title: Effect of lifestyle interventions of pregnant women on their dietary habits, lifestyle behaviors, and weight gain: a randomized controlled trial.
abstract: BACKGROUND
  Although it is known that lifestyle behaviors of pregnant women are closely related to maternal and fetal health, number of data concerning efficacy of intervention on lifestyle during pregnancy is limited. The purpose of this study is to determine the effect of lifestyle interventions on improving dietary habits and lifestyle behaviors, ensuring gestational weight gain (GWG) within recommended levels and limiting postpartum weight retention (PWR).
  
  
  METHODS
  The study was conducted as a randomized controlled trial in a family health center located in Istanbul, Turkey, between June 2011 and July 2012. The primary outcomes were GWG, and the proportion of pregnant women whose GWG was within the Institute of Medicine (IOM) guidelines. One hundred two pregnant women with gestation ≤12 weeks, age ≥18 years, gravidity ≤2, and who did not intend to lose weight in prepregnancy period were randomly included in this study as intervention (n = 51) and control (n = 51) groups. The study was completed with 45 women for each group. The control group received routine antenatal care. The intervention group was received an individualized lifestyle intervention focusing on healthy lifestyle, diet, exercise, and weight monitoring as four sessions at 12-15, 16-18, 20-24, and 37 weeks gestation. Lifestyle behaviors were evaluated with Health-Promoting Lifestyle Profile-II. Dietary habits were assessed by 3-day dietary recalls, and weight was followed from pregnancy until 6 weeks postpartum.
  
  
  RESULTS
  The lifestyle interventions had a significant effect on improving lifestyle behaviors, protein intake, percentage of energy from protein, calcium, magnesium, iron, zinc, and vegetable intakes when adjusted for confounders (p < 0.05). The proportion of women who were within the IOM recommendations was higher in the intervention group (51.1 %) than in the control group (28.9 %) The odds ratio for GWG within IOM was statistically significant between the groups (OR = 0.59, 95 % CI, 0.45-0.72). There were no difference between groups in terms of the other dietary intakes, total GWG, and PWR (p > 0.05).
  
  
  CONCLUSIONS
  Lifestyle intervention improves the lifestyle behaviors during pregnancy and increases the appropriate GWG for prepregnancy body mass index (BMI), but it has a limited effect in terms of improving dietary habits and has no effect on PWR.
authors.affiliation: Nursing Department of Health Sciences Faculty, Artvin Çoruh University, Çayağzı Mah. Liflevha Sok., 0800, Artvin, Turkey. asci.s.ozlem@gmail.com.
authors.forename: Özlem
authors.initials: Ö
authors.lastname: Aşcı
authors.affiliation: Nursing Faculty of Obstetrics Nursing Department, Florence Nightingale School of Nursing, Istanbul University, Abidei Hurriyet cad., 34381, Istanbul, Turkey. gulumyil@yahoo.com.
authors.forename: Gülay
authors.initials: G
authors.lastname: Rathfisch
mesh_terms: D000328:Adult; D015992:Body Mass Index; D000072001:Diet, Healthy / Q000208:ethnology; D005247:Feeding Behavior / Q000208:ethnology; D005260:Female; D005500:Follow-Up Studies; D006184:Habits; D000070497:Healthy Lifestyle; D006801:Humans; D008425:Maternal Behavior / Q000208:ethnology; D039382:Maternal Nutritional Physiological Phenomena / Q000208:ethnology; D050177:Overweight / Q000208:ethnology / Q000517:prevention & control*; D010349:Patient Compliance / Q000208:ethnology; D010352:Patient Dropouts; D057285:Precision Medicine; D011247:Pregnancy; D011248:Pregnancy Complications / Q000208:ethnology / Q000517:prevention & control*; D016037:Single-Blind Method; D014421:Turkey; D014504:Urban Health / Q000208:ethnology; D015430:Weight Gain / Q000208:ethnology; D055815:Young Adult