BackgroundFrom a life course perspective, pregnancy leads to a rise in nutrition awareness and an increase in information flow in favour of adopting healthier eating behaviours. This qualitative study was designed to better understand the determinants of eating behaviours in French pregnant women by focusing on their concerns, attitudes and beliefs and their nutrition-related information seeking practices.MethodsSeven focus groups were conducted, involving a total of 40 French pregnant women. An inductive thematic approach, adapted from the grounded theory, was adopted to analyse the data. Two major themes were identified: eating behaviour and nutrition-related information behaviour.ResultsThe eating behaviour theme was divided into four sub-themes using the attribution theory. Three external causes affected the eating behaviour of pregnant women (food restrictions, physiological changes and weight gain), and led to frustration and a perceived loss of control. By contrast the adoption of a healthier diet was perceived as internal by pregnant women, and resulted in self-fulfilment and empowerment regarding the health and the well-being of their baby and themselves, and their weight gain management. Greater attention was paid to nutrition-related information obtained from healthcare providers, the social environment and the mass media. Information was passively absorbed or actively sought by pregnant women, but most was perceived as contradictory, which led to confusion.ConclusionPregnancy is accompanied by a rise in nutrition awareness, substantiated by eating behaviour modifications due to external and internal causes. However, conflicts between and within information sources result in confusion that can limit the adoption of healthier eating behaviour.Electronic supplementary materialThe online version of this article (doi:10.1186/s12884-016-1078-6) contains supplementary material, which is available to authorized users.
Identifying the dietary changes with the greatest potential for improving diet quality is critical to designing efficient nutrition communication campaigns. Our objective was to simulate the effects of different types of dietary substitutions to improve diet quality at the individual level. Starting from the observed diets of 1330 adults participating in the national French Nutrition and Health Survey (Etude Nationale Nutrition Santé), we simulated the effects of 3 different types of food and beverage substitutions with graded implementation difficulty for the consumer in a stepwise dietary counseling model based on the improvement in the PANDiet index, which measures diet quality in terms of nutrient adequacy. In scenario 1, substitutions of a food or beverage for its "lighter" version resulted in a modest improvement in the PANDiet score (Δ = +3.3 ± 0.1) and a decrease in energy intake (Δ = -114 ± 2 kcal/d). In scenario 2, substitutions of a food or beverage within the same food subgroup resulted in a marked improvement in the PANDiet score (Δ = +26.4 ± 0.2) with no significant change in energy intake. In this second scenario, the improvement in nutrient adequacy was due to substitutions in many subgroups, with no single subgroup contributing >8% to the increase in the PANDiet score. In scenario 3, substitutions of a food or beverage within the same food group resulted in the greatest improvement in the PANDiet score (Δ = +31.8 ± 0.2) but with an increase in energy intake (Δ = +204 ± 9 kcal/d). In this third scenario, the improvement in nutrient adequacy was largely due to substitutions of fish for meat and processed meat (∼30% of the increase in the PANDiet score). This study shows that a strategy based on simple substitutions within food subgroups is effective in rapidly improving the nutritional adequacy of the diet of French adults and could be used in public health nutrition actions.
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