The Fit for Delivery study: rationale for the recommendations and test‐retest reliability of a dietary score measuring adherence to 10 specific recommendations for prevention of excessive weight gain during pregnancy

Abstract

Aiming at preventing excessive weight gain during pregnancy, 10 specific dietary recommendations are given to pregnant women in the intervention arm of the Norwegian Fit for Delivery (FFD) study. This paper presents the rationale and test-retest reliability of the food frequency questionnaire (FFQ) and a dietary score measuring adherence to the recommendations. The study is part of the ongoing FFD study, a randomised, controlled, intervention study in nulliparous pregnant women. A 43-item FFQ was developed for the FFD study. A dietary score was constructed from 10 subscales corresponding to the 10 dietary recommendations. Adding the subscales yielded a score from 0 to 10 with increasing score indicating healthier dietary behaviour. The score was divided into tertiles, grouping participants into low, medium and high adherence to the dietary recommendations. Pregnant women attending ultrasound screening at about week 19 of pregnancy were asked to complete the FFQ twice, 2 weeks apart. Of 154 pregnant women completing the first questionnaire, 106 (69%) completed the form on both occasions and was included in the study. The test-retest correlations of the score and subscales were r = 0.68 and r = 0.56-0.84, respectively (both P ≤ 0.001). There was 68% test-retest correct classification of the score and 70-87% of the subscales. In conclusion, acceptable test-retest reliability of the FFQ and the dietary score was found. The score will be used in the FFD study to measure adherence to the dietary recommendations throughout pregnancy and in the following year post-partum.

Changes in fruit and vegetable consumption habits from pre-pregnancy to early pregnancy among Norwegian women

“…A test-retest reliability study was performed in a sample of 105 pregnant women who completed the presented questionnaire 2 weeks apart [28]. The six included items in this paper (both before and in pregnancy yielding 12 correlations) were found to have acceptable test-retest correlations (Pearson’s correlation coefficients) ranging from r = 0.525 ( p  = <0.01) for the variable “other fruits before pregnancy” to r = 0.800 ( p  = <0.01) for “fruits before pregnancy”.…”

Changes in beverage consumption from pre-pregnancy to early pregnancy in the Norwegian Fit for Delivery study

“…Other obvious limitations were the cross-sectional design, the reliance on self-reported data and that the study did not investigate the full range of caffeinated beverages including tea, cola, energy drinks and cocoa. The FFQ used in the present study has shown acceptable test-retest reliability among pregnant women (68) . The FFQ challenges the respondents with complex tasks and in all dietary assessment methods misreporting is a serious problem (69) .…”

Study protocol: fit for delivery - can a lifestyle intervention in pregnancy result in measurable health benefits for mothers and newborns? A randomized controlled trial

“…The Fit for Delivery nutritional advice is based on recommendations from the Norwegian Directorate for Health [40], but is more specific and action-oriented. A complete discussion of the advice and its background is published elsewhere [41]. A follow-up consultation will take place 4–6 weeks after the first consultation.…”

“…Women will be encouraged to answer the questionnaire electronically, with access from the Fit for Delivery web site, but a written version will also be available in both Norwegian and English. The questionnaires will include demographic variables, the short version of the International Physical Activity Questionnaire (IPAQ) [43] and a questionnaire specially designed to assess the key nutritional behaviors which are highlighted in Fit for Delivery [41]. At the time of inclusion, women will be asked to report on both current status and status before pregnancy.…”

“…The questions are designed to test selected nutritional behaviors which are emphasized during the consultation sessions. The test-retest reliability of the questionnaire was evaluated and found to be acceptable in a study including 154 pregnant women who filled out the questionnaire two weeks apart [41]. Employment information and partner’s weight will also be included.…”