Lifestyle habits and novel means for dietary screening and health promotion in pregnant women and children

Doctoral Dissertation

Ella Koivuniemi

Abstract

Lifestyle habits, including diet and physical activity, that deviate from the
recommendations during pregnancy and early childhood may eventually increase the
risk for obesity and other lifestyle-related diseases in both the mother and the child.
High prevalence of obesity among pregnant women and children in Finland suggest
that novel means to support health-promoting lifestyle habits among these target
groups are needed. Thus, the aim was to assess lifestyle habits of pregnant women
and children with reference to the national recommendations. Another aim was to
study the effects of a health app for improving lifestyle habits during pregnancy and
to develop a short method for the assessment of diet quality in children for dietary
screening and health promotion purposes.

Weight, diet quality and physical activity during early and late pregnancy as well
as the efficacy of the health app on improving these lifestyle habits were investigated
in 1038 Finnish women (study I). Further, food supplement use during pregnancy
was studied in 1804 women from Finland, Italy, Poland and the United Kingdom
(study II). Diet quality was assessed with a validated index in 766 preschool-aged
children (study III) and diet with food diary and food frequency questionnaire in 266
elementary school-aged children (study IV). Moreover, a tool for assessing diet
quality in elementary school-aged children was developed (study IV).

The results indicated that the diet quality and physical activity levels were
suboptimal in majority of the pregnant women. Most of the women consumed
vitamin D and folic acid supplements during pregnancy, but adherence to the
recommended doses was low. No benefits on the use of the health app were seen in
diet quality and weight gain. However, physical activity level among app users
decreased less likely compared with app non-users over the pregnancy course,
indicating that the benefits of the app use may arise from maintenance of physical
activity. The results also showed that diet quality was suboptimal in most of the
preschool and elementary school-aged children; especially the consumption of
vegetables, fruits and berries was low. The developed stand-alone index depicted
diet quality in elementary school-aged children as defined in the dietary