Dietary intake, physical activity and sedentary behavior and association with BMI during the transition to parenthood: a prospective dyadic study

IntroductionLittle is known on how diet, physical activity (PA) and sedentary behavior (SB) changes during pregnancy and after childbirth in primiparous couples. Moreover, it is unclear how potential behavioral changes are associated with changes in BMI. This study examined changes in diet, PA and SB, and their association with changes in BMI in couples transitioning to parenthood.MethodsDietary intake (FFQ), PA, SB (both Actigraph GT3X accelerometers) and BMI of women and men were assessed at 12 weeks of gestation, 6 weeks and 6 months postpartum. Data were analyzed using dyadic longitudinal data analyses techniques.ResultsIn women, a decrease in fruit intake, an increase in alcohol intake, an increase of light-intensity PA, and a decrease in SB were observed from the beginning of pregnancy up to 6 months postpartum. Decreases in fruit intake between 6 weeks and 6 months postpartum was associated with increases in BMI. Men did not show significant dietary changes, while an increase in light-intensity PA and a decrease in moderate-to-vigorous PA (MVPA) was observed at 6 months postpartum when compared to 12 weeks of gestation. Paternal increases in “avoidance food group” intake were associated with increases in BMI between baseline and 6 weeks postpartum. No associations of changes in BMI and changes in PA and SB were found.DiscussionNot only mothers but also fathers experienced unfavorable changes in lifestyle during the transition to parenthood, with impact on BMI changes. This highlights the need to monitor unhealthy changes in lifestyle and body weight in both parents when expecting a child and after childbirth.Clinical trial registrationClinicaltrials.gov, NCT03454958

Relative Importance of Determinants of Changes in Eating Behavior during the Transition to Parenthood: Priorities for Future Research and Interventions

Background: Healthy eating behavior throughout pregnancy and postpartum is important. This study aimed to investigate the perceived sex-specific importance of determinants of changes in eating behavior during pregnancy and postpartum. Methods: Fifty-four determinants were rated by first-time parents (n = 179) on their impact. Experts (n = 31) rated the determinants in terms of their modifiability, relationship strength, and population-level effect from which a “priority for research”-score was calculated. Results: During pregnancy, the three highest rated determinants by women were “health concerns”, “physiological changes”, and “fatigue”. Men perceived “health concerns”, “health consciousness”, and “influence of the pregnant partner” as important. Postpartum, the three highest rated determinants by women were “adaptation to rhythm of baby”, “baby becomes priority”, and “practical constraints because of the baby”. Men perceived “adaptation to rhythm of baby”, “fatigue”. and “(lack of) anticipation” as important. According to the experts, “professional influence”, “food knowledge”, and “home food availability” received high priority scores for both sexes and during both periods. Conclusions: Priority for research and interventions should go towards tailored family-based approaches focusing on food education in a broad sense taking into account aspects such as health consciousness, self-efficacy skills, and the social and home food environment while being supported by healthcare professionals

The effect of nudges aligned with the renewed Flemish Food Triangle on the purchase of fresh fruits : an on-campus restaurant experiment

Objective: This study examined the effect of nudges, inspired by the recently renewed Flemish Food Triangle, on fruit sales in a Belgian on-campus university restaurant. Methods: In this mixed-method real-life experiment, nudges were added weekly over a period of four consecutive weeks: placement of (1) Food Triangle posters in the restaurant, (2) 'green heart' icons above the fruit stands, and (3) substitution and (4) social norm messages at the fruit stands. During baseline (no intervention) and all intervention weeks, dessert sales were registered. Short interviews were used to ask customers about their perceptions regarding the intervention. Follow-up measurements (7 and 30 weeks later) evaluated the longer-term effectiveness, while all nudges remained in place. Dessert sales were analyzed separately for both sexes, students and staff categories (based on academic degree). Results: Compared to baseline, the combination of the Food Triangle and the green heart intervention materials in week 2 resulted in significant increases in fruit consumption across almost all subgroups. The other intervention materials used in the current study had rather limited effects in the short term. After 7 weeks of followup, significant fruit sale increases were established for all subgroups compared to baseline. At 30 weeks followup, the effect for staff B (Bachelor's degree) disappeared. The majority of the respondents (66.4%) had noticed at least one of the nudges, while only 3.4% indicated to have adjusted their dessert choice as a result of the nudges. Conclusions: The combination of nudges was effective in the long term and increased fruit purchase in nearly all subgroups. Short interviews show that a more active approach may be needed to increase effect sizes

The effect of a portion size intervention on French fries consumption, plate waste, satiety and compensatory caloric intake: an on-campus restaurant experiment

Abstract Background One of the driving factors of dietary overconsumption throughout the last decennia is the increase of food portion sizes. Larger portions induce higher daily energy intake, so reducing portion size may reduce intake of excess calories. However, real-life studies about the effects of portion size reduction are lacking. Therefore, this study examined the effect of a French fries portion size reduction on French fries consumption, French fries plate waste, satiety and caloric intake during the subsequent afternoon among university students and employees in a Belgian on-campus restaurant setting. Moreover, this study evaluated consumers’ perception about the portion size reduction. Methods The study took place over a two-time (i.e. baseline and intervention week) 4-day period (Tuesday–Friday) in the on-campus restaurant where ±1200 meals are served every day. French fries’ portions were reduced by 20% by replacing the usual porcelain bowl served during the baseline week (±200 g) with smaller volume paper bags during the intervention week (±159 g) in a pre-post real-life experiment. French fries consumption and plate waste were measured in 2056 consumers at baseline and 2175 consumers at intervention. Additionally, interviews were conducted directly after lunch and again between 4 and 6 p.m. on the same day to assess satiety and caloric intake at pre and post in a small subsample of both French fries consumers (n = 19) and non-French fries consumers (n = 14). Post-intervention, the same subsample was interviewed about their perception of the portion size reduction (n = 28). Results Total French fries intake decreased by 9.1%, and total plate waste decreased by 66.4%. No differences were found in satiety or caloric intake between baseline and intervention week among the French fries’ consumers. The majority (n = 24, 86%) of French fries consumers noticed the reduction in portion size during the intervention. Although most participants (n = 19, 68%) perceived the reduced portion size as sufficient, only a minority of participants (n = 9, 32%) indicated post-intervention that they would agree with a permanent implementation. Conclusions Reducing portion size may lead to reduced caloric intake, without changing perceived levels of satiety

Misreporting of Physical Activity and Sedentary Behavior in Parents-to-Be: A Validation Study across Sex

This study validated the International Physical Activity Questionnaire (IPAQ) and the Context-specific Sedentary Behavior Questionnaire (CSBQ) against accelerometry among parents-to-be. Sex-differences in potential misreporting of physical activity (PA) and sedentary behavior (SB) were also investigated. Self-reported total PA (TPA), light-intensity PA (LPA), moderate-intensity PA (MPA), vigorous-intensity PA (VPA), moderate-to-vigorous-intensity PA (MVPA), and SB of 91 parents-to-be (41 men and 50 women) were compared with Actigraph data according to sex. Furthermore, the extent of misreporting was compared between sexes. Strong correlations for TPA and weak-to-moderate correlations for LPA, MPA, VPA, MVPA, and SB were observed. Participants underestimated TPA by 1068 min/week (=17.8 h/week; −50%), LPA by 1593 min/week (=26.6 h/week; −83%), and SB by 428 min/week (=7.1 h/week; −11%) and overestimated MPA by 384 min/week (=6.4 h/week; +176%) and MVPA by 525 min/week (=8.8 h/week; +224%). Males overreported VPA more than females in absolute minutes per week (238 min/week, i.e., 4.0 h/week vs. 62 min/week, i.e., 1.0 h/week), whereas, in relative terms, the opposite (+850% vs. +1033%) was true. The IPAQ and CSBQ can be used with caution to estimate TPA and SB among parents-to-be considering a strong correlation but low agreement for TPA and a weak-to-moderate correlation but acceptable agreement for SB. We disadvise using these self-reports to estimate PA on the distinct intensity levels

Relative importance of determinants of changes in eating behavior during the transition to parenthood: Priorities for future research and interventions

Background: Healthy eating behavior throughout pregnancy and postpartum is important. This study aimed to investigate the perceived sex-specific importance of determinants of changes in eating behavior during pregnancy and postpartum. Methods: Fifty-four determinants were rated by first-time parents (n = 179) on their impact. Experts (n = 31) rated the determinants in terms of their modifiability, relationship strength, and population-level effect from which a “priority for research”-score was calculated. Results: During pregnancy, the three highest rated determinants by women were “health concerns”, “physiological changes”, and “fatigue”. Men perceived “health concerns”, “health consciousness”, and “influence of the pregnant partner” as important. Postpartum, the three highest rated determinants by women were “adaptation to rhythm of baby”, “baby becomes priority”, and “practical constraints because of the baby”. Men perceived “adaptation to rhythm of baby”, “fatigue”. and “(lack of) anticipation” as important. According to the experts, “professional influence”, “food knowledge”, and “home food availability” received high priority scores for both sexes and during both periods. Conclusions: Priority for research and interventions should go towards tailored family-based approaches focusing on food education in a broad sense taking into account aspects such as health consciousness, self-efficacy skills, and the social and home food environment while being supported by healthcare professionals

Relative importance of determinants of changes in eating behavior during the transition to parenthood: Priorities for future research and interventions

Background: Healthy eating behavior throughout pregnancy and postpartum is important. This study aimed to investigate the perceived sex-specific importance of determinants of changes in eating behavior during pregnancy and postpartum. Methods: Fifty-four determinants were rated by first-time parents (n = 179) on their impact. Experts (n = 31) rated the determinants in terms of their modifiability, relationship strength, and population-level effect from which a “priority for research”-score was calculated. Results: During pregnancy, the three highest rated determinants by women were “health concerns”, “physiological changes”, and “fatigue”. Men perceived “health concerns”, “health consciousness”, and “influence of the pregnant partner” as important. Postpartum, the three highest rated determinants by women were “adaptation to rhythm of baby”, “baby becomes priority”, and “practical constraints because of the baby”. Men perceived “adaptation to rhythm of baby”, “fatigue”. and “(lack of) anticipation” as important. According to the experts, “professional influence”, “food knowledge”, and “home food availability” received high priority scores for both sexes and during both periods. Conclusions: Priority for research and interventions should go towards tailored family-based approaches focusing on food education in a broad sense taking into account aspects such as health consciousness, self-efficacy skills, and the social and home food environment while being supported by healthcare professionals

Body weight, body composition and energy balance related behaviour during the transition to parenthood: study protocol of a multi-centre observational follow-up study (TRANSPARENTS)

Abstract Background The transition to parenthood is a cornerstone event for both parents, potentially leading to relevant changes in lifestyle and behaviour. In women, the metabolic changes during and after pregnancy and the deleterious effects of excessive gestational weight gain and postpartum weight retention have been extensively described. However, there is no full understanding about which specific energy balance related behaviours (EBRB) contribute to unfavourable weight gain and weight retention. Furthermore, information on how transition to parenthood affects men is lacking. Therefore, this study aims to investigate changes in body weight, body composition and EBRB in couples transitioning to parenthood. Methods TRANSPARENTS is a multi-centre observational follow-up study that focuses on body weight, body composition and EBRB during the transition to parenthood. Couples (women and men) will be recruited during the first trimester of their first pregnancy. Study visits will occur at four occasions (12 weeks of pregnancy, 6 weeks postpartum, 6 months postpartum and 12 months postpartum). Anthropometrics of the parents and new-borns will be assessed including body weight, height/length, body composition (using bio-electrical impedance analysis and measurement of four skinfold thicknesses (biceps, triceps, subscapular and supraspinal/suprailiac)) and waist and hip circumference. Dietary intake, physical activity, sedentary behaviour, smoking habits, sleeping pattern, fatigue, diet and exercise related partner support, mental health, breastfeeding, contraception use, and socio-demographics will be assessed using a questionnaire. In addition, accelerometry will be used to assess physical activity and sedentary behaviour objectively. Also data from women’s medical record, such as pre-pregnancy weight and pregnancy outcomes, will be included. Multilevel modelling will be used to evaluate maternal and paternal changes in body weight, body composition and EBRB during and after pregnancy (primary outcomes). Multiple linear regression analyses will be performed to identify predictors of changes in body weight, body composition and EBRB. All analyses will be adjusted for possible confounders. Discussion TRANSPARENTS is a unique project identifying vulnerable parents and (un)favourable changes in EBRB throughout this potentially critical life period. Provided insights will facilitate the development of effective intervention strategies to help couples towards a healthy transition to parenthood. Trial registration Clinicaltrials.gov Identifier: NCT03454958. Registered March 2018

Determinants of changes in women’s and men’s eating behavior across the transition to parenthood: a focus group study

Background: During the pregnancy and postpartum period, both women and men experience physiological and psychological changes, which may negatively impact their eating behavior. A clear understanding of determinants of changes in eating behavior during this period is needed to facilitate the development of targeted family-based interventions countering unfavorable dietary changes during this critical life period. Methods: Thirteen focus group discussions targeting determinants of changes in eating behavior during pregnancy and postpartum were conducted, involving a total of 74 expecting and first-time parents. A semi-structured question guide was used to facilitate the discussions. An inductive thematic approach was used to derive main and sub-categories of determinants from the data. The Determinants of Nutrition and Eating (DONE)-framework was employed to systematically organize and label the categories and determinants. Results: Two frameworks were developed; one for the pregnancy and one for the postpartum period, comprising determinants of changes in eating behavior in both women and men. Three main levels of determinants were identified: (1) the individual level, including psychological (e.g., ‘health consciousness’), situational (e.g., ‘effort and convenience’) and biological (e.g., ‘discomfort’); (2) the interpersonal level (e.g., ‘social influence’) and (3) the environmental level, including micro- and meso/macro (e.g., ‘home/environment food availability’). Determinants acting as barriers (e.g., ‘time constraints’) or facilitators (e.g., ‘being a role model’) were identified. Many determinants were mentioned during both (e.g., ‘food knowledge’) or just one investigated period (e.g., ‘physiological changes’ during pregnancy, ‘influence of the baby’ postpartum). Finally, some were described by both parents (e.g., ‘self-regulation’), whereas others were mentioned by women (e.g., ‘(perceived) food safety’) or men (e.g., ‘other priorities’) only. Conclusion: The developed frameworks set the foundation for the development of future family-based interventions and may be used already by healthcare providers to provide dietary guidance and support for women and men transitioning into parenthood. A focus on the interplay of individual factors at the biological and psychological level together with situational difficulties during pregnancy is recommended. Postpartum, focus should go to support first-time parents to obtain balance of both maintaining one’s own health and taking care of the baby, on improving self-regulation skills, and on coping with related situational constraints