AUTHOR=Ainscough Kate M. , O'Brien Eileen C. , Lindsay Karen L. , Kennelly Maria A. , O'Sullivan Elizabeth J. , O'Brien Orna A. , McCarthy Mary , De Vito Giuseppe , McAuliffe Fionnuala M. 

TITLE=Nutrition, Behavior Change and Physical Activity Outcomes From the PEARS RCT—An mHealth-Supported, Lifestyle Intervention Among Pregnant Women With Overweight and Obesity

JOURNAL=Frontiers in Endocrinology

VOLUME=10

YEAR=2020

URL=https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2019.00938

DOI=10.3389/fendo.2019.00938

ISSN=1664-2392

ABSTRACT=<p><bold>Background:</bold> Diet quality and physical activity positively impact pregnancy outcomes among women with obesity, but successful lifestyle interventions require intense clinician time. We aimed to investigate the impact of a behavioral-lifestyle intervention (PEARS) supported by a smartphone app among pregnant women with overweight and obesity, on nutrient intake, behavioral stage-of-change and physical activity.</p><p><bold>Methods:</bold> Pregnant women (BMI 25–39.9 kg/m<sup>2</sup>, measured, <italic>n</italic> = 565) were randomized at 15.6 weeks' gestation to the intervention (<italic>n</italic> = 278), or a control group (<italic>n</italic> = 287) (ISRCTN29316280). The intervention was grounded in behavior-change theory. Participants received nutrition (low glycaemic index and healthy eating) and exercise advice, a smartphone app and fortnightly emails. The control group received usual care which does not include dietary advice. At baseline and 28 weeks' gestation, dietary data were obtained through 3-day food diaries (<italic>n</italic> = 290 matched), and stage-of-change and physical activity data were self-reported. App usage data were collected.</p><p><bold>Results:</bold> There were no differences between the groups at baseline. Compared with the control group, the intervention group had improved dietary intakes post-intervention with; lower glycaemic index (MD −1.75); free sugars (%TE) (MD −0.98); fat (%TE) (MD −1.80); and sodium (mg) (MD −183.49). Physical activity (MET-minutes/week) was higher in the intervention group post-intervention (MD 141.4; 95% CI 62.9, 219.9). The proportion of participants at “maintenance” stage-of-change for physical activity was higher in the intervention group (56.3 vs. 31.2%). App use was associated with lower glycaemic index and less energy from free sugars, but not with physical activity.</p><p><bold>Conclusion:</bold> A behavioral-lifestyle intervention in pregnancy supported by a smartphone app improved dietary intakes, physical activity, and motivation to engage in exercise.</p>