title: Maternal dietary intake and physical activity habits during the postpartum period: associations with clinician advice in a sample of Australian first time mothers.
abstract: BACKGROUND
  Numerous health benefits are associated with achieving optimal diet and physical activity behaviours during and after pregnancy. Understanding predictors of these behaviours is an important public health consideration, yet little is known regarding associations between clinician advice and diet and physical activity behaviours in postpartum women. The aims of this study were to compare the frequency of dietary and physical activity advice provided by clinicians during and after pregnancy and assess if this advice is associated with postpartum diet and physical activity behaviours.
  
  
  METHODS
  First time mothers (n = 448) enrolled in the Melbourne InFANT Extend trial completed the Cancer Council of Australia's Food Frequency Questionnaire when they were three to four months postpartum, which assessed usual fruit and vegetable intake (serves/day). Total physical activity time, time spent walking and time in both moderate and vigorous activity for the previous week (min/week) were assessed using the Active Australia Survey. Advice received during and following pregnancy were assessed by separate survey items, which asked whether a healthcare practitioner had discussed eating a healthy diet and being physically active. Linear and logistic regression assessed associations of advice with dietary intake and physical activity.
  
  
  RESULTS
  In total, 8.6% of women met guidelines for combined fruit and vegetable intake. Overall, mean total physical activity time was 350.9 ± 281.1 min/week. Time spent walking (251.97 ± 196.78 min/week), was greater than time spent in moderate (36.68 ± 88.58 min/week) or vigorous activity (61.74 ± 109.96 min/week) and 63.2% of women were meeting physical activity recommendations. The majority of women reported they received advice regarding healthy eating (87.1%) and physical activity (82.8%) during pregnancy. Fewer women reported receiving healthy eating (47.5%) and physical activity (51.9%) advice by three months postpartum. There was no significant association found between provision of dietary and/or physical activity advice, and mother's dietary intakes or physical activity levels.
  
  
  CONCLUSIONS
  Healthy diet and physical activity advice was received less after pregnancy than during pregnancy yet no association between receipt of advice and behaviour was observed. More intensive approaches than provision of advice may be required to promote healthy diet and physical activity behaviours in new mothers.
  
  
  BACKGROUND
  Australian New Zealand Clinical Trials Registry ( ACTRN12611000386932 13/04/2011).
authors.affiliation: Centre for Physical activity and Nutrition Research (C-PAN), Deakin University, Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia. p.vanderpligt@deakin.edu.au.
authors.forename: Paige
authors.initials: P
authors.lastname: van der Pligt
authors.affiliation: Centre for Maternal and Child Health Research, City University London, London, UK.
authors.forename: Ellinor K
authors.initials: EK
authors.lastname: Olander
authors.affiliation: Centre for Physical activity and Nutrition Research (C-PAN), Deakin University, Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
authors.forename: Kylie
authors.initials: K
authors.lastname: Ball
authors.affiliation: Centre for Physical activity and Nutrition Research (C-PAN), Deakin University, Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
authors.forename: David
authors.initials: D
authors.lastname: Crawford
authors.affiliation: Centre for Physical activity and Nutrition Research (C-PAN), Deakin University, Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
authors.forename: Kylie D
authors.initials: KD
authors.lastname: Hesketh
authors.affiliation: Centre for Physical activity and Nutrition Research (C-PAN), Deakin University, Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
authors.forename: Megan
authors.initials: M
authors.lastname: Teychenne
authors.affiliation: Centre for Physical activity and Nutrition Research (C-PAN), Deakin University, Burwood Campus, 221 Burwood Highway, Burwood, VIC, 3125, Australia.
authors.forename: Karen
authors.initials: K
authors.lastname: Campbell
mesh_terms: D000328:Adult; D001315:Australia; D004032:Diet / Q000523:psychology; D037001:Directive Counseling / Q000379:methods / Q000706:statistics & numerical data; D005247:Feeding Behavior / Q000523:psychology; D005260:Female; D005638:Fruit; D015438:Health Behavior; D006801:Humans; D009035:Mothers / Q000523:psychology*; D009043:Motor Activity; D010298:Parity; D049590:Postpartum Period / Q000523:psychology*; D011247:Pregnancy; D014675:Vegetables; D055815:Young Adult
references.citation: Eur J Clin Nutr. 2005 Aug;59 Suppl 1:S57-65
references.pmid: 16052197
references.citation: Am J Prev Med. 2008 Jun;34(6):523-8
references.pmid: 18471590
references.citation: Int J Gynaecol Obstet. 2005 Nov;91(2):125-31
references.pmid: 16202415
references.citation: J Community Health Nurs. 2006 Fall;23(3):183-97
references.pmid: 16863403
references.citation: Sex Reprod Healthc. 2011 Jan;2(1):43-8
references.pmid: 21147458
references.citation: Diabetes Obes Metab. 2012 Mar;14(3):195-203
references.pmid: 21851516
references.citation: Am J Prev Med. 2007 Apr;32(4):312-9
references.pmid: 17383562
references.citation: J Hum Nutr Diet. 2015 Jan;28 Suppl 1:15-28
references.pmid: 24267102
references.citation: J Sci Med Sport. 2011 May;14(3):233-7
references.pmid: 21276752
references.citation: J Obstet Gynecol Neonatal Nurs. 2008 Jan-Feb;37(1):71-9
references.pmid: 18226159
references.citation: Med Sci Sports Exerc. 2005 Oct;37(10):1748-53
references.pmid: 16260976
references.citation: Int J Behav Nutr Phys Act. 2013 Jul 06;10:88
references.pmid: 23829582
references.citation: J Acad Nutr Diet. 2013 Feb;113(2):297-306
references.pmid: 23168270
references.citation: Am J Prev Med. 2002 Aug;23(2 Suppl):98-103
references.pmid: 12133744
references.citation: Int J Obes Relat Metab Disord. 2004 Mar;28(3):402-9
references.pmid: 14724659
references.citation: Am J Obstet Gynecol. 1990 Dec;163(6 Pt 1):1805-11
references.pmid: 2256486
references.citation: Circulation. 2009 Apr 7;119(13):1720-7
references.pmid: 19307476
references.citation: Int J Behav Nutr Phys Act. 2012 Aug 28;9:100
references.pmid: 22925356
references.citation: Obstet Gynecol. 2005 Mar;105(3):633-8
references.pmid: 15738036
references.citation: Matern Child Health J. 2004 Sep;8(3):163-9
references.pmid: 15499872
references.citation: Ann Behav Med. 1999 Spring;21(2):143-8
references.pmid: 10499135
references.citation: Am J Obstet Gynecol. 2011 Oct;205(4):333.e1-6
references.pmid: 21784404
references.citation: BMC Public Health. 2013 May 29;13:518
references.pmid: 23714411
references.citation: BJOG. 2011 Feb;118(3):278-84
references.pmid: 21134106
references.citation: J Prim Care Community Health. 2014 Oct;5(4):275-8
references.pmid: 24695771
references.citation: Ann Epidemiol. 1996 Jan;6(1):53-9
references.pmid: 8680626
references.citation: J Am Diet Assoc. 2009 May;109(5):918-27
references.pmid: 19412993
references.citation: J Womens Health (Larchmt). 2010 Mar;19(3):397-406
references.pmid: 20156083
references.citation: Obstet Gynecol. 1999 Oct;94(4):616-22
references.pmid: 10511369
references.citation: J Nutr Sci Vitaminol (Tokyo). 2010;56(2):132-8
references.pmid: 20495295
references.citation: J Hum Nutr Diet. 2011 Feb;24(1):3-12
references.pmid: 21091918
references.citation: J Womens Health (Larchmt). 2003 Dec;12(10):991-8
references.pmid: 14709187
references.citation: Am J Clin Nutr. 2010 Feb;91(2):373-80
references.pmid: 19955397
references.citation: Health Promot J Austr. 2005 Aug;16(2):93-9
references.pmid: 16130582
references.citation: Am J Med. 1998 Aug;105(2):145-50
references.pmid: 9727822
references.citation: Int J Obes Relat Metab Disord. 2000 Sep;24(9):1111-8
references.pmid: 11033979
references.citation: Cad Saude Publica. 2008;24 Suppl 4:s531-44
references.pmid: 18797729
references.citation: Int J Obes (Lond). 2014 May;38(5):626-35
references.pmid: 24048142
references.citation: J Clin Nurs. 2010 Dec;19(23-24):3516-26
references.pmid: 20946442
references.citation: J Phys Act Health. 2011 Sep;8(7):988-93
references.pmid: 21885890
references.citation: J Am Diet Assoc. 2005 Jun;105(6):916-26
references.pmid: 15942541
references.citation: J Sci Med Sport. 2003 Dec;6(4):477-91
references.pmid: 14723397
references.citation: Women Health. 2013;53(3):317-34
references.pmid: 23705761
references.citation: PM R. 2009 Mar;1(3):261-6
references.pmid: 19627904
references.citation: Acta Obstet Gynecol Scand. 2012 Jan;91(1):62-67
references.pmid: 21880023
references.citation: Br J Obstet Gynaecol. 1998 Feb;105(2):156-61
references.pmid: 9501779
references.citation: Obes Rev. 2013 Jun;14(6):435-50
references.pmid: 23534901
references.citation: Obes Rev. 2013 Oct;14(10):792-805
references.pmid: 23773448
references.citation: Cir Cir. 2011 Mar-Apr;79(2):175-81
references.pmid: 21631979
references.citation: J Nutr Educ Behav. 2005 May-Jun;37(3):129-36
references.pmid: 15904576
references.citation: Health Psychol Rev. 2015;9(2):244-63
references.pmid: 26209211
references.citation: BMC Pregnancy Childbirth. 2013 May 20;13:115
references.pmid: 23688111
references.citation: Cochrane Database Syst Rev. 2007 Jul 18;(3):CD005627
references.pmid: 17636810
references.citation: Obesity (Silver Spring). 2013 May;21(5):904-9
references.pmid: 23784892
references.citation: J Pregnancy. 2013;2013:193170
references.pmid: 23431448
references.citation: Am J Prev Med. 2003 Jan;24(1):75-92
references.pmid: 12554027
references.citation: Aust N Z J Public Health. 2000 Dec;24(6):576-83
references.pmid: 11215004
references.citation: J Acad Nutr Diet. 2013 Jan;113(1):54-62
references.pmid: 23146549
references.citation: Br J Nutr. 2009 Mar;101(5):765-73
references.pmid: 18680630
references.citation: Obesity (Silver Spring). 2007 May;15(5):1061-7
references.pmid: 17495180
references.citation: Int J Obes (Lond). 2009 Apr;33(4):497-506
references.pmid: 19223851
references.citation: Women Birth. 2014 Jun;27(2):138-44
references.pmid: 24295597
references.citation: Prev Med. 2013 Nov;57(5):471-6
references.pmid: 23827722
references.citation: Body Image. 2004 Jan;1(1):29-41
references.pmid: 18089139
references.citation: J Womens Health (Larchmt). 2010 Jul;19(7):1327-40
references.pmid: 20575618
references.citation: PLoS One. 2013 Jun 14;8(6):e66385
references.pmid: 23799096
references.citation: Scand J Med Sci Sports. 2009 Oct;19(5):637-45
references.pmid: 18627550
references.citation: Women Birth. 2014 Mar;27(1):2-8
references.pmid: 23562582
references.citation: Women Health. 2005;42(3):95-110
references.pmid: 16901890
references.citation: Med Sci Sports Exerc. 2011 Jun;43(6):951-8
references.pmid: 21085038