Evaluation of a specialist antenatal nutrition clinic for women with a body mass index ≥ 40kg/m2: A qualitative study.

OBJECTIVE: To explore the views of women who attended a specialist antenatal nutrition clinic that was specifically developed and piloted for pregnant women with a BMI ≥ 40 kg/m2. DESIGN: A phenomenological approach, using individual interviews, was employed. Discussions were audio recorded, transcribed verbatim and scrutinised using Interpretive Phenomenological Analysis. Themes were pinpointed and supported with direct quotes to demonstrate results. SETTING AND PARTICIPANTS: Eight women, with a BMI ≥ 40 kg/m2, receiving antenatal care at a tertiary hospital in south eastern Australia and who participated in a specialist antenatal nutrition service were interviewed. FINDINGS: Three main themes emerged: 1) Motivation to be Healthy; 2) Woman Centred Nutrition Care; 3) Conflicts, Confusion and Assumptions. KEY CONCLUSIONS: Pregnant women with a BMI ≥ 40kgm2 responded positively to incorporating dietitians in the antenatal care setting. The reinforcement and reassurance provided by the specialist dietetic team was highly valued. More effective communication regarding referrals, improved consistency in information provided by the entire antenatal service and continuity of dietetic support beyond birth would add value to future interventions.

Associations between appetitive traits, dietary patterns and weight status of children attending the School Kids Intervention Program.

BACKGROUND: The nexus between appetitive traits, dietary patterns and weight status has predominantly been studied in a mixed sample (healthy weight, overweight and obese sample). AIM: This cross-sectional study examined associations between overweight/obese children's appetitive traits, dietary patterns and weight status. METHODS: We studied children (N = 58, body mass index z-score: 2.25±0.46), 4-12 years attending the School Kids Intervention Program. Children's appetitive traits and dietary patterns were measured with the Child Eating Behaviour Questionnaire and Children's Dietary Questionnaire, respectively. Children's height and weight were used to compute body mass index z-score; waist circumference was also measured and waist-to-height ratio was calculated. RESULTS: After controlling for children's age and gender, hierarchical linear regression analyses showed that lower scores for slowness in eating were associated with higher body mass index z-scores in children (ß = -0.31, p = 0.01). Higher scores for emotional overeating were associated with higher waist-to-height ratio in children (ß = 0.48, p = 0.01). Higher scores for fussiness were correlated with lower scores for fruits and vegetables (ß = -0.59, p < 0.001) and higher scores for non-core foods (ß = 0.26, p = 0.04). CONCLUSION: Results observed in the current sample of overweight and obese children are consistent with previous studies examining healthy-weight children. Slowness in eating may foster an obesity 'protective' effect, whereas emotional overeating may promote susceptibility to weight gain. Fussy eating may impair diet quality by lower consumption of vegetables and fruits and higher intake of non-core foods. This evidence will support dietitians to consider children's appetitive traits when providing dietary consultation to support obesity management among overweight/obese children.