Dietary Outcomes in a Spanish-Language Randomized Controlled Diabetes Prevention Trial With Pregnant Latinas

Abstract

Objectives. We evaluated the effectiveness of a community-based healthy lifestyle intervention in improving dietary behaviors of pregnant Latinas from 2004 to 2006 in Detroit, Michigan. Methods. The 11-week, culturally tailored, Spanish-language Healthy Mothers on the Move (MOMs) intervention offered home visits, group classes, related activities, and social support from trained community health workers (CHWs) and peers. Dietary behaviors were measured by food frequency questionnaire. Linear mixed models estimated pre- and post-intervention changes, within and between MOMs intervention and minimal intervention (MI) groups. Results. MOMs (n = 139) and MI (n = 139) participants had similar baseline characteristics and dietary intake. Post-intervention, MOMs participants showed significant improvement in all dietary behaviors, except fruit and fiber consumption. Compared with MI participants, MOMs participants had significantly decreased consumption of added sugar (P = .05), total fat (P < .05), saturated fat (P < .01), percentage of daily calories from saturated fat (P < .001), solid fats and added sugars (P < .001), and had increased vegetable consumption (P < .001). Their increase in fiber consumption (P < .05) was significant relative to MI participants’ decrease in fiber intake. Conclusions. We confirmed the hypothesis that a community-planned, CHW-led healthy lifestyle intervention could improve dietary behaviors of low-income Latina women during pregnancy.

Mediators and Moderators of the Effectiveness of a Community Health Worker Intervention That Improved Dietary Outcomes in Pregnant Latino Women

“…Setting, recruitment, intervention, data collection, outcome measurement, and analytic methods are described in detail elsewhere (Kieffer, Caldwell, et al, 2013; Kieffer et al, 2014). …”

“…Participants in both groups received the same incentives for participation. In depth descriptions of the interventions are reported elsewhere (Kieffer et al, 2014). …”

“…Culturally tailored interventions delivered by community health workers (CHWs) are effective in improving diabetes related risk factors in medically underserved, ethnic minority populations (Jackson, 2009; Katula et al, 2013; Ruggiero, Castillo, Quinn, & Hochwert, 2012; Valen, Narayan, & Wedeking, 2012). Few such studies have focused specifically on pregnant Latina women (Kieffer et al, 2014). …”

“…The Healthy MOMs study results showed improved dietary behaviors at follow-up among pregnant women in the CHW intervention arm, compared to the MI arm (Kieffer et al, 2014). However, studying RCT intervention effects alone does not explain the mechanisms by which the intervention was successful or help identify which participants may have benefitted most (Kraemer, Wilson, Fairburn, & Agras, 2002).…”

Importance of optimal fiber consumption duringpregnancy

“…Those who consume strict vegetarian diet during pregnancy need to consult with their doctor and nutrition professionals to make sure the protein and vitamin supplementation along with vegetarian diet are provided (3,16). A randomized trial study for Latino pregnant women has shown that dietary education for improving dietary behaviors and life style changes could improve fiber consumption in this population (2). To summarize fiber is an important part of daily diet and it should be considered vital for pregnancy due to many benefits.…”