Intervention
The FeLIPO intervention program consisted of two individual counseling modules given by trained researchers at the 20th and 30th week of gestation, respectively. The counseling sessions were structured and comprised the three main topics: nutrition, physical activity, and GWG monitoring. The first session lasted up to 60 minutes (min) and included the main components of the intervention. The second session (about 30 min) repeated topics from the first, but was more detailed for selected aspects in a problem-oriented manner. In addition, each counseling session included an individual component where women received personalized feedback on their nutrition and physical activity habits based on 7-daydietary records and physical activity questionnaires. In the diet component, we explained general topics like energy balance and a healthy nutrition according to the “Deutsche Gesellschaft für Ernährung” (DGE) (German Nutrition Society) [65]. We informed participants about additional energy requirements as well as macro- and micronutrient requirements during pregnancy. The dietary intervention aimed at decreasing the intake of energy-dense foods and high-fat foods (e.g. fast food, sweets, and sugar-sweetened beverages) by substituting them with low-fat alternatives, and increasing the consumption of fruit, vegetables, and whole grain products. Another goal was improving the quality of fat consumed by increasing the amount of fish in the diet and choosing the correct fat/oil for cooking and or use as spreads. As an individual component, we analyzed the dietary records checking for individual dietary problems.
The advice on physical activity was in accordance with the current guidelines for physical activity during pregnancy from the Society of Obstetricians and Gynecologists of Canada (SOGC) [66] and the American College of Obstetricians and Gynecologists (ACOG) [67]. The following recommendations were introduced for women using the FITT (frequency, intensity, time, type) criteria: thirty minutes of moderate intensity activity on most days of the week at an appropriate heart-rate zone. Non weight-bearing or low-impact endurance exercises using the large muscle groups like walking, cycling, swimming, or aquatic exercises were proposed. Furthermore, women were provided with a list of adequate local prenatal exercise programs and advised to participate in programs like these. For each prepregnancy BMI group, the IOM’sweight gain recommendations were incorporated in weight gain charts. Each woman in the intervention group received a chart personalized according to her baseline BMI group. Participants were requested to use their charts to monitor their weight development on a weekly basis.
Thus, the intervention consisted of three main parts: (1) providing general information on a healthy lifestyle during pregnancy; (2) prompting self-monitoring of behavior by recording diet and physical activity, and selfmonitoring of weight gain by using weight gain charts; and (3) setting behavioral goals based on the baseline situation (BMI, diet, physical activity) and the individual preferences of the women.
Intervention
The FeLIPO intervention program consisted of two individual counseling modules given by trained researchers at the 20th and 30th week of gestation, respectively. The counseling sessions were structured and comprised the three main topics: nutrition, physical activity, and GWG monitoring. The first session lasted up to 60 minutes (min) and included the main components of the intervention. The second session (about 30 min) repeated topics from the first, but was more detailed for selected aspects in a problem-oriented manner. In addition, each counseling session included an individual component where women received personalized feedback on their nutrition and physical activity habits based on 7-daydietary records and physical activity questionnaires. In the diet component, we explained general topics like energy balance and a healthy nutrition according to the “Deutsche Gesellschaft für Ernährung” (DGE) (German Nutrition Society) [65]. We informed participants about additional energy requirements as well as macro- and micronutrient requirements during pregnancy. The dietary intervention aimed at decreasing the intake of energy-dense foods and high-fat foods (e.g. fast food, sweets, and sugar-sweetened beverages) by substituting them with low-fat alternatives, and increasing the consumption of fruit, vegetables, and whole grain products. Another goal was improving the quality of fat consumed by increasing the amount of fish in the diet and choosing the correct fat/oil for cooking and or use as spreads. As an individual component, we analyzed the dietary records checking for individual dietary problems.
The advice on physical activity was in accordance with the current guidelines for physical activity during pregnancy from the Society of Obstetricians and Gynecologists of Canada (SOGC) [66] and the American College of Obstetricians and Gynecologists (ACOG) [67]. The following recommendations were introduced for women using the FITT (frequency, intensity, time, type) criteria: thirty minutes of moderate intensity activity on most days of the week at an appropriate heart-rate zone. Non weight-bearing or low-impact endurance exercises using the large muscle groups like walking, cycling, swimming, or aquatic exercises were proposed. Furthermore, women were provided with a list of adequate local prenatal exercise programs and advised to participate in programs like these. For each prepregnancy BMI group, the IOM’sweight gain recommendations were incorporated in weight gain charts. Each woman in the intervention group received a chart personalized according to her baseline BMI group. Participants were requested to use their charts to monitor their weight development on a weekly basis.
Thus, the intervention consisted of three main parts: (1) providing general information on a healthy lifestyle during pregnancy; (2) prompting self-monitoring of behavior by recording diet and physical activity, and selfmonitoring of weight gain by using weight gain charts; and (3) setting behavioral goals based on the baseline situation (BMI, diet, physical activity) and the individual preferences of the women.
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