregnancies. Numerous sub-studies have examined associations between dietary factors and health outcomes in MoBa. The aim of this paper is to summarize the results from 19 studies of maternal diet and pregnancy outcomes, which is the complete collection of studies based on the MoBa FFQ and published before September 2014. The overall research question is whether maternal diet – from single substances to dietary patterns – matters for pregnancy outcome. The pregnancy outcomes studied till now include birth size measures, infants being small and large for gestational age, pregnancy duration, preterm delivery, preeclampsia, as well as maternal gestational weight gain and postpartum weight retention. As a whole, the results from these studies corroborate that the current dietary recommendations to pregnant women are sound and that maternal diet during pregnancy is likely to contribute to reduce the risk of pregnancy complications including preterm birth, preeclampsia, and reduced foetal growth. The results provide supporting evidence for recommending pregnant women to consume vegetables, fruit, whole grain, fish, dairy, and water regularly and lower the intake of sugar sweetened beverages, processed meat products and salty snacks. The results showing negative impact of even low levels of environmental contaminants support the precautionary advice on consumption of foods containing these. New findings are that particularly lean fish explained the positive association between seafood intake and foetal growth, and the indications of a protective effect of probiotic and antimicrobial foods on pregnancy outcomes. This points to the importance of diet composition for a healthy gut flora and the body’s immune response. Although these studies are observational and cannot infer causality, the results identify diet as an important modifiable lifestyle factor, suggesting that healthy eating, defined as following the official recommendations, is particularly important in pregnanc

Can Research Assessments Themselves Cause Bias in Behaviour Change Trials? A Systematic Review of Evidence from Solomon 4-Group Studies

BACKGROUND: The possible effects of research assessments on participant behaviour have attracted research interest, especially in studies with behavioural interventions and/or outcomes. Assessments may introduce bias in randomised controlled trials by altering receptivity to intervention in experimental groups and differentially impacting on the behaviour of control groups. In a Solomon 4-group design, participants are randomly allocated to one of four arms: (1) assessed experimental group; (2) unassessed experimental group (3) assessed control group; or (4) unassessed control group. This design provides a test of the internal validity of effect sizes obtained in conventional two-group trials by controlling for the effects of baseline assessment, and assessing interactions between the intervention and baseline assessment. The aim of this systematic review is to evaluate evidence from Solomon 4-group studies with behavioural outcomes that baseline research assessments themselves can introduce bias into trials. METHODOLOGY/PRINCIPAL FINDINGS: Electronic databases were searched, supplemented by citation searching. Studies were eligible if they reported appropriately analysed results in peer-reviewed journals and used Solomon 4-group designs in non-laboratory settings with behavioural outcome measures and sample sizes of 20 per group or greater. Ten studies from a range of applied areas were included. There was inconsistent evidence of main effects of assessment, sparse evidence of interactions with behavioural interventions, and a lack of convincing data in relation to the research question for this review. CONCLUSIONS/SIGNIFICANCE: There were too few high quality completed studies to infer conclusively that biases stemming from baseline research assessments do or do not exist. There is, therefore a need for new rigorous Solomon 4-group studies that are purposively designed to evaluate the potential for research assessments to cause bias in behaviour change trials

Harnessing horses in social pedagogy : Equine-assisted social education in a school context

This article introduces a school-based social pedagogical programme using horses to support pupils’ educational development, social and emotional skills and self-esteem. These are essential for pupils’ well-being, to reduce the risk of developing emotional disorders in youth and later life. In terms of academic outcomes, these social-emotional skills, character strengths and health benefits are recognised in the Finnish educational agenda. Equine-assisted social education (EASE) differs from recreational riding programs by its frame of reference in social pedagogy and in the human–equine bond it features, positioning horses as co-educators to improve interaction and collaboration. This human–equine communication supports both human and equine welfare if applied with attention, respect and empathy. Furthermore, the stables environment provides a setting for enhancing the pedagogical relationship and trust between pupils and their teacher. This equine activity practice, like other educational interventions, has physical, behavioural, social and emotional intentions. In addition, as social pedagogy is a complex and innovative discipline, EASE represents a ground-breaking practice within this discipline. The purpose is to respond to individual and social difficulties with preventive and problem-solving practice. As Finnish social pedagogy emphasises educational dialogue and communication, EASE facilitates non-verbal communication and positive behaviour. Additionally, it consists of factors improving collaboration through experiences, activities and dialogue.This article introduces a school-based social pedagogical programme using horses to support pupils’ educational development, social and emotional skills and self-esteem. These are essential for pupils’ well-being, to reduce the risk of developing emotional disorders in youth and later life. In terms of academic outcomes, these social-emotional skills, character strengths and health benefits are recognised in the Finnish educational agenda. Equine-assisted social education (EASE) differs from recreational riding programs by its frame of reference in social pedagogy and in the human–equine bond it features, positioning horses as co-educators to improve interaction and collaboration. This human–equine communication supports both human and equine welfare if applied with attention, respect and empathy. Furthermore, the stables environment provides a setting for enhancing the pedagogical relationship and trust between pupils and their teacher. This equine activity practice, like other educational interventions, has physical, behavioural, social and emotional intentions. In addition, as social pedagogy is a complex and innovative discipline, EASE represents a ground-breaking practice within this discipline. The purpose is to respond to individual and social difficulties with preventive and problem-solving practice. As Finnish social pedagogy emphasises educational dialogue and communication, EASE facilitates non-verbal communication and positive behaviour. Additionally, it consists of factors improving collaboration through experiences, activities and dialogue.Peer reviewe