title: Antenatal weight management: Diet, physical activity, and gestational weight gain in early pregnancy.
abstract: OBJECTIVE
  to investigate women's physical activity levels, diet and gestational weight gain, and their experiences and motivations of behavior change.
  
  
  METHODS
  analysis of cross-sectional data collected during a longitudinal, cohort study examining physiological, psychological, sociodemographic, and self-reported behavioural measures relating to bodyweight.
  
  
  METHODS
  women recruited from routine antenatal clinics at the Nottingham University Hospitals NHS Trust.
  
  
  METHODS
  193 women ≤27 weeks gestation and aged 18 years or over. MEASUREMENTS & FINDINGS: measurements included weight and height, the Dietary Instrument for Nutrition Education (Brief Version), the International Physical Activity Questionnaire (Short Form), and open questions of perceptions of behaviour change. 50.3% (n=97) were overweight/obese, and women gained 0.26kg/wk (IQR 0.34kg/wk) since conception. The majority consumed low levels of fat (n=121; 63.4%), high levels of unsaturated fat (n=103; 53.9%), and used a dietary supplement (n=166; 86.5%). However, 41% (n=76) were inactive, 74.8% (n=143) did not consume high levels of fibre, and 90.0% (n=171) consumed less than 5 portions of fruit and vegetables a day. Body mass index category was not associated with diet, physical activity levels, or gestational weight gain. Themes generated from open-questions relating to behaviour change were: (1) Risk management, (2) Coping with symptoms, (3) Self-control, (4) Deviation from norm, (5) Nature knows best.
  
  
  CONCLUSIONS
  early pregnancy is a period of significant and heterogeneous behaviour change, influenced by perceptions of risk and women's lived experience. Behaviour was influenced not only by perceptions of immediate risk to the fetus, but also by the women's lived experience of being pregnant.
  
  
  CONCLUSIONS
  There are exciting opportunities to constructively reframe health promotion advice relating to physical activity and diet in light of women's priorities. The need for individualized advice is highlighted, and women across all body mass index categories would benefit from improved diet and physical activity levels.
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Judy A
authors.initials: JA
authors.lastname: Swift
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Simon C
authors.initials: SC
authors.lastname: Langley-Evans
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD. Electronic address: Jo.Pearce@Nottingham.ac.uk.
authors.forename: Jo
authors.initials: J
authors.lastname: Pearce
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Preeti H
authors.initials: PH
authors.lastname: Jethwa
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Moira A
authors.initials: MA
authors.lastname: Taylor
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Amanda
authors.initials: A
authors.lastname: Avery
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Sarah
authors.initials: S
authors.lastname: Ellis
authors.affiliation: Division of Nutritional Sciences, University of Nottingham, Sutton Bonington, Loughborough, Leicestershire, LE125RD.
authors.forename: Sarah
authors.initials: S
authors.lastname: McMullen
authors.affiliation: Nottingham Trent University, School of Science and Technology, 50 Shakespeare St, Nottingham NG1 4FQ.
authors.forename: Kirsty J
authors.initials: KJ
authors.lastname: Elliott-Sale
mesh_terms: D000328:Adult; D015992:Body Mass Index; D000068959:Body Weight Maintenance; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004032:Diet / Q000523:psychology* / Q000592:standards; D004739:England; D015444:Exercise / Q000523:psychology*; D005260:Female; D006801:Humans; D009765:Obesity / Q000517:prevention & control / Q000523:psychology; D050177:Overweight / Q000517:prevention & control / Q000523:psychology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000517:prevention & control / Q000523:psychology; D011261:Pregnancy Trimester, First / Q000378:metabolism / Q000523:psychology*; D011295:Prenatal Care / Q000379:methods* / Q000523:psychology; D011594:Psychometrics / Q000295:instrumentation / Q000379:methods; D057566:Self Report; D012923:Social Class; D013222:State Medicine; D011795:Surveys and Questionnaires; D015430:Weight Gain
keywords: BMI; Body Mass Index; Pregnancy; diet; gestational weight gain; physical activity