Ciara A. McGowan

Childhood obesity is associated with increased risk of adult obesity and metabolic disease. Diet and lifestyle in pregnancy influence fetal programming; however the influence of specific dietary components, including low glycaemic index (GI), remains complex. We examined the effect of a maternal low GI dietary intervention on offspring adiposity at 6 months and explored the association between diet and lifestyle factors in pregnancy and infant body composition at 6 months. 280 6-month old infant and mother pairs from the control (n = 142) and intervention group (n = 138), who received low GI dietary advice in pregnancy, in the ROLO study were analysed. Questionnaires (food diaries and lifestyle) were completed during pregnancy, followed by maternal lifestyle and infant feeding questionnaires at 6 months postpartum. Maternal anthropometry was measured throughout pregnancy and at 6 months post-delivery, along with infant anthropometry. No difference was found in 6 months infant adiposity between control and intervention groups. Maternal trimester three GI, trimester two saturated fats and trimester one and three sodium intake were positively associated with offspring adiposity, while trimester two and three vitamin C intake was negatively associated. In conclusion associations were observed between maternal dietary intake and GI during pregnancy and offspring adiposity at 6 months of age.

The in utero environment is known to affect fetal development however many of the mechanisms by which this occurs remain unknown. The aim of this study was to examine the association between maternal dietary macronutrient intake and lifestyle throughout pregnancy and neonatal weight and adiposity.

Pregnancy increases the risk of being overweight at a later time period, particularly when there is excessive gestational weight gain. There remains a paucity of data into the effect of low glycaemic index (GI) pregnancy interventions postpartum. Aim: To examine the impact of a low glycaemic index diet during pregnancy on maternal diet 3 months postpartum. Methodology: This analysis examined the diet, weight and lifestyle of 460 participants of the ROLO study 3 months postpartum. Questionnaires on weight, physical activity, breastfeeding, supplement use, food label reading and dietary habits were completed. Results: The intervention group had significantly greater weight loss from pre-pregnancy to 3 months postpartum than the control group (1.3 vs. 0.1 kg, p = 0.022). The intervention group reported greater numbers following a low glycaemic index diet (p < 0.001) and reading food labels (p = 0.032) and had a lower glycaemic load (GL) (128 vs. 145, p = 0.014) but not GI (55 vs. 55, p = 0.809) than controls. Conclusions: Low GI dietary interventions in pregnancy result in improved health-behaviours and continued reported compliance at 3 months postpartum possibly through lower dietary GL as a result of portion control. Greater levels of weight loss from pre-pregnancy to 3 months postpartum in the intervention group may have important positive implications for overweight and obesity.

Background: Maternal diet is known to impact pregnancy outcome. Following a low glycemic index (GI) diet during pregnancy has been shown to improve maternal glycemia and reduce infant birthweight and may be associated with a higher fibre intake. We assessed the impact of a low GI dietary intervention on maternal GI, nutritional intake and gestational weight gain (GWG) during pregnancy. Compliance and acceptability of the low GI diet was also examined. Method: Eight hundred women were randomised in early pregnancy to receive low GI and healthy eating dietary advice or to receive standard maternity care. The intervention group received dietary advice at a group education session before 22 weeks gestation. All women completed a 3 day food diary during each trimester of pregnancy. Two hundred and thirty five women from the intervention arm and 285 women from the control arm returned complete 3x3d FDs and were included in the present analysis. Results: Maternal GI was significantly reduced in the intervention group at trimester 2 and 3. The numbers of women within the lowest quartile of GI increased from 37% in trimester 1 to 52% in trimester 3 (P < 0.001) among the intervention group. The intervention group had significantly lower energy intake (P < 0.05), higher protein (% TE) (P < 0.01) and higher dietary fibre intake (P < 0.01) post intervention. Consumption of food groups with known high GI values were significantly reduced among the intervention group. Women in the intervention low GI group were less likely to exceed the Institute of Medicine’s GWG goals. Conclusion: A dietary intervention in early pregnancy had a positive influence on maternal GI, food and nutrient intakes and GWG. Following a low GI diet may be particularly beneficial for women at risk of exceeding the GWG goals for pregnancy. Trial registration: Current Controlled Trials Registration Number: ISRCTN54392969.

Background: To date, there are no food frequency questionnaires that have been validated to assess nutrient intakes in pregnant women in Ireland. The present study aimed to assess the relative validity of a self‐administered food frequency questionnaire during pregnancy.Methods: The food frequency questionnaire was administered once during pregnancy between 12 and 34 weeks. Participants also completed a 3‐day food diary during each trimester of pregnancy (reference method) and intakes from both the food frequency questionnaire and the mean of the 3‐day food diaries were compared in a sample of 130 participants from the control arm of an intervention study.Results: Energy‐adjusted Pearson's correlation coefficients ranged from 0.24 (riboflavin) to 0.59 (magnesium) and were all statistically significant (P < 0.05). The food frequency questionnaire tended to report higher energy and nutrient intakes compared to the food diaries. On average, 74% of participants were classified into the same ± 1 quartile and 7% into opposing quartiles by the two methods.Conclusions: Overall, our food frequency questionnaire showed good relative validity. We conclude that a single administration of a food frequency questionnaire is a valid tool for ranking women in accordance with their nutrient intakes during pregnancy.

Objective: To determine the main dietary patterns of pregnant women during each of the three trimesters of pregnancy and to examine associated nutrient intakes.Design: Participants completed a 3 d food diary during each trimester of pregnancy. Thirty-six food groups were created and dietary patterns were derived using k-means cluster analysis.Setting: National Maternity Hospital, Dublin, Ireland.Subjects: Two hundred and eighty-five healthy pregnant women aged between 20 and 41 years.Results: Two dietary patterns were identified at each time point. They were labelled ‘Unhealthy’ (n 143, 150 and 155 at trimester 1, 2 and 3, respectively) and ‘Health Conscious’ (n 142, 135 and 130 at trimester 1, 2 and 3, respectively). Women in the ‘Health Conscious’ cluster were significantly older, had lower BMI and were higher educated than those in the ‘Unhealthy’ cluster. Of those in the ‘Unhealthy’ cluster in the first trimester (n 143), 103 (72·0 %) continued in this dietary pattern into trimester 2 and eighty-one (56·6 %) continued into trimester 3. Of those in the ‘Health Conscious’ cluster in trimester 1 (n 142), ninety-five (66·9 %) continued in this dietary pattern into trimester 2 and sixty-nine (48·6 %) continued into trimester 3.Conclusions: Cluster analysis produced two clearly defined dietary patterns at each stage of pregnancy. Knowledge of maternal dietary patterns is important for the development of pregnancy-specific dietary guidelines. Identifying women with an ‘Unhealthy’ dietary pattern in early pregnancy affords the opportunity for a dietary intervention which may positively impact both maternal and infant health.

Pregnancy is a critical period in a woman's life where nutrition is of key importance for optimal pregnancy outcome. The aim of this study was to assess maternal nutrient intakes during early pregnancy and to examine potential levels of energy underreporting. Three-day food diaries were collected from 260 healthy pregnant women sampled from the control arm of a large Irish pregnancy cohort at 14 weeks gestation (range 12–20 weeks). Up to 45% of pregnant women may be underreporting daily energy intake (EI). Multiple logistic regression analysis found that having a body mass index (BMI) of 25 kg/m² compared with a BMI 2 (odds ratio, 4.4; 95% confidence interval, 2.5–7.7) was the main predictor of energy underreporting. Educational attainment is also an important predictor of energy underreporting. Women who underreport their EI tend to be less compliant with the current dietary recommendations for pregnancy. These data highlight the need for more education and public health interventions among pregnant women to achieve current dietary guidelines. In the analysis of dietary intakes, removal of extreme under reporters (Goldberg's ratio <0.9) may allow for more accurate assessment of nutritional intakes amongst pregnant women.

Vitamin D has an important role in pregnancy in promoting fetal skeletal health. Maternal dietary intake is a key factor influencing both maternal and fetal status. There are limited data available on food groups contributing to vitamin D intake in pregnancy. The aim of this study was to determine dietary intakes of vitamin D throughout pregnancy in 64 women and to determine the main food groups contributing to vitamin D intake. Results showed that median dietary intakes of vitamin D ranged from 1.9–2.1 μg/d during pregnancy, and were 80% below the current recommendation. The principal food groups contributing to vitamin D intake were meat, egg and breakfast cereal groups. Oily fish, the best dietary source of vitamin D, was consumed by <25% of women. These data call for more education; they question the role of vitamin D supplementation and highlight the contribution of other food groups more frequently consumed, namely, breakfast cereals, meat and eggs.