|Study and||Nutrition||Physical Activity||Monitoring weight and behaviour change||Control|
▪ 1 meeting with dietician at enrolment: where appropriate food choices discussed and focused food plan given.|
▪ Patient focused caloric value divided up as 40% carbohydrate, 30% protein and 30% fat
|▪ Instructed to engage in moderate intensity exercise 3-5 times per week||▪ Use of gestational weight gain grid to plot weight at each antenatal appointment. Physician or nurse would inform participant if weight was within IoM guidelines and to modify diet and exercise accordingly.||
▪ Routine prenatal care and some educational material containing advice regarding diet and exercise.|
▪ Weight measurement at each routine obstetrical appointment.
▪ Three, one hour small group sessions led by a nutritionist. Supplemented with purpose designed brochure|
▪ Aimed at limiting the intake of energy-dense foods by substituting with healthier alternatives, increasing low-fat dairy products, increasing whole-wheat grains and reducing saturated fatty acids.
▪ Information given about energy balance, body composition and nutrition food labels and techniques of behaviour change to give insight into emotional eating.
|▪ Information given on how to increase physical activity||
▪ 7 day food diary kept every trimester|
▪ Weight measured at each antenatal visit
|▪ Routine prenatal care|
▪ The Food Choice Map (FCM) interview was used as a tool for both assessment and intervention. Participants recalled their usual food intake during 1 week. Dieticians provided a personalized plan for participants, including recommended changes in food choice frequency, portion size and pattern of intake.|
▪ FCM software analyzed total energy and macronutrients in daily intake, as well as gestation week-related gain based on information received during the interview.
|▪ Instructed in group session exercises and in home based exercise. Groups led by professional trainers and student assistants. Recommended exercise 3-5 times per week for 30 to 45 min per session. Weekly group-based session (~45 min/session). Video exercise instruction was provided to participants to assist with home based exercise.||▪ Information about daily physical activity including a self-recorded activity diary were collected.||
▪ Standard care|
▪ Physical activity was recommended for participants in the SC group, but they were not instructed in the group exercise sessions or on home-based exercise.
▪ Basic exercise advice that consisted of a simple statement that women should exercise regularly but given no instructions.
▪ Information package about national recommendations for dietary intake during pregnancy
▪ Stepped-care behavioural intervention: education and feedback about weight gain, which stressed healthy, low-fat eating Delivered by master's and doctoral level staff with training in nutrition or clinical psychology|
▪ Written and oral information in the following areas: (a) appropriate weight gain during pregnancy; (b) exercise during pregnancy (c) healthful eating during pregnancy.
|▪ Exercise intervention focused on increasing walking and developing a more active lifestyle.||
▪ Newsletters gave advice about exercise as well as diet and sent biweekly. Between visits women were contacted by phone to discuss progress towards the goals set at the previous visit|
▪ Personalized graph of their weight gain. Weight changes within the appropriate ranges were informed that they were gaining the expected amount of weight. Weight was measured at every clinic visit and participants advised accordingly.
|▪ Usual care/standard nutrition counselling well-balanced dietary intake and advice to take a multivitamin/iron supplement.|
▪ Women were instructed to eat a healthy diet according to the official Danish dietary recommendations.|
▪ 10 consultations of 1 hour each with a trained dietician during the pregnancy
|▪ Seven-day weighed food records were obtained at inclusion, and at 27 and 36 weeks of gestation in both groups. Weights monitored at 27, 36 weeks||
▪ The control group had no consultations with the dietician|
▪ No restrictions on energy intake or gestational weight gain