The rising prevalence of overweight and obesity is a worldwide public health challenge. Pregnancy and beyond is a potentially important window for future weight gain in women. We investigated associations between maternal adherence to the New Nordic diet (NND) during pregnancy and maternal BMI trajectories from delivery to 8 years post delivery. Data are from the Norwegian Mother and Child Cohort. Pregnant women from all of Norway were recruited between 1999 and 2008, and 55 056 are included in the present analysis. A previously constructed diet score, NND, was used to assess adherence to the diet. The score favours intake of Nordic fruits, root vegetables, cabbages, potatoes, oatmeal porridge, whole grains, wild fish, game, berries, milk and water. Linear spline multi-level models were used to estimate the association. We found that women with higher adherence to the NND pattern during pregnancy had on average lower post-partum BMI trajectories and slightly less weight gain up to 8 years post delivery compared with the lower NND adherers. These associations remained after adjustment for physical activity, education, maternal age, smoking and parity (mean diff at delivery (high v. low adherers): -0·3 kg/m2; 95 % CI -0·4, -0·2; mean diff at 8 years: -0·5 kg/m2; 95 % CI -0·6, -0·4), and were not explained by differences in energy intake or by exclusive breast-feeding duration. Similar patterns of associations were seen with trajectories of overweight/obesity as the outcome. In conclusion, our findings suggest that the NND may have beneficial properties to long-term weight regulation among women post-partum.
Preeclampsia and preterm delivery are serious complications of pregnancy and leading causes of perinatal mortality and morbidity worldwide. Dietary factors might be associated with these adverse outcomes. We investigated whether adherence to the New Nordic Diet (NND) was associated with preeclampsia and preterm delivery risks in the Norwegian Mother and Child Cohort Study (MoBa). Participants were recruited from all over Norway during the period 1999-2008. A previously constructed diet score assessing meal frequency, and the consumption of Nordic fruits, root vegetables, cabbages, potatoes, oatmeal porridge, whole grains, wild fish, game, berries, milk and water, was used to assess NND adherence. Associations between NND adherence and the outcomes were estimated in adjusted multivariate logistic regression models. Odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated. A total of 72,072 women was included in the study. High versus low NND adherence was associated with lower risk of total preeclampsia (OR 0.86; 95 % CI 0.78-0.95) and early preeclampsia (OR 0.71; 95 % CI 0.52-0.96). High compared with low NND adherence was associated with a lower risk of spontaneous preterm delivery among nulliparous women (OR 0.77; 95 % CI 0.66-0.89), whereas multiparous women with high NND adherence had a marginally significant higher risk of preterm delivery (OR 1.24; 95 % CI 1.00-1.53). High NND adherence was associated with a lower relative risk of preeclampsia and of spontaneous preterm delivery among nulliparous women; however, among multiparous women there was a higher relative risk of preterm delivery.
Pregnancy is characterised by large weight gain over a short period, and often a notable change in mode of transportation. This makes pregnancy suitable for examining the plausible, but in the scientific literature still unclear, association between active transportation and weight gain. We hypothesize that women continuing an active mode of transportation to work or school from pre- to early pregnancy will have a lower gestational weight gain (GWG) than those who change to a less active mode of transportation.
We analysed prospective data from the Norwegian Fit for Delivery (NFFD) trial. Between September 2009 and February 2013 606 women were consecutively enrolled in median gestational week 16 (range; 8-20). Of 219 women who used an active mode of transportation (biking, walking, public transportation) pre-pregnancy, 66 (30%) converted to a less active mode in early pregnancy ("active-less active" group), and 153 (70%) continued with active transportation ("active-active" group). Pre-pregnancy weight was self-reported. Weight at gestational (GA) weeks 16, 30, 36, and at term delivery was objectively measured. Weight gain was compared between the two groups. Linear mixed effects analysis of the repeated weight measures was performed including the group*time interaction.
A significant overall group effect was observed for the four time points together ("active-active" group: 77.3 kg vs. "active-less active" group: 78.8 kg, p?=?0.008). The interaction term group*time was significant indicating different weight gain throughout pregnancy for the two groups; the mean differences between the groups were 0.7 kg at week 16, 1.4 kg at week 30, 2.1 kg at week 36, and 2.2 kg at term delivery, respectively.
The findings indicate that active transportation is one possible approach to prevent excessive weight gain in pregnancy.
Cites: Int J Behav Nutr Phys Act. 2012;9:1222321640
Cites: Scand J Med Sci Sports. 2012 Feb;22(1):128-3820500556
Cites: Med Sci Sports Exerc. 2012 Jun;44(6):1067-7422143108
To describe changes in consumption of different types of beverages from pre-pregnancy to early pregnancy, and to examine associations with maternal age, educational level and BMI.
Cross-sectional design. Participants answered an FFQ at inclusion into a randomized controlled trial, the Fit for Delivery (FFD) trial, in median gestational week 15 (range: 9-20), reporting current consumption and in retrospect how often they drank the different beverages pre-pregnancy.
Eight local antenatal clinics in southern Norway from September 2009 to February 2013.
Five hundred and seventy-five healthy pregnant nulliparous women.
Pre-pregnancy, 27 % reported drinking alcohol at least once weekly, compared with none in early pregnancy (P
To analyse (i) differences in beverage pattern among Norwegian children in 2001 and 2008; (ii) beverage intake related to gender, parental education and family composition; and (iii) potential disparities in time trends among the different groups.
Within the Fruits and Vegetables Make the Marks (FVMM) project, 6th and 7th grade pupils filled in a questionnaire about frequency of beverage intake (times/week) in 2001 and 2008.
Twenty-seven elementary schools in two Norwegian counties.
In 2001 a total of 1488 and in 2008 1339 pupils participated.
Between 2001 and 2008, a decreased consumption frequency of juice (from 3·6 to 3·4 times/week, P = 0·012), lemonade (from 4·8 to 2·5 times/week, P
A healthy diet is important for pregnancy outcome and the current and future health of woman and child. The aims of the study were to explore the changes from pre-pregnancy to early pregnancy in consumption of fruits and vegetables (FV), and to describe associations with maternal educational level, body mass index (BMI) and age.
Healthy nulliparous women were included in the Norwegian Fit for Delivery (NFFD) trial from September 2009 to February 2013, recruited from eight antenatal clinics in southern Norway. At inclusion, in median gestational week 15 (range 9-20), 575 participants answered a food frequency questionnaire (FFQ) where they reported consumption of FV, both current intake and recollection of pre-pregnancy intake. Data were analysed using a linear mixed model.
The percentage of women consuming FV daily or more frequently in the following categories increased from pre-pregnancy to early pregnancy: vegetables on sandwiches (13 vs. 17%, p?
There has been an increase in screen-based communication, leading to concerns about the negative health effects of screen-based activities in children and adolescents. The present study aimed to (1) analyze changes in screen time activity in Norwegian children from 2001 to 2008, and (2) to analyze associations between the changes in screen time activity over time and sex, grade level and parental educational level.
Within the project Fruits and Vegetables Make the Marks (FVMM), 1488 6th and 7th grade pupils from 27 Norwegian elementary schools completed a questionnaire including a question about time spent on television viewing and personal computer use in 2001 and 1339 pupils from the same schools completed the same questionnaire in 2008. Data were analyzed by multilevel linear mixed models.
The proportions of 6th and 7th grade pupils at the 27 schools that reported screen time activity outside school of 2 hours/day or more decreased from 55% to 45% (p
To examine the roles of child cognitions and parental feeding practices in explaining child intentions and behaviour regarding fruit and vegetable consumption.
Cross-sectional surveys among pre-adolescent children and their parents.
The child questionnaire included measures of fruit and vegetable consumption and cognitions regarding fruit and vegetable consumption as postulated by the Attitude-Social Influence-Self-Efficacy (ASE) model. The parent questionnaire included measures of parental feeding practices derived from the Comprehensive Feeding Practices Questionnaire (CFPQ).
In total, 963 parents and 796 students in grades 5 and 6 from eighteen schools in the south-western part of Norway participated.
A large portion of child intention to eat fruit and child fruit consumption was explained by child cognitions (29 % and 25 %, respectively). This also applied to child intention to eat vegetables and child vegetable consumption (42 % and 27 %, respectively). Parent-reported feeding practices added another 3 % to the variance explained for child intention to eat fruit and 4 % to the variance explained for child vegetable consumption.
The results from the present study supported the application of the ASE model for explaining the variance in child intentions to eat fruit and vegetables and in child consumption of fruit and vegetables. Furthermore, our findings indicated that some parental feeding practices do have an influence on child intentions and behaviour regarding fruit and vegetable consumption. However, the role of parental feeding practices, and the pathways between feeding practices and child eating intentions and behaviour, needs to be further investigated.
To construct a diet score for assessing degree of adherence to a healthy and environmentally friendly New Nordic Diet (NND) and to investigate its association with adequacy of gestational weight gain and fetal growth in a large prospective birth cohort.
Main exposure was NND adherence, categorized as low, medium or high adherence. Main outcomes were adequacy of gestational weight gain, described as inadequate, optimal or excessive according to the 2009 Institute of Medicine guidelines, and fetal growth, categorized as being small, appropriate or large for gestational age. Associations of NND adherence with gestational weight gain and fetal growth were estimated with multinomial logistic regression in crude and adjusted models.
Women (n 66 597) from the Norwegian Mother and Child Cohort Study (MoBa).
Higher NND adherence implied higher energy and nutrient intakes, higher nutrient density and a healthier macronutrient distribution. Normal-weight women with high as compared with low NND adherence had lower adjusted odds of excessive gestational weight gain (OR=0·93; 95 % CI 0·87, 0·99; P=0·024). High as compared with low NND adherence was associated with reduced odds of the infant being born small for gestational age (OR=0·92; 95 % CI 0·86, 0·99; P=0·025) and with higher odds of the baby being born large for gestational age (OR=1·07; 95 % CI 1·00, 1·15; P=0·048).
The NND score captures diet quality. Adherence to a regional diet including a large representation of fruits and vegetables, whole grains, potatoes, fish, game, milk and drinking water during pregnancy may facilitate optimal gestational weight gain in normal-weight women and improve fetal growth in general.
The effectiveness of prenatal lifestyle intervention to prevent gestational diabetes and improve maternal glucose metabolism remains to be established. The Norwegian Fit for Delivery (NFFD) randomized, controlled trial studied the effect of a combined lifestyle intervention provided to a general population, and found significantly lower gestational weight gain among intervention participants but no improvement in obstetrical outcomes or the proportion of large infants. The aim of the present study is to examine the effect of the NFFD intervention on glucose metabolism, including an assessment of the subgroups of normal-weight and overweight/obese participants.
Healthy, non-diabetic women expecting their first child, with pre-pregnancy body mass index (BMI) =19 kg/m2, age = 18 years and a singleton pregnancy of =20 gestational-weeks were enrolled from healthcare clinics in southern Norway. Gestational weight gain was the primary endpoint. Participants (n = 606) were individually randomized to intervention (two dietary consultations and access to twice-weekly exercise groups) or control group (routine prenatal care). The effect of intervention on glucose metabolism was a secondary endpoint, measuring glucose (fasting and 2-h following 75-g glucose load), insulin, homeostatic assessment of insulin resistance (HOMA-IR) and leptin levels at gestational-week 30.
Blood samples from 557 (91.9%) women were analyzed. For the total group, intervention resulted in reduced insulin (adj. Mean diff -0.91 mU/l, p = 0.045) and leptin levels (adj. Mean diff -207 pmol/l, p = 0.021) compared to routine care, while glucose levels were unchanged. However, the effect of intervention on both fasting and 2-h glucose was modified by pre-pregnancy BMI (interaction p = 0.030 and p = 0.039, respectively). For overweight/obese women (n = 158), intervention was associated with increased risk of at least one glucose measurement exceeding International Association of Pregnancy and Diabetes Study Group thresholds (33.7% vs. 13.9%, adj. OR 3.89, p = 0.004).
The Norwegian Fit for Delivery intervention lowered neither glucose levels nor GDM incidence, despite reductions in insulin and leptin. Prenatal combined lifestyle interventions designed for a general population may be unsuited to reduce GDM risk, particularly among overweight/obese women, who may require earlier and more targeted interventions.
ClinicalTrials.gov ID NCT01001689 , registered July 2, 2009, confirmed completed October 26, 2009 (retrospectively registered).