A Qualitative Exploration of Pregnancy Experience With a Nutrient-Dense, Plant-Rich Dietary Pattern: A Pilot Study.

INTRODUCTION: A nutrient-dense, plant-rich diet may be promising as a nutrition intervention for pregnant women for a number of factors. Factors include the possibility of a decreased risk for gestational diabetes, excess weight gain, and preeclampsia. Little is known about the experience of following this type of dietary pattern while pregnant and what barriers are present that should be addressed in a large-scale intervention. METHODS: Qualitative interviews were used to understand the personal experience of women who aimed to eat a nutrient-dense plant-rich diet while pregnant. Semi-structured interviews were conducted from June to August 2020. RESULTS: Three main themes regarding a nutrient-dense plant-rich diet emerged. First, family and social influence played an important role. Second, women who had a previous pregnancy felt they had fewer pregnancy symptoms on this diet. Last, the participants may have experienced a reduced milk supply on this dietary plan. CONCLUSION: Future research should consider family context as a factor in adherence to a nutrient-dense plant-rich dietary pattern, investigate the possible associations between nutrient-dense plant-rich dietary patterns and reduced nausea and vomiting in early pregnancy, and determine whether nutrient-dense, plant-rich dietary patterns contribute to a reduction in milk production for women who experience over-engorgement.

Protocol and Preliminary Results of the Nutritarian Women's Health Study: A Longitudinal Effectiveness-Implementation Hybrid Study Assessing Dietary Intake and Health Outcomes.

Whole-food plant-rich dietary patterns have been shown to be associated with significant health benefits and disease-risk reduction. One such program, which has been gaining popularity, is the micronutrient-dense plant-rich (mNDPR) "Nutritarian" diet. The goal of this study is to determine the feasibility of implementing an online mNDPR "Nutritarian" intervention program and to determine the effectiveness of this program in reducing risk of chronic disease in women. The Nutritarian Women's Health Study is a long-term online longitudinal hybrid effectiveness-implementation study. Participants are recruited through social media, medical professionals/offices, and nutrition-related events and conferences. Participants receive online nutrition education and complete regular self-reported questionnaires regarding lifestyle, nutrition practices, and health. The online intervention program appears to be feasible and effective. Some decline in dietary adherence, particularly for certain food types, was observed during the study. For groups at risk, based on body mass index or waist-to-height ratio, there were initial decreases in body mass index and waist-to-height that leveled off over time, in some cases returning to baseline measures. The study suggests the implementation of the Nutritarian dietary pattern, through an online intervention component, may be effective in reducing the risk of chronic disease, with implications for clinical and public health practice.

Impact of a 6-Month Micronutrient-Dense Plant-Rich Nutrition Intervention on Health and Well-Being at the Worksite.

This nonrandomized pilot study utilized the health belief model and the theory of planned behavior to assess the effectiveness of perceived behavioral control to determine the impact of a micronutrient-dense plant-rich (mNDPR) dietary intervention on employee health and wellness at the worksite. Seventy-one employees and/or spouses (≥18 years) who met the inclusion criteria were recruited from a regional medical center and a local university. Participants were provided more than 14 hours of in-person lecture combined with take-home materials, and electronic resources to support participants in their transition and adherence to the dietary plan. The study consisted of a 6-hour introductory session followed by weekly 1-hour meetings for 7 consecutive weeks and then monthly 1-hour meetings, for 4 consecutive months over the span of 6 months. Retention of participants was approximately 55 percent. Participants were assessed for measures of weight, waist circumference, and blood pressure; physiological measures of blood cholesterol, triglycerides, blood glucose, and hemoglobin A1c; and well-being measures of gastroesophageal reflux disease, depression, sleep, pain, and worksite productivity, pre-, mid-, and post-intervention. A significant reduction was seen in weight (F(2, 78) = 19.81, p < 0.001) with a mean reduction of 6.65 lb., waist circumference (F(2, 72) = 40.914, p < 0.001) with a mean reduction of 2.8 inches, total cholesterol (F(2, 70) = 19.09, p < 0.001) with a mean reduction of 17.81 mg/dL, HDL (F(2, 70) = 4.005, p=0.023) with a mean reduction of 3.61 mg/dL, LDL (F(2, 56) = 10.087, p < 0.001) with a mean reduction of 13.1 mg/dL, blood glucose (F(2, 70) = 6.995, p=0.002) with a mean reduction of 3.7 mg/dL, hemoglobin A1c (paired samples t (39) = 2.689, p=0.01) with a mean reduction of 0.118%, GERD (F(2, 72) = 7.940, p=0.001, MSE = 4.225) with a mean reduction of 1.4, depressive symptoms as measured by the PHQ 9 (F(2, 72) = 10.062, p < 0.001, MSE = 5.174) with a mean reduction of 2.0, and an improvement in sleep quality was seen as measured by the PSQI (F(2, 74) = 11.047, p < 0.001, MSE = 2.269) with a mean improvement of 1.3. In most cases, improvement occurred across the first two time periods and then leveled off. Blood pressure, triglycerides, pain measurements, and WPAI did not change over time. Effect sizes for significant pairwise comparisons indicated medium to large effects of practical significance. This intervention was therefore effective at improving employee health and well-being. Widespread worksite implementation should be considered to improve the overall wellness of employees.