New paper on antenatal diet, activity and weight accepted

Our paper entitled ‘Antenatal weight management: Diet, physical activity, and gestational weight gain in early pregnancy’ has been accepted for publication in Midwifery. The study authors are Judy A Swift; Simon Langley-Evans; Jo Pearce; Preeti H Jethwa; Moira A Taylor; Amanda Avery; Sarah Ellis; Sarah McMullen; Kirsty J Elliot-Sale.

The abstract of the study is below.

Objective: to investigate women’s physical activity levels, diet and gestational weight gain, and their experiences and motivations of behavior change.

Design: analysis of cross-sectional data collected during a longitudinal study examining physiological, psychological, sociodemographic, and self-reported behavioural measures relating to bodyweight.

Setting: women recruited from routine antenatal clinics at the Nottingham University Hospitals NHS Trust.

Participants:  193 women £27 weeks gestation and aged 18 years or over.

Measurements & findings: measurements included weight and height, the Dietary Instrument for Nutrition Education (Brief Version), the International Physical Activity Questionnaire (Short Form), and open questions of perceptions of behaviour change. 50.3% (n=97) were overweight/obese and women gained 0.26kg/wk (IQR 0.34 kg/wk) since conception. The majority consumed low levels of fat (n=121; 63.4%), high levels of unsaturated fat (n=103; 53.9%), and used a dietary supplement (n=166; 86.5%). However, 41% (n=76) were inactive, 74.8% (n=143) did not consume high levels of fibre, and 90.0% (n=171) consumed less than 5 portions of fruit and vegetables a day. Body mass index category was not associated with diet, physical activity levels, or gestational weight gain. Themes generated from open-questions were: (1) Risk management, (2) Coping with symptoms, (3) Self-control, (4) Deviation from norm, (5) Nature knows best.

Conclusions: early pregnancy is a period of significant and heterogeneous behaviour change, influenced by perceptions of risk and women’s lived experience. Behaviour was influenced not only by perceptions of immediate risk to the foetus, but also by the women’s lived experience of being pregnant.

Implications for practice: health promotion advice relating to physical activity and diet could be reframed in light of women’s priorities. The need for individualized advice is highlighted and women across all body mass index categories would benefit from improved diet and physical activity levels.

Paper accepted by British Journal of Nutrition

The British Journal of Nutrition has accepted our paper entitled ‘Fetal and neonatal exposure to trans fatty acids impacts on susceptibility to atherosclerosis in apolipoprotein E*3 Leiden mice‘, for publication. The study authors are Louise Gates, Simon Langley-Evans, Jana Kraft, Adam Lock and Andy Salter.  The work was funded by the United States Department of Agriculture as a collaboration between the universities of Michigan, Vermont and Nottingham, and was an element of Louise Gates PhD studies.

The abstract of the paper is below:

Nutrition during pregnancy impacts on the susceptibility of the offspring to a range of chronic diseases, including cardiovascular disease. Postnatal consumption of trans fatty acids (TFA), associated with partially hydrogenated vegetable oil (P-TFA), has been linked to increased risk of atherosclerosis, while evidence for those trans fatty acids associated with ruminant-derived dairy and meat (R-TFA) remain equivocal.  Here, we investigate the impact of maternal consumption of dietary P-TFA and R-TFA on the development of atherosclerosis in their offspring, using the transgenic apoE*3 Leiden mouse.  Dams were fed either chow or one of three high fat diets: a high-fat diet designed to reflect the saturated fatty acid content of a ‘Western’ diet, one enriched with P-TFA or one enriched with R-TFA.  Diets were fed during either pregnancy alone or pregnancy and lactation.  Weaned offspring were then transferred to an atherogenic diet for twelve weeks.  Atherosclerosis was assessed as lipid staining in cross-sections of the aorta.  Compared to those born of chow-fed dams, mice from those fed R-TFA or P-TFA during pregnancy alone were protected from aortic atherosclerosis (p=0.011 and 0.017, respectively). This was not associated with changes in total or lipoprotein cholesterol.  Continuing to feed TFA during lactation increased atherosclerosis compared to that seen in offspring of dams fed TFA only during pregnancy (p= 0.024 and 0.028 for an interaction between diet and section number for P-TFA and R-TFA, respectively).  We conclude that dietary TFA have differing effects on cardiovascular risk at different stages of the lifecycle.

Weight loss paper gets media attention


Our paper on setting weight loss targets and actual achieved weight loss in the Slimming World cohort has had considerable media coverage today, with articles published in the Independent, the Times, Sun, Mirror and Daily Mail.

The message of the paper was that setting targets that were beyond what is normally considered practicable appears to increase the ability of individuals to achieve the clinically desirable 5-10% weight loss.