Intention to adopt a healthy diet among women with and without a history of gestational diabetes: Constructs and beliefs from the theory of planned behavior.

Women with a history of gestational diabetes (GDM) have difficulty maintaining a healthy diet after delivery. The theory of planned behavior (TPB) is effective in identifying the determinants of adopting a healthy diet. The objectives were to identify the determinants of the intention to adopt a healthy diet among the TPB constructs in women with (GDM+) and without (GDM-) a history of GDM, and to identify the beliefs associated with these constructs. The study was conducted in Québec (Canada) between 2009 and 2017. Data from 213 GDM+ and 91 GDM- women were analyzed. Women completed a questionnaire on the determinants of intention to adopt a healthy diet, defined as adherence to 2007 Canada's Food Guide. The subjective norm and perceived behavioral control (PBC) constructs were associated with the intention to adopt a healthy diet among GDM+ women (ß = 2.21 and ß = 4.37, respectively, p < 0.0001), whereas among GDM- women, PBC was the only construct associated with intention (ß = 0.78; p < 0.0001). More specifically among GDM+ women, the disapproval of a family member other than the partner (ß = 1.49; p = 0.0005), not feeling capable of adopting a healthy diet with access to food treats (ß = 1.58; p < 0.0001), lack of free time (ß = 1.31; p = 0.002), lack of information about healthy eating (ß = 1.02; p = 0.015) or lack of easy recipes to prepare (ß = 0.84; p = 0.042) was associated with a lower intention to adopt a healthy diet. Overall, among GDM+ women, different beliefs related to the subjective norm and PBC could be targeted to improve the eating habits of this specific population.

Determinants of Healthy Diet Among Children Exposed and Unexposed to Gestational Diabetes.

OBJECTIVES: To evaluate the association between individual and environmental determinants of diet quality with diet quality of children exposed to gestational diabetes mellitus (GDM+) and unexposed (GDM-); to study the association between mother and child vegetables and fruit (VF) intakes. DESIGN: Cross-sectional study. PARTICIPANTS: One hundred forty-two children (104 GDM+; 38 GDM-) aged 6.2 ± 2.5 years. VARIABLES: Canadian Healthy Eating Index 2007 (HEI-C) and VF were obtained with 2 24-hour dietary recall questionnaires in children. Maternal VF was obtained by a validated food frequency questionnaire, and weight and height were measured. Sociodemographic determinants were obtained by questionnaires. ANALYSIS: Linear regression models were used to evaluate the association between individual and environmental determinants and the HEI-C score with interaction for GDM status. RESULTS: Family meals were associated with HEI-C among GDM- but not GDM+ children (ß = 9.97, P = 0.01 and ß = -0.41, P = 0.84, respectively; P for interaction = 0.02). Children's age (ß = -1.45; 95% confidence interval, -2.19 to -0.72; P < 0.001) was a determinant of HEI-C among all children. Maternal VF intakes were positively associated with children's VF intake (r = 0.30, P < 0.001, r2 = 0.09), with association of larger variance among GDM- children (r = 0.38, r2 = 0.14, P = 0.02) than GDM+ children (r = 0.23, r2 = 0.05, P = 0.02). CONCLUSIONS: The food environment at home was associated differently with the diet quality of GDM+ and GDM- children. Whether targeting family meals and maternal diet quality is a good strategy to improve children's diet quality among GDM+ children needs to be further investigated.

The Feasibility of Magnetic Resonance Imaging Without General Anesthesia Using the "Bundle and Scan" Technique for Infants With Sensorineural Hearing Loss.

OBJECTIVE: The purpose of this study is to determine the feasibility of magnetic resonance imaging (MRI) without general anesthesia (GA) for infants being evaluated for sensorineural hearing loss (SNHL) using the bundle and scan technique. STUDY DESIGN: Retrospective study. SETTING: Pediatric tertiary care hospital. PATIENTS: All infants who underwent MRI using the bundle and scan technique as part of the diagnostic workup for unilateral or bilateral SNHL between June 2016 to April 2019 were included. MAIN OUTCOME MEASURE: The primary outcome was the proportion of clinically useful images produced. RESULTS: We reviewed 21 bundle and scan MRI examinations in infants being evaluated for SNHL. Patients had a median age of 10 (range: 6-25) weeks at the time of MRI. Motion artifact was noted in 38% (8/21) of cases. Eighty-six percent (18/21) of the magnetic resonance images produced using the bundle and scan technique were of diagnostic quality and/or sufficient for surgical planning for cochlear implantation. Repeat imaging with GA was required for three cases (14%) as the initial images were not clinically useful. All patients requiring GA had unilateral SNHL. All patients with bilateral SNHL successfully underwent MRI without GA using the bundle and scan technique. CONCLUSION: The results of our study demonstrate that it is feasible to perform MRI using the bundle and scan technique in the majority of young infants being evaluated for SNHL. This has the potential to help determine cochlear implant candidacy earlier, reduce exposure to GA, and reduce healthcare costs.

Association between lifestyle habits and adiposity values among children exposed and unexposed to gestational diabetes mellitus in utero.

AIMS: The objectives of this study were to assess the profile of lifestyle habits among children exposed (GDM+) or unexposed (GDM-) to GDM and to assess whether a healthy lifestyle profile is associated with lower adiposity values among these children. METHODS: A total of 105 GDM+ and 38 GDM- children aged 2-14 years were included. Vegetables and fruit intakes were collected using two 24-h dietary recalls. Physical activity and sedentary time were measured with accelerometers. Screen and sleep time were assessed using questionnaires. Weight, height and waist circumference were measured. Body composition was assessed by absorptiometry. RESULTS: GDM+ children had lower moderate-to-vigorous physical activity practice (p = 0.043) and fruit intake (p = 0.020) than GDM- children. Among children with an unhealthy lifestyle (meeting 0-2 lifestyle recommendations), GDM+ children had greater percentage of fat mass (p = 0.021) and android fat mass (p = 0.020) than GDM- children. Moreover, among GDM+ children, children with a healthy lifestyle (meeting 3-4 lifestyle recommendations) tended to have lower percentage of fat mass (p = 0.053) and android fat mass (p = 0.071) than those with an unhealthy lifestyle. CONCLUSION: Improving lifestyle habits among GDM+ children could represent a promising approach to prevent deteriorated adiposity values.

Is A Healthy Diet Associated with Lower Anthropometric and Glycemic Alterations in Predisposed Children Born from Mothers with Gestational Diabetes Mellitus?

Children born from mothers with gestational diabetes mellitus (GDM) are at high-risk of obesity and type 2 diabetes. To date, there is a lack of effective strategies to prevent these complications. The aim of this study was to evaluate the association between diet quality and anthropometric and glycemic profiles of children exposed (GDM+) and unexposed (GDM⁻) to GDM. A total of 104 GDM+ and 38 GDM⁻ children were included. Two 24-h dietary recall questionnaires were used to assess dietary intakes. The Healthy Eating Index adapted for the Canadian population (HEI-C) was used to assess diet quality. Spearman correlations adjusted for children's age and sex were computed. Mean age was 6.0 ± 2.5 and 6.8 ± 2.3 years for GDM+ and GDM⁻, respectively (p = 0.03). Total HEI-C score was negatively associated with the android-to-gynoid fat mass ratio (r = -0.29, p = 0.03) and homeostasis model assessment for insulin resistance (HOMA-IR) index (r = -0.22, p = 0.04) in GDM+ children only. The prevalence of being overweight or obese during childhood was 4-fold higher among GDM+ children with a HEI-C score ≤70 compared to GDM+ children with a HEI-C score >70. Results of this study show that a healthy diet is associated with a better cardiometabolic health profile in GDM+ children, including a lower risk of being overweight or obese.