Abstract
Background
Knowing the percentage of women planning a pregnancy who meet preconception dietary
and physical activity (PA) guidelines and which health-related preconception factors
are associated with body mass index (BMI) could help improve preconception care.
Objectives
In a study conducted in women who were planning to conceive, the aims were to describe
and compare eating and PA habits to current guidelines, as well as to identify the
factors associated with BMI.
Design
This was a cross-sectional study.
Participants/setting
From 2017 to 2020, women planning to conceive within the next year (n = 217) were
recruited in the province of Québec (Canada) to participate in the Apports Nutritionnels
durant la GrossessE – Cohorte Contrôle study. Among them, 184 (84.8%) were included
in the analyses.
Main outcome measures
Women completed three (90.2%) or two (9.8%) Web-based 24-hour dietary recalls and
the International Physical Activity Questionnaire. Weight and height as well as the
presence/absence of weight/body image concerns were self-reported. Eating and PA habits
were compared with dietary reference intakes and Canadian guidelines, respectively.
Statistical analyses
Descriptive statistics were used to describe the sample, eating and PA habits, as
well as adherence to guidelines. A multivariable regression analysis was performed
to identify the factors associated with BMI.
Results
On average, women were aged 30.8 ± 4.1 years and identified as White (94.0%). Most
of them had weight/body image concerns (58.7%), 54.6% of whom had a normal body weight.
Overall, 42.3% engaged in 150 minutes/week or more of moderate-to-vigorous intensity
PA and 84.8% consumed <135 g alcoholic beverages per week. Mean dietary intake was
below Dietary Reference Intakes for carbohydrates, vitamins D and E, and above Dietary
Reference Intakes for total fat and folic acid. Factors associated with a higher BMI
were weight/body image concerns (β = 1.83; R2 = 13.0%), higher dietary protein intake (β = .05; R2 = 4.0%), lower income (β = .85; R2 = 2.9%), no folic acid supplementation (β = .83; R2 = 2.5%), spending less time in moderate-to-vigorous intensity PA (β = –.006; R2 = 2.4%), eating <2 snacks (β = .75; R2 = 2.2%), and <3 meals (β = 1.38; R2 = 1.5%) daily.
Conclusion
Women planning to conceive do not have optimal eating and PA behaviors. Modifiable
factors associated with BMI in preconception were identified.
Keywords
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References
- Intervention strategies to improve nutrition and health behaviours before conception.Lancet. 2018; 391: 1853-1864
- Origins of lifetime health around the time of conception: causes and consequences.Lancet. 2018; 391: 1842-1852
- Before the beginning: nutrition and lifestyle in the preconception period and its importance for future health.Lancet. 2018; 391: 1830-1841
- Physical Activity Guidelines for Americans, 2nd edition.https://health.gov/sites/default/files/2019-09/Physical_Activity_Guidelines_2nd_edition.pdfDate: 2018Date accessed: September 2, 2020
- Dietary Guidelines for Americans, 2020-2025. 9th edition.https://www.dietaryguidelines.gov/sites/default/files/2020-12/Dietary_Guidelines_for_Americans_2020-2025.pdfDate: 2020Date accessed: April 15, 2021
- American health guidelines.
- Dietary Reference Intakes tables.https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/dietary-reference-intakes/tables.htmlDate: 2010Date accessed: December 22, 2021
- Canada's Food Guide.
- Family-Centred Maternity and Newborn Care: National Guidelines. Chapter 2: preconception care.https://www.canada.ca/en/public-health/services/maternity-newborn-care-guidelines.htmlDate: 2017Date accessed: September 2, 2020
- Pre-conception folic acid and multivitamin supplementation for the primary and secondary prevention of neural tube defects and other folic acid-sensitive congenital anomalies.J Obstet Gynaecol Can. 2015; 37: 534-549
- Dietary Reference Intakes: The Essential Guide To Nutrient Requirements.National Academies Press, 2006
- Dietary reference intakes: summary of applications in dietary assessment.Public Health Nutr. 2002; 5: 843-849
- Canadian 24-hour movement guidelines for adults aged 18–64 years and adults aged 65 years or older: an integration of physical activity, sedentary behaviour, and sleep.Appl Physiol Nutr Metab. 2020; 45: S57-S102
- 2019 Canadian guideline for physical activity throughout pregnancy.Br J Sports Med. 2018; 52: 1339-1346
- Alcohol and health in Canada: a summary of evidence and guidelines for low-risk drinking.https://www.ccsa.ca/alcohol-and-health-canada-summary-evidence-and-guidelines-low-risk-drinkingDate accessed: March 31, 2022
- Caffeine in food.https://www.canada.ca/en/health-canada/services/food-nutrition/food-safety/food-additives/caffeine-foods/foods.htmlDate: 2012Date accessed: November 24, 2020
- Beyond positive psychology? Toward a contextual view of psychological processes and well-being.Am Psychol. 2012; 67: 101
- Lifestyle and fertility: the influence of stress and quality of life on female fertility.Reproduct Biol Endocrinol. 2018; 16: 113
- Physical activity and consumption patterns of reproductive-aged women by BMI category.Maternal Child Health J. 2018; 22: 713-724
- Adults meeting aerobic and muscle strengthening guidelines.https://nccd.cdc.gov/dnpao_dtm/rdPage.aspx?rdReport=DNPAO_DTM.ExploreByTopic&islClass=PA&islTopic=PA1&go=GODate: 2019Date accessed: January 27, 2022
- Accelerometer-measured moderate-to-vigorous physical activity of Canadian adults, 2007 to 2017.Health Rep. 2019; 30: 3-10
- Assessment of diet quality in pregnant women using the Healthy Eating Index.J Am Diet Assoc. 2005; 105: 240-246
- Table 13-10-0096-01 Health characteristics, annual estimates.
- Peer Reviewed: Physical activity before and during pregnancy, Colorado Pregnancy Risk Assessment Monitoring System, 2012–2015.Prev Chronic Dis. 2020; 17: E55
- Body mass index (BMI) nomogram.
Statistics Canada. Measured adult body mass index (BMI) (World Health Organization classification), by age group and sex, Canada and provinces, Canadian Community Health Survey - Nutrition. Table 13-10-0794-01. 2015. Accessed June 22, 2021. https://doi.org/10.25318/1310079401-eng
- Risk factors and outcomes of maternal obesity and excessive weight gain during pregnancy.Obesity. 2013; 21: 1046-1055
- A systematic mapping review of the associations between pregnancy intentions and health-related lifestyle behaviours or psychological well being.Prev Med Rep. 2019; 14: 100869
- Physical activity before and during pregnancy: a cohort study.Int J Gynecol Obstet. 2021; 152: 374-381
- International physical activity questionnaire: 12-country reliability and validity.Med Sci Sport Exerc. 2003; 35: 1381-1395
- Assessing the relative validity of a new, web-based, self-administered 24 h dietary recall in a French-Canadian population.Public Health Nutr. 2018; 21: 2744-2752
- Canadian Nutrient File - Search by food.
- Diet quality in Canada.Health Rep. 2009; 20: 41
- The healthy eating index: design and applications.J Am Diet Assoc. 1995; 95: 1103-1108
- Eating Well with Canada’s Food Guide.
- Search licensed natural health products.
- Understanding Normal and Clinical Nutrition.Cengage Learning, 2014
- Statistical power analyses using G∗ Power 3.1: Tests for correlation and regression analyses.Behav Res Method. 2009; 41: 1149-1160
JMP Pro. Version 14. SAS Institute Inc; 1989-2019. www.sas.com
- Comparing usual dietary intakes among subgroups of mothers in the year before pregnancy.Public Health Rep. 2019; 134: 155-163
- Diet quality before or during pregnancy and the relationship with pregnancy and birth outcomes: the Australian Longitudinal Study on Women’s Health.Public Health Nutr. 2016; 19: 2975-2983
- Pregnancy planning and antenatal health behaviour: findings from one maternity unit in Turkey.Midwifery. 2010; 26: 338-347
- Prepregnancy habitual intake of vitamin D from diet and supplements in relation to risk of gestational diabetes mellitus: a prospective cohort study.J Diabet. 2018; 10: 373-379
- Dietary guideline adherence during preconception and pregnancy: a systematic review.Maternal Child Nutr. 2019; 16: e12916
Statistics Canada. Chart 1: Percentage of Canadians above and below selected vitamin D cut-off (50 nmol/L), by age group. Accessed May 3, 2021. https://www150.statcan.gc.ca/n1/pub/82-624-x/2013001/article/chart/11727-01-chart1-eng.htm. Published 2009-2011
- Factors associated with serum 25-hydroxyvitamin D concentration in two cohorts of pregnant women in southern Ontario, Canada.Nutrients. 2019; 11: 123
- Trimester-specific dietary intakes in a sample of French-Canadian pregnant women in comparison with national nutritional guidelines.Nutrients. 2018; 10: 768
- Diet in early pregnancy: focus on folate, Vitamin B12, Vitamin D, and choline.Can J Diet Pract Res. 2019; 81: 58-65
- Assessing the dietary habits of Canadians by eating location and occasion: findings from the Canadian community health survey, cycle 2.2.Nutrients. 2018; 10: 682
- Poor adherence to dietary guidelines among French-speaking adults in the province of Québec, Canada: the PREDISE study.Can J Cardiol. 2018; 34: 1665-1673
- Consumption of low nutritive value foods and cardiometabolic risk factors among French-speaking adults from Québec, Canada: the PREDISE study.Nutr J. 2019; 18: 1-12
- The Role of Physical Activity in Preconception, Pregnancy and Postpartum Health.Semin Reprod Med. 2016; 34: e28-e37https://doi.org/10.1055/s-0036-1583530
- Reproductive history, maternal anxiety and past physical activity practice predict physical activity levels throughout pregnancy.Prev Med Rep. 2019; 16: 100992
- The meaning of body image experiences during the perinatal period: a systematic review of the qualitative literature.Body Image. 2015; 14: 102-113
- Association between body mass index and macronutrients differs along the body mass index range of German adults: results from the German National Nutrition Survey II.J Nutr Sci. 2021; 10: e8
- Lipid, protein and carbohydrate intake in relation to body mass index: an Italian study.Public Health Nutr. 2007; 10: 306-310
- Lipid, protein and carbohydrate intake in relation to body mass index.Eur J Clin Nutr. 2002; 56: 37-43
- A comparison of folic acid pharmacokinetics in obese and nonobese women of childbearing age.Therapeut Drug Monitor. 2011; 33: 336-340
- Directive clinique no 410: Anomalies du tube neural: Prévention, dépistage, diagnostic et prise en charge de la grossesse.J Obstet Gynaecol Can. 2021; 43: 140-157.e148
- Physical Activity and Body-Weight Regulation.Oxford University Press, 2019
- Effects of meal frequency on weight loss and body composition: a meta-analysis.Nutr Rev. 2015; 73: 69-82
- Self-report and direct measures of health: bias and implications.in: The Objective Monitoring of Physical Activity: Contributions of Accelerometry to Epidemiology, Exercise Science and Rehabilitation. Springer, 2016: 369-376
- Muscle mass, BMI, and mortality among adults in the United States: a population-based cohort study.PloS One. 2018; 13e0194697
- Women in larger bodies’ experiences with contraception: a scoping review.Reproduct Health. 2021; 18: 89
- It’s time to include couple-based body mass index counseling in the infertility clinic visit.Fertil Steril. 2020; 114: 971
Biography
A. St-Laurent are PhD candidates, School of Nutrition and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada; and Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada
Biography
C. Savard are PhD candidates, School of Nutrition and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada; and Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada
Biography
M. Gagnon is a master’s degree student, School of Nutrition and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada; and Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada
Biography
J. Robitaille are professors, School of Nutrition and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada; and Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada.
Biography
A.-S. Morisset are professors, School of Nutrition and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada; and Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada.
Biography
A.-S. Plante is a research professional, Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada; and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada.
Biography
S. Lemieux is a professor, School of Nutrition, Laval University, Québec City, Québec, Canada; and Endocrinology and Nephrology Unit, CHU of Québec-Laval University Research Center, Québec City, Québec, Canada; and NUTRISS Research Center, Institute of Nutrition and Functional Foods, Laval University, Québec City, Québec, Canada.
Biography
S. May-Ruchat is professor, Department of Human Kinetics, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.
Article info
Publication history
Published online: March 30, 2022
Accepted:
March 21,
2022
Received:
February 3,
2021
Footnotes
STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors.
FUNDING/SUPPORT There is no funding to disclose.
Identification
Copyright
© 2022 by the Academy of Nutrition and Dietetics.
