No Improvements in Postnatal Dietary Outcomes Were Observed in a Two-Arm, Randomized, Controlled, Comparative Impact Trial among Rural, Southern, African-American Women

Published:February 01, 2018DOI:https://doi.org/10.1016/j.jand.2017.11.010

      Abstract

      Background

      Suboptimal diet quality, prevalent among postpartum women, is troubling for mothers and their children because positive relationships between maternal and child diet quality exist.

      Objective

      The primary objective was to determine whether postnatal diet quality scores of participants in the two treatment arms differed or changed over time.

      Design

      Delta Healthy Sprouts was a two-arm, randomized, controlled, comparative impact trial.

      Participants and setting

      Pregnant women at least 18 years of age, less than 19 weeks pregnant, and residing in three Mississippi counties were recruited between March 2013 and December 2014. Postnatal data was collected from 54 participants between September 2013 and May 2016. The postnatal attrition rates were 17% and 13% for the control and experimental arms.

      Intervention

      The control arm received the Parents as Teachers curriculum, and the experimental arm received a nutrition- and physical activity-enhanced Parents as Teachers curriculum.

      Main outcome measures

      Multiple-pass 24-hour dietary recalls were collected from participants at the postnatal month 1, 4, 6, 8, and 12 visits. Healthy Eating Index-2010 was used to calculate diet quality.

      Statistical analysis performed

      Linear mixed models were used to test for treatment, time, and treatment by time (interaction) effects on postnatal dietary outcomes.

      Results

      Control arm mean (95% confidence limits) total Healthy Eating Index-2010 scores were 36.8 (range=32.5 to 41.1), 36.5 (range=31.9 to 41.1), 40.2 (range=35.7 to 44.8), 39.3 (range=34.7 to 43.9), and 36.4 (range=31.8 to 41.0) at postnatal months 1, 4, 6, 8, and 12, respectively. Corresponding experimental arm scores were 42.3 (range=37.5 to 47.0), 41.6 (range=36.3 to 46.9), 40.2 (range=34.8 to 45.7), 45.8 (range=40.5 to 51.1), and 37.6 (range=32.6 to 42.7), respectively. Experimental scores were significantly higher than control scores across time. No other effects were significant.

      Conclusions

      Neither the standard Parents as Teachers curriculum nor the enhanced Parents as Teachers curriculum was effective at improving the poor diet quality of this cohort of rural, Southern, African-American women during the 12 months following the birth of their infant.

      Keywords

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      Biography

      J. L. Thomson is a research epidemiologist, US Department of Agriculture, Agricultural Research Service, Delta Human Nutrition Research Program, Stoneville, Mississippi.

      Biography

      M. H. Goodman is an epidemiologist, US Department of Agriculture, Agricultural Research Service, Delta Human Nutrition Research Program, Stoneville, Mississippi.

      Biography

      L. M. Tussing-Humphreys is an assistant professor of medicine, Department of Medicine and Cancer Center, University of Illinois at Chicago, Chicago, Illinois.

      Biography

      A. S. Landry is an assistant professor of nutrition, Department of Family and Consumer Sciences, University of Central Arkansas, Conway.