Pregnant Adolescents, Beliefs About Healthy Eating, Factors that Influence Food Choices, and Nutrition Education Preferences

Understanding consumer liking of beef patties with different firmness among younger and older adults using FaceReader™ and biometrics

Sensorial perceptions change as people age and biometrics analysis can be used to explore the unconscious consumer responses. Investigation was conducted of effects of consumer age (younger, 22-52 years; older, 60-76 years) on facial expression response (FER) during consumption of beef patties with varying firmness (soft, medium, hard) and taste (±plum sauce). Video images were collected and FERs analysed using FaceReader™. Younger people exhibited higher intensity for happy/sad/scared and lower intensity for neutral/disgusted, relative to older people. Interactions between age and texture/sauce showed little FER variation in older people, whereas younger people showed considerable FER variation. Younger people, but not older people, had lowest intensity of happy FER and highest intensity of angry FER for the hard patty. Sauce addition resulted in higher intensity of happy/contempt in younger consumers, but not older consumers. FER collected using FaceReader™ was successfully used to differentiate between the unconscious responses of younger and older consumers.

Nutritional Knowledge and Dietary Intake Habits among Pregnant Adolescents Attending Antenatal Care Clinics in Urban Community in Ghana

INTRODUCTION

Proper nutrition during pregnancy is important for the wellbeing of the mother and foetus and supports health during pregnancy, delivery, and breastfeeding. However, there are little data on nutritional knowledge and dietary intake among adolescents who are pregnant in Ghana. Hence, the study assessed the nutritional knowledge and eating habits of this vulnerable group in the Ledzokuku-Krowor Municipality, Ghana.

METHODS

The study was cross-sectional and employed a multistage sampling technique to select 423 participants. The study was conducted between October and November 2019. A statistical software was used to analyse data and employed Pearson's chi-square and logistics regression to assess associations between the outcome and predictor variables. A p value <0.05 at a 95% confidence interval was considered statistically significant.

RESULTS

Less than half (44.9%) of the pregnant adolescents have high nutritional knowledge. About 19.4% of them have good eating habits, while 23.9%, 18.2%, and 6.4% of them do not take breakfast, lunch, and supper, respectively. However, 15.6%, 13.9%, and 9.2% do take snacks after breakfast, lunch, and supper, respectively. About 55.9%, 59.8%, and 23.0% do not take their breakfast, lunch, and supper on time, respectively. Additionally, only 3.8% of them do take fruits and vegetables daily, while 9.7%, 23.2%, 30.0%, and 26.5% of them do take animal products, energy drinks, carbonated drinks, and legumes/nuts/seeds daily, respectively. The study showed that educational level (p=0.014), occupation (p=0.016), ethnicity (p=0.017), and number of pregnancies (p=0.021) were associated with good eating habits.

CONCLUSION

Eating habit of adolescent pregnant women was not encouraging. Therefore, the municipal health authority with the concerned stakeholders should intensify efforts, including nutritional education to improve good eating habits, such as taking snacks in between meals, eating on time, and balance diet among pregnant adolescents, and to reduce adolescent pregnancy in the municipality.

Grocery Delivery of Healthy Foods to Pregnant Young Women With Low Incomes: Feasibility and Acceptability Mixed Methods Study

BACKGROUND

Poor maternal diets increase the risk of excess gestational weight gain which can contribute to serious intergenerational morbidity for both the mother and infant. Pregnant young women with low incomes have disproportionately high rates of inadequate fruit and vegetable consumption as well as excess weight gains during pregnancy.

OBJECTIVE

Our aim was to describe the feasibility and acceptability of Special Delivery, a longitudinal nutrition intervention that delivers healthy foods to pregnant youth (aged 14-24 years) with low incomes.

METHODS

The Special Delivery pilot study, conducted in Michigan, enrolled pregnant young women with low incomes. Study participants were sent twice-monthly grocery deliveries consisting of US $35 worth of healthy foods, primarily fruits and vegetables. Between grocery deliveries, participants received daily SMS text message prompts to confirm receipt of delivery and document diet and weight. Program feasibility was assessed by the number of grocery orders placed, delivered, and confirmed by participants. Qualitative interviews and SMS text message data were used to determine acceptability by assessing participants' perspectives on grocery delivery, participants' perspectives on dietary impact of the program, and foods consumed by participants.

RESULTS

A total of 27 participants were enrolled in the pilot study. The mean age was 20.3 years (SD 2.0), and 59.3% (16/27) were African American or Black. During the pilot, 263 deliveries were sent with 98.5% (259/263) successful deliveries and 89.4% (235/263) deliveries confirmed by participants. Participants reported that grocery delivery was convenient; that delivered foods were high quality; and that the program improved their diet, increased access to healthy foods, and promoted healthy habits during pregnancy.

CONCLUSIONS

A grocery delivery-based weight gain and nutrition intervention is both feasible and acceptable among low-income pregnant youth. Grocery deliveries were successfully completed and participants were willing and able to receive grocery deliveries, eat the healthy foods that were delivered, and communicate via SMS text message with study coordinators. The Special Delivery program warrants further evaluation for efficacy in promoting healthy weight gain for low-income youth during pregnancy.

Influence of breakfast and meal frequency in calcium intake among pregnant adolescents

Calcium is an essential micronutrient that plays a role in growing and pregnancy, and its necessity is increased during pregnancy in adolescence. Thus, the aim of the study is to describe the daily calcium intake and its associations with dietetic habits, sociodemographic data and perinatal outcomes among pregnant adolescents. A prospective cohort study was conducted among primiparous adolescents who started prenatal care before 20 weeks of gestation. Sociodemographic data, weight and height, 24‐h dietary recall (24hRec) and perinatal outcomes were collected over four meetings (three during pregnancy and one in puerperium). All 24hRecs were analysed by the Nutrition Data System for Research (NDSR)® programme, and descriptive analysis and univariate and multivariate logistic regression were done. A total of 150 pregnant adolescents were included, with a mean of daily calcium intake of 659.9 mg (50% of recommended intake). Adolescents who ate more than three meals per day (89.3%), and ate breakfast every day (69.3%), were shown to have higher daily calcium intake, odds ratio (OR CI 95%) of 3.4 (1.0, 11.0) and 16.8 (1.0, 302.1), respectively. No correlation was observed between calcium daily intake and sociodemographic data or perinatal outcomes. Dairy products were the foods that mostly contributed to achieving recommended daily calcium intake. In our cohort, pregnant adolescents had a low daily calcium intake. They should be advised to eat more than three meals per day, eat breakfast in particular, increase the consumption of calcium rich‐foods, such as dairy products and green leafy vegetables, and consider calcium supplementation.

"Baby Wants Tacos": Analysis of Health-Related Facebook Posts from Young Pregnant Women

Objectives Pregnant young women gain more weight than recommended by the National Academy of Medicine, increasing the likelihood of adverse maternal and fetal outcomes. The purpose of this study is to use online social media to understand beliefs and practices surrounding weight gain, diet and exercise during pregnancy among young women. Methods Facebook posts were mined from young women ages 16 to 24 during pregnancy who were consented from two Midwest primary care clinics serving low-income communities. Natural language processing was used to identify posts related to weight gain, exercise and diet by keyword searching. Two investigators iteratively coded the mined posts and identified major themes around health behaviors. Outcome measures included the frequency of posts and major themes regarding health behaviors during pregnancy. Results Participants (n = 43) had a mean age of 21 (SD 2.3), and the largest subgroups identified as black (49%; 26% white, 16% Hispanic, 9% other) and having graduated from high school (49%; 24% completed some high school and 24% completed at least some post-secondary education). Among the 2899 pregnancy posts analyzed, 311 were related to weight. Major themes included eating behaviors and cravings (58% of identified posts), body image (24%), the influence of family, partners and friends (14%), and the desire to exercise (4%). Conclusions for practice Facebook posts revealed that young women often frame their thoughts and feelings regarding weight gain in pregnancy in the context of food cravings and body image and that friends and family are important influencers to these behaviors.

Influence of dietary intake and decision-making during pregnancy on birth outcomes

AIM

This study aimed to examine dietary intake and decision-making in a cohort of pregnant South-East Queensland women to determine compliance with dietary guidelines and the relationships between dietary intake, decision-making and birth outcomes.

METHODS

Pregnant women attending maternity services at participating hospitals reported food frequency and motivations using the Maternal Outcomes and Nutrition Tool, a novel digital instrument. Birth outcomes were sourced from hospital records. A cross-sectional cohort design was used to examine the data.

RESULTS

Analysis demonstrated suboptimal intake of core food groups; meat and alternatives (median [IQR]) (2.6 [2.0-3.4] serves/day) and grains (3.1 [2.1-4.1]) fell below recommendations; fruit (3.8 [2.5-5.3]) and discretionary foods (3.1 [2.1-4.4]) exceeded them. Hypertensive disorders demonstrated a negative linear relationship with vegetable intake (P = .017). Cultural diversity was significantly associated with decreased birthweight (P = .022) but increased intake of meat and alternatives (3.1 vs 2.6, P < .001) compared to Caucasian women; median intake of meat and alternatives was lower in women who reported smoking in the examined time frame. Smokers were less likely to declare health motives for food selection than non-smokers; smoking and health were inversely associated with increasing maternal age. Food choice was primarily sensory-driven.

CONCLUSIONS

This cohort demonstrated poor adherence to dietary guidelines. Culturally and linguistically diverse women and smokers exhibit dietary behaviours which may contribute to suboptimal birth outcomes; targeted nutrition counselling may improve outcomes in these women. These findings highlight the need for transdisciplinary maternity care and provide a foundation for further research aimed at optimising nutrition-related birth outcomes in at-risk groups.

A social media intervention to improve nutrition knowledge and behaviors of low income, pregnant adolescents and adult women

Pregnant adolescents are at increased risk of adverse pregnancy outcomes compared to adult women, necessitating a need for early and comprehensive health care. This study aimed to evaluate the effectiveness of a social media intervention (i.e. weekly prenatal health messages) on improving diet quality, and health beliefs and knowledge. Participants (10 adolescents and 12 adults) completed pre-post intervention interviews, nutrition knowledge and health belief questionnaires, and 24-hour diet recalls. Participants entering pregnancy as overweight or obese were more likely to experience excessive GWG during the intervention. The adults had greater participation during the study despite high levels of social media access among both groups. Participants were able to identify sugar-sweetened foods and acknowledged the benefits of whole grains; however, overall knowledge of MyPlate Guidelines was limited. Social media-based education was well received by participants but did not result in large changes in dietary intake and knowledge. Although larger studies are needed, social media appears to have the potential to reach high-risk women.

"It's always on the safe list": Investigating experiential accounts of picky eating adults

Previous research into severely restricted eating for reasons which are not cultural, medical, due to a lack of food or due to concerns about body image has focused predominantly on "picky/fussy eating" in children. Despite evidence that picky eating does continue into adulthood and recognition in the new diagnostic category Avoidant Restrictive Food Intake Disorder (ARFID) that problematically avoidant and restrictive patterns of eating affect people across the lifespan, relatively little is known about the challenges and consequences faced by older adolescents and adults. This research employs qualitative methods to explore the experience of living as an adult with picky eating behaviours. Semi-structured interviews were undertaken with thirteen adults who identify as picky eaters and eat a highly limited diet, as determined by a checklist food questionnaire. Data were analysed using interpretative phenomenological analysis (IPA). Two themes are presented in this paper: "Constructions of food" and "Motivators for and barriers to change". These themes show the importance of how individuals perceive food, their diet and themselves, and implications for clinical practice and future research in light of these findings are considered.

Effectiveness of recruitment and retention strategies in a pregnant adolescent nutrition intervention study

AIM

To report the methodological strategies used to recruit and retain pregnant adolescents into a nutrition-focused intervention study.

BACKGROUND

An important step to meeting the developmental and healthcare needs of pregnant adolescents is to conduct high-quality research studies that generate reliable and accurate data. However, recruitment and retention of pregnant adolescents into research are challenging and time intensive.

DESIGN

A quasi-experimental, one-group, pre, post, 6-week postintervention repeated measures study was conducted among inner-city pregnant adolescents.

METHOD

Study participants' nutrition knowledge, eating habits, and personal self-efficacy were measured prior to pregnant adolescents' participation in the workshop, immediately after the intervention and 6-weeks following the intervention. A total of four workshops were conducted over 14 months from 2014-2015.

RESULTS

Gatekeepers were influential in recruitment efforts due to trusting relationship they had with study participants. The use of texting reminders and pregnant adolescent-related incentives that included gift bags and baby items were also effective recruitment and retention strategies. Despite designing the recruitment strategies and using a developmentally tailored workshop, based on empirical evidence gleaned from pregnant adolescents that was modified to meet study participant's schedules, an adequate sample was unable to be recruited and retained for this study.

CONCLUSION

High-quality research studies that generate reliable and accurate data are essential in meeting the developmental and healthcare needs of pregnant adolescents. A major barrier in developing evidence-based care practices to promote the health of these young mothers and their children involves recruiting and retaining them in research studies.

Development of an Interactive Pregnant Adolescent Nutrition Education Workshop

The health of pregnant adolescents affects the well-being of future generations. Modifying unhealthy eating patterns among pregnant adolescents is critical because of their association with risk of poor pregnancy and birth outcomes. Therefore, it is important to provide age- and developmentally appropriate nutrition education during this time. To sustain healthy behavior changes, nutrition interventions must be grounded in theory and reflect both motivating factors and barriers to healthy eating. Factors such as taste preferences, personal self-efficacy, developmentally appropriate nutrition education, and hands-on meal preparation have been identified as influences on dietary patterns in this population. The purpose of this article is to describe the development of an evidence-based nutrition education program for pregnant adolescents based on Pender's health promotion model.

A Brief Survey of Dietary Beliefs and Behaviors of Pregnant Adolescents

STUDY OBJECTIVE

To provide a brief assessment of dietary beliefs and behaviors in an understudied high-risk population of pregnant adolescents.

DESIGN, SETTING, AND PARTICIPANTS

Diverse pregnant adolescents (n = 66) recruited from the Rochester Adolescent Maternity Program at the University of Rochester Medical Center in Rochester, New York completed a nutrition knowledge and beliefs survey once during pregnancy.

INTERVENTIONS AND MAIN OUTCOME MEASURES

Responses were recorded by a health project coordinator who had good rapport with the teens. Study staff evaluated responses for emergent themes and thematically coded survey data. All responses were assessed relative to demographic variables using χ(2) and analysis of variance tests.

RESULTS

Most (83%; 55/66) pregnant teens self-identified as African American with 21% (14/66) identifying as Hispanic. Most (92%; 61/66) adolescents had medical insurance and 28% (19/66) reported participating in the Supplemental Nutrition Program for Women, Infants, and Children. The importance of proper nutrition was acknowledged but 14% (9/66) reported that diet did not matter or they were unsure of the importance of nutrition for the fetus. Money, access to food, and personal relationships were reported as constraining factors for a healthy diet. Response themes did not differ according to demographic characteristics.

CONCLUSION

Overall, pregnant teens recognize the importance of dietary intake during pregnancy but this knowledge does not always translate into behaviors. Understanding the health knowledge and behaviors of pregnant adolescents might provide a foundation for future lifestyle and clinical interventions.