Literature Review: Pregnant and breastfeeding ... - Eat For Health

ReferenceKinnunen 2007bDietary patterns Advice to 1) have a regular meal pattern, emphasising the importance of breakfast and at least one hot meal every day; 2) to eat at least 5 portions (400g) per day of different kinds of vegetables, fruits and berries, 3) to consume mostly high fibre bread (≥ 5 g fibre/100 g) and 4) to restrict the intake ofhigh-sugar snacks to ≤ 1 portion per day (e.g. 50 g sweets, one pastry, one piece of cake, two biscuits, 2 dl ice cream or a glass of soft drink) [plusadvice to be physically active]Study typeControlled trial (ISRCTN21512277)Level of evidence III-2 (nonrandomised concurrent comparison; interventions)SettingSix antenatal clinics in Finland (three intervention; three control)FundingUS NIH, Ministry of Education and Ministry of Social Affairs and Health, Finland, Doctoral Programs in Public Health, FinlandParticipants 92 postpartum primiparas; recruited between August 2004 and January 2005Exclusion criteria: under 18 years of age, type I or II diabetes mellitus (but not GDM), twin pregnancy, physical disability that prevents exercising,otherwise problematic pregnancy, substance abuse, treatment or clinical history for any psychiatric illness, inability to speak Finnish and intention tochange residence within 3 months.Baseline comparisons Characteristics of women in the intervention and control groups were not significantly differentDietary assessment FFQTiming2, 5, 6 and 10 months postpartumComparisonIntervention (dietary and physical activity counselling from 2 to 10 months postpartum) versus standard antenatal careOutcomesAchieving recommended dietary pattern; gestational weight retentionResultsIntervention (n = 46) Control (n = 37) aOR/MD (95% CI)Retained ≤ 0 kg at 10 m pp* 23 (50%) 11 (30%) 3.89 (1.16 to 13.04)Weight retention, mean (kg, SD) at m pp 1.8 [4.3] 1.0 [4.4] 0.8 (-1.1 to 2.7)Waist circumf at 10 months pp, mean (cm SD) 78.1 [10.2] 75.4 [6.2] 1.0 (0.7 to 2.7)Veg, fruit, beries (prtions/day) at 10 m pp** 2.6 [1.4] (n = 44) 2.5 [2.1] (n = 37)Adj mean difference = +0.2 95% CI -0.3 to 0.8High-fibre bread (% total bread) at 10 mpp** 65 [27] (n = 44) 52 [31] (n = 37)Adj mean difference = + 16.1 95% CI 4.3 to 27.9High-sugar snacks (portions/day) at 10 mpp** 2.1 [1.2] (n = 44) 2.1 [1.4] (n = 37)Adj mean difference = 0.0 95% CI -0.6 to 0.6)FollowupConfoundingRisk of biasRelevanceOther commentsTo 10 months posptpartum*Adjusted for age, pre-pregnancy BMI, education, gestational weight gain, weight at 2 months postpartum, duration of exclusive breastfeeding andsmoking status**baseline intake of the outcome variable, age, education, smoking status, gesational weight gain and BMI at 2 months postpartumModerate risk of bias: 5/53 (9%) lost to followup in the intervention group and 2/39 (5%) in the control group; three clinics volunteered to be interventionclinics and the other three clinics were controlsLikely to be reasonably relevant to Australian womenUnderpowered; pilot for a larger studyPregnancy and Breastfeeding Dietary Patterns37