Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Dietary Patterns and Diet Quality before and/or during Pregnancy and How These Affect Birth Outcomes: A Systematic Review and Meta-analysis(Elsevier Inc. on behalf of American Society for Nutrition, 2025-10) Salatas C; Bronnert A; Lawrence R; Alexander T; Wall C; Bloomfield FH; Lin LLimited consistent evidence exists on how diet quality before and during pregnancy influences preterm birth and low birthweight risk. This study aims to assess whether diet quality based on dietary patterns before and during pregnancy affects preterm birth and low birthweight risk. We systematically searched 3 electronic databases and 4 registries for randomized controlled trials (RCTs) and quasi-RCTs without restrictions on publication date or language until 22 November, 2024. Included RCTs evaluated dietary patterns to enhance diet quality before/during pregnancy compared with a usual diet or placebo. Results were synthesized using random-effects meta-analyses with risk ratios (RRs) and 95% confidence intervals. Study quality was assessed using the Cochrane Risk of Bias 1 tool, and certainty of evidence was evaluated with the Grading of Recommendations Assessment, Development and Evaluation approach. Twenty-nine RCTs (7367 participants) were included. Improved diet quality through dietary patterns providing the recommended macronutrient intake or high unsaturated fats before and during pregnancy reduced the incidence of low birthweight (<2500 g) (7 RCTs, 2178 participants, RR 0.53 [0.37, 0.77], low certainty of evidence) and have potential benefit for reducing preterm birth (15 RCTs, 4949 participants, RR 0.79 [0.62, 1.02], low certainty of evidence) compared with usual diet. The data available support interventions starting in the first trimester (RR 0.30 [0.11, 0.80]), lasting 4–7 mo (RR 0.52 [0.37, 0.73]), with similar effects in both high-/upper-middle-income [RR 0.44 (0.19, 10.04)] and lower-middle-income (RR 0.44 [0.31, 0.63]) populations, especially in low-risk women (RR 0.52 [0.37, 0.73]). Diets providing the recommended macronutrient intake or high in unsaturated fats significantly reduced risk of low birthweight when initiated in the first trimester and maintained for 4–7 mo, regardless of country-level socioeconomic context. Healthcare providers should consider recommending dietary patterns emphasizing whole foods and high-quality fats as part of early prenatal care.Item Dietary patterns and dietary adaptations in women with and without gestational diabetes: Evidence from the growing up in New Zealand study(MDPI (Basel, Switzerland), 2020-01-15) Lawrence RL; Wall CR; Bloomfield FHDiet is a cornerstone of the management of gestational diabetes (GDM). We investigated differences in dietary patterns and dietary adaptations among pregnant women with and without GDM participating in the Growing Up in New Zealand study. Presence of GDM was determined using coded clinical data and plasma glucose results meeting the New Zealand Society for the Study of Diabetes diagnostic criteria. Women answered a food frequency questionnaire and questions regarding dietary changes and information received during pregnancy. Women with GDM had lower adherence scores than those without GDM for ‘Junk’ (mean (SD) score −0.28 (0.95) versus 0.02 (1.01) p < 0.0005) and ‘Traditional/White bread’ dietary patterns (−0.18 (0.93) versus 0.01 (1.01) p = 0.002). More women with GDM reported avoiding foods high in fat or sugar (25.3% versus 5.7%, p < 0.05) compared to women without GDM. A greater proportion of women with GDM compared with those without GDM received information from dietitians or nutritionists (27.0% versus 1.7%, p < 0.05) or obstetricians (12.6% versus 7.5%, p < 0.05). More women diagnosed before the antenatal interview received advice from dietitians or nutritionists compared with those diagnosed after (46.9% versus 6.0%, p < 0.05). Women with GDM appear to make positive changes to their diet in response to advice received from health care professionals.Item Evaluation of Preconception Dietary Patterns in Women Enrolled in a Multisite Study(Oxford University Press on behalf of the American Society for Nutrition, 2022-07) Lim SX; Cox V; Rodrigues N; Colega MT; Barton SJ; Childs CE; Conlon CA; Wall CR; Cutfield WS; Chan S-Y; Godfrey KM; Chong MF-F; NiPPeR Study GroupBACKGROUND: Diet indices are widely used in nutritional research across communities but do not "capture" the full extent of diet variability across multiple countries. Empirically derived dietary patterns can provide additional information because they reflect combinations of foods potentially associated with health outcomes. Limited studies have evaluated preconception dietary patterns in heterogeneous populations. OBJECTIVES: In the multisite Nutritional Intervention Preconception and During Pregnancy to Maintain Healthy Glucose Metabolism and Offspring Health (NiPPeR) study, the secondary aims included: 1) derive pooled and site-specific preconception dietary patterns, and 2) evaluate these patterns using anthropometric measures and metabolic biomarkers. METHODS: Women planning pregnancy (n = 1720) in the United Kingdom, Singapore, and New Zealand completed interviewer-administered harmonized FFQs and lifestyle questionnaires at recruitment. Across-cohort ("pooled") and site-specific dietary patterns were derived, and associations between dietary pattern scores and BMI, waist-to-hip ratio, plasma lipids, and glycemia assessed using multivariable linear regression, expressing results as SD change in outcome per SD change in dietary pattern score. RESULTS: The pooled analysis identified 3 dietary patterns: "Vegetables/Fruits/Nuts" ("Healthy"), "Fried potatoes/Processed meat/Sweetened beverages" ("Less Healthy"), and "Fish/Poultry/Noodles/Rice" ("Mixed"). The "Healthy" and "Less Healthy" pooled pattern scores were highly correlated with their corresponding site-specific dietary pattern scores ("Healthy": ρ = 0.87-0.93; "Less Healthy": ρ = 0.65-0.88). Women with higher scores for the "Healthy" pooled pattern had a lower waist-to-hip ratio (standardized β: -0.10; 95% CI: -0.18, -0.01); those with higher scores for the "Less Healthy" pooled pattern had a higher BMI (standardized β: 0.17; 95% CI: 0.09, 0.24), higher LDL cholesterol (standardized β: 0.10; 95% CI: 0.01, 0.19), and less optimal glucose profiles. However, we noted higher adherence to the "Healthy" pooled pattern with higher BMI. CONCLUSIONS: The "Healthy" and "Less Healthy" pooled patterns were comparable to the corresponding site-specific patterns. Although the associations between these patterns and objective anthropometric/metabolic measures were largely in the expected directions, future studies are required to confirm these findings. This trial is registered at clinicaltrials.gov (NCT02509988).Item An Investigation of the Relationship Between Dietary Patterns in Early Pregnancy and Maternal/Infant Health Outcomes in a Chinese Cohort(Frontiers Media S A, 2022-04-22) de Seymour JV; Beck KL; Conlon CA; Jones MB; Colombo J; Xia Y-Y; Han T-L; Qi H-B; Zhang H; Baker PN; Juturu VBACKGROUND: Studies assessing links between maternal diet and pregnancy outcomes have focused predominantly on individual nutrients or foods. However, nutrients are typically consumed in combinations of foods or beverages (i.e., dietary patterns). Taking into account the diet as a whole appreciates that nutrient absorption and metabolism are influenced by other nutrients and the food matrix. OBJECTIVE: The aim of this study was to investigate the relationship between dietary pattern consumption in early pregnancy and pregnancy/infant outcomes, including gestational diabetes mellitus, gestational weight gain, preeclampsia, placental weight, gestational age at delivery, small-for-gestational-age, large-for-gestational-age, macrosomia, measures of infant body composition, and scores on two main indices of the Bayley Scales of Infant Development [Mental Development Index (MDI) and the Psychomotor Development Index (PDI)] at 12 months. DESIGN: Our study included 1,437 participants from a mother-infant cohort in Chongqing, China. Maternal diet was assessed using a 96-item food frequency questionnaire at 11-14 weeks gestation. Dietary patterns were constructed using principal component analysis. Multivariate regressions were performed to assess associations between maternal dietary pattern scores and pregnancy and infant outcomes, adjusting for confounders. RESULTS: Two dietary patterns were derived: a pattern high in pasta, sweetened beverages, and oils and condiments (PSO-based dietary pattern) and a pattern high in fish, poultry, and vegetables (FPV-based dietary pattern). Higher scores on the PSO-based dietary pattern were associated with lower infant standardized scores on the PDI of the Bayley Scales of Infant Development, β (95% confidence interval) = -1.276 (-2.392, -0.160); lower placental weight, β (95% CI) = -6.413 (-12.352g, -0.473); and higher infant's tricep skinfold thickness at 6 weeks of age. β (95% CI) = 0.279 (0.033, 0.526). Higher scores on the FPV-based dietary pattern were associated with higher gestational weight gain between visit 1 (11-14 week's gestation) and 3 (32-34 week's gestation). β (95% CI) = 25.612 (13.255, 37.969). No significant associations were observed between dietary pattern scores and the remaining pregnancy/infant outcomes investigated or MDI scores on the Bayley Scales of Infant Development. This was the first study to investigate the association between dietary patterns in early pregnancy and infant neurocognition in a Chinese cohort.Item Seven weeks of home-cooked meals: changes to New Zealanders’ grocery shopping, cooking and eating during the COVID-19 lockdown(Taylor and Francis Group on behalf of the Royal Society of New Zealand, 2021) Gerritsen S; Egli V; Roy R; Haszard J; De Backer C; Teunissen L; Cuykx I; Decorte P; Pabian S; Van Royen K; Te Morenga LThe first COVID-19 pandemic lockdown in Aotearoa New Zealand resulted in disruptions to everyday life, including changes in grocery shopping, cooking and eating. This study aimed to capture changes in behaviours and perceptions of grocery shopping and food preparation during the lockdown, and the extent to which dietary patterns changed during this period. Data were collected in an online survey of 3028 adults (89% women, mean age = 44 years, range 18–87 years, the median time in lockdown = 40 days), during Aotearoa New Zealand's lockdown Alert levels 4 (33.4%) and Level 3 (66.6%). Respondents had decreased enjoyment of grocery shopping and increased home cooking and baking from scratch. There was an overall shift toward an unhealthy dietary pattern, with some respondents reporting increased consumption of sweet snacks (41%), salty snacks (33%), alcohol (33%), and sugary drinks (20%) during the lockdown. Age moderated the effect of lockdown for nearly every measure, with adults aged under 50 years the most likely to report adverse changes to their eating behaviours and diet. Future pandemic responses by government and employers should include public health nutrition policies and mitigate the stress for younger adults and those caring for children at home.Item Who We Seek and What We Eat? Sources of Food Choice Inspirations and Their Associations with Adult Dietary Patterns before and during the COVID-19 Lockdown in New Zealand(MDPI (Basel, Switzerland), 2021-11-01) Roy R; Gontijo de Castro T; Haszard J; Egli V; Te Morenga L; Teunissen L; Decorte P; Cuykx I; De Backer C; Gerritsen SResearch shows the shaping of food choices often occurs at home, with the family widely recognised as significant in food decisions. However, in this digital age, our eating habits and decision-making processes are also determined by smartphone apps, celebrity chefs, and social media. The 'COVID Kai Survey' online questionnaire assessed cooking and shopping behaviours among New Zealanders during the 2020 COVID-19 'lockdown' using a cross-sectional study design. This paper examines how sources of food choice inspirations (cooking-related advice and the reasons for recipe selection) are related to dietary patterns before and during the lockdown. Of the 2977 participants, those influenced by nutrition and health experts (50.9% before; 53.9% during the lockdown) scored higher for the healthy dietary pattern. Participants influenced by family and friends (35% before; 29% during the lockdown) had significantly higher scores for the healthy and the meat dietary patterns, whereas participants influenced by celebrity cooks (3.8% before; 5.2% during the lockdown) had significantly higher scores in the meat dietary pattern. There was no evidence that associations differed before and during the lockdown. The lockdown was related to modified food choice inspiration sources, notably an increase in 'comforting' recipes as a reason for recipe selection (75.8%), associated with higher scoring in the unhealthy dietary pattern during the lockdown. The lockdown in New Zealand saw an average decrease in nutritional quality of diets in the 'COVID Kai Survey', which could be partly explained by changes in food choice inspiration sources.