Effects of a Lifestyle Intervention in Routine Care on Prenatal Dietary Behavior—Findings from the Cluster-Randomized GeliS Trial

Abstract

The antenatal lifestyle and excessive gestational weight gain (GWG) modify the risk of obstetric complications, maternal weight retention, and the risk of obesity for the next generation. The cluster-randomized controlled “Healthy living in pregnancy” (GeliS) study, recruiting 2286 women, was designed to examine whether a lifestyle intervention reduced the proportion of women with excessive GWG. Trained healthcare providers gave four counseling sessions covering a healthy diet, regular physical activity, and self-monitoring of GWG in the intervention group. In this secondary analysis, the effect on maternal dietary behavior was analyzed. Dietary behavior was assessed by means of a 58-item food frequency questionnaire in early and late pregnancy. The intervention resulted in a significant reduction in soft drink intake (p < 0.001) and an increase in the consumption of fish (p = 0.002) and vegetables (p = 0.023). With the exception of higher percentage energy from protein (p = 0.018), no effects of the intervention on energy and macronutrient intake were observed. There was no evidence for an overall effect on dietary quality measured with a healthy eating index. Some dietary variables were shown to be associated with GWG. In a routine prenatal care setting in Germany, lifestyle advice modified single aspects of dietary behavior, but not energy intake or overall dietary quality.

Associations between the Prenatal Diet and Neonatal Outcomes—A Secondary Analysis of the Cluster-Randomised GeliS Trial

“…Although alcohol intake was found to be associated with a reduction in birth weight in the GeliS trial, there was no evidence for a modification of the SGA risk. However, reported alcohol consumption was generally low among our study population [32] and intake may be underreported, thus limiting the validity of our observations as well as those from others.…”

Evaluation of antenatal risk factors for postpartum depression: a secondary cohort analysis of the cluster-randomised GeliS trial

“…The GeliS intervention was neither successful in reducing the proportion of women with excessive GWG [24], nor influenced the maternal postpartum weight development substantially [25]. However, the intervention resulted in small to moderate improvements in maternal dietary [26] and physical activity behaviour [27]. Further, the GeliS study included a large sample of pregnant women with extensive data on maternal health and used a validated tool for assessing PPD.…”

Effects of a Lifestyle Intervention in Routine Care on Short- and Long-Term Maternal Weight Retention and Breastfeeding Behavior—12 Months Follow-up of the Cluster-Randomized GeliS Trial

“…The primary aim of the GeliS study was to reduce the proportion of women with excessive GWG according to the weight gain recommendations of the Institute of Medicine (IOM) [24] by offering a comprehensive lifestyle intervention alongside antenatal routine visits [25]. Although the intervention was not effective in limiting excessive GWG [26], it yielded some improvements in dietary (manuscript under revision) and physical activity behavior (manuscript under revision) [27,28]. The long-term influence on maternal health remains to be investigated.…”